Have you noticed that, even without looking at a watch, we usually wake up at about the same time every morning and feel sleepy and go to bed nearly the same time each night? We do not need to know the time to do all these things. Somehow our body knows the time, as if we have a clock inside. This internal clock is called the biological clock.

Jet lag is a similar example. The traveller who flies from one side of a continent to another is unable to reset his biological clock immediately. The clock is still running at the same time back home; hence there is a feeling of disharmony. Sleeping and eating at a new time disrupt the jet traveller’s old pattern. It may take a few days to get used to the new time. There is one way to reduce the effect of jet lag and that is to reset your biological clock closer to the local time of your destination a few days before travelling. For people travelling westward, you should stay up later and later each night for a few nights before departure. For people travelling eastward, you should go to bed earlier and earlier each night instead. By doing so you may reduce the gap between your biological clock and the new local time of your destination.

Jet lag can become a problem for someone who has to make frequent trips overseas, especially if he has to make important decisions immediately on arrival. The inadequacy of performance after travelling across different time zones has led the military and many large corporations to forbid high level decision-making after a long flight until after a proper resting time. The ‘rest formula’ now used by the International Civil Aviation Organization, developed by Dr L. E. Buley, takes into account the hours of the day the traveller departed and arrived, the number of time zones flown through, and the number of hours travelled:

Rest time (days) – [ 7/2 + (Z - 4) +Cd + Ca ]/10

T is the travel times in hours, Z is the number of time zones, Cd and Ca are coefficients of departure and arrival which introduce gains and losses of time.

If one flies from Melbourne to London, departing Melbourne at 1300 hours (Eastern Standard Time) and arriving London at 0555 (Greenwich Mean Time), the rest period is calculated as follows:

Rest time =[26/2 + (10-4) + 1 + 3]/10 = 2.3 days.

An overseas trip is one of the very few instances in which sleeping pills are to be recommended. A drug that is short acting is preferred so as not to cause drowsiness on arrival.

*46\174\4*

Do not be alarmed at the thought of regression. Remember that it is a completely normal phenomenon which all normal people experience in moments of reverie. In fact, it would seem that periods of reverie, like sleep, are necessary for the normal healthy functioning of our mind. In moments of reverie we are no longer concerned with our immediate surroundings, and our mind is left to wander from topic to topic. These moments are extremely relaxing, and the relaxation of the mind remains with us for some time after we have abandoned our reverie, and have returned to our normal way of alert thinking. It seems that in reverie,, just as in sleep, there is an integration of nervous impulses so that we lose some of our tension and anxiety, and as a result feel calmer and more relaxed. In this respect it is interesting to note that the person who suffers from severe tension and anxiety no longer has this normal tendency to moments of reverie. He is alert and on the lookout all the time. He cannot relax and let himself go off guard into a state of reverie. As a result he is without this normal mechanism which helps to save us from anxiety, so his tension is still further increased. The exercises with their consciously induced regression help to make up for the loss of spontaneous reverie, and so work to relieve tension and anxiety.

The common difficulty in allowing ourselves to regress concerns the letting go which is such an important part of it. There is a biological reason for this. Over countless generations we have been conditioned to be on guard. Those that were not on guard fell by the wayside and did not survive. True, we have some reverie, but reverie is characteristically a momentary affair. Now, to regress we have to let go and let ourselves be off guard. But now we can do it because we are safe. We know that we are safe and that nothing will befall us.

We are really rather afraid to let go. This applies to all of us, but especially to those who are tense and anxious. When we suffer from tension we are all the time holding ourselves in, as it were. We keep a hold on ourselves. We keep ourselves in check. We feel that if we did not do this our tension would somehow get out of control, and anything might happen. The difficulty is that the anxious person is continually holding himself in, while in the exercises he is asked to let himself go.

There are two things which help us to overcome this difficulty. The first is that we know that we are completely safe. This simple idea is of the utmost importance. You are safe. It is perfectly safe for you to let yourself relax and go off guard, so that your mind can wander where it will. It is safe because it is the normal thing that all healthy people do in reverie. We must feel safe and secure, because if we feel unsafe and insecure we are automatically on guard, which is the exact opposite of what we are aiming to achieve.

The other way that we get help in allowing ourselves to drift into regression is to become more and more familiar with the sensation of letting go.

I feel the muscles of my legs let go.—The thighs and the calves, they really let go.—My arms let go so that they are just flopped on the sides of the chair.—And the muscles of my face, they let go.—My jaw has let go, I feel it loose.—And my face lets go so that I can feel it smooth out.—I let go my whole body.—I let myself go.—I just drift with it.

