ATHLETE’S FOOT

We often think that athlete’s foot is a condition suffered mainly by teenagers. After all, they’re the ones tracking around in dirty locker rooms and wearing sneakers without socks. But don’t kick your feet up and relax just yet. Anyone can get athlete’s foot, and you don’t have to walk around a locker room to catch it.

The phrase “athlete’s foot” really is not accurate because it has nothing to do with exercise or sports. Athlete’s foot is caused by a mold-like fungus that thrives just about everywhere on your body – on your hair, skin and around your nails. Most of the time it doesn’t cause any problems. But occasionally the fungus is able to survive and thrive. When it does it can cause a variety of itchy skin infections – not only athlete’s foot, but also such things as jock itch and ringworm. The athlete’s foot fungus thrives in warm, damp places, which is why it grows so well on bathroom (or locker room) floors or on the insides of shoes.

It’s impossible to avoid the fungus entirely, but there are ways to keep it under control and to prevent infections from taking hold. Here’s what experts recommend for healthy, fungus-free-feet.

Kill it with garlic. For ages, Russians have used garlic to relieve athlete’s foot infections. There’s some evidence that they’re on the right track. Garlic contains natural chemicals that kill a variety of organisms, including the athlete’s foot fungus. The next time you have an infection, you may want to try peeling and mincing a clove of garlic, putting it in your sock, and wearing the sock to bed. Do this every nigh for a few nights. You should start to observe improvement within a few days. Or you can simply peel a garlic clove and rub it on the sore areas on your feet twice a day.

Keep them high and dry. Because athlete’s foot thrives in warm, moist environments, you can keep it under control simply by keeping your feet dry. One of the simplest strategies is also the most comfortable – going barefoot. This allows air to circulate around your feet and between the toes, which makes it harder for the fungus to survive. After showering, walk around barefoot as long as you can, then dry your feet thoroughly before putting on your socks and shoes.

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WHEN TO SEE THE DOCTOR
Athlete’s foot is rarely serious and will usually go away with home
treatments. If the infection lasts more than a few weeks, however,
you should see your doctor. There are other skin infections that resemble
athlete’s foot but persist without medical attention. You should also see
your doctor if the itching gets worse or begins to spread.
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Give them all-day protection. The same antiperspirant that keeps your underarms dry will work on your feet, as well. Applying an antiperspirant to your feet after bathing will help prevent sweating, making it harder for the fungus to thrive.

Powder your toes. Another way to keep your feet dry is to add some baking soda to the insides of your shoes, or lightly sprinkle some over your feet to absorb moisture. Don’t use cornstarch, however, which can encourage other types of infections.

Dry your shoes. To prevent athlete’s foot from setting up shop inside your shoes, doctors recommend giving your shoes a good drying between wears. You can use a blow dryer, set on low, to dry the insides of your shoes. Or make it a point not to wear the same shoes two days in a row, which will allow them to dry on their own. Putting your shoes on a sunny window ledge will help them dry more quickly.

Wash your feet regularly. By washing your feet with soap and water, paying particular attention to the area between your toes, you will help wash away the athlete’s foot fungus and help prevent infections from taking hold.

Don’t wear shoes without socks. Clean, fresh socks absorb moisture and keep your feet dry. Shoes are meant to be worn with socks. Stick with socks make from natural fibers, like cotton or wool. Other fibers don’t absorb moisture as well.

Don’t bother with flip-flops. There’s nothing wrong with wearing sandals or flip-flops, but don’t count on them to prevent infections. The key to prevention is keeping your feet dry, which open shoes won’t do.

See your pharmacist. There are a number of over-the-counter athlete’s foot medications that are designed to help kill the fungus. Doctors usually recommend using medicated powders rather than sprays because they have the added attraction of absorbing moisture. Using antifungal creams can add moisture to your feet, possibly making the infection harder to treat.

ASTHMA

Nothing is more natural than breathing – unless you have asthma, in which case every breath can seem precious.

Doctors estimate that upto 30 per cent of the children and anywhere between 10 to 20 pre cent of adults have asthma. Doctors still aren’t sure what causes asthma, although the symptoms – coughing, wheezing, shortness of breath, and tightness in the chest – are all too familiar. Asthma causes tiny airways in the lungs to be swollen and inflamed. It also causes the body to make more mucus, making breathing even harder.

One of the most frightening things about asthma is how suddenly it can appear. Exposure to pollen or other allergens, vigorous exercise, or even taking a breath of cold air can trigger an attack. So can a bout with the flu or even a common cold. Asthma attacks can last anywhere from a few minutes to several days. In severe Cases, people need to go to the hospital because they simply can’t breathe.

People with asthma always need to be under a physician’s care. But there are many things you can do at home to relieve your symptoms a bit.

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WHEN TO SEE THE DOCTOR

If you’ve started wheezing when you exercise, don’t chalk it up
to aging. It could be asthma, and you need to see your doctor right
away. Without treatment, asthma can be life-threatening. But with
proper care it can be controlled. A variety of medications, including
steroids, are effective at relieving symptoms and preventing future
problems.

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Brew some parsley (prajmoda) tea. Parsley is a natural expectorant that can help clear mucus from the airways. When you are having an attack, sipping a cup of parsley tea will help you breathe more easily. To make the tea, steep a few sprigs of dried parsley in a cup of boiling water. As an additional benefit, steam from the tea will help loosen mucus and will provide quick relief.

Pour a cup of coffee. Doctors often urge people to drink less coffee. But if you have asthma, a cup of coffee may be just the thing. The caffeine in coffee is chemically related to a commonly used asthma drug. Having a cup or two of coffee when you feel an attack coming on will quickly cause airways to relax, making it easier to breathe.

Take some licorice (mulethi). In Asian countries, people traditionally have used the herb form of licorice to help treat asthma. Some experts believe licorice has a mild anesthetizing effect that can ease the coughs that often accompany asthma attacks. You can buy licorice supplements in tablet form at health food stores. Licorice candy isn’t the same, however, because it contains only trace amounts of the healthful elements. (If you have high blood pressure, don’t take licorice, because it may make your condition worse).

Clear the air. To keep your lungs in good working order, make sure everything you do is lung-friendly. For starters, don’t allow people to smoke in the house. It’s also helpful to cover your mattresses with dust covers to cut back on skin dander – tiny flakes of skin that can trigger allergies along with asthma attacks. Your doctor may also recommend that you buy a portable air filter that will help remove the irritating particles from the air before they get into your lungs.

Unfortunately, doctors have found that there are more than 2000 substances that can trigger asthma attacks – and that’s only inside your house. Outside there may be thousands more. You need to do everything you can to keep the air you breathe clean. At the very least, it’s a good idea to keep your windows closed and to use central air conditioning during the warm months. This will help trap airborne particles before they reach your lungs.

Read labels carefully. Some people with asthma find that aspirin, ibuprofen, and other over-the-counter pain medications can bring on severe attacks. In addition, foods containing sulfites, such as preserved meats, may trigger asthma attacks in some people.

Take care of your tummy. Doctors have found that heartburn may play a role in causing asthma attacks. Heartburn occurs when irritating stomach acids back up into the esophagus (the tube that connects the mouth to the stomach) and throat. The resulting irritation may trigger a breathing problem. To prevent heartburn, it’s best not to eat big meals late at night. Instead, eat smaller meals throughout the day, and eat a small dinner early in the evening. Some people also prop themselves up with pillows, which can help keep stomach acids where they belong.

