Health news blog

To-date, no treatment has been developed that is effective for all women with endometriosis because little is known about the causes of the condition. However, many different approaches have been tried.

In general, the treatments aim to relieve the symptoms and, where desired, improve the chances of conception by eradicating as many endometrial implants, cysts and adhesions as possible.

The main options available for the management of endometriosis are:

* observation

* symptomatic management

* hormonal treatment

* surgical treatment

* combined treatment

* alternative therapies

Observation

Observation or a ‘wait-and-see’ approach involves no active treatment. Rather, as the name suggests, it simply involves a period of observation and monitoring. Such an approach should still involve regular visits to your gynecologist to monitor any possible progression of your endometriosis and its symptoms.

Some gynecologists believe that a period of observation is the most appropriate form of management for young women who have minimal endometriosis with no significant symptoms. Others believe that it is inappropriate because they believe endometriosis should be treated as it usually progresses.

A period of observation may be the most appropriate form of management if a woman decides that she does not want to have active treatment, particularly if she has minimal or no symptoms.

Symptomatic management

Symptomatic management for endometriosis involves treating only the symptoms – usually the pain – without attempting to treat the underlying disease.

It usually involves the use of various analgesics or anti-inflammatory drugs if the pain is intermittent, or a range of pain management techniques if the pain is chronic and ongoing.

Symptomatic management may be appropriate if a woman decides not to have treatment or if she has symptoms that have not responded to previous treatments.

Symptomatic management may also be used as an adjunct to conventional or alternative treatments in order to relieve ongoing symptoms.

If you decide to have only symptomatic management you need to be aware that it will not treat your endometriosis in any way and that in fact your endometriosis may progress.

Hormonal treatments

The hormonal treatment of endometriosis uses drugs to treat the condition. In general, hormonal treatments aim to eradicate the endometriosis by suppressing the menstrual cycle and preventing the growth and development of the endometrial implants and cysts.

Surgical treatments

In general, surgery for endometriosis aims to remove as many endometrial implants, cysts, endometriomas and adhesions as possible and to repair any damage caused by the disease. In the case of a hysterectomy, surgery aims to cure the disease by removing the uterus and sometimes the ovaries as well.

Combined treatment

Combined treatment is the use of a course of hormonal treatment before, or after, surgery to enhance the effects of the surgical treatment.

Alternative therapies

A variety of treatments are used by alternative therapists. Each therapist uses a combination of treatments, although the actual treatments used for each individual will usually depend on an assessment of her problems.

*29/41/5*

Noted brain experts Richard Wurtman and Judith Wurtman conducted experiments with CCO (carbohydrate-craving obesity) patients. Their work demonstrated how the urge to consume carbohydrates strikes predictably during the late afternoon. But why should this be so? If a person has a disorder that compels her to eat huge quantities of food, why should her appetite be greater at certain times of day? And why is it limited to a certain type of macronutrient? Not all of the answers are in yet. However, some evidence points to the neurotransmitter serotonin-or rather, a defect in serotonin secretion-as one possible source of the problem.

A normal person who feels the urge to eat something sweet might be satisfied with a couple of cookies or a candy bar. In contrast, a carbohydrate craver continues to eat beyond the point of satisfaction. As we learned earlier, serotonin usually acts to suppress eating. The Wurtmans believe that carbohydrate-craving behavior suggests something has gone wrong with the feedback loop that signals the brain when enough food has been taken in.

There’s another level to the problem as well. When asked why they succumbed to such dangerous eating practices, carbohydrate-craving people reported that they weren’t interested in the taste of the food. Instead they ate as a means of fending off tension, anxiety, or mental fatigue. In other words, carbohydrate cravers seem to use food as a kind of self-prescribed regimen of antidepressant therapy. Earlier we saw how carbohydrates lead to increased serotonin levels. Could a defect in the serotonin system be a common link between these disorders?

Knowing that a faulty serotonin system may underlie certain kinds of abnormal eating has led to the use of medications to correct the problem. A chemical called d-fenfluramine, for example, acts as a kind of biological boxing coach. It calls on serotonin to get out there and fight by triggering its release from nerve cells. Then d-fenfluramine prolongs the bout by blocking reabsorption of serotonin back into the cell-in a sense, keeping the boxer from returning to his corner before the fight is over. The popular antidepressant Prozac (fluoxetine) also increases serotonin levels by blocking the reabsorption of serotonin by the nerve cells.

Through this one-two punch, d-fenfluramine helps serotonin do the job it was designed for: control appetite. Use of this and other similar compounds can help some carbohydrate-craving patients enjoy more normal moods and in some cases lose weight. There has also been some success in using these medications for PMS and SAD. Recent research in patients with PMS has also shown that consumption of high-carbohydrate meals (which increases serotonin) can help improve premenstrual depression, tension, and fatigue.

