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‘Subcutaneous’ means ‘beneath the skin’, and this is how the implant works. A tiny pellet, about the size of the tip of a lead pencil, is inserted under the skin of the lower abdomen. The technique is simple, takes about 5 minutes, and can often be carried out in a general practitioner’s surgery under a local anaesthetic, leaving little or no mark. The big advantage of an implant is that, once it has been inserted, you can forget about it for several months. No need to take tablets or change patches. Unlike other forms of HRT, it can also be combined with small quantities of the hormone testosterone if your doctor thinks this would help you. Although testosterone is the male hormone, it is also produced in the ovaries of women, so it is not unnatural to receive it. It can be helpful for women who have certain psycho-sexual problems, a drop in libido (interest in sex), much reduced energy levels or severe loss of confidence. Being a male hormone, it may cause a slight increase in facial hair.

Nearly all women with implants gain relief from hot flushes, and three-quarters gain relief from depression. Improved collagen levels lead to better skin and stronger bones.

As with the patch, the oestrogen is released straight into the bloodstream, and avoids the digestive system, so a lower dose can be used, giving fewer side-effects than oral HRT. There is no question of forgetting to take it, or of suffering the skin irritation some women get with the patch. It also avoids the necessity of ‘popping a pill every day’, which is what many women don’t like about HRT; until it needs replacing you can forget you are using it at all. It also offers good protection against osteoporosis, except at the lowest dosage.

The implant does not last forever, and it will need to be replaced every 4-6 months, depending on when the level of oestrogen in the implant falls and the menopausal symptoms return. You will need to return to your GP or gynaecologist for a replacement Although this may seem rather a nuisance, it does ensure that you are regularly monitored, and a check-up may also detect irregularities that might otherwise have gone unnoticed.

This condition is called tachyphylaxis, and has received unfavourable publicity following reports of some recent research into it One or two newspapers decided that it suggested the women were ‘addicted’ to oestrogen, because they needed ever-higher doses at ever-more-frequent intervals. This type of reporting is irresponsible and unjustified, but many newspapers seem unwilling to present HRT in a neutral light, choosing either to extol its ‘sexy forever’ image or to condemn it for exaggerated side-effects.

The problem of tachyphylaxis should not, however, be dismissed as irrelevant, because for the small minority of women affected by it, it can be a serious disadvantage, and one for which doctors can’t at present agree on a solution. Simply to refuse further HRT in any form produces a return of the symptoms and much suffering; it may also be a dangerous approach in women whose falling oestrogen is producing feelings of depression. However, to replace the implant at ever-closer intervals in a woman whose oestrogen level may be well above normal is not desirable either. It is obviously an area in which more research is needed. If you feel you are developing this condition, talk to your doctor about a gradual withdrawal from this type of HRT, as a different type might be the solution for you. He may decide to monitor your blood oestradiol level regularly, and to replace the implant when it falls to a certain level.

The second disadvantage of the implant concerns those women who still have a uterus and who need to take progestogen. The raised levels of oestrogen from an implant are eliminated from the body only very slowly, so that even once you have stopped using implants the lining of the womb continues to thicken every month and you need to continue taking progestogen until this stops happening.

Implants come in three different strengths (25, 50 and 100 milligrams); the higher dose lasts longer, and continues to relieve severe symptoms longer.

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Radical or Wertheim’s hysterectomy. A radical hysterectomy means that the surgeon removes the entire uterus including cervix and support structures, both ovaries, Fallopian tubes, nearby lymph nodes, and the upper portion of the vagina.

In some women, for example a patient with cancer that has infiltrated several reproductive organs, there may be no option but a radical hysterectomy. In other circumstances there may be more flexibility about the amount of tissue taken.

