Health Issues is a general health based blog concentrating on multiple health topics.

Most people with HIV infection are admitted to a hospital at some time during the course of the infection; most will be hospitalized two to four times, spending an average of thirty to sixty days, total, in the hospital. They may or may not have a choice of what hospitals they are admitted to. As discussed in a later section, the choice is largely dictated by the type of insurance they have and the hospitals to which their physicians have admitting privileges. People are often frightened about going to a hospital—to be sure, hospitals are confusing places. This section discusses hospitals, and their people and practices, in an attempt to lessen the fear and confusion.

Teaching and Community Hospitals-Hospitals differ in the services provided and the style of care. One of the biggest differences is between teaching hospitals and community hospitals. Teaching hospitals are generally larger hospitals that provide on-the-job training for medical residents and often for medical students as well. Teaching hospitals are often affiliated with medical schools, the physicians are often on the medical school faculty, and physicians may be responsible both for patient care and for research programs.

The advantage of teaching hospitals is that their resources for testing and treatment are both extensive and up to date. This is important in a field that changes as rapidly as research in the treatment of HIV infection. Teaching hospitals are also more likely to have comprehensive

programs for the care of people with HIV infection. A survey of physicians by U.S. News and World Report in 1990 showed that all the top-ranked hospitals for the care of AIDS were teaching hospitals. In order of rank, they were: San Francisco General Hospital, the Johns   Hopkins Hospital in Baltimore, Massachusetts General Hospital in Boston, St. Vincent’s Hospital in New York City, Memorial Sloan-Kettering Cancer Center in New York City, the University of Washington Medical Center in Seattle, Duke University in Durham, North Carolina, and the Mayo Clinic in Rochester, Minnesota. This list is of particular interest because it was made up by physicians; these are the hospitals the physicians themselves would choose for AIDS care.

Community hospitals tend to be smaller hospitals with fewer resources and whose staff physicians often have less experience with HIV infection. Nevertheless, many community hospitals have devoted physicians who provide excellent care in an environment less overwhelming than that of a large teaching hospital.

Experience counts, however. Surveys of hospitals caring for people with HIV show that survival is better and the length of stay is shorter in hospitals which treat many people with HIV, compared to hospitals which treat few people with HIV infection. Still, there is no doubt that many of the common complications of HIV infection can be easily managed in a community hospital.

*158\191\2*

Though up to 85 percent of American women get hot flashes within the first year of menopause, and more than a quarter of women have symptoms lasting five or more years, just 30 percent of women seek medical attention for them. Of all women who leave their doctors’ offices with a prescription for hormones in hand (usually in response to complaints about menopausal symptoms), only two-thirds ever fill it. A quarter of all those women stop taking hormones within two years, mostly because they are still afraid of breast cancer or fed up with monthly bleeding or other side effects. All told, less than a quarter of American women take advantage of HRT. Those who feel crummy while taking hormones may be right to rely instead on diet, exercise, and supplements to protect their bones (if changing the type or dose of estrogen does not eliminate unwanted side effects.) But otherwise, anyone who stops taking HRT is missing out on the real benefits. On every point, the best results are seen in those still taking HRT compared to those who have stopped, and those who have taken it for the longest show the biggest benefits.

*141\228\2*

“Whether counseling a younger child is different from counseling a teenager depends on the age of the child, the child’s level of understanding, and the child’s problems. Let me tell you about Jenny, who was nine years old when I first met her. She was a bright youngster, one of four children. Her mother was a former nurse and had a fair amount of medical knowledge about epilepsy. The father had gone back to law school at night, so the family was under real financial stress. In addition to caring for the family, her mom was working two jobs. Let me tell you, tensions in that family were real high.

“Jenny had several seizures, but that wasn’t the reason she was referred to us. She was initially referred because her doctor thought she might have a degenerative brain disease. Over the previous year, she had deteriorated dramatically, both at school and at home. She was always sick with headaches or stomach aches and was missing a fair amount of school. Visits to the doctor’s office weren’t helping the family financial problems, either. Neither her mother nor her physician could tell what was related to the seizures or to the medication or what was psychological. She had become a very belligerent and disruptive child, causing havoc in the family. Her actual seizures were not that bad, but the family was disintegrating, even though they wanted to stay together.

