Men's Health Encyclopaedia

 

 

 

Back-tr. from Russian

 

Men's Health Encyclopaedia – M. Oppenheim

 

   Michael Oppenheim

   ENCYCLOPEDIA OF MALE HEALTH

 

   Publ. house Kron-Press, 1997

   OCR Palek & Alligator, 1998

 

   INTRODUCTION

 

   According to medical observations, men Need to     think more   of   your health. Although women and Approximately 60% of the total number of visits to doctors, but in practice Men are more   susceptible to   diseases.   However, guided by the false   Ideas   about   manifestations   Masculinity, many of them go to the doctor too late.

   Statistics of the 10 main reasons leading to death indicates that in 8 lethal case, the mortality rate prevails in men. Women are more likely to suffer from hypertension, but It is better than   men, and even Obesity is less harmful to their health.   Women   are more likely   to be left without a life partner: if one of The couple dies - the chances of 6: 1, what is it a husband.

   Twenty years ago, when I have accumulated   sufficient   practical medical experience, I tried start writing articles on this topic, but found that magazines for women were selected 50% of the volume for publications of this kind, and men's magazines are completely ignored the subject. When I   wrote an article on such a seemingly interesting topic for men as   impotence, then could publish it only Women's magazines. When in   your notes I mentioned the device worn as a condom to   improve the erection, the flow of letters with questions where to get it, proceeded   from... women. Men are limited to random buying popular books About health, but their authors were mostly women.

   But even in those days, men gradually Began to change the way   of life. In the 70's they began to pay more attention to the sport and quit   smoking, in the 80's worried about their cholesterol, and in the 90's   quite ripened to release     the first   Journals   on Men health (despite their sexual orientation, indicated on the covers). True, they were bought mainly by women.

   My main concern has always been prevention. Therefore, regardless of the reason that brought the patient to my office, If   I   He found     obesity, high cholesterol, if   he   was   a smoker or not was engaged in sports, I warned it about the consequences and   proposed a reform program. Patients are usually prefer not   to join    open quarrels with a doctor, and therefore almost everyone   promised   Change   behavior   and habits.

   Almost no one thought about it Doing. Prevent the   disease much More difficult than enthusiasts say. Of course, some   of the   my patients succeeded, but I often lost patience, communicating with   men who did not want to change anything, Especially if, say, the smoker   was Relatively healthy and sufficiently intelligent   and   Intelligent young man. It was unbearable. “Do you not   realize,   What   awaits you? - I rattled. - And not Arguing with me: quitting smoking is nothing   Compared to those diseases and mischievous species that    are   guaranteed to you if you Going to the same vein!”

   Even in those years, I noted the characteristic reactions: Men Stupid   Teeth and Accept Try again; women burst into sobs. Their tears upset me, and I Quickly learned to insist on his own. But for men I was   cruel,   and   It   worked.   Maybe they are more accustomed to orders chiefs,   army   sergeants, police officers, coaches and captains Sports teams. When a platoon sergeant or baseball coach showed me their lousy   character, I silently listened to injustice and rudeness and   waited,   When   it's all over. Men value courage and independence, so     It is unbearable to them if Others see their pain or resentment.

   Real bravery in male interpretation - to test yourself   with difficulties. Men climb to the mountain peaks, get involved in fights, go to war, with danger   speed   cars are chasing for life,   Playing   American football and They fight the bulls. With a certain   Point of   view, these classes are not healthy, but undoubtedly require courage.    Such a special male behavior can wrap and positively: although men smoke more women, but after   in a difficult   situation, quickly part with this It's a bad   habit.   Women   95% of the clientele of clinics specializing in diet and   struggle   with   excess weight, but with more Easily lose weight men.

   With an honest approach, most of them Accept the   challenge.   V   I suggest that men go to the doctor more often: to to control his control over himself, you also need courage. In return, they will be   with   more rewarded: will retain signs of masculinity  , which so   do not   want to lose (potency, hair) and get rid of many   trouble (  wrinkles, prostatitis) and so on.).

   Looking at the covers of women's magazines, you can see Women.

   On the covers of magazines for men depicted... also women.   Men Ity draw conclusions and learn from women to monitor health   and   Take care of your body.

   This book, based on   research   The author is     of a recommendatory nature. Opinions, expressed in it, are not     mandatory or supported by the publisher. The advice in any case should be considered as additions to Consultation with your doctor.

 

 

   Chapter 1

   ENTRIAL TRUTHS FOR MEN

 

   Although the knowledge of how you have become    adult   man,   has a little practical benefit, it will help you   understand   why   Individual problems are only your sex.

   Why nature can't do one Half? Do not think   that only the simplest life forms like bacteria   can   multiply   asexually, simple division. This is characteristic of many more complex creatures, and   some, realizing sperm and eggs at the same time, fertilize   themselves,   for example, female individuals of lizards (producing the same females).

   If a woman could have called for Pregnancy   by self-fertilization, it would make its exact copy - a clone. Scientists know how   to do it with living creatures, so complicated as   frogs.   In fact, they have not yet learned Giving Women the Opportunity to Cloning Yourself   yourself, but it can happen in the near future.

   The combination of two sexes does not give exact copies, but contributes to   variations and deviations, and it is similar to the fact that   Nature   prefers   it   This is the way. The offspring in which the genes of the two parents are combined is   different from both of them and from any other an individual produced earlier. Such a multivariance means, that living   nature   changes faster, which is accelerating the process evolution. The whole history of the Earth confirms this. Life was born more than two billions of years ago. Lots of   interesting things occurred for most of the   this   period,   but   the active development of animal life began only 500 million years   ago,   When sexual reproduction appeared.    Although same-sex creatures   like   Microorganisms   can multiply simple division, they also evolve, because their genes do not have perfect stability. Genes are rebuilt accidentally   and undergo chemical changes, forming New   Varieties   (mutations). Such changes are very slowly, so that even microorganisms accelerate the course of events, with the help of Some kind of sexual   life. Then here from time to time, two unicellular creatures are cramped closely to each other a friend, in their walls, holes are formed through   which they exchange part of the protoplasm. Although   the teachers   Biology   is often joking about bacterial sex, the process described is not   sexual intercourse. Nevertheless, he naturalness is very interested in mixing genetic material. One of the sexes - male - the most Effectively provides such material.

 

   MALE SEX CREATURES

 

   It was meant to be a man in the moment when a sperm containing half a set of genes to which you have, penetrated into the egg, containing the other half of them. You can   ask   The question is,   what will happen if Eggs will get   more than   one   Sperm? I answer: as a rule, such an egg dies, but many higher   plants are well developed, Having doubled or   even   accountable   number of genes compared to the norm.

   During the first week after fertilization nothing happens, from what you could predict your gender or even conclude that from   the embryo it will turn out It is a human being. Egg   is divided   into others identical cells. During the first divisions, when there are only two cells, then four, eight, etc., they are so equal that each of them would develop a complete independent being, if   would     separate it at this point. Although    this   sometimes   happens, multiple births are not the best option. Women's   uterus   created   nature for bearing during pregnancy no more than one   child,   Therefore, even when carrying twins, chances of miscarriage or Congenital   defects of offspring are greater.

   In a week you are a small lump of cells   that look like the embryo, say, a cockroach or sturgeon in the same   Stages   of development. Then the Cells Beginning to change: each of them gradually   is transformed according to its purpose to form a certain part   of your body and since then has already unable to develop into an independent full version of the body.

   This differentiation occurs when Some of the genes in the cell begin "disconnect",     in that   Time   as   Others   continue to act. We don't know exactly how    occurs,   and   the knowledge of this process is the main Desire for every geneticist. Miracles that could be realized, Managing   the state of   genes,   so stunned that you will probably be interested in learning   more   A little   about genes.

 

   ALL THIS IS IN YOUR GENES

 

   In the nucleus of each cell lie folded long Molecophas chains called chromosomes. Human cells contain   46   such   chromosomes   (except for eggs and sperm,   wherein    23   chromosomes). Each chromosome consists of thousands of genes. Each   gene,   in     In turn, keeps one bit (one unit) of information that   Manages   life cells, and every cell of your body contains all these genes!   In the end, all the cells develop from the   same   fertilized egg, and every time, When the cell divides, all of its chromosomes are shared too.

   You may have already realized that your cell the brain contains the same genes as the cell of the finger, bone, liver or thyroid glands. In the cell of the brain there are only those genes due to which it looks and acts like a cell - it is the brain. If it could “Turn off” these   current genes and "include" others instead, the cell     would be converted, for example, into a kidney cell.

   In primitive creatures, all genes function in the cages.   If   you divide the adult sponge by a thousand individual cells, then each will grow into a separate sponge. More developed living creatures lose this possibility, but if you cut off a decent piece from rain worm or starfish, then nearby cells are converted and Replace the cut part. Even a frog can under favorable conditions Growing a new   foot.   The best that a person is capable of is overgrow the cut on the skin or repair the damaged bone. Be given to us the ability to manipulate the state of genes, we could, if necessary to grow a new stomach or hand for you, but it seems to me that before that we We'll get along very, very   soon.

   Returning to the conversation about the embryo, Note that     when   this   lump of week-long cells age begins to change, then his first   modifications are quite solid: the cells turn into external, media and internal - scientific terminology calls them, respectively Ectoderma,   mesoderm and entoderma. External cells are designed to form the skin, eyes, ears and nerve systems. Knowledge of embryology helps the doctor,   faced with a medical problem. If he, inspecting child,   will find a birthmark or other skin anomaly, he needs to look more closely from him neurological deviations, because defects   Ectodermas can lead to its anomalities. At the same time with    A doctor   will not be necessary to explore the same, for example,   digestive system that develops from entoderma - internal cells.

 

   ORIGIN OF THE GENITALS

 

   The genitals develop from the mesoderma. After 3   weeks   at   embryo appears lumps of cells, which will become   and   urinary  , and   sexual system. The simplest animals do not neither of them, and the more   developed have A system that combines both of the above. Even birds are used for excretion (discharges) and reproduction of the same hole.

   Approximately in the sixth week of some cells form a couple of   simple gonads, which will develop the ovaries or testicles,   others   form   genital elevation, subsequently developing in the external   genitalia. At this stage, the embryos of the future boy or   The girls   are the same.   Over the next two weeks of the race begin to be drawn up or   in the ovaries, either in the testicles, but the external genitalia is still indistinguishable.

 

   SIGNS OF A MAN

 

   In the eighth week of the testicles of the embryo begin Produce male hormones that are largely developing signs by which we determine the belonging of a person to the male sex (penis   and   scrotum),   as well as internal Structures (prostate   and   seedling   the duct).   Shortly after the start the activity of the testicle begins to descend into the abdominal cavity, and then, by the end The eighth month, in the scrotum.

   You can conclude that if the gonads Embryo begins   to produce female sex hormones, then a girl will be born - and you will be wrong.   In the embryo there are many females Hormones: It's his mother's hormones. There is nothing to develop ovaries     to encourage the development of a female embryo in The girl. In fact, if by some   the cause of the testicle of the male embryo is not   Produce   (or   produce   few) male hormones, then such a child will appear   on   Light   similar to     normal girl (testicles do not descend into the scrotum, so     You can't   see them). Parents will raise their daughter, and no one will not notice anything   strange   until it is found that the child does not Sexual maturity. All this means that the basis of the human body is a female organism. Therefore, the formation of a man is required Significant   changes to it.   Because nature is not perfect, with such Changes increase the chances   of error and deviations. Understanding this helps to explain   Great   vulnerability and pain of men compared to women.

   So, the very fact of birth a man puts you before the first   obstacle.

 

   FORMATION OF A MAN

 

   The birth of a male child The first   step   on   its   way to   the male part Humanity, but not the most important.

   In the first decade of life, the most important thing is socialization, and   in the second - puberty.

   Under the term "socialization" I I mean the treatment of parents and other people as a boy or as with the girl. Children   in   the first   A Few Years Able to Learn   Amazing   volume of   different   things. For example, they know the language with much more ease than   you   Or   me. Provide them Possibility, they will learn two languages at the same time.

   Parents very quickly let the child know, The boy   is   he or   girl. Although children can not know anything about the relationship of the sexes, but   Nevertheless, they are firmly aware of their belonging to   a certain   sex   and   are very offended when Someone attributes them to the opposite category.

   In the previous part, I mentioned   that the men's   the embryo   whose   testicles   failed to cope with the production of male hormones, is born similar to The girl. However, this is detected only when doctors find out   the cause of   delayed puberty. But in this case, no sensible The doctor will not tell the child the truth. Tell a teenage girl that   she's actually a boy is to shake her to depth of the soul. It is unlikely that parents will be able to accept such   news   -   they   will   Shattted   as much as much. Rather The doctor will explain that the child   there are   some   defects in internal organs that make childberebirth is impossible, but the girl will be able to lead a normal lifestyle, and will refer her to     the surgeon.   The surgeon   will remove the testicles (not the testicles that fall into the scrotum sometimes cause malignant tumors), and the doctor will prescribe estrogen to ensure subsequent development appearance of an adult woman.

   Although, as you were treated in Childhood, you already know that you are a man, for mental health, don't less, it is very important that the body corresponds to the expected species. All the main Changes in the body begin to occur from about the age of ten.

   Having fulfilled the task of forming a child male, male hormones in the late stage of pregnancy are produced the fruit   in much   smaller quantities. At birth in boys and girls' level of male   hormones approximately the same. Then their production increases and reaches   a peak about three months of age, after which is falling again. No one knows what task this sharp surge is performed; Maybe   it's   something vital to your development, and perhaps now   lost its meaning and the part of the former evolutionary process that we have inherited. At 3 years old Most children already know   which   sex   belongs to,   but, despite the rapid growth during the first 9-10 years, the bodies of boys and Girls are very different.

   During the maturation period, the genitals developing   and   accepting   final shape and size,   and   also   change   Body shape     (shoulders   in boys and hips in girls become wider), occurs redistribution of tissues (masons develop more muscles, in women - fat tissues) and hair (hairs recede from the forehead and temples back, forming the contours of the face of an adult). Both sexes increase   the amount of hair.

 

   STAGES OF MATURITY

 

   EARLY YOUTH

 

   With careful examination of the teenager Detects     at the base   Penis small amounts of curly hair. The scrotum is a little darker,   and     wrinkles appear on it.

   Shortly after the boy is performed 10 years (although this process can last up to 15 years), begins "official" sexual   maturation (this period is also called early   youth,   its   duration,   as a rule, occurs from six months to two years).   The penis   is lengthened,   the growth of the testicles accelerates, and they take the final "adult" configuration: the left hangs below the right. Patients with Enviable constancy is asked why one of the testicles is below the other.

   There are many theories about this, and one of the These are as follows: for a long time the testicles of men were located at different heights. Theme, u Who   They Are   hanging at the same level, it was impossible to move the legs, not With   pain, and they had to walk with wide-ranging legs. Women laughed at this sexually unattractive gait and preferred   have things to do with these men. Those who have the testicles   were   different levels, posture was slim, and the gait - beautiful, which Many   more attracted women to them. So it is quite natural that      the variety of men with testicles at the same level disappeared, because      There were few descendants born.

   In early youth thin and silky Pubic hair   is predominantly concentrated At the base of the penis. First   ejaculation   occurs   about a year after the acceleration begins the growth of the testicles, when pubic hair   is already good noticeable. It can happen in a dream   or     during   masturbation. There are not as much publications on this topic as the first menstruation, although this is a big surprise for a teenager.

   A small number of hairs appear in corners of the upper lip.   Hair around the anus grows earlier than on the face, but   No one     is not noted as a certain milestone in the development of the body.

 

   MIDDLE AND LATE YOUTH

 

   The average youth of boys begins around 12 years   (with   slow development - from 15) and lasts from Six months to three years. Boys finally get rid of awkwardness, Resulting in   growth   from   Girls: they begin to grow rapidly, adding up to 15 cm per   year.   Average   annual increase - about 10 cm. After this outbreak, the growth   stops, so that the longer its duration, the higher Becoming an individual. When the parents of a teenage girl go to the doctor, Worried that their daughter is too tall and continues to grow, a doctor can prescribe estrogen to speed up maturation.

   During this period,   the outlines are outlined   Figures   of an adult  . Men's Hormones Cause Increments muscle mass, especially     in the upper part of the chest and shoulder muscles, as well as elongate the bones, so that men have denser shoulders, longer arms and legs   in comparison with The female body. Female hormones expand the pelvis, so    Women are wider than men.

   When the boy is 13, the parents   notice,     that his   former indifference to the mud was transformed into something opposite: he takes a shower several times a day, without reminder changes clothes and clothes and   shows Significant interest in deodorants.   Adults,     understandingly smiling, say to each other that son Interested in girls.

   In fact, he is concerned about his own smell (the second   effect of   male hormones). The body of a woman in normal conditions always produce a little male hormones; those who do not has, do not emit   a smell, and also not suffer from inflammation of the sebaceous glands, manifested on   the face   in the kind of acne is another traumatic feature of this period.

   In middle youth, pubic hair is coarse and   darken,   begin   to curl and spread throughout the pubis. The penis thickens and lengthens, the scrotum darkens and becomes wrinkled.   Men's   Hormones   increase cartilage and muscle the larynx, why the voice acquires a screed sound and   begins to "break"; only through For several years, a young man will appear a pleasant baritone.

   Boys are capable of fertilization, as The rule, already     at the age   14 years old, girls about a year earlier. They begin to   occupy very much   sex, they are looking for information and in huge numbers find it in   movies, television programs and buddies. Such “knowledge” often lead teenagers to early Pregnancy and sexually transmitted diseases.

   In late youth, not noticeable changes Occurs. This period   begins in 14-16 years, and lasts up to twenty with a little. The body is approaching Final adult outlines. On the chest, chin and indoor parts The hips appear hair. Upper   the boundary of   pubic   hair is stretched towards   the navel,   forming   (with   stable   the level of male hormones) is a rhombological form. Women   with   Normal   Development Border pubic hair does not   move,   saving   shape   of a triangle. Larynx reaches the usual sizes for an adult, the voice becomes   lower and stops breaking. Growth is slowing down and ceases.

 

   HOW TO TELL A BOY ABOUT SEX

 

   By using your child’s authority, you You can     teach him something. If the boy believes that the last word about baseball,   cars and algebra rightfully belongs to the father, so he behaves   like that,   as if he knows the object well, and speaks of it freely. Ten years Defaults   about sex can greatly undermine credit of trust.

   In fact, sexual training begins A few months after the birth of the child. Kids start playing with genitals as soon as they learn to manage enough with your own hands, usually at 5-6 months. Contrary to the teachings of Freud, this is only the usual Childhood   curiosity and research more one unfamiliar part of the body and the world around, although even the infant of manipulation with this zone deliver more pleasure than in the study of other parts bodies. Increased interest of   the baby Your penis usually unnerves parents.   In my opinion,   there is no   need to explain that hit him on the hands, withdraw them or, as offer   more progressive authors, distracting it with the help of new toys is   by no means the best way out of the situation. Approximately in a year of age, when the child will have more opportunities to know the world, His attention will be switched on its own.

   Children begin to talk about their genitals, barely   learned   to speak. Most often they are quite fast They realize that parents do not share their interest at all, and leave this topic, Continuing, however, to experiment and discuss such things with each other, When parents are not there. Sex games of same-sex and heterosexual children   -   normal   part of   the growth process. You can't do this Prevent, especially since there is no harm from them.

   Your first active step in sexual Learning – Ability to Avoid   Infantile euphemisms   in conversation with   the child.   Use   the right names The genitals. Answer the child's questions immediately   But     as soon as they are set; do not delay the answer Then,   because   the child   will find it somewhere else, and you will never hear such   a question again.   Do not avoid discussing such topics, but within   a few   the first years do not give more information than the child is able to Absorb.   If he is interested in where children are taken, it is enough to say that they come out of the mother's abdomen, and To stop there. The child   will need later a more detailed explanation, and if it is not   ask   about   it   in Ages 5-6 years, then you better start a conversation before   it is enlightened by friends. If you are always frank with It's not gonna be hard.   He, of course, will receive an ordinary rough version from friends and from the media, But if you are an authority for him,     There is a chance   to rectify the situation. Children who learn about sex from parents, much   more successfully   can avoid   subsequent   Disappointments   and    Failures.       Unfortunately,    for most adults, "sexual children’s education consists in traditional conversations about birds, bees, Pestics and stamens.

   I still remember the embarrassment with which listened to the father, explaining   some Reality of life. He was as embarrassed as me, but he knew he had to Fulfill your duty. At that time, the sex relationship seemed to me only one from incomprehensible areas of activity of adults, from which they, oddly enough, Enjoy it. I think it was   the same as watching boring movies, where nothing at first   glance,   Does not happen, or drink disgusting bitter drinks like coffee and Whiskey. I knew that sex was somehow connected with the birth of children,   but     I couldn't figure out why   he was       Adults like it so much.   Naturally,   such actions seemed to me wildly grotesque and, most importantly, forbidden; and for a decade This boy is enough to   to   be very interested. When the father explained that the man inserts a penis into   the vagina of a woman, he, in fact, did not inform me Nothing   new,   but   was   so serious that I got the impression that sexual intercourse   A   kind of religious ritual. It even more embarrassed   me   because   My   friends and I assumed that It's the opposite. I am with   relief sighed when he stopped spreading about the genitals, But   then it started completely incomprehensible: The father spoke about women who "sell   himself.” I never heard anything like that and I didn’t understand. What   does this have to do with the sexual relations. Why sell themselves? V   Generally, the conversation with the father did not add anything to my knowledge.

