Health and medical information

Babies sometimes bring up some of their feeds, and find pleasure and gratification from the action. ‘Rumination’ actually means chewing the cud, a natural action in cows who enjoy regurgitating some of their previously eaten meal to chew on it again. It often starts in babies still on liquids, possibly starting when food is brought up with wind. Bottle-fed babies readily learn to regurgitate at will. One merely makes a funnel of the tongue, tightens the abdominal muscles, and presto! Up it comes. The food will be partially dribbled out. Some will be rolled around in the mouth and later swallowed.

Treatment

Most cases are self-curative and require no active treatment. The baby is not vomiting, as many parents believe, and reassurance can be given that baby is not suffering from some dire gastro-intestinal disorder. Ideally, prop the baby up after feeding. Soon after starting solids and cereals the baby will stop the habit.

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Key to maintaining good health, nutrition refers to the relationship between the food we eat and our bodies’ needs. While there are hard and fast rules about the things our bodies require to operate efficiently, confusion often arises from the fact that nutritional needs vary from person to person as a result of physiological and environmental differences. Commercial interests may also exploit our desire for good health and seek to mislead us with exaggerated or even false claims about goodness or dangers of certain foods. A thorough understanding of the essential food groups and their sources, your daily requirements and the pressures of your environment and lifestyle will help you on the road to good nutrition. It is also recommended that any symptoms of dietary deficiency, which can range from marks on the fingernail to lethargy and more serious illnesses, be considered from a nutritional perspective. Your natural health practitioner will be able to help you identify and rectify problems with your diet.

Our basic nutritional requirements divide into five categories: water, carbohydrates, proteins, fats or lipids, vitamins and minerals.

Water makes up about 70% of our body mass. While it is often said that water has no nutritional value, it is essential for cell function, nutrient absorption, temperature control and waste elimination. Most people will die within days if water is withheld.

Starches and sugars are known as carbohydrates. Both are broken down into simple sugars called monosaccharides and stored in the muscles and liver. Providing our most immediate source of energy and assisting with the body’s uptake of nutrients, carbohydrates should comprise about 60% of a normally active person’s diet. Starches are complex carbohydrates and are found in grain foods such as breads and rice, pasta, peas and potatoes. Bulky and often high in fibre, vitamins and minerals, complex carbohydrates are the better source of carbohydrate in the diet. Sugars, particularly refined sugars, have less nutrient value and, because they contain less bulk than starches, are easily overconsumed, resulting in obesity. They are also a major cause of tooth decay. Refined white flour may contain similar levels of carbohydrate to wholemeal flour, but it is low in fibre and therefore of less benefit to your general health.

Proteins are responsible for growth and development and for the repair of body tissue. Made of amino acids, they also form the enzymes and hormones which regulate the body’s chemistry and function. You will obtain protein from meat, fish, eggs, dairy products such as milk, yoghurt and cheese, nuts and beans such as soya beans, lentils and haricots. The amount of protein required by the body is a matter of some controversy. Generally, it is thought that 40-60 grams a day is sufficient. Excess protein can be converted and stored as fat.

It may sound like a dirty word, but fat is an essential element of any healthy diet. Also known as lipids, fats allow you to absorb the fat soluble vitamins such as A, D, E, and K. Fat provides protection for the abdominal organs and nerve fibres, conditions the hair and skin and helps to keep the body warm. The issue, of course, is what kind of fat you eat and how much. Excess fat or too much of what are known as saturated fats, as opposed to polyunsaturated fats, contain high levels of cholesterol, leading to gallstones, obesity, blocking of the arteries, heart attack and stroke. Saturated fats generally come from animal products such as meat, eggs and dairy foods but beware: palm and coconut oils are also high in saturates. Polyunsaturated fats are mostly derived from vegetable sources like maize, sunflower, sesame and rape seed, and oily fish such as tuna, salmon or trout. Olive oil and some fish oils are known as mono-unsaturated and are better for your health than animal fats.

