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The majority of alcoholics are members of the work force. Probably a conservative estimate is that 8% of the nation’s work force is adversely affected by the use of alcohol. Business and industry have begun to recognize the costs to them of employees with alcohol problems. As a result, there has been a rapid development of special programs by employers to identify problems and initiate alcohol treatment. These programs are generally termed either employee assistance programs or occupational alcohol programs.
Drinking has long been interwoven into work. To offer just a few examples of its intrusion, consider the office party, the company picnic, and the wine and cheese reception…. The martini lunches, the “drink date” to “review business,” and the bar car on the commuter train…. The old standby gift for a business associate? A fifth of good liquor. . . A round of drinks to celebrate the closing of a business deal.. . The construction crew stopping off for beers after work. But the meshing of drinking and business has come under fire. First, the IRS decreed the martini lunch was not a legitimate business expense. Then the growing interest in physical fitness took its toll. Concern about liability when alcohol is a part of company-sponsored parties has come into play. While receiving more attention recently, court cases addressing this go back to the mid-’70s.
Possibly most telling about the new attitudes is the very recent and growing discussion about the use of mandatory drug testing as a condition for initial hiring and continuing employment. This discussion has centered less on alcohol than other drugs; however, alcohol no longer enjoys a status of being “okay,” whereas all other drugs are seen as “bad.” To our minds this is evidence of the growing recognition by businesses that substance use can and does interfere with performance and productivity, and is therefore a legitimate concern.
Nonetheless for too long, drinking in many work situations was not only accepted but expected. Whenever the use of alcohol is tolerated, the potential for alcohol problems among susceptible individuals rises, and more so if drinking is subtly encouraged.
*111\331\2*
Morning Sickness
Women become sick for the first few weeks of pregnancy because the placenta produces high levels of oestrogen. Some women suffer so badly from nausea and vomiting that they can vomit themselves to death. In such cases medical assessment becomes an urgent priority.
Unfortunately, drugs in the first few weeks of pregnancy are an anathema to most doctors and their patients. The pendulum of non therapeutic intervention may have swung too far however, and there are a number of antihistamines that have been used by many women during pregnancy “without an increase in the frequency of malformations or other direct or indirect harmful effects on the foetus having been observed”. One of these antinauseants is Ancolan. Ancolan can safely be taken three times a day. As with all the other antihistamine antinauseants, sedation is an inseparable side effect.
Myocardial Infarct
Myocardial Infarct is the technical term for a heart attack. It is a fundamental rule of medicine that doctors never use a simple word when a complicated one will do.
Myocardial Ischemia
Myocardial Ischemia is another technical term meaning the heart muscle receives an insufficient supply of oxygen. Usually this cardiac oxygen insufficiency causes the pain of angina. However in some cases the insufficiency is silent and it can only be detected on a cardiograph. When the lack of oxygenation to part of the heart becomes total: a heart attack occurs. These are commonly very painful; but as with partial insufficiency some people still suffer from silent heart attacks.
*104/131/5*
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Athletes suffer the cramps of Lactic Acidosis. Tourists to the tropics suffer the cramps of salt deficiency. Sometimes Fluid Tablets in the treatment of heart and kidney failure cause cramps because they deplete the body of sodium and potassium. By far the most common cause of cramps is cause unknown. This particular variety of cramps comes to bother older people late at night. They wake up with excruciating pain and spasm in the muscles of the legs.
The medical response to nocturnal cramps in the elderly is to prescribe a derivative of Quinine. Quinine is very effective as far as it goes; but it has the potential for some very unpleasant side effects. Quinine derivatives reduce the strength of cardiac contractions. People with weak hearts or heart disease are advised not to take derivatives of Quinine in treatment of night time cramps. Recent work out of Newcastle, New South Wales, raises concern in relation to Quinine’s effects on the liver. People taking Quinine products regularly must also beware of side effects involving the eyes.
Home Remedies
People with severe nocturnal cramps will try anything to reduce the levels of their pain and suffering. Some praise the efficacy of empty wine bottles under the bed. Even more sing the praises of mothballs. So many cramp sufferers have gained relief from mothballs placed under the bed sheets that there must be a scientific basis for this substance’s efficacy.