Keep under wraps. Cold, dry air makes breathing difficult for everyone, especially people with asthma. In nose and mouth when venturing outdoors. This will warm and humidify the incoming air, which will help keep your airways calm. In addition, you may want to use a humidifier indoors to moisten the air.

Pay attention to your hormonal cycles. Research suggests asthma might be influenced by the levels of various hormones in your body, particularly estrogen levels in women. Many women with asthma tend to have attacks just before or during the menstrual periods. If you notice that your breathing problems correspond with your monthly cycle, call a doctor. He or she may recommend medications to help keep your hormone levels more stable throughout the month.

Learn to relax. Several studies suggest that stress may play a role in bringing on asthma attacks. Doctors often recommend that people with asthma do their best to relax more often. This can be as simple as giving yourself time every day to do something you enjoy, or as intricate as taking up t’ai chi or meditation. It really doesn’t matter what you do as long as it helps keep you calm and relaxed. Don’t think of rest and relaxation as luxuries. For people with asthma, regular rest is as important as taking proper medications.

Start an asthma file. One of the worst things about asthma is that it’s unpredictable. It can be hard to pinpoint what’s most likely to cause an attack, and what will calm it down. To figure out your asthma ‘triggers,’ start keeping an asthma file. Whenever you have an attack, write down what you were doing when it occurred. Was it hot or cold outside? Were you active or sitting still? Excited or depressed? What did you have to eat that day? The more information you can accumulate, the easier it will be to figure out what’s contributing to your problems – and what you need to do to stop them.

ARTHRITIS

Arthritis is an incredibly common condition that affects about eighty per cent of the adult population at some time in their lives. While there are many types of arthritis, they all cause pain, stiffness, and swelling in the joints. People with arthritis may have trouble getting out of bed in the morning or bending over to tie their shoes. In some cases, the joints get so stiff and achy that even fastening a button can seem like an impossible task.

Even though there are more than one hundred kinds of arthritis, the two most common forms are osteoarthritis and rheumatoid arthritis. Osteoarthritis, also known as “wear and tear” arthritis, occurs when cartilage in the joints breaks down – as a result of injuries or too much weight, or even simply a lifetime of repeated bending, flexing, and shifting. When the cartilage is damaged, bones begin rubbing against each other, causing pain. This can make even the most simple tasks, such as opening a jar, difficult.

Rheumatoid arthritis also causes cartilage to weaken and bones to rub. However, it’s not simply caused by wear and tear. For reasons that aren’t yet clear, rheumatoid arthritis causes the immune system to begin attacking the joints, wearing away cartilage and causing the joints to become inflamed and very tender.

Even though the different types of arthritis act in different ways, many of the remedies are the same. At present, arthritis can’t be cured, but there are many things you can do to alleviate pain and swelling and to help keep your joints mobile.

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WHEN TO SEE THE DOCTOR
Doctors be can helpful in prescribing a program of treatment that
Suits you. Also, if you are considering fasting to lose weight, you
Should only do this under a doctor’s care.

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Relief as close as your kitchen. You wouldn’t think that what you put on the menu would have any market effect on arthritis, but research suggests that some foods, like asparagus, garlic, and onions, can help. These foods contain sulfur compounds, which can help your body repair damaged tissue throughout the body, including the tissue in the joints.

Get more vitamin C. This all-purpose nutrient has been shown to help relieve a variety of problems, including arthritis. Vitamin C is an antioxidant, which means it helps block the effects of harmful oxygen molecules in the body. It has also been shown to help the immune system work more efficiently. This can help ease inflammation in the joints and arthritis pain.

Help from a special fat. Most of us are trying to cut back on the amount of fact we eat, but one type of fat, gamma linolenic acid (GLA), can help fight swelling in the joints as well as calm the immune system in people with rheumatoid arthritis. You can find this fatty acid in oils, nuts, and fish. To get the most benefit, experts recommend eating cold-water fish, such as mackerel, tuna, salmon, sardines, and bluefish, at least twice a week.

You can also find this fatty acid in primrose oil, borage oil, and black currant oil, which are available in health food stores. When taking these or other fatty acid supplements, read the label to make sure you’re getting the proper amounts.

Consider cayenne. Cayenne contains a substance called capsaicin, which has been shown to block chemicals in the body responsible for transmitting pain signals to the brain. Of course, you’d have to eat a lot of cayenne pepper to get the benefits. An easier strategy is to take cayenne capsules, which are available in health food stores.

Put it on ice. One of the quickest ways to stop arthritis pain is to simply apply cold to your aching joints. You can use cold packs, or simply wrap ice cubes in a washcloth or towel and apply it for fifteen or twenty minutes, several times a day. A shortcut is to use a bag of frozen peas.

Or try some heat. Hot towels or a heating pad on painful joints will help increase blood flow, which can relieve pain and ease swelling and stiffness.

Keep your weight in check. If you’ve wanted to lose weight but haven’t, here’s another reason to try again. Carrying extra weight puts additional strain on your joints, increasing their wear and tear, and making them more likely to hurt when arthritis flares. In fact, there’s some evidence that extra body fat increases arthritis even in joints that don’t bear body weight.

Keep your joints moving. Regular exercise is a powerful ally in fighting arthritis pain as well as in preventing it in the first place. Exercise helps in several ways. It helps strengthen muscles surrounding the joints, so they provide more support. Keeping the joints moving also increases their internal lubrication so they move more easily and with less strain.

Taking walks once or twice a day is superb exercise for people with arthritis. Not only will walking strengthen muscles, it is relatively low impact, so it puts very little stress on the joints. Swimming and bicycling are also good for easing and preventing arthritis pain.

When starting an exercise program, be sure to start out slowly. Doing too much all at once will only make your joints hurt more. As a rule, doctors recommend exercising three or four times a week, for twenty to thirty minutes each time. And don’t forget to warm up by stretching for several minutes before putting your body in motion. This will help keep muscles and joints limber, so you don’t hurt yourself along the way.

Make simple changes. When arthritis flares, even the simplest things – like cleaning or ranking the yard or opening a door – can be painful. There are many small things you can do that will make life easier. For example, replace door knobs (which can be hard to turn) with easy-to-lift levers. Buy and electric can opener to replace your hand-held model. Some people even shop for clothes with zippers instead of buttons. Little changes, yes, but over time they can make life a lot more comfortable.

Anxiety & Panic Attacks

May be you’ve invited forty guests for a pot-luck dinner and all of a sudden you’re beginning to wonder what you’ve gotten into. Your internal dialogue may sound something like this: “What was I thinking? I can’t handle this big a crowd! Besides, no one’s going to show up anyway. If they do, they’ll probably leave early because they’re bored. Have I bought enough wine. Is the house really clean enough?”

Sound familiar? Nearly everyone experiences periodic bouts of anxiety and panic. It’s normal to feel frightened by life’s stresses – an upcoming job interview, meeting your in-laws for the first time, or having a dinner party. But sometimes these emotions spiral out of control, causing your heart to pound and your mind to go blank. Panic makes you feel as though the worst is about to happen and there’s nothing you can do to stop it.

There will always be times when you feel like you’re in over your head. But doctors have found that it’s not stress itself but how you react to stress that determines whether you’ll experience a little anxiety or a full-blown panic attack. Here are a few ways to give yourself a moment’s peace and put the brakes on panic and fear.

