REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: HOW TO IMPROVE YOUR CHOLESTEROL LEVEL – DIET

Three main avenues can be used to achieve and maintain cholesterol levels that minimize your risk of future coronary artery disease: diet, exercise, and medications. The first two are almost universally advisable and achievable, regardless of an individual’s LDL-cholesterol, HDL-cholesterol, and triglyceride levels (the lipid profile). It appears that risk can be reduced at least somewhat even for people whose lipid profile is not very “abnormal.”
On the average, dietary measures can reduce your cholesterol level by up to 15 percent. Some people may respond even more impressively. For others with a strong genetic influence on their cholesterol level, changes in diet and exercise may not be enough to improve blood cholesterol levels.
Diet. Dietary changes are the mainstay of cholesterol management. The key concepts in making dietary changes lower cholesterol are to reduce the total fat (especially saturated fat) and cholesterol that you eat and to lose weight (especially if your triglyceride level is elevated).
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REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: HOW TO IMPROVE YOUR CHOLESTEROL LEVEL   – DIETThree main avenues can be used to achieve and maintain cholesterol levels that minimize your risk of future coronary artery disease: diet, exercise, and medications. The first two are almost universally advisable and achievable, regardless of an individual’s LDL-cholesterol, HDL-cholesterol, and triglyceride levels (the lipid profile). It appears that risk can be reduced at least somewhat even for people whose lipid profile is not very “abnormal.”On the average, dietary measures can reduce your cholesterol level by up to 15 percent. Some people may respond even more impressively. For others with a strong genetic influence on their cholesterol level, changes in diet and exercise may not be enough to improve blood cholesterol levels.Diet. Dietary changes are the mainstay of cholesterol management. The key concepts in making dietary changes lower cholesterol are to reduce the total fat (especially saturated fat) and cholesterol that you eat and to lose weight (especially if your triglyceride level is elevated).*249\252\8*