   When talking to a child about sex, you feel uncomfortable and awkward, it is better not to talk to him. He will also be out of himself, and   he will   learn nothing. Give He has a good book on the subject. And please don't send your son to talk to your doctor, The doctor is likely to embarrassed by no less than you.

 

   TEENAGERS AND SEX

 

   Tendering Birth Management and   precautions against venereal Diseases are     annoyed by   many   parents.   They are convinced that it means teaching children how to   sin with impunity  , and are convinced that such knowledge is pushing Students   to   Increased   sexual activity. As a result, the teenager or does not   receive at all   information, or this information is presented at such a level that Students are not able to learn to behave wisely.

   Fortunately, most teenagers reach mature age without   suffering Excessive sexuality and   Avoiding   the devastating consequences. The greatest disaster is not   sexually transmitted   diseases, and even Not early pregnancy, but early marriage. Even if   the newlywed is not pregnant, it is far from The best start to adulthood.    V I note that sex among teenagers is not as common as Many think. At the age of 19, virginity   Retain   40%   of American girls and 20% of boys.

 

 

   Chapter 2

   THE ROLE OF NUTRITION

 

   Although America was a rich country and 150 years back, the workers and their families consumed mostly bread, cheese and beer, and only from to the case on   their table appeared A piece of meat. For almost everyone, except a few eccentric people, there was meat the most desirable food, so representatives of the middle and rich classes ate it is in exorbitant quantities: often at lunch there were half a dozen meat meals - on a par   with   alcohol   and   sweets. Fruits counted exotic food (you could find an orange in   a Christmas gift), and vegetables and cereals - Food of the Poor.

   Doctors of the 18th century considered meat as the basis of a healthy diet and   an important element for the treatment of diseases. High quality meat was considered the best, low meat qualities are harmful, but no one objected to fat. Practically experts   disapproved   of the fast   meat,   because   everyone knew that healthy animals should to be fat. Patients   were prescribed to eat more meat; weakened patients who could not cope with solid food, drank the healthiest liquid: fatty beef broth. The weakest Received broth with an enema.

   Today is a forty-year-old American, European or a Japanese may enjoy the opportunity to live to 80 years and more, 150 years He would   have   come back to the end of his life path. Among poor nations are the case and now   the situation is Oh, wow. Medical science contributes its modest contribution to the sensational increase Life expectancy is mainly through the immunization of children. Huge role play improvement of diet and sanitation (  proof water, building sewage systems and structures for   cleaning scum.). Sanitary measures reduced the threat of fatal   infectious diseases of the past centuries to the minimum, so that the current doctors   can and Do not recognize them.

   Huge increase in agricultural products on a par   with   the development of the production of canning and transportation Food has opened people access to a much more varied food than before. But, as     in many other areas of life,   developed   The technology   is     in a certain meaning by a dubious good. Modern men enjoy the so-called "Beautiful food" type of hamburgers,   not at all   food   ("snickers",   etc.) and food leading to premature Death, which many   unknowingly Make the main part of your food.

   Foods have become so cheap,   What Even   The poorest   segments of the population in Developed countries are not starving.   About   this   In   particular, it is evidenced, in particular, The Increase in Two Diseases Caused by Excessive Incessant   Food Intake: Obesity and Destruction teeth. These violations   are   now much more common among the poor, than among the wealthy, that before the industrial revolution was not noted.

   Improving nutrition in the literal sense Words   have rebuilt   our   body. Now we are 10-12 cm above the people of average height   of the past   Centuries.   Ancestors would be shocked the type and sexual   development   of the current   teenagers, since in our time, sexual maturity occurs   approximately   Three   years earlier.

 

   FULL DIET

 

   Attention to diet is the most important and Reasonable Step   to   Improvement   health. It’s not just the consumption of food that is vital for growth, development and optimal functioning of the body of a man. Modern science testifies that proper nutrition provides protection against   certain chronic diseases, in Some cases leading to degeneration.

                                          Table 1

Food product Water     Proteins (protein) Carbohydrate Fats Minerals

Almond 5                 .1      21.0     54.0     16.00    

Apples                   85.0     0.4.     0.5      13.0     0.5

Artichoke 79                .0     2.0      0.1      17.0     1.0

Avocado                  70.0     2.2      20.0     6.0      1.0

Bananas                   75.0     1.1      0.6      22.0     1.0

Black currant         86.0     1.0      1.1      11.00     0.5

Oil Cream          11.0     1.2      85.0     0.0      3.0

Cabbage garden        90.0     1.9      0.2      5.0      1.0

Cheese                      39.0     24.0     30.0 1.5    .4    

Cream                   74.0     2.5      18.0     4.5      0.5

Dates                   20.0     2.1      2.8      70.0     1.6

Eggs                     73.0     12.0     12.0     0.5      1.1

Garlic                   65.0     6.8      0.1      27.0     1.5

Grapes                 78.0     1.3      1.2      19.0     0.6

Grapefruits               86.0     0.5      0.0 7     .3      0.4

Nuts                    3.7      15.0     67.0     11.0    

Fuck                     77.0     2.7      0.3      16.00     1.5

Blueberries                  78.0     0.8      0.6      17.0     1.0

Onions                87.0     2.8      0.3      6.5      1.2

Lentils                 12.0     25.0     2.0 53     .0     3.5

Beans                     68.0     7.1      0.7      22.0     1.7

Milk (removed)          90.0     3.2      0.3      5.2      0.7

Plump                    11.0     9.1      3.8      70.0     1.9

Mushrooms                    89.0     2.6      0.3      6.1      0.7

Peaches                  83.0     0.6      0.0      16.0     0.6

Oatmeal                  7.3      16.0     7.2      68.0     1.9

Olives                   30.0     5.2      51.0     10.0 2    .3

Pears                    4.0      0.6      0.5      14.0     1.4

Potatoes                75.0     2.1      0.2      21.0     1.1

Bread rye rough       42.0     4.2      0.7      43.0     1.3

Rheuven                   94.0     0.6      0.7      3.6      0.7

Fig 13.                     0     7.8      0.9      76.0     1.0

Rye                     16.0     11.0     1.8      67.0     1.8

Spinach                   88.0     3.5      0.6      4.4      2.1

Strawberries, strawberries      88.0     1.0      0.6      77.0     0.8

Beans                   84.0     3.9      0.2      8.3      1.2

Soy 10.                     0     34.0     17.0     34.0     4.7.

Tomatoes                 94.0     0.9      0.2      3.7      1.0

Truffli (Mushrooms)          77.0     7.7      0.5      6.6      1.9

Turnip                     89.0     3.5      0.1      11.0     1.9

Kress-salat              92.0     1.9      0.1      1.3      1.5

Watermelons                   93.0     0.5      02.      6.0      0.3

Wheat whole          36.0     8.9      1.8      52.0     1.5

Yams                      72.0     1.8      0.2      23.0     0.9

   Over the past two decades, we have been thrown away many tips   on choice diet. Countless new dietary guidelines   have confused Americans. Accustomed   to caring   about   their   health.

   Eating right is not as difficult as they think some. If   in your daily Diet contains a low amount of fat   and   increased complex carbohydrates, You're on the right path. Do not make radical changes in your diet and not Give up your favorite dishes. I will help   you   will find the best diet, Including all the nutrients necessary for   active life.

   Table 1 provides an indicative chemical composition of certain   products

Meal (%)

 

   NUTRITION AND ATHEROSCLEROSIS

 

   Being the cause of heart   failure,   heart attacks   and   strokes, atherosclerosis is partly a consequence of the wrong   nutrition   and   completely prevent due to the diet.   Because   Atherosclerosis   tops the list the causes of death in the United States and most developed countries,   is   A very good opportunity. Among Americans 40-50 years of mortality   from   Cardiovascular disease accounts for 16% of the total number   of deaths. For 50-60-year-olds, this figure increases to   30%,    70-85-year-olds reaches 50%.

   That those affected by atherosclerosis of the artery Loss of   elasticity   is not the main problem. Most It is known that the main   violation is The vessels are clogged. Material that narrows their optimal diameter - Cholesterol, which begins to stick to   walls     at an early age. Studying this phenomenon began in the 50-ies, when at   the autopsy Soldiers Killed in Korea Finds Intensive   Cholesterol Detox on 18-25 Years' Vessels Men.

   Atherosclerosis affects all the arteries, but large vessels have some capacity stock, so   weak     The link is small arteries. When vascular obstacles limit blood flow to   the coronary arteries, the deficiency blood-borne   oxygen   causes cardiovascular disease (pain in   the chest,   angina pectoris,   heart failure, and with a defeat of part of the heart muscle - of a heart attack). Blockage of any small artery in the brain provokes temporary   neurological disorders (weakness, dizziness,   confusion   in   thoughts).   If due to constant blockage dies part of the brain,   there is   a stroke, accompanied by Paralysis.

   Since 1960, the number of heart attacks in The United   States   has declined   30% and continues to decline. The frequency of strokes fell   by half.   Improved nutrition deserves some recognition, although other actions (disaster of smoking, sports) also played a role. However,   and   heart attacks and strokes remain the greatest   risk factor     for most men, though The right diet can lead it to zero. You probably   already understand that we are talking about plant, fibre-containing food, including little fat and meat, for which Nutritionists have been advocating for decades. To avoid atherosclerosis on such a diet should   be switched   at a very early age, but never late Start from zero. It is proved that a person who has dramatically improved his diet, already The resulting cholesterol layer dissolves.

   Rational nutrition to some extent will protect you   from   other diseases. Here is facts that, together with the thought, will show you the right path.

 

   NUTRITION AND MALIGNANT TUMOR

 

   In non-smoking men, prostate cancer, direct Intestines and bladder top the list of possible locations tumors.

   Prostate cancer. If you focus on that, that in 1993 recorded   165 thousand again, this     is the main   Male   disease. This indicator for several   Decades   have been growing   rather slowly. Proper nutrition seems to be one of the prophylactic measures.

   Colon and rectum cancer. Meets in 2 times less than   prostate cancer; in the last 40 years, the incidence among the white   population   decreased;   and among blacks increased, possibly due to changes in consumption fat. Obesity increases the risk of getting this type of cancer. Consumption a large amount of fibrous food and the exclusion of fats   to a certain extent reduces this risk, probably due to the acceleration of waste through the intestines and carcinogenic substances or changes in the ratio of bacteria living in intestines.

   Bladder cancer. Being a filtrate   of all   existing   organisms in   liquids, urine is the concentrate of any toxins, so environmental carcinogens - The main cause of urinary tumors   bubble.   Moreover, since men make up 80% of the victims of this disease, specific, Monthly male   factors   increase   Danger.   Men   smoke more women, and Smoking doubles the risk of a bladder tumor. They are more likely than women to work in chemical industries, and   Employees of foundry, rubber, paint   and   the leather industry   is more   susceptible to this species Cancer. But no dietary factor increases the risk; ten years ago, newspapers graced a lot   of stories about   damage to the coffee of artificial sweeteners, but Subsequent   studies   have not confirmed initial fears. Vitamins and minerals   that will be discussed further, can activate the protective functions   organism.

   Pancreas cancer. This less common than the three   mentioned ones higher diseases, the disease is one of the most unpleasant and almost certainly leads to death, occupying   the fifth place in the list of causes of death after lung cancer, prostate, intestines and bladder. Located in the depths of the abdominal cavity, the pancreas is difficult to examine, and violations of its functions may not manifest   themselves   in the early stages.

   For most of the 20th century,     the incidence of cancer   the pancreas has grown, but since 1970 has been based on constant level,   most likely due to the balance Between the number of people who quit smoking   (Smoking doubles and even trips the risk)   and   Increased   number of elderly people. Men get this type of cancer in almost   3   More   often than women. Most Cases of the disease are noted in   men   are over   60 years old, 60% of them are black.    To reduce this risk, quit smoking and Go to a diet with   a low content fat.

   Nutrition plays a big role in prevention Cancer. Studies show that cruciferous contribute best plants (ordinary cabbage, colored, broccoli and Brussels). Consumption large amounts of bulbous (onone, green, garlic) in significant Degree reduces the risk of stomach cancer.   Chemical   compounds   that give these plants a specific smell, Influence     the decrease   Cholesterol   and provide anti-inflammatory action, in the future we will   hear more than once about them.

   Natural Lifestyle Advocates Condemn the use of food   additives in modern food production, and the process itself   is not approved. If I could choose, I would eat exceptionally fresh food of organic origin, but, alas, none of the Citizens do not have such an opportunity, except for very rich people. Although   modern   additives do not improve food, but should   be skeptical   Treat   and     Supporters Return to the preparation and conservation of food products using old technologies. Many traditional methods of cooking contribute to development of cancer. Even in such a developed country as   Japan, where they love salted, smoked and nitrited food is very   high the incidence of tumors of the upper part of the digestive tract of   the esophagus and stomach. It is better to use Achievements   of Modern   Chemistry.

   It is proved that vitamins A, C, She selenium -   very   Reliable   protection   against malignant tumors (see below).

   If proper nutrition can prevent atherosclerosis, then in cancer, it is only one of the prophylactic measures.   A Balanced   Diet   can reduce the risk of the disease by 30-50%.

 

   NUTRITION AND HYPERTENSION

 

   This disease is almost entirely dependent on food. In industrialized countries, blood pressure rises with age,   reaching in many dangerous levels. This does not happen in underdeveloped countries, where little Salt. This disease is almost unknown.

   People have always sought to get food easy and fast, and underdeveloped (or simply poor) communities are always Experienced difficulties   with   meat, sugar, alcohol and salt. Becoming richly,   you can afford to eat what you want, and people immediately switch to previously inaccessible food. Americans experience a special addiction to salt, consuming it at least 10 times more than the body requires.

   In all countries there is “empty food” - easy to prepare, with clearly   expressed taste, cheap and often     not at all   nutritious.   Crunchy Potatoes are just one example of such food.

   In American products of this type a lot of salt, but this is not due to the technology of their preparation, but With   that,     Americans love salty food. To some extent, this has developed historically.

   Before the development of freezing technology and The salutation     was one of the most easy ways to preserve food,   since microorganisms are not multiply in a salt-fed environment. When in   the beginning of the XIX century learned to preserve, then   manufacturers     Already cooked steeply salted products. Unfortunately, this contributes to the preservation of Not just food, but also bad habits. Food without salt   seems   tasteless.

   However, a person who has never salut   food   and   does not   buy canned or cooked with salt   Foods  , consumes   salt more than enough.

   Of course, not everyone who eats Western model, suffers from threateningly high blood pressure, but trouble in that we   still   do not have an easy way Definition of "sensitivity   to   the salt."   V   Most cases high pressure makes itself felt in middle age, so   if you have passed a 50-year mark with normal pressure, hope that it will continue to remain at this level, no matter how much salt you consume.

 

   FOOD AND DIABETES

 

   Approximately 2% of the population suffers from diabetes. manifested in two forms. The so-called insulin-dependent diabetes occurs suddenly, usually   affecting children, but sometimes both adults and with the beginning requires the introduction of   insulin. According to the most popular theory, this disease   develops when the virus provokes erroneous immune system response to the destruction of pancreatic cells, Producing insulin.

   Improper diet can provoke Diabetes in children. Precautions  , The ones described in this book will certainly be too much   belated for those who are already suffering from them, but can benefit in family planning . The American Children fed exclusively   The   risk of diabetes is about 33%. In the rest of the world, its manifestations   are associated with consumption Cow's milk. In the countries with the highest   milk consumption, for example in Finland, the incidence rate 5   times   higher than the United States. In Japan, where the cow Milk is not included in a regular diet, cases of childhood diabetes are quite rare.

   Researchers suggest that the intestines Premature babies   suck part protein contained in cow's milk   (Intestine intensions   normally developed infants do not absorb large molecules), and this body-bearable   protein stimulates their immune system. Everything is going well until   for some reason the protective reaction affects the cells that produce insulin.

   Then exacerbated sensitivity is incorrect Coordinated Immune The system causes even more A powerful attack of these cells. Female   Milk   is not contains foreign proteins, so children who do not receive   another   Food   in the first 6 months of life grow with a stronger immune system.

   More common (3/4 of all cases) diabetes among adults.     In its occurrence, the main Heredity plays a role.   If   the parents   Or close relatives suffered from diabetes, your risk   is   30%,   (For insulin-dependent diabetes - 10%). Improper nutrition can provoke diabetes, and the main culprit is not the general enemy -   sugar,   but absorbed by you calories. Almost all of these patients also suffer from   overweight, and the best treatment is not tablets, insulin and refusal of sweets, and even not   a diabetic   diet,     and   weight loss.   Keeping a slender figure, you are more than 90% Reduce the risk of   diabetes. Losing excess weight often returns   a diabetic blood sugar to normal values and allows it get rid of taking pills or injections insulin.

 

   FOOD AND GASTROINTESTINAL DISEASES

 

   Paradoxically, it sounds, digestive tract for proper functioning needs large Amount of undigested food. The small intestine almost completely digests and   assimilates   refined sugar, meat and milk products.   As a result of   the waste,   which could go into the colon, almost not remains. Bread from good white flour, from where in the manufacturing process are removed dark wheat   bran, also Digested almost completely. White bread began to bake at   the end of the XIX century. Increased Welfare of the Western Population   countries   have given the opportunity to almost everyone to eat so much     meat,   milk   and   sweets, as much as only the rich allowed themselves in the previous centuries. Thick   intestines of Westerners, over millennia Adapted to large   quantities uncultivated fibrous plant food,   It   was difficult to   see small amounts of waste. Its most important function is the absorption of water, And the longer there is no chair, the dry it will be when it appears.   The century was too small for the evolutionary process,   so the large intestines are not has adapted to a much lesser   volumes   much more dry chair. As a result, the muscles of the rectum contract more   slowly and create more pressure, what can withstand   its   weak tissues, why they often inflamed and lose the ability to perform   their functions.

   Almost all, experiencing nausea and vomiting, bloating, dyspepsia, diarrhea (diarrhea) or spasms in the stomach, consider the cause of a   violation The last meal they eaten. However, none   of   my   patients , for some reason, did not blame the local restaurant, when I found them   appendicitis, diverticulitis, diaphragmatic hernia, hemorrhoids or irritation of the rectal . And these diseases affect all those who feed on fatty and poor herbal fibers. Listed   violations   are the consequences of a long   bad   Relation   of   own   digestive tract, and the sooner you will switch   to a rational   diet,   the greater your chances of success (ironically,   when   I diagnose     men with an ulcer, they immediately blame food for their troubles, but it is the same ulcers   that are the only gastrointestinal disease that is not   related to nutrition).

 

   WHY NUTRIENTS ARE NEEDED

 

   Men suffer from many diseases, Possible   to prevent   with the help of A balanced diet. Even people with strong   health,   old age, are exposed to food-related diseases (for example,   obesity),   since with age, muscle mass (exhaustive of more   heat) decreases, and the layer fat (which allocates much less heat)   increases. If you’re over 60, reduce the amount of calories absorbed Approximately 30%.

   All living beings, producing energy, should burn food. I emphasize that this is not an analogy, but a literal description What happens in the body. Complex food molecules products are broken down and converted into carbon dioxide and water, emitting volume Heat that could be obtained from the burning of these products in the fire. Just in The cell is   slower. Any food you are   able to     digesting and assimilating, i.e. burn, contains a certain number of calories.   Unabudgeable substances, such as some Types   of Fibers   and   undigested food (mainly chemical extracts Types of coffee and tea), no calories   are contained.

   Cold-blooded animals in motion It takes   the same   amount of energy as warm-blooded or birds, but they almost do not need it, being at rest. In warm-blooded animals, the thirst for energy is   inexhaustible; people spend 2/3 of their own   Daytime Calories   Only     maintaining a constant body temperature. That is why you need to burn excess calories Such a depressing amount of sports exercises.

 

   PROTEIN

 

   Proteins are large complex molecules. which serve     to construct the structure of the body (muscles, skin, nerves) and the implementation of metabolism   (hormones, enzymes, blood). Meat - enough their rich   source,   but   proteins are so widely represented in nature, that those who   eat   a variety of things can almost do without him.

   Daily amount of protein for men - 45-60 grams.   Non-professionals are usually difficult to believe that one mutton mutton a day   fully satisfies the need of the body squirrels, but that's   undeniable.   Americans, like the people of other rich people countries, consume too much protein - 2-4 times more, what is necessary. Although for healthy   a person   is so supernatural, there is nothing useful in this, since the protein   in the body is not preserved, but is converted into Carbohydrates or fat.

   Men who play sports are convinced of   that the protein   builds on muscles. This is true, but even the most ardent bodybuilder can increase only a few grams of muscle mass per day, and therefore he does not need an excess of protein.

 

   FATS

 

   Fat molecules are made of glycerin molecule, associated with three   molecules of one of Three fatty acids. The medical name of fats is triglycerides. For example, fat, in Large quantities contained in beef and consisting of glycerin and stearic acid, is called   tristerarylycered. With the help of tests on triglycerides determine the content of fat in the blood. Most rich sources of fat (except meat, eggs and dairy products) are nuts and vegetable oil.

   With the exception of a small amount the remaining   carbohydrates,   the body translates excess calories, obtained with food, in fat, concentrating energy. Burning one gram of fat gives 9   calories,   and   From   one gram of carbohydrates or proteins, only 4 calories are obtained. Even the worst a person needs some fat, because we   save very little carbohydrates: on average in Human body contains 150 thousand calories in fat and only 2 thousand - in carbohydrates. Energy supply in   Carbohydrates can be consumed faster than in one restless day.

