But unlike colds, there are many fewer viruses that cause the flu, and despite their fickle nature, it is possible to prevent the flu by an annual vaccine taken weeks before the flu season. Researchers worldwide monitor the changes in the flu virus, and before each flu season, manufacturers are usually able to produce a revised vaccine that incorporates protection against the newest virus variants.
Chances are you’ve heard recommendations that flu vaccine be given annually to people over sixty-five, to people like the police and firefighters who perform essential services, and to anyone with a chronic illness like heart or lung disease or an immune deficiency that can turn even a mild flu into a deadly disease. Being a younger, healthy person in a “nonessential” occupation, perhaps you think the flu vaccine is not for you. Perhaps you view a bout with the flu as a mini-vacation, an excuse to escape from your normal duties. Or perhaps friends told you that when they took the vaccine, they got a reaction that was almost as bad as the flu itself.
Well, if any of these “perhapses” applies to you, think again. Anyone, regardless of age or health status, is entitled to and can benefit from flu vaccine, assuming the person can afford it. The public health recommendations about who should be immunized are designed to protect those at highest risk of suffering life-threatening complications from the flu. They were issued primarily because there simply isn’t enough flu vaccine to go around if every young, healthy person got the shot too. But times are changing, and new technologies and an increased number of vaccine producers have helped to expand the supply, which would no doubt grow larger if the demand for the vaccine were greater.
Having the flu is no fun, and chances are you’ll feel too ill to do any of those housebound projects you’ve been meaning to get around to. If you can’t afford to be flattened by the flu for a week or more, and debilitated for weeks longer, you’d be wise to get the vaccine in October or early November every year. Waiting until the flu hits your community is not wise; it usually takes two to three weeks after you receive the vaccine for your body to build up an immunity to the viruses. However, public health officials advise that high-risk individuals who were not previously immunized should get the vaccine even if a flu outbreak is already under way.
Vaccine side effects have been greatly exaggerated. It is biologically impossible to get the flu from the vaccine because the viruses in the vaccine are dead and incapable of invading and reproducing in your cells. All they can do is rev up your body’s immune system and prompt it to produce antibodies that would knock out the live flu viruses should you encounter them. If you do suffer a flulike reaction from the vaccine, chances are you are extremely susceptible to the viruses the vaccine is designed to protect against. If you were unprotected and contracted the flu from one of those live viruses, you would undoubtedly become extremely ill. It’s better by far to have a brief flulike vaccine reaction than the full-blown flu. The most common vaccine reaction is not illness at all but rather some minor redness and soreness at the site of the injection that goes away in a day or two.
There are, however, a few people who should not take flu vaccine. Since the vaccine is produced from viruses that are grown in eggs, those with a severe allergy to eggs should avoid it. People who are already suffering from an infectious illness had best let themselves recover before getting a flu shot. The vaccine can be given safely to very young children, although they commonly get more side effects than adults do. Babies over age six months who have ailments that place them in a high-risk category for serious complications of the flu can be given a so-called split-virus vaccine to minimize side effects.
Flu vaccine is effective, but it is not perfect. In general it is 70 to 90 percent effective in preventing the flu that is going around that year. Unfortunately, it is more effective in younger people than in the elderly, who most need its protection. Also, it has a time-limited benefit. Even if the flu viruses don’t change from one year to the next, the immunity induced by the vaccine only lasts about one year. So you would need to get an annual shot no matter how the virus behaves.
*18\296\2*

Fungi
Hundreds of species of fungi, multi- or unicellular primitive plants, inhabit our environment and serve useful functions. Moldy breads, cheeses, and mushrooms used for domestic purposes pose no harm to humans. But some species of fungi can produce infections. Candidiasis (a vaginal yeast infection), athlete’s foot, ringworm, and jock itch are examples of fungal diseases. Keeping the affected area clean and dry plus treatment with appropriate medications will generally bring prompt relief from these infections.