Eating is not just a simple process. A complex network of signals exists between the brain and the rest of the body. Some of these signals arise from within. Others- anything from the amount of daylight outside to a friend’s invitation to go and grab a burger-come from the outside world.

These signals trigger the release of biochemicals that stimulate appetite. The digestive organs respond to what we eat by releasing still more chemical messengers that report to the brain. The brain processes the information and issues orders to stop, continue, or eat something different next time.

Although social cues play a role, eating is largely a self-sustaining physical process. Disruptions can occur at any point in the system. There may be insufficient supplies of a certain brain chemical or a defect in an organ’s ability to respond to a neurotransmitter’s message. Fortunately, our growing knowledge of how physical problems contribute to eating disorders points the way to new and effective biological treatments.

*44/35/5*

Seven years ago, Mitch Lipka tipped the scales at 450 pounds, thanks in large part to a steady diet of high-fat foods. But he never got serious about slimming down until the day he tried to climb a short flight of stairs to his mother’s apartment. The effort left Mitch, who could no longer fit through a turnstile or slide into a restaurant booth, exhausted and gasping for air. On the spot, he resolved to lose weight.

He started by giving up meats and fried foods, then eliminated cheese, ice cream, and other high-fat fare. In their place, he learned to prepare low-fat meals, using a cookbook that his mom gave him. The pounds started coming off almost immediately.

Inspired by his progress, Mitch started plotting his next strategy: exercise. At first, he tried walking around the block. But because his job as a newspaper reporter had him working odd hours, he had to find an activity that better fit into his crazy schedule. So he invested in a stationary bike, which he rode when he got home from work. “I’d set little goals for myself,” he recalls.

“I’d ride for 5 minutes the first five sessions, then 7 minutes the next five sessions, and so on.”

Of course, some nights Mitch could hardly bear to look at his bike, much less ride it. That’s when his diversionary tactic came into play. He’d throw a towel or a T-shirt over the timer, then concentrate on something else. He’d get so lost in thought that before he knew it, his time was up.

After 2 years of his diet-and-exercise regimen, Mitch had lost 200 pounds. Five years later, at age 34, he’s still fit and feeling good about himself.

WINNING ACTION

Let your imagination go. Boredom can put a crimp in even the best-laid exercise plans. If you’re not enjoying what you’re doing, chances are, you won’t stick with it. So find ways to make your workout interesting. Mitch hides the timer and thinks about something else. If you’re using a stationary bike or other fitness equipment, try watching TV, flipping through a magazine, or cranking up some Tina Turner, Madonna, or your favorite uptempo tunes. Personally, as dull as it seems, I’m a fan of nothingness, like Mitch. I like quiet time when I’m on my treadmill. My mind wanders everywhere!

*98\89\8*

Hand in hand with affirmations goes visualization. While affirmations are spoken instructions you give your mind, visualizations are mental pictures that allow you to see yourself as you want to be.

Set aside 10 to 20 minutes a day. Find a room or place where you will not be disturbed. Make yourself comfortable. Close your eyes. Let your mind’s eye see yourself acting, feeling, doing, having and being what you want yourself to do, feel, have and be. Picture yourself remaining calm in a tense situation. Imagine that you’re walking away from an argument. If you’re a stress phobic, visualize yourself standing up calmly for your rights. Those of you on a diet can see and feel yourself 20 pounds lighter, happily and easily refusing a proffered piece of cake.

Put the words and pictures together by combining visualizations and affirmations. Say it, see it and feel it in your mind and body. Say, see and feel yourself having and being what you deserve to have and be.

With visualizations and affirmations, any positive situation you desire can be etched into your subconscious mind and made a part of your behavior.

*146\80\8*

NOT JUST WALKING

Brisk walking, 25 minutes a day, four days a week, is enough to provide you with physical and psychological well-being. For the more eager and adventurous, there are many other great exercise activities.

Riding a bicycle is an excellent exercise, whether it be a real bicycle or an exercise bicycle. When it gets too hot or too cold to exercise outdoors, I go with my sons to a health club. While they’re lifting weights and playing basketball, I ride a stationary bicycle and watch the pretty women lifting weights, stretching and taking aerobics classes.

Swimming is another excellent, all-around exercise that gives you the health benefits of brisk walking. And because swimming takes the weight off your lower back, it’s a wonderful activity for those with problem backs.

Brisk walking, jogging, swimming, cross-country skiing, rowing, aerobics, karate—anything that keeps your heart beating in your Heartbeat Target Zone for about 25 minutes will do the trick. If you prefer more strenuous and difficult activities, fine. If not, brisk walking is all it takes to strengthen your “doctor within.” Such sports as baseball and touch football are fun, but they don’t give you the aerobic benefits of walking, because the action isn’t continuous. Your heart rate doesn’t stay in the Heartbeat Target Zone. Instead, it bounces up and down as you start and stop.

