Most of the coffee’s pharmacological impact comes from its high concentration of caffeine, a psychoactive drug of great power, and the most active alkaloid principle in it. This is an addictive drug similar to cocaine in as much as it stimulates the central nervous system. These effects are short-lived, but it has been observed that they lead to withdrawal symptoms of irritability, lethargy, headaches and anxiety. This shows that it is a strong enough drug to constitute a potential health hazard.

Sir Robert Hutchison, an eminent nutritionist, found about 100 mg. of caffeine and 200 mg. of tannin in a cupful of coffee, made by infusing 60 g. in 450 ml. of water.

Research studies have shown that coffee drinking has potential health hazards. They have linked it to several serious diseases including cancer.

The harmful effects of coffee have been particularly observed on the gall bladder. It can stimulate the gall bladder to bring about gall bladder attacks. This may result in gallstone and ultimately gall bladder cancer. Bruce R. Douglas and colleagues at the University Hospital in Leiden, Netherlands, discovered in a test of healthy normal men and women that drinking as little as 115 ml. of decaffeinated coffee stimulated gall bladder contractions. The researchers advise people prone to gallstones to avoid all types of coffee.

*40/355/5*

Trying to define love is a difficult task. Besides loving a spouse or boyfriend or girlfriend, people can love their children, parents, siblings, pets, country, or God, as well as rainbows, chocolate sundaes, or the Boston Red Sox. Although the English language has only one word to apply to each of these situations, there are clearly different meanings involved.

When we talk about person-to-person love, the simplest definition may be one given by Robert Heinlein in the book Stranger in a Strange Land: “Love is that condition in which the happiness of another person is essential to your own.” This is certainly the love that Shakespeare described in Romeo and Juliet, that popular singers celebrates, and that led Edward VIII to abdicate the throne of England to marry the woman in his life.

In any type of love, the element of caring about the loved person is essential. Unless genuine caring is present, what looks like love may be just one form of desire. For example, a teenage boy may tell his girlfriend “I love you” just to convince her to have sex with him. In other cases, the desire to gain wealth, status, or power may lead a person to pretend to love someone to reach these goals.

Because sexual desire and love may both be passionate and all-consuming, it may be difficult to distinguish between them in terms of intensity. The key feature is the substance behind the feeling. Generally, sexual desire is narrowly focused and rather easily discharged while love is a more complex and constant emotion. In pure, unadulterated sexual desire, the elements of caring and respect are minimal, perhaps present as an afterthought, but not a central part of the feeling. The desire to know the other person is defined in only a physical or sensual way, not in a spiritual one. This end is easily satisfied. While love may include a passionate yearning for sexual union, respect for the loved one is a primary concern. Without respect and caring, our attraction for another person can only be an imitation of love.

Respect allows us to value a loved one’s identity and integrity and thus prevents us from selfishly exploiting them.

The importance of caring and respect was central to the thinking of Erich Fromm influenced all subsequent study of this subject. Fromm believed that people can achieve a meaningful type of love only if they have first reached a state of self-realization (being secure in one’s own identity). Thus, Fromm defined mature love as “union under the condition of preserving one’s integrity, one’s individuality,” and noted that the paradox of love is that “beings become one and yet remain two.” In speaking about the respect inherent in all love, Fromm suggested that a lover must feel, “I want the loved person to grow and unfold for his own sake, and in his own ways, and not for the purpose of serving me.”

Fromm’s insistence that people must be self-realized before having a “meaningful” type of love overlooks that love itself can be a way of attaining self-realization. We believe that people have a great capacity to learn about themselves from a love relationship, although we also agree with the psychologist Nathaniel Branden’s observation that love cannot be a substitute for personal identity.