BENIGN BREAST DISEASE

There are many terms used to describe benign breast diseases. Fibrocystic breast disease is the most common one. A more broad umbrella term, such as “lumpy breast disorders,” should be used. Benign breast disorders occur mainly in menstruating women but usually not in the teenage years. Collectively, benign breast lesions are commonly called fibrocystic disease by physicians and lay persons. Some are inconsequential, others can predispose the person to breast cancer.
About 50 percent of the female population in the United States will have lumpy breast disease at one time or another. Unless the cysts are greater than 3 millimeters in diameter, they are usually not a risk factor for the development of cancer. And although smaller cysts can come and go and ultimately disappear, it is very uncommon for a cyst greater than 2 centimeters in diameter to do so. A single cyst having a diameter of 2 centimeters or more puts the patient at a higher risk for subsequent breast cancer. Also, a number of studies have shown that the more atypical the cells are in the cysts when looked at under the microscope, the higher is the risk of developing breast cancer.
Lumpy breast disease is influenced greatly by a number of factors: hormonal changes, dietary practices such as consumption of caffeine and foods high in fat and an inadequate intake of certain vitamins and minerals, and nicotine exposure. A randomized trial involving 21 patients who had painful breasts premenstrually for at least five years showed these women to benefit from a diet that reduced the fat content to 15 percent of their total calories and increased complex carbohydrate consumption to maintain the normal caloric intake. There was a significant reduction in the severity of the breast tenderness and swelling after six months. Physical examination also showed reduced breast swelling, tenderness, and nodularity in 60 percent of the patients.
Since 1979 I have treated women with breast cancer and benign breast disorders, specifically lumpy breast disease. All the patients with lumpy breast disease followed my Ten-Point Plan as outlined in this book, with particular attention paid to low-fat, high-fiber foods, supplementation with certain vitamins and minerals, abstinence from alcohol and smoking, and avoidance of passive smoke. Almost 90 percent of the patients had decreased breast pain premenstrually, and about half of the patients experienced a decrease in the size of their cysts. In most cases the size of the breast diminished somewhat; however, in about 10 percent of the women, the size of the breast increased slightly.
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BENIGN BREAST DISEASEThere are many terms used to describe benign breast diseases. Fibrocystic breast disease is the most common one. A more broad umbrella term, such as “lumpy breast disorders,” should be used. Benign breast disorders occur mainly in menstruating women but usually not in the teenage years. Collectively, benign breast lesions are commonly called fibrocystic disease by physicians and lay persons. Some are inconsequential, others can predispose the person to breast cancer.About 50 percent of the female population in the United States will have lumpy breast disease at one time or another. Unless the cysts are greater than 3 millimeters in diameter, they are usually not a risk factor for the development of cancer. And although smaller cysts can come and go and ultimately disappear, it is very uncommon for a cyst greater than 2 centimeters in diameter to do so. A single cyst having a diameter of 2 centimeters or more puts the patient at a higher risk for subsequent breast cancer. Also, a number of studies have shown that the more atypical the cells are in the cysts when looked at under the microscope, the higher is the risk of developing breast cancer.Lumpy breast disease is influenced greatly by a number of factors: hormonal changes, dietary practices such as consumption of caffeine and foods high in fat and an inadequate intake of certain vitamins and minerals, and nicotine exposure. A randomized trial involving 21 patients who had painful breasts premenstrually for at least five years showed these women to benefit from a diet that reduced the fat content to 15 percent of their total calories and increased complex carbohydrate consumption to maintain the normal caloric intake. There was a significant reduction in the severity of the breast tenderness and swelling after six months. Physical examination also showed reduced breast swelling, tenderness, and nodularity in 60 percent of the patients.Since 1979 I have treated women with breast cancer and benign breast disorders, specifically lumpy breast disease. All the patients with lumpy breast disease followed my Ten-Point Plan as outlined in this book, with particular attention paid to low-fat, high-fiber foods, supplementation with certain vitamins and minerals, abstinence from alcohol and smoking, and avoidance of passive smoke. Almost 90 percent of the patients had decreased breast pain premenstrually, and about half of the patients experienced a decrease in the size of their cysts. In most cases the size of the breast diminished somewhat; however, in about 10 percent of the women, the size of the breast increased slightly.*83\360\2*