Some people experience difficulty in that they remain too alert to everything that is going on around them. Their eyes are closed, but they are still conscious of the furniture and the things around them. If someone in the next room moves, they think that is so-and-so getting ready to prepare the meal. This is not what we want. We aim to let ourselves be oblivious of our immediate surroundings, and if we hear a noise from the next room, it is just a noise, and it has no particular significance for us. We can help ourselves like this:

I am just sitting here relaxing.—While I am doing it nothing else matters, nothing else matters.—I am just here, easy, comfortable, relaxed.—There is just me relaxing.—Me relaxing, that is all that there is.

Occasionally sleep may be a difficulty. Some people, as they start to relax, go straight to sleep. This is to be avoided. Sleep is some help in relieving tension, but it is very, very much less help than this relaxed state of mind. If you have a tendency to fall asleep when you start your exercises, use a more uncomfortable posture, and concentrate on keeping awake. Then when you have finished the exercises, just let yourself drift off to sleep to have a rest.

*72\57\2*

The latest scientific research shows that the single most important health and longevity factor is a scanty diet or underfeeding. Statistics collected from the several thousands of centenarians in Russia show that one common characteristic of all people who lived 100 years or longer is that throughout their lives they were all moderate eaters. Extensive animal studies reveal that moderate underfeeding increases longevity and decreases incidence of degenerative diseases.2 The eminent scientist, Dr. C. M. McCays of Cornell University, has shown by his research that overeating is the major cause of premature aging in civilized countries. To prolong life and assure good health he recommends a scanty diet of nutritionally superior natural foods.

As Benjamin Franklin said, “A full belly is the mother of all evil.” Obesity is, perhaps, the biggest American health problem and a contributing cause in the contraction of many diseases, including arthritis. As Thomas Edison suggested, “People gorge themselves with rich foods, use their time, ruin their digestion, and poison themselves…”

Food eaten in excess of the actual bodily need acts in the system as a poison; interferes with digestion; causes internal sluggishness, gas, incomplete assimilation, and other metabolic disturbances. It causes fermentation and putrefaction and actually poisons your system.

Leave your table when the food tastes its best. Several smaller meals or snacks are better than a few huge meals. Train yourself to systematically undereat and you will give yourself the best—and the cheapest—health insurance possible.

*29\176\2*

The surgical treatment of epilepsy is becoming increasingly useful, particularly when the seizures are not controlled by anti-epileptic drugs. However, surgery must only be undertaken after a careful detailed assessment of the patient. This, and the operation, should only be carried out in recognized specialist centres. This is because both the assessment of the patient, and the operation itself involve expert and sophisticated procedures—and clearly surgery is an irreversible treatment.

Surgical treatment depends on two main principles or ideas. The first is that a local abnormal area of brain can be entirely removed, leaving behind only healthy, normal brain. The second is that the spread of the seizure discharge, can be prevented by cutting the nerve fibres which cause the discharge. Penfield and Rasmussen, two Canadian neurosurgeons, were the pioneers of surgery for epilepsy and much of the surgical assessment and treatment of patients today is based on their early work. One of the most important questions that must be answered before surgery can be considered is from where

precisely within the brain do the seizures originate. When the cause is a tumour or cyst, then this is relatively easy, but frequently the cause is an area of brain that developed abnormally in fetal life. The identification of the abnormal part of the brain relies upon magnetic resonance imaging, and the use of special electrodes to try and record or ‘capture’ the epileptic discharge. The scalp electrodes (used in a routine EEG) are not usually sensitive enough for this task, and so other electrodes, called depth electrodes, are frequently used. They are also called ’sphenoidal’ or ‘foramen ovale, electrodes because this describes how they are placed close to the brain. Electrodes may even have to be placed directly on the surface of the brain, or, as fine silver needles, within its substance. Because these special electrodes are in very close contact with the brain, there is a much greater chance that they will pick up the epileptic discharge.

As well as these assessments, people being considered for surgery may also need detailed psychological evaluation, specifically to try and identify which side of the brain is responsible for language and memory, so that these areas are not damaged during the operation. Consideration must also be given to avoid operating in those parts of the brain responsible for movement—it would be unacceptable to stop the seizures at the expense of causing a paralysis on one side of the body (hemiplegia), which might result in losing the ability to walk or write.