By the time Robyn turned thirty-seven her medical history included a myomectomy and an endometrial resection. Both procedures were undertaken to control heavy bleeding due to fibroids, but neither provided lasting relief. She had decided to accept the advice of her gynaecologist and have a hysterectomy, but was uncertain which sort would be most appropriate. The doctor proposed removing her ovaries and Fallopian tubes, along with her uterus, because of the possibility that ovarian cancer could develop some time in the future. This form of cancer tends to evade detection until it is advanced; treatment prospects are then poor. Robyn asked about the short- and long-term implications of ovary removal at her age and was told that her menopause would occur earlier than expected. Acute menopausal symptoms such as hot flushes and vaginal dryness were likely to accompany an early menopause, and hormone therapy would then be advisable. Long-term implications included an elevated risk of osteoporosis and heart disease. Even if the ovaries were left it was possible that she might experience a somewhat earlier than expected menopause, although this was by no means certain. As Robyn’s family had a tendency for heart disease, but not for ovarian cancer, she declined to have a total hysterectomy with bilateral salpingo-oophorectomy. Instead, a total hysterectomy was performed, and care was taken to preserve her ovaries intact.

There may also be some flexibility when it comes to the question of removal of the cervix. Women who have asked doctors about the implications of losing their cervix and the upper part of their vagina have received varied responses according to whether they were pre- or post-menopausal. Pre-menopausal women whose ovaries are to remain may be told to expect a reduced amount of lubricative cervical mucus around the time of the month that they ovulate. This might be one factor contributing to reduced sexual satisfaction for them and their sexual partners. At other times of the month when the output of cervical mucus is minimal, the impact of cervical secretions on sexual satisfaction would be negligible. Although recent studies do not show a reduction in vaginal size after the cervix has been removed, the absence of the cervix itself might be expected to alter the sensations experienced during intercourse. For postmenopausal women loss of the cervix would not affect lubrication, but its absence might alter sexual satisfaction for one or both partners if tapping it during intercourse was important for orgasm. On the other hand, removal of the cervix might be seen to have convenience value for some women as it would do away with the need for repeated Pap smears. It has become increasingly common to offer women the option of preservation of the ovaries and cervix and upper part of the vagina during hysterectomy.

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Bed-wetting at night during sleep is technically known as nocturnal enuresis. Bed-wetting is a nuisance to parents, and hence toilet training begins at an early age. After the age of four, when they start going to school, most children are dry at night. However there are some that continue to wet their beds at night even to a much older age.

In the past, a lot of people believed that children wet their beds while dreaming. Now, with the advent of the sleep laboratory, we are certain that they wet their beds during NREM sleep, especially in stages three and four of deep sleep. Children who sleep deeply lose control of their bladders in NREM deep sleep. As the children grow older, it is normal for them to sleep less deeply and this increases their bladder control. Ultimately, as these bed-welters become older,

bed-wetting cures itself. Most parents seek medical advice if their children still bed-wet at about school age. The doctor will make sure there is no urine infection or sugar diabetes. Diabetes mellitus, having sugar in the urine, is known to cause excessive urination, although few sufferers of diabetes bed-wet. If the doctor is satisfied that there is no physical illness, normally no treatment is required before the age of eight, as bed-wetting is a self-limiting condition. We are quite sure that the majority of bed-wetters are of normal intelligence and parents need not be worried or concerned about their child’s future development. These children should be rewarded when they have a dry night, and when they have a wet night it should be ignored. Do not punish them, as this will only give them a feeling of guilt which may be harmful to their future personality and may make their bed-wetting worse.

If treatment is required, two methods are commonly used. The first is a medicine called imipramine. This can be given to children when they need to be dry for a night or more as when they stay overnight at a friend’s home or go away to a school camp. It is only a temporary measure, as relapse is common once the medicine is stopped.

A second well-known method is the pad and alarm system. This is an electrical device consisting of two electrical pads separated by a small piece of cloth, and it is placed under the bed sheet. When the child wets the cloth between the pads, a short circuit is created which switches on a battery-run alarm which then wakes the child up. This trains the child to wake up once bed-wetting begins. This training may take anything up to 12 weeks before bed-wetting stops.

Bed-wetting sometimes runs in families and seems to be an inherited characteristic. It has been shown that an identical twin has double the chance of bed-wetting if the other twin bed-wets. Bed-wetting can also be caused by emotional factors; for example the addition of a new baby to the family may be perceived as a threat to the older child. In these cases of stress induced bed-wetting, most of the children have been dry for a period of months or years after toilet training, but bed-wetting begins again when they experience emotional stress. This is called secondary bed-wetting and is commonly stress related. This is less common than primary bed-wetting, in which the child has not gained bladder control at night since birth.

