Health News and Information

The trick is to balance acceptance of help with preservation of control. First, don’t give up independence too easily. “I have a friend with AIDS,” says Steven, “who sometimes asks me to bring stuff down from his attic or install his screen windows—things I know he can do for himself. I say no. I know, because I have other friends with AIDS, that he has to take some responsibility. Lots of people give up, but mental and physical health go hand in hand.” People feel better about accepting help if they think they’ve done their best to accomplish the task on their own first.      Next, accept the fact that having some help is going to be necessary. Certainly such physical limitations as fatigue require that you accept help. Helen, who had worried about depending on her parents or on welfare, made her peace with getting help. “I know I’m not going to be able to count on myself for everything,” she finally said. “I’m not going to be afraid of becoming dependent, of saying I need help. My father and stepmother have been very supportive. My church will always help.” Some people feel they need help so badly they have no choice but to accept it. Some people feel they can accept help because they have helped others: what goes around comes around, they say. Some can accept help because they understand that their caregivers need to be involved with them. Some know that if circumstances were reversed and their caregivers were sick, they would help their caregivers. Some feel they have led good enough lives that they are worthy recipients of care.
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Although standard drugs for osteoarthritis reduce pain, there is worrisome evidence that they may contribute to the problem by interfering with the efforts of cartilage to repair itself. When this was discovered, researchers in Europe began to look for substances that could protect cartilage from further harm. The term for such a substance is a “chondroprotective agent.” The concept of chondroprotective agents has not been widely accepted among U.S. physicians, although veterinarians in the United States have begun to use it.A number of substances have been proposed as chondroprotective agents. The reasoning behind two of them, glucosamine and chondroitin, is almost embarrassingly simple: They contain raw materials necessary for rebuilding cartilage. Hypothetically, supplying extra amounts of these raw materials may enable cartilage to repair itself faster.Another proposed chondroprotective agent, S-adenosylme-thionine, is believed to help cartilage repair and possibly exert other helpful effects.If chondroprotective agents live up to their name, they might even stop osteoarthritis from following its natural course and becoming worse with time. If so, they could be called “disease-modifying drugs,” unlike other treatments that just reduce symptoms temporarily. More research, however, is necessary before we can say for sure that chondroprotective agents really work this way.7/306/5*

The cervix is the neck of the uterus that juts into the upper vagina. It is usually about 3-4 cm long and 2-3 cm in diameter. The cervix often gets bigger following pregnancy. The outside of the cervix is usually covered by the same tissue as that which lines the vagina (‘squamous’). The inside of the cervix consists of glandular tissue responsible for producing mucus which in turn ensures that sperm is able to swim up into the uterus and subsequently along the tubes to meet the egg so that fertilization can take place and pregnancy occur.The junction where the outside skin and inner glandular material meet is called the ‘transformation zone’ and it is at this site where precancerous change develops. In younger women this site is on the outside of the cervix. In postmenopausal women it is usually within the canal of the cervix, which is why a brush sample is routinely taken during a Pap smear.The principal reason why cancer of the cervix develops is due to an infection with a virus – the ‘human papilloma virus’ (HPV). It is estimated that at least 80% of the sexually active adult population at some point are both exposed to and infected with human papilloma viruses of which there are over 100 different types. Approximately 15-20% of these can affect the female genital tract and can be responsible not only for the development of cancer of the cervix, but in some cases can also cause vaginal cancer and vulval cancer.Since these viruses are transmitted sexually, infections are usually quickly resolved through a woman’s immunity and therefore do not result in cancer. It is still unclear as to why in some women these infections persist and eventually lead to precancerous and ultimately cancerous changes. Certainly smoking cigarettes increases the risk by about 4 times. It is obvious that the more times a woman can be exposed to such viruses, then the higher the chances of her getting cancer of the cervix.The incidence of this cancer is increased in women with multiple sexual partners, particularly when barrier contraception, such as condoms, is not used. Lesbian women also have a risk of developing cancer of the cervix and need to have regular Pap tests.There are two common cancers affecting the cervix. In about 80% of cases, the cancer arises from the outside skin of the cervix – the ‘squamous epithelium’, thus these are called squamous cancers.In about 20% of cases, however, the cancers can arise either from the glandular tissue in the canal of the cervix (‘adenocarcinoma’), or can be mixed cancers called ‘adenosquamous cancers. These cancers grow locally into the upper vagina and into the ligaments supporting the cervix – the so-called ‘cardinal’ ligaments or ‘parametrium’. Because the tube running from the kidney to the bladder runs in the parametrium, if local spread of cancer does occur, these tubes can get blocked and the kidneys become swollen causing pain in the back, below the ribs on either side of the midline.These particular cancers are prone to infection, so foul smelling discharge and heavy bleeding can be a problem if left untreated. In advanced cases the bleeding can be life threatening. As in uterine cancers, advanced cancers of the cervix can invade into the bladder and into the rectum with leakage of bladder and/or rectal contents into the vagina. Because the nerves supplying the pelvis run along the ligaments supporting the cervix, then pain can be a feature, particularly in advanced cases.Cancers of the cervix take a while to spread outside of the pelvic area. The cancer spreads most often to the lungs and occasionally to the bones so that a cough or chest pain and/or bone pain becomes prominent.*4/144/5*