Under increasing scrutiny is the process of hydrogenation, a food industry technique which saturates polyunsaturated oils with hydrogen usually in the presence of a metal catalyst such as nickel. Normally liquid, the unsaturated oils become solid when hydrogenised: for example, sunflower oil becomes margarine. The process creates non-natural fat substances which are now thought to act like saturated fats, depositing fatty substances on the organs and making the blood cells sticky. Don’t be fooled by clever marketing. Keep your intake of hydrogenised fats to a minimum.

Although required in tiny quantities, vitamins and minerals are essential for food absorption and body function and deficiencies will affect a person’s health. (For information on specific vitamins and minerals, see individual entries). There are 13 major vitamins, only two of which are produced by the body: Vitamin D is made by the action of sunlight on the skin and Vitamin K is a byproduct of the activity of bacteria in the large bowel. All other vitamins must be ingested and, fortunately, most are readily available in fresh food. Supplementation in the form of tablets is rarely necessary. Remember, however, that the recommended daily allowance (RDA) for each vitamin and mineral is calculated as the minimum requirement for health in ideal conditions. Such conditions rarely exist.

The following is a list of just some of the factors, physiological, environmental and behavioural, which can affect your daily requirements: alcohol, caffiene, smoking, allergies, oral contraceptives, reliance on convenience foods, pollution, pregnancy and lactation, stress, antibiotics and other medication, certain medical conditions, menopause and old age. For these reasons, among others, your medical practitioner may recommend you adjust your diet or supplement your vitamin intake with tablets or tonics from time to time.

Fibre is the next important consideration in your diet. It has no real nutritional value as it cannot be absorbed by the body. Instead it passes through our digestive system as roughage, pushing through waste products and keeping the digestive tract healthy. Both constipation and cancer of the bowel can be avoided with a high fibre diet. Most unrefined cereals and plant foods contain fibre. Eat plenty of unrefined grains and raw or lightly cooked fruit and vegetables. Those who suffer from irritable bowel complaints should choose a source of fibre which will not scour the bowel, such as oatbran.

While you may think you need a chemistry degree to eat well, good basic nutrition comes down to common sense. Make sure you eat at least four serves a day of breads, rice, pasta or potatoes and four serves of fresh fruit or vegetables, including green and yellow/orange vegetables. Eat three serves a day of meat, fish, poultry, nuts, beans, peas or lentils. Have one serve of milk, cheese or yoghurt and keep additional fats, oil and salt to a minimum. The fat and sodium you need should be available from other foods in a balanced diet.

Whenever possible, eat fruit and vegetables raw. If cooking, opt for a technique which preserves the nutritional value of food or uses minimal fat such as steaming, grilling, roasting, stir frying and stewing. Western style frying of foods should be avoided.

Finally, eat three meals a day, vary your diet regularly, keep tabs on your general health to pinpoint any deficiencies and try to eat when relaxed. Fifteen minutes of relaxation before eating will aid digestion and increase your absorption of nutrients.

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These two different conditions are both associated with anxiety—nervous headache directly so, and migraine less directly.

The pain of nervous headache is felt on both sides of the head, and mainly in the front part of the head and behind the eyes or at the back of the head. There is often an accompanying feeling of something pressing on top of the head or of a tight band around the head. Nervous headache is the direct result of nervous tension, and if the tension is relieved by appropriate measures the tendency to headache soon vanishes.

Migraine is a different kind of headache. It is usually preceded by some strange feeling which acts as a warning that an attack of migraine is about to develop. There are often disturbances of vision, so that sight is impaired and further disturbed by flashes of light or bright wavy lines. Then the headache itself comes on. Unlike nervous headache, migraine is usually felt only on one side of the head, quite often behind the eye. As the headache develops there is a feeling of nausea and frequently actual vomiting. The attack may last for some hours or even days before passing off.

