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Лечение аллергии-Allergy treatment

PROBLEMS AT WORK AND SCIATICA

While it’s up to you to make sure that you take sensible precautions at home to protect your health, it’s a different matter when you’re at work where the demands of the job or the facilities provided for doing it can force you into a situation where damage to your back can result.

Sciatica and back pain are. of course, part of a much wider range of, at times, work-related ailments of all kinds that fall under the broad label of ‘musculoskeletal disorders’, a term that encompasses those conditions that affect the bones and muscles of the body and the tissues that hold them together.

Musculoskeletal problems often arise from tasks performed while employed, and each year more than half a million cases are reported as being caused by work. Says the Health and Safety Executive (HSE): «The potential to cause these conditions exists in most workplaces – although certain types of work are more often associated with musculoskeletal disorders than others, such as poultry processing, clothing manufacture, keyboard operation, nursing and assembly line work.»

According to the HSE, the causes fall into three main categories:

Manual handling and lifting – poorly designed tasks and incorrect lifting techniques and posture all increase the risk to workers. More than 55,000 injuries due to handling, lifting or carrying accidents are reported yearly.

Repetitive work – where work is done too quickly, such as in piecework, or where the work rate is controlled by a machine. This can be a particular problem when combined with the need for force; where the operator is positioned badly; or where the job is not varied enough.

Unsuitable posture – often caused by poor seating arrangements or by reaching and stretching awkwardly.

While a specific injury to the affected part can be detected in many instances of work-related disorders, in others, pain and discomfort may be the only evidence of problems, as in the case of chronic back pain or sciatica.

The HSE firmly believes that most of these problems can be avoided, often through relatively simple corrective action, such as perhaps modifying how a job is performed, or through re-siting parts of machinery or adapting seating positions.

The responsibility for preventing health problems caused by working conditions is one that is shared to a large extent by both the employee and the employer, and these can be summed up as follows:

The employer has a legal duty to safeguard the employee’s health and safety, and should identify tasks which could cause problems and take steps to improve the situation.

The employee must, however, exercise care and follow good work practices, particularly where lifting and carrying are involved. It is also up to the employee to ensure that any workstation is correctly adjusted when adequate adjustment is possible. Spelling this out more fully, current relevant legislation includes:

- Section 2 of the Health and Safety at Work etc Act 1974 (HSW Act) which places a duty on employers to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all their employees.

Section 6 of this Act also places a duty on manufacturers, designers, suppliers and importers of articles for use at work to ensure, so far as is reasonably practicable, that the article is so designed and constructed as to be safe and without risks to health.

Under section 7 of the Act, employees have to take reasonable care for their own health and safety and that of others who may be affected by what they do (or fail to do); they also have to cooperate with their employer, so far as is necessary, to enable

the employer to comply with legal duties.

It must be noted that the HSW Act deals with general duties and does not provide specific requirements on the prevention of particular ailments. However, various Regulations are more to the point as far as reducing the risk of back pain or injury are concerned, as shown below.

The Management of Health and Safety at Work Regulations 1992 (the Management Regulations) include requirements for employers to:

Assess risks to health or safety.

Arrange for the effective planning, organisation, control, monitoring and review of preventive and protective measures.

Appoint competent people to assist the employer in complying with health and safety law.

Cooperate and coordinate health and safety actions where the activities of different employers interact.

Provide appropriate health surveillance, information and training.

The Provision and Use of Work Equipment Regulations 1992 place duties on employers concerning the safe and proper use of work equipment. The risk assessment carried out under the Management Regulations, as mentioned above, is intended to help employers select work equipment and assess its suitability.

The Health and Safety (Display Screen Equipment) Regulations 1992 are directed mainly to protect employees who habitually use display screen equipment as a significant part of their normal work. Employers have duties to:

Assess and reduce risks.

Make sure new workstations meet minimum requirements covering equipment, furniture, the working environment, task design and software. There was a transition period until 31 December 1996 for existing workstations

Provide breaks or changes of activity, information and training.

While the health risks most commonly associated with operating computers and other VDUs are upper limb disorders (including repetitive strain injury) and sight problems, back troubles can easily arise from inadequate seating and a lack of breaks in the day’s work.

The Manual Handling Operations Regulations 1992 require the avoidance or reduction of risk where the manual handling of loads involves a risk of injury.

The Workplace (Health, Safety and Welfare) Regulations 1992 include requirements for lighting, workspace, workstation arrangements, seating and facilities for rest.

The Supply of Machinery (Safety) Regulations 1992 apply to the supply of new machinery which will need to meet relevant essential health and safety requirements.

Taken together, the HSW Act and the various Regulations put a strong onus upon any employer to ensure that everything reasonable be done to prevent employees from contracting work-related ailments. Despite that, it remains a fact that many sufferers from back problems certainly attribute their difficulties to conditions at work. Should you think that your health problems are due to unsatisfactory work practices, this is what the HSE says you should do:

In the first instance, consult your doctor, giving as much information as is possible to enable him to decide whether or not your condition is likely to be due to your work. In some cases individuals suffering from specified conditions can get state compensation under the Industrial Injuries Prescribed Diseases Regulations. Ask your doctor about this or get leaflet N12 from your nearest Social Security office.

If you suffer from symptoms which may be attributable to work, particularly if they recur, then it is important to tell your doctor and employer. If you have a works nurse or doctor, then you should also tell them about your problem. You may also want your union representative to know that -you think your job is affecting you. If you are off sick for more than seven days your doctor will inform your employer of the cause via a sick note.

You can also contact a doctor or nurse from your local Employment Medical Advisory Service. You’ll find them at your local office of the Health and Safety Executive.

If you need more information, contact the HSE’s Information Centre on 0541 545500.

Additionally, should you develop a musculoskeletal disorder that makes it difficult for you to continue with your current job or you are out of work, you can get advice from your local Job Centre on assessment and rehabilitation schemes, registration as a disabled person, job retention, work aids for people with disabilities and help with job applications.

*56\124\2*

ANTI-DEPRESSANT LIFESTYLE: SUPPORT AND RECOVERY GROUPS

Support groups now exist for many serious and debilitating illnesses, and depression is no exception in this regard. Such organizations provide up-to-date information and meetings to help members and their families cope with depression. A listing of available support groups that deal with depression and related disorders is provided in the Resources chapter at the end of this book.