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WHEN TO SEE THE DOCTOR

Anxiety and momentary panic are common and entirely normal. For
some people, however, even small setbacks can result in full-blown
fear – not just for a few minutes, but for hours, days, or even months.
If you find that you regularly feel like you’re out of control and are
Experiencing a rapid heartbeat, fast breathing, sweating, stomach
Problems, or other symptoms of anxiety, you should call your doctor
Right away.

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Take a deep Breath. It sounds like a cliché, but taking deep, regular breaths is one of the best ways to keep panic and anxiety under control. People breathe very rapidly when they’re anxious – a symptom called hyperventilation. Rapid breathing actually reduces the amount of oxygen in the body, which makes you feel nervous and out of control. Slow, deep breaths, on the other hand, flood your body with oxygen, making you feel calmer. In addition, taking a few minutes to breathe deeply is like counting to ten; it gives you time to think and to put things in perspective, instead of merely reacting to emotions.

The next time you feel panic coming on, stop when you’re doing and take a deep breath. Breathe in slowly while counting to five. Hold the breath for one second, then slowly breathe out. Continue doing this for a minute or two. The surge of oxygen will help you feel calmer and more in control – and better able to handle the stress that’s bothering you.

Get a whiff of relaxation. Your nose is one of your most powerful weapons for countering anxiety and panic. Evidence suggests that certain scents can stimulate feelings of calm and relaxation. A whiff of lavender (dharu) or sandalwood incense, for example, can help take the edge off stress. So can the smell of a scented candle, Or you can simply sprinkle some cinnamon (dalchini) into a pot of boiling water. It will fill the air with a delicate, lovely smell that reminds many people of simpler, calmer times.

“B” calm. The B vitamins are nature’s stress relievers. Studies have shown that people who don’t get enough B vitamins in their diets may experience confusion, anxiety, or irritation. You can get a lot of B vitamins by eating a healthful diet. But when stress and anxiety are riding high, you may want to take a B-complex multivitamin, which will help fortify your emotional defenses.

Take some herbal relief. For thousands of years, people around the world have been finding emotional strength in their gardens. Herbs such as chamomile (babunah), ginkgo, kava, valerian (jalakan) and St.John’s Wort (basant) have been shown to help ease panic an anxiety. In fact, recent studies suggest that St.John’s Wort may be as effective as some prescription drugs for imparting feelings of calm and well being. You can buy these healing herbs at natural food stores or from natural apothecaries. Many people prefer to buy dried herbs and make a tea. Some take herbs in capsule form. They can be as effective. When taking herbal supplements, bu sure to read the label carefully to ensure taking the proper amount.

Put water to work. When your emotions are running high and you feel as though you’re about to collapse, nothing is more soothing than taking a long, relaxing bath. Many people prefer their baths hot, but before you fill that tub full of steaming hot water, keep this in mind: Some experts believe that a lukewarm or slightly cool ath does a better job of relieving tension and anxiety. Fill the bath with water until it feels comfortable and soak for about twenty minutes adding hot or cool water to keep the temperature constant.

Rub yourself the right way. Massage is one of the quickest ways to take the edge off panic and anxiety. There’s good reason for this. Massage improves the circulation, removes waste products like lactic acid from the muscles, and helps take your mind off stress. And, it just plain feels good. Even if you don’t feel like having a professional massage, it’s easy to take ten to fifteen minutes a day to indulge yourself in a little self-massage. Take a few moments to rub your neck. Rub your fingers across your scalp. Squeeze your shoulders, your thighs, and your calves. You can even try rolling a tennis ball along your arms to relieve tension, or roll a rolling pin on the long muscles of your upper legs. Doing this regularly helps lower stress and ease anxiety.

Walk off your stress. Many people, when they first start feeling anxious, put on their sneakers and head outside. Taking a long walk – or, if you’re athletically inclined, a jog or a bike ride – is one of the best ways to put the brakes on panic attacks. Research has shown that exercise can increase your tolerance to stress and make you more optimistic and upbeat. Walking, swimming, or even dancing several times a week will help you feel more confident and in control – and less vulnerable to anxiety.

Be careful what you eat. Just as some foods, like carbohydrates, can help you feel calm and relaxed, others can put your nerves on edge. When you’re feeling stressed, it’s a good idea to avoid caffeine and alcohol, which can boost your anxiety levels. During high-stress times, you may want to drink soothing, non-caffeinated herbal teas or simply some ice water flavored with lemon or lime. You should also avoid sweets and eat more filling “comfort” foods, such as potatoes, pasta, or whole-grain breads.

Turn off the internal chatter. Many doctors believe that negative thinking can have a profound impact on how we feel. Unfortunately, negative thoughts are hard to avoid. We all get panicky from time to time. But many of us have the equivalent of little tape machines in our heads that are constantly playing irrational and negative messages: “I’ am losing control,” or “I’ am so stupid, what was I thinking?” Sound familiar? If so, you can turn things around by changing what’s on the tape. Start “playing” positive messages: “I’m strong. I’m in control. I’m nervous, but that’s OK.” If you constantly replace negative thoughts with positive ones, you’ll find that they have a way of coming true. You’ll still experience stress and anxiety, but you’ll feel better able to handle them and this is the key to keeping panic under control.

Immunizations

Immunizations have had far greater positive impact upon health in the developed nations than all of the other health services provided by physicians. Only a few years ago, smallpox, cholera, paralytic polio, diphtheria, whooping cough, and tetanus killed large numbers of people. These diseases are now effectively controlled by immunization in the United States and in most other developed nations. Smallpox has been eradicated from the entire world, and there is no longer any need for smallpox immunization. An incredible success story!

Frequent immunization is not needed now because these diseases occur less often and because we know that the immunizations provide protection for a long time. Thus, tetanus boosters are not required more often than every ten years for adults who have had the basic series of tetanus injections. As these conditions become rare, the problems of
side effects from the inoculations are in some instances as great as the risk of illness.

Do not allow yourself to be reinoculated just because you have lost records of previous immunizations. If you haven’t had a tetanus shot for ten years or so, ask for a booster shot while visiting the doctor for another reason. You can save future trips to the doctor by being protected for the next ten years. In general, do not seek out the optional immunizations. Flu shots, for example, are only partially effective and often cause a degree of illness themselves; they are recommended only for the elderly and for those with severe lung diseases.

Recommended Immunization Schedule

2 Months DPT (diphtheria, pertussis, tetanus), and Oral Polio

4 Months DPT and Oral Polio

6 Months DPT and Oral Polio

15 Months Measles

18 Months DPT and Oral Polio

5 Years DPT and Oral Polio

12 Years Rubella (Only for females with a rubella hemagglutination test that is

negative or less than 1:16)

Every 10 Years T(d) (adult tetanus, diphtheria)

We recommend that the optional immunizations (including mumps, hepatitis, pneumovac, and flu) be taken only upon the recommendation of your doctor, and than only after careful discussion. In general, do not initiate requests for those inoculations. They have a definite role for some people, but not for all.

Finally, here is a summary of what you need to remember about preventive medicine:

You don’t need frequent checkups if you feel well, except for a few specific tests. Blood pressure, Pap smears, breast examination, tuberculosis screening, glaucoma testing, and dental checks are the most important; most people will not even need all of these. Most of these procedures can be obtained through public health departments at city or county expense. Take your doctor’s advice concerning the need for a urinalysis, urine culture, tests of the stool for blood, rectal examination, or sigmoidoscopy.
Elaborate physical examinations or multiphasic screening may detect trivial abnormalities and thus worry you unnecessarily.
Complete physical examination should include counseling on health habits.
You should have a plan for obtaining medical care before the need arises.
You should be immunized according to recommended schedules, but you need “boosters” only occasionally in adult life.

