Weight loss and diet plan for a healthy lifestyle.

•    The way that your labour is handled greatly depends on the obstetrician at your local hospital. There is no evidence that hospital is a safer place to have a baby (unless you are at high risk for some reason)-a home birth can be just as safe or even safer. Make a birth plan and discuss it with your obstetrician early on in pregnancy. If you want to avoid having an episiotomy, an epidural, and so on, say so and put it all in writing to the hospital. Surgical and other interventions can save babies’ lives but can produce problems too. The best way of ensuring that you have as trouble-free a birth as possible is to go to ante-natal classes to learn about birth and to prepare you for what is to come.

During the labour keep upright and walking around as long as possible and then give birth standing, squatting, kneeling or indeed in any position that keeps your body upright. This provably helps improve the blood supply to the baby, and makes labour shorter and less painful. Most women who give birth in this position are very loath or even refuse to deliver on their backs in subsequent labours. Because labour is quicker the baby is less likely to suffer from a shortage of oxygen. All of these factors contribute to a greater chance of having a normal, healthy baby.

Asphyxia (a shortage of oxygen) is the commonest cause of preventable death or handicap occurring at the time of delivery, but much of the danger can be avoided by giving birth in an upright position and by having trained staff with oxygen available in case a baby is born with asphyxia. Permanent brain damage can occur after a remarkably short period of time with an insufficient supply of oxygen to the brain.

•    After low birth weight, congenital malformations are the next most common cause of infant death. In the UK 18 per cent of first-week deaths and 20 per cent of perinatal deaths are caused by congenital malformations. Some of these can be prevented by taking proper care before conception and during pregnancy.

•    Treating neonatal jaundice is a way of preventing cerebral palsy (a diffuse group of neurological conditions that produce a ‘spastic’). There are six spastic babies born every day in the UK-over 2,000 a year. In some cases the recognition of a failing placenta, followed by appropriate action, is another way of preventing this heartrending handicap: babies who are suffering from poor placental blood supply can be delivered with the minimum of trauma and have their asphyxia (if any) treated so as to be born healthy and normal. The prevention of premature babies and their care in intensive nursing facilities can dramatically reduce the numbers of spastic babies born from this cause.

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Reproductive and sexual behaviour

These both influence the incidence of certain cancers, and change with westernization. Early first childbirth and having large numbers of children both reduce the incidence of breast cancer. In the West we delay the birth of the first child and women have few children. Both of these things have produced substantially higher levels of breast cancer in the West. Cancer of the ovary is also seen more in populations with reduced fertility. Cancer of the cervix, in contrast, increases in incidence with greater fertility. This relationship may be related to the proven link between early promiscuous sexual activity and cervical cancer. No one knows why this should be but the current theories are that smegma (the white matter that can collect under an uncircumcised man’s foreskin) or even semen itself might be carcinogenic. A more recent suggestion is that cancer of the cervix is caused by a venereally transmitted virus such as herpes. Genital hygiene and the use of a condom (sheath) reduce these risks.

Occupational exposure to chemicals

This is an unfortunate side-effect of moving off the land and into factories. It has led to increasing numbers, of men especially, being exposed to carcinogenic chemicals, for much of their working lives in certain industries. It has definitely caused an increase in tumours of the bladder and the skin. A particular type of lung tumour is seen commonly in those who work with asbestos dust. No one knows how great a problem industrial exposure to carcinogens is and today many known hazards have been reduced or totally removed, but westernized peoples are still exposed to food additives, washing-up liquid residues, air pollutants, water pollution from industry and agriculture and frank chemical hazards at work in varying amounts. The harm done by some of these agents is well known and provable, yet we continue to bombard ourselves, often quite unnecessarily, with chemicals of a dubious nature.

Improved hygiene

Better sanitary conditions are a reason for falling levels of certain sorts of cancer as populations become westernized. Cancer of the liver is the best example here. There is increasing evidence that hepatitis  is an important factor in the production of liver cancer and this infection falls with improved personal and community hygiene. Greater personal hygiene in the West has also led to a reduced number of cancers of the penis.

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When it comes to how men regard the effects that aging has on their sexuality, I’ve seen three distinct groups of opinions: in one, a man believes the popular myth that his sexuality peaked years ago, when he was 18, so since then life’s been all downhill. A man in the second group tends to deny that aging has any effect at all, even though his physiological signs tell him otherwise.

And then there’s the group in between: At first, a man may rebel a little at the changes in his sexuality—which may be anything from needing more time to become fully erect to wanting to have sex less often—but he eventually accepts the changes and may even learn to use them as a way to make sexuality more exciting and challenging.

From the time a man is in his teens all the way to his 80s and 90s, his reproductive system ages slowly from one year to the next. For most men, sexuality continues to be a very important aspect of life throughout their lives. Sexual desire continues indefinitely, despite the popular image of an uninterested, grumpy old man. One problem an 80- or 90-year-old man may have is that he is ashamed of his sexuality, because he—along with a lot of other people of all ages—has bought into the myth that older people are not and should not be sexual. This myth about sexuality is particularly a problem if he is living in a nursing home or at home with his children, because if the people around him believe the myth, chances are he will, too.