Peele and Brodsky, authors of a book called Love and Addiction, have an interesting viewpoint on what happens when respect and caring are missing from a love relationship. They believe that some relationships of this variety serve the same needs that-can lead people to alcohol abuse or drug addiction. The resulting “love” is really a dependency relationship:

When a person goes to another with the aim of filling a void in himself, the relationship quickly becomes the center of his or her life. It offers him a solace that contrasts sharply with what he finds everywhere else, so he returns to it more and more, until he needs it to get through each day of his otherwise stressful and unpleasant existence. When a constant exposure to something is necessary in order to make life bearable, an addiction has been brought about, however romantic the trappings. The ever-present danger of withdrawal creates an ever-present craving.

Peele and Brodsky suggest specific criteria for distinguishing between love as a healthy relationship with growth potential versus love as a form of addiction:

Does each lover have a secure belief in his or her own value?

Are the lovers improved by the relationship? By some measure outside of the relationship are they better, stronger, more attractive, more accomplished, or more sensitive individuals? Do they value the relationship for this very reason?

Do the lovers maintain serious interests outside the relationship, including other meaningful personal relationships?

Is the relationship integrated into, rather than being set off from, the totality of the lovers’ lives?

Are the lovers beyond being possessive or jealous of each other’s growth and expansion of interests?

Are the lovers also friends? Would they seek each other out if they should cease to be primary partners?

These questions are not listed to suggest that there is only one “right” way to love. While most people in love probably can not answer “yes” to all six questions, thinking about these issues may give you some ideas for present or future relationships.

As a practical matter, it is often difficult to draw a line between loving and liking. Although various researchers have tried to measure love, we agree with the observation “The only real difference’ between liking and loving is the depth of our feelings and the degree of our involvement with the other person”

*109\342\2*

General strategies for successful smoking cessation

1. Stay away from opportunities to smoke. Do not go where you are likely to be tempted.

2. Analyze when you smoke and what cues you to smoke, and then identify activities you can use to replace smoking.

3. Develop a negative image of cigarettes. They are smelly, dirty, and disgusting. They turn your fingers and teeth yellow, make your breath and clothes smell, cost you money, and offend your friends.

4. Remind yourself of all the benefits you have gained from not smoking.

View relapses as a learning experience. Read and use helpful materials and programs from the American Cancer Society, the American Lung Association, and the American Heart Association.

Basic responses to a smoker’s fears about quitting

I have failed before, and I will probably fail again.

Remember that fewer than 25 percent of smokers are able to quit on the first try. Most take three or four tries. Stopping smoking is like learning anything new: it takes several tries. Did you learn to ride a bicycle on the first try? / will have unbearable cravings.

Most cravings last less than 20 minutes. Plan what you can do until the urge goes away.

I will get irritable and frustrated.

While you are quitting, make fewer demands on yourself. Give yourself a break.

I will be unable to concentrate.

Maybe you could quit smoking during your vacation, so the need to concentrate is not as great.

I cannot stand feeling so restless.

Take walks or other “time out” periods. Handle objects. Use your hands for other things.

I need the stimulant effect of smoking.

Increase your activity and begin an exercise program. Work on getting better sleep.

I will gain weight.

One-third of ex-smokers gain weight, one-third lose weight, and one-third stay at the same weight. Only 10 percent of those who gain weight keep the increased weight. It may help to keep a diet diary and start an exercise program while you are quitting.

I will not be able to sleep.

Do not read or watch television in bed. Go to bed only when tired. Do not nap during the day. Exercise during the day. Avoid caffeine at night. If you do not fall asleep in 30 minutes after you go to bed, get up for a while

*280\252\8*

Hopelessness, complete loss of faith, despair. Hope and faith are the main ingredients of thedriving force in man. A labourer toils through out the day in the hope of securing 2 square meals for his family. A young ambitious man works hard in the hope of reaching the pinnacle of success; a scientist denies himself many pleasures of life to find new discoveries in the hope of getting world recognition; and a dictator works ruthlessly in the hope of one day ruling the world.

Hope in the future is thus necessary to motivate any body to work.

GORSE embodies the soul quality of HOPE.

