Health and medical information

As pure cotton, and in blends with synthetics, cotton is very widely used. Allergy to cotton is very rare, despite its wide exposure. It is a cellulose fibre, not a protein fibre like wool, and is hence less likely to provoke an allergic reaction. However, if a reaction does occur, it is the cotton flock – the small particles given off from the fibre – which causes reactions when inhaled. Some people allergic to cotton find they can tolerate it if they avoid very fibrous cotton, such as towelling, knitted cotton or cotton wadding.

When people react to cotton fabrics, it is often found that they are sensitive to resins applied to the fabric to give easy-care properties, rather than to the cotton itself. If you follow the guidelines for testing cotton in the Pillow Test, resins should not interfere with the test. They are not applied to cotton towels or blankets; and they are rarely or lightly applied to T-shirts and pillowcases. They are also usually washed out after several washes, so using a well-washed cloth for testing should prevent problems for even those highly sensitive to resins.

Always wash clothes or fabrics well before using. It may prevent any problem with chemical treatments unless you are highly sensitive.

Fabric resins are applied to furnishing fabrics as well as to clothing fabrics. In addition, pure cotton furnishing fabrics are often treated with fire-retardant chemicals to meet with fire regulations, and some have stain-protection chemicals applied as well. These chemicals may be responsible for apparent reactions to cotton.

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Certain allergens or substances are more likely to cause cross-reaction than others. Moulds, for instance, have a high degree of cross-reactivity and if you react to one particular mould, you are more likely to react to other moulds or yeasts. Grass pollens cross-react with other grass pollens. Foods are also prone to cause cross-reaction, especially between closely related foods within the same biological cl; Certain chemicals, natural and synthetic, are known to with other chemicals, drugs or foods – the active chemical in aspim, a specific example.

Some pollens cause cross-reaction to nuts and fruits that are related to them, but, by and large, if you react to one species of pollen, there is no reason why you should cross-react to other pollens. Being allergic to grass pollen, for instance, does not pre-dispose you to react to tree pollens, say, or any other species of pollen. Similarly, being allergic to one species of animal should not make you cross-react to another species of animal, though you can react to related animals; people known to be allergic to horses have cross-reacted to donkeys, mules and zebras, which are of the same species.

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Try and make a special diet as flexible and normal as you can. Have the confidence to ignore any pressure from family or friends to conform or not to give unusual foods – if the child is well on his or her special diet, that is your justification.

One of the most difficult areas is to establish rules on things that a child can or cannot do – especially things to eat and drink. If you operate a total ban on some things (e.g. playing with friends’ pets, buying sweets, eating ice creams, going swimming or eating biscuits) then you have to trust the child to observe them when out of your sight.

If you are fairly sure that the child is breaking the ban but lying about it, it may be better not to have an absolute prohibition. One option is to allow treats or outings at regular intervals, so that there is less emotional friction around the issue. Although the child may be doing things that

upset him or her, at least you know the extent of the damage and the child is sharing in the responsibility for his or her actions.

Food fads can also be tricky to handle. Food sensitive children often have strong food cravings or obsessions, and aversions to other foods. Craving, addiction or aversion to a food is often an indicator of allergy or intolerance. However, food faddiness is also common to many children – most children have periods of strong preference and aversion, and go through phases in which they will only eat certain things, or phases in which they use refusal of food you offer as an emotional tool. Managing food fads can be exhausting at the best of times, without adding to it the need to stop a child eating a food that clearly does him or her harm.

Again, there is no easy solution, except that if you decide that your child must stop eating a particular food in the interests of health, then you will have to carry it through firmly and take the storms that will follow. If you are concerned that your child does not eat enough or has the wrong balance of nutrients, be reassured that studies have shown that children left to themselves to choose what they eat select foods which give them a proper balance of nutrients – even if they only eat one food for a day or more.

A child who is hungry will eventually eat, and although you may have to endure two or three (or more) terrible days when you first take out a loved food out of a child’s diet, a child will eventually co-operate if you are firm and do not weaken.

It helps a great deal if other family members do not eat the deprived food in front of the child (and do not tease him or her about it). But often this cannot be managed and you will have to sit things out.

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If reducing the level of any food has little effect, you should go further and leave the chosen food totally out of your diet totally. If you do this for common foods, such as cow’s milk, wheat, eggs, yeast, com and soya, it can mean drastic changes to your diet and usually entails leaving out most processed and manufactured foods.