If you follow these general principles and if you moderate your habits as discussed in my older posts, you are well on the way toward taking care of yourself.

Early Treatment

An effective health maintenance strategy includes seeking medical care promptly whenever an important new problem or finding appears. If you have a lump in your breast, unexplained weight loss, a fever for more than a week, or if you have begun to cough up blood, you should seek medical attention without delay. These may not represent true emergencies, but they do indicate that professional attention should be sought within a few days. Most times, nothing will be seriously wrong; on other occasions, however, an early cancer, tuberculosis, or other treatable disease will be found. In many cases, you can take care of yourself with home treatment. However, you must respond appropriately when professional care is needed.

To ensure timely treatment you need to have a plan. Think things through ahead of time. Do you have a doctor? If you need emergency care, where will you go? To an emergency hospital? To the emergency room of a general hospital? To the on-call physician of a local medical group? If you are not sure what to do after reading this matter, who can you call for further advice? Have you written down the phone numbers you need?
Only rarely will you need emergency services. But the time that you need them is not the time to begin wondering what to do. For all these Questions answer is plan ahead.

Multiphasic Screening

The term “multiphaisc” simply means that many laboratory tests are performed in an attempt to find abnormalities that are not readily apparent. Some multiphasic screening programs involve fifty or more tests, including blood studies, urinalysis, X rays, electrocardiograms, and other procedures. With automation, these tests can be performed quickly and economically.

Experience with these screening systems over the years has shown that many laboratory abnormalities are detected but surprisingly few major problems that need attention are found. No laboratory test is perfectly accurate, and each test has a certain number of “false positives” associated with it. There is danger that the doctor may feel obligated to follow up the “false positive” test with additional tests, thereby unnecessarily increasing both the patient’s cost and worries.

Because of these problems, we do not routinely recommend multiphasic screening except as part of a total health care program, such as the Kaiser-Permanente
Health Plans. In such programs, multiphasic screening has allowed more effective use of nurse practitioners and has encouraged more efficient health care delivery systems. Some physicians also feel that multiphasic screening is an effective way to reassure the “worried well.” That is, a negative multiphasic screening examination may help people who are overly concerned about their health to accept the fact that medical treatment is not likely to help them with their problems. Thus, like the complete physical examination, multiphasic screening may be of value not so much for the detection of disease as for providing a good opportunity for reassurance and counsel.

Screening for disease detection is justified only for those individual tests that can detect important and treatable problems. For many people, the blood pressure measurement is by far the most important test.

An Ounce of Prevention

An ounce of prevention, it is said, is worth more than a pound of cure. Medicine in recent years has been oriented to “cure” rather than prevention, even though many of the greatest medical successes, such as eradication of smallpox and control of paralytic polio, have been achieved through preventive measures. We have been “crisis-oriented”: our approach has been to wait for a consequence to appear and then try to treat it. Now, interest is appropriately focusing upon preventive medicine. The most important part of preventive medicine, moderating health habits, was discussed in my previous posts. The idea of preventive medicine also includes the following four strategies, and it is important to understand both their strengths and their limitations;

The checkup or periodic health examination
Multiphasic screening
Early treatment
Immunizations and other public health measures

The Myth of the Annual Checkup

The “annual checkup” is still recommended by some schools, camps, employers, and the army. Curiously enough doctors seldom go to each other for routine checkups, nor do they send their families. The complete “executive physical,” made popular a few years ago by large corporations that wished to insure the health of their most critical employees, is slowly being discontinued. Even these elaborate checkups, involving several days in the hospital, do not detect early and treatable diseases with any regularity, and they raise false confidence to some degree. That is, they encourage the false belief that if you are regularly checked you do not need to concern yourself as much about personal health maintenance.

There are a few areas in which periodic screening is necessary, and it is important to keep them in mind:

High blood pressure is a significant medical condition that gives little warning of its presence. During adult life it is advisable to your blood pressure checked at least every year or so. This measurement can easily be done by a nurse, physician’s assistant, or nurse’s aide; a full examination is not required. If high blood pressure is found, a doctor should confirm it, and you should carefully attend to the measures needed to keep it under control.
If you are a women over twenty-five, you should have a “Pap smear” taken every year or so. Some authorities now recommend beginning Pap smear testing at the age of beginning sexual activity, decreasing frequency to every three to five years after the first three are negative and again increasing the frequency to every one or two years after age forty. This test detects cancer of the womb (cervix), and in early stages this cancer is almost always curable.
Women over age twenty-five should practice breast self-examination monthly. Any suspicious changes should be checked out with a physician; the great majority of breast cancers are first detected as suspicious lumps by the patient. Women with large breasts cannot practice self-examination with as much reliability as other women and may wish to discuss other screening procedures with their doctor. In general, we do not like to recommend mammography as a screening procedure for women below the age of fifty, but there are exceptions, such as women who have already had a breast tumor or women with a strong history of breast cancer in their family.
A test for glaucoma (a treatable disease that can cause blindness) should be done every few years after age forty if there is a family history of glaucoma. Most cases of this disease are discovered during eye examinations, so it is generally advisable that such examinations include a routine check for glaucoma.
Tuberculosis skin tests (PPD or Tine Test) or periodic chest X rays are indicated if there has been any possibility of exposure to this disease. If the skin test was negative and becomes positive, check with your doctor.
Dental checks can save teeth, and regular dental examinations are recommended. The primary purpose of an annual dental examination is to find and fill cavities; the benefits of other aspects of the examination ritual are less well established.
Screening tests of Urine, tests for blood in the stool after age thirty, and regular sigmoidoscopy after age fifty are of more dubious value. Some doctors feel that these are worthwhile, and others do not.

The importance of these few examinations is underscored by their availability as a public service, free of charge, at many city and country clinics. These are the crucial elements of periodic checks; others are optional and controversial.

Self-Destruction Syndromes

Cigarette smoking, inactivity, alcohol abuse, obesity, drug use, and accidents all represent a form of suicide or self-destruction. These factors combine to be the most important determinants of your present and future health. You can live longer and feel better by employing enjoyable disciplines in your life-style. Get back in control. Remember that the effects of each bad health habit are cumulative. The probability of early death or disability increases the longer you continue to smoke, the longer you are obese, the longer you lack exercise, and the percentage of time that you ignore your seatbelt. Stopping bad habit at any time is beneficial. And for most of these problems, moderation, rather than total elimination, is the crucial health element.

Avoid making excuses: “Everyone is overweight in my family.” “I just wish I had the time to exercise.” “It’s easy to give up smoking, I’ve done it fifty times.” “I never drink before lunchtime.” “I can handle it.” I don’t smoke cigarettes all the way.” “Diets just don’t work for me.” It is embarrassing to hear such statements offered by apparently intelligent people. First you need insight; then change is possible.

How can you conquer a habit? This is accomplished only by hard work. We have given most of the principles above. Avoid self-deception. Set goals and write them down. Chart your progress. Work with others who have the same problems. Plan to work at it the rest of your life. Tell others what you are doing. Discover the pleasant dividends of your change of habit and remind yourself of them: a better sex life, better physical reserve during the day, admiring looks from others, more energy, more money, a clear mind, less illness.