Throughout life, illness and medication can have a significant impact on your sexuality; even acetaminophen and allergies can dampen a man’s sexual desire. Though men do not experience a formal cessation of their reproductive ability such as women do when they enter menopause, the production both of sperm and testosterone decreases as a man ages. However, this usually has no bearing on his ability to father children; even 90-year-old men have become fathers.

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The main course of treatment for hemorrhoids is getting off your butt—both literally and figuratively. You should start exercising, and don’t sit for more than an hour at a time if you can help it. You should also eat a diet that is high in digestible fiber such as cereals and bran but low in nondigestible fiber such as nuts and popcorn. You can also use a stool softener such as Colace two or three times a day, especially if the stool is hard, and use premoistened Tucks pads after a bowel movement to help soothe the area. Preparation H or Anusol in cream form or suppositoties will help shrink the hemorrhoids. Your doctor may also give you a prescription for a suppository containing cortisone, which will help reduce the swelling.

If your hemorrhoids tend to recur, your doctor may want to remove them surgically with a laser or by rubber banding them, a procedure in which a band is placed around the hemorrhoid, cutting off its blood supply so that it falls off. Or he may opt for traditional surgery.

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Even if you normally don’t dwell on the general state of your health, coughing up blood or phlegm mixed with blood is bound to get your attention and your doctor’s as well.

It should. Whether you cough up blood or phlegm mixed with blood that is bright red, brownish red, or pink and bubbly, you must see your physician. It’s usually the sign of a serious underlying disease. Anytime you cough up blood that is bright red in color, the cause can be a problem with your blood’s ability to clot, a tumor in your lung, an aneurysm of the thoracic aorta, a low blood platelet count, or a burst blood vessel. When it’s a frothy pink substance that’s accompanied by wheezing and shortness of breath, it’s a sign of heart failure. Another possible cause of coughing up blood is lung cancer or tuberculosis, especially if your cough has persisted for months and it hasn’t been treated. However, when the blood is brownish and resembles coffee grounds, it’s coming from the digestive tract and is a sign of a bleeding ulcer.

In addition to coughing up blood or phlegm mixed with blood, you may also have a fever, overall body aches, and a general feeling of malaise, all of which are signs of pneumonia.

It is also important to be aware of the amount coughed up. A small amount—a teaspoonful or less—can indicate that a small vessel in the trachea or upper airway has burst, which is a relatively minor occurrence. In fact, if you’ve had a cold or flu recently, it’s highly likely that you have burst a blood vessel by frequent coughing. An amount larger than a teaspoonful can signify a serious medical condition requiring immediate medical attention.

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The first thing you must know about skin rashes is that they cannot be diagnosed over the telephone; they need to be examined by a physician.

I’ve found that the way a patient describes the rash is almost never the way it appears, at least to my diagnostic eyes.

The causes of rashes run the gamut from a reaction to a new medication that you’ve just begun to take, such as penicillin, to a low blood platelet count (if a rash is bleeding). The latter is a condition that looks like a red rash or skin irritation when it first appears but can quickly start to ooze or bleed. The cause may be a viral or bacterial infection that causes a skin infection called cellulitis, or it may be recent exposure to a toxic chemical you’ve never handled before. And people who are highly emotional sometimes break out in rashes periodically. All of these conditions require medical attention, which is why it’s so important to see your doctor for proper treatment when you first notice the rash.

First, however, ask yourself the following questions, since your answers will help your physician to determine the diagnosis and the proper treatment for your rash:

1. Have I recently been exposed to a chemical or a new medication?

2. Does the rash itch?

3. Is the rash flat, diffused, or pinpointed, confined to a certain area?

4. Where did the rash first appear?

5. Is it localized, or does the rash appear all over my body?

6. Do I have a fever and/or chills?

7. Have I recently been exposed to a person who has a rash?

8. Has my skin recently been broken due to a trauma or a bite?

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Cavities form when the bacteria that ate naturally found in the mouth combine with the sugars in food to form plaque, a sticky substance that can eat away at tooth enamel and the exposed tooth roots of adults who have gum disease. Midlife adults who have even a minor case of gingivitis ate especially prone to cavities on the tooth root because there’s no enamel on the exposed surface. And when a cavity forms on the root, it can hasten an advanced case of gum disease. Saliva does help to wash away excess bacteria. But since saliva production decreases with age, you’ll need to pay close attention to your dental hygiene.

Your dentist will treat a cavity by first removing the decay and then placing a filling in the tooth. Fillings are made of gold, a porcelain cement that blends in with your natural tooth color, or silver amalgam, which is a combination of silver, mercury, and copper.

If the decay is extensive and threatens the tooth, your dentist may suggest a root canal, which removes the deep decay and the tooth nerves but allows the tooth to remain.