   In addition to storing energy, fat covers vascular walls, nerves and other organs, protecting them from physical damage and heat loss. Fat is distributed throughout the body (especially This applies to membranes covering cells and cell nuclei), which provides chemical protection when interacting with the most important substances of the body, such as prostaglandins.

   Dietary recommendations in this case Complicated   because   the body builds molecules of glycerin and fatty acids from simpler molecules. Exclusion constitute two fatty acids, linoleic and arachidonic, which are found in many foods, so special   efforts   to obtain their required daily doses not needed. There are no certain   requirements for Limitation of Fat, but Cooking   delicious   dietary   dishes at least without 10% calories due to fats are difficult.

 

   CARBOHYDRATES AND FIBERS

 

   The most familiar to you are the carbohydrates Sugar: Small   Molecules Produced plants in the combination of carbon dioxide   (carbon dioxide) and water during photosynthesis. The most important of the Sakharov is glucose. Animal plants get energy by burning   carbohydrates, again turning them into excurrence Carbon and water. Our cells burn only glucose and, although we consume along with other   carbohydrates   and other sugars (fructose, maltose and sucrose), the body   before   processing turns them into glucose.

   Plant tissues are formed by   adhesion   Sakharov for     construction Large molecules, called   complex   carbohydrates,   or   Polysaccharides. Wood consists of pulp - Insoluble polysaccharide.   Some from polysaccharides, such as starch, tasteful   and   used in  food. Others (cellulose, gum, lignin)   absolutely   not   digested the higher animals. Rude (fiber-containing) food does not provide the body nutrients, but plays a crucial role   in   our   diet. People who consume little rude   Food is   prone to   chronic   constipation. Large volumes of this food are formed the masses   required   for   Proper the work of the intestine, and perform protective functions mentioned above.

   We burn glucose from food so quickly, which in several Hours after eating nothing from her does not remain. Humans and   animals   convert some sugars into a complex carbohydrate - glycogen, keeping   it in the liver and muscles. He needed to avoid dependence on other sources of glucose - fat and squirrels. In the absence of   glycogen,   the body produces glucose from these substances.   As a result   the   so-called hungry ketosis occurs when tissue breakdown products are excessively oxidized blood, slowing down the usual metabolic activity and causing   nausea. Ensuring minimum consumption carbohydrates (at least   15%   of all daily calories), you get the opportunity to burn fat by avoiding   Ketosis. The best diet is at least 50% of carbohydrates.

 

   DO NOT FORGET ABOUT VITAMINS AND MINERAL

 

   Vitamins are organic compounds, - necessary for the body in small quantities for chemical reactions, Supporting life. Minerals are the main elements: iron, copper, calcium and t.D.

   The role of vitamins, minerals and trace elements in the organization of the diet is huge, so I will talk about the main ones.

   Vitamin A is vital for your skin and the retina of   the eye.   General   for the poorest countries blindness caused by lack of vitamin A,   almost   never seen in more developed countries, since it is found in many foods: greens and mature vegetables, ripe fruits     in the form of carotene, or provitamin A, converted by the body into   a vitamin   And,   in dairy products, eggs, liver and fish oil (in its pure form).   I'm   never did not receive information about cases of its shortage in the United States,   but   From time   to time I had to read about vitamin A poisoning, usually   in people who consumed it in large quantities to improve vision or Color of Face. Remember that vitamins are involved in the chemical reactions necessary for life the body, but their consumption in   Excess quantities won't make you superhuman, how to increase the supply voltage of your TV will not improve images,   but   will lead     to call the master. Prescribing "Retin-A" and other derivatives of vitamin A   for the treatment of skin diseases, Doctors   actually   use   toxicity   of these agents, not the usual effect of the vitamin.

   It is not known how vitamin A protects the body from cancer of the digestive system, bladder and lungs, but it is becomes obvious Comparing people who consume sufficient amount of vitamin with   those, who gets under the way. Evidence that vitamin A reduces the risk the occurrence of malignant tumors, while quite modest, but   the number of They are growing. During the 10 years more than 20 thousand   doctors   took   pills, containing either aspirin or vitamin A, or placebo to determine them Impact on manifestations of heart attacks and cancer. After 5 years, it became clear that  Aspirin protects against heart attacks, so the study of this   Directions stopped. Results of the vitamin action And on malignant   tumors should appear by the time you read these lines.

   Recommended daily dose (RSD) of vitamin A equal to 1.5 mg.

   Vitamin B1 or thiamine is part of an enzyme system that breaks down glucose to produce   energy.       The process of glucose breakdown   a complex reaction consisting of dozens of stages. In   it     Many vitamins are involved, thanks to which they have gained a reputation for energy production. The True Source Energy is definitely glucose. Its lack causes increased fatigue. Ironically, the symptoms of shortage Vitamin B1 is very diverse, but the lack of energy is not the most noticeable.

   Any doctor knows about the role of thiamine in Warning   and   treatment   beriberi disease, but information about its deficiency in The United States is almost non-existent, because it is widely available: found in meat, whole grains, dairy products, legumes and nuts. Nevertheless,   Category:   Urban   hospitals   observe a special form of such insufficiency in men who consume almost all their calories in the form of dry alcoholic beverages.

   This is a disease known as encephalopathy Werqueric, is neurological   Disorder   that leads   to   muscle   weakness,   reduced sensitivity, difficulty gait and delirium -   delirium   condition. One injection of thiamine leads to a sharp   improvement   conditions,   from which it follows that the lack of vitamin is not chronic. the RSD of Vitamins B1 is 1.5 mg.

   Vitamin B2 or riboflavin is also important for Metabolism of energy and vision function. Its insufficiency is extremely rare and is noted only     in conjunction with the lack of other substances in Poor   food.   Meat,   liver, fish, as well as dairy products, grains, vegetables, greens and eggs provide a sufficient amount of B2. RSD Riboflavin is 1.7 mg.

   Vitamin B6, or pyridoxine, also plays a role in   the breakdown of glucose, but is more involved in       the conversion of protein. RPD - 1.5 mg pyridoxine for every 100 g of protein. He   found in     meat, liver, whole grains and vegetables.

   Like B1 and B2 vitamin B6 deficiency   It is very   rare. It is often used in combination with other drugs.

   For example,   isoniazid   -   the most   effective    anti-tuberculosis agent - in some cases causes neuritis in patients. Pyridoxine   prevents them, so anyone who is treated isoniazid, must   additionally Accepting him too. Some medications neutralize pyridoxine, so doctors prescribe large doses of B6 to patients taking   penicillamine, cyclocerine and hydraazine. U a woman in   depression   caused by oral contraceptives, daily intake of 50 mg of pyridoxine, the condition often improves. His used in the treatment of   pyridoxine-dependent anemia, and apparently, this disease is caused   not only by the lack of B6, Therefore, pyridoxine here acts as a medicine, not a nutrient. MSD pyridoxine - 2 mg.

   Vitamin B12, or cobalamin, has miraculous properties. It is vital for the growth and reproduction of all cells in animals, and in humans plays a crucial role in the production of red blood cells (erythrocytes) and in the metabolism of nerve tissues. Insufficiency B12 leads   to continuous progression anemia (malignant anemia accompanied by increasing weakness and Paralysis. The disease   is quite   common and is not a consequence of lack of B12 in nutrition, and   is caused Violation of the stomach function. The stomach produces a secret  , called the “inner factor” that interacts with B12 (which used to be called "external factor"), obtained from food, and contributes to   the absorption of its subtle intestines. For unknown reasons, in some   patients, the stomach loses the ability to isolate this secret, in connection with   which B12 passes through The digestive tract is excreted without being absorbed.

   In the 20’s, researchers found that Feeding   patients   with very large doses the liver reduced the manifestations of malignant anemia.   This diet, although it saved Life was pretty inappetizing. Fortunately, scientists quickly identified from the liver extract, and later from   extract - pure vitamin B12.. Modern victims Malignant anemia (and   gastrointestinal diseases) feel well thanks to   Monthly injections B12.

   Appearance B12 in medical practice - A kind of turningaway in   the history of medicine. In the 20-ies of the doctors made him    A   few fantastic healings. For surgery, miracles were already familiar (untreated appendicitis led to severe agony and death, so the usual   appendectomy was a real magic). When the doctor injected   a bedridden   patient liver extract, then for literally a few days, faded in front of the patient, came to life and even got up, a week later   he walked, and a month later returned to normal life.

   The first news of the miracles done   B12,   spread at     the speed of a forest fire, proportional to the emergence of     medical professionals among the population, and the next 70 years     Applications Failed   Overshadow his reputation as the elixir of life. Doctors prescribed it   to everyone   as   Panacea, despite the fact that I knew everything A few people who really believe in his action. Many patients themselves asked to appoint them B12 when   it seemed to them that it was time Support the fading forces. Envided actors and singers kept with them The Nurse Who Injected Them before every performance.

   Careful studies have shown that B12 activates energy only Those who do not receive Enough of it from food. However, when I visit some patients, I I always take a little B12 with me. I never offer it myself, but I do not refuse requests either. It's   Safe   the drug, and its history enhances the beneficial psychotherapeutic   effect. Non-professionals (but not doctors!) prefer injections to tablets. Strengthens the impression that B12 is the only colored liquid of all commonly used medicines. When   I   fill   syringe   brightly red   liquid, patients think: here it is, A real life-giving tool.

   The richest source of B12 is liver, but   all   parts   bodies of animals, as well as eggs and dairy products They keep it. Dietary Insufficiency of B12 in our contemporaries almost impossible, with the exception of The most ardent vegetarians, They don’t even eat eggs and dairy products. They should take supplements B12, not necessarily in   injections.   ARMS B12 - 2 μg.

   Folic acid and B12 in any textbook always appear side by side, because they are jointly involved in the process of growth and   reproduction   cells.   Absence or lack of any of these substances causes anemia,   leading to the formation of abnormally large nucleiate   erythrocytes.   Despite the similarity, they are chemically correlated   with each other   A friend.   All   foods contain folic objects in one form or another, especially   greens,   vegetables, liver, yeast, nuts and legumes. Insufficiency of folic acid is observed rarely; the exception is chronic alcoholics and   suffering from gastrointestinal diseases that disrupt its absorption.   Long-term use of anticonvulsants funds   and   oral   contraceptives sometimes neutralize the effect of folic   acid,   causing   megaloblastic anemia.

   In contrast to B12, folic acid has preventive (preventive) properties. Pregnant women take it additional doses to prevent nerve defects of the fetus at birth.   Suspected of precancerous cells in the cervix   for women   prescribed a three-month course of treatment, providing 10 mg of folic acid in day, after which the cells are normalized. RSD - 200 mcg.

   Niacin, nicotinic acid, or nicotinamide, - a vitamin     that has nothing to do with nicotine contained in   tobacco,   so   Scientists gave him an additional name to Avoid confusion and misconceptions. Niacin promotes production of energy. Its sources –   all   meat products and fish, as well as whole grains, greens, vegetables, nuts and legumes.

   Lack of niacin leads to disease Pellagra,   known to   medical students as "three disease D":   dermatitis   (inflammation   skin),   diarrhea (diarrhea) and dementia (dementia). In some cases, inflammation of the skin manifests itself like a sunburn with ulcerations, diarrhea is accompanied by vomiting, and mental disorders reach a delusional state and   hallucinations. Pellagra has been an endemic for centuries (specific   disease for the area) in the southern United States, and doctors noted that among the poor, the incidence is higher, but its victims are sometimes The rich also became. In some Families have been followed by multiple cases of pellagra, in others There was none. Doctors came to the traditional for those times the conclusion that Pellagra contagious and provoked, in particular, by poor hygiene.

   Only at the beginning of the 20th century researchers corrected this opinion.   Pellagra manifested where people consumed a large number of products made of crushed grain and corn, but almost did not eat meat - a typical picture for the old South. For the synthesis of niacin, the body uses tryptophan - one of the 20 amino acids of protein. Meat, fish, poultry, nuts and legumes contain a lot of tryptophan, in the protein of grain it is much smaller. To get a normal amount of niacin, you need a little meat and some variety in the diet, so now its lack has ceased to be a problem.

   Large doses of niacin lower cholesterol in blood and reduce the risk of heart attacks. Niacin is the most affordable   and   cheap   means   to combat high level of cholesterol. However, doctors rarely   prescribed it because of side effects. Almost everyone who receives effective dose (2-6 g daily), red and inflames   the skin,   It is often   a severe itchy. Some note stomach irritation. Such reactions can be minimized by separating the dose and taking the medication after eating,   taking aspirin before each dose, but in Most patients   discomfort remains, so doctors prefer to prescribe   the latest   medicines   that do not create inconvenience. I usually suggest that patients try niacin, but your doctor may not even mention it. So   remind yourself   him   about this tool. RPD - 20 mg.

   Pantothenic acid is involved in reactions breakdowns of carbohydrates and fats, synthesizing hormones and other substances. Volunteers   who   have tested a diet for several months with insufficiency   of pantothenic acid, experienced headache, nausea, muscle cramps,   weakness and in extreme manifestations - loss sensitivity of the skin.

   This proves the need for pantothen acids for the body.   It is found in many foods, especially in eggs, meat and peanuts. RSD has not been established, but experts estimate the need for adults at 4-20 mg per   day.

   Biotin is also involved in reactions breakdown of carbohydrates and fats.   Contained in many products, in particular in meat, egg yolk,   dairy products, yeast and nuts, as well as Synthesized by   thick bacteria intestines. Almost all cases of biotin deficiency   were observed   Patients who have been subjected to long-term Intravenous   nutrition     using Artificial diet. Symptoms are expressed in inflammation and peeling of the skin, loss of Hair. All manifestations disappear immediately after   Prescribing biotin. RSD is not established, but, according to the current assessment, should   be 30-100 mcg per day.

   Vitamin C, also known as ascorbic acid (ascorbon = anti-smosorne == anti-sadorbent, and grief is scurvy), necessary   to create and maintain the normal state of connective tissue - coarse rubber-like tissue connecting organs and filling   the space between them. Connective tissue forms blood vessels   and   ligaments that attach the muscles to the bones and fastening bones with each   other;     it consists of almost all the skin, with the exception of   thin   surface   layer of   the epidermis.

   The most famous disease caused by the lack of vitamin C, is scurvy, hit by the crews of sailing trade vessels deprived of fresh produce for a long time and months   of consuming   salinized or canned meat, dried beans, stale   bread   and   alcoholic beverages. Symptoms were exactly as it should have   expect from the breakdown of connective tissue - bruises on the skin, caused by the destruction of small blood vessels, Swelling   and   soreness   joints, loosening and prolapse of teeth, increased Skin hurtability, poor wound healing, general weakness. Death is usually It occurred as a result of internal bleeding.

   Most people know that the most rich in vitamin C   citrus fruits, but it also found in many other products, including   meat, meat by-products, milk and vegetables. Nowadays, scurvy manifests itself rarely and almost invariably - in lonely old people, whose nutrition consists   of   hamburgers, snacks, sweets and alcohol.

   Vitamin B12 among modern vitamins headed by a relatively old generation, vitamin C - young. Everything appears more   evidence in favor of a leading reception, but so far this issue   has not yet been completely   clear.   In the 60's, the preacher of vitamin C was Linus Pauling, probably   the most prominent chemist of the 20th century. He is deeply Convinced of   the exceptional   role of ascorbic acid in the prevention of colds and cancer,   Improving   the immune system and prolonging life.

   At the age of 92, he continues every day take about 18 g of vitamin C (three-time HR) and encourages everyone Do the same.   However,   he made his discovery at 65 years of age, and a healthy person of this age   has a good chance to live to 90 years and without overdose of vitamins.

   In addition to the functions of creating a connecting tissues, vitamin C   affects   the immune system, but The mechanism of this impact has not yet   very   clear. Scientists have been studying parts of our defense system that neutralize bacteria and viruses. Until recently, they paid little   attention   Protection functions against no less destructive toxins   absorbed   or   inhaled by us, produced under normal conditions organism itself. No living creature is   perfect,   Therefore,   with   the usual   Metabolism is always realized highly active Chemical compounds called free radicals and oxidants oxidants that destroy   tissues, contribute to the degeneration of normal cells into malignant and   activates the aging process.

   Just like white blood cells and antibodies fight     with most infections, other substances neutralize destructive destructive free   radicals, oxidants and other toxins. Infection can overload the best immune system, so It is not surprising that some       of them are eluded from neutralization for a time sufficient to cause damage to the body. Increased reserves of neutralizers of toxins by taking an additional amount of vitamin C - it is quite Reasonable preventive measure. Oddly enough, the food industry also contributes to this. The bacteria in   the intestines affect nitrates and nitrites (including those used in the production of food), producing   Nitroamines   are   potential carcinogens. Vitamin C blocks this transformation, therefore it is added in processed meat (such meat is not included     in the recommended   by me

The diet!)

   Vitamin C reduces the risk of rectal cancer, bladder, stomach   and lungs. The best proof is   a comparison   subjects who consume different amounts of vitamin C; the benefits of   taking   large doses are not yet clear, Although this may change in the future. I AM   I take   one gram of vitamin C per day, despite the heroism of Pauling. ARMS - 60 mg.

   Vitamin D, aka calciferol, is itself It   is   a hormone.   Under ideal conditions, it does not require the inclusion in the diet, as it is synthesized by the skin under the influence of sunlight. Then he transferred with blood to   distant organs and attached to the receptors of the cells   on which it affects.

   In combination with other hormones, vitamin D regulates the level of calcium in the blood and bones; promotes absorption of calcium intestines and   Phosphorus taken from food. The Richest sources are fish oil, eggs   and liver, but today so many foods contain its additives that getting the required amount is not difficult.

   Vitamin D insufficiency of calcium and phosphorus from food is not absorbed, their level in the blood drops, and the body replenishes deficiency by excretion of calcium from the bones, as a result of which they are softened and deformed. This disease in childhood is called rickets, and in adults - softening of bones, or osteomaloaltia. In tropical climate,   vitamin D deficiency is rarely manifested even among the poor part   of the population due to solar radiation, which converts ergosteric skin into   calciferol (iracidated food gives the same effect). This requires not   so much solar energy, so vitamin D deficiency   is not observed in people with warm   climates,     Except for   extreme circumstances. In the 50's and 60's, British doctors found cases of rickets in children of black Indians and Pakistanis who immigrated to the poor sun of England, but these manifestations disappeared as they added a large dose Vitamin D in food.

   Doctors prescribe increased doses of vitamin D for the treatment of some   non-traditional hormonal or renal disorders, with   which   reduces the level of calcium in the blood. Conventional diseases (such as osteoporosis) do not   require such treatment, so in any healthy   person   taking excessive amounts of vitamin D, blood calcium levels    increases   to the limit, more than   able to   recycle   organism.     As a result, calcium is deposited in the kidneys (causing   their   damage   and   formation of stones), other tissues are explored - heart,   pulmonary   and   The skin. This leads to increased fatigue, headaches, diarrhea and vomiting. For such Self-poisoning requires the introduction of pure vitamin   D;   only from solar radiation, food additives and Pharmacy   multivitamins   will not happen. RSD vitamin D - 400 ME.

   Vitamin E is a common antioxidant, which prevents the formation of harmful products of oxidation in the body and Destroys existing ones. Premature children need additional taking   vitamin   E to   prevent disorders caused by pure oxygen, which they   so much need.

   Vitamin E is found in whole   grains,   vegetable   oils,   eggs, nuts and legumes. Volunteers-experimenters, to disappointment   scientists, did not get sick after a few months diet with   a lack of vitamin E. Therefore, it is assumed that it does not perform   specific   Metabolic functions. On the other hand, in animals with a lack of There   is a lot of vitamins symptoms  , including   infertility,   Muscle destruction, heart disease and anemia. V As a result of the observations, enthusiasts suggested that vitamin E can improve a person’s sexual capabilities, treat muscle convulsions, prevent   atherosclerosis   and   accelerate energy returns. The validity of these claims has not been proven, but the effect of vitamin E as an antioxidant is a sufficient reason to Pay attention to him.

   Unlike vitamins A and D, supplements Vitamin E   is relatively   safe. The RSD is 30 ME.

   Vitamin K participates in complex the sequence of reactions necessary for the coagulation blood. In the absence of this   vitamin bleeding    often becomes threatening. Main sources: greens, liver and   other   meat products. Apparently, bacteria The large intestines produce   a vitamin In sufficient quantities for the body, but these data   are approximate. Therefore, the recommended RSD equal to 80 mcg. According to other reports, vitamin K deficiency is caused and disorders of   the bile duct, since it is absorbed from food only   in the presence of   gall salts .

   In addition to vitamins, life is necessary dozens of minerals, but for everyday nutrition and prevent some Diseases can   be limited to less quantity.

   Calcium is the main mineral   contained   in   the bones   and   teeth,   present in the blood and other liquids, as well as   in cells   and   fabrics.   He provides muscle contraction, normal   State of   the Nervous   System   and cellular structure, blood clotting and many other functions.

   Dairy products, greens and vegetables, sea and river   mollusks   (shells), as well as fish eaten in total   (sardines)   are   Good sources of calcium. However, this The nutrient     occupies a border position in the American diet. Experts advise   the topics,   Who does not drink one liter of milk per day (full and removed)  to compensate for one gram of calcium. Presumably, it   prevents colon cancer, perhaps Because it binds toxins in the intestines. I suggest that everyone   follow   this   advice.   Clean   Calcium carbonate (cmalter) is the cheapest thing.

   Decreased calcium levels in the blood leads Behind   yourself   irritation     of muscles and nerves, itching, ringing in ears and muscle cramps that, progressing, can lead to convulsions and Death. However, the body regulates the calcium content so effectively, What   these   Symptoms     are manifested only   with severe insufficiency or   as a result of   failure of   the hormonal   system (for example, after surgical removal of the parathyroid glands).     Indomnomal in the body this mineral calcium level in the blood   is retained due to its receipt from the bones, but this, in his queue,   causes rickets, osteomalomatization.