Protozoa
Protozoa are microscopic, single-celled organisms that are generally associated with tropical diseases such as African sleeping sickness and malaria. Although these pathogens are prevalent in the developing countries of the world, they are largely controlled in the United States. The most common protozoal disease in the United States is trichomoniasis. A common water-borne protozoan disease in many regions of the country is giardiasis. Persons who drink or are exposed to the giardia pathogen may suffer symptoms of intestinal pain and discomfort weeks after infection. Protection of water supplies is the key to prevention.

Parasitic Worms
Parasitic worms are the largest of the pathogens. Ranging in size from the relatively small pinworms typically found in children to the relatively large tapeworms found in all forms of warm-blooded animals, most parasitic worms are more a nuisance than a threat. Of special note today are the new forms of worm infestations commonly associated with eating raw fish in Japanese sushi restaurants. Cooking fish and other foods to temperatures sufficient to kill the worms or their eggs is an effective means of prevention.

Prions
One of the newer and more frightening pathogens to infect humans and animals in recent years is a self-replicating, protein-based agent that has been labeled as a prion, or unconventional virus. Believed to be the underlying cause of spongiform diseases, such as “mad cow disease,” this agent systematically destroys brain cells.
*17/277/5*

If bringing up the drinking practices and potential problems of a family member or close friend makes someone squirm with discomfort, the idea of saying something to a coworker is virtually unthinkable. Almost everyone accepts a separation between work and home or professional and private life. So until the alcohol problem flows into the work world, the worker’s use of alcohol is considered no one else’s business. That does not mean that no one sees a problem developing. Our suspicion is that someone with even a little savvy can often spot potentially dangerous drinking practices. The office scuttlebutt or work crew’s bull sessions plus simple observation make it common knowledge who “really put it away this weekend,” or the “poor devil who just got picked up DWI,” or “you can always count on Sue to join in whenever anyone wants to stop for a drink after work.”
Even if an employee does show some problems on the job, whether directly or indirectly related to alcohol use, coworkers may try to “help out”—by doing extra work, or not blowing the whistle. Because employee assistance programs, if they are present, are based on identifying work deterioration, any attempt by coworkers to help cover up job problems makes spotting the alcohol problem all the more difficult. If a company does not have a program to help alcoholics, odds for a cover-up by coworkers are even greater. Another important party in this concealment strategy is predictably the spouse, who usually doesn’t want to do anything to threaten the paycheck.
In the past when the cover-ups no longer could hide a problem, the alcoholic usually got fired; this may still happen in many companies. In such instances, the company loses a formerly valuable and well-trained worker, statistically a costly “solution.” The current thinking is that it is cheaper for a company to identify problems earlier and to use the job as leverage to get the employee into treatment and back to work.
*112\331\2*

This medication can be administered as an aerosol powder, a metered aerosol or a respirator solution. Commonly known as Intal, this sodium cromoglycate is designed for long-term prophylactic use. After using Intal, physiological improvement has been noted in both allergic and non-allergic asthmatics. Intal can be effective in preventing exercise-induced asthma if it is used a few minutes before starting to exercise.
Studies are underway to determine exactly how Intal prevents mast cells from releasing the mediators that cause allergic and non-allergic inflammatory reactions. What is known so far is that Intal seems to reduce non-specific bronchial hyper-reactivity.
Whenever you find that you are starting to experience asthma symptoms, it is recommended that you use Intal a few minutes after a bronchodilator spray has opened up the airways, thus allowing Intal to penetrate deeply into the lungs. If you are using the Intal respirator solution, it can be mixed for the same effect with a beta-agonist solution in a nebulizer. As with all the medications discussed in this book, the recommended doses of Intal should be worked out with your doctor.
SIDE EFFECTS OF INTAL
Intal has very mild side effects, such as coughing or a slight irritation after breathing in the powder. Most people report no side effects at all.
*20\148\2*