Before a patient is considered for surgical treatment of their epilepsy, it must have been shown that the patient’s seizures could not be adequately controlled using anti-epileptic drugs. For how long a patient should not have been controlled is dependent on individual circumstances. It is unwise to operate too early, as the epilepsy might remit (stop) spontaneously, although this is unlikely in the difficult epilepsies. However, if surgery is delayed for too long, then this may limit the potential success of the operation, either because the patient has suffered irreversible educational and social consequences of repeated seizures, or because other parts of the brain which were previously normal may have developed abnormal foci of electrical activity as a result of the continuing activity of the primary focus. Generally speaking most patients with difficult, drug-resistant epilepsy are being considered for surgery too late; surgery can safely be undertaken in children—even young infants. Most specialists would now consider that if acceptable seizure control has not been achieved using optimal doses of anti-epileptic drugs after one to two years, then surgery should be considered as the next step in a patient’s treatment. It has been estimated that many patients in the UK might currently benefit from surgery, but only about 200 operations per year are at present being performed.

There are four types of surgical procedure that are currently undertaken:

• removing a large, identifiable lesion such as a tumour or cyst.

• removing an entire cerebral hemisphere. This is done when the whole of one side of the brain is abnormal, this being associated with a hemiplegia (weakness down one side of the body). The operation sounds dramatic, but is often successful leading to a complete resolution of seizures and, frequently, an improvement in the hemiplegia. Hemispherectomy is particularly useful in children with the Sturge-Weber syndrome.

• removing a small or large lesion which has been identified on the basis of detailed specialized EEG recording and imaging. This procedure is the one frequently used in temporal lobe epilepsy, where different parts and amounts of the temporal lobe are removed. Advances in imaging have led to the identification of subtle structural abnormalities in the temporal lobes, which are responsible for seizures.

• carrying out a disconnection procedure; this is to try and separate the focus (site of abnormal electrical activity) of origin of the seizure from other parts of the brain, by cutting the nerve fibres which allow the epileptic discharge to spread. Operations attempted have included division (cutting) of the corpus callosum. This is a large band of fibres which transmits electrical information from one hemisphere to another. A more sophisticated, technically difficult procedure (called subpial transection) appears to be more successful.

Overall, the results of epilepsy surgery are encouraging, as many as 60-70 per cent of people who have operations for epilepsy have no further seizures, whilst another 10-20 per cent are much improved. Patients undergoing a hemispherectomy or temporal lobectomy do better than patients who have a corpus callosotomy. For some patients who have had to live with uncontrolled seizures for many years, a cure of their epilepsy following surgery may come as something of a ’shock’, requiring a major adjustment in their lives. These patients need careful and expert support and counselling.

It must be emphasized again that patients must be assessed carefully in specialist centres before undergoing surgical treatment of their epilepsy. No one person can have a guarantee that their seizures will stop.

*66\188\2*

Migraine and vascular headaches are caused by the dilation, distention, and inflammation of the branches of the carotid artery. They are often throbbing headaches affecting the areas behind the eyes. They may be accompanied by nausea or vomiting, moodiness, depression, irritability, and visual disturbances. They may also be caused by eating or inhaling toxic or irritating substances.

Cluster headaches come suddenly, are severe but of short duration, and tend to recur several times in a day. They usually affect only one side of the head near the eyes, but may radiate to the temple, nose, jaw, and neck. They can cause reddening of the eyes, tearing and nasal stuffiness. They may be caused by allergies or chemical sensitivities and temporary relief can often be achieved using antihistamines.

Tension headaches are usually caused by tension or spasms in the muscles of the neck and shoulders. They are an occupational hazard of desk-bound employees, dentists, chiropractors, carpenters, and others forced to remain in awkward positions for long intervals.

Migraine, vascular, and tension headaches usually respond well to CMO because of the chronic inflammatory processes involved. Cluster headaches that are normally relived by antihistamines often respond even better when CMO is added to the therapy. CMO may even help reduce the number of recurrences per day.

*82\142\2*

Signs and symptoms

The symptoms of bacterial pneumonia include a mild upper respiratory tract infection, followed by the sudden onset of high fever (40.6°C), chills, cough, rapid breathing, and sometimes pain on either or both sides of the chest. In infants the respiratory distress may cause flaring of the nostrils, retractions (pulling in) of the soft spaces of the chest, and grunting sounds when the child breathes out.

The onset of viral pneumonia is gradual, creating symptoms of headache, fatigue, fever of variable degrees (37.8°C-40.6°C), a sore throat, and a severe, dry cough.

The diagnosis requires careful examination of the chest, X rays, a complete blood count, and sometimes cultures of the blood and, in older children, the sputum (the coughed-up discharge).