Recovery or 12-step groups are modelled on the principles set down by Alcoholics Anonymous, which was the first such group to be developed. There are currently recovery groups for drug addicts, sex and love addicts, compulsive gamblers, overeaters and the adult children of alcoholics. There are also separate groups for the spouses, partners or family members of those who participate in these various groups. Recovery groups combine a programme consisting of working through a series of specific steps with fellowship, support and simple wisdom. In meetings people learn that they are not alone in their unhappiness. They are encouraged to talk freely and are listened to in a non-judgemental way without being challenged or confronted. There is a spirit of respect for what people have to say and the problems they are grappling with.

I have encouraged many of my patients with depressions and addictions to go to an appropriate recovery group, often with good results. At times I have managed to locate another group member who is willing to pick the newcomer up and take him or her to a meeting of the group. I have encountered considerable reluctance in my patients to go along with this suggestion and they have frequently cited concerns about confidentiality and their professional reputations. Nevertheless, all those who have followed my suggestion have found such groups to be quite valuable. It is very important in choosing a group to pick one where you feel you can identify with the other group members. Token contributions are requested of members. I often appeal to the ordinary human instinct (possibly genetically programmed) for finding a bargain, by pointing out to my patients that at 50 pence a meeting, recovery groups are the best deal in town.

Even if one is not an addict, these groups might still be helpful and, given the large number of groups available, it is usually not difficult to find one where you feel at home. One of my patients, a woman in her mid-sixties, has suffered from severe intermittent depressions for decades despite my best efforts at medicating her with multiple anti-depressants including St John’s Wort. She would qualify as an adult child of an alcoholic as her mother was drunk through much of her childhood and died of cirrhosis of the liver when the patient was a young girl. She was reluctant, however, to go to a recovery group, so I shared with her some of the slogans that members of recovery groups often repeat to themselves and to others by way of encouragement.

To my surprise, this extremely sophisticated woman, a veteran of many years of all sorts of psychotherapy, repeated the slogans to herself several times and wrote them down carefully every day. The slogans I shared were:

One day at a time.

Just get your body there; the rest will follow.

Fake it till you make it.

These are all useful slogans for the depressed person, who amplifies his or her troubles and projects them into the distant future. Take one day at a time, the slogan urges. If you consider all possible future problems at once they will seem overwhelming and you can drown in a sea of sorrows. In the case of an addict, this can drive a person to drink, drugs or acting out in some addictive way.

In a depressive person, it can drive one to despair. In contemplating some professional or social commitment, a depressed person frequently asks, ‘How can I possibly handle it?’ Just get there, urges the slogan. Often your automatic pilot will take over and see you through. In a song written to encourage those in despair, the singer Billy Joel counsels the listener not to forget his second wind but rather to wait for the momentum to kick in. My patient used this way of thinking to help her get to a wedding which she had no wish to attend. Once there, however, she surprised herself by having quite a good time and afterwards felt very pleased that she had been able to come through for her friends and family. The slogan ‘fake it till you make it’ suggests that if you pretend you are managing, you might be surprised to discover that you really are managing after all. Things may turn out this way for all sorts of reasons. First, the anticipation of the task or event may be worse than the thing itself. In certain types of depression it is impossible to anticipate pleasure, but once placed in a pleasurable situation you may actually be capable of enjoying it. Another reason why you might make it after you fake it is related to daily or circadian rhythms of mood, whereby it is common for a person’s depression to be at its worst in the morning and to improve as the day wears on.

Some people balk at recovery groups because many of the steps are geared round the concept of a Higher Power and, as such, may offend a person’s religious sentiments or lack thereof. Nevertheless, the whole matter is generally handled with a light touch and in a non-coercive way that many people find acceptable.

In summary, support groups offer invaluable information and encouragement around specific illnesses including depression, while recovery groups provide fellowship, wisdom and tangible assistance for people with all manner of sorrows and problems.

*71\75\2*

THE DIFFERENT TYPES OF EPILEPTIC SEIZURE: TYPICAL ABSENCES

(PETIT MAL SEIZURES)

Although a translation of petit mal is the ‘little illness’, petit mal does not mean the same as ‘minor epilepsy’ as there are all sorts of small attacks which are not attacks of petit mal. True petit mal seizures, or typical absences are, by definition, associated with a characteristic EEG discharge. Short-lived partial seizures arising from a focus of abnormal nerve cells in one temporal lobe of the brain may be somewhat similar on clinical grounds, but the distinction is worth making because of the difference in cause, treatment, and outcome between the two.

Absence epilepsy is virtually invariably a disorder of childhood. A typical attack is very brief, lasting only a few seconds. The onset and termination are abrupt. The child will suddenly cease what she is doing, stare, look a little pale, perhaps flutter her eyelids, and drop her head slightly forwards. Posture of the limbs and trunk is usually maintained so she does not fall. After the seizure, the child resumes what she has been doing. Because the interruption of the normal stream of consciousness is so brief, attacks may be unobserved by parents, and not remarked upon by the affected children. One of us has seen a typical attack in a supermarket. A girl aged about nine was helping her mother unload a wire basket at the checkout. She suddenly paused, with a pot of honey held in the air between basket and counter, fluttered her eyelids, and then continued transferring the purchase without further pause.

Whereas one would be unfortunate to have more then one grand mal seizure in a day, absence seizures may be very frequent—10 to 50 seizures a day being occasionally encountered. Fortunately most children have far fewer attacks.

Absence seizures are often associated with myoclonic jerks, which are particularly frequent soon after waking. These are brief shock-like contractions of the muscles, which are so

short-lived it is not really possible to tell whether consciousness is disturbed or not. We have heard this described by one family as ‘the flying saucer syndrome’ in reference to the broken crockery that may occur as a result of jerks at breakfast-time!

*10\188\2*

SYMPTOMS, HOME CARE AND TREATMENT OF CHILDREN’S HIVES

Signs and symptoms

Hives appear as itchy, red, raised welts that can range in size from 5 millimeters to several centimeters across. The most noticeable characteristic of hives is that they change appearance rapidly – they come and go and change in size from one hour to the next. No other type of rash has these same characteristics, so you can be pretty sure that any welts that itch and change appearance rapidly are hives.