Although manipulative methods are mainly applicable only by another person, there is one limited — but usually effective — technique which the patient may apply to himself. In cases of distressing spasm in the heart region, relief from the pain can often be achieved by the following: With the fingers and thumb of the right hand  slightly fanned—each separated from its neighbours by about a finger’s width — rest the tip of the thumb in the notch at the top of the breastbone. The tips of the index and middle fingers will now be found to lie in two shallow, adjacent grooves between the ribs. Pushing the tips of these fingers into the flesh, keep the pressure on firmly for as long as seems necessary to ease the distress. Usually about a minute is enough. Please be quite clear: this is not a curative treatment; it is merely a harmless method of gaining relief.
*80\253\8*

What you are actually feeling when you take your pulse is the waves of blood travelling from the heart along a main artery. The pulse is normally felt at the wrist, because the beat is strong and in an easily accessible place, but pulses can be felt in many other parts of the body, such as the neck.
To take your pulse, use a watch that shows seconds. Hold the watch in your left hand and hold the left wrist with your right hand – move the first two fingers of your right hand until you can feel the pulse just under your thumb on the left wrist. Count the number of beats that occur during a thirty second interval and then multiply by two to get the number of beats per minute. To get the ‘resting pulse’ you should do this first thing in the morning, while you are sitting in a relaxed position.
The next step is to work out what your safe maximum pulse rate during exercise should be. This depends on two things: your age and your current level of fitness. For a fit person, the heart can beat at a maximum of about 200 beats per minute at age 20, but at only about 150 beats at age 70. When you are exerting yourself, your pulse rate should not rise about 75 percent of your maximum. A useful and very safe formula for calculating the ideal rate for you is: 200 minus your age minus another 40 if you are very unfit. Thus for an unfit 50-year-old the rate would be: 200-50-40 = 110 beats/minute.
*77/353/5*

Nutritional Deficiencies
According to recent statistics from the U.S. Department of Agriculture and the U.S. Department of Health, Education and Welfare, about one half of all Americans suffer from various degrees of malnutrition and nutritional deficiencies. It has been shown in more than a hundred studies from around the world that almost any serious nutritional deficiency of one or more vitamins, minerals or other nutritive substances can lower the resistance to spontaneous cancer and increase the risk of contracting the disease. Thus, even a mild deficiency of Choline will produce cancer of the liver, Vitamin E deficiency increases the risk of contracting cancer and leukemia, deficiencies of various B-Vitamins result in liver damage which leads to malignancies, serious deficiency of the mineral zinc may lead to cancer of the prostate, Vitamin A deficiency breaks down the body’s defenses against most carcinogens and leads to tumour development, Magnesium deficiency is also linked to cancer development, as shown in studies conducted at the University of Montreal, in Egypt, and other places.

Exposure to Sun
Numerous studies have conclusively established that excessive and continuous exposure to the sun’s ultraviolet rays can cause cancer of the skin in some people. Rimless eyeglasses, which concentrate the sun’s reflections, are especially harmful and they can lead to skin cancer on the face.
*19/355/5*

the term “compulsion,” like “obsession,” has taken on a broad, which is to say vague, meaning. Popularly, it is used to indicate anything done to excess: compulsively eating Ben and Jerry’s ice cream, for instance, or compulsively planning one’s day. But again, the clinical meaning is much more specific.
A clinical compulsion is sometimes defined simply as “a repetitive act that is performed according to rules that must be applied rigidly.” A better definition, however, is one that stresses the close relationship between compulsions and obsessions: A compulsion is a repetitive act that is clearly excessive and is performed in order to lessen the discomfort of an obsession.
An obsession strikes, anxiety mounts, and repetitive acts provide a way out. Why compulsions are effective in the short run to alleviate anxiety is not completely understood. As will be discussed in Chapter 8, animals are known to perform many stereotyped rituals when under stress (monkeys in the zoo strumming the mesh of their cage, or rocking back and forth continuously). Many OCD experts believe that compulsions are related to these and involve genetically programmed tendencies.
Compulsions can take an infinite number of different forms. Most often they are reasonable responses gone haywire, such as checking a gas stove a hundred times in a row for fear of a leak. They can also be acts that are completely foreign to reason, however, like jumping up and down eight times because of the thought that an accident will occur. But all compulsions have this property: Although they provide short-term respite from obsessions, in the long run they only make obsessions worse. Obsessions, in turn, make compulsions worse. It’s a vicious cycle.
*11/338/2*

