•     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*

Antioxidant Salad

4 stems broccoli

4 stems cauliflower

1 celery stick

4 large lettuce and kale leaves

4 large rocket leaves

1 handful green beans

È chopped Spanish purple onion

1 stick carrot

1/2 cucumber

10 cherry tomatoes

1 handful walnuts

Chop and mix all of the ingredients together in a glass bowl. Serve with Antioxidant Dressing.

Apple, Celery and Tuna Salad

80 grams tuna in spring water, drained (not brine)

1 green apple

2 sticks celery, sliced

1 gem lettuce, sliced

1 large handful bean sprouts

75 grams natural live yogurt

2 teaspoons apple cider vinegar

Black pepper to taste

Rye bread 1 avocado

Drain tuna and combine with the other salad ingredients. Blend the yogurt and vinegar into the salad. Season with black pepper. Serve with rye toast, thinly spread with avocado.

Brown Rice Salad

1 cup brown rice

2 stalks celery, chopped

1 handful snow peas

Sweet pepper, chopped

2-3 cloves garlic, crushed

1 small chunk of ginger, crushed

1 tablespoon tamari

1 tablespoon apple juice concentrate

1/2 lemon, squeezed

Boil the rice and drain. Add the chopped celery and sweet pepper, and the snow peas. Make a dressing from the rest of the ingredients by simply stirring them together. Drizzle dressing over the vegetables and serve.

Brown Rice, Tuna and Bean Sprout Salad

100 grams brown basmati rice

100 grams tuna in spring water, drained (not brine)

1 tablespoon olive oil

1 teaspoon tamari or soy sauce

The juice of half a lemon

100 grams bean sprouts

1 carrot, chopped

1 spring onion, finely sliced

Cook rice and allow to cool. Combine with the other ingredients.

Exotic Bulgar Salad

225 grams bulgar

400 ml boiling water

1 teaspoon salt

2 tablespoons chopped mint and parsley

2 tablespoons sunflower seeds

1 garlic clove, crushed

50 ml olive oil or flaxseed oil

50 ml lemon juice

Freshly ground black pepper

450 grams tomatoes, chopped

1 small cucumber

Mix the bulgar, water and salt. Leave to stand for 15 minutes. Add all but the tomatoes and cucumber, and leave until cold. Stir in the tomatoes and cucumber, and serve.

*228/34/5*

According to food expert Adele Davis, ‘calcium can be as soothing as a mother, as relaxing as a sedative, and as lifesaving as an oxygen tent.’

It is said that despite a diet adequate in calcium, stress can lead to relative lack of this mineral because of the buildup of lactic acid in the blood. This may be particularly so in those conditions where generalised muscular pain is associated with soft tissue injury. Lactic acid is said to ‘bind’ the calcium, making it difficult to assimilate.

Taking a glass of ultra-filtered calcium-enriched milk together with a daily supplement of calcium may help sleep to return to normal. (It should also be noted that all women require between 600 and lOOOmg of calcium per day between the ages of 30 and the beginning of menopause just to prevent the loss of bone mineral density which leads to the often painful consequences of osteoporosis.)

Foods rich in calcium include yoghurt, cheese and other dairy products, eggs figs, oranges, almonds and calcium rich vegetables such as cauliflower and broccoli.

The most readily absorbable natural sources of calcium are soft-boned fish such as sardines and salmon.

If you consume large amounts of sugar rich foods, excessive amounts of flour or alcohol you are likely to be low in dietary magnesium which is essential for calcium absorption. Magnesium-rich foods include sea salt, kelp, seeds of all kinds,nuts, beets, spinach, dates and prunes. According to some nutritionists magnesium oxide supplements taken a half hour prior to going to bed have replaced the sleeping pill for many insomniacs.

Of the B group vitamins the one said to be most influential in helping sleep is pyridoxine or Vitamin B6. This vitamin is said to have sedative effect on the nervous system. It appears to be essential for the normal functioning of the brain, and for maintaining the level of magnesium in the blood. When B6 is deficient, the amino-acid tryptophan is not used properly by the body. This has particular relevance to chronic pain patients where the levels of serotonin or 5 HT are known to be depressed in some with chronic pain. The taking of L-tryptophan has been associated with both promoting natural sleep and a natural anti-depressant and has been shown to increase the brain levels of serotonin.