Sometimes an insect bite looks like a hive at the point of a bite; however, it does not come and go as rapidly. Hives that are triggered by an allergic reaction to an insect bite appear at sites distant from the bite itself. Hives can also accompany allergic arthritis, which is signaled by stiff, swollen, red joints.

The form of hives known as erythema multiforme appears as welts that look like red targets of different sizes painted on the skin.

You can sometimes pinpoint the cause of your child’s hives by considering his or her activities in the minutes or hours before the hives appeared.

Home care

Unless the child has been given medication with instructions to take it when the hives recur, home treatment of hives should be confined to measures to relieve the itching. Cold water compresses, calamine lotion, and corn flour baths may help make the child more comfortable. Frequent or repeated cases of hives require medical attention. Also, if the child has been given medication but the medication fails to relieve the symptoms, you should call the doctor.

Precautions

• If hives appear on the tongue, make the child cough, or cause difficulty in breathing or swallowing, see your doctor immediately.

• If hives are accompanied by fever see your doctor to rule out a strep infection.

• If antihistamines don’t help relieve a case of hives, telephone your doctor for advice.

Medical treatment

When your child has hives the doctor may administer epinephrine to reduce the intensity of the outbreak and then prescribe antihistamines to be taken by mouth. If the hives recur and it’s not possible to pinpoint the cause, the doctor may order skin tests or refer the child to an allergy specialist. The doctor may also order a throat culture to check for strep infection. If the child shows symptoms of arthritis, tests are necessary to confirm or rule out that possibility. If the hives are caused by an allergy to the venom released in an insect bite, the doctor may suggest a long-term course of injections to decrease the child’s sensitivity to the venom; these shots may be given over a period of years. In the case of an allergy of this type, the child may also be given medication and instructed to take it if he or she gets bitten.

*117/84/5*

SELF-HELP PREVENTION: DENTURE PROBLEMS

What are they?

There are many problems connected with wearing dentures, many of which are related to the fact that they are not nearly as stable as natural teeth. Advertisements suggest that denture fixatives are the answer and they certainly do work, but even the best false teeth are clumsy and cannot match up to natural teeth. Surveys have found that between 15 and 45 per cent of denture wearers are unhappy with them, and that 20 million people wear dentures in the US alone. This amounts to a very large number of individuals worldwide. One study found that about 30 per cent of denture wearers thought they needed refitting, or that they needed new dentures.

What causes them?

Some problems with dentures are inevitable because they are not fixed structures like natural teeth. They are only as good as the bony ridge or foundation on which they sit. In a fair percentage of denture wearers the bony ridge shrinks away. As this happens the dentures fit less and less well. This bone loss can be prevented.

Prevention

• Take more calcium. One study of people with denture problems found that those with good underlying bone were consuming about 900 mg calcium a day and that those who had jawbone problems were getting only about 500 mg calcium. Another trial looked at dummy tablets versus vitamin D (which helps with calcium absorption and better bone formation) for jawbone loss. After a year those taking the supplemental calcium had lost 34 per cent less bone from their upper jaws and 39 per cent less from their lower jaws than had the un-supplemented group. This study also found that the ratio of calcium to phosphorus the person consumed was important too. As levels of phosphorus rose jawbone resorption speeded up. The ideal ratio of calcium to phosphorus is 1:1. In red meat, though, there is twenty times too much phosphorus and in refined cereal products six times too much. They found that meat, bread and potato eaters experienced more of this bone loss than did other people. Also, soft drinks contain lots of phosphorus. Even teenage girls have been found to have started losing bone abnormally as a result of their soft-drink intake. This study recommended taking Dolomite, a phosphorus-free calcium and magnesium supplement. It can be bought at health-food shops and chemists. All of this is interesting even to those of us who still have our teeth, because the breakdown of tooth support is seen in gum disease. A study of people with bleeding, inflamed gums found that taking l g of supplemental calcium for six months produced considerable improvement. X-rays of the jawbones showed that bone loss reversed in 70 per cent of the cases.

*134/72/5*

CONSTRUCTIVE CRITICISM OF ARTHRITIS TREATMENT

Trials and influential factors

In order to determine the safety and value of substances that are to be used to create a change in human or anima conditions, various trials are necessary. Even cosmetic preparations can come into this category because they can influence the physiology of the body by being absorbed through the skin and hair. Trials usually begin with animals and progress to studies using human patients, once safety and reasonable chances of efficacy have been established.

There is little to criticize in the actual trials themselves, provided that they are carried out with the true aim of the trial in mind. This means that these trials should not just be thought of as routine procedures: they must take account of any special application that the substance under trial may have. They must also take into account both the specific nature of the substance and the specific purpose for which it is being used. This all sounds so obvious, but unfortunately trials are not always carried out this way. This can, of course, mean that a potentially valuable substance can be missed or given a false evaluation because of incompetence in trial application.

The interpretation of results

Perhaps the main faults in trial work come in the interpretation of results. In most scientific trials or survey work, once the structure of the trial system has been suitably established, the trial procedures are fairly simple and can be conducted by non-specialist staff. Where expertise and specialist training come in is the interpretation of the results produced by the trial. Unfortunately, even in some of the highly-rated establishments, errors in judgment and mismanagement creep in.

It might be argued that this is, after all, the kind of human error that occurs in all spheres of life. Agreed; but in these cases such errors can result in something of great value in the treatment of disease being incorrectly assessed and perhaps lost, to the detriment of thousands of afflicted people. There are also problems of corruption and bias, particularly when governmental and commercial interests are involved. Having pointed out, perhaps rather dramatically, the way in which trial results are so dependent on the character and ability of those who organize and interpret them, it might be as well to suggest a possible remedy for this disorder in the testing system.

Basically, there is no guaranteed remedy because there will always be corruption. If we ignore this aspect and concentrate on the more practical one of ability, then there are possibilities. Normally, the rating of a person or an establishment is based on ability, though not always. It is suggested that future assessment of potential, new, therapeutic substances will need to be done by assessors who have ability as well as knowledge. This means that they are able to apply their knowledge beyond the narrow confines of books of regulations. This will be a necessity in the future as we progress into the greater utilization of the earth’s resources for survival. This sort of comment is not so dramatic as it may sound. Just think for a moment of the world-wide change in energy and fuel policy over the last few years! The same may happen in medicine and nutrition, though perhaps to a lesser degree.