In the negative Gorse State, the person has lost faith in the future. Perhaps he has been driven to the stage of hopelessness by circumstances—a long and tortuous medical treatment has failed to relieve his trouble and the doctor has confessed that there is no treatment which can relieve him and he has to live with his troubles for the rest of life. Perhaps, he has tried many specialists under different systems of treatment, and has got no relief or temporary relief, and has now lost hope and stays resigned to fate. He may have convinced himself that his trouble being hereditary and he being at an advanced age, the process of disease-is irreversible.

A man deceived by a friend may lose faith in all other persons and a man denied justice in court of law may lose faith in the very institution of law and justice, and a devout religious person may lose faith in his Guru, and the religion itself after knowing the dark side of the private life of his religious leader.

Be as it is, the end result of loss of hope is disastrous for the individual and for the society at large. He has no motivation to work and progress for the benefit of himself or that of the society. He remains sad and depressed and tends to infect the surrounding atmosphere with loss of cheer.

If he falls ill, his recovery is difficult because without hope, the patient does not get well.

*107\308\8*

Many chronic medical conditions can contribute to drastically low bone density. Some interfere with bone metabolism directly. Some impair your ability to absorb and use the nutrients you need for healthy bones. Some require medication that can damage your bones even as it addresses your other concerns (see section on medications).

Anorexia and other eating disorders increase your risk of low bone density, no matter what your age. For one thing, anorexia almost always has amenorrhea (no periods)—meaning low estrogen levels—associated with it. For another, taking in too few calories means by definition that you are not getting enough of the nutrients that are so important to bone health. Finally, anorexia is most common in girls and young women during the years when bone growth should be its fastest, meaning there’s a strong likelihood peak bone density will never be reached. That is, when women who had eating disorders early in life go into the accelerated bone loss of menopause, they will be starting with a sizable disadvantage.

Anorexia and eating disorders are complicated to treat and potentially life-threatening. One component of treatment you might consider is taking birth control pills to supply the estrogen your body isn’t making (think of it as a form of hormone replacement therapy).

High blood sugar levels, as in diabetes, inhibits the absorption of calcium, and long-term uncontrolled diabetes increases your risk of osteoporosis. It may be that insulin has a role in bone breakdown that contributes to that increase in risk. Diabetics have, on average, bone mass 10 percent lower than you would otherwise expect.

Other endocrine diseases, including Cushing’s syndrome, hyperparathyroidism, hyperthyroidism, and thyrotoxicosis, are major culprits—and the treatment can also be problematic. Anything that lowers your sex hormones (hypogonadism)—for men or women—will also raise your risk of osteoporosis. Increased risk of osteoporosis and fractures also accompanies chronic irritable bowel syndrome, celiac disease, scoliosis, jaundice, hypertension (high blood pressure), rheumatoid arthritis, cirrhosis, hyper-cortisolism, removal of the small colon, chronic lung disease, and removal of part or all of the stomach. All these conditions change your metabolism, and so alter your body’s nutritional requirements and demands and interfere with absorption of nutrients. You then may either have a higher requirement for calcium and other key nutrients for bone health that you are not meeting, and/or you may not be absorbing and using what you do take in.

Some people with kidney stones seem to be at higher risk for low bone density. If the stones contain calcium, the usual recommendation is to decrease the amount of calcium in your diet in order to lower the levels in your urine. But along with hindering stone formation, less calcium will also hinder bone formation. Sometimes diet changes do not affect how much calcium is excreted, and that indicates a different kind of problem. It is a sign of calcium imbalance, which your body addresses by taking calcium out of the bones to meet its needs. That’s obviously not good for your bones, and if, on top of that, you are restricting your calcium intake, your risk of osteoporosis climbs higher still.

Being bedridden for an extended time, or spending a long period of time getting all your nutrients through a tube or IV, for any reason, causes excess bone loss. Complete inactivity over time doubles the amount of calcium you excrete.

And anything that gives you impaired balance or coordination, making you more likely to fall or have some other sort of accident (for instance, the very common “postural hypotension”— light-headedness as you stand up as the result of a sudden drop in blood pressure), increases your risk of fractures, no matter what the status of your bones. Dementia is also a risk factor, probably because it affects the way you eat and increases the risk of falling.