*104\80\8*

Let’s suppose you eat an abundance of Super Foods, that your diet is filled with vitamins and minerals significantly above the RDAs. Do you need to take supplements? Absolutely!

How many vitamins and minerals you consume is only one side of the equation; your nutrient requirement is the other. There are many factors that increase your need for vitamins and minerals. Alcohol, coffee, tea, tobacco, marijuana, refined foods and radiation, for example, lower the blood levels of one or more B vitamins. Premenstrual tension lowers the blood level of vitamin E. Physical and emotional stress increases with your need for vitamin C, the B vitamins and zinc. Air pollution increases your need for vitamin C.

Many common medicines interfere with the absorption of the vitamins and minerals you eat or prevent your body from utilizing them properly. Aspirin, mineral oil, antacids, oral contraceptives, antibiotics, diuretics, pain medications and heart medications can increase your nutrient requirements.

*61\80\8*

I was describing the “doctor within” and the immune system recently to a friend of mine. He said, “What’s the problem, Arnie? If I get sick, I go to my doctor and he’ll give me a shot to fix my immune system.”

Unfortunately, our medical system is not the answer. You see, we don’t have a health-care system in this country, we have a disease-care system. Disease is fussed over. People suffering from obscure and “glamorous” diseases are given the medical red-carpet treatment. Millions of dollars, hundreds of journals and some of the best minds in this country are devoted to disease. Medical students spend most of their time studying rare diseases and practicing crisis medicine, instead of learning to prevent disease by protecting the “doctor within.” And health? It gets lost in the shuffle.

Our medical system has been captured by the disease-loving “Band-Aid philosophers” of medicine, who pay homage to such high-tech procedures as coronary artery bypass surgery, various chemotherapies, plasma electrophoresis, PTCA (percutaneous transluminal coronary angioplasty), CAT scans and, lately, MRI (Magnetic Resonance Imaging) scans.

These surgeries and machines are exciting: it’s high-tech glamour. What doctor wouldn’t want to be in an operating room, replacing one heart with another? Isn’t the chance to play God more fun than trying to teach people to eat and think properly? Sure it is, but it doesn’t work. There is no Band-Aid that can restore good health once it’s gone.

Our medical system has been led astray. And so our medical researchers concentrate on building new hearts, not on keeping the old ones strong and healthy. Hospitals are filled with tons of amazing machinery that can do everything but give people back their health. Bigger and better machines, more surgical techniques, artificial organs; it’s a wonder that there’s any room left for patients in our medical system.

Doctors are paid large fees to perform surgery, office procedures and laboratory tests. They are paid very little for spending time listening to their patients, for carefully going over their medical and personal histories, for teaching them how to change their life-style. And they are paid nothing for preventing disease.

*17\80\8*

In the face of all these difficulties, it is reasonable to ask why anyone bothers with such studies. But they do, in the interests of establishing scientifically valid forms of diagnosis and treatment. Attempts to do this in relation to food intolerance are many and varied, and we will not try to cover them all. What matters in such studies is the care with which they are designed and the details of how they are carried out. To assess a trial properly, one must look carefully at the details and we will therefore concentrate on five trials – two dealing with rheumatoid arthritis, two dealing with irritable bowel syndrome, and one dealing with migraine. These trials are the main ones carried out in Britain within the last eight years, and they are among the most scientific attempts to evaluate the food-intolerance concept.

*105\180\8*

Since your primary care doctor functions as the “gatekeeper”—blocking or granting access to specialists—choosing a good gatekeeper can be vital. You want someone who, if necessary, will appeal on your behalf if you need a special test or an extra day in the hospital. It’s often hard to tell much about a doctor from the brochures, so again, talk to other members, even people you bump into in the waiting room.

If you feel you’re being unjustly denied services you need, don’t be afraid to fight for them. If politely making your case to your doctor doesn’t work, try appealing to an administrator. All HMOs have formal grievance procedures.

Finally, the more you can learn about any medical conditions you have, the better position you’ll be in to assert yourself. HMO doctors have a difficult time saying no to reasonable, well-informed patients.

*84/47/1*

what òî look for: Whole rye should be the first ingredient. Long, slow cooking causes the natural sugar in rye flour to darken and sweeten the bread.

typical nutritional data per slice: 100 Calories, 0.5 g

fat, 3 g fiber, 200 mg sodium.

good brands: Mestemacher Genuine Westphalian Pumpernickel… Rubschlager 100% Rye, Rye-Ola Pumpernickel.

Dietary silicon, found in whole grains and their products (such as beer), reduces bone loss and promotes bone formation.

Beer is an especially good source because it is readily absorbed. Other sources of silicon include oat bran, barley and rice.

warning: More than two drinks per day for men or one for women is considered harmful.

*75/47/1*