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We have already discussed the very close relationship between the body and the mind, and we have seen that relaxation of the body itself produces some relaxation of the mind. But we can go further than that, and we continue our exercises in this fashion:

Our whole body is relaxed.—We feel it all through us.—It is in our face.—Our face is utterly relaxed.—We feel it in our forehead, and in the sides of our forehead.—We feel it there deeply, deeply in the sides of our forehead.—Deeply, we feel it in our mind.

This sequence follows on easily enough. We feel the relaxation in the muscles of our face, and with this relaxation we feel our face smooth, out in calm. There is a very intimate relationship between the state of our mind and the state of our face. If your mind is calm, so is your face. Conversely if we learn to make our face calm, we experience a feeling of increasing calm of our mind.

With our jaw loose the muscles that work the jaw are fully relaxed. The two temporal muscles extend up to the sides of the forehead. You can feel them by placing the fingertips at the side of the forehead and firmly clenching the jaw. You can feel the muscle contract and then let go as the jaw is relaxed. The feeling of relaxation here gives us the feeling of relaxation deeply within us—in the mind itself.

The whole of our body is relaxed.—We feel the relaxation of all the muscles of our body.

—They are relaxed.—They are relaxed and calm.—We can feel the calm.—We feel the relaxation and we feel the calm.—The relaxation is all through us, and so is the calm that goes with it—The calm of it is part of us.—It is all through us in our body and our mind.

Again, the sequence is logical and straightforward. We feel the relaxation of our muscles. Our relaxed muscles are calm. We can feel the sensation of calm in them, we feel the calm of it all through us. We feel the calm of it in our mind.

Remember that the feeling of relaxation of the mind may at first be variable. It may come and go. There may be a momentary experience of calm of the mind and then it is gone. This is to be expected for the first few attempts. Remember that people who can attain relaxation of the body can all learn to attain relaxation of the mind. If you are able to capture just a moment of calm, it will not be long before you can achieve the full state.

Remember, too, that relaxation of the mind is greatly enhanced by physical relaxation which is attained in relatively uncomfortable circumstances. So as we become more adept at our physical relaxation we do it in increasingly uncomfortable positions.

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The second rule of vital nutrition is that your foods should be whole, complete, unrefined, and unadulterated. Whole wheat, brown rice, orange, sugar cane, and potatoes are whole foods. White bread, polished rice, orange juice, white sugar, and instant potatoes are not whole foods. They are refined, concentrated, or are fragments of the foods from which important vital nutritive factors have been removed.

Whole foods are simply foods which still contain all the nutrients which nature has put in them—all the vitamins, minerals, proteins, carbohydrates, enzymes, etc. But 80 per cent of the foods consumed by the average American today have been tampered with in one way or another, and most of the nutrients have either been taken out of them or destroyed. White bread, white sugar, breakfast cereals, and processed oils are typical examples of such devitalized nutritionless foods.

Whole foods contain not only complete nutrition but also all the enzymes and other factors necessary for proper digestion and good assimilation of these particular foods. When certain parts are removed, the digestion and assimilation can be incomplete and nutritional deficiences may result.

Only whole foods can supply optimum nutrition for optimum health.

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As mentioned above, the first choice drug should be used alone (monotherapy) and in the lowest dose to control seizures without producing any unacceptable side-effects. If the initial control of seizures is less than complete, then the dose of that drug should be increased gradually until either complete control is achieved, or side-effects develop. If unacceptable side-effects occur before control is reached, then there are two alternatives: either a different drug can be used to replace the first drug, or an additional drug can be added to the first drug. Which alternative is chosen depends on the individual patient and also on the doctor. If there has been some reasonable control with the first drug, it is our practice to add the next most appropriate

anti-epileptic drug without withdrawing the first drug. If complete seizure control is then achieved, we will attempt to withdraw the first drug after a period of two to three months free from seizures. If the initial drug has been ineffective we would simultaneously replace the first drug with the second. In some children and adults, therapy with two anti-epileptic drugs is justified, as this may result in further significant (even complete) control in an additional 5 per cent to 10 per cent of children. It is unlikely that polytherapy with three drugs will result in any further control, and there is certainly an increased risk and frequency of side-effects and toxicity due to interactions between this many drugs.

