Medical Weblog

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*

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*

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*

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*

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*

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.

*74\80\8*

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.”

*30\80\8*

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.

*118\180\8*

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.

*1194/28/1*

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.

*1125/28/1*