The very best way to keep total blood cholesterol and LDL cholesterol levels down is by directly curtailing your intake of saturated fats and dietary cholesterol while simultaneously increasing your intake of minimally processed carbohydrates that are rich in soluble fiber, which, as we’ll learn soon, also help to suppress cholesterol absorption and/or synthesis.Taking cholesterol-lowering drugs while you’re on the standard American diet is definitely not the safest solution! Besides risking adverse side effects, relying on medications will do nothing to change the poor food choices that led to high serum cholesterol in the first place. What’s worse, sticking to a diet that raises your cholesterol level (in the mistaken belief that you can undo all the cholesterol damage with medication) also increases your risk for the development of obesity, hypertension, adult-onset diabetes, and certain types of cancer. And the drugs will do nothing to alter your risk factors for these diseases!Moreover, research tells us that even when dietary cholesterol does not increase serum cholesterol there’s a possibility that it may promote atherosclerosis. Exactly how dietary cholesterol can be atherogenic independent of its effect on serum cholesterol levels is still a matter of debate, but four recent studies all showed a much greater increase in cardiovascular-disease deaths in people who consumed a high level of dietary cholesterol.*12/345/5*
The most striking aspect of adolescence is the rapid physical growth. These changes are mediated by the sex hormones. The rough charts above indicate that the first recognizable change in the male is due to fat increase dictated by a small but gradual increase in estrogen. Every boy gains weight at the expense of height during these years. Some boys due to become tall and muscular men are actually chubby and effeminate-looking during these early adolescent years. To add insult to injury, the next body part to grow is the feet, then thighs, which make him appear short waisted and gawky. This slows, allowing the rest of the body to catch up. Androgen influence may not come for a few years, with often unrecognizable pigment changes in the scrotal sac, then enlargement of the penis, testes, the beginning of pubic hair, and early voice changes. The first nocturnal emission or “wet dream” may occur as early as age 10 or as late as age 15. Even so, the majority of boys remain “relatively sterile” till age 15. The major male growth spurt appears at age 14 1/2 and is due to growth in the backbone. This averages 4 to 4 1/2 inches over an 18-month period. Some boys will shoot up 8 to 10 more inches during this time. Axillary and facial hair soon follow. Facial hair may develop entirely in 1 year. Other boys, equally normal but with different genes, may not complete the facial and body-hair growth till the mid to late 20s.We are indeed taller than our ancestors, which can be shown from historical evidence. Clothing, doorways, and furniture were made for shorter men and women. Better nutrition is mainly responsible for the changes seen.A girl’s first hormonal response is around age 7 or 8 with a normal vaginal discharge called leucorrhea. The feet then grow, but this is rarely as noticeable a change as in the male. A breast “button” begins about age 11 under the skin of one breast first, to be followed in weeks or months under the remaining breast. The breasts develop into adult breasts over a span of 4 to 5 years. Pubic hair begins approximately 6 months after the breast button stage. The hips widen, and the backbone gains 3 to 4 inches before she is ready for her menses. Although a critical body weight is not the only initiator, the body is influenced by this. If other criteria are met, such as developing breasts, pubic hair, widened hips, and growth spurt, a sample of American girls will begin their menses weighing from 100 to 105 pounds. Nutrition has a great deal to do with the menarche (first menses); girls in countries with poor nutritional standards begin their menses 2 to 3 years later. The mean age for menarche in America is 12. (Pilgrim girls, who suffered from many nutritional deprivations, often had menarche delayed until age 17.) A regular menstrual cycle is not established immediately. Quite commonly a girl will have anovulatory (no egg) periods for 6 to 18 months before having ovulatory periods. This change may bring an increased weight gain, breast tenderness, occasional emotional lability, and cramps at the midcycle. These are consequences of progesterone, a hormone now secreted by the ovary at the time of ovulation. An adult pattern in ovulation will not be completed till the early 20s.Until puberty, boys and girls are equally strong in muscle strength (if corrected for height and weight). Total body fat increases in girls by 50% from ages 12 to 18, whereas a similar decrease of 50% occurs in boys. Muscle cell size and number increase in boys; muscle cell size alone increases in girls. Internal organs, such as the heart, double in size. Blood pressure increases with demands of growth. Pulse rate decreases, and the ability to break down fatigue metabolites in muscle prepares the male, especially, for the role of hunter and runner that was so important for survival centuries ago.Marked fatigue coupled with overwhelming strength is often difficult to fully appreciate. An adolescent may wolf down several quarts of milk, a full meal or two, play many hours of active sports, and yet complain bitterly of severe fatigue at all times! This human metabolic furnace needs the food and rest as well as the drive to have the machine function and test itself out. These bodily inconsistencies often show in mood swings and unpredictable demands for self-satisfaction and physical expression.The rapidity of these changes tends to produce almost a physiological confusion in many adolescents. Quite commonly, they become preoccupied with themselves. This can lead to an overconcern with their health. In some instances it is almost hypochondriacal. Adolescents may complain of things that to an adult appear very minor. The thing to remember is that their concern is very real and deep. Attention should be paid to their concerns. Remembering the rapid rate of physical changes that confront adolescents makes their preoccupation with their bodies understandable.*143\331\2*
It is more usual for children to have common migraine than classical attacks with visual symptoms; these become more frequent in the teenage group. Children suffer from conditions called migraine equivalents which often take the form of periodic (cyclical) vomiting not due to any obvious cause such as over-indulgence of food. These ‘bilious attacks’ can occur once monthly but last no more than a day.Recurrent abdominal pain with, or without, vomiting is another warning that the child may develop migrainous headaches on growing up. Children who are more prone to travel sickness than others are a further group with a tendency to develop migraine in later life.In all these cases, a clue as to the true nature of the condition will often be found in the family because there is very likely to be a close relative with migrainous headaches.Although more women than men suffer from migraine, in children, boys are just as likely to have symptoms as girls.