*23/48/5*

BREAST LUMPS: COMMON COMPLICATIONS AFTER OPERATION, RECURRENCE

Complications of general anesthesia

As has already been mentioned, there is always a small risk associated with the use of a general anesthetic. However, you are far more likely to be run over while crossing the road than you are to suffer any serious complication caused by a general anesthetic.

Very rarely, the supply of oxygen to the brain can be interrupted during anesthesia, and brain damage, possibly with paralysis, or death can occur. Although this risk has to be borne in mind, it should be kept in perspective.

Other minor complications are a sore throat, coughs and chest infections. Muscle pain which may develop as a result of the muscle relaxants used usually lasts for no more than 48 hours.

If a complication arises

If you are at all concerned about anything that occurs after your operation, contact your doctor, the consultant or the hospital ward for advice. Although serious complications are not common, it is better to err on the safe side, and most doctors will be happy to discuss your worries with you.

Recurrence

One of the worst complications to follow surgery for cancer is to have a recurrence of the disease. The risk of cancer recurring in the scar of the operation or in the lymphatic in the armpit should be less than 5 per cent. The surgeon will take all possible steps to be sure that local control of the cancer is achieved. Recurrence outside the area of the breast and its immediate lymphatic drainage is less easy to predict and to treat.

*49/39/5*

HORMONAL TREATMENTS OF ENDOMETRIOSIS: DANAZOL

 

The hormonal treatments currently available in Australia for the treatment of endometriosis are Danazol, Duphaston, Provera, Depo-Provera, Primolut N and the oral contraceptive pill.

GnRH agonists and Gestrinone are two newly developed forms of hormonal treatment used in some overseas countries which are currently only available in Australia on a trial basis.

Danazol is the drug which is most commonly used for the treatment of endometriosis. First developed in the early 1960s, it has been used for the treatment of endometriosis in Australia since the late 1970s; it is also used for the treatment of menorrhagia (heavy bleeding).

Danazol is a weakened form of the male hormone testosterone. Testosterone is one of a group of male hormones known as androgens which are produced by the male testes. They are responsible for the functioning of the male reproductive system and the development of the male characteristics such as facial hair and a deep voice. Women also produce very small amounts of androgens in their ovaries.

Danazol is distributed by Winthrop in the form of 100 and 200 milligram white gelatin capsules. In Australia, Danazol is also known by its trade name of Danocrine. In die United States, the United Kingdom and Canada it is marketed under the trade names of Danocrine, Danol and Cyclomen respectively.

In Australia, Danazol can only be supplied under the Pharmaceutical Benefits Scheme for the treatment of endometriosis if your endometriosis has been definitely diagnosed during a laparoscopy or a laparotomy and if your doctor fills in a special prescription form known as an ‘Authority’. If this is done a script of Danazol will only cost you the maximum cost of a prescription under the Pharmaceutical Benefits Scheme as opposed to its full cost.

*33/41/5*

WEIGHT LOSS: THE GOALS OF TREATMENT FOR BULIMIA NERVOSA

Treatment of bulimia has a different focus. For one thing, anorexics need to do more of something – eating – while bulimics need to do less of something – bingeing and purging.

Rodney Dangerfield, the comedian, tells about the time he went to his doctor with a sore shoulder. Raising his arm, he said, «It hurts when I go like that.» The doctor replied, «Don’t go like that.»

Unfortunately, breaking the binge-purge cycle is rarely that easy. Instead of just telling the patient, «Don’t go like that,» one must reduce the forces behind the urge to binge and purge. These forces include the physical effects that are caused by an irregular pattern of eating or trying to maintain a weight that is too low.

Another goal of treatment is to change the patient’s characteristic cognitive distortions and disturbed emotional responses. For example, learning how to be more assertive can be a key element in recovery. A binge is frequently triggered by anger that the patient feels powerless to express. One woman told me her boss demanded that she work on a Saturday when she had made other plans. She suppressed her fury, telling herself that «I’m lucky to have this job, no one else would hire such a worthless person.» She worked that Saturday, then went home and pigged out for two hours. After assertiveness training, such patients find it easier to «just say no» without feeling guilt or self-hatred.

Finally, improving family relationships can be very helpful, especially for patients living at home. But because bulimic families can vary widely in their dynamics, therapy must address the particular family pattern involved.

*57/35/5*

WIN THE FAT WAR: HER «SMALL» SURPRISE WAS TOPS

In 1997, when David Zimmerman arrived home after a year of active duty overseas in the U.S. Marine Corps, he got the surprise of his life. His wife, Hope, was there to greet him—121 pounds lighter.

He didn’t recognize her. He’d never seen her so svelte.

«It was a big motivator for me, to try to shock him,» Hope says. And shock him she did. «He didn’t know who I was at first,» recalls the 31-year-old Leavittsburg, Ohio, resident. «After he hugged me, he stepped back to look at me and said, ‘Oh my gosh, how did you get smaller than me?’ That whole day, he kept touching me now and then, saying, ‘I just don’t understand where it all went!’

Hope had set out on her secret weight-loss mission after watching her obese grandmother struggle after breaking a rib. «She was so overweight that it took two people to move her out of bed,»

Hope recalls. «And she was so independent. I could see what it was § doing to her pride. I didn’t want that to be me one day.» So at 6 feet and 306 pounds, and with her husband far away, © s Hope joined TOPS—Take Off Pounds Sensibly Through the program’s sound diet-and-exercise program, she whittled her way to 185 pounds in just over 11 months.

Months later, still jazzed by her weight-loss success, Hope bought herself a sexy velvet dress. Her husband was on the phone with a relative when she walked downstairs to model it. He paused to lavish her with compliments, then described to the caller how fabulous his wife looked. «The reply was, ‘She’s not as thin as your brother’s girlfriend,’ Hope recalls. «I was devastated.»

