Health and medical information

I have observed differences in the way men and women react to discovering faults in each other. Perhaps I may be just expressing a view based on experience in Australian society; perhaps I may even be wrong. Perhaps there are men who hold what I would see as a female view, and women who hold what I would term a male view.

It seems to me that men don’t like to think of their girlfriends and wives as having any faults. It is as though they prefer to see them through the soft-focus lens of rose-coloured glasses, because if they had in mind their wives’ faults, their wives might be less desirable in their eyes. A man may not be able to say what colour his wife’s eyes are, or what dress she was wearing when he last saw her, but this failure to perceive basic facts about his wife’s external appearance is not due to lack of interest or ‘taking his wife for granted’. Far from taking their wives for granted, as some women wrongly suspect, men tend to see their wives in a sort of dream image of beauty. If they are pressed to acknowledge some unpleasant fact about their wives, they will resist accepting it as long as possible.

Women, on the other hand, tend to be well aware of the failings of the men they love. It is as though they have a list of the faults and weaknesses of their boyfriends and husbands which they are willing to overlook. ‘He may not be all I ever wanted in a man,’ she says, ‘but he’s still my Jack!’ She sees his faults, she accepts them, perhaps secretly intends to work on them after they’re married, and loves him in spite of them. She needs, therefore, to be able to ignore significant things about his behaviour, things that would otherwise bother or irritate her.

From what the reader has already learned about the symptoms of severe stress breakdown in the third stage, it will be apparent that an over-stressed wife may not be able to overlook, or forgive, or not respond to, the little faults and failings of dear Jack, and she may begin responding angrily to them.

‘Jack,’ she says, ‘I have put up with your mess in the bathroom without saying anything for the last fifteen years. The very next time I have to go into that bathroom after you and wipe up the water from where you left the shower curtain open, so help me mate, you’ll die!’

Jack’s response, of course, is utter bewilderment. Thinking like a male who never sees his wife’s bad points if he can get out of it, he has assumed all these years that the water just evaporated very quickly, and that nobody seemed to care if there was a bit of water lying around the floor. He feels guilty, and a little betrayed, because Beryl had never told him how this made her angry.

A male response to being unable to tolerate things previously tolerated might be exemplified by the following situation. Jack has met up with an old friend who used to take his wife Beryl out before they were married. Perhaps the relationship between the wife and her previous beau became too intimate, and she had confessed this to her present husband before they were married. Now, after ten years, they all meet up again. This time, it happens that Jack, the husband, is suffering from stage three stress breakdown symptoms.

A few days after their group outing, Jack finds he is unable to block out the thought of his wife and the previous boyfriend becoming intimate. He refuses to sleep with his wife – ‘I can’t get the picture out of my mind of you and that creep being together!’ he says. She is hurt and humiliated at the thought that her husband could be such a hypocrite. She told him about the previous boyfriend in good faith. He has now revealed himself as a person who is unforgiving and unreliable!

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Scientists are working hard to identify the cancer in younger men while it is still confined to the prostate. It is no trivial issue. This year doctors will find 317,000 cases of prostate cancer in the United States, and 41,000 will die of it. The only cancer that kills more American men is lung cancer.

“We are diagnosing the disease much earlier than before,” said Dr.  Patrick Craig Walsh, urology chairman at the Johns Hopkins Medical Center in Baltimore and author of The Prostate: A Guide for Men and the Women Who Love Them. “Up ’til 10 years ago,” Dr. Walsh says, “we could detect it only by feeling the gland.” His reference is to the digital rectal examination (DRE), in which a doctor inserts a gloved and lubricated finger through the patient’s rectum to feel the prostate gland. If the prostate seems enlarged, hard, or bumpy, the DRE usually is followed by a biopsy, a microscopic examination of a tissue sample.

“Now,” says Dr. Walsh, “we also have a blood test that alerts doctors to cases that are suspicious. To follow them up, we do a simple biopsy to rule out or identify the cancer. And if it is cancer and it has not spread, then we cut it out.”

That blood test measures prostate-specific antigen (PSA), a chemical produced in the prostate gland. If cancer attacks the gland, the antigen is emitted in large amounts. A high level of PSA in such a test alerts doctors to the chance that the cancer might be growing.

Dr. Joseph E. Oesterling, formerly of the Mayo Clinic in Rochester, Minnesota, and now chief urologist at the University of Michigan Medical Center in Ann Arbor, helped develop a new test with two Scandinavian doctors. It showed that PSA exists in the blood in two forms: free, or attached to a protein molecule. If the prostate is enlarged but not cancerous, more of the free PSA is found; if cancer is present, more of the attached form is found. Dr. Oesterling recommends a yearly blood test for PSA, because a rapid rise in its level can indicate cancer growth.

Testing for PSA has doctors at odds. Some complain that the tests don’t find early cancer but do trigger a sequence of expensive medical steps without prolonging lives. Others urge watchful waiting for aging patients, to spare them the risks and trauma of major surgery.

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Vocal Cords

Another rare complication of RA is involvement of the joints of the vocal cords (cricoarytenoid joints). Usually there are no symptoms when this occurs, although some persons experience hoarseness, difficulty swallowing, a feeling of fullness in the throat, or pain radiating toward the ear. This complication is usually evaluated and treated by an ear, nose, and throat (ENT) doctor.

The Heart

The heart is infrequently involved in RA, and when the heart is affected, most people experience no symptoms. When inflammation involves the membranous sac enclosing the heart (the pericardium), however, the person may experience symptoms similar to those of pleurisy. This condition is called pericarditis. In rare situations, a significant amount of fluid accumulates around the heart, in a condition called pericardial effusion. This condition usually responds to medications (corticosteroids) and only rarely requires drainage of the fluid. Other parts of the heart are rarely involved in RA.

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