Home care

Many cases of viral pneumonia are mild and are not recognized as pneumonia at all. You may assume that the child has a cold and give cold remedies. The pneumonia then clears up on its own after ten to 14 days.

If signs of respiratory distress as listed above are present, the child should be seen by a doctor.

Precautions

• Sudden worsening of a cold accompanied by high fever, cough, chills, chest pain, or rapid breathing suggests pneumonia.

• In infants, flaring of the nostrils, pulling in of the chest, and grunting breathing are serious symptoms and require immediate medical care.

• In children, sputum tinged with blood may or may not be serious, but it indicates the need for a doctor’s attention.

Medical treatment

Your doctor will diagnose pneumonia by means of a physical examination and laboratory tests. In the past a child with pneumonia was always hospitalized. Now, only the youngest and the most severely ill are hospitalized.

Most pneumonias respond to antibiotics. A patient with pneumococcal pneumonia will recover rapidly once antibiotics are begun. Another, with a streptococcal or staphylococcal infection, may require in-hospital administration of the antibiotics. Mycoplasma pneumonia responds to some antibiotics, but viral pneumonias do not. For viral pneumonias, your doctor will recommend rest, plenty of fluids, and time for the condition to run its course.

*168/84/5*

There are a number of different brands and types of insulin called Insulin Zinc Suspensions. The presence of zinc in the insulin suspension slows down the action of the insulin.

Ultratard HM (Insulin zinc suspension)

Ultratard has a very slow action.

This is very slow acting insulin and it is a suspension of insulin zinc crystals. It has its main effect from about eight hours to twenty-eight hours and then a slow fading away of effect until thirty hours or even longer. Some doctors, however, recommend giving a single dose of Ultratard at night so that there is a small amount of insulin in the body throughout the twenty-four hours, and then give extra unmodified insulin such as Actrapid before each meal.

Humulin UL (Insulin zinc suspension) Humulin UL has a very slow action.

This is very slow acting insulin and it is a suspension of insulin zinc crystals. It has its main effect from about eight hours to twenty-eight hours and then a slow fading away of effect until thirty hours or even longer. Some doctors, however, recommend giving a single dose of Hamelin UL at night so that there is a small amount of insulin in the body throughout the twenty-four hours, and then give extra unmodified insulin such as Hamelin R before each meal.

Monotard HM (Insulin zinc suspension) Monotard HM has a moderately slow effect.

Monotard is rather slow acting insulin. It has a start of effect about four hours after injection with the maximum effect from six to about eighteen hours and a fading of activity after this time to about twenty-four hours.

A hypoglycemic reaction due to Monotard insulin given before breakfast may occur either in the late afternoon or particularly during the night. Because of this late effect it is common to mix Monotard with Actrapid insulin to give a better effect during the day. This combination modifies the effect of insulin through the Actrapid and may retain some of its own activity as well. It is also common for Monotard with Actrapid to be given in a divided dose, morning and evening rather than as a single dose in the morning.

Humulin L (Insulin zinc suspension) Humulin L has a moderately slow effect.

Humulin L is rather slow acting insulin. It has a start of effect about four hours after injection with the maximum effect from six to about eighteen hours and a fading of activity after this time to about twenty-four hours.

A hypoglycemic reaction due to Humulin L insulin given before breakfast may occur either in the late afternoon or particularly during the night. Because of this late effect, it is common to mix Humulin L with Humulin R insulin to give a better effect during the day. This combination modifies the effect of insulin through the Humulin R and may retain some of its own activity as well. It is also common for Humulin L with Humulin R to be given in a divided dose, morning and evening, rather than as a single dose in the morning.

*12/54/5*

Our homes are full of devices which emit electromagnetic radiation, including televisions, radios, mobile phones and microwave ovens.

Here are some simple tips to reduce your exposure to radiation at home:

• Don’t use an electric blanket which can stay on all night. Apart from the electromagnetic radiation, it can also be too hot for the man’s sperm. It is better to heat the bed up first and then switch it off. Better still, use an old-fashioned hot water bottle.

• Position electrical alarm clocks and radios so that they are not right next to your head while you are sleeping.

• Keep a good distance away from televisions and VDUs.

Mobile Phones

To reduce the risk from mobile phones:

• Keep use of your mobile phone down to a minimum and use a landline whenever possible.

• Buy a separate mike so that the handset is not next to your head.

• When the phone is being carried, or if you are using a mike, keep the handset as far away from your body as possible. I regularly see men carrying a mobile phone in their breast pocket right over their heart.

Microwave Ovens

What you can do:

• Think whether you really need to use a microwave oven at all.