The migraine attack is due to a temporary constriction of some of the arteries of the brain which is soon followed by a dilatation of the same vessels. It seems that a number of factors combine to produce this effect, and that emotional stress is one of the most important of these factors. Of the patients with migraine treated by myself with relaxing methods to relieve tension approximately one third have practically ceased to have any attacks at all, one third have been markedly helped but still have some attacks, and one third were not helped at all. So it would seem well worthwhile for anyone who suffers with migraine to give the relaxing mental exercises a fair trial in order to reduce nervous tension as a means of relieving the attacks.

Painful Monthly Periods-A great number of women and girls suffer from this distressing condition, which is technically known as dysmenorrhoea. There are different physical conditions which predispose toward this complaint, but in almost all cases there is an important emotional factor. If this can be remedied by reducing the patient’s general level of anxiety so that she ceases to overreact to stress, the condition is usually cured or at least greatly relieved.

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Here’s a massage which helps people with pain at the nape of the neck. For this one again you need two people. (If you are alone, I give a good exercise to ease tension in the neck and shoulders) This massage is also good for tense shoulders. Put your hands on your patient’s shoulders, fingers pointing downwards towards her waist. Your thumbs should be resting against the nape of her neck, pointing in towards her spine. You use your thumbs for this massage. Hold her shoulders lightly under your fingers. Don’t grip tightly or you’ll undo all the good you’re doing with your thumbs. Sweep both your thumbs in circular movements up and in towards the top of her spine, where it joins her neck. This method of massage can be more helpful if it’s firm. Gentle fingertip massage works sometimes, but quite hard pressure is usually better. In fact, many people find this massage is best when it leaves the skin quite flushed afterwards.

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Have you ever noticed a peculiar, acrid odor in fruit and vegetable markets? This smell may very well be coming from the crates used to pack citrus fruits, which are impregnated with fungicide. This is a good way to stop the growth of molds on cartons but can cause serious health problems for those inhaling the vapors. One patient, Doris Meredith, carelessly took a peck of citrus fruit in a fungicide-impregnated case into her home. Every time she entered the part of her house where the cartons were stored, she couldn’t seem to catch her breath and began to wheeze uncontrollably.

Her husband eventually suspected that spray residue on the oranges was the cause and therefore washed each orange in hot, soapy water, drying each fruit separately. The odor still lingered, however, and continued to cause Mrs. Meredith to have acute respiratory symptoms.

Somewhat later, when she and her husband were moving to a new home, she became acutely ill and was confined to her bed, complaining of asthma and headaches. Her husband then recalled that her asthma had started shortly after the packing cases (citrus boxes) were brought into the home. Her symptoms subsided after the boxes were removed but recurred when the same boxes were brought back into the house (this time without her knowledge).

This woman also became depressed for days whenever she ate commercially available oranges. Her depression was so severe that she had contemplated going to a psychiatrist. However, treatment by the methods of clinical ecology was more effective in locating the cause of her problem, namely, fungicide residues, and in eliminating future such instances. She found, for example, that she could eat organic oranges with impunity—that is, oranges which had not been sprayed, dyed, or packed in fungicide-treated cartons.

We are just now beginning to understand the full power of these chemicals. For example, we now know that packing cases and express cars which have been contaminated with insecticides retain this contamination for long periods of time and may subsequently contaminate other loads.

This type of “second-hand” contamination may explain why some people are made ill by wheat which is shipped in paper or cardboard containers for long distances but not from the same organic wheat when it is shipped in metal containers. Some of the pesticides in the railroad car or truck manages to seep into the grain which is packed in porous paper.

Although cases such as Mrs. Meredith’s are extreme instances, the fact that they occur underlines the need for chemically susceptible patients to have local sources of supply, so that food can be transferred from producer to consumer without becoming contaminated.