   Increased calcium levels in the body leads   to weakness,   depression, nausea, weakening of bowel function (contforce),   heart arrhythmias,   abnormal calcium deposits in bones and   tissues.   But     this is not   a consequence of the diet, and even calcium supplements, as a rule, do not   cause   such violations. The highest level of calcium is observed with   developed cancerous tumors, and almost all other cases accompany hormonal disorders, for example hyperactivity   of the glands or   an overdose of vitamin D. RSD calcium - 1.2 g.

   One iron atom is present in the center each of the four   groupings of hemoglobin atoms,   which   consists of   erythrocytes   that transport oxygen from the lungs to the tissues. This atom attaches   a similar one to itself,   the Smaller Myoglobin Molecule (muscle hemoglobin),   which   retains oxygen in the muscles and stains them red.

   Iron is found in meat, egg yolk, whole grain, greens, legumes and nuts, but the body absorbs it from meat and eggs are more   efficient than vegetables. Anemia in healthy men is quite   rare   phenomenon,   but is considered the leading disorder associated with nutrition  , in   Young   women who sometimes lose more   iron with menstrual bleeding,   What is provided   by a diet.   Every   woman,    which   is difficult   menstruation, should take iron preparations in addition. Men don't need it. I'll explain why now.

   Calcium is easily introduced and excreted, but for   Iron the human   body clings to fierce perseverance. Methods   of its   allocation   actually not - no urine, no bile, no sweat almost   Does not   contain   iron.   A small number of it Every day goes into   the cells   from   mucous and   intestinal walls. This movement looks even more extraordinary  , if you remember that adult about two liters of red blood cells, and they live only 4 months, and then excreted from circulation, split and converted by the liver into bile, brought to the small intestine for   Help with fat absorption. Iron comes   into   Bone   brain for    production of more hemoglobin. As a result   The body's need for iron is only 1% of the need   in   calcium.   Po   This is why many experts are inclined to Classifying   Iron   as   Micronutrient.

   In the liver and spleen persists only One   gram of   iron.   More of it, getting into the body, Delayed     in various   fabrics. It should be noted that the clean Iron is a toxin,     like other metals. Its surplus is detrimental to   the heart   (closing   to the heart insufficiency), the liver (causing cirrhosis) and the pancreas   (diabetes). Polyvitamins contain too little iron to   worry about it, and even those who consume iron in small amounts, rarely get into trouble, but also the benefits   That's     not what it's wrong.   Women suffering from iron deficiency anemia, Maybe,   as   usual,   blame   for this menstruation, and the man   Unusual   bleeding   is related   Mostly with ulcers or tumors. Additive iron cures anemia,   but   does not stop Bleeding. MEDG iron - 12 mg.

   Zinc is involved in many processes, Promoting growth and   reproduction tissues, so children and pregnant women need    large   quantities of it, but men need it. Skin, walls of gastrointestinal tract, immune cells and testicles are reproduced most quickly, so the consequence of zinc deficiency is inflammation of the skin, poor healing of wounds, hair loss, diarrhea, Decreased immunity   and   infertility. These symptoms are most evident with old genetic   disease - acrodermatic enteropathy, in which the digestion of the body is impaired zinc; as a result of taking its large doses, there was a sharp improvement.

   The shortage of zinc mainly affects    residents of   the poorest   countries, because meat, dairy products, grains and nuts contain it     in sufficient quantity. Magical effect of zinc on acrodermatical   enteropathy (like the effect of B2 on malignant anemia) has become a   stimulus for its use to improve its fertilizing ability, increase immunity, early healing of wounds, as well as improving hair growth and   facial color. Reception several RSDs a day may be safe, but do not forget that metals very quickly Turn into poison. The ARMS is 15 mg.

   Selenium plays an important role in metabolism oxygen and the breakdown of   peroxides, and Also in the process of cell growth.

   It is widely represented in meat and vegetables, its   insufficiency is not observed - except, perhaps, the province of Cashan   in   China, where selenium is not enough in the soil. Observed only in this   area   selenium insufficiency, called Cache disease, leads to degeneration of   the heart muscle and some others.

   Selenium protects animals from viruses and Chemical compounds   that cause cancer. Evidence of such an action in relation to a person is much less, but, according to research data, the incidence of lung, stomach, rectum and the esophagus is higher in the localities   with   a reduced content of selenium in Soil.

   Excess of selenium for animals is harmful; Agricultural wastewater consumption  Selo selenium farms can destroy all   wildlife in the county. Poisoning of people occurs as a result of industrial activity, not food, although the situation may change if   there is more evidence of the anti-cancer properties of selenium and its supplements will become more popular.

   Magnesium is involved in the formation of teeth and bones, necessary for the transmission of nerve signals, as well as to maintain cardiac and muscle activity. Insufficient leads to weakness, irritability,   confusion of thoughts, increased muscle tension and spasms, and ultimately to seizures. Excess magnesium reduces the nerve   and   Muscle   Activity   so good that doctors prescribe large doses to suppress convulsions in certain conditions, for example, with toxicity of pregnancy.

   Grain, nuts, legumes, meat and fruits - rich sources of magnesium, so its insufficiency in healthy men outside Laboratory conditions are rarely observed. In need of rebuilding forces, Americans   tend to ignore magnesium, preferring other traditional pathogens: B vitamins, especially B2, and iron preparations. The Germans, on the contrary, consider even small magnesium insufficiency a significant cause of fatigue, irritability and various pains. They consume enough   a lot   of magnesium on their own initiative, and doctors often   Prescribe it  .   People   with healthy kidneys can, like the Germans, take large doses of magnesium,   not afraid to damage the body. However, it must be remembered that traditional medicine outside their own culture is less effective, so    Americans are more likely to succeed by using vitamins Group B.

   MSD magnesium is 400 mg.

   Iodine refers to elements with the only function. It   is necessary to   ensure normal functioning of the thyroid gland that implements the hormone that regulates the intensity of energy use by the body, in other words, the intensity of the main exchange. The main source   of iodine is seaweed, so before Some of its insufficiency was quite common. With a lack of iodine   increases   thyroid gland, trying to get more iodine from   blood.   The enlarged   thyroid gland is called goiter. In the past centuries, the goiter was   so   It is common that at one time women considered His sign of beauty.

   Violation of the functions of the thyroid gland leads to   drowsiness,   lethargy, loss of appetite, constipation, chills, swelling and formation of skin folds.

   Adding iodine to salt was the first triumph Public Health of the 20th Century. Today, iodine is everywhere: in dough, food additives, even in car exhaust, so in   iodization   Salt   more No need. A small excess of iodine is not dangerous; iodine solutions are the best expectorant means softening thickened sputum. Doctors prescribed them in the treatment of bronchitis and asthma.

   RPD iodine is equal to 150 mg.

   Fluorine accumulates in the teeth, strengthening the external enamel and increasing its   resistance Destruction and rotting. Although fluoride and its compounds are present in almost all foods, its most effective source is water, along with oral preparations and direct imposition of fluoride on freshly damaged teeth. Fluorine is only needed for the development of teeth,   so probably an adult from him not too much, as permanent teeth grow by about 14 years.

   Excess fluoride in the diet leads to the appearance of on the teeth of white   scattered spots that do not cause harm. A significant overabundance   causes abnormal pain calcification of bones, ligaments and   muscles.   Despite numerous warnings about that fluoride causes cancerous tumors, this does not happen. The reasonable RSD is 1.5-4.0 mg.

   According to studies in 1955, only 5% of American adults are not was a hollow in the teeth. This figure has not changed for 100 years, but today do not have a hollow of more than 50% of adults The Americans,   and   this   The indicator continues to grow. Distribution to the world of   dental   diseases is equivalent to an epidemic, and in the United States, thanks to fluoridation of water,   their   It is getting smaller and smaller.

   Thirty years ago, opponents   of fluoridation   The waters   branded   him   How the devil's trick of dentists, regardless of that as a result of the appearance of this innovation, the profession of a dentist has lost popularity. Schools of dentists and technicians across the country were closed, their   income   became   to fall, and in the newspapers disappeared announcements of hiring.

   Other micronutrients - manganese, copper, silicon, chromium, cobalt   and   molybdenum - also the body needs, but they are not so   much   affect   Health as discussed above. Insufficiency of nickel, tin, vanadium, arsenic causes diseases in plants and animals, but   their   role in   human life is unknown.

 

   WHO NEEDS VITAMINS AND MINERALS?

 

   Everyone needs them. People who do not receive their in    Sufficient   quantity, Get sick. Americans tend to believe that vitamin deficiency   is malnutrition, but such a statement is only true only     for East Africa, Bangladesh and some other regions.

   The consequences of traditional nutrition of many Americans ("fast"   food, canned food, sweets, drinks, salted, too fatty and overburdened food) are most often associated with overeating: obesity, heart attacks, hypertension and spoilage of teeth.   However,   occasionally,   with   certain circumstances, there are and insufficiency of individual nutrients, which can be avoided, Observing   the Basic   Rules   and taking preventive measures.

   A small-calorie diet. If the day Consumption   of calories   with   food   is not less than 1000, it has enough vitamins and minerals, but   on   Supplements are already needed. Their The dosage will be determined by the doctor.

   Vitamins and vegetarians. A balanced   diet   without   meat   contains enough vitamins, but it should include milk and eggs. Vitamin B12 is only in animal products, so every adherent A strict vegetarian diet should be taken B12 additionally.

   Vitamins and infants. Infants, breastfeeding     during the first three months They don’t need vitamins. Then   Black   children   and those who are missing sunlight, should receive     Vitamin D supplements. Children who are fed with nutritious mixtures need vitamins C and D if they are not part of the mixture.

                                          Table 2

 

Vitamin RSD (for United States)    Action                  Food Sources

                                VITAMINS

       A 1.5 mg      Promotes    butter, egg oil

                   exchange of substances, improves    yolk, liver (especially

                   skin and vision               of fish), ripe (yellow)

                                              Vegetables with dark green

                                              Leaves

 

B1       1.5 mg      Provides splitting    Pork, milk, eggs,

                   glucose, promotes       green peas, sprout

                   Normal Functioning      Wheat

                   Curing of the nervous system

 

B2       1.7 mg      Promotes the release -    Milk, Domestic bird,

                   energy from food.        internal organs

                   Participates in the metabolism of     animals, products from

                   protein and the synthesis of          crushed grain

                   Hemoglobin

 

B3       4-20 mg     Helps the body in        Poultry, fish,

        (   prevention of energy       of peanuts, milk, card         reader -   from food                   

        but)

 

B6      .1 mg      Ensures the regulation of      beans, nuts, eggs,

        100 g of    brain functions. Involved    yeast

        Protein       in animal treatment

                   Protein

 

B12      2 mcg       Provides normal     eggs, beef, liver,

                   Functioning of Nerve      Milk

                   The system, participates in

                   Production of erythrocytes

 

Biotin   30-100      Plays a key role in      the Liver, milk, eggs

        μg (pre-forming of fatty

            Position-acids

        Contingently)

 

Folic 200 μg    Participates in the formation of    Vegetables with dark green

acid             erythrocytes leaves                , products from

                                              grain, an orange                                               Blue Juice

 

With        60 mg       Promotes the healing     of Tomatoes, strawberries,

                   wounds. Necessary for          citrus

                   Synthesis of connective

                   Fabric

 

D        400 ME      Required for    normal-setrine, tuna, milk,

                   growth of bones. Reguli- Fish liver

                   No calcium level

 

E        30 ME       Helps creating           whole grain, salad,

                   normal erythrocytes.     wheatgrass

                   Acts as a common

                   Antioxidant

 

To        80 mcg      Conforms   Cotton-Capust, broccoli cabbage,

                   other blood                    soybeans, greens

 

Calcium 1.2 g       Required for forming -    Milk, sardines, vegetables with

                   teeth and bones          with dark green leaves

 

Iodine      150 mg      Participates in production    Mollusks, crabs, yodiro                    Hormone                    Bathroom salt, sea

                                              algae, sea cauliflower                                               the one, the dairy products,

                                              Vegetables

                MINERALS

 

Iron   12 mg       Required to transfer      the Egg, meat, liver, product                    Oxygen with            lyn from crushed grain

 

 Magnesium 400 mcg     Helps the body in        the Legumes, milk, whole

                   release of energy and     grain, seeds

                   promotes bone growth

                   and teeth

 

Phosphorus   800-        Necessary for         the growth of the Egg, Domestic bird,

        1000 mcg    of bones                      fish, meat, legumes

 

Selen 70    mcg      Plays a big role in       Meat, clams, crabs,

                   Oxygen and     liver metabolism

                   Cell growth

 

Zinc     15 mg       Plays a big role in       Meat, Eggs, Home

                   wound healing,     revolt-bird, fish, products from

                   Renewal of damaged       grain

                   Fabric

   Note. ME - international units;   mg   -   milligram   =   1/1000 grams; μg - microgram = 1/1000000 A gram.

   Vitamins and medicines. Their interaction and Mutual influence is very great. However, most species interactions of drugs and vitamins are described in the traditional form of annotations or   advertising for the attached to them   "If you have a cardiovascular disease, high blood pressure, thyroid disease, diabetes or prostate hypertrophy, Do not   buy this drug until Deal with the doctor.” I am always nervous, reading such texts, but not I can remember a single patient   who has become sacrifices of such phenomena, and letting anyone take them.

   In most cases, the interaction medicines with nutrition does not   lead to violations, but the risk increases in proportion to the time,   in   This is where you are taking the drug. Antibiotics, anticonvulsants and chemotherapeutic agents, as well as Anticoagulants cause the greatest number of negative reactions. Doctors usually do not know whether their patients consume any supplements, so when they come to Doctor for the prescription,   let him know This.

   Vitamins and stress. Physical stress   reduces   The level of   certain vitamins in the blood, especially vitamin C. Common sense suggests that   the reverse process will help to overcome stress, and many popularizers   advise people who constantly experience physical and   emotional   stress, take   vitamin   additives.   Some   vitamins   advertised only as anti-stress.

   Vitamins and diseases. Vitamin C Definitely   effective   in   symptoms of a cold, but if you feel So   bad that    are going to see a doctor, then taking ascorbic Acids will briefly relieve your condition.

   Minerals. Men should show active interest in calcium. From about 35 years, each of us is gradually losing Calcium   contained in   the bones. Many middle-aged women suffer from curvature of the spine, slouching, they Fractures of the hip are not uncommon. Men begin to experience such difficulties later, because their bones are thicker and provide more stock Calcium. However, everyone should drink   about a   liter of milk per day or take one gram of calcium in any form.

   As already mentioned, young women often need additional iron, but before Prescribe iron supplements to a man suffering from iron deficiency anemia, it is necessary to Be sure to establish its cause.

   Vitamin and mineral supplements. Does it follow Taking them for   prevention? Yes, if You will feel better from this.   Some   doctors exaggerate the risk of overdose -   To   be poisoned   with vitamins, a huge dose is needed. Other experts believe   that such   Supplements are   useless.   Here   There is   a certain   proportion   truth,   but   many actions do not bring of visible benefits, including those from which we enjoy.

   Everything in the world is relative - based on this thesis,     the vitamin tablet is better than a chewing gum plate, but worse than fresh carrots.

   Reasonable rule. Polyvitamins and mineral Supplements   are effective   if you have It's not a bad health. And if it is seriously undermined, the additives are most likely not will help. For example, for the treatment of iron deficiency anemia in typical multivitamin It's too little iron. Lack of vitamins A, D or folic acid indicates significant violations, and you need to consult a doctor in order to Determine   their   cause.   Maybe some excess vitamins A, C and E or selenium does reduce the risk of cancer, but I recommend taking   daily no   more than one gram vitamin C, and the rest - no more than they contain   multivitamin tablets.

 

   PURPOSES OF YOUR DIET

 

   Full food should:

   1. Preventing diseases caused by Improper nutrition.   In the United States   and the majority European countries are the main such disease is   atherosclerosis. Hypertension and cancer, although follow atherosclerosis by   a large margin, also require attention.

   2. Normally pass through the digestive Tract. It is better to change the diet than to experience constipation, spasms, swelling of the abdomen from gases,   hemorrhoids and other similar Symptoms.

   3. To be delicious. Tasty food causes depression; I       mean the purely medical meaning of the word. The feeling that food has lost     taste alone of the first signs. Many species   normal   activities contain elements of discomfort (for example, medical procedures), deprivation (weight loss, rejection of certain habits) or fatigue (daily sports exercises). But the process of eating is one of the main   pleasures in life, so it is always must be pleasant.

   4. Provide the entire set of necessary nutrients.   I point out this goal to the latter, because it is easiest to achieve it.

 

   FULL FOOD: SIX MAIN RULES

 

   Many authors dedicate the problem of nutrition whole books,   explaining how small changes in the diet will improve your health. I am convinced that   the organization good nutrition - simple   It's a case.   Any   reasonable person should follow only a few rules.

 

   RULE 1

 

   Eat a variety of food

   Eating fresh fruits and vegetables, different varieties of bread,   products made of crushed grain (cereals), products containing protein, and dairy   products, a person gets everything you need organism. You can, of course, write in detail how much is necessary and enough Eating     this or   other product per day. For example:

   - 250 g of bread and cereals;

   - 500 g of vegetables;

   - 1000 g of fruits;

   - 3000 g of proteins;

   - 500 g of dairy products.

   But do not remember these norms. Understand   this    Reasonable amount.

   There is no need to remember the same, what food rich, say,   riboflavin. I don't remember that myself. One thing is important: a full meal should be varied.

   Because the most important diseases associated with with   malnutrition  , are the consequences of excesses, most of the other   rules   Tell me what to avoid.

 

   RULE 2

 

   Reduce the consumption of protein foods

   Excess proteins in itself are not harmful to healthy person, but saturated food, as a rule, is very high in calories and (if we are talking about   meat) with a high fat content.

 

   RULE 3

 

   Avoid fat, especially the animal Origin

   Food cholesterol, especially animal fat, which the body   converts into the same Cholesterol, leads to     education   solid   precipitation on   the walls of vessels, i.e. to atherosclerosis. For decades, these precipitation accumulates and eventually Coverage of blood supply. When it happens in the heart, a heart attack occurs when a stroke occurs in the brain.

 

   RULE 4

 

   Reduce your sugar intake

   We consume about 59 kg of sugar per year, but zealously watching their health Americans reject it with the same condemnation with which Christians do not accept the idea of sin. Like sin, sugar,   Probably, it does not bring anything good, and     completely   Definitely   contributes to obesity and spoil the teeth.

   Despite the   universal   belief,   use   Sugar does   not   cause serious diseases, such as diabetes, atherosclerosis or   cardiovascular.

   Do not forget that the three main elements, The most improving the taste of food - fat, sugar and salt. Of this trio  , the most   harmful     to health the first, and therefore with the ideal diet, the fat content should be minimal. You can give up the other two (first    from salt), but a diet devoid of all three flavoring components,   clearly   too spartan for Most of the people.

   Children most susceptible to tooth decay, and Adults with excess   weight should stay away from sugar. Others can take     it less seriously. I am not an ardent opponent of sweets,   except for those made of fatty dairy products such as cream and   fatty milk; here The labels should be read carefully. Simple sugar is found in many products of the food industry, and under different names.

   Brown (uncleared) sugar, molasses, syrups and honey are all   ordinary sugar. Some enthusiasts object to the inclusion of honey here, but they are wrong. Honey is pure sugar plus the release of bees   plus   dirt   and pieces of honeycomb.

   Simple Sugars Can   Produce   called     sucrose,   glucose, maltose, decrosses, lactose, fructose and Corn syrup. Canned vegetables, bread and concentrates of cereals, from which prepare porridge for breakfast, often contain sugar as the first or The second   ingredient.

   My own research allowed deducing a reliable rule for the evaluation of "fast food", snacks and others loudly advertised products:   if they have few fats, then a lot of sugar, and vice versa. For example, low-fat chilled The yogurt is well-sweetened. "Granolas", loudly announcing    the complete absence of sugar in them, contain Lots of fat and oil. Neither of them will shake your health, but   you should   realize that "low-fat" or "unsweetened" does not mean "Low-calorie."

   The lot of sweet food on its own It contains little sugar: fresh fruit, dried fruits, Fruits canned in their own juice.

 

   RULE 5

   Teach yourself to complex carbohydrates

 

   When I was a kid, medical professionals frowning at   the word   "sticmile", and enthusiasm in his Only people who suffered   constipation. Today we are related to complex carbohydrates   with   Great   respect. This is partly because after the speeches   specialists   who reject   proteins, fats, salt and sugar, There is nothing left in your memory. And       However, a mixture of fruits, vegetables, nuts and whole   grains   (not   whole   wheat!), cereals and bread of different varieties - the healthiest diet that   can only be adhered to man. Representatives of societies with   a primitive   culture , where nothing else is eaten, does not suffer from atherosclerosis, hypertension and heart attacks, they almost do not have hemorrhoids, constipation, irritation intestines, appendicitis, ulcers, stones in the gallbladder and tooth decay. Apparently, over the course of their lives, they would have had fewer tumors, but members of such societies tend to   become victims of crime, famine, parasitic diseases and   bacterial infections.

 

   RULE 6

   Reduce salt intake

 

   Excess salt causes hypertension.   In Japan,   where   they love   salt   even More than in the United States, strokes are The leading cause of death.   17% Adults     of Americans are observed   hypertension,   and   strokes   are on  The third place in the list of the most common causes of death.

