If you have just been diagnosed as chemically sensitive, or have just come through one of the elimination programmes just described, you are probably feeling very unnerved by what you have discovered, wondering how you will cope.
Take heart, it is not as bad as it seems. It is perfectly possible to live with even very severe sensitivity and to function quite happily in everyday life, if you take precautions and follow some basic guidelines. You are not sentenced to a prison cut off from ordinary life. There will inevitably be things in your life that have to change, and you may well have to give up some things that you cherish, but you will not have to become a hermit, remote from the world.
There are no really effective treatments for chemical sensitivity and allergy. Neutralisation therapy can work for some people , and some people find that complementary therapies help. Taking high doses of vitamins and minerals can also help. The only thing that is consistently of any benefit is avoiding chemicals and eliminating them from your environment as far as you can.
Your basic precautions for coping with chemicals are to:
• Manage your load
• Air things when new
• Take care when things get warm
• Avoid fumes
• Think twice before using chemicals
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Treatments for dry and wet rot are usually composed of a fungicide, dissolved in an organic solvent. Timber treatments often contain an insecticide as well. Treatments for dry rot on brick and stonework contain a fungicide, or sometimes bleach. The fungicides used are unpleasant toxic chemicals, including phenols and tributyltin, and they, plus the solvents used, can cause persistent sensitivity. Avoid them if you possibly can.
Treatments of this kind are usually sprayed or applied on site. If you absolutely have to use them, make sure you are not around while they are being used, and air the building well, if necessary staying somewhere else for some time before returning.
Use alternatives wherever possible. Timbers affected by rot can often be cut out and replaced with timber treated in advance. Ask for timber which has been vacuum-impregnated with salts of copper, chromium and arsenic, and ask for it to be aired for some time before use. These are toxic salts which are forced into the timber through vacuum treatment. These salts do not cause sensitivity over the life of the building. This treatment is available from all major rot treatment firms and is accepted by building societies to meet conditions of mortgage. Timber of this type can also be used for fencing, doors, window frames and other external timber applications.
Some hardwood timbers are more resistant to rot than softwoods such as pine. Use a resistant hardwood if you can, although they are more expensive and now less available because of concerns over rainforest depletion. The choices include greenheart, iroko, cedar, padauk, white oak, teak and hickory.
If you cannot cut out timber and replace it, and need to apply something on site, use Boric Salt powder which again is solvent-free and fume-free, although it is toxic and needs handling carefully. It will not cause sensitivity, but can irritate on use. This is available from Livos and from The Healthy House.
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For an office building or work environment, you can build in air filters, either in air conditioning systems, or into individual rooms. Consult an architect or air conditioning engineer. Air Improvement Centre and Beta-Plus can also advise on systems for workplaces.
Icleen produce filters that fit or stand over heaters or radiators. They work by filtering out particles or fumes in the air rising up from the heaters. The filters are constructed of a fabric web in a metal frame. They only function when a heater is working, but they use no electricity, make no noise and are particularly effective against particles circulating in convection currents. The filter frames can be adapted to use for storage heaters, convectors, and desktop use, such as computers. They can be wall-mounted or free-standing, and are not conspicuous.
These niters are less effective than an air filter that recirculates room atmosphere constantly, and they may have limited effectiveness against chemicals. But their other advantages may outweigh these drawbacks, and reports have said that they do make some difference. Current prices quoted are £35 per metre fitted. Replacement fabric filters cost £10 per metre – renewable once or twice a year, dependent on use.
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House dust mites live on the debris of human environments, and on other small living organisms. They do not cause harm directly to humans, apart from being a potential allergen. The species of mite particularly associated with allergy in the UK is called Dermatophagoides pteronyssimus. Dermatophagoides means ‘skin-eating’ and, in common with other mites, house dust mites feed especially on human skin scales. Humans shed on average up to one gram of skin scales a day -enough to feed many mites for months and these fall and collect around where humans live. House dust mites also feed on animal skin scales, and on micro-organisms such as moulds, bacteria and viruses.
Having house dust mites in your environment is not a sign of dirty or insanitary conditions, nor of slovenly or poor housekeeping. They need a particular ecology to survive and human environments provide the best conditions for them. House dust mites thrive where food supply is plentiful, and where the environment is moist, warm and dark. They like ideally a moisture level of 80 per cent relative humidity and a temperature of about 25°C (77°F). For humidity year round, the UK is ideal for them; and for temperature, many warm, dark places indoors such as unaired beds, duvets, chairs and carpets, are also well suited.
They are present all year round and hence are responsible for many cases of perennial rhinitis or other year-round symptoms. Their presence can increase when the weather is very damp and, like mould allergy (>MOULDS), allergy to house dust mites often gets worse in damp weather.
They can be found in very high densities where the environment is favourable to them. Up to thousands have been measured in one gram of surface dust. It is their droppings – their faecal pellets – that cause most problems with allergic reactions, although some people are allergic to debris of the mites themselves. The faecal pellets remain even when the mites themselves move on or die, so dust, bedding or pieces of furniture can continue to cause problems even if you kill the mites.