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Many gastrointestinal diseases respond promptly and extremely well to CMO. Crohn’s disease, colitis, diverticulitis, irritable bowel, etc, all involve chronic inflammatory processes that are readily influenced by CMO. However, some problems, like ulcers, need special attention. And for these gastrointestinal diseases we do, when necessary, make exceptions to the “empty stomach” rule. If CMO is not well tolerated because of digestive difficulties, it’s better to take it along with a little light food.

Crohn’s disease (also known as transmural colitis or granulomatous colitis) has in practically all cases responded fully to CMO. Just what causes the inflammation of the large and/or small intestine remains a medical mystery. Apart from certain foods, stress is considered to be a major trigger factor. There are probably also genetic factors involved.

Though its symptoms are frequently treatable, many do not respond well. There seems to be no permanent solution to this recurring chronic problem available through conventional medicines. CMO, on the other hand, has almost always been able to provide permanent relief with just one set of capsules for a multitude of patients. Nevertheless, a few patients have needed to continue taking a couple of capsules now and then when they feel a flare-up may be coming on.

The most frequent symptoms are abdominal cramping and pain, excessive intestinal gas, diarrhea, and occasional fever. These are often brought on by food irritations. Severe cases can result in perforation of the colon and rectal problems or bleeding. CMO usually brings relief within a week. It has been as successful with severe cases as with mild ones, although it may take more than one bottle. If complete relief is not obtained, just keep a bottle of CMO handy and take two or three capsules the moment you detect any signs of a flare-up.

Ulcerative colitis can be very serious and require hospitalization for severe episodes. The most telltale sign of this disease is frequent bloody diarrhea or bloody mucosal discharge. Pain, cramping, and tenderness usually occurs in the left colon. Weight loss and anaemia are frequent complications. Fever may indicate infection.

Because of its effects against the autoimmune inflammatory process, CMO (taken with a bit of food) has often been quite effective against this ailment. When cortisone has been prescribed it should not be discontinued until the ailment has been resolved. You should definitely seek medical supervision for this problem.

Diverticulitis patients usually suffer from the same lower left abdomen tenderness, intestinal pain and cramping, constipation or diarrhea, and autoimmune inflammation that appears with ulcerative colitis. Diverticulitis appears more often with advancing age. Perforation of the colon may also occur in severe cases.

Treatment with CMO usually brings good results, often all by itself without other therapy. Nevertheless, it would probably be best to continue any conventional therapy with medical supervision until the problem is completely resolved.

Irritable bowel syndrome is the catch-all label put on any number of common bowel disorders of unknown cause. CMO has been very effective in eliminating most of these complaints.

Sjogren’s syndrome, when it appears, usually does so in patients suffering with arthritis and related conditions like fibromyalgia, scleroderma, lupus, etc. The most common symptoms are dryness of the eyes and mouth. The nose, throat, larynx, bronchi, skin, and vagina may also be affected. Errant autoimmune attacks occur against the tear, salivary, and thyroid glands — and sometimes even RNA. Serious problems with scratchy eyes, speaking, and swallowing food often develop.

The best conventional medicine has to offer for Sjogren’s sufferers is an artificial tear formula, mouth moisteners, skin creams, and vaginal lubricants. Our reports indicate that CMO has been very successful in conquering this ailment.

Behcet’s Syndrome is a chronic inflammatory disease that may be dormant for years and years, or may produce many serious complications. Painful ulcers of the mouth, penis, scrotum, vulva, and vagina are common. The eyes may also be affected. Hazy vision or blindness may result. Steroids are about the only treatments that are employed conventionally.

This disease is quite rare in the US and we have feedback regarding only two cases. CMO was quite successful with one and the other was helped somewhat. In both cases steroids were not discontinued while taking CMO, but so far the one who responded well no longer needs them.

Reiter’s syndrome is a complicated disease with autoimmune components more commonly found in young males rather than mature men. It is often triggered by sexual intercourse, chlamydial infection, and/or bacterial diarrhea. Frequently a combination of clinical manifestations appear: arthritis, urethritis, conjunctivitis, uveitis, and mucosal tissue infections or disturbances. Successful treatment usually requires the use of conventional therapy along with CMO, although use of steroids should be minimal.