   If you never plant food, prepared without salt, did not use canned, smoked, processed products, restaurant dishes or snacks, they would still get more sodium  , what the body needs. Unfortunately, from early childhood we are accustomed to the taste of salt, so the rejection of it would be a disaster (try unsalted canned soup!). On the other hand,   Substitute seasonings   improve the taste of food. Residents of rich countries   Beginning   to neglect   the seasonings,   As soon as they get the opportunity to eat as much fat, salt and sugar as they want.

   Learn to enjoy the smells Unsalted food.   Despite this optimistic council, most unsalted   dishes   not interesting, but experimentation will teach you that, How to improve their taste.   I   like unsalted potato chips and Fryed nuts are no   less   than their salty option. Most of the cereal products used for   Breakfast, contain salt (and   Sugar),   the exception   is   wheat cutter,   "air" wheat, rice, corn and some others, also Delicious. Once again, read the labels!

   Remember products in which there are too many salt:   gravy   (soy sauce, meat sauce), marinades and pickles, cheese, smoked meat, soups and almost all popular snacks and "fast food" (hamburgers, cheeseburgers and T. p.).

 

   CHOLESTEROL AND GOOD FOOD

 

   Going to a rational diet, you immediately get rid   of   constipation, spasms, bloating and other symptoms,   accompanying   intestinal irritation caused by a lack or absence of coarse fibrous food, as for almost 20% of the US population. As you know, there is no world perfection, another immediate consequence of nutritional change   is gases. Saturated with fibers Diet   activates   the release   gases that may decrease over time or Staying at the same level.

   The advantage of avoiding fat you realize not   immediately,   but   Doing   this is very important because the best diet will require the exclusion of   some of your favorite dishes. I have been enjoying everything   I eat now for 30 years, and I don't I eat sausages and ice cream, but I still remember, How delicious they were...

   You can experience a future win by watching Cholesterol in   the blood. Low levels in a healthy person who adheres   to a balanced diet, guarantees a decrease in Risk   is not   only   atherosclerosis   and chronic gastrointestinal diseases, but also malignant formations. If you in condition puncture your finger with a scalpel,   Buy   a home set of tests and Measure your cholesterol monthly while   It will not reach normal values, after which you can measure it   once   a year. Do not check often - cholesterol levels change slowly, and   One meal will not give an obvious effect. Experienced Laborts and   nurses   know how to take painlessly blood from a vein; you can choose such a path.

   Ideal cholesterol levels. Medium   Cholesterol levels   in   Blood for U.S. residents is 220 mg/100 cc. c blood, but it's   statistical the indicator, and its real values for different people are different.   In healthy members Societies with primitive culture this figure is noticeably below 150 mg. For them it is Not a bad indicator, because such people,   Most likely, from time to time starve and are forced to share their   food   with many intestinal parasites.

   American doctors take the level   Cholesterols about   200   mg Like good news. The owner of this level reduces   the risk   cardiovascular and some other diseases.

   At cholesterol levels below 180 mg of cardiac attacks become rare; at a level below 150 mg, they do not appear In general. You can   achieve this with Helping a diet alone. I support   its   cholesterol at the level of 170 mg, despite the fact that all members of my family   had high levels (above 240 mg; mine; mine The father suffered the first heart attack at     the age of 46). Food continues is a pleasure for me; I always eat snacks, eat plenty of a few once a week and I love sweets. I like my diet, although my friends have long Stopped inviting me to dinner because I refuse a lot of dishes. I AM I can still lower your cholesterol, but it will require More deprivation than I would like. You may think   differently, but still don’t take Cardinal   Solutions,   So far   Do not   reach the level of 180 mg.

 

   LOW-FAT DIET

 

   You can eat:

   - all vegetables, except coconuts and avocado;

   - all fruits;

   - all grain, legumes and nuts;

   - fish;

   - chickens and turkey - without skin.

   I rarely deal with the topic of alcohol consumption drinks because   I don't like their taste. However, in moderation they do not cause harm, Some of their ingredients are probably even useful.   Periodically   There are reviews in the press, Contesters that people,   alcohol in small doses is noticeably healthier than those who drink A lot,   and a little healthier than not drink at all. The latter fact is inexplicable;   probably moderate drinkers get more pleasure from life than people who limit themselves It's tea.

   The following are food products that better avoid.

   - Animal meat. Fat, not protein is     a major problem, so many healthylife popularizers call for cutting fat from meat and recommend cooking, rather than frying meat. These measures will certainly save you from a decent amount of fat, but, nevertheless,   it remains enough in the meat It is also between the fibers. My practice shows that Reducing cholesterol levels below 180 mg without a sharp decrease in animal meat consumption is very simple.

   - Dairy products, except for the removed milk, cottage cheese and low-fat frozen yogurt.

   - Any all-hydrogenated or partially products,   including hydrogenated vegetable oils,   peanut   butter   and   Margarine. Hydrogenation is chemical treatment Fat, why   foods   look better (for example, peanut butt does not seem fatty and oily), but this process turns normal fats into harmful fats.

   - Oils that retain hardness in room temperature.

   - Egg yolks, cakes, cupcakes, pies and   any   Desserts   covered crust or cooked on milk or cream.

   Ask how the dishes are cooked, which you eat. Roasted in hot oil crispy potatoes or donuts are completely useless in relation to the decrease in the level of Cholesterol. Do not order   fish and vegetables in the restaurant, as they will be poured with butter. Mexican cuisine is considered one of the healthiest, but Traditional Mexican Cooking in mainly uses a lard (smelted pork fat), although the employees of some Restaurants deny it.

   - Salt - as little as possible.

   Compared to what usually eats the average American, a full diet includes significantly less fat and protein in   Same   time   is richer in fruits, vegetables and fibrous food. It also contains almost no salt. A person himself chooses what he eats, but does not prevent him from remembering   that some consequences of consuming fatty foods (e.g., heart attack)   is irreversible. Atherosclerosis itself can be reversible, but this is a slow process, Demanding a very strict diet. High blood   pressure as a result of eating large The amounts of salt can   be   adjusted much faster. Refusal of salt will help to contain pressure at the level of moderate hypertension, and taking medications will bring it to normal. Of course, life on medicines is not the best way out, but when the pressure   is normalized, you will no longer have hypertension, and therefore the   risk of   its   consequences, This is an impressive reward.

   Many men find it difficult to exclude from daily nutrition and   fats  , and salt, but necessary Remember that   by sacrificing   the small ones,   you   will get   a significant   result. If you have to choose between fats and salt,   refuse   Especially from fat.

   - Sugar is also smaller.

   Although complex carbohydrates are preferable simple,   however,   sugar is not Prohibited product. In sweets   and   sweets     There is nothing wrong with that they do not contain milk and fat.

   The same applies to the cool drinks. Puddings and musses are acceptable under the same conditions, although it is unlikely that There are cooks that prepare them in such a safe way.

   - This diet will help you.

   Cholesterol levels with sequential Compliance with such a diet will   decrease. When it will reach 150 mg, you will not only stop threatening atherosclerosis, but also precipitation of cholesterol, already formed on the walls of   blood vessels, most likely, will dissolve (the opinions of   doctors   are different,   But   many experts, including me, are convinced of this).

   This diet is not low-calorie. Food with Low cholesterol   or fats are not should be low-calorie. You can   there are   as much as you want, so do not wait for weight loss, unless    Try to achieve this on purpose.

   Do not blame the exchange for emerging difficulties substances. Your body   can sabotage a low-calorie diet by slowing down processes   metabolism (metabolism), but in this case It won't happen. If the cholesterol level is unchanged, then you Keep   eating   too much   A lot of unsuitable food. I'm also from time to time I break the diet, but not to the point of Increase the cholesterol. Going on the diet I have described, you should not experience any deprivation. With discomfort, make yourself a relaxation, Do not rape the body. Cholesterol levels of 200 mg are not bad.

 

 

   Chapter 3

   THE IMPORTANCE OF SPORTS

 

   Although regular exercise is not so important as   proper nutrition, they support health, protect against diseases and,   more and more evidence slows down the ageing process. Exercise is   good for men in any age, because the usual day activity   Rarely can provide sufficient physical load.   With the exception   of   Those whose   Profession   involves   intensive   training   (professional sports, ballet, etc.), any man who wants to enjoy the effect of physical exercises, should make special efforts for this.

   Since 1962, scientists have started one of the most Famous and large-scale studies, conducting monitoring the health of 17 thousand Harvard graduates who studied there from 1916 to 1950. Many of the results did not cause Surprise - the health of smokers and people with high blood pressure left to be desired better, but the analysis of physical activity revealed interesting data.

   At first glance, there was nothing in them Special.     At the end   After all, an active, intelligent man usually and eats better, and does not gain excess weight, and drinks less and drinks less Smooting. All this allows him to support   health at a higher level. However, The researchers excluded   from the consideration all the positive factors, focusing on the study of benefits only from exercise.

   Men who burned 2 thousand weekly calories  , differed   in noticeably stronger health than less than 500 calories. The number of cases of cardiovascular diseases in the former was 30% less, cancer - Approximately 20%. Even fatal accidents    Suicides among them were noted less.

   Former members of Harvard sports teams have, at the end of the study of   the leading sedentary image life, health indicators were no better than     Those who did not exercise physical activity in college. Students who avoided sports during their studies, but are physically active later,   clearly won in terms of indicators.

   It turned out that in men who Sports, better sleep.   They   are also less susceptible stress, depression, constipation and headaches; and in addition, more confident. Sports   Exercises Strengthen   not   only muscles, but also bones, so physically active men with age are less likely to suffer from osteoporosis and muscular atrophy.

   Men who regularly do exercises, Blood pressure is reduced. Drop in cholesterol remains in question, but it is known that it does not increase. Exercises do not contribute to dissolving   deposits   Cholesterol - this requires the right diet. But a   man engaged in sports has less consequences Cardiovascular   disease, including Heart attacks. He also has a lower risk of diabetes,   rectal cancer and mental Disorders.

   In terms of stress, the university Southern   California   was watched by two groups of students. In one group, students took   tranquilizers, but did not play sports, and In the other, the opposite. Students of the second group were more calm, among There were fewer mental Disorders. One of the leading Theories Explain the Anti-stress Effect   exercise because people who regularly have them, in the brain increases the level of the hormone norepinephrine, which is calming.

 

   ENDURANCE AGAINST force

 

   Exercise increases and endurance, and strength. Aerobics classes (developing endurance) strengthen cardiovascular   system. More a strong heart pumps more blood in one contraction   and gets tired later weakened. Fortified vessels supply more blood to the muscles, with more Efficiency   from   them   products   of decay.   Many are considering endurance of the cardiovascular system as the basis of   good health.

   Such exercises burn a lot of calories. You consume faster     energy by performing rhythmic and energetic movements in   which   extensive muscle groups are involved. Good aerobic exercise complexes include walking, jogging, jumping through a rope,   cycling,   swimming, skiing on rough terrain and such   interactive   Sports, such as tennis, basketball and rocketball.

   Exercises aimed at the development of force (anaerobic, i.e.   "without air"), build muscle and form the body. Instead of rhythmic compression and muscle relaxation work intensively on resistance to efforts.   Growing Tension reduces blood flow rather than increases it.   Fatigue comes quickly, so these You     will not be able to perform exercises for a long time. When Blood circulation decreases, then reflexively quickly rises blood Pressure. That is why doctors warn hypertension or Cardiovascular diseases from lifting even moderate weights or Execution of isometric exercises.

   The force increases the ability to perform many actions, some of them allow Get more pleasure from life. Athletes of the previous generation, engaged in mainly aerobic (alphic) sports, diliged to avoid strength exercises, following   the theory that the development of the muscular reduces it Functionality. It is now known that in fact all on the contrary: reasonably selected exercises with weights play an important role in athletics   training, especially in the development of fat-free muscular mass.

 

   WHAT HAPPENS IN PHYSICAL ACTIVITIES EXERCISES

 

   - In the muscles. Working muscles consume   more   glycogen   (glucose accumulated in mitochondria cells) is taken more glucose from   the blood   and burn fat carried by blood from places his savings. Enhanced   metabolism requires additional oxygen and   greater   blood flow,    Otherwise, the muscles are tired very Fast. All necessary switches in the body is produced by the brain. Glycogen Originally   from   internal sources carbohydrates, but with prolonged activity, is ultimately produced from accumulated fat.   In the lungs.   Depth   Frequency of respiration immediately Intensifies.   Normal   ventilation   lungs, for an adult component of 10-12 l air per minute,     during vigorous exercise can increase by 10 times. The lungs of a healthy non-smoking man without difficulty take enough of the air to   any   reasonable loads The amount of oxygen.   Feeling of   "lack   of air"   has nothing to do with the capacity of your lungs, just   your   heart   and blood vessels are not able to tolerate sufficient amount   of oxygen to Muscles. You will understand this by remembering that   endurance exercises strengthen the cardiovascular system, but not the lungs. In the blood vessels. Shortly after the muscles begin to work with the load, the decay products diffuse into nearby tissues,   causing   a general   dilation of blood vessels, which allows you to increase blood flow.   Disintegration products stimulate the brain the team's return to increase blood flow to   working muscles. During the Intensive     Muscle exercises   can   use blood flow 20 times more than with normal conditions. In   the heart.   Frequency of heart contractions increases to ensure the necessary blood circulation. In a 40-plus-sporting person, not engaged   in sports,   the pulse rate at rest is about 70 beats per minute. With an average load it can double, and with an increase in Load to reach 180. On average, in men at rest, the heart pumps   about   75 ml of blood in one contraction. Exercises can increase this volume by more than 50%. Pumped minute volume of blood,   at rest equal to about 5 liters of blood (70 beats, Multiplied by 75 ml), can   increase fourfold during the exercises. Blood pressure. When measuring Blood pressure is controlled by two phases: systolic - the maximum pressure developed by contraction of the heart, and diastolic minimum pressure, When the heart is relaxed between contractions. Level equal to 120/80 mm Hg, respectively, is considered a generally accepted normal indicator, but the pressure is not   remains   unchanged,   since a person does not have an absolutely fixed frequency of heart and breathing shortens. Based on this, the values   of the pressure between 100140 systolic and 60-90 diastolic.

   With   Execution   of   systolic exercises   pressure    increases    to 180-190, but diastolic (pulse) pressure       It should not change. Its increase in The load is   a sign of   heart   Diseases: This means that the heart is not capable of Responding to   it correctly.   When Doctors Remove electrocardiogram (ECG) under load,   that   increasing diastolic pressure - not the abnormality of the electrocardiogram itself can be the first signal to indicate heart weakness.   In case of deviations in the ECG Exercise is vital because it strengthens the heart – the most important muscle. But in     this   Close     monitoring of doctors is necessary.

 

   TRAIN, BUT BE UNDERSTANDABLE

 

   Regular sports take time and discipline.

   Men who are accustomed to it at school, easily continue them even when life is filled with official and family Duties.   Older people who are unusual in physical activity should be reserved for sports exercises for several hours in a week. They should properly Thinking about this question.

   Sport is just one of many important   activities   For   a man   who decides to be healthy. Putting too much in front of you   Many   goals   at once,   You can easily defeat   everyone   fronts.   To   the success   can   only bring correctly set, real and practically feasible tasks.

   Don't overload yourself and don't expect immediate results. Don't   be disappointed And don't give up exercise just because,     It   felt like you weren't working. Always remember the saying of the sage Lao Jie: "The most A long journey begins with   one   step.”   Someone, less famous and Therefore, he who remains unknown, he added: "But be careful and careful: taking   this   step,   It's easy to   stumble   and   fall into   the dirt.”

   Anyway, determination and Thoughtfulness will help you in sports, how they help and in life situations. Always and     in everything positive and build further actions on it.

   One of the most common Mistakes   made   by beginners,   this overload, which in principle can have quite   serious   consequences. But do not worry, realizing that they overdid it - many   professional bodybuilders behave exactly Same thing. Too intense workouts usually lead to the opposite results - After all, muscle growth (hypertrophy) occurs during their rest. Control phrase Here is: "Less is more." Try not to overdo it with such   athletics, such as running, swimming and skating skiing.   They are very pleasant and cause a natural desire again and   again   overcome the treadmill, the iron pool or to conquer another snowy slope, but all these sports can cause joint damage and others   serious complications.

 

   EXPERIENCE PLEASURE

 

   Key words are pleasure, joy. Make your exercises   fun and joyful, as if you watch your favorite movie or read a   great book. Do not allow yourself to be upset and stop classes because   you look like the frail guy in gymnastics room, which you will probably need a lot of time to   find   a decent   sporty form, or that you have no idea   about     the role of your   Cardiovascular systems. Don't torture yourself and do not take a defensive position. On the contrary, start classes with a good mood and a sense   of humor - do not be afraid sometimes and Laugh at yourself. Relax and Try to get the maximum pleasure from exercises.

   I'll share with you a secret that Hate for most sports coaches. V Human inclination to obesity is a great role in heredity, it plays no less in the structure of your body and in your   ability to sports. From a purely physical point of view, all men are different. We need calmly accept the fact that you are you, and try   to do   the best you are capable of, remembering that above You can't jump your heads. Popularizers of physical exercises that force everyone and everyone   achieve   the ideal   and observe unrealistic diets cause great damage to the desire for self-improvement. In other words, it is better at least   A little sports   than not do it at all.

   A good set of exercises should consist of of the three independent   training days in week. Do not blame yourself if you can not   be present at the class for reason beyond your control And even if they're just   lazy to come. If there are never any unforeseen   events or special occasions in your life, violating a pre-compiled schedule, then it must be quite boring. Visit a sick friend or go to a romantic date is sometimes much more important than an extra hour to "pump muscles." Don’t get used to finding a convenient reason for each time Avoiding classes will be a prelude to your surrender.

   Attend the gym with a friend - great   opportunity to   make the classes brighter and lively, but not Become too much dependent on it. Reluctance or inability A friend   or   girlfriend   to do certain exercises can force you   to refuse   of them. Or vice versa, your partner will be A "star" compared to   you, and it will cool you down. There are other ways to revitalize your activities: training alone, turn on the tape recorder   with   suitable   music,   change the gym, if you are tired environment, add new exercises to the usual program, wear during   Characteristics of sportswear, vary the number of repetitions of exercises and / or weight weight.

 

   CHOICE IS VERY IMPORTANT

 

   Read more. There are many good journals devoted to physical development, which describes exercises for   development   different   parts of the body. Other journals are designed for already trained athletes, they publish articles on how to become a champion. By the way,   now   good books about sports, however, a lot of Bad. Avoid publications that are poorly disguised advertising of some special products   and   certain persons, or hastily concocted scientific works of the type "How to achieve in 20 minutes perfection.”

   Choose a "club carefully" “Housing,” where you will study. Stay away from offering "life" membership and from those that More like a disco than a gym. If You need   disco music, Better listen to the house tape with old notes Donna Summer. Don’t forget that the number of disappointed people leaving "health clubs",   equal to Number of patients leaving dietary   Clinics.   Do not become the object of sad statistics.

   Never buy home training equipment. The case will inevitably end with the fact that it will dust in the corner; these Machines are   mainly for filling pockets of their manufacturers. Really   Good home sports equipment is A whole condition.   Having mastered   certain skills, you can acquire bicycle ergometer, rowing stand, running path, slalom simulator or Swedish wall.

 

   PRECAUTIONS FOR THE YOUNG MAN

 

   Before the start of the future Amateur athlete needs to undergo a full medical examination - this applies to any age group. Complicate or even do Impossible Sports Can   Cardiovascular violations, diseases respiratory organs,   diabetes,   epilepsy,   asthma, the condition of the muscles and skeleton, as well as Neurological complications. The Doctor   Carefully will listen to your heart. U   Athletes   Who Fell   Dead   during competitions or matches, most often were small congenital heart anomalies such as hypertrophic cardiomyopathy and subaortic   stenosis. These violations reveal an ECG or ultrasound diagnostics. You don't need an ECG with a load   or   other   complicated   checks,   unless the doctor suspects coronary artery diseases or you yourself   will not complain about symptoms of the type of rapid breathing, fainting or   pain in   the chest. Usually, a standard blood test is performed.   Meticulous   The therapist will also check the percentage fat content,   levels   of relative flexibility and strength, blood pressure, and possible genetic predispositions.

 

   PRECAUTIONS FOR MIDDLE MAN YEARS

 

   Relatively healthy fifty-year-old man does not need much caution, than a 25-year-old. According to many, the average   Age is the heyday of life. However, if you suddenly Declare the intention to do sports, the attending physician He will carefully     examine your heart.

   The ECG, removed at rest, does not detect diseases of the coronary arteries in healthy people, but you will most likely have Pass this research. An ECG with a load can detect much more; when narrowed arteries cease to satisfy the increasing need of the heart in the blood, in cardiogram There are deviations.   ECG   with   the load,     in essence, should be mandatory for middle-aged people who start classes sport. If the result of a simple ECG is normal, you   can   enjoy walking on the spot on the running track until complete   exhaustion.   At the same time, many devices will be businesslike to record your cardiogram and blood pressure. After all these torment you are with full   the right to devote your athletics Evenings,     which are probably   At first,   we will remind you of Marquise de Sade.

   For each man of this age groups with   risk factors such as high cholesterol or a large experience of a smoker, an ECG with a load Especially mandatory. The error of this study is about 5% (not One test is not perfect, so 95% accuracy is considered an acceptable value).

