Comprehensive men's sexual health information, tips and news about men's sexual health.

Rheumatoid arthritis is a disease in which the joints become painful, swollen and warm, due to internal inflammation. There are characteristic changes in the level of certain factors in the blood that help to confirm die diagnosis. Contradictory results from different trials are often due to a failure to diagnose rheumatoid arthritis properly. This disease should not be .confused with other forms of joint pain, which are more transient and do not produce the same sort of changes in the blood, or damage to the joint – it is well known that joint pains of this type can be due to allergic reactions to food. What is at issue is whether foods can ever be a factor in true rheumatoid arthritis. In the two studies described here, all the patients involved were diagnosed as cases of rheumatoid arthritis by a standard set of tests.

Dr Gail Darlington, a consultant rheumatologist at Epsom District Hospital in Surrey, carried out one such trial, with the help of Dr John Mansfield, a private practitioner with many years’ experience of elimination diets. Dr Norman Ramsey, an experienced medical physicist, helped with the assessment of changes in the patients’ symptoms.

This was a reasonably large-scale study with 53 rheumatoid arthritis patients involved, and 44 actually completing the trial. They all underwent a two week ‘wash-out’ period, when the medicines they had been taking were withdrawn, and they all received paracetamol instead, plus a dummy tablet that they were told was a ‘new drug’. This sort of treatment is known as a placebo. Placebos play an important part in scientific trials.

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Since its introduction in 1967, coronary artery bypass graft (CABG) surgery has enabled thousands of people to survive severe coronary artery disease.

Coronary artery disease (atherosclerosis) occurs when fatty deposits form in the coronary arteries, restricting flow of oxygen-rich blood to the heart. Over time, atherosclerosis may lead to a form of chest pain called angina…or to heart attack.

In bypass surgery, doctors reroute blood flow around arterial blockages, using blood vessels grafted from another part of the body, usually a leg.

The procedure has become so common that people tend to forget just how serious it is.

One surgeon slices open the chest, cracking the breastbone (sternum) to reach the heart, while another “harvests” the arteries or veins to be grafted. The heart is stopped for several hours as doctors attach the grafts.

Bypass surgery generally requires a hospital stay of four or more days, plus a one-month convalescence.

Bypass surgery is often the best therapy for heart disease, but it is not the only approach, other options to consider…

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Common foods can cause headaches, fever, visual disturbances, confusion and a dangerous rise in blood pressure when eaten by individuals taking a prescribed antidepressant.

self-defense: Avoid tyramine-containing foods while taking a monoamine oxidase (MAO) inhibitor—even for several weeks after you stop taking the drug. Tyramine-containing foods include avocados, bananas, bologna, broad beans, aged cheese, caviar, chicken liver (stored), miso soup, meat concentrate (in gravy), pepperoni, pickled herring, salami, summer sausage, soy sauce, wines (Chianti and vermouth) and yeast extract (marmite).

Peanuts are easily aspirated into the lungs…and peanuts are one of the most common—and dangerous—foods to which one may develop an allergy.

most at risk: Those from high-risk families—where both parents or one parent and a sibling are food-allergic. Even trace quantities can trigger an attack in peanut-allergic individuals.

example: A boy began wheezing when ajar of peanut butter was merely opened nearby.

helpful: Alert teachers and other caregivers to the food allergy…have the child wear a MedicAlert bracelet (call 888-633-4298 for information)…older children should be taught to use spring-loaded syringes of epinephrine to ward off attacks after inadvertently ingesting a food to which they are allergic.

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Male pattern baldness is a form of hormone-related hair loss. But of more concern to many men and women afflicted with hair loss is alopecia areata, a lesser-known disorder that causes hair loss in nearly four million Americans.

Typically, hair grows in cycles of two to six years, after which hair lies dormant, and then falls out. On a normal head, some hair is at the beginning of the cycle while some is further along in the growth cycle. With alopecia areata, some or all of the hair follicles stop growing at the same time, leaving tiny bald spots or complete baldness. Normally, hair will grow back in anywhere from six months to a year. But for those afflicted, the wait can be devastating.

However, research shows that alopecia areata may be an autoimmune disease, and this information has opened the door for a new treatment. Many doctors use ultraviolet light to prevent the body’s immune system from attacking hair follicles. In what may be one of the few cases when a slight sunburn is a good thing, psoralen, a medicine that increases sun sensitivity, is rubbed onto the affected area. Then, the doctor shines a UV light on the scalp until the bald area shows some redness or irritation.

Figuratively speaking, the body’s immune cells start worrying about the irritation caused by the sunburn, and stop worrying about the hair follicle, which really never meant the body any harm in the first place!