Be sure to talk to your doctor about any steps you can take to avoid or counteract any negative impact on your bones. Generally, if you are dealing with any of these issues, you should be screened earlier than the average recommendation, and medical follow-ups should include bone density monitoring. Good diet and exercise habits and calcium supplements—as described later in this book—will be even more important for you than they are for people without these additional complications.

*32\228\2*

If you can achieve and maintain your ideal weight, most, if not all, of your diabetes symptoms may disappear. You won’t cure your diabetes, but you probably will be able to keep your blood glucose levels within the normal range and you may reduce your risks for diabetes complications and for other life-threatening health problems, such as heart disease and stroke, without having to take additional medication.

This may read like a claim made by one of the “miracle” diet concoctions you have seen on TV or in a magazine. But, unlike the advertising claims made by these diets, there is plenty of valid scientific evidence that a sound weight loss should be the number one prescription for people like you with Type II diabetes. As someone who has recently been diagnosed, you have a unique opportunity to get rid of that excess weight before it creates permanent damage to your blood vessels, heart, kidneys, lungs and nerves.

More than eight out of every ten people with Type II diabetes, even those with just “a touch of diabetes”, are overweight or obese.

*38/210/5*

Ever since medicine began, people have been trying – vainly, until recent times – to give effective treatment for serious heart complaints. The modern assault on the heart began at about the time that Hitler was undertaking his assault on the rest of the world. The year was 1938 and the surgeon was Robert Gross of the Harvard Medical School in Boston. Gross was one of a number of doctors who had been anxious to attempt the surgical treatment of congenital cardiac defects. He had been encouraged by progress made in the important (and often overlooked) field of anaesthesia, which was enabling the surgical team to maintain greater control over the patient’s respiration while the chest was open. For example, in London Ivan Magill gave pre-war surgeons the ability to remove all or part of an infected or cancerous lung while the patient remained satisfactorily anaesthetized. This also gave the surgeons a chance to familiarize themselves with prolonged surgery in the region of the heart. Moreover, great advances had been made in stitching blood vessels together.

Confident that his patients were being well looked after by the anaesthetists, Gross decided to attempt an operation on a condition that had been first described by the great physician, Galen, 800 years before – patent ductus arteriosus. His patient was a seven-year-old child suffering from this inborn defect, whereby blood leaks from the aorta to the pulmonary artery because a channel or duct has remained open (‘patent’) after birth instead of closing up a few hours or days after the lungs have begun to function. This results in a shunt of blood between the aorta and pulmonary artery, which floods the lungs and puts strain on the left-hand side of the heart; if the condition is untreated the child becomes and remains an invalid. It is estimated that, of all the congenital abnormalities of the heart and surrounding vessels, patent ductus accounts for 17 out of every 100 cases, so you can see why Gross’s planned operation had considerable importance for future generations of unfortunate children.

To cut a long story short, Gross managed to tie off the duct, the operation was a brilliant success, and the news of this major advance spread quickly.

*10/353/5*

Cancer progresses slowly. It starts with the “Initiation” of a single cell by cancer-causing substances. According to John D. Poter, M.D., of the University of Minnesota, foods and food compounds can interfere with this cancer process at about ten stages of development. Food compounds can prevent activation of cancer-causing agents. They can block the mutation of a cell’s genetic material. They can stimulate enzymes in the body, which remove cancer-causing chemicals out of the body.

These compounds can prevent cancer-causing oncogens from becoming active. They can combat bacteria which cause stomach cancer. They can manipulate hormones and neutralize toxic agents that promote cancer. These compounds can reduce the ability of cancerous cells to proliferate and form tumours. They can even help prevent cancer cells from spreading to establish new cancers. Fruits and vegetables have high concentration of anticancer compounds.