 

   PRECAUTIONS FOR ELDERLY

 

   Physical Exercises Never Do Anything It's late. Efforts   to Maintenance of health can very quickly lead to   the opposite result, if   not   adhere to   a constant   busy training program. Thus, an elderly person,   a distant   from   sports, may be on the same level with his peer involved in sports in my youth, but lost this useful habit.

   You will need to do an ECG with a load not only to identify cardiovascular diseases, but also for checks   of functionality - how intensively you can practice, what weight you can Raise without threat to health, etc. The doctor should make sure that your arteries, Bones and joints are able to cope with increased   load. You probably have a chance that they won’t fail. In gyms you can see the elderly without a sporty past, for the first time beginners engage in aerobics and exercises with slight weights.

 

   EFFECTIVE ATHLETICS PROGRAM

 

   To improve your work cardiovascular   system   load   on the heart should be 60-70% of Maximum permissible. Lower   load not able to strain the system in sufficient   Degree,   and   the big will be too tired of you Before you have time to feel any benefit.

   Calculate your pulse at rest in 15   seconds   and   multiply the resulting figure by four. This will give you the number of beats   per minute from 60 to 100 depending on age and Weights. Then   count the   pulse again, but already performing vigorous Aerobic exercise. The resulting figure will be equal to the so-called "target number of heartbeats per   minute", i.e. the level of intensity, which you want to achieve.   Finishing take care, rest for 3 minutes and again measure the pulse. The resulting figure should be approximately equal to the original.

   Maximum number of heartbeats in minute is   220   minus your age. For A forty-year-old man is     180.   The target   number of beats per minute will be 70-85% of 180 beats, i.e. 126153   strokes.   Intensity level for a more trained person    80%   or more of the maximum number. Of course,   all of them   The focus     is to support Intensity is not lower than the desired level.

   But the number of heartbeats per minute - only Guidance. To   improve health, it is necessary to constantly increase energy production.   Specialists engaged in the study and development of exercise, measured the difference in energy expenditure between sedentary people and   individuals, leading an active lifestyle. This figure was only 300 calories per day, that is, the excess of energy that you owe   Spend at first. Running pantyhose or walking on a flat A distance of   1.6 km, cycling at a distance of 3.2 km or a swim of 360 m burn about 100 calories.

 

   INCREASE THE FREQUENCY OF THE WORK OF THE CARD REDUCTIONS

 

   Whatever your activity Aerobic exercise, all   the salt is to constantly increase the frequency of your heartbeats. Good breathing technique is also important, as it provides a saturated oxygen flow to maintain energy. To effectively strengthen cardiovascular system you will have to exercise 4 times a week, spending at least 20 minutes to class, but not   more than   one   hour.   The duration of training for beginners is   5-10   minutes,   gradually bring it to half an hour.

   Ideally, aerobic and   anaerobic   exercises   must be performed almost simultaneously. It would seem that by strengthening   the cardiovascular system, you can perform intense exercises with weights. But don't try to do this - time and   Efforts   required for    physical adaptation in aerobics and anaerobics, very different. Separating two   goals - strength and endurance - you will avoid abnormal   overloads   and   health damage. для здоровья.

   Except the miracles that aerobics perform with the cardiovascular system and the pulmonary and resurgence system, it is also perfectly copes with the general and local increase in   muscle tone   and   promotes   intensive fat burning. With the wealth of choice from   all   Possible   activities will determine which ones are best for you. All aerobic   exercises affect the heart and lungs, Therefore, this criterion is not decisive. You have to ask yourself two Question:

   - What exercises do I like better?

   - What parts of the body I would especially like tone, while strengthening the cardiovascular system?

   As you can see, it's very simple. And now Let’s     take a closer look at some of the opportunities available to you.

 

   RUNNING A TRUCK AND WALK

 

   Running jogging does not limit you in time and does not   require   special sports equipment and material costs.

   If you are very busy with deeds, it is - The most   sensible   choice.   Walking is the most universal exercise for men   of all   age groups and in any state of health.

   The Seventies Were a Time of Flourishing universal and insane hobby of jogging (running jogna) and appearances sports bestsellers with exotic names such as "Attage Plan for the Royal Canadian Air Force. Although the Canadian Air Force is still   receiving the author's reward for this, I must admit,   good   book, jogging these days has ceased to be a crazy thing,   but,     However, it is very popular.

   For Jogging you will need everything 2 hours   in   week.   Speed of movement should be about twice as much as when walking quickly. Put on some old clothes and   sneakers   and   do not   forget Take a watch with you. Run through the street -   5   minutes   from   Home   and as much back. As soon as you stop, measure the pulse. If it is below 70% of the maximum number of heartbeats, add every   day   one minute of jogging, until the pulse will reach the desired size. Conversely, reduce time if the pulse is Too frequent.

   If you have never (or long ago) have not been in sports, even   4   minutes of jogging excessively They'll get tired of you. But don't give up - through     A few weeks you will Significantly lighter. Then add one minute or   run one quarter more - in general, Choose the most   convenient   option for yourself. Quite It is possible that in a week or two   you   will feel   A little more willingness to move forward.

   Running for 15-20 minutes, you feel that you no longer get tired at the end of the run, although Previously exhausted in a few minutes. Now you’re finally in shape and can probably run   for an hour without losing your breath.

   At this stage, it is possible to establish regular   Jogging schedule:   by 30 minutes 4 times in week. It will keep you in shape, even   if You will occasionally miss One day. Should not be timed     Jogging - like, However, and any other physical exercises - for the weekend. Better Learn the habit of training daily in one and At the same time, you’re likely to enjoy running in the morning.

   Some experts promote the run paved-door (ccumal or concrete). Of course,   ground   tracks   are softer   and slightly muffle kicks, which is more pleasant, but hard   The coating does   not lead to unpleasant consequences.   Don't   forget   to warm up   before the Jogging: This is more important than choosing a path.

   Half an hour's run usually covers 4.5-5 km, so you can also explore the surrounding area. Use different   paths,   try   Don’t run on the same too often. V Bring   heavy rain classes and Never run without shining on the icy   tracks.   You can run under the light drizzling rain, if the weather is warm enough.

 

   CAN NOT RUN - WALK

 

   Walking is a beautiful aerobic exercise, which is feasible in almost any situation. It doesn’t matter if you were physically active before - in a month of walking your condition will improve, your legs will become stronger, endurance will increase, and the pulse is at rest will be less often.

   Before the start of the walks, find a comfortable pair Shoes -   Best    light cloth shoes or sneakers. This Particularly important in the first months of classes. Wear cotton or Wool socks - they absorb sweat better.

   Forget about the ridiculous   gait   Participants of   the competition in    Walking at the Olympics that you Watched on TV. Ignore the advice when walking your legs with your fingers Strictly   forward.   The gait should be natural (slightly turn your socks to the sides). Walk quickly as if rushing to an important meeting. For a man of average height,   it is advisable to take 120 steps per minute. Wash your hands a little, but do not get too carried away. Before starting a walk for 5-10 minutes   do the stretching exercises,     When he returned   home,   Do   it again to cool down.

   Walk for an hour a day 4 times in week. At first your pulse   in 15 minutes of walking should reach   60%   of   Maximum   number of impacts. Having achieved some progress, you can walk faster,   increasing the pulse rate. If she stays   at the same   level,   Try to walk with a load (for example, with a backpack) or Wear heavy shoes during walks. During the first week, go to 20 minutes a day,   the second - 30, the third - 40, fourth - 50 and during the fifth week and then - one hour a day. After the fifth week, do not increase the time walks, and try to walk a   little next week next week   Faster. Weekly incentive of pulse rate   is not   should   exceed   6-10 beats per minute. It is reasonable to spend about two months to reach 80% of the maximum number.

   After each walk, reduce a little Maximum amount of heartbeats. Check it weekly in the middle importance.   In   the days,   when you walk, record your pulse in the state Peace before going to bed. A clear reduction in this figure will demonstrate the effect of your training.

 

   JUMPING THROUGH THE ROPE - NOT ONLY FOR CHILDREN

 

   Jumping through the rope is also One of    The most   effective types of activity. These exercises increase mobility, improve   reflexes, tone the lower back and legs. Get a strong rope with   wooden handles and try jumping on a hard surface: three minutes   of jumping - one minute of rest, and again three Minutes of jumping.   Don't   think,   that it's easy to achieve such level, we'll have to work.

   Straighten your hands along the hips and rotate galloping only with light and smooth movements of the hands. The knees should be half-bent, legs -   spring on fingers. To get the greatest effect, you can vary exercises: jump on your left foot, then on   right,   alternately   change your legs; jump with widely separated feet, one leg in front of the other,   etc.

 

   OTHER EXERCISES

 

   - Aerobic dances. No, no, it's not just For a lady, although   at first you may feel like a idiotic way. Don't think about   it.   Take a closer look at the instructor's actions - and you will   see,     that the program   is not so much sealed, How intense.

   - Training of the cardiovascular system. Make all parts of your body work. This can be done by accessing popular   simulators. Take 30-45 minutes 4 times a week   on   the combined   program, using a running track or staircase, cycling ergometer, gymnastic wall, slalom simulator and ergometer for the torso, for example,   a rowing simulator. These advice relates to more prepared people who want to maximize the tone of their body for limited time.

   - Skiing on rough terrain. During the winter vacation, this is a fabulous opportunity. Possible   Skiing   in     Weekends to diversify the standard aerobic program. This sport Gives a huge pleasure.

   - Riding a bike. Another great option, but only   on the condition that you will ride a low gear cycling to increase the frequency Heart contractions. In the city of this   It   is difficult to do   because you have to constantly adjust speed to the movement of transport.

   - Swimming. Wonderful year-round view   of aerobic   activity,   especially if you have the opportunity to visit the heated   pool. You can think of some innovative   swimming   Exercise, alternately loading torso and legs. If you love Swimming,   make it your main Aerobic exercise.

   - Gymnastics. Good old classes in the School Gymnastics Hall in Times of Tough budget savings were well combined aerobic   and anaerobic exercises. Try jumping with dumbbells,   reach the hands to the toes, to do exercises with the lifting of the legs standing and   lying,   squeeze off the floor. This It’s also a great way to warm up.

 

   EXERCISES FOR THE WHOLE BODY - BEGINNERS

 

   Starting a development program endurance, try some strength exercises (ingrown resistance to efforts). Incentive to such activities, apparently, there is some attraction to assert one’s “I”, although this assumption does not apply   to everyone.     In any case, learn the basics, learn to listen to reasonable   advice,   and everything will be fine.

   This book is not a textbook on exercise  , do not forget that after reading it you will need   to know   There's still   a lot. Accumulate knowledge as you succeed.

   It is best to go to a familiar gym where qualified staff will select an exercise program   that satisfies   your   specific needs or desires. Remember that no Two bodies or organisms similar to each other.

   How often should I study? The best - Start   with   exercises   for the whole body, performing them at 3 days a week (say, Monday, Wednesday and Friday). Do not forget about self-heating:   The correct     technique of heating provides from 3 to 5 minutes of exercise for the cardiovascular   system and from 5 to 10 minutes - for stretching. Confident flexibility not   only helps to avoid damage, but also contributes to more effective   muscle stimulation. Stretching exercises should be done slowly and carefully, without making excessive efforts.

   Try to come to the gym well rested; strength   exercises after Difficult working day - dubious   Pleasure.   Never choose too difficult and stressful program - you will quit   classes in a record time. Start with the lightest weight,   short duration and low intensity. Even   a twenty-minute   lesson can be extraordinarily useful. Three exercises for 10 times each - great for a beginner. Slowly increase the severity until   you feel, that easily do these 10 repetitions and   could   I'd   take a little more. More often remind yourself: "Never    overstrain.” Keep records of classes, recording the date loaded parts of the body, name and   quantity exercises, their repetitions, used   weight   (weight),   as well as the observed progress. Combining real goals with reasonable   Motivation and appropriate exercises, you You will achieve noticeable results.

   The newcomer must carefully observe the most important rule: rest   for a minute between every series of repetitions of exercises. Useless and   even harmful to hold your breath during work; try to breathe so naturally, as much as possible. But be sure to coordinate movements   with breathing: inhale when relaxed (lowering the load)   and   exhale   at voltage (lifting or the boost of the cargo). With pulling movements, exhalation is done during the movement of the hands to body, and inhalation - when repulsed from the hands   yourself. Breathe out with a belt tilt forward, and unbending, take a breath.

 

   FREE BURDEN OR SIMULATORS?

 

   You can ask the question: what preferably - free goods (dumbags, weights, barbells, etc.) or Simulators? The simplest answer   is: use both depending on the purpose you face.   On simulators is better achieved clean tonic effect, and free loads are good for building muscle mass. To work with   different   groups   muscles you will have to switch from the simulator to simulator, but the change of effort on the simulator easier and easier than a change, say,   pancakes   on   the barbell. Muscles and Ligaments work more   intensely, if   used   cargo,   and simulators are designed for resistance applications, taking into account ergonomics. For special development and strengthening of the joints   Free   cargoes   are mandatory. Elderly, especially weakened men, as well as   injured, it is better to practice simulators.

   Cases of injuries during classes distributed   between   free cargoes and simulators approximately equally, although manufacturers of the latter are sure Trying to inflate you a different thought.

   The basis of strength training - their intensity, i.e. the amount of effort, energy and degree Difficulties necessary to perform   or   other exercise. Intensity can be increased or reduced by alteration the number of tests and the exercises themselves, acceleration   or   deceleration speed of movements in the execution,     as well as   efforts   to positively or Negative orientation. Positive, or   concentric, the effort develops in the phase of the rise, and the negative, or   eccentric, with Lowering   (see   below).   Beginners   are advised to   make fewer repetitions in the purpose of reducing discomfort in the muscles and their   Pain. To avoid injuries, it is recommended to perform Exercise is   slow; it is also helps to prevent gravitational sprains and helps to adhere to the correct sequence of movements.   Negative efforts contribute to more Conformity between muscle movement and overcoming Resistance.

 

   PROGRAM FOR BEGINNERS

 

   The proposed exercises are aimed at the general development of the muscles of the whole body. Perform them 3 times a week in Combination   with   Aerobic   activity. Focus on the following main muscle groups: shoulder muscles, arms muscles, chest, back, abdomen and legs.

   - Shoulders.

   Army weight squeezing (3 exercises 8-10 times each hand).

   - Biceps.

   Variable weights weights (3 exercises on 8-10 times each hand).

   - Triceps.

   Stretching of triceps lying (3 exercises 8-10 repetitions).

   - Breasts.

   Push-ups from an inclined bench (3 exercises 8-10 times).

   - Back. - Yeah.

   Rowing on the simulator with slopes back (3 exercises for 8-10   repetitions).

   - Stomach.

   Inclinations forward (3 exercises 10-12 times).

   - Feet.

   Lifting the legs standing (3 exercises of 10-15 once). Squats (3 exercises 8-10 times).

   Start with one or two, Exercises if you are not   able to perform three at once. Raise the light loads. Do not hesitate to use simulators in parallel.

 

   AVERAGE COMPLEXITY PROGRAM

 

   When your classes become tense and Complicated, pay special   attention Proper nutrition. Be sure to try about an hour before the start of classes Consume more carbohydrates in   any   kind;   better   all drink carbohydrated drinks, containing glucose, fructose or   polymers Glucose.

   Get to know more about the three types Muscle contractions.

   - Concentric: the muscles are shortened for Overcoming Resistance.

   - Eccentric: the muscles lengthen in in accordance with the resistance.

   - Isometric: Muscles Resist the load applied from the outside, without changing in size (without moving). Perhaps it has already come for you   time to move on to advanced exercises. This a set of exercises in which   one without a break is replaced by another (other). When performing such exercises, the supply of carbohydrates very quickly depleted, leading to the breakdown of     backup fats source of energy. Concentrated   Advanced   exercise usually focuses on one muscle or muscle group.

 

   PERFORMING EXERCISES UNDER THE CYCLICAL SCHEME

 

   This is another option for training with very A quick and   effective   result. The trainer performs one set of exercises from   the program   -   initial, then proceeds to others not related to   program,     and then makes the second exercise from the original program, completing the cycle.

   With this method, all muscle   groups   loaded   proportionally, in parallel increasing force. Usually, speaking of cyclic training, we mean exercises on simulators, where     resistance force   can be changed quickly and Efficiently. This greatly facilitates the transition from one type of exercise to another and back. Although cyclic exercises are aimed at the development of one parts of the body, they can be used to train opposite muscle groups.

   Separate systematized implementation exercises involve working on certain parts of the body in a special Allotted days,   for example, in one day you Do exercises only for   Breasts,     in the second   only for hands and feet. These are very intense   and   effective   exercises. Most of these programs can discourage you, because you will have to   work on the same part of the body more than two   days   in   week.   This is because when loading progressively increasing   resistance, the muscles need more time for rest and recovery.

   Periodization (long-term scientific program planning  )   is   another method worth getting acquainted with. Here you focus   on training goals, think about consistency and   mutual influence   their stages. Training schemes are considered most carefully: you   learn to manipulate them, composing complex complexes and getting   almost   infinite number of different options with different possibilities. You Beginning to learn the relationship between   the volume   and   intensity   of training, learn to evaluate the volume of the lesson on the number of exercises and the number of their repetitions, as well as how to   determine   the intensity   training   by counting interest from   Declared   Load for    individual   exercises (maximum load on one repetition).

   You may already be at this stage training   when   you can think of your own coach, if you have a desire to invest   time and money in sports. Or you can successfully train on your own, expanding knowledge   in the field   physical training   along   with   muscle growth. From time to time you will have to revise and rebuild the complexes exercises to overcome "dead points", or "plateau", - moments when the old program will become ineffective. It will also be necessary to make changes in order for the program You're not bored.

 

   EXTENDED PROGRAM

 

   - Feet.

   Sty feet (10 times); feet with lift lower leg (10 times); feet press. Complete the exercise by doing three such sets every foot.

   - Back. - Yeah.

   Pull-up (10 times); rowing with inflection on simulator (10 times); pull-ups. At Langule to do 3 such sets of 10 once.

   - Breasts.

   At least 3 sets of 10 direct presses and Straight Machs by weights.

   - Stomach.

   At Late 3 sets of 10 squats and Raising the legs.

   - Shoulders.

   At Late 3 sets of 10 army presses dumbbells   (or   rods)   and pulling up on the trapezoid.

   - Triceps.

   Alternate 3 sets of 10 stretching every hand and   blows   (leschouettes).

   - Biceps.

   At Late 3 sets of 10 concentrated bending-extension   of the hands and flexion-extensions of the hands sitting. To perform these exercises requires a minimum of equipment, which, as a rule, always has access.

 

 

   Chapter 4

   MENTAL AND EMOTIONAL HEALTH

 

   Among the patients who turn to psychiatrists and Psychologists, 70%   are women. Men in this regard are not "normal", just women are more willing to Recognize that they need help, and show a greater   willingness to find and get it. Men, Possibly, as a natural compensation, usually Looking for other ways to cope with   stress   or mental pain. They abuse alcohol   and   Drugs     are 3   times more women and commit 90% of serious crimes.

   Traditionally in "bad behavior" Men are accused of   the hormone testosterone. But male hormones, making men (and other   creatures   male  ) more aggressive and excitable, in any case do not affect the mental abilities do not suppress emotions and do not dull the reaction to stress. It's not testosterone, but two   Other     factors     Responsible for the great Part of the painful   manifestations   in   emotional life of men. The first is temperament, or character. Character is   an innate consistent behavior that tends to remain constant throughout life. Some individuals are always in high state of spirit and invariably sociable and   communicative,   others, as rule, sad, others   are very   sensitive   Or   critical . Parents notice such manifestations almost from   the cradle, apparently, they are congenital.

   The second factor is learning. Boy learns about how a man should behave, mainly from his parents, but also from Friends,     as well as   from the media. His Behavior,   in addition,    must   match the social culture of its time and your country.   For example, the Confucian culture, which before still affects China   and Japan, teaches a man the unquestioning duty and absolute   loyalty to the people he is in one way or another. It can be to seem extreme, but such a philosophy in rigid   social systems reduces stress to minimum.

   Our democratic society encourages to respect loyalty   where it is really necessary, and not to maintain injustice and illegality. American men are convinced that they should not tolerate   injustice - a painful source stress at work and in relationships, where the possibility of choice is limited.

 

   CONNECTION OF REASON AND BODY

 

   Unfortunately, the stresses that overtake men, not simply   make   them   unhappy Or forced to drink. There is an obvious   connection   between thoughts and mood and the occurs at this time in the body. Your mouth is filled saliva even when remembering your favorite food, although you do not see it. But salivation is only one,   The     simplest reaction of the body to the thought. Are there any other   relationships   between   Mind   and state of the body?

   Researchers have begun to collect evidence of the connection between the mind and body   in the mid-70’s, starting with the discovery of endorphins –   “good”   hormones that were supposed to block chronic pain and alleviate   certain types of depression. In a few   Tennessee scientists at Tennessee University Observations to find out whether a person's thoughts can   affect the level of endorphins in his organism.   Tennessee   researchers worked with a group of patients suffering from “incurable” pain   in the back. Research began with measurement     level of endorphins   in   cerebrospinal fluid, then patients were prescribed a placebo. About 30% of patients   said they felt better. But in fact, their   suffering   it   was not a placebo that relieved the level of endorphins. What caused his increase? Of course, not a placebo, but thoughts themselves patients. Somehow, the belief that from "medicines" they will soon become better, "transferred" to   the bodies producing endorphins and other substances that reduce pain syndrome.

   Many other studies have confirmed and   Expanded these   discoveries. For example, employees   of the University of California measured   the effect   of the influence of emotions on The immune system. This time     The object of the study was actors who can "feel" the emotions of the depicted heroes and entering into the role so much that it really felt the rage   or   pleasure prescribed by the character script.