There is also advice on what substitutes to use, on nutritional balance and precautions to take against new sensitivities developing in the baby.

Babies with a tendency to food sensitivity can become sensitive to foods that are introduced into a breastfeeding mother’s diet as substitutes (e.g. to goat’s milk or soya milk used as an alternative to cow’s milk) and you need to take care not to binge on or overuse any foods you use as substitutes in case this happens. So, even if a mother is not food-sensitive herself, she needs to observe the preventative guidelines.

If leaving out these foods seems hard at first, an easier route, and one that women sometimes try before they turn to total exclusion of cow’s milk, etc., is to leave out some common culprits which are less fundamental parts of the diet, and see if baby improves. You could choose one of these food groups at a time and leave it out for two to four days to see what happens. Move on to another if you get no response. Try leaving out one of the following groups at a time:

• Tea, coffee, cocoa and chocolate

• Alcohol

• All sweet and fizzy drinks, sugar, sweets, biscuits and bakery

• Orange, grapefruit, lemon and other citrus fruits and juice

• Onions, garlic, leeks, spring onions

• Spices (NB curry)

• Cabbage, broccoli, sprouts, cauliflower, kale, spring greens

Some babies are sensitive to chlorine and other chemicals from tapwa-ter passing in breastmilk. The mother could try as an alternative using filtered or bottled water (Evian, Buxton or Malvern for preference). Use the chosen water for drinking, making hot drinks and soups, and for all cooking purposes. For more information on water.

A breastfeeding mother needs to take care of her own diet. Consult your doctor about any intentions you have to leave out common foods, and about the need for any vitamin and mineral supplements.

It can sometimes take several days for the benefits of exclusion to be seen on a breastfeeding baby. So give each food (or group of foods) time to show results.

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There are some things you can do specifically to help babies and young children who have house dust mite allergy, or to prevent it developing. Add these to any of the other measures you carry out.

Take Care with Soft Toys

Soft toys snuggled in bed are frequently a prime source of house dust mites for allergic children. To avoid such problems, buy washable toys and wash them frequently to remove the faecal pellets. Then hang outside to dry in the sun, vacuum them, or air and dry them, to remove the mites themselves. Buy a duplicate favourite toy if necessary, to substitute while washing is done.

Some parents report success in killing mites by freezing the soft toy after washing. (Poor Teddy!) Remember, if you do this, make sure the toy is thoroughly dry after defrosting.

Bunk Beds

It is better for an allergic child to sleep in the top bed rather than the bottom, if this is feasible. House dust mites are scattered from the top mattress as the inhabitant turns and moves during the night.

Childminders and Nurseries

If your child seems fine at home, but gets worse after going to a childminder’s or nursery, the cause can be, amongst others, house dust mites – particularly in a warm, damp, carpeted environment. If this is worth taking action over, either look for a childcare place where the environment is more favourable – for instance, uncar-peted and well ventilated – or see if you can lend the childminder or nursery a filtered vacuum cleaner to see if things improve. Be tactful.

Take Care with Young Babies

If you have a history of any allergy in the family, it can help to take avoidance measures with young babies, to prevent them developing house dust mite allergy. Remember that very small babies spend much of their time with their noses stuffed into the very surfaces that harbour dust mites – carpets, bedding and furniture. They have a much more intense exposure to house dust mites than older children or adults have.

So do what you can with all the basic and other measures suggested to reduce the level of mites around a baby or young child. In particular, use washable bedding, especially using cotton blankets (washable at high temperatures) rather than duvets. Keep bedding and insulation around a baby to a minimum – avoiding cot bumpers and pram ‘nests’ if possible, or washing and airing them frequently. Air mattresses and keep them dry.

Pay particular attention to carpets and rugs where the baby plays, crawls or rubs its nose a great deal. Vacuum with niters, or wash if possible. Keep these mite-free if you can. Prevent pets sleeping on beds or cots, or where a baby or young child plays a great deal. Warmth, damp and animal skin scales encourage mites to grow.

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“I’m an optimistic person. At first it was new. You think oh my God.’ Now I don’t even think about it. It just takes a little practice, like with everything new,” says Janice, a real estate agent whose high energy is reflected in her vibrant voice. “It took at least a couple of months to adjust to it. After a while it was the same as natural,” she explains. Janice and her husband, Bill, have been married more than 30 years.