Decide to make permanent changes in your life. Crash diets, periods of time “on the wagon,” and spurts of physical activity are all poor practice. When you exercise beyond your conditioning, you stress muscles, ligaments, and the heart. When your weight bounces from high to low to high like a yo-yo it is just as harmful to your heart and arteries as if you had kept the initial high weight. The spree drinker adds additional social and medical problems to those of the steady alcoholic. These issues are for a lifetime, and there are no short-term solutions.

You are the patient. It is your life and your responsibility. Define for yourself those health goals which are important to you and your family. Define a solid and workable program to approach these goals, and plan to maintain that program for the rest of your life. You will live longer, feel better, and have more energy to share with your family and friends.

The Errant Vehicle

Fastening an automobile seat belt doesn’t seem like medical treatment, but it is very powerful preventive medicine. Trauma now accounts for 74 percent of all deaths between the ages of fifteen and twenty-five, and accidents are the fourth most important cause of death at all ages.

Seat belts interlock devices, speed limits, and drunken driving programs are often considered to be annoying interferences with our personal freedoms. Yet, attention to safety measures is the easiest of all of the personal health habits. Because accidents kill often in youth, the total health impact in terms of years of life lost is even greater than statistics suggest. Young people forget the importance of good health habits because they do not feel threatened by cancer, heart disease, and strokes. But poor driving habits, such as not using seat belts, showing off, and drinking before driving, can kill just as surely as cigarettes, and even more quickly. Young Americans who die on the highway usually perish at the hand of another young American.

The Fat of the Land

Once you are ten pounds over your ideal weight each additional pound costs you a month of your life. Each pound slows you down, makes you less effective in personal encounters, and often lowers your self-image. Fat people are hospitalized more frequently than people of normal weight; they have more gallbladder problems, more surgical complications, more cases of breast cancer, more high blood pressure, heart attacks, and strokes. They also develop atherosclerosis (hardening of the arteries) at earlier ages. These facts are well-known.

It is less commonly known that the fat person cannot even eat much more than his or her thin counterpart. A day’s food represents about one pound of body weight: if you fast, on average you lose a pound a day; if you eat double, you gain a pound. Thus, if you gain ten pounds each year, you will be very fat, but this weight gain represents only an additional ten-days worth of food over the year, or approximately 3 percent. The fat person can eat only 1 to 5 percent more than a thin person.

We respect the difficulty of this problem, and we share these difficulties with you. But the solutions are personal, not medical. A few people have glandular illnesses that cause their weight problem, but for most of us the problem is not a medical one. As with the other habits that change health, management of the problem begins with its recognition as a problem. Weight control requires lifelong discipline and vigilance. It is not easy.

There are generally two phases to weight control: the weight reduction phases and the weight maintenance phase. The method you use to lose weight doesn’t matter too much (although liquid-protein diets are some what dangerous), and you can choose from any of a number of sound diets. Diets usually have a gimmick of some kind which encourages you and helps you remember the diet. Most people have some success with losing weight; if you se a target, tell people what you are trying to do, and stick with it for a while you can probably lose weight.

Weight Maintenance at your new weight is more difficult. Weigh yourself regularly and record the weight on a chart. Draw a red line at three pounds over your desired weight and maintain you weight below the line, using whatever method you need. Accept no excuses for increasing weight; it is easier and healthier to make frequent, small adjustments in what you eat than to try to counteract binges of overeating with dieting. Keep yourself off the roller coaster. You have to choose between calories and complications, early diet and early demise.

THE DRUG SCENE

All drugs can be used to excess, with harmful consequences. The major drugs of our society are alcohol, nicotine, and caffeine, and each has its well-known problems. But there are two other categories of drugs whose consequences are more easily ignored: the illegal or “street” drugs, and the various “happiness pills” obtained with a doctor’s prescription.

Marijuana is a rather mild drug with a soothing effect. However, experiments indicate that large amounts of marijuana administered over a long period of time may cause genetic damage in animals. Heavy use is associated with loss of motivation in many individuals. Marijuana has been used extensively by young people and has adversely affected their early life decisions regarding further schooling and choice of occupation. Its medical consequences are presently not well known. Marijuana users are fond of saying that their drug is not as hazardous as alcohol or cigarette smoking; this statement will probably prove to be false, but even if it were true, it is a very naive kind of argument. Armed robbery is not as bad as murder, but this is a rather weak justification for armed robbery.

Amphetamines and “speed” stimulate the body, creating an illusion of extra energy, but they almost certainly increase some forms of heart disease by constricting the small blood vessels. It is now generally agreed that they have almost no medical use, their prescription is much more tightly controlled than it was five years ago, and tragedies such as that which occurred to Elvis Presley have increased public awareness of the problems posed by these agents.

The “hard” drugs and narcotics (such as heroin, cocaine, morphine, Demerol, and methadone) have potential for fatal overdose, and addiction invariably leads to social degeneration of the user. A large fraction of crimes, both violent and nonviolent, are related to these drugs; not because the user is directly crazed by the drug but because money must be obtained to buy more. Recently, there has been some “fashionable” use of cocaine in social circles noted more for their high income and personal idiosyncrasies than for their good sense. Cocaine is a highly dangerous drug, and do not let anyone tell you differently. Stay away from it!

Legal drugs are no less hazardous than illegal drugs, but because they are “respectable,” we forget their hazards. The number of prescriptions for these drugs is going down, and we hope that Take care of yourself has had something to do with the decline in their sales. These drugs hinder your taking care of yourself. During the period of peak use, more than one out of every of every six people in the United States were regularly using a prescribed mood-changing drug. Even now, such drugs are in first and second place of all drugs prescribed and hold eight positions in the top twenty prescription drugs used – a truly shocking indictment.

Tranquilizers, in the language of the street, are “downers.” These have been the most popular mood-changing drugs and include Valium, Librium, Equanil, Miltown, and others. They used to be prescribed when a patient reported “nervousness” or “anxiety,” or as a quick and satisfactory method of getting the patient out of the office. That is, they were given for symptoms reflecting difficulty in coping; but “downers,” like alcohol, further impair one’s ability to cope with the immediate environment. One standard tablet of the stronger of these medications (such as Librium or Valium) is roughly equivalent, as a sedative, to one alcoholic drink. Most would agree that taking one or two drinks three times a day is not the best way to solve life’s problems.

Sedatives may also be given to “help” patients sleep. Insomnia, while a troublesome complaint, is not often helped by sleeping pills. The body’s instinct for sleep is extremely powerful; sleep is demanded by the body when it is needed. Many adults require only six hours of sleep, and this amount appears to decrease with age. A feeling of poor sleep one night often leads to an early bad time the next night; this leads to a restless night with periods of wakefulness, causing the patient to think sleep has been inadequate, and a vicious cycle begins. True insomnia requiring medical care is unusual. Sedatives, which do not simulate natural sleep vary closely, are seldom needed.

If you do use sedatives, you or your child may die of an overdose of them. They affect enzymes in the liver, and can lead to complications when other drugs are used at the same time. They may carry over into a morning hangover, and they increase the chance that your children won’t listen to you when you tell them about the evils of their drugs.

“Uppers,” usually amphetamines, used to be prescribed in a misguided attempt to help patients lose weight. They do not assist in weight reduction, except very temporarily, and many studies have demonstrated the futility of weight reduction programs based on the use of these agents. They cause severe mood changes, tightening of the small arteries, and impose an extra strain on the heart. Amphetamines were once used in the athletic arena by trainers and players because they create the illusion of physical prowess. However, careful studies in track- and field events, where direct measurement of performance is possible, indicate that amphetamines neither help nor hinder performance at events such as the hundred-yard dash or the mile run but have a tendency to impair performance in such events as the hurdles or pole vault which require close coordination.