Hurt and angry, she headed to the kitchen for some solace. But she stopped in her tracks, then went outside for a walk instead. Thirty minutes later, she returned home, calm and enlightened. «I let go of those hurtful words by focusing on the kindness that I received from others who supported me,» she says.

Eventually, Hope began strength training to shape and tone her body. Now a Zena-esque size 10 and 195 pounds, she no longer turns to food to heal those emotional blows. If she feels down, she bypasses the kitchen and heads out for a walk.

WINNING ACTION

Realize that you have weight-loss friends and foes.

When hurtful words hit you, consider the source. Understand that there will always be negative people in your life, but don’t accept their perception of you. Remember the title of the book written by Saturday Night Live character Stuart Smalley: I’m Good Enough, I’m Smart Enough, and Doggone It, People Like Me!

*111\89\8*

WHAT VITAMINS CAN DO FOR YOU? VITAMIN A AND VITAMIN B1 (THIAMINE)

VITAMIN A

Functions: the single most important vitamin with respect to the immune system • necessary for night vision and protein synthesis • promotes fertility • stimulates bone growth • assists in growth and repair of body cells • essential for healthy skin and respiratory tract, as well as the linings of esophagus, stomach, intestine, colon, rectum, gall bladder, kidneys and urinary tract • prompts secretion of digestive «juices» • necessary for growth in the young.

Deficiency signs and symptoms: increased susceptibility to infection • night blindness and other eye problems • dryness, thickness and eruptions of the skin • dry, brittle nails • softness of bones and teeth.

Vitamin A’s enemies: mineral oil • alcohol • light • high temperature • air.

VITAMIN B1 (thiamine)

Functions: vital for a healthy immune system • necessary for the conversion of carbohydrates into energy in the nervous system and in muscles.

Deficiency signs and symptoms: mental problems such as loss of mental alertness, irritability, memory loss, confusion and depression • fatigue • loss of appetite • heart irregularities • numbness, tingling and weakness in the extremities and other parts of body (polyneuritis) • constipation • tenderness in the calves • burning sensations in the feet • the classic Bj deficiency disease is beriberi • extreme deficiency leads to heart failure, degeneration of nerve endings, and death. Vitamin B{s enemies: heat • air • excessive cooking of food • caffeine • alcohol • excessive dietary sugar.

*159\80\8*

TESTING FOR RELAXATION: TOTAL = TRUNK

Fill your lungs with as much air as you can. Holding the air in your lungs, bear down as if you were going to have a bowel movement. While holding the air and bearing down, place your fists up by your chin. Squeeze your arms tightly against your chest. Feel the tension in your chest muscles as you slowly count: one thousand . .. two thousand .. . three thousand … four thousand … five thousand … six thousand … seven thousand . . . eight thousand . . . nine thousand . . . ten thousand.

Slowly relax, letting the air out of your lungs.

Now, take in a deep breath through your nose. Hold it for a moment. Let it slowly out through your mouth, very slowly, taking at least five seconds to let it all out.

Take another breath … hold it … let it out slowly.

Fill your lungs once again, bear down, hold your fists by your chin and squeeze your arms against your chest. Hold that position, chest muscles clenched tightly, as you count slowly: one thousand … two thousand … three thousand … four thousand … five thousand … six thousand … seven thousand . . . eight thousand . . . nine thousand . . . ten thousand.

Slowly relax and exhale.

Take in a deep breath through your nose … a nice, deep breath.

Hold the breath for a moment. Now let it out slowly, very slowly, through your mouth, taking at least five seconds to empty your lungs. ^

Take another big breath, filling up your lungs.

Hold it for a moment. Now let it out very slowly.

Your trunk now feels relaxed.

*117\80\8*

FOOD FOR IMMUNE: SUPER RECIPES WITH FISH

FLIPPER’S CHOICE

1 lb. low-fat fish fillets pepper garlic powder basil oregano onion powder

1 sweet red pepper

1 can tomato sauce (no salt added)

Wash and dry fish fillets, cut into 2-inch strips. Place in baking dish; sprinkle on all the spices. Wash and slice red pepper, and place slices on top of fish. Pour tomato sauce over fish. Bake 10 minutes at 375° without turning.

Serves 2.

MILK FISH

4 6-oz. snapper or perch fillets 1/2 cup nonfat milk tarragon dillweed onion powder paprika

Preheat broiler. Dip fillets in milk, place in shallow baking dish and sprinkle with tarragon, dillweed, onion powder and paprika to taste. Broil about 3 inches from the heat source for 3 to 4 minutes, basting once with drippings. Turn, baste and sprinkle with additional herbs if desired. Broil 3 to 4 minutes longer.

Serves 4.

PASSYUNK FISH

2 onions

2 lemons

3 garlic cloves, minced 1 cup celery

1 small eggplant 1 large tomato 1 small can tomato paste, with water to make 11/2 cups 1/2 tsp. cumin 1 1/2 lbs. low-fat fish

Preheat oven to 350°. Wash vegetables. Thinly slice onion and lemon, chop garlic buds and celery, dice eggplant and slice tomato. Use a heavy pan to saute onions and garlic in water. Add celery and eggplant, tomato paste, water and spices. Cook about 10 minutes. Spread half the resulting sauce in a baking dish, put in fish; top off with remaining sauce, lemon and tomato slices. Cover dish and bake about 20 minutes. Uncover; cook 5 minutes more. Serve with brown rice.

Serves 2 to 3.

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SUPER FOODS FOR IMMUNE: «GOOD” AND “BAD» ITEMS

Cholesterol: Leave It to Nature

Cholesterol is a «good/bad» item: good because it’s essential for life, bad because it’s associated with clogged arteries and heart disease.

Here’s the general rule I explain to my patients: Your body is very good at making all the cholesterol it needs. You don’t have to help it out by eating a lot more. In fact, you really don’t have to eat any cholesterol at all.

But eat it we do, in large amounts. Working hand in hand with fat, cholesterol plugs up arteries, especially the tiny arteries that supply the heart muscle and brain. When those arteries close up, some or all of your heart or brain will die.