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Signs and symptoms

You will have no difficulty recognizing a nosebleed. Since the two sides of the nose join in the back, and also join with the throat and the oesophagus (which lead to the stomach), blood may flow from both nostrils or from the mouth; the child may also vomit blood.

Home care

Teach your child at an early age how to stop a nosebleed by him- or herself. Tell the child to remain calm and to sit upright with the head held high; this will decrease blood pressure in the blood vessels. Show the child how to grasp the whole lower half of the nose between his or her thumb and fingers and in this way compress both sides of the nose firmly against the septum. The child should hold the nose this way for ten minutes to allow time for the blood to clot. If bleeding recurs when the pressure is released, it probably means that a large clot in the nose is preventing the broken blood vessel from sealing. The child should blow the nose vigorously to dislodge the clot; then, after the clot has been removed, compress the nose again for ten to 12 minutes.

To prevent recurring nosebleeds, put petroleum jelly in the child’s nose morning and evening for seven to 14 days. Use a vaporizer or humidifier to add moisture to the air at night.

Precautions

• To stop a nosebleed, do not merely pinch nostrils together, but compress the entire soft portion of the nose. Otherwise, the blood will dam up and run down the throat.

• Do not lay your child down.

• Remain calm and reassure your child.

• It is not necessary to use cold compresses, pressure on the upper lip, nose drops, and other household remedies.

• Do not pack the nose with cotton or gauze.

Medical treatment

Generally, your doctor’s treatment will be the same as your home treatment, and you only need to consult the doctor when home treatment is not effective. If the nosebleed is due to an allergy or a cold your doctor will treat that condition. Your doctor will rarely need to pack the nasal passages or cauterize (seal off) the blood vessels in order to control recurring nosebleeds.

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Insulin is a natural hormone produced by the pancreas and helps to control the use of glucose in the body. A child with diabetes is producing inadequate amounts of insulin, so we must replace the deficit with insulin given by injection.

Insulin is given once or several times a day Although your child may have to receive several injections a day when he is being ‘stabilized’ after he has first been diagnosed, it will be possible eventually to control the diabetes with one or two injections a day. This has been made possible by the development of modified types of insulin which have been produced by laboratory research, particularly in Scandinavia. The type of insulin that is likely to be most suitable for your child will be selected by his doctor. After a period of stabilization the dose required to keep him in good health will also be determined.

There are many insulin types and names and this can be confusing. Sometimes it turns out that it is hard to achieve good control on one type of insulin. Then it is possible to mix two insulins, or split the dose to two (or more) parts during the day. Occasionally your doctor may decide that a different type of insulin is worth trying. In all events, different people respond to insulin in somewhat different ways and it is sometimes a matter of trying one insulin and altering it if it doesn’t prove entirely satisfactory.

There are different types of insulin

You may wish to know about the different types of insulin and why there are several brands. This is partly due to the different processes used to make the insulin, and partly due to the fact that there are several insulin manufacturers each with their own brand.

In the past, there were two major ways that insulins differed from each other:

1. The animal species from which the insulin was derived;

2. The way in which insulin had been modified to change its time of action.

Insulin may be beef, pork, ‘human’

In the past almost all insulins were made either from beef or pork pancreas. Both worked perfectly well, but each insulin was a little different in its chemical composition to each other and to insulin made in the human body. Some few people have developed allergies or resistance to insulins derived from beef or pork, and all people developed some antibodies to animal insulin.

It is now possible to make insulin identical with human insulin. This should have the advantage that antibodies would not be formed. ‘Human’ insulin is not made from human pancreas of course.

It is made in the laboratory by a process of genetic engineering. In this process, simple yeast cells or bacterial cells have had their gene structure changed so they make human insulin in a similar way to the way pancreas cells make insulin in the human body. The altered bacterial or yeast cells can make large quantities of insulin commercially in a way that human pancreas cells cannot.

Insulin may be modified chemically to make it work more slowly

Insulin, as it is produced in the body, has a very rapid effect once it enters the blood stream. This effect wears off very quickly. This is what is required if the body is making it normally. It is also suitable for the person with diabetes who is given insulin continuously by slow injection or at short and frequent intervals during the day before meals. Most people find it more convenient, however, to have one or two injections a day rather than injections each time they have a meal. To do this, it is necessary to alter the insulin so that it has a prolonged effect.