Drugs are Chemicals. The drugs you swallow react in the bloodstream, with other drugs or with various chemicals already made by your body. If several drugs are taken together, the complexity of their interactions is such that no physician or scientist can adequately analyze the situation. Almost any medical symptom can represent a side effect of a drug or a combination of drugs. Between 10 to 20 percent of all hospital admissions are now felt to represent complications of prescription drugs. The great majority of the drugs that have caused these reactions were medically optional and were not required to maintain the health of the patient. Medications sometimes help to eliminate disease, but they do not make you healthy; do not look for health in a pill bottle.

THE TWO-MARTINI LUNCH

The drinking of alcoholic beverages is a social custom for the great majority of adults in the United States. In moderation this custom may improve circulation, reduce blood pressure, and act as a relatively mild and safe tranquilizer. However, 10 percent of our population have serious drinking problems. These people constitute over 20 percent of all hospitalized patients. They typically suffer from one or more of a set of related serious problems; cirrhosis of the liver, ulcer disease, bleeding from the bowel, premature senility, and vitamin deficiencies are among the most frequent. Sometimes they show signs of severe mental psychosis, and they may exhibit the spectacular “delirium tremens” – the “DT’s” or “the shakes.” They drive automobiles into immovable objects or innocent folks with a frequency that is truly alarming; deaths related to alcohol represent nearly one-half of all deaths in young adult life. Suicide and homicide are frequently related to alcohol use.

Alcohol is high in calories. It may increase obesity, as in a “beer belly,” and it thereby increases other health problems related to obesity. People who drink heavily tend to eat less nutritional food. This can result in a variety of nutritional problems as well as cirrhosis of the liver.

Treatment of the alcoholic continues to be a frustrating, often unsuccessful venture. Within the medical community, enthusiasm for a wide variety of treatment methods waxes and wanes. Non-medical organizations, especially alcoholics Anonymous, enjoy a success rate that is at least equal to that of any “medical” treatment. Associated organizations, such as Al Anon, which work with the families of alcoholics, also show considerable promise. The key elements of these treatments are that they deal with motivated people who truly wish to change, and the treatments continually reinforce the subject’s desire to remain free of alcoholic influence.

When should you seek help? Everyone has a different definition of how much alcohol is too much, and the amount probably is different for different people. You should seek help if you have problems with alcohol, and you should not make excuses for the problems. Face up to them. Here are some of the frequent signals that you need help: a drunken driving citation, an automobile accident after two or more drinks, missing work because of feeling poorly from drinking the night before, a pattern of work absences on Monday mornings, a hospitalization for an alcohol-related problem such as gastritis or upper bowel hemorrhage, inability to function at top efficiency in the afternoon because of a two-martini lunch or its equivalent. If you develop the insight that you have these serious problems and that your situation must be changed, you are a good candidate for successful treatment.

COFFIN NAILS

Cigarette smoking, it says on the pack, may be hazardous to your health. This is the most harmful of the personal vices, and is fortunately becoming less socially acceptable. Physicians rate smokers by their number of “pack-years,” which is the number of packs per day multiplied by the number of years that you have smoked. For example, if you have smoked two packs per day for five years, you are a ten pack-year smoker. For each pack-year that you smoke, you decrease your life expectancy by about one month. You greatly increase your chance of sudden death. A heavy smoker, smoking two packs daily for thirty years, or sixty pack-years, has decreased his or her life expectancy by five years.

THE CIGARETTE SMOKER

More Heart Attacks (x2)
More strokes (x4)
More Lung Cancer (x300)
More Emphysema (x300)
More skin Wrinkles (x4)
More High Blood Pressure (x2)

Other bad things happen too. The physical reserve of the cigarette smoker is decreases. Smokers are less healthy, less vigorous, have less active sex lives, and appear to develop skin wrinkles at earlier ages. They spend twice as much time in the hospital as nonsmokers.

Just as important, the last years of a cigarette smoker are not a period of grace and beauty. Tortured wheezing, swollen purple lips, and the feeling of suffocation mark these years. In medical slang, the late-stage cigarette smoker is termed a “blue bloater.” Fortunately, present evidence suggests that the ex-cigarette smoker can regain much lost function and improve life expectancy, although not back to that of the nonsmoker. Pipe and cigar smoke, when not inhaled, is less hazardous and accounts for only a fraction of the problems created by inhaled cigarette smoke, but smoking a pipe or cigar can also certainly decrease your social acceptability. The militant nonsmoker (“Would you mind putting out that cigarette?”) is a constructive new social phenomenon, and the smokers are being packed into smaller and smaller spaces in the back of the airplane. The hazards of “second-hand smoke” are real, although relatively small, and many people feel that forced exposure to the smoke of others is deeply offensive. Five up your cigarettes and avoid the hassles.

Fitness

Probably the most important lifetime habit is active exercise. Body parts need to be used to work will; use them or lose them. Our organs tend to rust out more quickly than they wear out.

Without exercise the muscles get flabby. The bones become brittle. The sex drive decreases. The heart muscle becomes soft; in medical terms “cardiac reserve” is lost. The weakened heart muscle is less able to respond to the needs of stressful situations. The body cells cannot use oxygen as efficiently. The reflexes decay, and falls and accidents become more likely.

Exercise is the key to many of the health risk factors. It helps with weight control, decreases cholesterol, lowers pulse and blood pressure, helps counter stress, and helps prevent depression. It increases physical reserve, improves stamina during the working day, and promotes personal confidence.

Your exercise program should be pleasurable, and almost all people obtain deep satisfaction from their exercise program after it has become a habit. It is the initial undertaking and perseverance that are difficult. You don’t have enough time? Exercise is the activity that adds time to your day by increasing your stamina, and it adds vigorous years to your life.

Exercise should be regular, at least four days a week. It should be “aerobic,” so that it conditions the heart and the oxygen-utilization mechanisms; this means steady exercise for at least fifteen minutes that is sufficient to raise the heart rate and break a sweat.

Exercise should be undertaken gradually, to allow the body to prepare for the next level of activity. You may require many months or even several years to develop your full program. Be gentle in the beginning, increasing your activity slowly as you feel the ability and the desire. If your activity is causing discomfort, you are progressing too rapidly.

The particular activity matters little and can be freely chosen. Jogging is currently the most popular, but it has no particular advantages over other forms of exercise. We have been regular runners for many years and enjoy the solitude of the fields and hills. Other people like to run on a track, whim, bicycle, walk, or jump rope. Some sports, such as basketball and soccer, can give aerobic exercise. Your particular choice is much less important than choosing an activity that gives you pleasure, one you can anticipate continuing for a long period of time. Schedule the activity into your routine: an early morning or lunchtime or cocktail-hour run, bicycling to work a time for swimming, a brisk walk after breakfast.

Even if your work is physical, you need an exercise program; you will find that it helps you to maintain your energy level at work. Very few physical jobs require aerobic exercise, and lifting and pushing at intervals throughout the day, while tiring, is not good conditioning. Then too, there are psychological benefits from exercise programs that are freely undertaken, from the voluntary decision to take personal responsibility.

People who exercise tend to become intolerable converts, and their new euphoria is often translated into missionary zeal. Many overly detailed exercise formulas have been promoted, but in fact, common sense is your best guide. The body was designed for a less pampered life than we have given it over recent decades, and it works better if used more. You need to decide how to translate this general principal into your own life.