To treat insomnia Vitamin B6 is usually taken in doses of 25-50mg daily.

Pantothenic acid, another of the B group of vitamins has also been linked with insomnia. This is a key vitamin in the conversion of fats and sugar in the body into cellular energy. The dose of this vitamin to promote natural sleep is lOOmg per day.

The vitamin B12 has also been used by orthomoloecular psychiatrists to treat depression and insomnia. It should be given only after a test for B12 deficiency is carried out. Supplements of 25 milligrams daily may then be of help in sleep disorders.

*174\37\8*

The Associate-Professor of Psychology at the University of Sydney’s Department of Behaviourial Sciences, Professor Wendy-Louise Walker, has developed a whole range of imagery techniques described in an article in the Australian Journal of Clinical and Experimental Hypnosis in 1984. Amongst these, in her article entitled ‘Some Uses of Imaginative Involvement in Therapy’ was the following (slightly adapted for this book with thanks):

‘Imagine that you’re standing, in the very early morning on a beautiful beach, standing quite alone on that beautiful beach in the pastel stillness of that beautiful beach.

‘Now imagine a wide sweep of fine, pale sand. A clear, blue sea with waves forming, curling, breaking and washing up the beach in curves and scallops of lacy white foam, receding to leave the sand wet and glossy.

‘Imagine a deep blue sea on the horizon shading into paler colours. The sunlight is glinting on the water, the clear brightness of the sky is reflected in the wet sand as the waves recede.

‘Imagine it vividly, still in the cool of the morning so that everything is bright. The colours are so clear and you can feel a cool breeze against your face.

‘Further, imagine some grey and white seagulls are fluttering down to float ever so lightly on the water, out beyond the breakers.

‘Imagine everything looking so fresh, clean and new. The sound of the water, the breeze and the fine clean sand — the bright clear colours. You are now walking along the water’s edge — along the wet sand which is hard, and yet comfortable under your feet. As you walk along the wet sand, you feel the water occasionally washing over your bare feet.

‘You begin to feel exhilarated. You begin to feel joy and exhilaration. It’s such a clear, fresh morning. The colours are so clear and bright. You walk along with the cool air in your face and the waves sometimes washing in a sweep of lacy foam over your feet and then receding.

‘You feel that your body is healthy and light and you walk along with a fine, swinging stride feeling exhilarated and optimistic. You feel the future is great, the exhilaration is quite a vivid, physical feeling and you are intensely aware of the beauty of the sea and the beach and the sky as you walk along.

‘It becomes a very vivid, and very complete, real and total experience.

*147\37\8*

One of the more controversial areas of the surgical treatment of pain in recent years has been the implantation of electronic devices into the body to stimulate the nerve pathways directly in the spinal cord. Such devices, known as spinal cord or dorsal column stimulators, have been implanted into patients’ spines over the past ten years.

Fine gold electrodes are inserted into the spine through an incision over the vertebral column. At first these are connected to an external computerised electrical stimulator while it is assessed for accuracy of location in the spinal canal and different stimulation methods are tried.

When it is found to be successful the patient undergoes a second stage of the operation in which a battery powered electronic stimulator is implanted under the skin of the patient’s chest or abdomen. After this has been done the patient uses a powerful radio device to send messages to the stimulator and direct the current being delivered, its strength and pattern of stimulation.

The success of such treatment varies according to which surgeon is reporting his, or her, success. But there is a certain degree of scepticism about the procedure from some of the innovators of the technique who have subsequently stopped performing it. Unfortunately, one of the major complications of the treatment is infection in the location of the fine electrodes — in the spinal canal. This usually leads to the removal of the $5000 stimulator unit which cannot be reused on other patients. Another unfortunate problem is the unexplainable loss of effectiveness which occurs in a previously helped patient — typically within the first six months of treatment.