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These areas of yellowish, thickened skin atop or between the toes can be quite painful. They’re usually caused by friction and pressure on the foot.

self-defense: Soak your feet in water containing Epsom salts. Afterward, apply moisturizer and cover the area with plastic wrap. After 15 minutes, remove the plastic and use a pumice stone to smooth out the corn.

also helpful: Orthotics or foam insoles. Orthotics, which are custom-made, cost $350 or more—but are usually covered by insurance. Insoles are available at drugstores for less than $15.

This problem—twisted or misshapen toes that may overlap each other—is common among people who have high arches.

self-defense: Relieve pressure on the toes by wearing shoes with wide toes…and by covering corns with corn pads, lamb’s wool or bandages. In severe cases, outpatient surgery may be necessary.

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Do you—or does someone you love—keep losing keys, forgetting names or having other memory lapses? If so, you may be worried that the culprit is Alzheimer’s disease or another incurable form of dementia. While it’s a good idea to consult a doctor, the odds are that it is simple forgetfulness— which can be treated.

In some cases, memory problems—especially those associated with aging—stem simply from a lack of mental activity. If your job isn’t particularly stimulating—or if you’re retired—you might consider keeping a journal, joining a book discussion group, playing chess or Scrabble, doing crossword puzzles, etc.

Physical exercise is also a memory-enhancer. Aerobic exercise boosts circulation throughout the body—and that includes the brain.

Another way to ensure adequate blood flow to the brain is to eat a low-fat diet. The arteries that feed the brain are tiny to begin with, and any narrowing that occurs as a result of eating a fatty or cholesterol-rich diet drastically reduces oxygen flow. Blood flow problems can lead to tiny strokes, which are now believed to be the cause of much age-related memory loss.

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The postnatal examination is in the first instance an examination of the woman’s physical health. Routine questions about her general wellbeing, lactation, duration of lochia and healing of the perineum will be asked as a matter of course. Details of the delivery may need to be discussed. Blood pressure and weight are checked and pelvic organs examined. However, the postnatal examination is far more than this. It is also an examination of her psychological health and of how she is coping with the ‘maturational crisis’ she has undergone. More may be revealed about her feelings from her general appearance and manner than from her answers to the doctor’s questions; feelings that must first be explored before a decision about contraception can be reached. Sometimes her anxieties are not fully expressed until the genital parts are examined, and if the doctor can combine the necessary physical examination with psychosomatic listening and observation it can be very fruitful (Tunnadine, 1970). This is a moment when patients may be able to get in touch with and share their feelings about the birth for the first time.

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Mr. C. has severe premature ejaculation and he put it this way. ‘Imagine what it is like. You put on a condom to stop coming. Sometimes I come when she is watching me put it on, and if I get inside I am likely to go soft and it will come off before I ejaculate.’

He was desperately in love with and excited by his younger wife. He had coped by not lying close to her in bed, and when they came to make love he tried with condoms to show willing, but it did not help. His problem led to such stress that his wife had an affair with someone else and got pregnant. By this time he was completely impotent. Later, when his jealousy was out in the open, his anger exploded one day as she went out to playgroup in clothes revealing most of her body. He was able to express his need to have more of her for himself, and when she withdrew her exposure to the privacy of their bedroom, he became potent again.

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Miss J., aged 19, was 17 weeks pregnant. This would be her second abortion. She was very ambivalent about whether she wanted to have a baby or continue with her free, youthful life of going out whenever she felt like it and spending her wages on clothes. She revealed that she had had a lot of physical pain after her previous abortion but denied any emotional pain. She looked away much of the time and conversation was difficult. As the doctor palpated her now large uterus, she said, ‘That’s my baby. I can take him for walks in the park.’

This young woman was not very articulate. Her pain over her last abortion had been expressed in physical symptoms and only a physical examination enabled her to get in touch with her deepest feelings about this pregnancy.

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History-taking will not be regarded as an interrogation or intrusion if its relevance is explained. To facilitate rapport during history-taking and to avoid misunderstandings, the doctor needs to be specific and wherever possible avoid medical terminology. Thus the words ‘clotted or inflamed blood vessels’ may replace ‘thrombophlebitis’. It is important that words such as ‘migraine’ should be understood and the details of the symptom explored. It is easier for both patient and doctor to face the idea that the COC is out of the question now and forever if there is a history of focal or crescendo migraine, at the first consultation (Guillebaud, 1985).

Having shared their medical, family and menstrual history with the doctor they are not surprised to be asked, ‘How long have you been sexually active?’ and ‘Any problems with sex itself?’ Additionally, they see the taking of routine smears as a positive health check. If the sexual history is known and recorded then it is unlikely that a smear will be suggested to a virgin. When the offer of a smear test is refused, it is worth spending sometime looking for the reason behind the refusal. Reasons given can include the rather vague ‘I can’t be bothered’, which may be a sign of a general lack of esteem and self-care, but is more likely to be a way of voicing embarrassment, or even a sign of a phobia of any clinical procedure. An open-ended nonjudgemental enquiry into the difficulty can usually allow the patient to express her fears.

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