Your Habits and your health

For the most part, your health is upon to you. You can do much more than any physician to maintain your health and well-being. To do this, you have to get in the habit of health. At the age of fifty, individuals with good health habits are physically thirty years younger than individuals with poor health habits; you can have a physical age of sixty-five or a physical age of thirty-five. It’s up to you.

Your doctor’s examination of your heart will not prevent a heart attack, but you can greatly decrease chances of a heart attack by maintaining a good diet and exercising, and by not smoking cigarettes. You don’t really need physician to remind you that alcohol acts to destroy the liver and stomach lining, or that you can avoid lung diseases if you quit smoking tar-laden cigarettes, or that fat people have more health problems than slim people. You already know these things, and your destiny is controlled by your decisions.

In contrast, surprisingly few diseases can be prevented by actions of the physician. On occasion, the physician may detect an illness, such as high blood or cancer, at any early stage, and appropriate medical treatment can contribute significantly to you long-term health. Unfortunately, at the present time there is no way that your doctor can halt the progression of our major chronic diseases such as atherosclerosis, diabetes, osteoarthritis, emphysema, cirrhosis, and cancer of the lung. Perhaps it would be nice if the doctor could do it and you could avoid the responsibility, but this is not possible.

If we could eliminate all unhealthy habits, what would happen? Lung cancer and emphysema would almost completely disappear, death due to all cancers as group would decrease by almost one-half, cirrhosis of the liver would become a rare disease. Peptic ulcers and gastritis would decrease greatly, massive upper GI bleeding (bleeding from the stomach) would become unusual, pancreatitis (inflammation of the pancreas) would be rare. High blood pressure would be less common, and there would be fewer strokes and heart attacks. Atherosclerosis (hardening of the arteries) would occur less frequently. We could eliminate one-half of the hospital beds now available. The cost of medical care would decrease, the price paid for the expensive bad habits would be saved, and the consumer would have more pocket money. The number of sick days would decrease by over one-half, and the national productivity would rise. An incredible set of possibilities!

Without the help of the patient, medicine can make no such promises. It is up to each of us. Here we review some of the habits that directly affect our health.

Hypertension

High BP is one of the 3 main risk factors for heart attack and stroke.

The other risk factors are smoking and raised blood cholesterol levels.

Lowering blood pressure ( and lowering blood cholesterol) saves lives.

If your blood pressure is consistently over 160/90mmHg, your doctor would tell you that you have hypertension. But generally speaking, the lower your blood pressure, the better. If your pressure is between 140/90 and 160/90mmHg, then you may be diagnosed as having ‘border line’ hypertension. Blood pressure readings are a remarkably accurate predictor of life expectancy: the higher the pressure, the greater the risk of heart disease than people with lower than average levels.

For this reason, it has been extremely difficult to find a working definition of hypertension. Perhaps the most sensible view is to define it as ‘that level of blood pressure where treatment with anti-hypertensive drugs does more good than harm’, because there is no such thing as drug treatment that does not have some potential side effects.

If your BP is found to be more than 160/90 mmHg, and if you have several different risk factors for heart disease, such as high cholesterol, being a smoker and a family tendency to heart disease, then treating your high BP is likely to be very worth-while. On the other hand, for some young people with only marginally raised blood pressure, and no other risk factors for heart disease, the value of BP lowering drugs is very small and drug treatment may therefore be held back. However it is however, crucial that such people are re-checked at regular intervals of about 6 months.

Hypertension has been called the ‘silent killer’ because it usually causes no symptoms until a late stage of the disease, contrary to what many people believe, it is not possible to feel you own blood pressure. The only way to find out whether your blood pressure is raised is to have it measured with a BP machine. As BP causes no symptoms until complications begin to show themselves, about half of all individuals who have it remain unaware that they have a problem.

WHY HYPERTENSION MATTERS:

Blood vessels are like rubber tubes that carry blood constantly to wherever it is needed. Arteries have to withstand the great pressures with which the blood is pumped out of the heart. If the BP is higher than usual over many years, as in untreated hypertension, the vessel gets damaged. The lining of the arteries can become rough and thick, and this eventually causes them to narrow and become less flexible, or elastic, than previously, this is known as arteriosclerosis. If an artery becomes too narrow, Blood cannot get through properly, and the part of the body that relies on that artery for its blood supply is starved of blood and the all important oxygen that it carries. As the artery narrows there is an increased tendency to develop blood clots (thrombosis), which may cause total blockage of the artery so that the part of the body that it serves dies, If the heart or the brain is affected, the dead area is called an infarct.

OTHER RISK FACTORS: High BP over many years can cause health problems, and the whole point of measuring BP regularly, and treating it effectively if it is high, is to prevent these complications. However, you are more likely to develop these complications if you smoke and if you have untreated high blood cholesterol levels. The reason is that smoking damages blood vessels in much the same way as high BP, making them narrower and their lining thick and rough. High cholesterol can cause fatty deposits called arthromeres in the lining of the artery to develop more rapidly than normal, which also helps to narrow the arteries. It is not possible for your level of serum cholesterol to be too low, and treatment to lower cholesterol saves lives. Another common risk factor that can also contribute to narrowing of the arteries is diabetes (diabetes mellitus), which affects 4 to 5 percent of the population and a greater proportion of the indigenous population. High glucose levels in the blood damage arteries in a similar way as high BP. But it would not do to paint too gloomy a picture.

Its better to have your BP checked than feel sorry at a later stage:

The whole point of having your BP checked is that if you are found to have hypertension, it is possible to treat it effectively and thus bring down to normal. It does not matter particularly how severe the hypertension was in the first place. What is really important is how well your blood pressure is controlled over the ensuing years. It is better to have had severe hypertension that has been well treated than to have slightly raised blood pressure that remains untreated or neglected.

LONG TERM EFFECTS OF HIGH BLOOD PRESSURE:

The heart is a muscle that needs its own blood supply, which is brought to it by the coronary arteries. If these arteries are narrow, blood does no get to the heart muscle efficiently, the heart needs to work a bit. Harder than usual, E.g when your walking up a hill the heart muscle cannot get the blood supply and oxygen that it needs. This causes pain in the chest, known as myocardial is chaemia or angina. If a coronary artery narrows and then a blood clot forms, the part of the heart muscle that relies on that coronary artery dies.

This is known as coronary thrombosis, a myocardial infarction or a heart attack.

Over the years, as arteries narrow and become less elastic as a result of hypertension, it gets harder and harder for the heart to pump blood out efficiently to he rest of the body. The increased work load eventually damages the heart and impairs it’s performance. Fluid collects in the lungs, causes shortness of breath. This is known as congestive cardiac failure.

Narrowing of an artery that carries blood and oxygen to the brain can lead o temporary loss of function in he part of the brain served by that artery, this is known as Transient Ichaemic Attack (TIA). Permanent closing off of the artery with a blood clot results in the death of the part of the brain reliant on that artery, which results in a stroke.

Smaller blood vessels in the legs can be damaged, resulting in the legs getting damaged, resulting in less blood getting to the feet and pain in the calf muscles on walking.

When blood vessels supplying the kidneys are affected, the result may be gradual kidney damage. This is why a blood test to check kidney function is a vital part of regular check ups for any one with hypertension.