There are certain foods, which can serve the purpose of chemotherapy after the development of cancer. The chemicals contained in these foods have chemotherapeutic powers to fight cancer by retarding tumour growth, spread and recurrence. They can even attack malignancy by destroying cancer cells. Foods with such chemical compounds can be used as supportive therapy to modern medical cancer treatments. Foods which possess major anti-cancer activities are beet, cabbage and other cruciferous vegetables, carrot, citrus fruits (grapefruit, lemon, lime and orange), curd, garlic, green vegetables, liquorice, milk, olive-oil, rice (brown), soya beans, tomato, watermelon, wheat bran and some other foods.

*31/355/5*

Being housebound is the most extreme kind of avoidance. Twenty-nine percent of the people in my studies have been completely housebound for at least a week because of their BDD symptoms. They didn’t leave to go to work or school, or even to do simple errands. Many more stay in for briefer periods, and others remain inside far longer. Some are trapped in their house for years, petrified of going out and being seen.

“I’ve stayed home for weeks at a time because of my beard,” Josh said. “I was in my own world. I worried people were talking about it. It’s the root of my paranoia.” Kelly stayed in her house for three months. “I stayed in because I didn’t want anyone to see me and how bad my skin looked,” she told me. “My parents took care of me. This happened after I destroyed my looks by picking at my face at any tiny blemish. I felt unpresentable. My face is ugly. My skin is ugly. I didn’t want anyone to see my face.”

“I hide from people,” Max told me, “especially after I get a bad haircut. I don’t want to do anything. I just want to hide. There’ve been weeks when I didn’t leave my house at all. I didn’t go into town or shop or go out to eat because I was insecure. I ate my roommates’ food and ordered out. I didn’t even answer the door when someone came to the house. I was afraid. I was petrified of running into people. I’m afraid they’ll think ‘Here’s this guy who looks awful. I don’t want to have anything to do with him.’

*130\204\8*

Who Should Be Tested?

The diagnosis of early Lyme disease is based on clinical evidence and a known exposure in an area with a high prevalence of Lyme disease. Current guidelines from Centers for Disease Control and Prevention and the American College of Physicians support empiric therapy for patients with objective clinical signs of early disease and a high-risk exposure. Serologic testing is indicated in patients with clinical findings consistent with early disseminated or late disease.

Who Should Not Be Tested?

It is very important to consider pretest probability before testing for Lyme disease. In areas of low prevalence, false-positive findings outnumber true-positive findings. Patients are needlessly subjected to the costs and complications of antibiotic therapy. Patients with nonspecific complaints such as myalgias, fatigue, headache, and fever in the absence of objective signs or exposures should not be tested.

Serologic Testing

Serologic evidence supports the diagnosis in patients with clinical findings suggestive of early disseminated or late disease. For this group of patients, CDC guidelines recommend enzyme linked immunosorbent assay (ELISA) or indirect fluorescent antibody (IFA) test, two sensitive assays, for initial evaluation. If results are positive or equivocal, the more specific Western blot test should be used to verify or support ELISA or I FA results. Western blot analysis detects immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies directed against B. burgdorferi proteins. If the ELISA or I FA results are negative, no further testing is necessary.

Western blot analysis findings are positive in the minority of patients during the first few weeks of infection. Positive results usually demonstrate IgM antibody. If suspicion of Lyme disease is high, and the early serologic testing result is negative, paired acute and convalescent samples obtained 2 to 4 weeks apart can be tested for IgM and IgG antibodies. Approximately 70% to 80% of convalescent serum samples will be positive, even after antibiotic therapy. The IgG antibody isotype is more common in convalescent samples. A positive Western blot finding for IgM antibody after 1 month or more of illness is likely a false-positive finding and should be ignored.

The presence of antibodies alone cannot make the diagnosis of Lyme disease. They may persist for years after appropriate therapy and resolution of infection. Polymerase chain reaction testing of skin, blood, cerebrospinal fluid, and synovial fluid has not been standardized and is not reliable. Urine antigen testing is also not useful.

*163/348/5*