“Jenny’s behavior was the main issue at our first meeting. She didn’t like taking medicine. She didn’t like being sick and going to the doctors. All kids seek attention, but some do not distinguish between attention for the positive things they do and attention for misbehaving. Jenny was not always aware of what she was doing. Her temper outbursts and not feeling well took up much of the limited time this family had for each other. Her brother and sister resented all the attention and concern Jen was getting, and they let her know it; they also began to manifest the same symptoms in attempts to draw attention to themselves. The family was a mess. This is a good example of how epilepsy becomes a family problem, not just a problem for the affected individual.

*227\208\8*

Shiv Nath belonged to a well-to-do family in Peshawar (Pakistan). But when he came as a refugee to Amritsar in 1947, he was a destitute in the true sense of the word. He had lost all elder relatives and landed here with an aged mother and two young sisters with literally no assets. He was perforce required to work hard to earn a living. In time he earned quite a bit of money, but had inculcated such busy routine of life that he had no time for rest.

Besides, he had in a very hard way learnt the value of money in present-day modern life and had an innate desire to earn more money so that he could be ‘one up’ from his School days chum Srinath who had refused to recognize him when he was poor and friendless.

Shiv Nath worked and earned more and more money -only sky was the limit. In this senseless pursuit of riches, he worked like a machine day in and day out without a moments rest, till his body could no longer obey the dictates of his mind due to fatigue.

He lost his appetite, could not sleep at night, became very tense and irritable. Muscular tension caused pain on every movement and he started having attacks of migraine. Allopathic pain-killers could only give temporary relief. He started pining, losing flesh and weight. Fear gripped him when he realised that there was nobody to look after him if he became incapacitated due to total break-down of health which looked imminent.

He was given Mimulus (for fear) and Vervain Remedy (for over zealousness), and got quick relief in all his physical troubles. After one week, there was no apprehension or fear of the future left in his mind. Therefore, Mimulus was discontinued. Vervain Remedy was continued T.D.S for 12 weeks to rationalize his over-zealousness on healthy lines when he could be called as cured physically and mentally.

*191\308\8*

But a person in the negative Rock Water state is the very antithesis of his counterpart in the positive state. He is rigid like steel which will break but not bend.

He sets before himself some ideals and some principles which he wants to follow. He follows those principles till his last breath. He would not digress from his path under any circumstances. No threats, no allurements, and no arguments would make any dent in his chosen way of life.

His life- style, his mental or spiritual values are a closed book for one and all. To stick to his fixed ideals, which are usually set very high, he willingly foregoes many pleasures of life and accepts sacrifices in the hope that others would follow his ideas.

Unfortunately that seldom happens. For one thing, his ideal is difficult to follow by an ordinary person, and then it is far removed from the realities of life, because it is fixed and does not admit of any change. May be the negative Rock

Water character imbibed his high ideals from old scriptures, from the days of Ramayana & Mahabharat and is still caught up in rigid theoretical maxims and ideas far removed from present-day realities.

Whether it is the physical side or the mental side or the spiritual side, the Rock Water type follows the set course doggedly. He makes no allowance for the changed times and the changed circumstances. To all intents and purposes, he is a slave of the code of conduct, which he himself set for himself. His personality stands frozen within the precincts of his principles and is bereft of the guidance of his Higher Self which alone can show the correct path in all circumstances.

Thus he stands as an odd man in society who foregoes normal human pleasures of life and is prepared to make sacrifices in order to slavishly follow a code of conduct which he cannot change under any circumstances. Even if the very purpose for which he originally set his high code of conduct is being defeated by his persisting in that code of conduct, he will not still change it.

*171\308\8*

Strokes and blood clots

Opposed HRT (where both oestrogen and progestogen are used) has a similar effect on the circulatory system and our veins and arteries as does the Pill. It can lead to risks connected with raised blood pressure, migraine, strokes and thrombosis. You must ask yourself: is taking HRT worth the risk?