A more common source of container problems is the ubiquitous “tin” can, now usually made of aluminum or steel. Certain patients react to canned foods, while tolerating the same foods raw or uncanned with no trouble. I had made this observation often enough but could not figure out a way to separate the contribution of the can and its golden-brown phenol lining from that of the various sprays and chemicals found in processed foods. Phenol-containing compounds are used on the inside of tin cans to prevent the metal from bleaching the color of the food. I was finally able to make this distinction when a relative who lived in the state of Washington sent me some salmon which she and her husband had caught and “put up” in glass jars, as well as some tomatoes which had also been home-grown and packed.

When these foods were given to selected patients, they had no reaction. But when these same patients were later given salmon and tomatoes from commercial cans, lined with the golden-brown coating, they all became sick.

These patients have been able to eat fresh or home-packaged salmon or tomatoes since then with no difficulty. It is only when they try to eat such food in cans with phenol lining that they run into trouble.

Admittedly, only a minute amount of the resins and other chemicals used to line cans gets into the food. Is this really enough to cause a reaction? Yes, it is! Think of the difference in taste between canned and uncanned salmon, peaches, or other foods. Some of the characteristic “canned” taste of these foods comes from the substances in the lining, which seep into the food itself. If you can taste it, it can certainly have an effect on your health as well.

Patients who have suffered from depression, asthma, headache, and other symptoms have found relief of their long-term problems by avoiding chemicals and also by eliminating canned foods from their diets.

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Deafness is a partial loss or a complete loss of the sense of hearing. A hearing loss may be slight or severe in one ear or both ears. A child may be born with a hearing loss, or it may develop at any age.

Normal hearing occurs when sound waves pass down the ear canal and cause the eardrum to vibrate. Vibrations of the eardrum in turn move the three tiny bones in the middle ear. This motion of the bones transmits the vibrations across the middle ear to the inner ear. In the inner ear, the vibrations are changed to electrical impulses which are carried to the brain through the eighth cranial nerve. The brain interprets these electrical impulses as sound. Damage, disease, or malfunction of any of these structures can result in deafness. Any of the following problems may lead to hearing difficulties.

Ear canal problems that may cause hearing loss include a buildup of earwax, a foreign object in the canal, or swimmer’s ear.

Eardrum and middle ear problems may be caused by an inflammation of the middle ear or a blocked Eustachian tube (the tube that connects the nose and the middle ear).

Inner ear problems may be caused by injuries or infections.

Eighth cranial nerve, problems have several possible causes. A child may be born with a nerve that has not developed properly or that has been damaged before birth. (For example, if a pregnant woman develops rubella, this virus may infect the eighth cranial nerve in the unborn child.) After birth, this nerve can be damaged by an injury or by an infection with a virus (mumps, measles) or with a bacterium (meningitis). This nerve can also be affected by certain medications.

Signs and symptoms

Signs of a hearing loss usually can be seen in a child’s behavior. Suspect a hearing loss if any of the following behavior occurs: an infant over three months old ignores sounds or does not turn the head toward sound; a baby over one year old does not speak at least a few words; a

child over two years old does not speak in at least two-word or three-word sentences; a child over five years old does not speak so that a stranger can understand; a child of any age has learning problems in school; or a child simply does not appear to hear well at home. Any of these symptoms may be caused by a hearing loss, but they also may have some other causes. Every child should be given a professional hearing test before starting kindergarten.

Home care

Home care for a hearing problem depends upon the cause, as well as upon the degree of the hearing loss. If you think your child may have a hearing problem, see your doctor. A doctor can more properly determine if there is a problem and prescribe the best treatment.

Precautions

• Every woman of child-bearing age should consult her doctor about rubella (German measles) immunization.

• Do not put any object, including cotton swabs, into your child’s ear canal for any reason. You may force earwax to become packed into the canal, or you may damage the eardrum.