The Pick-Me-Up That Lets You Down

Caffeine is another food item you can do without. Many studies have linked caffeine to irregular heart rhythms, increased blood pressure, heart disease, anxiety, the heartburn of gastritis and esophogitis, peptic ulcers, digestive problems and cancer. Ironically, the caffeine we drink to give us a lift eventually does the opposite. Caffeine gets your heart beating faster and increases your blood sugar. That’s what gives you the lift. Your body then reacts to the sudden energy surge by gathering up all the blood sugar it can and stuffing it into your cells. Too much sugar, however, is often gathered up. Now your blood sugar is low; you feel fatigued and want another cup of coffee. For many of my patients, every day is a cruel cycle of fatigue, coffee, brief lift, fatigue, coffee, brief lift, fatigue.

That’s why I call caffeine the pick-me-up that really lets us down, overstimulating our heart and muscles at the same time. It just makes trouble for our «doctor within.»

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DUBIOUS TESTS FOR FOOD ALLERGY AND INTOLERANCE

An elimination diet is not an easy method of diagnosis, and unless the patient fully understands the procedure it may not work at all. Doctors have been searching for a simpler method of diagnosing food intolerance for many years, but so far without success.

As alternative practitioners have moved into this field, they have found the elimination diet too difficult and time-consuming, and have sought easier diagnostic tests. Some, such as the pulse test and the cytotoxic test, are based on methods that were originally devised by conventional doctors but found to be too inaccurate. Others are frankly unscientific. All have helped their practitioners to earn a very comfortable living, without necessarily doing the patients a great deal of good. We will only consider the most common tests.

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TELEVISION AND HEALTH – SHORTER WORKING HOURS – NO SOLUTION (PART 2)

Nothing exciting happened to disturb the peace and pleasure hours of leisure. No noise and no radio programmes subjected the body to further tension and no television shows demanded the undivided attention of the viewer. In the place of these canned programmes there was often heard rising from the valley a beautiful song that refreshed the singer and the listeners alike. These aspects of life led to wholesome relaxation which we search for today but seldom find in spite of all the money spent. Often, sound sleep escapes those who did not retire early enough, not wanting to miss out on some nocturnal pleasure. For them the hours of the night become more arduous than even their work during the day, but sleep is an indispensable and natural requirement.

While some people are never able to relax, there are others who cannot do enough to make money. Some workers, for example in the catering industry, do not enjoy their days off as a time of rest and relaxation, but to make more money they accept casual work as well. Such demands on the body may be possible for a little while but they will sap the person’s energy reserves in the long run. We must recognise that the rhythm of life consists of periods of tension and relaxation, the latter being necessary to recharge life’s batteries. Another modern tendency is to seek the necessary relaxation in sport, but unfortunately this often degenerates into competition and the body is overtaxed once again.

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MISCELLANEOUS TOPICS – AN EXAMPLE OF POISONING THROUGH CHEMICAL SPRAYS (POISON CLOUD)

Sure enough, what she remembered confirmed my suspicions because she told me that her husband had been spraying the trees round about that time; in fact, the girl had walked straight into the poison cloud. From that moment onward, her mother said, the trouble started. I was in no doubt at all that the circumstances and symptoms proved what the cause really was.

Now all I wanted to know was whether the doctors had been told of the incident, and she said that they had. Yet only one doctor at the hospital considered pesticide poisoning to be the cause of the girl’s condition, whereas his colleagues flatly rejected this opinion. It was perfectly clear to me, however, why penicillin could not even relieve the symptoms, because it would have given at least temporary improvement if bacteria, instead of chemical poisons, had been the cause of the illness. Having made the correct diagnosis, I had no problem in choosing the appropriate treatment and remedies, and I suspect, no, I am convinced, that the natural treatment and necessary natural remedies helped the little girl to recover.

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OILS AND FATS – REFINING AND SOLIDIFYING

Oils and fats have not escaped being tampered with either. By being refined and solidified, and by having emulsifiers added, they have received a bad name, and rightly so. Not only polyunsaturated fatty acids, but the whole structure of natural products with all their known and still undiscovered qualities, has been thrown off balance. Every oil or fat, left as nature made it, would provide us with what we need to meet our nutritional requirements. It is only when we interfere by introducing chemical and technical methods in the manufacturing process that damage is done and loss of value ensues. More often than not these interferences cause health problems. Of course, oils have been refined, and their taste improved, for many years, but simpler methods were used in the past. Oil was refined by means of wood ashes, because their alkaline substances removed some of the excess acid in the oil, thereby improving its taste. A further advantage of the old methods was that large quantities of oil were not stored, but a fresh supply was pressed from time to time. Oil-bearing fruits keep longer than the oil once extracted.

It is especially harmful when fats are hardened by electrolysis, as metal salts are used in the process. Although this method destroys much of the goodness in the natural product, this is not the only bad result. The traces of metal salts remaining in the oil can cause further damage to health by acting like poisons in homoeopathic potencies. Scientific research, as well as information disseminated by groups promoting a more natural way of life, have accomplished a great deal of good by encouraging greater awareness of these problems in recent years.

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RAW JUICES, MEDICINAL JUICES – WHICH JUICES ARE COMPATIBLE?

Some people assume that it is permissible to combine fruit and vegetable juices, such as orange with carrot juice. This, of course, is no better than eating fruit and vegetables at the same time, which, as already discussed, is apt to cause fermentation and flatulence, especially in sensitive people. Generally speaking, one juice can be mixed with another of the same kind, so that the best way is to take, for example, carrot and beetroot juices at one time, and orange and another fruit juice some other time. This way your digestion will not suffer. As a rule, it is better to drink only one juice, not a mixture. What is more, sipping is much better than gulping it down, because little sips, properly insalivated, will avoid flatulence or any other digestive disturbance. The curative effect will be greater too. Insalivating well helps to warm ice-cold juice in the mouth and so avoid chilling the stomach. A bite of crispbread or rusk with each sip of fruit juice will help to neutralise the acidity somewhat and protect the stomach lining.

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QUESTIONS OF NUTRITION – VEGETABLES AND HERBS (INTRODUCTION)

If you want healthy vegetables they must be grown organically. They depend upon the soil in which they are grown and for the soil to be healthy it must be worked and looked after properly. If you live in the country, take advantage of the various edible plants growing wild in the woods and fields. You will find wild spinach and many other wild vegetables, all tasty and nutritious. Do not neglect to gather and eat them. Bear’s garlic (ramsons), for example, is a prized vegetable, one of the best blood-purifying plants there is, and it should be gathered and eaten in the spring. It regenerates the blood vessels, and lowers and normalises blood pressure. The blood pressure problems that often accompany old age, brought on by the loss of elasticity of the arteries, can be effectively counteracted with brown rice, bear’s garlic and mistletoe tea, if taken on a regular basis. Young nettles, finely chopped and mixed in with salads or steamed like spinach, are also very good for the blood.