*103/131/5*
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The mountains are the place where I recharge my batteries. After the toil of a steep walk you stand on the summit with the fresh wind on your face, looking out over mile upon mile of hills and valleys, to the endless sky with its sweeping clouds and changing lights.
Mountains are places of beauty, and most of their beauties are not hard to reach, requiring just a little effort and energy. But this ease of access belies their need to be treated with respect. Every year people die in the mountains, usually because they underestimated the potential dangers. The most important safety rule is to assume that the worst may happen and then work out how you can prevent it or cope with it. You must be able to cope with getting lost, staying out all night, someone becoming ill or injured, getting too cold, too wet, too hot or too dry.
National mountaineering organizations will give you specific advice about walking in your area. Ask for it and follow it. They know – they are the ones who rescue people who have not asked for advice. If none of you is experienced in mountain walking it is best to find someone who is to help you. A large group of people with diabetes on anything other than a short walk should have an accompanying doctor; BDA/OB course groups are accompanied by BDA and OB staff on their first expeditions and shadowed by staff (who only intervenes in emergencies) on subsequent expeditions.
*103/102/5*
DIABETES
Team work and shared responsibility are an important part of these OB courses. Each student is there as an individual to try new activities and overcome personal challenges, but the participants are also part of a group and are expected to keep an eye out for each other. It is rare for BDA staff to have to treat hypoglycemic attacks. Generally fellow students deal with them at the first sign that all is not well. Students teach each other how to monitor blood glucose levels and all sorts of new tricks with injection techniques and diabetic problem solving. As the course progresses they take a pride in sorting themselves out. Weaker students are supervised by more able ones, with continuous encouragement and support. Many of the activities are team challenges with everyone in the group contributing. The idea of taking responsibility for other people may come strangely to a young person who has been diabetic for a long time. Generally, the person with diabetes is the one who is looked after. Yet because of this, people with diabetes are good at looking after other people and are sensitive to their needs.
*102/102/5*
DIABETES
Most children will not need any special investigation. The diagnosis of asthma is usually made on the basis of history and physical examination. Children who have more severe asthma, or who have frequent attacks, may require a chest X-ray. Some children may have special breathing tests, often arranged by a paediatrician or respiratory specialist. This usually applies to those who have ongoing, persistently severe asthma.
Once children with asthma reach 6-7 years of age or thereabouts, their management may involve regular measurement of lung function two or three times each day using a peak flow meter. This is a small device which measures how well the lungs are functioning, and may give early indications that the asthma is worsening.
If your child needs to use a peak flow meter, your child’s doctor will explain how to use it properly and record the results.
*245\90\8*
Since diabetes can result in more frequent infections of all types, vaginitis is a particular problem for sexual functioning. Both partners may experience pain in intercourse related to this and other tissue infection. About one third of women with diabetes have problems with orgasmic contractions, probably related to the same neurological and vascular damage as in the male. Erection of the clitoris would also be expected to be affected. Diabetic women should check for recurrent mild urethral infections, cystitis, and vaginal abscesses, these are all treatable, so there is no reason to continue to have pain in intercourse. If you notice a decrease in natural lubrication (maybe due to microcirculation problems), check with your doctor. Again, do not assume that sexual problems are always related to your disease. If there is a lubrication problem, lubricants can be prescribed or recommended.
As with men, all areas of the sexual-response system remain intact for diabetic women. Interest, arousal, psychasms, and other dimensions do not have to be impaired if open communication and degenitalized approaches are considered and practiced.
Diabetes is like any other disease in that it is helped by positive emotions and intimacy, and hindered by fear and helplessness. Even if your diabetes gets worse, remember, you do not cause it to get worse. Even with your best efforts, diseases run different courses. None of these courses preclude intimacy. Every couple I treated in which one or both partners were diagnosed as diabetic were able at five-year follow-up to experience a mutually pleasing sexual life, even when the diabetes itself might have worsened. There were eighty-seven diabetic men in the sample and forty-seven diabetic women. While initially thirty of the men were considering implants, none of them went ahead with that procedure following counseling.
If severe genital problems have resulted from diabetes, there are still several things that ean be done to enjoy sex. You read about some of these in Chapter Eight. One of the oldest medical jokes relates to a man whose arm hurts every time he tries to raise it. He tells the doctors about his problem and the medical advise is, “If it hurts when you do that, then don’t do that.” I would add, “If it hurts, check out why, if it can’t be helped, try something else.”