Your dentist will also map out a detailed home care plan designed to prevent future cavities.

Tips and Precautions

The many different brands of fluoride treatment on the market today can go a long way toward protecting your teeth from decay. Your dentist or hygienist may prescribe a special gel or paste for you. You may find that some are painful to your sensitive teeth, so it’s a good idea to experiment until you find the kind that works best for you.

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Remember your Uncle Charlie and the problems he used to have reading the newspaper? It seemed as though he had trouble focusing, so he first tried his bifocals. When that didn’t work, he held the paper out at arms length. Then, with his arms fully outstretched, he was finally able to settle into his reading.

But you couldn’t understand why he ended up that way. “Bring it closer, Uncle Charlie, not farther away,” you informed him with the naivete of youth. Or you may have handed him your father’s glasses to try. But while you may have been nearsighted as a child, presbyopia, a form of farsightedness, which is what Uncle Charlie had, is much more common among midlife adults. In fact, as you age, and if you wear glasses or contacts, you may find that your prescription has gone from one extreme to another, from nearsightedness to farsightedness.

Presbyopia is only one characteristic of the aging eye. If you know a man or woman over the age of 50 who has never worn glasses or contact lenses, you should consider yourself to be in rare company. Besides the possibility of having presbyopia as you grow older, you may find that you need to rely on your reading glasses more, whereas before you only needed them for reading or night driving. You may also find that it takes longer for your eyes to adjust to the dark, and even once you’ve become used to the poor light you may not be able to make out certain objects as clearly as you once did. Your eyes may not water as easily as when you were younger, something that is especially true for post-menopausal women.

There’s not much you can do to prevent the effects that each additional year has on your sense of vision. Some ophthalmologists believe that if you work at a computer or a craft where you frequently need to focus on objects up close, your vision will deteriorate less rapidly if you wear regular eyeglasses instead of contact lenses. And remember what your mother told you about reading under poor light? It’s true that the less you strain your eyes, the longer you’ll keep your eyesight intact.

The chances of getting certain ophthalmologic diseases—such as glaucoma, cataracts, and retinal detachment—increase with age, but the good news is that after about the age of 50, your eyesight will stabilize and may even improve significantly. Overall, if you try to stay aware of any changes in vision you experience and visit your eye doctor at the early signs of change, you’ll improve your chances of having healthy eyes well into your 70s, 80s, and beyond.

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If your insomnia is due to a temporary stress in your life, your sleep habits will return to normal once it ends. In the meantime, try to take catnaps during the day whenever you feel tired. The traditional advice for insomnia—warm milk before going to bed and using your bed only for sleeping—may work for you. It may help if you stay busy during the day and eliminate eating late at night and drinking caffeinated beverages past midafternoon. Staying up later until you’re really tired sometimes helps. And if you’re getting up in the middle of the night to urinate and find that it’s hard to fall back asleep, don’t drink liquids after 8 P.M. If your insomnia lasts longer than a week, however, and these suggestions haven’t worked, you should see your doctor. When I complete the examination and conclude that a patient’s inability to sleep is due to stress, he or she often asks me for a prescription to induce sleep. I try to discourage them, since most sleeping medications are extremely habit forming, and the effects usually only last for a few days before they begin to lose their effectiveness. Certain sleep-inducing medications may also cause short-term memory loss.

Medications to help you sleep should be used for only a short period of time to help you get over a temporary period of stress and worry.

The effects of over-the-counter sleeping medications are of a very limited duration. These preparations typically consist of a natural sedative called tryptophan, which is the same substance that makes us feel sleepy after a turkey dinner. Use them only once in a great while, if you must.

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Description and Possible Medical Problems

The movie Vertigo is everyone’s nightmare of a world that won’t stop spinning no matter what you do. If you feel dizzy and faint whenever you stand up from a lying or sitting position, it’s likely that the cause is a temporary one and easy to fix. Most often, a high emotional state, certain medications that lower your blood pressure—most often cardiac and psychiatric drugs—and even prolonged bed rest can make you feel dizzy and faint. Sometimes, even quickly changing positions can bring on this feeling of vertigo.

In rare cases, however, dizziness and a faint feeling can occur in a person who has a bleeding ulcer or severe anemia, which lowers the blood pressure. Any change in blood pressure that results from these illnesses is called orthostatic hypotension.

Treatment

If you think your dizziness is caused by changing positions quickly, try moving around less abruptly to see if that’s all that is necessary. And if you’ve recently been upset or have spent a lot of time lying down and resting, the dizziness should disappear when you return to your previous state. If you’ve recently changed or added a new medication, see your doctor about switching to a medication without these side effects.

If these suggestions don’t help, you should see your doctor, who will do a complete medical history and physical and take your blood pressure when you’re both standing and lying down to check for any significant change. If you have anemia or a bleeding ulcer, your doctor will prescribe a regimen to treat these conditions, which will include medication, diet, and exercise.

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