Heart disease

Second to osteoporosis, heart disease is the reason given to many women for starting HRT because it supposedly decreases the risk of heart disease. In fact the Framingham Study (the best-known long-term study of 670 women on HRT in Framingham, Massachusetts), which reported its findings in the New England Journal of Medicine in 1985, showed that the risk of heart disease actually increased on taking the hormones.”‘ As HRT contains the same combination of hormones as the Pill (with differences in dose and structure), the British Medical Journal m December 1992 stated, ‘Many doctors have been surprised to discover that a hormonal treatment they had learned to avoid in women at risk of cardiovascular disease is now being specifically advised in this situation.’ Yet HRT is currently touted as a preventative measure.

Osteoporosis

One of the other main reasons women take HRT is that they are told that it will protect their bones. Such is the fear of osteoporosis that women have been persuaded that HRT is a prime preventative measure. It is quite extraordinary that women are prepared to take powerful hormones to try to prevent something that may never happen anyway – or that can be avoided in most cases by perfectly benign means such as diet and exercise. It’s even more extraordinary when you consider the full meaning of the research into the impact of HRT on bone health. The Framingham Study showed that only women who had taken oestrogen for at least seven years had significantly higher bone mineral density than women who had not had oestrogen.” Even those who had been on oestrogen therapy for ten years were not protected from fractures. Their bone mineral density declined rapidly as soon as they stopped taking oestrogen. By the time they were seventy-five to eighty years of age – the age at which most fractures happen – their bone mass was only marginally higher than the women of comparable age who had never had oestrogen at all. They had only a trivial advantage.

The conclusion is that for HRT to be effective against osteoporosis, women who start taking it at the menopause must take it for decades. In fact they must take it for the rest of their lives if it is osteoporosis they are worried about. Or perhaps not think about taking it until much later – nearer the time that fractures happen. This is perhaps one sensible option worth exploring -but one which would blow a big hole in the billion-pound market for HRT products which needs to get women on to HRT as soon as possible. Even worse, the Framingham study was based on women taking oestrogen alone, rather than the oestrogen-progestogen combination that is now the most widely used form of HRT. The truth is that we really have no idea whether women taking the combined HRT will get any bone benefits at all. Yet every frightening leaflet you pick up about osteoporosis proclaims the efficacy of HRT while the reality is that very little of any practical relevance has actually been proven. As Dr Bruce Ettinger, an osteoporosis expert, says, ‘It definitely works, but you’re talking about taking hormones for ten years – maybe twenty to thirty years – to prevent a largely asymptomatic, self-limited disease. And what are you offering – the risk of endometrial cancer? Lifelong periods? Endometrial biopsies?’ HRT is certainly not a ‘cure’ for osteoporosis.

*15/101/5*

Some doctors say that people with diabetes should drink no alcohol. Others permit a drink or two. But drinking has some special pitfalls for someone with diabetes. First of all, alcohol has calories, and they count in the diet. In addition, alcohol lowers blood sugar at first. Alcohol also impairs a person’s judgment. Dr. Raymond Herskowitz at the Joslin Diabetes Center in Boston points out that teens are more likely to have a serious insulin reaction when they’ve been drinking. A person who is “high” may not be alert to the warning signs, and other people might mistake the effects of low blood sugar for drunken behavior.

Marijuana, like alcohol, can dull your judgment and make you forget about eating a meal or taking an insulin injection. Or it may make you so hungry that you forget to stick to your diet.

Cigarettes have been linked with so many damaging effects on the heart, lungs, and other body systems that smoking is not a very good idea for anyone. It is an even worse idea for people with diabetes, who are already at risk for heart disease.

*43\268\2*

A sudden weight gain for any reason can cause stretch marks, those first reddish and then pearly white lines that just never seem to go away. Well, the truth is that the best way to get rid of them is to nip them in the bud – obviously, easier said than done.

If you are pregnant, a daily application of vitamin E oil really elasticizes that stretching skin, as cocoa butter does. (Gaining weight slowly is the best preventive.) Taking 200-400 IU vitamin E daily, along with 1,000 mg. vitamin С (which is necessary for the formation of collagen) also helps.