The small blood vessels in the eyes can also be affected, although this may not become apparent until the damage is extensive. Rarely, in severe hypertension there may be damage to the retinal with haemorrhages. This condition is called malignant hypertension, although with treatment the outlook is very good.

Oh! Pain in the Neck?!

Oh! Pain in the Neck?!

Neck pain, at times, can become pain in the neck' quite literally. People who have experienced neck pain alone know how painful the neck pain can turnout to be.

Neck is one of the most flexible regions of the spine, which consists of vertebrae, seven shock absorbing discs, muscles, and vertebral ligaments to hold them in place. The uppermost cervical disc connects the top of the spinal column to the base of the skull. The spinal cord, which sends nerve impulses to every part of the body, runs through a canal in the cervical vertebrae and continues all the way down the spine.

What Causes neck pain?

Most people experience neck pain at some point in their lives. Neck pain can be acute, lasting for few hours or a few weeks, or it can be chronic. Neck pain that lasts several weeks or longer is considered chronic neck pain.

Neck pain can be caused by an activity or injury or by a medical condition. Your head and neck region is vulnerable to many different stresses. Bad posture can cause misalignment of your neck, head, and spine. Car accidents can cause whiplash. Age and wear and tear can cause arthritis. Even activities such as chewing gum and reading in bed and cause pain. How do we avoid these potential problems? And if we can’t avoid them, how can we recover as quickly as possible.

Non-specific neck pain

Many people develop a stiff and painful neck for no obvious reason. It may happen after a minor twisting injury, for example while gardening. Since the underlying cause for this type of neck pain is not fully understood hence it is called ‘non-specific neck pain’ Having non-specific neck pain does not mean that your neck is damaged. Often it happens in people whose necks would appear completely normal under an x-ray. It is the most common type of neck pain and disappears after a few days.

Activities that cause neck pain

Neck pain mostly is caused by activities that result in repeated or prolonged movements of the neck’s muscles, ligaments, tendons, bones, or joints. This can result in a strain(an overstretched or overused muscle), a sprain (injury to a ligament), a spasm of the neck muscles, or inflammation of the neck joints.

• Holding your head in a forward or odd position for long periods of time while working, reading, watching TV, or talking on the telephone.
• Sleeping on a pillow that is too high or too flat or doesn’t adequately support your head, or sleeping on your stomach with your neck twisted or bent.
• Spending long periods of time resting your forehead on your upright fist or arm.
• Work that uses the upper body and arms, such as painting a ceiling or other overhead work.

Injuries that cause neck pain

The Spine consists of interlocking bones(vertebrae) and discs that separate the vertebrae. The portion of the spine that runs through the neck is known as the cervical spine. Muscles and ligaments in the neck hold the cervical spine together. Injury to any of these structures may result in neck pain.

Minor injuries may occur from tripping or from excessive motion of the cervical spine. Severe neck injuries may occur from whiplash in an accident, falls from significant heights, direct blows to the face or the back or top of the head, sports-related injuries , a penetrating injury such as a stab wound, or pressure applied to the outside of the neck, such as strangulation.

Pain from an injury may be sudden and severe. Bruising and swelling may develop soon after the injury. Sudden (acute) injuries can result in strain and pain in the neck, dislocation of the spin, or a ruptured disc.

Medical conditions that cause neck pain

Neck pain may be caused by or related to medical conditions such as:

• Cervical Spinal Stenosis
• Cervical Spondylosis
• Illnesses, such as meningitis, which cause inflammation around the tissues of the brain and spinal cord.
• Chronic conditions such as fibromyalgia, rheumatoid arthritis, or ankylosing spondylitis
• Torticollis (wryneck): Torticollis is caused by severe muscle tightness or a shortened muscle on one side of the neck, causing the head to be tilted to one side.
• Referred pain: Referred pain occurs when a problem in one place in the body causes pain in another place. For example, a problem with your jaw or your heart can cause neck pain.
• Infection or a tumor in the neck area.
  

Signs and Symptoms

Neck pain takes many forms. Signs and symptoms of neck pain may include:

• Pain in your neck that may be sharp or dull
• Stiffness in your neck
• Difficulty going about your daily tasks because of pain or stiffness in your neck
• Shoulder pain in addition to neck pain, in some cases
• Back pain in addition to neck pain, in some cases
  

Help yourself to prevent neck pain

Take frequent breaks: Don’t sit in one place for a long time, such as your car or at your desk.
Arrange some of the items in your office that cause inconvenience. This will force you to get up, stretch or walk around.

Maintain good neck posture:
Adjust the seat of your computer or desk chair so that your hips are slightly higher than your knees. Your head and neck will naturally follow in the correct position. While traveling in a car, airplane or train, place a small pillow or rolled towel between your neck and a head rest to keep the normal curve in your neck.

Avoid too many pillows:
Avoid sleeping with too many pillows or falling asleep in front of the television with your head on the arm of a couch.

Exercise: Treat your body to a consistent regimen of stretching and strengthening to balance your muscle groups. This protects your neck as well as helping your whole body. Walking at any pace is excellent exercise for your neck. The rotation of the spine provides a great natural workout for the neck muscles.

Eat smart and Drink water:

Good nutrition and staying well hydrated are not only important to stay healthy, but vital in the healing process.

Swim 2 Slim

Swimming is a great relaxing and helathy activity and for many it is a form of exercise. Swimming is one of the most popular forms of aerobic excecise, and an excellent activity for anyone who wishes to get fit and stay active.

Swimming recruits all the major muscle groups, including the shoulders, back abdominals, legs, hips, and glutes. Regular swimming builds Endurance, Muscle strength and Cardio-Vascular fitness. It can serve as a cross-training element to your regular workouts. Swimming with increasing effort gradually increases your heart rate and stimulates your muscle activity.

The density of the human body is approximately similar to that of water. The body is supported by the water and less stress is therefore placed on joints and bones. Since the buoyancy of the water protects the joints, exercise is a particularly good choice for people who are overweight or who are prevented from taking part in other activities because of injuries or other physical limitations. Therefore, swimming is frequently used as an exercise in rehabilitation after injuries or for the disabled. For most adults, the upper body is the weakest part of the body is the weakest part of the body. In swimming you can get an upper body workout and a lower-body workout, unlike running or biking or other activities like tennis, where you ge a good workout for just the legs. In addition, as with most aerobic exercises it is believed to reduce the harmful effects of stress.

Swimming helps you shape your body. It is effective to burn fat.

More effectively that the other exercises as the resistance in the water is a lot more that on the ground and a swimmer has to face tremendous pressure while swimming. That is the reason why a short span of swimming exercise can give the benefit of losing more fat as compared to the long term ground exercise.

Swimming helps pregnant women strengthen their abdominal and shoulder areas. It reduces the stress and stiffness because of carrying a baby. It improves blood circulation and keeps a good and balanced blood flow throughout the body.

Swimming consumes a large amount of calories. According to the latest studies a half and hour of swimming exercise can burn more than 1100 calories. So it can be considered as an ideal exercise for weight loss!

People who go and dip in the water will actually enjoy several benefits of swimming ---- physically, psychologically, emotionally, and socially. Physically, it gives a whole body conditioning, without giving any painful after effects of the exercises like strained muscles or overworked bones and joints or injuries. Psychologically, it gives the mind some moments of peace and calmness by just concentrating on the water and the strokes. Emotionally, it allows you to vent your anger, stress, or frustration by shouting underwater or punching and kicking the water, thus not hurting anyone. Socially, it serves as bonding times with family and friends or a time to meet new people.