COPING WITH ADHD: THE FAMILY’S ROLE

Medication, psychotherapy, a healthful diet, and behavior modification are all essential components of a multimodal approach to the management of ADHD. However, none of these modalities can be fully effective if the patient’s family isn’t behind him 100 percent in his struggle to live a normal life.
Adults with ADHD often have long-standing family difficulties. If married, their ADHD symptoms may well lead to frustration, anger, blaming, and poor communication in the marriage. Frequently, they become less than effective parents, and their impulsivity, short fuse, and emotional liability may lead them to be inconsistent, punitive, and even violent with their children. It is essential that any treatment approach to the adult sufferer include the education of his family about his condition and their involvement in helping to change some of the patterns of behavior and communication within the family.
It is just as vitally important that the family of an ADHD child be involved in his treatment. Parents of a child with ADHD must feel empowered to become their child’s strongest advocates. Once a thorough workup confirms a diagnosis of ADHD, parents must become superbly educated consumers, capable of taking charge of their child’s treatment, education, and other necessary support systems.
Various professionals in the child’s life may focus on the need to modify the child to better fit into his environment, and drug therapy may be the mainstay to this approach. But it’s also important for the child’s parents to focus on the need to sometimes modify both the home and school environments to better suit the child. This may involve the following.
Insisting on a thorough workup and diagnosis and gathering all the information they can find from all sources regarding their child.
Becoming a vigilant and energetic supporter of their child in the community, which may mean making a fuss at school and elsewhere. It may also mean taking a hard stand against their insurance carrier or HMO to guarantee coverage of the medical care their child will require. This can be extremely difficult because managed care companies often set strict limits, such as one medication visit every six weeks, which many providers erroneously claim is the only care necessary for attention deficit hyperactivity disorder.
Having the insight to question the emotional climate at home—how the family works together, what stresses may impact on the ADHD child, how the siblings interact, the state of the parents’ marriage, the consistency of their discipline, the kinds of role models they provide and so on.
In my practice, I usually find it necessary to work closely with families of ADHD children in helping them understand their child’s difficulties and the impact the syndrome can have on the lives of every family member.
The families of adults with ADHD must also strive to achieve a sense of empowerment as they work to help the patient deal with his condition. A great deal of understanding and support is essential here, especially in the first few weeks following a clinical diagnosis. It’s often difficult for the patient to come to terms with his disorder and even more difficult for his family. Everyone involved must work extra hard to help the patient make the necessary adjustments.
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COPING WITH ADHD: THE FAMILY’S ROLEMedication, psychotherapy, a healthful diet, and behavior modification are all essential components of a multimodal approach to the management of ADHD. However, none of these modalities can be fully effective if the patient’s family isn’t behind him 100 percent in his struggle to live a normal life.Adults with ADHD often have long-standing family difficulties. If married, their ADHD symptoms may well lead to frustration, anger, blaming, and poor communication in the marriage. Frequently, they become less than effective parents, and their impulsivity, short fuse, and emotional liability may lead them to be inconsistent, punitive, and even violent with their children. It is essential that any treatment approach to the adult sufferer include the education of his family about his condition and their involvement in helping to change some of the patterns of behavior and communication within the family.It is just as vitally important that the family of an ADHD child be involved in his treatment. Parents of a child with ADHD must feel empowered to become their child’s strongest advocates. Once a thorough workup confirms a diagnosis of ADHD, parents must become superbly educated consumers, capable of taking charge of their child’s treatment, education, and other necessary support systems.Various professionals in the child’s life may focus on the need to modify the child to better fit into his environment, and drug therapy may be the mainstay to this approach. But it’s also important for the child’s parents to focus on the need to sometimes modify both the home and school environments to better suit the child. This may involve the following.Insisting on a thorough workup and diagnosis and gathering all the information they can find from all sources regarding their child.Becoming a vigilant and energetic supporter of their child in the community, which may mean making a fuss at school and elsewhere. It may also mean taking a hard stand against their insurance carrier or HMO to guarantee coverage of the medical care their child will require. This can be extremely difficult because managed care companies often set strict limits, such as one medication visit every six weeks, which many providers erroneously claim is the only care necessary for attention deficit hyperactivity disorder.Having the insight to question the emotional climate at home—how the family works together, what stresses may impact on the ADHD child, how the siblings interact, the state of the parents’ marriage, the consistency of their discipline, the kinds of role models they provide and so on.In my practice, I usually find it necessary to work closely with families of ADHD children in helping them understand their child’s difficulties and the impact the syndrome can have on the lives of every family member.The families of adults with ADHD must also strive to achieve a sense of empowerment as they work to help the patient deal with his condition. A great deal of understanding and support is essential here, especially in the first few weeks following a clinical diagnosis. It’s often difficult for the patient to come to terms with his disorder and even more difficult for his family. Everyone involved must work extra hard to help the patient make the necessary adjustments.*88\173\2*

THE EVOLUTION OF INSOMNIA DRUG THERAPY: BENZODIAZEPINES – TEMAZEPAM

Sold as Restoril, temazepam is especially appropriate for people whose insomnia takes the form of middle-of-the-night awakenings, because its half-life of about ten hours means the drug stays effective throughout the period of sleep. On a temporary basis some people may be able to take a temazepam pill as needed after a nighttime awakening to help facilitate a return to sleep, with only a relatively small risk that the sedative effects will persist into the morning. However, the drug is absorbed slowly in the gastrointestinal tract; some people thus find it ineffective in helping them fall asleep unless taken an hour or two before bedtime. Temazepam does prevent nighttime awakenings, and it improves the duration and subjective quality of sleep. Some physicians may also use temazepam to treat cases of nocturnal myoclonus or restless legs, although this is not an approved indication for the drug.
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MEASLES 2

The disease has an incubation period of about fourteen days and it is therefore not surprising that within another ten or twelve days the next case will break out, either in your family or your neighbour’s.