• If you continue to cook with a microwave then do not stand directly in front of the oven, especially if you are pregnant.

• Have the oven checked periodically for leaks.

• Never open the door when the oven is on.

*65/73/5*

•     Noise can be a real nuisance, especially on busy roads, and electroencephalograms done on people asleep in such situations show that they are registering the noise even though they are asleep. (Some people, used to the noise of a city become insomniacs when they move to the peace of the country-they ‘can’t stand the silence’.) If you are super-sensitive to noise ear plugs are an answer, and if light rooms are a problem you can buy a mask or an eye-shade.

•     Depression must first be recognized and then treated to prevent this common cause of sleep loss.

•     Watch out for foods and drinks that give you nightmares or simply disturbed sleep.

•     Although millions of people sleep perfectly well without ever having sex there is little doubt that intercourse and/or masturbation help the average person to drop off. Unsatisfactory sex on the other hand can prevent sleep. This is especially true in women who are left unsatisfied by their partners. Such a woman can always masturbate if she is left ‘high and dry’. If she can’t masturbate, for whatever reason, she may well be able to sleep better if she doesn’t have sex.

Sex is part of a pre-sleep ritual for many. Most of us use some form of pre-sleep ritual, often without even realizing it. At roughly the same time each night we turn off the TV, put down our book or newspaper, make a hot drink, have a bath or shower, cuddle our partner, perhaps make love, and then go to sleep. Some people listen to music in bed, others pray-it doesn’t matter what it is as long as it’s a relaxing, predictable and unwinding process that prepares us for sleep. The best schedules are regular without being rigid.

•     Stop worrying. If we have effective sleep rituals, the worries of the day slip away and we don’t lie there thinking about them. Sex, or indeed any other activity that absorbs our attention, is a good antidote to worry. But often the worry is best confronted and discussed with your partner, if you have one. Try to think around the problem and then go to sleep at least having made some effort to solve it rather than trying to sleep on an unsolved problem. Serious problems can be solved at night when you are alone and peaceful and able to think. Don’t lie there worrying about not sleeping-work through the problem and see what can be done. Some people find deep breathing or forms of meditation help them let go of their insoluble problems.

Don’t worry about insomnia. No one ever died of it and it will probably have very little effect on your performance. Keep a pad of paper and a pen by your bedside and make notes of what you decide to do to sort out the problem that’s worrying you. Next day go through it rationally and implement whatever you can.

*188/72/5*

The decision whether or not to have your ovaries removed is an extremely complex and difficult one because at the present time there are no clear answers regarding the pros and cons of removing or retaining the ovaries.

Some gynecologists routinely remove the ovaries in women with endometriosis; others base their decision on the extent and severity of the woman’s disease and her age, while still others routinely retain them except under special circumstances.

It is extremely important that you find out what your gynecologist intends to do and that you make your decision perfectly clear as to whether you want your ovaries removed or retained.

If you retain your ovaries you will not undergo a premature menopause but there will be a greater likelihood that your endometriosis will persist or recur. Unfortunately, it is not known how often endometriosis persists or recurs following a total hysterectomy: the few statistics in the medical journals range from around 10% to 85%.

Many gynecologists believe that the ovaries should be retained in the majority of cases as they believe that the risk of recurrence is low and the risks of a premature menopause are considerable.

If your ovaries are removed you will undergo a premature menopause and have less likelihood of having a recurrence of endometriosis because it does not recur if you do not produce oestrogen. It is estimated that as few as 3% to 5% of women will have a recurrence if their ovaries are removed. The unusual cases where endometriosis recurs following a radical hysterectomy are usually due to the fact that a piece of an ovary was left behind because the gynecologist either could not see it or could not remove it safely.

Surgical menopause – menopause due to the surgical removal of the ovaries – is usually more severe than the natural menopause because it occurs instantaneously in a younger woman whose hormone levels are higher. The drop in the hormone levels is both dramatic and sudden and many women will experience significant symptoms as a result.

Most women will experience the early symptoms of the menopause soon after their surgery – often within 24 to 48 hours. The most common early symptoms are hot flushes and night sweats. Some women will also experience tiredness and lethargy and sometimes depression, particularly if their hot flushes and night sweats stop them sleeping.

After a couple of months most women will start to experience some of the other effects of menopause. These include a dry vagina, which may cause painful intercourse, a change in sexual response, decreased libido and decreased breast size.

The main long-term effects associated with surgical menopause are a substantially increased likelihood of developing heart disease and osteoporosis later in life.

*57/41/5*