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CONTRACEPTION AFTER CHILDBIRTH – CONCLUSION

After childbirth a contraceptive choice must be made as few women will want to risk another pregnancy immediately. As always, that choice will rest on the balance between what is medically appropriate and the emotional factors involved.

The experience of childbirth exerts profound changes, both physically and mentally. The doctor providing contraceptive care is in a unique position to observe these changes, which in most cases will be part of a healthy maturational process but which may have an important effect on the choice of contraceptive method and its efficient use.

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THE STEREOTYPES – ‘MEN NEED TO BE IN CONTROL’ (WITHDRAWAL)

Can withdrawal be considered the ultimate test of control for the man? It involves fully potent sex up to a point that only he can recognize. Most men have tried it at some time, and talked excitedly about the experience until it came to describing the difficult bit. In addition to recognizing the importance of his own control, several said it was impossible if, at the last moment, the woman grabbed hold with her arms or legs and held him in. These men were describing risky sex, and the group must contain a number whose enjoyment is particularly connected with the risk of conception.

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INFERTILITY AND THE CONTRACEPTIVE CONSULTATION – INSTANCE

Mrs H. had hidden the nonconsummation of their marriage for eight years. She had requested repeat prescriptions for the Pill, avoided examinations by having a period or a pressing engagement, and had also moved house and general practitioner (GP) on several occasions. Eventually she plucked up courage to approach her new female doctor, saying that she wanted to have a baby and thought it sensible to have a smear before stopping the Pill. She did not mention the lack of intercourse.

The doctor noticed the hesitancy in her preparation to get on to the couch and remove her underwear for the examination. She looked like a young girl, despite her 28 years, rather like a china doll with neatly parted and waved hair, no make-up and wearing a summer dress with puffed sleeves. She sat up on the couch with her arms clutching her knees and to the doctor’s comment about her apparent reluctance to be examined she began to talk about the lack of penetration in their sex life. Nobody had asked her about sex before and if they had the answer would have been ‘it is all right’, for they did enjoy a degree of intimacy when she achieved an orgasm with manual stimulation. It was only now that they wanted a baby that the situation had become a problem.

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THE DOCTOR AND THE UNPLANNED PREGNANCY

Greater social and medical sophistication in our society has also meant greater involvement between the medical profession and pregnant women. Doctors have become increasingly responsible for the health of the pregnant woman and her unborn child. Laws designed to liberalize abortion have also made doctors more involved with unwanted pregnancies. Throughout the ages and in all societies women have sought to control their own fertility using methods ranging from trying to abort themselves and obtaining an illegal abortion, to infanticide. Although the consequences were sometimes disastrous, it did mean either that women took measures themselves or sought the help of other women. Doctors now have the legal power to terminate a pregnancy and the knowledge to do so safely. If there had been another method of procuring abortion, not requiring medical skill, it is doubtful that doctors would have been so involved. The abortion pill has proved to be a disappointment to women in this way as it still involves medical input. Many women feel that the decision as to what happens to their own body and their own pregnancy should be theirs alone and resent the need to ask doctors for permission to terminate their pregnancies.

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WHAT ABOUT THE MESS? – USING CONTRACEPTION (INSTANCE)

Silence. In the background, the practice nurse looked at her watch. ‘My husband and I are no longer together.’ Mrs A. looked quickly at the doctor, and then back at her watch. ‘I’ve got a new bloke . . . don’t know why . . . just felt I ought to have a check-up . . .’ Suddenly, the defences were lower, and Mrs A. was able to talk about the new man in her life. ‘He’s smashing, really nice

. . . [another anxious sideways look] but . . . well . . . he don’t really get on with the sheath, says he never had to use it with his ‘ex’. But, there’s no way I am going back on those Pills!’ ‘Why don’t we get on with the check-up,’ said the doctor. ‘We can talk about it then.’

Behind the screen, although the examination continued as requested, the talk was all of contraception. She had hated the Pill, well, to be fair, her ‘ex’ was an alcoholic, had wanted sex when fairly drunk, incapable of it later. ‘Every time I took that Pill, I felt sick.’ The oral contraceptive pill had equalled anger and humiliation. ‘When I left him, I said, never, never again.’ The doctor commented that the anger at the husband had turned into anger at the Pill, and wondered if it was only the new partner who did not like the sheath. Was sex OK now? Mrs A. blushed. ‘Smashing,’ she said, in an embarrassed way. ‘But it is true, neither of us like the sheath. It seems … a bit cold, really.’ (The pelvic examination was normal, and Mrs A. had been completely relaxed. It was warm and intimate behind the screen.) Had she thought of the cap? ‘It had been discussed, originally, but . . . wasn’t it too messy?’ ‘Well,’ said the doctor, ‘so was sex, come to that.’ Both laughed. A cap was fitted, she took it out, put it in again, ‘It’s perfect,’ she said. ‘I like to be able to do it, and I know he will be pleased. Who would have believed it? Fancy that!’

A cheerful, sexy lady left the room. The doctor looked back at her old notes: ‘Cap discussed. Positively rejected.’

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BODY SIGNAL ALERT DENTURES THAT DONT FIT PROPERLY: TREATMENT

The most important thing to do to prevent damage to your gums and your remaining teeth if you wear dentures is to go for regular dental checkups so your dentist can detect any tiny changes that occur in the fit of the dentures and make appropriate adjustments. It’s important to see your dentist immediately upon noticing any change in the way your dentures fit. And, as your bone structure changes over the years, your dentist will occasionally need to make a new denture for you.

The abrasion of the denture against your bone and the resulting irritation may occasionally result in an infection of the soft tissue of the gum. If this occurs, your dentist will prescribe an oral solution of antifungal medication such as nystatin suspension or Mycelex troches, lozenges that you’ll slowly dissolve in your mouth. Both should be taken three to five times a day for a week or two to totally clear up the infection.