   The actors were instructed to play joyful and the sad scenes, during which the changes that occurred in their organisms, in particular the secretion of immunoglobulin A. This substance, represented by   antibodies located in the mouth and other parts of the body, is an important part of the immune system. During the fun scenes immunoglobulin levels   The actors fell, during the sad ones - he rose.   This   was   a strong   proof that emotions are capable of Influence the immune system and health.

   In 1990 in   the "Journal   The American   Medical   Association published   an article about How strong can there be a connection between   mind and body. It turned out that the mortality rate   among   The elderly   Jews are declining before Easter. Easter for Jews is one of the most important religious holidays; especially for fathers and   Grandfathers     who rule   during this celebration. Immediately after   the end     Easter   Commerce Mortality Rate men rise sharply, and then again decreases to the average. University of California study found the same phenomenon, but this time among the elderly   Chinese women,   the mortality rate among which briefly fell before the Prevental Moon Festival, of particular importance for older   women.   The figures   indicated, what is fun, impenetrable by Jewish men and old Chinese Women's Pirapations in Some Way   They were kept alive until the end of the fun.

   Every medal has a flip side. And If good thoughts strengthen Health, the bad can Serverly service.

 

   FEAR, UNCERTAINTY, DEATH

 

   The first irrefutable proof of this, that sad thoughts   can harm a person, revealed by chance in   implementation   of   the American space program. In the 60-70s, young engineers and psychologists of the cosmodrome "Capeus of Kennedy" who took part in sending astronauts to the moon, Becoming Dead by Heart   Attacks   that have occurred   with   An alarming frequency. Drinking, abuse Drugs and divorces in this group were also at a suspiciously high level. When People Die from   Cardiovascular Diseases, doctors usually pay attention to standard risk factors - high cholesterol, obesity, diabetes and smoking. These factors were   in the inhabitants of the "Cape Kennedy"     within   the norm. In addition, they do not found blockages of the coronary arteries - the usual cause of death Heart attacks.

   Some of the government are already conceived,   not   involved   Are     the Russians for this, but soon The true cause of misfortune was found. Due to financial problems, the worker staff of the cosmodrome was subjected to a large reduction. People, yesterday the ex the best missile specialists, today could be Unemployed.

   Despite the common success of space Programs     related   with   her , scientists noted an unusually high level of concern   and   Depression. Excitement caused by fear for your The future led   to the massive the release of adrenaline and other substances that   quickly   Disabled the heart muscle. All these people were   literally    Words are scared to death.

 

   EFFECTS ON THE HEART

 

   These discoveries are confirmed   by various   laboratory   studies that have proven that fear, uncertainty, overexcitement and similar to them Emotions can harm the heart. In one of the early   studies, a group of rats locked in cells,   Forced   with   regular   Interpendrites to listen to cat meowing. The rats could not   know   that   It's just a record, they were sure that The cat is really somewhere nearby and is preparing to attack. Quite soon, the rats began to die. Openings showed the destruction of the heart muscles, as well as in the cosmodrome workers.   But   this applies not only to rats and scientists. If you allow an aggressive   earthcraper to constantly try to attack the calm, dividing them with a grille, the   latter will die in a few weeks. If the rabbits are   carried all the time from cells in the cell, not allowing them to adapt to the new   situation, they will begin to die in about 6 months of such an experiment.

   Not every test with fear is deadly, but it    may   be detrimental to   you. In the article, Published in 1988 in the New English Medical Journal, described how subtle stress can damage the heart. Patients who have already   had diseases   coronary arteries ("blockage"), asked Engage in arithmetic   calculations   in the mind, speak in public and perform other tasks related to the potential Possibility of stress. Some of the subjects decreased the flow of oxygen to the heart muscle, the volume of blood   pumped by   the heart in one contraction fell, and the heart wall itself sometimes decreased in a state in a state.

 

   WHAT IS STRESS

 

   Many definitions of stress revolve around the reaction to     the danger type of "fight or flight". The idea behind   this   Formula,   very simple. The human body is usually “programmed” for consumption the amount of energy required for Providing normal   activity. But with the body switches to high   speed of work: the heart begins to beat sharper and more often, additional sugar enters the blood to provide increased   energy consumption,   vision is escalating, and Breathing becomes intermittent. These   and   other   changes immediately prepare you either to fight or to flee   in the name of saving lives.

 

   WHEN TO USE THE REACTION "FIGHTING OR "FLIGHT ESCAPE"

 

   The reaction to danger is excellent Mechanism for     Rescue   life,   but it should be used rarely and with caution. Powerful chemical   compounds produced by the body in moments of   threat,   can   cause   a significant harm if you use the inclusion of this reaction   too much   Frequently or without a proper reason. Such The reason     in this   strictly   speaking, there is a direct and serious danger. This can be a car rushing directly to you, a person trying to hit you, or an angry dog. What does an improper reason mean? Such reasons in principle no, there are just moments that are not suitable for using such a reaction, when, having noticed and realizing the danger, you are not   able to   Neither   fight or avoid it. The body switches to high   speed,   but you have to stay in place and take everything as it is.

   When people lived in caves, they did not have encounter   with   rough clerks and road police. Life was much simpler, and the difference   between dangerous and non-dangerous circumstances - much more clear. Today,   however, many The situations we face are more annoying than Frightening. Despite   this,   we   We still   retain the ability to include a “fight or flight” response. We don't have opportunities to beat their bosses and wives or Escape from them when they   poison us life. We can neither fight   nor   run,   When   our   children are acting on us nerves or undeservedly fines   Road   inspector , or panic begins on the stock exchange. At such moments, it remains only   to maintain self-esteem and Respond is reasonable enough  . Unfortunately, we are trying to fight and run even with   the most insignificant provocation. As a result,   the body   produces   a lot   of potent substances without using them For that, neither for the other. Instead, we have to "brown in your own juice."

 

   THE MODERN CONCEPT OF STRESS

 

   What is said leads us to   the modern   Definition of   Stress:   Stress is a person’s reaction What happens to him     in life.   Most events and circumstances, except Physical injuries should not be stressful. Ours Their own reaction makes them that way.

   Controversy with his wife should not cause stress, but This is what happens most often    , because that we allow ourselves to be angry and offended. Situations that can be frightened Most people, others are not caused by stress. For example, for astronauts return from the moon to Earth is not stressful in nature, if they believe in their ship,   are sure that their work is no more dangerous than the morning   Walk   in   the surrounding area. However, if they start to think about what can happen when a pair of tiny burns out in the computer   chips,   stress   is provided.   Circumstances are the same. Returning the spacecraft   home. It is the perception of this situation - it is dangerous or not dangerous - that makes it stressful or vice versa.

   Noise in the middle of the night in the house can cause extremely stressful   situation   if you assume that you have climbed Robber. But if you are sure that it is a cat scrape through the door, returning from the night   Walking,   you won't have any stress.

 

   WHAT IS ANXIETY

 

   Anxiety is a combination inconvenience,   anxiety,   uncertainty, fear and excitement associated with stress. People become restless, waiting for some danger, although they may not know   what     It will take shape or where to wait for it.

   Worry often causes critical situations such as   exams, Unexpected Challenge to the Tax Inspectorate   or   even   reflection   about your own life in her tense moments.

 

   SYMPTOMS OF CONCERN

 

   When you are concerned, the muscles are tense, you are covered   with praina or sweating, the heartbeat intensifies, breathing   increases   and   becomes deeper. You are being overwhelmed by anxiety. Attention is dispelled, the ability to adhere to the given direction is reduced. It is possible to increase the urge to urinate or defecation. If you are surrounded by people, you   can   start asking them too many questions, often change the topic and direction of the conversation, constantly looking for confirmation of what has been said. V in some cases,   this can lead to attacks of anxiety and fear, accompanied   by dizziness, increased sweating, heartbeat, fainting, gastrointestinal disorders and feeling of approaching unhappiness or death. Symptoms Anxiety coincides with the symptoms of stress.

 

   STRESS AND BLOOD PRESSURE

 

   Hypertension, it is hypertension (increased blood pressure)   is the main A murderer these days. Although   the mechanisms of   hypertension   quite complex, the main equation is very simple: Blood flow, multiplied by resistance, is equal to the pressure.   Blood flow   -   the output   characteristic   of the heart, blood volume, which the heart pumps     for each   reduction. Resistance is how easy it is or The blood is hard on   the arteries. If blood flow or resistance increases, blood pressure   rises.

   When you are exposed to stress or you think you're   threatening danger, a part of the brain called a hypothalamus   (where   there are nerve centers that regulate body temperature, appetite, water balance, carbohydrate and fat metabolism, blood pressure and sleep), includes a specific a sequence of actions that prepares   you to   escape or struggle for your life. Part of the response to stress is increased and tightening of the heartbeat, causing a rise in blood   pressure. In chronic (long) stress, blood vessels “compressed” and decreases in diameter.   As a result   resistance increases    , increasing even more Blood pressure. Studies have shown that     Residents of areas with high levels of crime are more likely to have hypertension.

   High blood pressure is only one of the side effects of   stress. Long-term or repetitive stress leads to   depression,   increased risk of diabetes and/or peptic ulcers (stomach and duodenum), lowering the level of sex hormones and total Reducing the ability of the immune system to fight diseases. Platelets   can   become   more "glue" than should be, Exposing You to Greater Risk of Heart   Violations. Balance of chemicals of the body at the end of stress usually recovered. But when the stress too   much,   levels   The content of these substances in the intervals can "hang" on stress marks,   corresponding high speed of the body, saving in your Invariably high blood pressure and   Putting   more   at risk   heart disorders, ulcers and other complications.

 

   IMPACT OF STRESS ON THE IMMUNE SYSTEM

 

   Some may doubt that thoughts   strengthens or   weakens the immune system. It is not the only and unchanging object your reflections, and in general, millions of cells are scattered throughout the body, belonging to the immune system. However, in the 70-ies of   the researchers found nerve connections, the brain and   nervous   system   with bone marrow, fork, spleen,   lymphatic tissue   and other parts the body where the immune cells are located. The mind   may not be directly related to a single removed cell of   the immune system, but it has direct connections with different places where   only   There are fresh cells that “trained” for their protective functions, while mature cells monitor the state of the body.

 

   RESULTS OF IMMUNE SYSTEM RESEARCH

 

   Study of the group of cadets of the military school in West Point,   showed how emotions can affect the immune system. Blood of cadets   was checked for the absence of antibodies in it EB virus (inducitation of   the presence of infectious mononucleosis).     During the time   Tension   related   to   with mental and emotional overloads and stress, some of the cadets fell ill with mononucleosis, and the other part remained   healthy.   It was those who were exposed to the greater   psychological   pressure   and   had the worst grades.

   Although the photos are all Astronauts     are smiling broadly, They also experience quite a lot of stress. Available for checking their condition before and after, you would find that the reaction of T-cells in within the first four days after returning to Earth, it was lowered. Stress, caused by take-off into space in a small metal cylinder,   and   then the risk of burning when entering the atmosphere or break during   landing,   large enough to weaken the immune system system.

   To be stressed, you do not It is necessary to   take off   in   Space. The immune system can be weakened, When someone     close to him dies, when you are caring for a seriously ill loved by a loved one, go through a difficult and unpleasant divorce procedure or prepare to   hand over the important exam. One of the culprits here is a substance   called cortisol. Its level in the body increases with stress,   Helping you cope with the temporal danger. But chronic Stress   leads to prolonged lifting the level of cortisol,     which can   deplete the muscles, weaken the bones and disable The immune system.   Elevated levels of cortisol cause diabetes, depression, cancer,   strokes,   hypertension and other ailments. Doctors have long known that the patient can cause certain diseases, giving him large doses of cortisol.

 

   BURN "SILENT"

 

   "Of course," some will say. "All,   What they say about   stress,   It's very bad, but it's none of my business. I am   calm   man."   It is wonderful if the contents of the premise could be judged by the appearance of its packaging, but I knew a few seemingly impermeable people who died, "burning from the inside,” and it’s the stress. Such people can be identified with the help of special monitors, offering them to play video games. They do not suspect that this is a special kind of game, when to win   Impossible.   Observing    You might think they're taking the game easily and serenely, without taking care of Victory, no defeat. But the monitor at this time   will tell you the truth about the stress that already leads   to   their   organisms   are destructive work: the most powerful chemicals     that make the heart beat harder and more often, the vessels are compressed more, the sugar content in blood increases, and internal alarm signals are turned on.

 

   ARE YOU AFFECTED BY STRESS

 

   There is no perfect description of the signs of stress, For each of us reacts to events in its own way. For one man, say, the break with a friend is a misfortune, for another - a good opportunity to find yourself New. To get a scarce enough idea of Tom   how   You   react to   everyday life and unusual events, check that   of   what is described   below. You:

   - tolerate in vain to waste time;

   - drive a car quickly, even when you're not anywhere belated;

   - overload your working day, work without interruption;

   - experience impatience when the interlocutor speaks too slowly;

   - all do very quickly - eat, swim, get out of the house, work in the garden, etc. ;

   - do not like to lose, even playing for the sake of pleasure;

   - believe that relations with loved ones are taken away you are away from work and other important things;

   - often do more than one business simultaneously;

   - do not have a hobby, as you do not have it time;

   - believe that in the responsibility of any ORDER,   as   other   either do it badly or too long.

   - upset when someone has something It turns out, but you do not have.

   - have to keep up everywhere on time;

   - speak quickly, with pressure, using obscene swearing;

   - use the numbers to assess success (as A lot   of people   get, how many products he produces, how much land has). The   more   Positions from this list are attached to you, You are more susceptible to stress. Many purely physical diseases, such as stomach ulcers and back pain,   too Signaling stress.

 

   HOW TO COPE WITH STRESS

 

   There are no indisputable rules and treatments stress, and, moreover,   some Provocating moments you simply cannot avoid. For example, you can not be able to resign, even if the boss is spinning with you. But there are certain measures and actions that can be opposed at least separate stressful situations.

   1. Never try to do more than one Things right away.

   2. Do not overload your work schedule. Plan for the day only what you can do, not feeling discomfort and tightness in time.

   3. Drive the car at medium speed. Even If the road is covered   by transport, Take it more calmly.

   4. Go a little early.

   5. Take a little time every day for relaxation and   exercise. Ordinary walk in the early morning or evening   -   excellent way Relax.

   6. Spend some time with your family and friends, even   if   you have to sacrifice time for work and hobbies.

   7. Do not take on yourself voluntarily Responsibilities   or work for a career. Think carefully about whether you can do this without reducing the time of rest.

   8. Wherever you go, put   The task of   seeing there or on the way something beautiful - flowers, sunset or dawn, interesting building, unusual Cars, etc.

   9. The next time you talk with someone at a party or at a meeting, don't talk too much Lots of. Quietly sit   and   listen to the interlocutor, asking questions or Commenting     on the story only   to maintain the conversation.

   10. If a person does something slower, Whatever you could, do not interfere.

   11. Before      toffee before   you   new   task,   think about whether you really need it, and if so, whether   the food is   give   it immediate and can anyone replace you.

   12. Take a little time every day hobby - reading, working in the garden, collecting. Don't try to be the best gardener or "brutal" reader, and also do not turn a hobby into a hobby The source   of income   just enjoys it.

   13. At work, if your boss is not object,   every day   every   2 hours arrange yourself 5-10 minutes Break.

   14. Look for a reason to do a daily basis someone   compliment   (employees, family members, friends).

   15. If you don't need a watch to work, Leave them at home.

   16. The next time you play with children, relatives or friends, consciously Lose them. Be proud of how great you managed to hide the fact that you did it intentionally. Remember that     the effect of stress is much greater depends on your reaction to what is happening   from   the event itself. Often there is no need to spend all your efforts on changing   the situation,   but you can change your reaction.

 

   IF YOU ARE ANGRY

 

   Today, anger seems to be an epidemic.   Did   two clutch down   man because of the parking space or intruder Social Communities Revolt, Dissatisfied with Decisions the authorities - both indicate that anger has become the main social problem. Anger   affects   and   on health. If you use this feeling rationally,   you can   use it as a tool that stimulates you in dangerous situations.   Too strong anger leads to   Release of   Huge   Volumes   adrenaline, cortisone and other potent substances that can cause pain in the neck and back of the head, excruciating headaches, stomach ulcers   and   duodenum and other complications.

   Anger leads to indecency, for by itself    is   useless to myself. Of course, you can scare some people, for the sake of them, but in this way You will not find what is really valued in life –   respect and love of others, a sense of satisfaction and ability to love   others. Most likely, anger will not even provide you with seats   the car park  , because of which you came into vegetation, because   the one, the other   The guy's   probably gonna fight back even more. He can even shoot you!

 

   USEFUL TIPS: HOW TO REPAY ANSIL

 

   If you realize that you are angry too often:

   1. Try to understand that you are usually It's not what   you think. You are not angry because someone slipped without a queue and took your place in the parking lot - no, you are angry with his disrespect   to you or because it is very Hurry up. Real causes of marriage   quarrels,   as a rule, are money, supremacy in the family or methods and principles of   raising children, and not who should   Wash   the dishes now.   If   you feel like you’re angry, ask yourself, why? Maybe you're struggling Not with that enemy?

   2. Try to cool down. You will be surprised, How easy it is to say to yourself: "Let's forget about it, it's not It is worth it."   Many   people   They say that, having practiced a little, they learned to "turn off" anger, constantly reminding yourself that anger blocking the path to the intended goals. If you still live old grievances, for example,   be angry   at   his   drunkard-father who beat your mother, think about the fact that he has no evil, but you're already because of her 10 years suffer from   stomach ulcers   -   It's you, not him. And that teacher in the third class that disgraced   you   at the board in front of everyone classmates? It was 30 years ago, she   won't remember you, even if will, and you all grieve and torment yourself with memories. And your anger hurts you, not her.

   3. Forgive the man you're mad. People often don’t   know that did something wrong. Probably more likely   All in,   the driver   who "cut" You're on the highway, didn't even think you're hurting or offending you;   he's just a bad driver. So forgive him. Even finding out that someone has taken some action to prevent Your career, I'm sorry. No, don't forget What he has done, take action,   to   protect yourself from further attacks, try to identify   and   show   everyone   this "rotten apple" until it collapsed the whole company - but forgive him.   The moment of immediate danger is already passed.   It's   time   careful planning, and anger will only hindrance.

 

   OVERCOME THE FEELING OF GUILT

 

   Although guilt is usually discussed less often, than malice, many   men bear this heavy burden. They often feel guilty   because it’s bad perform marital and paternal duties   or   earn little. They can blame themselves for putting an old mother in   a nursing home Instead of putting it in your place.   There are   many reasons to feel guilty, but   try   Ask yourself if what you did was really so bad. Were there Are you   wrong to deny a friend his request, or did he just try   to take advantage of your kindness? Really whether you are a bad father or judge   yourself, Taking advantage of a far-fetched and funny standard of "excellent father"?

 

   USEFUL TIPS: HOW TO OVERCOME THE FEELING OF GUILT

 

   If you did not really do something then:

   1. Confirm to yourself what you have done Mistake. Throw   away all   excuses and arguments in your favor - just You'll agree with that.

   2. Apologize to a person or group people you   are upset (unless you hurt them more). Tell   your wife,     that they were a bad husband, confess to the employee that they defamed him before   the authorities. If your confession The punishment will follow, accept it.

   3. Try to correct the error before those, who   was in   trouble. Do something special for the wife. Tell your boss that   the employee you didn't really talk about is actually a great guy. If it doesn't fix anything, do good   to someone   another   or a society (at least donate money to charity).

   4. So as   not to no longer   Make   mistakes,   try   Draw up   a plan of further action. Ask your wife what you can and They must be a good husband. Visit the consultation   on   issues     of family and marriage. Ask The purpose or to speak well of colleagues,   Or   keep your mouth shut.

   5. If you are a believer, take part in The ritual of purification from sins.

   6. Continuing to do the best you do able, and without justifying their wrong actions, Realize the soul that you are so,   What   it is. Movie stars and footballers earn a lot of money and are considered   our   the pride, but the true core of the country is   still   "the average Joe." We can do well   without   another   two-meter basketball player, but we will not live without accountants and farmers, doctors and   factory workers, clerks and managers and any other who conscientiously does the daily work. Of course, it is pleasant to stand out among others, but you should be proud of the results of your work, no matter how small they may seem.

 

   HOW TO RESIST THE SAFETY AND GRIEF

 

   Sorrow is a very powerful emotion and can undermine your protection from diseases. Studies have shown that after the death of one of the spouses, the immune system the survivors   are weakened,   and   immunity is sharply reduced to dangerous levels   during   6   months.   For   Full recovery requires the same as much time.   During   this   Years a person is especially affected by any Diseases.

   The causes of sorrow and grief are different: death parents close   to a relative, spouse or child, which is probably the most   worst;   amputation   of some parts of the body as a result of the unfortunate cases; loss of health after prolonged and serious illness; loss of life   Earnings or   prestige   due to the collapse of the career.

   Saddened, grieving people are still surround the joys of   life,   but the inner eye of them is not Notices. Any pain increases, all   The pleasure is depreciated.

   Sorrow, grief - a natural reaction of a person for difficult life events. There is nothing shameful, but it should not Renew this state to unnatural limits. To help people in mournful periods of their lives, various cultures and religions   developed   special   rituals. Many of them provided for different "stages" of sorrow: first   for a short period of time almost completely He excluded himself from public life, then partially returned to her and   eventually   again   He gained   his role in the family, at work and in society.