The first symptoms of measles can vary, but might include a head cold, nose bleeding, bronchial catarrh and conjunctivitis (with sensitivity to light, burning of the eyes and lacrimation).

Soon the child’s temperature will rise to perhaps 39 °C (102 °F). It will then drop, but on the fourth day may rise again as high as 40 °C (104 °F). It usually goes down again as soon as the rash appears, but if it remains high for more than 3—4 days after its first outbreak, complications are likely to set in and more specific treatment must be given. You should immediately give the child Lacbesis I Ox to prevent the development of sepsis and apply flan­nels wrung out in a hot infusion of herbs (for example wild thyme) repeatedly to the affected areas. This will draw out the internal toxins through the skin. Even when the disease takes its normal course, it is advisable to apply these hot packs to bring the rash out properly. During the fever, give the child nothing but fruit juices, particularly orange and grape juice or carrot juice, the latter also being very good for the liver. If you have no juices available, give the child a mild herbal tea sweetened with honey. In addition, like all infectious diseases, a case of measles demands careful oral hygiene. For infants and smaller children, wrap a clean cloth around your finger tip, dip it in diluted whey concentrate and rub the gums, the inner cheeks and the tongue (which always become furred with measles). For older children use a soft toothbrush to disinfect the mouth.
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MEASLES

Even though in many lands this is a harmless infectious disease of childhood, in areas where it has only recently become known, for example among some American Indian tribes, the affected children often die. The causative agent is a virus, one of the submicroscopic entities that have been discovered only in more recent times. These viruses are even smaller than bacteria and cannot be seen under a normal microscope simply by colouring as can bacteria; only with the aid of modern electronic microscopes have scientists been able to study them. Even so, measles has always been considered an infectious disease because of the course the illness takes and the fact that children catch it so easily.

Most parents are familiar with the rash of pink-brownish blot­ches, accompanied by a high temperature. And yet, you might be uncertain as to the nature of the child’s illness in its early stages, unless you check the inner cheeks in the region of the molars. In a case of measles these areas are red, and a day or two before the rash breaks out red spots with tiny white spots in the middle of them, 2-3 mm in diameter, (so-called Koplik’s spots), will appear.
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TALKING ABOUT JOB RELATED RISKS

Do you believe your job threatens your health or safety? You can report bad working conditions to OSHA (Occupational Safety and Health Administration) by filing a complaint under Section 11(c) of the Job Safety Act. The system is supposed to help and protect workers against discrimination by the boss.
But some workers say they complained to OSHA and later learned that they had been named as informers to their bosses. They suspect OSHA of the leak. Joseph Kinney says it must be noted that the OSHA inspector’s job is not problem-free. “Sometimes,” he explains, “workers who are angry will take revenge by phoning in a false safety violation.”
Now a new approach is being tried. In 1987, the New York State Legislature set aside 1 million dollars for a network of clinics to diagnose and treat job-related illness.
“With this program,” says Dr. Landrigan, “we can go to the workplace, speak to the manager or union bosses, and screen other workers who might be exposed to similar hazards. This is a way to prevent disease, which you cannot do under workers’ compensation.”
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GENERAL HEALTH