Pneumonia was once one of the most feared of all human diseases. Its death rate was about a third of all those whom it attacked. The germ that caused it is one called a “pneumococcus” which lives ordinarily in the noses and throats of anywhere from five to sixty per cent of people. The condition comes on most often in the winter months and can affect people of all ages.
The pneumococcus gets down into the lungs and there sets up a severe infection which follows a typical course. For a few days the symptoms are like those of an ordinary respiratory disease. Then comes the sudden hard, shaking chill, rapid rise in temperature and pulse rate, with a severe pain on one side of the chest that the doctor recognizes as the beginning of pneumonia. The cough comes on painfully and with small amounts of pink or rust-colored sputum. Breathing is rapid, shallow and painful. There may be blueness because the blood is not getting enough oxygen.
The doctor, by the use of his stethoscope and by watching the motion of the chest, by thumping to discover areas of consolidation, recognizes that the lung is congested and unable to function. Usually after seven to ten days a crisis occurs. The body temperature falls to normal in from six to twelve hours, accompanied by profuse sweating, and the pneumonia as such is over.
The development of the new antibiotic drugs has changed the whole picture. Now, following the administration of penicillin, the pain in the pleura which lines the chest disappears in a few hours and the temperature, pulse, and respiration fall to normal in twelve to thirty-six hours. The spread of the inflammation can be stopped even before a single lobe is involved. This change in the nature of pneumonia is one of the most dramatic occurrences that has ever taken place in medicine and represents one of the greatest accomplishments of the present century.
For the treatment of pneumonia nowadays the chief reliance is on the drugs. The patient is kept in bed in a position in which he is most comfortable. He is given considerable rest but is permitted to sit up for examinations and for any other necessary procedure. He usually has little appetite and need not be urged to eat, but within a half a day after the specific treatment has been begun, he may be hungry and can take a soft diet. Formerly great efforts were made to keep the bowels moving; that too is no longer a serious problem for the doctor. If there is a real shortage of air and the person seems blue, oxygen can be given. It is customary to give oxygen now as soon as it is needed and not to wait until the patient seems actually to suffer from oxygen lack.
The pain in the chest can be controlled with suitable drugs. It is also possible to relieve severe pain by the injection of local anesthetic drugs or by strapping or wrapping the chest wall to prevent unnecessary motion.
The doctor is alert for complications. If penicillin is not as effective as seems to be desirable, aureomycin, the sulfonamides, such as sulfadiazine, and other methods may be tried. Particularly, however, the doctor must look out for complications such as secondary formation of pockets of infected material at the bottom of the lung.
The former fatality rate of 25 to 30 per cent has now dropped to less than 7 per cent. Pneumonia is stiff a particularly serious disease to those who have been long weakened by some other disease such as cancer or alcoholism or malnutrition, or some other serious complication involving the heart.
*15/318/5*

If people with BDD see someone who looks as bad as they do, they still don’t feel much better about themselves. Somehow they interpret the situation negatively, thinking such things as “He doesn’t have much hair, but he’s laughing and seems to be enjoying himself. Why can’t I?” Or “She looks as bad as I do, but she has a boyfriend. What’s wrong with me?” A 40-year-old man said, “I stare at peoples’ faces thinking ‘He has freckles and he’s talking to people. Why can’t I do that?’” The situation is interpreted in terms of—and usually ends up reinforcing—the BDD sufferer’s own perceived shortcomings.
“When I’m standing in line at the drug store or the grocery store, I talk to myself, trying to reassure myself that I don’t look so bad and that I should stay in line instead of leaving,” Jason said. “I look at other people and think they’re uglier and worse off than me. But then my thinking takes a negative turn: I think things like ‘It’s true, he’s really ugly, but he doesn’t seem to care. He seems to be doing fine! What’s wrong with me?’ Or I check out all the successful people on TV—a lot of them aren’t attractive, but they’re smiling and seem happy, so I think maybe I can be happy too. But then I get down on myself because I’m not.”
*106\204\8*