A second opinion Those who are offered this form of therapy should always seek a second opinion. At best, it is an uncomfortable operation, at worst it is potentially harmful and fraught with postoperative problems.

*122\37\8*

Adjuvant or co-analgesic drugs

These are drugs which are not specifically developed to treat pain, which are used to enhance the pain relieving effects of the analgesics. They include the antidepressants, tranquillisers and some muscle relaxants.

Analgesics

These can be divided into simple and mild pain killers and narcotic or opiate based and potent pain-killers. The narcotic drugs are all developed from the age-old knowledge that the opium poppy produces a natural and extremely potent pain killer and euphoria producing substance — opium, from which can be derived other substances such as morphine and heroin (diamorphine).

Steroids

Cortisone-like drugs, which are often injected into joints or into inflamed areas, have a limited role in chronic pain treatment.

The major side-effects of such drugs, when taken in high dosages, are a reduction in the body’s natural capacity to fight off infection or inflammation, a softening of the bones (osteoporosis) and in some cases extreme weight gain and stretch marks.

The intra-joint usage of such drugs is sometimes associated with weakening of the muscular tendons and the tissues surrounding the joints.

*97\37\8*

Most children wet the bed until they are three or four. Thereafter about 25 per cent of children continue to wet the bed, and some may also wet themselves during the day. In some children, this may continue until they are ten or more. Sometimes a urinary infection causes bed-wetting, and so can diabetes. However, in the vast majority of cases, the cause is probably psychological, with anxiety or insecurity at the root of the problem.

In many children with food sensitivity, bed-wetting has unexpectedly stopped when they were treated for other symptoms, and recurred, along with those other symptoms, when certain foods were reintroduced.

At first this was put down to coincidence, but most doctors now accept that food sensitivity (either allergy or intolerance) can cause bed-wetting.

It probably does so by making smooth muscles throughout the body contract. As well as being found in the bronchi (where their spasms can cause asthma) and the bowels (where they can cause diarrhoea), smooth muscles make up the wall of the bladder. If they contract excessively, the bladder empties much more frequently, and with less control.

Some adults with food sensitivity have to empty their bladder very frequently, and the mechanism is probably the same.

*169\180\8*

Promoting health through happiness is an interesting pursuit. The poet Conrad Ferdinand Meyer thought deeply about this subject and concluded that a heavy heart is not cured by unrestrained hilarity but responds very quickly to even a little happiness. Was he really right? Can life’s problems be sorted out by just a little happiness, even though our everyday demands, worries and sufferings continuously erode our energies?

Imagine a beautiful peach tree espaliered against the wall of your house. Each spring it blossoms anew and a few months later it brings forth delicious fruit. Why should we think it could be otherwise? Yet suddenly the unexpected happens. The peach tree flowers as usual, but just as the flowers open they fall to the ground. The bark of the tree dries up and the tree dies. What has happened? The tree was the pride of the household; its healthy growth, its beautiful blossoms and delicious fruit were the talk of the neighbourhood. How could this tree die so quickly and unexpectedly? What malicious enemy could have attacked it? You ask yourself all these questions but you can only find the answers by digging up the tree. It is then that you discover the cause: field mice have eaten the roots and so killed the beautiful tree.

*1245/28/1*

If you want to move house, you should check the location you have chosen from the standpoint of bioclimatology; of course you will also wish to see whether the area is suitable, that is, whether you actually like it and it suits you. For this reason it would be useful if you could live in the selected area for a while before finally deciding to build or buy a property there. In accordance with our constitution and sensitivity, various circumstances can be significant, for example atmospheric humidity, elevation, and whether the area is known for the fohn or any other influential winds. You should also take into account whether you feel the cold or the heat, your preference as regards food and exercise or movement, or whatever type you are. In view of the different idiosyncracies and natures we have inherited and from which we cannot escape, it is by no means of little importance where and under what conditions we live. The various members of a family often differ in their needs and preferences, in which case it would be advisable to be guided by the more sensitive ones, choosing your site to suit them.

*1176/28/1*