HONEY SUCKLE REMEDY: Always thinking of the past, talks of the past events—lives in the past. Cannot break contact with the past events. Regrets and remorse for the past events. Does not live in the present, and makes no effort to solve the present difficulties. When a difficult situation arises, he escapes to the past, as if the present does not belong to him. Cannot get over the loss of a person one loved (parent, child, spouse, friend).
HORN BEAM REMEDY: Mental weariness. Feels tired and exhausted even before he has started the work. Awakes in the morning but feels too weak to leave the bed. Visulises the work to be done, and without touching the work feels weak and exhausted. Once he starts doing the work, he accomplishes it without difficulty. But this mental lethargy is the cause of his feeling of weakness. Feels more tired in the morning after night’s rest than in the evening after day’s labour.
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A thorough examination by a skilled and experienced physician is a critical first step in diagnosing knee problems. In fact, if properly done, the physical examination can result in a diagnosis of anywhere between 80 and 90 percent accuracy. If necessary, further testing can achieve an accuracy rate of nearly 100 percent. This chapter will not only review state of the art diagnostic techniques, but will show patients how they can work with their physicians to help achieve an accurate diagnosis.
Before the physician begins the physical examination, he or she will take a thorough medical history of the patient. Therefore, you should be prepared to provide your physician with relevant information that could help determine your diagnosis.
Family Medical History
Some orthopedic problems may be hereditary. Be sure to tell your physician about any significant family illnesses that might shed some light on your problem. These include a primary relative (e.g., sibling, parent, or grandparent) with a condition such as arthritis or gout or a relative with a congenital abnormality such as a dislocated kneecap. Obviously, your physician need not know about nonhereditary orthopedic problems.
The body is always striving for balance; therefore it is not surprising that stress can also result in an underproduction of hydrochloric acid. It is very confusing because the symptoms can be similar to overproduction of acid and people often compound these symptoms by taking antacids.
Symptoms include excessive burping, a feeling of fullness after even a moderate meal, bad breath (which comes from food fermenting in the stomach). If the symptoms are severe, nausea, vomiting, bloating, wind and diarrhoea or constipation can result.
The presence of undigested food in the stool often indicates that food is not being digested in the stomach. Proteins (meat, fish, eggs, dairy produce, pulses) are the most difficult to digest. Large undigested protein molecules in the intestines can damage the lining and lead to food intolerances, allergies, overgrowth of ‘bad’ organisms and inflammation.
The production of hydrochloric acid declines with age, and even if a good diet is taken if it reaches the bowel in a half-digested state, then vital minerals and vitamins may not be absorbed. Eating when you are tired, bolting food or over-eating all make hard work for the stomach, and in the case of the latter a small amount of acid has to go a long way.
The name “diabetes mellitus” describes two striking symptoms of the disease. People with uncontrolled diabetes usually have a constant, urgent thirst. Though they drink huge quantities of liquids, the fluid seems to run right through them, for they also have a continual need to urinate. Indeed, it often seems that more fluid comes out than went in. So the first part of the name, meaning a siphon or drain, seems quite appropriate.
The urine of a person with diabetes contains sugar, which is the reason for the “mellitus” part, from the Latin word for honey. Most people today just talk about “diabetes,” but physicians prefer to use its more precise, full name, diabetes mellitus. In this way they avoid confusion with another much rarer disease called diabetes insipidus, in which great quantities of urine are also produced, but it does not contain sugar.
