The blog is about health and gives useful information on health and disease.

Unfortunately, there are several major drawbacks to this study. Firstly, the number of patients involved was very small, and they were probably what doctors call ‘a highly selected group’: that is to say, they were not representative of IBS patients as a whole, for reasons that have already been discussed. Secondly, 59 per cent of the patients studied refused to undertake a full elimination diet, and according to the authors ‘wheat was not excluded in all these patients’. Thirdly, and most seriously, the method used for double-blind testing was highly questionable. In order to disguise the taste of the foods being tested, the Manchester team used dried, powdered foods and placed them in gelatine capsules. It has been calculated that a single tablespoonful of food would fill 12 such capsules, yet only one capsule was used for each test. It is widely accepted, by orthodox and unorthodox doctors alike, that food intolerance reactions do not occur with such small amounts of food. Food allergy reactions can, of course, and the test procedure was probably designed with these sort of reactions in mind. It is significant that the three patients who showed consistent positive reactions also had a range of atopic symptoms – asthma, eczema, urticaria or hay-fever. In other words, the double-blind test was probably detecting those with IgE-mediated allergic reactions to food and missing others with food intolerance. As the authors themselves admit ‘… even patients with clear evidence of immunologically mediated sensitivity may not react every time they are exposed, particularly if the dose is limited.’

Another trial of IBS patients, carried out two years later by a different group of doctors, produced similar results. In this study, only three out of 49 patients were found to be food intolerant. Unfortunately, this study followed a similar procedure to that of the Manchester group – wheat and citrus fruits were not excluded, and capsules were used for double-blind testing.

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When you pay more than 50% of the support for an individual, tax benefits can result… • When the individual’s income doesn’t exceed $3,200 in 2005 or $3,300 in 2006 (excluding tax-exempt income, such as from municipal bonds and the tax-free portion of Social Security),

you may be able to claim him/her as a dependent to obtain a tax exemption of $3,200 in 2005 and $3,300 in 2006.

note: New rules apply to a qualifying child. Income may not matter and support only becomes critical if the child pays more than half.

• Even if the individual has income exceeding the limit, you may be able to deduct medical expenses you pay on his behalf if the individual is a relative. (Ë “relative” is a parent, grandparent, sibling, child, grandchild, aunt, uncle, niece, nephew or in-law.)

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Consider asking your doctor not to include especially sensitive information in your record. You might say, “If I tell you something very personal that may be relevant to my care but that I don’t want to be written in my chart, would you respect my wishes?” If your doctor is unwilling to honor your request, you’ll have to decide whether you still want to reveal the information.

Keep in mind that keeping important information out of your chart could compromise your care down the road—especially if you see another doctor or if your doctor fails to remember what you said. Keep information out of your record only if you feel doing so is absolutely essential.

Be wary of any medical information you give out, no matter how innocent it seems. A TV ad once offered free information on pollen counts to anyone who called an 800 number. The names of those who called were then used by the drug company that had sponsored the ad to market an allergy medication.

Get a copy of your medical records to make sure all information is factually correct. An error in your chart could lead to the loss of employment or future insurance coverage.

In most states, you have a legal right to your medical records. In the rest, you can ask your doctor for a copy of your chart. If your doctor won’t provide it, you’ve got to wonder whether your doctor views health care as a democracy or a dictatorship.

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Grain products, including pasta, oatmeal, hot and cold breakfast cereals and bread, are divided into two subgroups— whole and refined. Whole grains, by definition, contain the entire grain—the bran (outer coating), germ (seed embryo) and endosperm (also called the kernel, it makes up most of the seed). Examples include whole-wheat flour, cracked wheat (bulgur) and brown rice.

Whole grains are rich in fiber, which has been shown to reduce risk for heart disease, diabetes and some cancers. They provide large amounts of vitamins and minerals that are sometimes lacking in our diet, including magnesium, selenium, potassium, zinc, vitamin E and chromium.

Refined grains are milled to remove the bran and germ, which gives them a finer texture and lengthens their shelf life. This process is also nutritionally devastating—it removes the healthful fiber, iron and many  vitamins and other vitamins and minerals found in whole grains.

Since refined grains are digested more quickly than whole grains, they can cause spikes in blood sugar and insulin secretion, which can increase hunger—and diabetes risk. Refined grains include white flour, white rice and white bread.

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Placing duct tape (or other tape) over warts to get rid of them is not just an old wives’ tale. A recent study found that placing tape over warts is more effective at eliminating them than standard medical therapy.

the study: Participants who had warts on fingers, palms, heels or soles of the feet were divided into two groups. One group put tape on warts for six days, then soaked the warts and scraped them with emery boards, waited 12 hours and reapplied the tape, repeating the process. The other group had their warts frozen off by a doctor, which is standard therapy.

result: After just two months, 85% of those using the tape had gotten rid of their warts, versus only 60% of those who had received the standard freezing treatment.

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The researchers say there is no clear proof that surgery is better than rehabilitation, and suggest that rehabilitation should routinely be made available to people who have chronic low back pain.

Their cost analysis also found that, on average, surgery is much more expensive per patient than rehabilitation.