PRESERVATION OF FOODS: CAUSES OF FOOD SPOILAGE

Bacteria and parasites in food are a frequent cause of illness; yeasts produce fermentation, as in fruit juices and cider; molds attack berries, citrus fruits, breads, jellies and jams, and other foods. Enzymes, normally present in food, cause chemical changes that lead to softening of the food, development of off flavors, loss of some nutrients such as vitamin C, darkening of peeled fruit, or rancidity of fats. Physical factors also cause undesirable changes in food: milk in clear glass bottles exposed to a few hours sunlight loses much of its riboflavin and takes on a tallow flavor; ice cream held too long in a freezer may become grainy or gummy. Animals or insects may contaminate food with hairs, droppings, or insect fragments.
Foods are contaminated by any of the following ways:
1.   Preparation by persons whose hands have not been washed after each use of the handkerchief or toilet, or contact with other source of dirt and filth.
2.   Exposure to dust, flies, insects, and nasal sprays of persons who cough or sneeze.
3.   Use of equipment and dishes that are poorly cleaned and rinsed.
4.   Failure to refrigerate fresh or cooked food promptly, thus speeding up the action of bacteria, molds, yeasts, and enzymes.
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GENERAL HEALTH

CHILD’S HEALTH/SKIN DISORDERS: KELOID SCARRING AND MLLIA (NEWBORN FACIAL SPOTS)

KELOID SCARRING

Some people have a greater tendency to form prominent scars. If scars become pink, firm, lumpy and raised, this is called keloid. Sometimes keloid scars become limbs. Dark-skinned people are more prone to keloid scarring than Caucasians. There is no way of preventing this overgrowth of scar tissues, although some doctors recommend the injection of small amounts of steroids into the scar. If the scar is very unsightly, you may wish to discuss the option of plastic surgery with your doctor, although the results are not always an improvement over the original scar.

MlLIA (NEWBORN FACIAL SPOTS)

These are tiny white lumps (cysts) which appear on the face soon after birth, and are harmless. They occur in 40% of newborn babies.

Cause

They are caused by blocked skin pores.

They appear mainly on the nose and cheeks, but may be anywhere on the face. At their largest, they measure 2-3 millimetres. They do not hurt or itch, and are not infected.

Treatment

Milia are harmless and will disappear without any intervention. All that is needed is a little patience. Creams or ointments are of no use. The lumps will disappear within 2 months, and will not leave any scars. See your doctor if there is any redness or swelling around the spots.

Prevention

It may help to make sure your baby is not overheated. Make sure you gently wash the face each day. Milia are difficult to prevent, but nothing to worry about.

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COMING HOME WITH YOUR NEW BABY: BUILDING YOUR CONFIDENCE AS A PARENT

The less confidence you have as a parent to begin with, the more likely you are to end up having feelings of not being able to cope. Confidence is built on a number of factors, which include previous positive experiences of being a parent. You may feel that you are the only one in the world experiencing problems with a new baby. Speaking to others who have been through a similar experience — and there are many — can be very helpful.

Enlisting the practical support of your partner, of grandparents, relatives, friends and neighbours is very important, as it helps ease the burden. Support given by your doctor or maternal and child health nurse can also be very reassuring.

When you are a new parent, everybody seems to want to give you advice. This will often come uninvited from people standing behind you in supermarket queues or at the bus stop. Even though people are generally well-meaning, the advice given is often conflicting or just plain wrong. Don’t waste your energy getting angry about people trying to tell you what to do. Listen to those whom you trust, assess the factual accuracy of what you are told, and make your decisions using your own common sense and instincts as your guide. After all, no one knows your child better than you do.

Society tries to idealise mothers and babies, from the Madonna and child right down to washing powder advertisements. External pressure to be seen as ‘coping’ is sometimes enormous. Being confident in yourself and knowing that you cannot be perfect will help you to see through these false expectations and values. We can only encourage you to follow your own feelings and trust your own judgment.

Parents who generally feel positive about things tend to take child-rearing more in their stride than those who are anxious and tentative. However, having a baby with an easy-going temperament makes it easy for any parent to feel that they are doing the right thing. On the other hand a fussy, intense and whingey baby who feeds and sleeps erratically will constantly raise doubts and guilt feelings in even the most self-assured or parents. It is all too easy to blame yourself it a baby does not settle. Often, however, very difficult behaviour can be attributed solely to the baby, and try as you may, you will not be able to pacify him. Understanding that the baby’s behaviour has nothing to do with your own parenting skills often allows you to take a more objective view of your child. This may be the first important step to gaining control of things again.

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