Jane, a 48-year-old self-described “retired Mom” who’s been married 20 years, is also satisfied with the results of her husband’s surgery. “I’m definitely pleased. It’s 90 percent as good as when he was in his 20′s, and that’s terrific. And no more premature ejaculations! Even if he does ejaculate, he can go longer. You do have to change positions. The woman-on-top works better because of the bend of the prosthesis.” The only change Jane noticed is a slight reduction in the circumference of the erect penis. “Thaf s where he loses about 10 percent,” she says.

For Jane, a clear-headed look at the potency problem and the solution was helpful. “We’ve adjusted. Ifs like false teeth, or a false arm. I look at it like this: You lose something, you replace it.”

Studies have found that, generally, women are satisfied with the results of the implant. Not surprisingly, there is a correlation between the partners’ satisfaction: Usually, when one is happy, so is the other. And the more involved the partner is from the beginning, the more likely she is to be pleased with the results.

Getting Used to the New You

Ifs normal to have some adjustment problems after implant surgery. Most couples solve these without much difficulty. Just knowing what to expect can make it easier.

Each couple is different but ifs not uncommon to:

• Have some anxiety about being able to have intercourse.

• Notice that the penis looks somewhat different.

• Take some time to adjust to the fact that erection is no longer physical evidence of arousal—that desire can be shown in other ways.

• Need to try out different positions.

• Need to spend time getting comfortable to the point where the implant is no longer an issue.

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Because of the considerable expense and inconvenience of sleep lab tests, cheaper at-home versions of the NPT test have been developed. These take-home varieties can actually measure how many erections you have during the night, and how long each one lasts. Usually, you just carry home a little suitcase containing equipment similar to that used in the sleep lab. The device is safe and quite accurate when used properly. Be sure you get an in-office demonstration so you understand just how to use the device before you take it home.

Some of the take-home tests have a beeper that goes off when an erection registers, so the man or his partner can check the firmness. One home NPT test monitors the rigidity itself. But many of these tests do not test firmness, which is certainly an important factor.

Other at-home tests, while useful, can only measure one erection per night. There are essentially two types: the Snap-Gauge and the stamp test. The Snap-Gauge is a piece of Velcro which is placed around the penis. As the penis expands and becomes rigid, little plastic bands on the gauge will break, indicating that a firm erection has taken place. However, it can’t measure how long the erection lasts. Like all other types of NPT tests, this one doesn’t hurt. And it is easy to use.

Another alternative is the use of commercially available stamps, called PotenTest, made specifically to test erection capability. Like the other methods, you place the stamps around your penis and go to sleep. The stamps break along the perforation when you have an erection.

Both the Snap-Gauge and the stamps have drawbacks. They don’t measure the length or the frequency of erections. Most men normally would have several erections during the course of a single night, and this information is not collected by these methods. Furthermore, if you roll over or are a very active sleeper, both the stamps and the gauge may falsely indicate an erection.

There’s one method that requires no equipment at all—you just need a willing partner who will observe you while you sleep to see if you have any erections. If you do, she can feel the penis to determine rigidity. For this test to be accurate, your partner has to stay awake all night. You have to lie on your back or side—this won’t work for stomach sleepers! Trying this once should be enough. If it doesn’t work, you can use another technique to get the same information. Not all partners want or are able to stay up all night, but finding out that you have just one normal erection is an important piece of information to share with your doctor.

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Harold, at fifty-five, had a dangerously high cholesterol count of 300 milliliters, coupled with a very low HDL of 25 milligrams. (It’s important to note that both high cholesterol and low HDL are markers of ED.) I began him on a course of Mevacor, a cholesterol-lowering agent, and his reading soon dropped to 220. Unfortunately, he also developed ED. Understandably upset, Harold wanted to try other medications.

At his next visit I recommended that he switch to prescription niacin (which is not found in health food stores). While this proved to be an effective treatment for both his cholesterol and erection problems, there were other unpleasant side effects to confront: abnormal liver function and facial flushing. Fortunately, there was another alternative. Harold began to take Cholestid, a bile-acid resin, and in a couple of months his cholesterol stabilized at 210, and his HDL levels rose to a much-improved 41. His liver function was normalized, and the new cholesterol-lowering drug did not produce any erection problems.