However, the researchers caution, this conclusion could change if more patients who receive rehabilitation go on to require back surgery in the future.

Limit conversation with your doctor before he/she takes your blood pressure.

background: Many people whose blood pressure is normal at other times experience a sudden rise in pressure at the doctor’s office.

cause: Anxiety associated with interacting with the doctor. This “white coat” effect—named for the doctor’s garb—makes it hard to get an accurate reading.

study: Hypertensive patients who talked with the doctor before having their blood pressure checked had a sudden rise in blood pressure. This effect was more drastic during discussions of stress and disease than during chitchat. During periods of silence, blood pressure rapidly fell.

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Mrs A. took the progestogen-only Pill while she was breast feeding her second child but was advised to change to the combined Pill when she began to wean him. She now had a girl and a boy and felt her family was complete. She was already working part-time. Before her first pregnancy she had taken the combined Pill and again between the children, but now it did not seem to suit her. She had been back to the doctor several times with minor complaints and tried different brands. This time she asked to be fitted with a cap. The doctor noticed that Mrs A. seemed very anxious and asked a lot of questions during cap fitting. She wondered whether Mrs A. was worried about choosing a less effective method, having said she wanted no more children, or whether perhaps she really did want more children and was hoping ‘to make a mistake’, but she kept these thoughts to herself and listened.

‘Can the cap do any damage? How long does it take the Pill to get out of your system? Should I have another cervical smear?’ Instead of offering reassurance, the doctor said, ‘You seem to be rather worried about yourself.’ ‘It’s only since my son was born. It’s all so silly really, but I feel I’ve got to keep myself healthy for them. I suppose it all goes back to when my little brother was born. My mother was a long time in hospital with him. I don’t really know what was wrong, but I know she nearly died. I was only four but I still remember it.’

Did Mrs A. think that what had happened to her own mother might happen to her, or was it the frightened child of four within her that the doctor was reassuring?

The doctor shared these thoughts with the patient, thoughts which had been provoked by the patient’s remarks and were therefore more relevant than her previous ideas about reliability, and after a moment or two Mrs A. said, ‘I think I’ll try just one more Pill. There’s no reason at all why I shouldn’t. I was perfectly happy on it before and I really don’t want to risk getting pregnant again.’ Two months later, having shared her anxieties with the doctor, Mrs A. had settled happily on the Pill and all was well.

In this case the experience of the birth of her son reawakened memories and feelings in Mrs A. from her early childhood. In some women the feelings may come from the deepest levels of the unconscious, and may be so traumatic that serious psychological upset can occur. However, in many women such as Mrs A. the memory can easily be dealt with once it is put it into words, and the doctor who can assist in that process has a great deal to offer.

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The cap lies in the vagina. It is a temporarily accommodated guest without eyes or ears. Provided it does its job, it is tolerated, and guests are fine to have around if you feel well. If you are not feeling so well, they are not so fine.

Most doctors are familiar with the issues that a cap brings to the fore for a woman, but the feelings it arouses in the man are less well studied. Men have been heard to use combative phrases to decribe it. T don’t fancy catching my weapon on that’, and ‘What if I knock it into the wrong position?’ For them it is not an unnoticed companion in their private place.

Mr E. is now separated from his wife. Things had been strained for some time. She had asked him to go back to condoms ‘because of the mess’. Later she announced, ‘You can leave them off if you want now.’ Mr E. said he could cope with the cap, but could not understand how hurt he felt when she told him she had been using it for several weeks before she told him. ‘I had hoped it meant we were getting closer’, he said, ‘but that thing [the cap] was worse because I couldn’t see it.’

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This may well be a happy event requiring no special support, but an unplanned pregnancy may occcur when a woman feels ill-prepared for parenthood and she may need extra emotional and social support. If she had considered abortion, she may harbour feelings of guilt, sometimes resulting in over-zealous protection of her child. The very factors making her consider abortion may still be present when the child arrives and the practical difficulties will need to be faced.

The patient with an unplanned pregnancy may present with many conflicting emotional needs, which require rapid assessment. The doctor with psychosexual training is in a particularly good position to help such women reach a satisfactory conclusion and make sense of her situation. A student once asked this author if she found the work depressing. Interesting, exhausting challenging, frustrating possibly, but helping women with unplanned pregnancy is not depressing. There are perhaps very few situations where one can be of such benefit to the patient so quickly.

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At the next visit Miss R. had stopped taking the Pill and then started it again, and had many complaints about feeling weak and tired, and having vague aches and pains. Again, she was not examined. During the next year she saw many different members of the clinic staff with complaints about sore breasts, fear of infection, pain in her leg (which could have been a deep vein thrombosis), and continuing anxieties about her parents finding out she was on the Pill, and about her marriage prospects. Finally, one day Dr A. noticed that the boyfriend was always in the waiting room, and was able to lead the patient to a discussion of the question of choice, and the patient’s right to say yes or no to sex. This led to further questions about virginity, and the state of her hymen, although again no genital examination.

Following this important consultation her visits to the clinic became less frequent, and later she was able to admit that she was not ready for sex when she started and that she should not have done it. However, there was no discussion of the feelings that led her to start.

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