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Inhalants
Allergy to inhalants, particles you can inhale, is usually clearly identified by skin and blood tests. The IgE mechanism appears to be principally responsible for such reactions.
Foods
Food allergy is perhaps less common than most people believe, since many cases of reaction to foods are food intolerance, rather than true allergy. Allergy to foods, rather than intolerance, will show positive results to skin and blood tests. You are likely to react whenever you eat a food to which you are allergic, even if you have not eaten it for a very long time; and you are more likely to have an immediate reaction, even to a small or tiny amount of the food. You may also be able to remember a precise date or occasion when you first reacted to a food. Food intolerance has a different pattern of reaction, and different symptoms (see page 20).
Table 1: The Most Common Causes of Allergy
INHALANTS
House dust mites
Animal and pet hair
Mould spores
Pollens
Feathers
Wools
Dusts at work
FOODS
Cow’s milk, butter, cheese, yogurt
Eggs
Wheat
Yeast
Oranges, lemons, grapefruit, satsumas
Nuts
Beans, pulses, soya products
CHEMICALS
Formaldehyde
Perfumes and fragrances
Paraphenylenediamine (PPDA)
Rubber
Phenols and cresols
METALS
Nickel
Chromates
Chemicals and metals
Allergy to chemicals and metals is sometimes very hard to distinguish from chemical sensitivity. In allergic contact dermatitis, where reactions are often delayed, positive results from patch tests on skin can often establish that an allergic reaction is involved. However, in many cases of asthma, eczema and dermatitis, tests are inconclusive and the dividing line between allergy and sensitivity is unclear.
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Surgery to install an inflatable implant is usually done under a general or spinal anesthetic, and not a local, because the operation is more extensive. And with this type of implant, a two to four day hospital stay is the norm.
The surgeon gets access to the body through the scrotum, or through an incision in the lower abdomen, above the penis. He then cuts into the corpora cavernosa. All the components are usually inserted through one incision and placed in their proper locales. Before the patient is sewn up, the reservoir is filled with fluid—usually a solution of water and contrast material so the fluid will show up on an X-ray. Then the tubing which connects each part is hooked up. And all the components are tested to make sure they work.
Some surgeons prefer to leave the prosthesis partially inflated, others leave it completely flaccid. If s typical for a catheter to be inserted into the bladder for a day or so. And while the patient is still under the anesthetic, the doctor will pump the implant up and down several times to make sure everything is in working order.
In general, it takes a little longer to recover from inflatable implant surgery than from an operation to put in a semirigid prosthesis, because the surgery takes longer and is more complicated. If s typical to have a bruised and swollen penis and scrotum following surgery (ice bags on the area can help), and if s common to feel a burning sensation the first few times that you urinate. You’ll want to take a week or two off from work, and to take it easy while recovering.
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The concept is very simple: eating fish at least once a week will lower your cholesterol, enhance overall vascularity, and improve erectile health in the process. New studies on the effects of fish eating support the idea that polyunsaturated fatty acids are responsible for this. The omega-3 fatty acids, found primarily in the oils of the fish, lower blood triglyceride levels. The omega-3s seem to make blood less likely to coagulate, which, in turn, makes it less likely to clot. They accomplish this by raising the levels of prostacyclin in the blood, thereby making the arterial walls relax. At the same time, they lower the levels of thromboxane, another chemical messenger which is responsible for the constriction of blood vessels.
One study of 1,300 men showed that those who consumed at least eight to nine ounces of fish weekly (and that was mostly canned tuna) had an incredible 40 percent lower risk of a fatal heart attack than those men who ate little or no fish.
To get the fullest benefits of all fish has to offer, I suggest that you eat it two or three times a week. Fatty species, such as herring, cod, mackerel, salmon, and sardines, contain greater quantities of omega-3s than do leaner varieties. But if the idea of eating that extra piece of fish each week is just not appealing to you, there are other ways to get the omega-3s you need. Flaxseed may be the source that will work for you.
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ED is not only one of the most troubling side effects of many psychiatric drugs, it is also the least discussed. “I thought it was just me,” a patient said after learning that an antidepressant that he had been taking daily for two years caused his ED. “I was embarrassed to talk to you about it. And I didn’t know if there was anything you could do for it, anyway.”
If ED is going to become a problem for men undergoing pharmacotherapy with tranquilizers or antidepressants, the trouble usually begins during the first month of treatment. For many men who experience this initial side effect, and then stay on the program long enough to benefit from diminished anxiety and/or reduced depression, there will eventually be a reawakening of sexual interest and, consequently, improved sexual performance.
Over time, however, the sexual picture may change, again because of the drugs. Many of the treatments for psychiatric-related disorders negatively affect sexual response by impacting the autonomic nervous system, which controls the genitals. Other psychiatric drugs can block nerve function, making it difficult, or even impossible, to achieve an erection or ejaculation. High doses of tranquilizers prescribed for anxiety and depression not only cause ED, they can also be responsible for the lessening of libido (sexual desire), an inability to ejaculate, and gynecomastia (breast enlargement in men).