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Adrenal or thyroid glands go into overdrive, or shut down almost completely, can sabotage erections quite effectively – by reducing sexual desire and by marking the man feel terrible. In many cases, such disorders are fairly easy to spot because the symptoms are oblivious to a trained medical eye – sometimes the’re so dramatic that anyone would realize something was wrong. A man with an overactive thyroid, for example, may have affine tremor in his hands, bulging eyes, thinning of his skin and a very fast heart rate, as well as a decreased desire for sex and poor erections. In fact, in most cases, patients with such problems do get treated, because the unpleasant and uncomfortable symptoms send them to their doctor. There are some cases on record, however, in witch the only symptoms were erection problems. Blood tests can identify these less obvious cases.

The two adrenal glands, which are located just above the kidneys, can also wreck potency if they produce too much or too little of cortisone-like substances. Once this condition is corrected by surgery or medication, adrenal patients will find their potency restored. No permanent damage to potency take a place.

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Mike is now in the plateau phase, which is a steady maintenance of the excitation stage. During the plateau, Mike’s testicles will actually increase in size, although he probably won’t be aware of this change. The head of his penis will swell even more, and secretions from glands in his urethra may start to flow out of his penis. (This is not an ejaculation, but a very small amount of sperm may be part of this flow.) He will spend several minutes in the plateau phase, but at other times, this phase may last a much longer or a much shorter period of time.

Many men try to prolong intercourse during the plateau to make the lovemaking last longer. Mike may deliberately slow down his thrusts and movements in order to stave off his orgasm and increase his and his wife’s pleasure. Twenty years ago, staying in the plateau phase was more difficult for Mike, but now in his 40′s he finds it easier to do. Sometimes the plateau is very brief, leading to early ejaculation. Mike’s plateau lasts for several minutes before he reaches the next stage, orgasm. Orgasm lasts for only a few, extremely pleasurable, seconds, and it usually signals the end of the erection. Still, orgasm has little else to do with erection because it is controlled by a different part of the nervous system. Remember, a man can have an erection without an orgasm, and an orgasm without an erection.

Though brief, orgasm actually has two distinct stages. During the first part, emission, the fluid from Mike’s seminal vesicles, prostate and testicles flows into his urethra. The sphincters which prevent this fluid from traveling back up into the bladder also close down. These sensations are experienced by Mike as ejaculatory inevitability—he feels that any second he will ejaculate and he won’t be able to stop it.

The second part of the climax is Mike’s actual ejaculation. The muscles around Mike’s urethra contract every 0.8 seconds, combining with contractions from muscles in his pelvis and anus. This generates a great amount of force that pushes the semen in his urethra out of his penis. Mike experiences a powerful feeling of release. The excitement he feels gives way to relaxation. His desire to continue thrusting disappears. Mike is now in the resolution phase (which also happens if stimulation stops before orgasm and ejaculation). The increased blood flow to his penis, which caused the erection, stops. The sinuses become smaller, and the veins open up to their normal levels, allowing the extra blood to drain out of Mike’s penis. His scrotum becomes less tense, and the testicles drop to their normal, lower position. Mike loses his erection.

When Mike was younger, there were occasions in which he did not lose his erection even after an ejaculation. This is not uncommon in men of high school or college age, but ifs much less typical for older men. As a man ages, he loses his erection more easily during the resolution phase. Once the penis becomes flaccid, Mike enters the final stage of the erection cycle, the so-called refractory period. This is the period of time after resolution when Mike is unable to enter the excitement phase and get an erection, although he may still feel desire. Typically, this period lasts longer as a man ages. Some young men have virtually no refractory period at all, but ifs not uncommon for a man in his 40′s, like Mike, to have this period last hours.

Why does the body have this enforced rest from intercourse? Scientists do not fully understand why nature has programmed this time for a sabbatical from intercourse. Maybe ifs to allow time for sperm to move into position where they can be ejaculated. (Sperm are made in the testicles, travel to the epididymis, which has a remarkable 15 feet of tubing, all wound up, and then move into the vas, the tubes which carry the sperm to the urethra where they can be ejaculated.)

Desire may return before the body’s ability to get an erection is restored, causing a certain amount of frustration, but this situation is not impotence.

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