*281\97\8*
READINESS: Readiness is the one phase of the ten-phase super sex model that was focused upon by the first three perspectives. Readiness refers to the body’s response to interest and arousal. It is the physiological reaction that accompanies interest and arousal, the tumescence stage, when blood rushes to erotic areas of the body, including the genitals, preparing for body-to-body interaction. Readiness is an entire body response, not just a genital response. Remember, lack of readiness does not mean lack of interest or arousal. Research does not support such a relationship. Readiness is a reflex, and can take place with little arousal and be absent even when there is a great deal of both interest and arousal.
Your own experience teaches you that you have been aroused, but not ready. Sometimes you have awakened ready, but not aroused. You have been interested and ready, but not aroused. You have been ready, but not interested, and your desire, your frequency might or might not have reflected any of these changes in the sexual system, because sex is really not an automatic cycle, it is a system of interactions of different mind and body states. The cycle orientation of the first three perspectives mislead us. Use your own experience as the couples did and you will see that sexuality is not some type of automatic slide, but a complex mind/body interaction. This fourth perspective emphasizes the subjective experiences of the couples rather than the observational orientation of earlier perspectives.
“I know you think I’m ready,” reported the husband. “You think I’m always ready. Well, I’m not. My penis does not speak for me.”
“If I can’t tell by your penis, how am I supposed to know if you are ready?” asked the wife.
The orientation of the first perspectives is clear in this exchange. Both partners have confused what the body does with how the person feels.
*108\97\8*
Previous chapters in this book provided quite some criticism of the practices of conventional medicine.
The indisputable progress in many areas of medical and other related sciences was yet to be mentioned. This would include among others: the life saving emergency treatments, technology and instrumentation for chemical and biological analysis and the breathtaking progress on the frontiers of “mind-body” medicine.
Deepak Chopra, MD, a pioneer of modern mind-body medicine, is the author of numerous inspiring and mind-bending books, which are listed in the References. In his books,* he illustrates the process of mind and body interaction drawing up on many clinical examples as well as research results from medical science and modern quantum physics. He has met and continues to meet with the considerable opposition from his colleagues – conservative medical scientists, who insist that they should see everything under their microscopes to believe it. Deepak Chopra points out, that medical sciences simply ignore monumental advances made in other sciences, mainly in the Quantum Physics.
Not only do microscopes have limited resolution, and the visible bandwidth of light is extremely narrow (0.4-0.7 micrometers), but even if we could separately look at each molecule, atom or an elementary particle – there is exactly nothing to look at ! Physicists have found quite a long time ago, that any elementary particle or atom is just a form of energy, oscillating in some state of equilibrium, and therefore it is essentially 99.999 % empty space. We can see, detect or sense the matter composed from such atoms, only because their energy interacts with us as observers, ie. for example reflects light that is visible to us. On that level of understanding, even physicists agree, that there is essentially no difference between thought and matter. Thought can become matter and matter can become a thought. Deepak Chopra gives some stunning examples of such transformations not from the mysterious ancient past, but from within contemporary India.
If you need more explanation from the modern Quantum Physics point of view, and do not feel an expert in physics, please read an excellent book “Superforce”, by Paul Davies, listed in the References. Paul Davies is a respected professor of physics, and he does a wonderful job of explaining achievements of modern physics to non-experts. It is really worth the effort to read his book.
*7\96\8*
Vertigo (giddiness or loss of balance) may occur with the disorder known as Labyrinthitis. This is thought to be a viral infection. Crops of cases tend to occur at the same time. The attacks are short-lived from a few days to one or two weeks and they pass off completely with no permanent ill effects.
These attacks may be mild, and giddiness only occurs with movement of the head. Nausea and vomiting may be associated with the giddiness and these attacks may come spontaneously even at rest.
The doctor needs to examine the patient to exclude some more serious cause of these symptoms such as vascular accident (stroke) or a tumor.
No treatment in mild cases of labyrinthitis is required, but drugs will reduce the giddiness and the nausea and are used if the symptoms are severe.
*475/71/1*
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