But if we’re talking after the fact, how about trying one of the all-time great stretch un-markers that was suggested to me by M.J. Saffon in the book Body Lifts.

Bring to a boil in an enamel, glass, or stainless-steel pot (not aluminum):

One 4-oz. bar cocoa butter   2 tbsp. apple-cider vinegar

6 tbsp. dried sage                     1 qt. water

Cover and simmer for 15 minutes and then let cool to room temperature.

When cool soak any natural fibre fabric – muslin, cotton, cheesecloth – in the mixture, and then wrap around your body for 20 minutes.

My addition: Rinse in warm shower. Then apply 28,000 IU vitamin E topically and leave on overnight. Keep up your supplemental intake of vitamin E and С and watch those stretch marks fade!

*12/137/5*

“There’s another child I want to tell you about. Remember Jeb ? He was only six. He had the mildest of seizures, just a few absence seizures, and he was adorable. But what an anxious family. Mom, a former nurse, read everything available and learned of allergic reactions to medication the doctors had never seen before. Jeb was having some stomach problems and had become a monster at home. His mother thought he was not doing well in school. He had taken to fighting at school and misbehaving at home. Jeb was very verbal, bright, and with lots of questions. Both the doctors and I took him aside and explained his epilepsy. We asked him to write down his questions and asked his sister, who was a year younger, to have her mother list hers. We promised to discuss them at the next visit. Jeb knew the family was very upset, but he didn’t know why. He felt different and asked, ‘What’s wrong with me?’ His mom was extremely knowledgeable, but even though she was a former nurse, she was really just a mom. She couldn’t step back, and so she became very nervous. She called me every day for several weeks. That’s another way to do counseling, just to provide reassurance by phone.

“Jeb also was given permission to call me. He didn’t always need to have his mom interpreting things for him. He could tell me, ‘I don’t like this,’ ‘I’m sick of that.’ ‘Do you want to know how I did in school today?’

“What he did was to take ownership of his condition, his medication, and of his young life. That’s pretty remarkable for a six-year-old and also remarkable for a parent to permit it and still provide appropriate supervision.

“His sister, who also played an important role, had her own questions. Her first question was ‘Will I catch this?’ That is a typical question I hear from brothers and sisters. Her second question was, ‘Why did this happen to Jeb ?’ Only after she knew that she was safe could her concern for her brother come out. There were other questions, ‘Do more boys than girls get epilepsy?’ The questions themselves were less important than the fact that both children had the right to ask them. Each child was important, and both were an important part of Jeb’s getting well.

*229\208\8*

Because moisturizers make the skin less dry, they are suitable for people with dry or normal skin but not for those with oily skin or acne. It is not necessary to spend a fortune on moisturizing creams. Although cosmetic companies generally test their moisturizers very thoroughly, it is as well to remember that you are subsidizing their advertising, marketing and packaging. Cheaper moisturizers often have similar ingredients and the same effect. It is a good idea to compare ingredients, which must now be listed on all products.

Younger people should keep away from heavy, super-rich moisturizers as they will produce pimples. Light, vanishing-type moisturizers are fine but it is better to use a light moisturizer underneath a sunscreen on a daily basis as this will help prevent photoageing. Cosmetic moisturizers alone generally provide little protection from ultraviolet light.

For the more mature person, a moisturizer may be necessary because the skin gets drier with age. Heavier moisturizing creams should be kept to a minimum, however, as you would with heavy hair conditioners. It is quite common to see people over fifty with a multitude of whiteheads and blocked pores around their eyes from using heavy moisturizers.

If you want to spend a lot of money on moisturizing creams there is no real harm in doing so. You must realize, however, that they are really no better than cheaper products. Examples of good, inexpensive day moisture creams include Neutrogena moisturizer and Simple moisturizer. Good, heavier creams include Candermyl and Nutra-D. Recently, Choice magazine stated that sorbolene cream is the best facial moisturizer. This is not true. Sorbolene cream is rather occlusive for the face and tends to produce acne and blemishes. It is more suitable for the body.

*77/150/5*