Insulin manufacturers have developed methods of prolonging the effects of insulin by chemical processes that modify insulin. This may involve adding the metal zinc and a protein to the insulin which slow down its absorption into the bloodstream. You can usually recognize these modified insulins because they are a cloudy suspension while the unmodified quick insulins are clear solutions. Insulins therefore can be in one of several groups.

1.     Fast acting, unmodified clear soluble solutions.

2.     Slow acting modified insulins which may last up to 24 hours,

or

3.     Intermediate acting modified insulins which last between 8 and 24 hours.

4.     A mixture of slow or intermediate insulins and fast insulins.

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We now know that certain pollutants and chemicals in the environment can affect both male and female fertility, and there may be many more substances that we come into contact with in everyday life that combine to form a ‘toxic cocktail’ with unknown long-term consequences.

The problem is that these suspect substances seem to be absolutely everywhere – in the food we eat, the air we breathe, and the things we use at work and at home. We can avoid many of them, and minimize our exposure to others. But we obviously cannot completely eliminate them, short of finding a non-polluted desert island to go and live on.

However, reducing your exposure is only part of the plan. There are plenty of ways to fortify yourself and your partner against the effects of unavoidable exposure and to ensure that toxins are successfully eliminated from your system. In my experience, dramatic results have been achieved by couples whose ‘unexplained fertility’ turns out to have been due to exposure to some of these substances.

Xenoestrogens

These are synthetic oestrogens which affect the fertility of wildlife and are causing some animals to grow both male and female sex organs. They come from pesticides and plastics and are stored in body fat and can affect men and women differently.

The massive proliferation of xenoestrogens has coincided with:

• A decrease in sperm counts of 50 per cent over the last ten years.

• An increase in testicular cancer.

• Earlier onset of puberty. (At the turn of the century the average age was 15. Now some girls as young as eight are growing breasts and pubic hair. It has been found that girls can enter puberty almost a year earlier if their pregnant mothers had higher levels of two synthetic chemicals, PCBs and DDE, while they were pregnant.)

• A doubling in the number of boys born with undescended testes (which means they may not produce sperm) between 1962 and 1981.

• Increasing numbers of male babies born with problems with their penis. Some boys are born with the opening of the urethra (where urine passes out of the body) on the side of the penis instead of the top. In extreme cases male babies have been born with both male and female organs.

Synthetic oestrogens, similar to those in use in the pesticides and plastics industry, have been linked to cancers and abnormalities.

Years ago women who suffered recurrent miscarriages were treated with a synthetic oestrogen called dithethylstilbestrol (DES). Now their grown-up daughters, who were exposed to DES in the womb, are showing high rates of cervical abnormalities that can lead to recurrent miscarriages or infertility. Some have developed a rare and sometimes fatal vaginal cancer (clear-cell adenocarcinoma).Their sons are not so severely affected but some have suffered mild genital abnormalities.

Further evidence comes from Professor Ana Soto in Boston, USA, who was studying breast cancer cells stored in large incubators. These cancer cells started to divide and multiply as if oestrogen was present. But when the laboratory changed the tubes on the incubators the cells stopped dividing. It turned out that nonylphenol, a synthetic oestrogen similar to those widely used in paints, toiletries, agricultural chemicals and detergents, had been used in the manufacture of the tubes.

In another example of the power of these chemicals, some male workers developed breasts after inhaling dust containing bisphenol A, a synthetic oestrogen used in a wide range of packaging (e.g. for soft drinks, bottled Water and even babies’ bottles).

Phthalates, found in PVC, food packaging and glues, are another class of chemical which has an oestrogen-like effect on humans.

Types of chemicals that affect hormone balance and fertility include:

• Pesticides (DDT, DDE, endosulfan, methoxychlor, heptachlor, toxaphene, dieldrin, lindane)

• Plastic compounds (Alkyphenols such as nonylphenol and octylphenol, biphenolic compounds such as bisphenol A, phthalates)

• Pharmaceutical drugs (Synthetic drugs like DES)

• Industrial substances (PCBs, dioxin)

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