Medical treatment

Your doctor will examine the ear to determine the cause of deafness. Specialists have equipment to test hearing in children of any age past early infancy. If there is any doubt about the cause or treatment of the hearing loss, your doctor may refer you to a center that specializes in speech and hearing. A deaf child should start special education as soon as the condition is discovered, even if the child is as young as one or two years old.

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Weeds, seeds, stems, leaves, roots, flowers – these are the stuff manly medicine is made from. Really.

For example, there’s a palm seed that relieves prostate enlargement as well as or better than prescription drugs and with fewer side effects. In your spice rack, there’s a seasoning that will lower cholesterol, lower blood pressure, fight minor bacterial infections, and help guard against cancer. Chewing certain roots just plain makes you feel more vibrant. It’s true. What’s more, about a quarter of modern prescription medicines in North America are derived or synthesized from natural plant remedies just like the ones we’ve mentioned above – herbal remedies that have been used, in some cases, for thousands of years.

As you’ll learn, herbs can help you live longer, better. We think you should know about them. We are not in any way encouraging you to self-diagnose and self-treat any potentially life-threatening illness. Far from that. But we do believe that an informed man should be aware of his options, including the availability of natural healing compounds that often are effective in guarding against common ailments that attack men. You can find these herbs at your nearest health food store. Many are available in drugstores and groceries. Some may even be growing in your own backyard.

Just what are herbs good for? Here’s a list of ailments and complaints men face that herbs have been shown to help.

Cutting cholesterol, fighting infections. If you want to do both, garlic is your herb. Eating about a clove per day ought to do it, recommends Varro E. Tyler, Ph.D., dean emeritus of Purdue University School of Pharmacy and Pharmacal Sciences in West Lafayette, Indiana, and distinguished professor emeritus of pharmacognosy (natural pharmaceuticals). Garlic kills many bacteria, including those that cause ear infections. It reduces cholesterol and keeps blood from clumping and sticking to artery walls, thus avoiding the deadly narrowing of the arteries that can lead to high blood pressure and heart attacks.

Garlic gets its power from a natural antimicrobial ingredient called allicin (pronounced like the girl’s name Allison), which is formed when the garlic is chewed or crushed. So if you’re going to take your garlic raw, you need to chew it, says Dr. Tyler. Of course, taking garlic that way will get you your allicin, but in the process you may lose your Allison. Dr. Tyler recommends getting your garlic the odorless way-through a coated tablet or capsule. Make sure that the label says it yields between 2,500 and 5,000 milligrams of allicin per dose.

Reversing liver damage. Taking lots of prescription medication over the years, drinking too much alcohol, breathing or ingesting too many pollutants of any sort-all of the above gets processed by the liver. Take in too much of this stuff and the liver can wear out or get damaged. An herb known as milk thistle seems to guard the liver and even help reverse some damage, says Dr. Tyler. The active ingredient here is silymarin. In Europe, doctors have been able to effectively counter otherwise often deadly mushroom poisoning by injecting a standardized form of silymarin into patients. An effective formulation of milk thistle herb should state on the label that it contains 80 to 85 percent silymarin, says Dr. Tyler. Follow the dosage instructions on the labels.

One milk thistle no-no: Don’t down a handful of capsules because you’re heading to a party and planning to get smashed, Dr. Tyler says. Taken as an herb, milk thistle is a gentle liver healer, not a poisoning preventive or liver protector.

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You will probably be visited by an anesthetist on the ward before your operation.

An anesthetist is a hospital doctor who has been trained in the special skills of giving drugs which cause loss of sensation or consciousness, or both (anesthetics), and those which block feelings of pain (analgesics). Anesthesia is a vital part of any operation, and a great deal of time and trouble will be taken to make sure that you receive the anesthetic which best suits you.

The pre-anesthetic visit

The main reason for the anesthetist’s visit before your operation is to decide what type of anesthesia would be safest for you. This visit also gives you the opportunity to discuss any problems or worries you may have concerning your anesthesia.