The popular new class of depression-fighting drugs, SSRIs, such as fluoxetine and sertraline, also inhibit sexual function. SSRIs are selective serotonin-reuptake inhibitors, a group of drugs which affect the neurotransmitter, or brain chemical, serotonin, which affects mood. These medicines often contribute to ED, diminish sex drive, and block orgasm. This latter problem is so widespread with Prozac, Paxil, and Zoloft, three of the most widely used SSRIs, that I often prescribe low dosages of them to men complaining of premature ejaculation. Current estimates of men taking SSRIs who have erectile problems range from 9 percent to 24 percent.
While it sometimes happens that sexual problems diminish after a man has adjusted to the drug he is taking, it is usually the exception to the rule. Taking a drug “holiday,” or having sex when the drug is at its lowest concentration in the body, are alternatives that work for some men (see pages 165 and 166-68). For others, yohimbe (the pulverized bark of an African tree, available in health food stores or by prescription) or red ginseng can alleviate ED when taken in combination with their SSRI medications. Many of my patients have responded very well to changing from Prozac to either Wellbutrin or Serzone.
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Any relationship is bound to have its physical ups and downs. However, a realistic appraisal of personal satisfaction is something that must be faced if a couple is to reach an enlightened connection. In the case of Rachel and Joshua, their sexual problem was, interestingly enough, related to the society in which they lived. A couple in their early twenties, they had been married for a year when they came to see me. Participants in an arranged marriage dictated by their culture, they were expected to have children as soon as possible. They told their respective families that they were seeing doctors to address their fertility problem.
Sadly, whether fertility was an obstacle was a moot question. The fact was they had only achieved intercourse a couple of times. At his young age, Joshua was experiencing erectile dysfunction.
“Our parents brought us together, we got married, and now we’re expected to have children,” Joshua told me with frustration rising in his voice. “We want to—of course. It’s just that I can’t perform regularly.
I don’t understand it!”
His physical exam revealed abnormally high cholesterol, which, I hastened to explain, very often contributes to ED as a man ages. I suspected that in Joshua’s case, the ongoing pressure to immediately build a family might be the major culprit and I suggested a consultation be with a sex therapist.
After numerous sessions, the therapist reluctantly agreed that no progress had been made. It was at this time that Joshua and Rachel enrolled in the Vasomax study.
My only concern in their case was that they had little frame of reference to compare before-and-after personal sexual experiences. “We’ve been together for a while now,” Rachel ventured, “and, despite the problems we’ve been having, we’ve been able to get to know each other in a very positive way. What I see this pill giving us is the opportunity to build on what we’ve already established. If we can get over this hurdle, I’m convinced that the love and affection we have for one another will move us forward to where we want to go.”
Joshua nodded in agreement. “Rachel is right. We want to get past this dark period and move on—even if it takes us a while to do it.”
Happily, the pill did for them what they hoped it would, and their joint feelings made the outcome the satisfying one they were hoping for. The personal satisfaction issues in this case were:
• mutual frustration at the lack of a sex life
• shared comfort in the basic relationship, based on compatibility
• anticipation of exciting and fulfilling sexual experiences—as well as becoming first-time parents
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The penis is where erection all comes together, but the penis isn’t acting alone. Looking at one, it might be difficult to imagine that it contains thousands of tiny blood vessels and a sophisticated network of nerves. The mystery deepens when you consider that all this complicated biological machinery must work together to control the flow of blood which produces an erection,
Long cylinders called the corpora cavernosa run down each side of the penis. These paired cylinders have to fill with blood for a man to obtain an erection. They are like long balloons: When pumped up with blood they are erect; when vacant, they are not erect. And they hold a lot of blood. When erect, the penis holds about eight times as much blood as when flaccid,
A tube called the urethra runs along the bottom of the penis. The urethra carries sperm and urine, but not, thankfully, at the same time. When a man ejaculates, a valve between the urethra and the bladder closes off the bladder and allows only sperm to pass. Although some sperm may be washed out when a man urinates, in general the same sophisticated valve system prevents sperm from traveling down the urethra when a man is urinating.
Surrounding the urethra is other spongelike tissue called the corpus spongiosum. This area also fills with blood during an erection. It is connected to the most sensitive part of the penis, the tip or head, called the glans penis.
The glans penis is a little bonus from nature, an extra source of sexual enjoyment for the man. It normally becomes firmer and larger when a man is aroused. And a man will respond more quickly to stimulation at this pointthan anywhere else along the penis.
The skin of the penis slides easily over the entire penile shaft. All males are born with an extension of this skin, called the foreskin, which covers the glans penis. However, it has been very common for American men to have had the foreskin removed shortly after birth with a minor surgery called circumcision. (There is usually no medical reason for circumcision, and these days many parents choose not to circumcise their baby boys.)
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