There are actually two main types of diabetes mellitus. Type I diabetes used to be called “juvenile diabetes,” because it most often (but not always) occurs in children, teenagers, and young adults. This form is also called insulin-dependent diabetes mellitus (IDDM), because the bodies of people with this condition produce little or no insulin, and they must receive insulin injections every day in order to live. Type II diabetes or non-insulin-dependent diabetes (NIDDM) usually strikes people after the age of thirty-five or forty. These people’s bodies do produce insulin, but their body cells cannot use it properly. This kind of diabetes can generally be controlled with diet and exercise, or with drugs that lower the amount of sugar in the blood.
Cancer can develop in any organ of the body. The most important characteristic of many cancers is the development of a new growth, a nodule or a tumour in the tissues of their origin. The other features of cancer are that the original tumour or growth has a remarkable tendency to form colonies at some distant parts of the body. This tendency of forming tumours elsewhere in the body makes the disease extremely difficult for satisfactory treatment.
There are two types of tumours known as Benign and Malignant. Only malignant tumours are termed as cancers. They do not have capsules or limiting membrane. They therefore, invade and destroy the tissues in which they occur.
They reproduce their cells in a disorderly and uncontrolled way. The cells are of a more primitive type than the originating tissue. The rate of growth is unusually rapid. They are capable of producing secondary growths in parts of the body remote from the original tumour.
Benign tumours are opposite to malignant growth. They have capsules of fibrous tissues and do not invade normal tissue. They reproduce themselves in orderly ways. The cells resemble the tissue in which they originate. The rate of growth of benign tumour is slow and they stop spontaneously. They do not spread, except by direct extension. They are not fatal, except perhaps in the skull. They only produce ill-effects by occupying space and pressing on adjacent normal tissue.
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Yes, they do. The presentation of ADHD in a six-year-old is much different than in an adolescent or adult. The symptoms are very similar, but their manifestation changes with age.
An adolescent with ADHD will present the syndrome in a much different way. He may do very poorly in school despite obvious intelligence, have a tendency to “zone out” during class or while his parents are talking to him, be moody or irritable and exhibit serious behavior problems that result in few friends. Again, a great many teenagers are moody, irritable, and difficult to be around—but not all the time. Nor do most normal adolescents present such a neat package of telltale symptoms.
ADHD is a bit trickier to see in an adult, though the symptoms are similar. He may have trouble focusing on and finishing projects at work, experience difficulty relating to bosses and co-workers, be irritable and moody at home, and have problems with interpersonal relationships because of his temper and inability to focus.
“Lisa has been having headaches for a year or more, Doctor, but these past few months they’ve become more frequent. Now she has one several times a week, and she is missing a lot of school. She says that they are all over her head, but mainly start behind her eyes. She has to come home from school and feels sick to her stomach. She usually goes to bed and wants the lights off because they bother her eyes. Sometimes she will throw up, and then she feels better. She sleeps for a few hours and then is fine. She hasn’t had any seizures for almost two years now, but the headache is like the ones she sometimes had after her big seizures. Do you think she could have migraine? I used to have migraine attacks when I was young.”
Migraine headaches are not uncommon in children but often do not resemble adult migraine. They rarely are unilateral or associated with warnings (auras) such as flashing lights or unilateral sensory symptoms. Migraine headaches in children may build up as pounding headaches, with nausea, and sometimes with vomiting. The child usually tries to avoid light, goes to his room, lies down, and goes to sleep. Such headaches typically last for hours. In children these headaches are often bilateral. This kind of an attack is not like a seizure, but the episode is sometimes confused with a seizure when the headache component is less severe or when nausea and vomiting are less prominent.
Migraine commonly occurs in families, hence there appears to be a genetic predisposition. Longer duration of the episode and nausea suggest migraine. The presence of other seizures may indicate, however, that the headaches are related to a seizure. Both the headache of the migraine attack and the headache after a seizure can be similar since both are caused by dilation of blood vessels in the brain.
The EEG may be abnormal both in persons with migraine and in those with seizures; therefore, the EEG is an unreliable procedure for deciding which kind of episode has occurred. In some instances, it may not be possible at all to differentiate between migraine headaches and headaches related to seizures (epileptic cephalgia). Indeed, as noted, migraine and seizures may coexist. Migraine is more common in those individuals and families with a history of seizures, and seizures are more common in those with a history of migraine. If the doctor thinks these events are more likely to be seizures, he may suggest a trial of anticonvulsant medication; a good response to these drugs suggests that the events were, indeed, seizures. If the doctor thinks these are more likely migraine attacks, he will prescribe antimigraine drugs. Again, a good response to this medication will suggest that he was right. Migraine has been known to respond to some anticonvulsants, but it is doubtful that seizures will respond to some medications now used to treat migraine.