The anesthetist will ask you several questions about any anesthetics you have had before, any drugs you are taking, and about your general health. It is important that you answer these questions as fully as possible. You should also mention to the anesthetist if you have any false or crowned teeth.

If you have had any problems in the past such as an allergy to a particular anesthetic, it will be helpful if you know the name of the drug concerned or the hospital where the operation was carried out. The appropriate records can then be checked to make sure another type of anesthetic is used for your breast operation. You should also tell the anesthetist if you know of any other member of your family who has reacted against a particular drug, as you may have the same problem.

The anesthetist may also want to examine you and to look at the results of any tests you have had. There are different types of anesthetic which can be used for breast operations, and some health problems will preclude the use of certain ones.

General anesthetic

Virtually all breast operations require a general anesthetic; the only exception may be for a biopsy, which can be performed in the out-patients’ department using a local anesthetic. A general anesthetic will put you to sleep, and abolish any feelings in your body. It can be given in two different ways.

1    Intravenous anesthetics can be injected into a vein via a plastic tube which is inserted into your hand or arm, and will put you to sleep within a few seconds.

2     Inhalational anesthetics are gases which you breathe in through a face mask and which act within 1 to 2 minutes. As the use of a face mask can cause some people to panic, it is not normally applied until you are asleep.

During the operation, the anesthetist will make sure you stay asleep by giving you more drugs as necessary.

Risks of general anesthesia

People with certain medical conditions, such as heart or lung disease, may not be given general anesthetics as they are potentially at greater risk.

Some people are afraid of being put to sleep by a general anesthetic because they fear the possibility of never waking up or of suffering brain damage. General anesthetics are very much safer today than they were even 20 years ago, because of the many advances in techniques and drugs. Therefore, their risks are small, although they do have to be borne in mind. If you are worried about this, you should discuss with your anesthetist the possibility of an alternative.

Local anesthetic

When the general anesthetic has taken effect and you are asleep, the anesthetist or surgeon may inject some local anesthetic into the area of the wound. This is the same type of anesthetic that a dentist uses to numb the teeth before a filling. The injection will provide you with pain relief after the operation, for about 4 to 6 hours.

Other medication

In some hospitals, a pre-medication drug (‘pre-med.’) is given routinely to patients to reduce their anxiety before an operation. A ‘pre-med.’ is given by mouth, as tablets or syrup, or by injection several hours before the operation, and will probably make you feel sleepy and relaxed.

You may be asked whether you would like to have a ‘pre-med.’, or you may have to ask for one yourself if you feel anxious and have not been offered one. You can, of course, also say that you do not want one if they are given routinely in your hospital. The anesthetist will be able to discuss this with you.

You may also be given any drugs that you normally take, such as diuretics (‘water tablets’) or drugs to reduce high blood pressure.

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Is endometriosis cancerous?

Endometriosis is definitely not a form of cancer, nor is it a pre-cancerous condition.

Endometriosis is sometimes referred to as a benign cancer because it behaves like cancer in some ways. Like cancer, it is able to grow and expand, to implant itself in a distant part of the body after having been transported there by the bloodstream or the lymph vessels and to invade or penetrate organs and tissues in the body.

But unlike cancer, endometriosis does not destroy the organ or tissue on which it implants itself.

Any tissue in the body can develop into cancer. Therefore, theoretically, any endometrial implants and endometriomas have the potential to become cancerous. But it is extremely rare for endometriosis to become cancerous.

Is adenomyosis the same as endometriosis?

Adenomyosis is sometimes confused with endometriosis because some gynaecologists still refer to adenomyosis by its old names of ‘internal endometriosis’ or ‘endometriosis interna’. These terms should no longer be used as endometriosis and adenomyosis are two quite different conditions.

Adenomyosis is a condition in which the endometrium lining the uterus penetrates and grows into the adjacent muscle layer of the uterus. How the endometrium invades the muscle wall is not clear.