Tips and Precautions

Some people sleep with their dentures in, but this can aggravate and speed up the deterioration of gum and bone tissue. Your gums need a break from the pressure the dentures place on them. That’s why it’s important to clean them thoroughly each night and to store them in a glass of water each night to prevent them from warping.

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EARS, BUZZING AND HISSING SOUNDS IN

Description and Possible Medical Problems

If hitting the buzzer on your alarm clock each morning does nothing to relieve the constant ringing or buzzing in your ears, you probably have tinnitus. And you have probably lost some of your hearing as a result of the aging ear.

Tinnitus is a ringing in the head. It is usually caused when the arteries in the ear—like elsewhere in the body—begin to narrow; as a result, the ear «hears» the blood rushing through the ear. And sometimes a person with tinnitus can hear his own heartbeat. Regardless of the particular sound, however, tinnitus tends to get worse at night, when there is a lack of sounds to drown it out. And some people may feel they need to seek psychological treatment, because the constant sound can begin to drive them crazy.

Treatment

It’s sometimes difficult to pinpoint the sudden onset of tinnitus, since the cause can be due to an infection or obstruction, or to an underlying disease such as anemia or arteriosclerosis. If you have tinnitus, it’s important for you to see a doctor to rule out the possibility of a serious disease.

To diagnose tinnitus, your physician will go through an elimination process. Sometimes the culprit is as simple as removing an accumulation of earwax, which is the first thing she will check for. Next, she will test your hearing with a tuning fork to see if you have a problem hearing it. She will also do a neurological exam to check your coordination and balance, and if she finds that you have lost some degree of control over your balance in addition to having a significant hearing loss, you will be referred to a hearing specialist.

It might be a good idea to eliminate caffeine, alcohol, and cigarettes, since these can frequently aggravate tinnitus. People with constant tinnitus find that playing the radio at night helps drown out the ringing enough so they can fall asleep. Others have found that a sound machine that emulates water can help mask the ringing, as can a fan or air conditioner. Or, if you live in the city, just open the window. Often, a standard hearing aid will help ease the ringing of tinnitus because it decreases the internal buzzing and amplifies external noise.

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VISION, SLOW, PROGRESSIVE CHANGE IN, ACCOMPANIED BY GENERAL CLOUDINESS: TREATMENT

If you’re one of those people who develop a mild case of cataracts and your vision remains relatively stable, your doctor may suggest that you do nothing for the time being. She may prescribe special eyedrops, which will enlarge the pupil and thus reduce the effect the cataract has on your vision, and take a wait-and-see approach. But if the cataracts develop and begin to hamper your eyesight, the only treatment is surgical removal.

Because cataract removal is such a common and relatively simple procedure, the surgery can be done under local or general anesthesia on an outpatient basis. During the operation, the lens of the affected eye is removed and a new, artificial lens is inserted in its place. The surgery takes about an hour, and the new lens may negate the need for glasses or contact lenses, since the surgeon can tailor a lens so that it will be the only corrective lens you’ll need.

My mother had her cataracts removed several years ago, and after the surgery she had to wear an eye patch for about a week. The family arranged for my sister to stay with her during that time, because we were concerned that she might fall because of her temporary loss of vision. Three weeks later, she was back to driving her car without wearing glasses.

For some people, however, a lens implant is unwise because of the shape and structure of the eye. In this case, when the lens is removed and no artificial lens is inserted, you will become farsighted. However, this condition can be corrected with eyeglasses or contact lenses.

Cataract removal with or without lens implantation will improve most people’s vision. Sometimes, however, the eyesight will remain poor. In this case the problem may lie with the retina, and your doctor will be able to treat this condition as well.

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FOCUSING, PROBLEMS IN

Description and Possible Medical Problems

If you have had trouble focusing your eyes lately, you should check to see if other symptoms are present. You should also ask yourself whether the focusing problem has come on suddenly or has appeared gradually. If your inability to focus appears all of a sudden, the problem is frequently just one of several symptoms—such as redness and irritation—that signal a temporary eye disorder such as conjunctivitis, the inflammation of another part of the eye, or a corneal ulcer.

Treatment

If you’ve only recently noticed that you find it difficult to focus easily, the problem is usually easy to fix. Maybe all you need is to have the strength of your glasses or contacts increased. Deterioration of vision is a given for most midlife adults, but the good news is that after the age of 65, usually no further vision loss takes place. In fact, some people have discovered that the shape of their eyes has changed in such a way that they don’t have to wear glasses at all. If, however, your inability to focus has appeared suddenly and your eyes are red and painful, you probably have an eye infection, and you should see your eye doctor to clear it up. For treatment details, see «Discharge with Redness» above.

Rest assured that if you’re having trouble focusing and it’s not accompanied by any other eye problem, it’s a normal sign of aging and is usually nothing to worry about.

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BODY SIGNAL ALERT EYE PAIN WITH REDNESS: DESCRIPTION AND POSSIBLE MEDICAL PROBLEMS

When you feel a pain in one or both eyes, it is usually one of several symptoms that accompany other eye problems. However, when it appears by itself and is accompanied by redness, it is usually due to an inflammation of one of the parts that make up the eyeball. Just as conjunctivitis, or pinkeye, is an inflammation of the conjunctiva (the membrane that lines the insides of the eyelids and part of the eyeball), other parts of the eye can also become inflamed. These include the iris, which is the colored part of your eye, and the sclera, a transparent film that serves as the outermost layer of the eye.

The choroid is located in the back of the eye, between the retina and the sclera. The choroid is the layer of the eye that contains the many blood vessels that nourish the eye, and, like the other parts of the eye, the choroid can become inflamed.

Iritis, or inflammation of the iris, is sometimes known as uveitis since the iris is part of the uvea, a membrane that lies just underneatl the sclera. The retina at the back of the eye can also become irritated.

Some of these conditions—such as scleritis—are more likely t( appear in a person who has rheumatoid arthritis, while others may arise for no apparent reason. Because it will be difficult for you to detemint – the cause of the pain yourself and the only symptom you’ll have is gen eralized pain in your eye with perhaps some redness, it’s important that you see your doctor.

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