Adenomyosis is most commonly found in women in their 40s and 50s who have had children.

The main symptoms of adenomyosis are heavy bleeding and painful periods. It is thought that about 25% of women with adenomyosis have no symptoms at all.

The severity of the bleeding is related to the extent of the condition and in some women the bleeding is so excessive that the woman is actually haemorrhaging.

The severity of the pain appears to be related to how far the endometrium has penetrated into the muscle wall and some women may experience severe and incapacitating pain during menstruation.

A doctor may suspect that a woman has adenomyosis from her symptoms and an examination will usually indicate a moderately enlarged uterus. A definite diagnosis is difficult and is often only made when the uterus has been examined following a hysterectomy.

The drugs used for the treatment of endometriosis are not effective in the treatment of adenomyosis and for many women the only treatment for adenomyosis is hysterectomy.

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The way we think and the attitudes and beliefs we subscribe to have a great influence on our health and the way we look at prevention.

In a stressful world which is full of change most of us have to cope with the problems of growing up, going to school, leaving school, forming relationships, having children, making a home, holding down a job, bereavement, problems with children, illness, and much more besides. Many of these problems are in no way ‘our fault’, yet they can have a profound effect on our health, often reducing our ability to withstand infections and even making us susceptible to killer diseases such as cancer. Several studies have confirmed that stress impairs the functioning of the immune system. The typical responses of individuals to bad luck and stress vary enormously. A few people seem to thrive by overcoming obstacles, but it is probably true to say that more ‘illness’ and ‘disease’ is caused by stressful events in people’s lives than is caused by ‘real’ disease. But as well as these ‘external’ sources of stress and emotional upheaval there are many more ‘internal’-or self-generated-causes and some people are much more likely to be troubled with these than are others.

Some people hold beliefs that are almost bound to make them suffer more than necessary in the hurly-burly of everyday life, and others have personality types that make them exceptionally vulnerable. Both of these can be modified-at least to some extent-and increasingly people are realizing that their personalities have an enormous influence on their health and illness patterns.

Uncertainty is a potent cause of stress in many people’s lives but rational, clear thinking can overcome or reduce many of the stresses associated with uncertainty. For example, if you think you are about to be made redundant you can explore all the possible alternatives ahead of time, perhaps even starting to look into retraining. This positive action will make you feel a lot better and you will be less uncertain about your future because you will at least have explored, and

Uncertainty over a physical symptom is a major source of stress to many people who, often quite wrongly, imagine they have a serious disease. The answer here is to seek a professional opinion, and get the necessary tests done, so that your suspicion is either confirmed or proved wrong, and you can deal with the resultant situation appropriately. We all seem to have difficulty coping with problems which don’t have definite boundaries, yet can do so much better once the problem is defined clearly. Fear of the unknown is a disease-producer, yet so much information is available today that there is no need to fret unnecessarily over all kinds of imagined horrors.

Another source of stress is the inability many people have to make decisions at all. This in itself tears them apart because the very act of choosing one direction in life by definition rules out certain others and such people cannot bear to have any doors closed-they want all their options open all the time and so decide on nothing. In such circumstances it helps to write down the problem in logical steps and then to work out on paper all the possible answers you can see. This is best done with the help of a partner or a friend, but for some people in certain circumstances a professional counselor may be the answer. Often an outsider can see a way through an apparently insuperable problem, partly because he or she is outside the problem that looms so large in the troubled person’s life, and partly because he or she can bring experience from dealing with other similar problems to bear on this particular one. Often an outsider sees a totally new way out of the dilemma that is entirely invisible to the individual involved because of his or her upbringing, education and way of thinking, emotional state, or whatever.

One of the things that makes many people ‘ill’ is coming to terms with the fact that in modern life many problems simply don’t have an answer. Things are so complicated today that the simple answers of our grandparents often can’t be made to apply. Coping with the unchangeable is a sign of emotional maturity and again professional help may be necessary.

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