 

   HOW TO COPE WITH GRIEF

 

   There is no means to heal the grief, it must Pass through the natural   way. Some Opportunities help prevent abnormal prolongation of this condition:

   1. By doing good to other people, you will be better Feeling and   calmer Perceiving life. It could be   Even   an unexpected   compliment to someone.

   2. Set a goal: to do a certain number of good deeds, read some books or finally repaint the free room. In other words, Take up the job and give yourself   Opportunity   to look to the future, at least in the near future.

   3. Participate in the mourning rituals of your culture   or   religion,   even If you don't believe very strong. Rituals They will take you and stay in the company.

   4. When the initial, the most difficult period of sorrow, try Enjoy the pleasure of life, as before. Do not try to make yourself happy, nor do you Avoid all that   gave   you pleasure and joy before. Do not fall out of society. Keep visiting Friends and pursue your hobby. Join   the softball team or go to the Kegelban.

   5. Remember that, although no one will replace lost person,   in your heart there is always room for another love. Let someone take it Him when you are ready for it.

   6. Know that your sadness with time It will subside if you don’t resist it yourself.

 

   LIGHT SIDES ALSO SEE

 

   Millions   People   are   feeling today   complete   helplessness  , trying to somehow correct their life circumstances. They have little hope for the future - as for their own, and for tomorrow, society as     a whole. People who suffer Depression is often believed to be   Nothing in     the World   No worth their effort. In addition, they are usually feel tired,   devastation and Lost interest in life.

   Psychologists and psychiatrists identify many types depression:   phase   of psychosis, analytical, bipolar, endogenous depression, retropernation psychosis, or psychosis of the menopause, reactive depression   and   depressive state with maniacal depression   Psychosis.     We are probably all very susceptible to widespread reactive depression, which   is a normal reaction to loss or tragedy (such as death loved one). A person suffering   reactive   depression,   sad, inconsolable and discouraged usually proportionally overdue   loss.   Over time, this depression goes away on its own   in itself.   Other   types of   depression, such as endogenous, are comparable to a chemical imbalance   in   organism. In such forms, patients   Exaggerated   sorrow,   despondency, devastation, hopelessness and feel own worthlessness and   uselessness, Although there are no visible reasons for this.

   Diagnosis of depression is quite difficult, but there are several common   signs: implicitly a sense of dissatisfaction that has no definite object; feeling the impossibility of changing what you do not like; the desire to people listened to you, even though      not for long;   the acceptance of circumstances as is, to a greater extent than attempts to   change them, and, accordingly, the belief that   such   Attempts   only worsen the case; the feeling that you have nothing to be imagined and so will always; inability to imagine yourself prosperous,   popular   and a significant person; difficulties in Attempts to express your feelings and feelings to others people; thoughts that if you suddenly disappear, then no one even At times the conviction that suicide is the simplest way out of the situation.

 

   HOW TO HELP YOURSELF TO OVERCOME DEPRESSION

 

   Although most depressions require consulting with a doctor and medical treatment, men who experience depression in moderate forms, can take certain steps to Intensify your   energy   and increase interest in Life:

   1. Don't dwell on thoughts of the bad - Think and talk   about   what is in your life All right. If you are not able to think about the good,   ask your relatives and friends more often Tell you about it.

   2. Plan for every day as much as possible more things   that could   cause you Pleasure. Take the time to go to the movies or read funny books and magazines. Observe   the kids playing in the park. Go to the birthdays of friends and relatives, Christmas parties, attend anniversaries, presentations and other entertainment events. Don’t make yourself laugh until you fall, just go there.

   3. Help other people and you will Feel free.

   4. Visit individual or   group   Consultations.   Discuss your affairs, listen to others. Find a consultant and a group   where   You'll be interested. Avoid those where can spend 10 years on questions about the inconsistency of your life.

   5. Set a goal and move towards it A little bit of a day.

   6. Irrespective of well-being, keep the head   is high   and   Be as   if you are a happy person.

   7. If you are shocked by the loss or Tragedy,   allow   yourself   Burning. Take your reactive depression as a natural A process that   will pass over time.

   8. Focusing on the good that there is in your   life,   beware of people who require you to ALWAYS were happy and   happy.   Your emotions belong You, not them.

 

   NEW DRUGS THAT AFFECT EMOTIONS

 

   V   Previous   Times    Psychiatrists    were    sure that      Mental disorders such as depression, mania and Schizophrenia caused   by   diseases the brain, accompanied by disturbances in the transmission of nerve impulses and, more even visible anatomical anomalies. Any human   traits character (pesimism, optimism, sociability, shyness, fear of the new The result of experience gained in early childhood.

   Today we are beginning to think about what mental illness and ordinary character traits are not, The different sides of   the human temperament. You can build in one row deep depression, chronic pessimism,   changeable   mood,   normal   character, to continue this series with general fun, inexhaustible optimism   and   end with a manic state. Two poles this spectrum   of states is themselves diseases. The qualities placed between them are not manifestations of the disease, But some     of them can   Be a   source of   severe stress.

   Research on brain functions as a human being, so and the animals   carried out over the past 20 years have strengthened the biological approach   to   individuality, but practical doctors until recently paid   little   attention   Now obvious and even alarming The fact that the drugs   can change the character of a person. Yes, yes, safe medicine. For   thousands of people have used alcohol, opium and cocaine to reduce   stress,   and it worked. Shy people, for example, after   Drinks   became more sociable. The appearance of amphetamines seemed to add   to the world   hopes. Unfortunately, it turned out that these drugs are damaged The brain.   Modern psychoactive medicines - lithium, antidepressants and tranquilizers - are able to move a person with a mental illness   closer to the middle of the spectrum, without destroying the healthy brain tissue, but they all have many unpleasant side effects.

 

   THE LATEST WONDERFUL MEDICATIONS

 

   New psychoactive drugs with   minimal   side   effects appeared in the late 80's; and psychiatrists began to prescribe them in   some diseases. Latest Antidepressants of the "Prozac" type and   "Zoloft" in typical depressions did not act better older, but individual   patients Improvement in areas other than   moods:   usually self-sufficient people gained confidence, shy ones   found that they feel more in society   comfortable,   pessimists   recognized that the future looks promising. These people are not easy    "better"; the doctors came to the conclusion that they feel more than good.

   The news quickly spread among patients. In 1989, "Prozac" won and Public recognition. His packages were depicted even on   the covers of news magazines. After the period General   enthusiasm in    The press began to scold this medicine. On those strips, where previously printed stories about the miraculous transformations of the human Character, began to appear Stories of Victims of Side Prozac effects.   was   organized   "Society of survivors after Prozac, a lot of bailiffs Claims, and moralists tirelessly warned everyone and everyone   about     Harmfulness of chemical   intervention in the human soul.

   The press has lost interest in Prozac in about a year. Stories of Catastrophic Side the phenomena no longer spread, but the memory of the positive effect remained. Most doctors prescribe   Prozac and its derivatives for the treatment of depression, mania and other serious mental diseases.   Your   chances   Reception   "Prozac"   and   other   similar means to reduce stress are low, although there are other opinions.

 

   YOUR GOAL IS A HEALTHY MIND

 

   Life brings a lot of pain and disappointment. K Fortunately,     most people have more bright in life than bad. Anger, guilt,   sorrow hurt ours emotional and physical health; fun, optimism and confidence strengthen it. Your goal is the mental and emotional   equilibrium that can be found in numerous   ways.   If   work brings satisfaction and joy, if We have a loved one if we look confidently in Tomorrow - emotional difficulties not   There will be places in life, and we will be healthy and informative people.

 

 

   Chapter 5

   PRIORITIES OF MALE HEALTH

 

   Unmanaged factors, detrimental Affecting health include aging, Heredity and Gender (men in this regard)   is worse). Some scientists tend to include Here is also a race, but this   is not true, for harmful effects implied here     are not caused by   the race itself, but social factors such as income, education and dietary Preferences. There's nothing you can do with   the above three factors, but the other five are   quite   controlled: habits, medical care, Exercise, Diet and   Condition Spirit.

   This chapter describes the best strategy   to maintain   health at the proper level. It’s much easier than you think, and 4 short   chapters are all you need to know. V each   section   is discussed   5 factors in order of their importance during Four   Periods   of Life   -   from youth to old age. None of us is perfect, and I am far from thinking   that you will be strictly follow all the recommendations,   but by   deciding   Follow my advice, be consistent. A smoker   who is starting   to physical exercises, without quitting smoking, It is unlikely that he can count on   success.

   Each section begins with   a control   Questionnaire,     which by Counting will help Determine how well you care about your health. I spent a long time deciding what to include in these questionnaires and what the meaning of has a question  ,   and   tried Cover those points that you or your The doctor could have missed.

   As a result, you have a chance to improve your results.     The sum of points is 16 - excellent indicator. You are a responsible person if you scored 14 points or more, 10 or less - very low score. Take the questionnaire seriously, otherwise each of you counts   on yourself   14   with   minimal effort. A good condition health requires a certain difficulty, but (unlike many other parties Life is     a very achievable goal.

 

   IF YOU DON'T HAVE FORTY

 

   Do you smoke very little and on occasional only? (Check yourself three times.)

   - You smoked more, but now you quit?

   Do you practice safe sex?

   How often do you drink? For the measure, do not count more than four     beer cans , or four glasses wine, or two cocktails a week.

   Do you avoid being in the sun? Do you wear protective glasses and visor?

   - Brush your teeth and rinse your mouth Every day? Do you regularly visit a dentist for Examination of the oral cavity?

   Can you hold back your temperament? Do   you have   at home   Firearms?

   Do you play sports as much as I recommend it?

   - Are you normal? (Check twice).

   Is 180 Your Cholesterol Levels Below? (Check three times.)

   Is your cholesterol level between 200   and   180?   (Check twice.)

   Are you disciplined Driver, and does the seat belt? (Check twice.) What You consider yourself a good driver, not take into account.

   Healthy people get more from life Pleasure. Unfortunately,   with the exception of the general feeling of well-being, most of the benefits   of a healthy image the life of a young man - in the future; a man under 40 years old, who scored 16 points, may look like a little better than zero, but in the future this zero   Indicator   will bring   it   The owner   has a lot of problems.

   Over the years, everything changes. You might think,   that man,   only   that he has recovered after a heart attack, feels himself worse than a neighbor who has lost all his teeth, but it is not Definitely. Heart attack, of course, collapses suddenly, but people adapt to this. It is most likely that such   a person   will continue the usual life, slightly depressed by what happened, but most often Without even remembering him. The person who has to wear the false jaw, constantly thinks that it is not so Comfortable as real teeth, and worried, as if she did not fall into Inopportune time.   It is not known   which of these two are more are concerned about their troubles, but   you can    It is certain that someone who has the same There is no trouble, it is much   nicer to live. Take your teeth more seriously.

   Man who wants to live well to 40 years, should   use a seat belt in the car, practice safe sex and lead   a moderate lifestyle. To enjoy life and after   40,   he   You should stay thin and not smoke. Po Traditions, smokers   and   fat people are told that they will die young. This, of course, is an exaggeration. Although   their life expectancy is shorter, many live to old age, the trouble is that it is a life consisting of of chronic diseases.

   Priorities

   1. Habits

   2. Diet

   3. Condition of the Spirit (model of thought)

   4. Physical exercises

   5. Medical Surveillance and Maintenance

 

   PRODUCING GOOD HABITS

 

   Do not buy the bad ones! If you 20 or 30 years, all our warnings will go to the mark, because the young organism adapts to incredibly bad things without feeling their harm.   The man,   smoking   three packs of cigarettes per day, passes through this   period   with   an increasing disturbing cough, but heart attacks are still accidental.   Young   People who abuse alcohol suffer gastritis and sensitive,   "nervous", stomach, but their wrinkled and calfing liver does   not yet make itself felt. Even drug addicts at this age do not complain     Health, if they succeed Avoid overdoses and infections.   My   patients unquestioningly changed their lives for the better after the first deviations in an ECG, ulcerative bleeding or a positive HIV infection test. Although Starting to take care of your   Health   is never    late, a lot of irretrievablely lost in The time   when   your   The body has not yet made it known how tired it is from What you did with him.

 

   DO NOT SMOKE

 

   If you don't smoke, you'll win   the game.   where   the prize   is good health and longevity. If you haven't broken up with   this   bad habit, then throwing tobacco - the most An important goal towards   health promotion.

   With the exception of teenage schoolchildren, I I don’t warn anyone else about the dangers of smoking. Because today everyone knows how destructive it is. In fact, I I am proud that the battle with smoking   is   one of our triumphs: we win in it! In 1966, the smokers were 50% of men, and by 1988,30%, and the decline continues at a rate of about   0.5% per year. In one Beautiful Day of the 21st Century Smoking Finally   will stop   harming our health.

 

   USE CONDOMS

 

   Enhanced support for the idea by doctors Safe Sex in the Current   Decade is not some kind of innovation, but only a correction of shameful neglect this problem. AIDS is only the last   time disease in the chain of terrible diseases, Direct result of   indiscriminate connections. At the beginning of the 20th century, syphilis was much more   common than AIDS today, and led     to further   Increased   inherited diseases, the appearance of freaks and mentally incomplete   people; this ailment even provoked discrimination   against patients by those who were convinced that syphilis affects   immoral people, Deserving of what they got.

   Syphilis and   Now   remains   the most unpleasant   Infectious   Disease   and Mostly distributed among heterosexuals; but     In general,   the list of diseases, sexually transmitted, much more extensive than they can imagine Inexperienced people. Sex without precautions with   unfamiliar people is harmful to health Almost like smoking.

 

   LESS ALCOHOL!

 

   In principle, I have doubts even in the relationship of   moderate   drinks. Thanks to a continuous anti-niotine company, every smoker   knows that he is moving towards a miserable and painful future. But the alcoholic   This prospect is less frightening than a smoker. Of course, The attending   physician may not bother that his patient is an alcoholic, because our doctors Rarely interested in such information. The concept of “moderate and safe smoking” does not exist, but everyone is ready to agree with   That moderate drinking is good and Pleasant,   so   alcoholics   from   the middle classes, we are convinced that they are only   “moderately drinking”.   If you drink every day and will be annoyed, without having once received such an opportunity, it does not mean about that you are an alcoholic, but you have a lot   chances to become them.

 

   DRIVE THE CAR ACCURATELY AND CAREFULLY

 

   Although my young patients are the most afraid of cancer and heart   attacks, for White men under 40 years of age, the main cause of death   is car accidents (for blacks they are in second place).

   Nothing illustrates unhealthy Nature of   the male   sex   Better   than the tendency to die in cars. Partly   It   happens   because,   that men drink more, but even when they are Sober, they are still touchy and irritable drivers who are capable of idiotic   risk. About this Statistics also show. The total number of disasters for men and women is the same, but among the victims of accidents       The death toll of men is twice as much. Having reached the middle age, they begin to drive   more prudently. Young men with good vision and rapid reaction have   the same level of risk of disasters as the elderly 75 years and older.

   Catastrophe may not happen due to your fault, It doesn't matter if he's involved  your testosterone or not - in any case, using   the belt   safety reduces the possibility of getting half the injury.

 

   AVOID EXCESSIVE SOLAR RADIATION

 

   Excess sunlight damages your   skin,   causing   premature aging and wrinkles, sometimes even skin cancer. If you are subject to   the recommendations of specialists to accept Sun baths in moderation, then this risk will decrease. If you have read that sunlight is necessary for the body to produce vitamin D, this is only true if You don't get it in the diet.

 

   CLEAN THE TEETH AND SQUEEZE THE MOUTH AFTER EACH RECEPTION OF FOOD

 

   I know it sounds trite, but you I would   be surprised to   learn,   How many men carelessly relate to such   a recommendation,   and     As a result, dentures in middle age are guaranteed. They nod calmly when I ask if they have bleeds after   a strong one   massage with a toothbrush, as if it is normal phenomenon, but     on the   It   is a sign of chronic inflammation of the gums.   So   Time  , inflammation destroys the holes, the teeth loosen and eventually fall out.

   It is necessary to rinse the mouth with dental elixir. Toothbrush     never cleans the cracks and recesses between teeth - it does not penetrate them. When brushing your teeth, carry with a brush and language. This   will prevent the appearance of harmless, but ugly spots and   reduce   bad   breath. изо рта.

 

   DO NOT IGNORE THE DIET

 

   Balancing diet is not difficult; do full - a little   more complicated, but the winner will be the absence of heart attacks,   Reducing   the risk of cancer, etc. It's worth it.   Re-read     Chapter 2 again.

   In addition to improving health, the diet should maintain   the slenderness of your figure. Many men after 40 years begin     Gaining weight  . The Stomach of a Man middle age still somehow explain, but to the signs of obesity in a young man You have to take it seriously right away. Like   smoking, obesity may not cause special worries for several decades, but will cause great troubles later. Young man with   overweight at risk of getting cardiovascular disease and   high blood pressure. Even more risk of getting diabetes and arthritis,   making back pain and calluses, as well as acquire a lot of other depressing   diseases. Young people think little about it, but   mine   more   Senior patients are very concerned about the fight against such ailments.

   Losing weight is quite simple, although not I'll say it's easy. Need   to be half reduce food intake and exercise (see chap. 3). If you continue to gain weight, then   obesity in your genes, and the fight against it is always will be difficult. You can make it a little easier, continuously engaged in sports - get rid   of about 4 kg is easy for almost any diet; with the help of prolonged diet tablets can be dropped to 8 kg, and even the severe flu contributes to this Weight loss. But then dietary measures become   Ineffective.

   Your brain, alarmed by fat loss, assumes that you are   starving (every previous history of mankind, such   an assumption would be correct). Trying to protect you, the brain slows down the metabolic processes, As a result, a diet that lowered your   Weight  , it is   possible to provide you with all the necessary calories.

   You can keep losing weight, still reducing your diet, but it is not the best advice for a person, Aspiring to lose weight.   Initial enthusiasm evaporates, constant oppressive feeling of hunger   is endured with difficulty, and pills for reducing Appetite is no longer   valid. Most lose weights give up during this period. The solution   to the problem is only physical exercises. Why - I'll explain later.

 

   CONTAIN CONTACT!

 

   Although psychologists warn that Remove emotions is dangerous, relative to young people I adhere to the opposite opinion,   encouraging them humble your temper. This to some extent protects them from the risk of murder or suicide, become the culprit   of a traffic accident or get a production injury.

   It may seem strange that I I'm talking   about   the murders     due to   health problems, But forced death in the United States occupies the 12 th   place in the list of causes of death, and among blacks Men of this age group is the first. S Crime as such is not related   80%   of the murders that   are the result of quarrels between relatives, friends   or   random acquaintances in bars, on the streets, etc. Unlike   women   Men   are more tempered and more likely to show other features of their   evil   character, quickly move to gross actions; in In this case, hormones definitely play a role. Athletes and bodybuilders taking men   Hormones   are additional, become more irritable and excitable.

   Murders are adamant to the same extent, As   well as   cardiovascular disease. You will never encroach on Someone's life, if:

   - you will not have a gun (apparently, this the main precautionary measure);

   - leaving the house, you will not take with you no weapons;

   - you'll be careful when drinking in men company;

   Mindful of the possible consequences, try to pass   by   the ears of prickly and avoid provocations.

 

   ENGAGE IN SPORTS

 

   In addition to the fact that physical exercises healthy, without   them it is almost impossible to lose weight. An active man is usually thin.

   If you don't have excess weight, give it away priority of healthy habits   and good nutrition. If you are easily excitable or   quick-tempered,   Try to develop peace in yourself. Re-read sections about physical exercises in Chapter 3 and think about it.

 

   KEEP FOLLOWING HEALTH

 

   Hypertension does not particularly complicate   life   Men   to   Achieve   they are middle-aged, but it cannot Call a   rare   phenomenon.   Despite   the almost unanimous conviction of doctors, certain symptoms accompanying There is no high blood pressure. And to his   Measure,     you don't have to be A professional. I recommend you do this every 2-3 years.

   Death from cancer is 1/7 part deaths   from accidents and half of the number of murder victims.

   In relation to young men, only   one     the type   of cancer deserves special attention: testicular cancer, reaching a peak   of them   and decreasing in the group of men of average age. With early   recognition, testicular cancer is almost always curable, and it is quite easy to identify it. For men Monthly test-checks are as mandatory as breast self-examination for women. Most thickenings and seals are usually   not malignant, but all of them It is necessary to examine the doctor.

 

   IF YOU ARE IN THE FORTY

 

   Do you smoke very little and on occasional only? (Check yourself three times.)

   - You smoked more, but now you quit?

   Do you practice safe sex?

   How often do you drink?

   - Brush your teeth and rinse your mouth Every day? Do you regularly visit a dentist for Examination of the oral cavity?

   Can you hold back your temperament? Do   you have   at home   Firearms?

   Do you play sports as much as I recommend it?

   - Are you normal? (Check twice).

   Is 180 Your Cholesterol Levels Below? (Check twice.)

   Is your cholesterol level between 200 and 180?

   Are you disciplined Driver?

   Do you regularly visit your doctor?

   - Are you married (or have a permanent cohabitant)?

   Do you think your life at a   lesser extent   satisfactory; you work; money is not the main thing; you rarely   happen   Lonely? At the crossing of the forty-year mark Priorities are changing.   As   you can see,   The paragraph   on protection against   suns,   car accidents   become statistically less important, so the question of them is asked in abbreviated form. If you personally prefer to behave risky, then   this danger is for you persists.

   If you don't smoke, you have a huge advantage over peers, but with age health Begins to   depend   on and   from   other   household   circumstances, as well as the situation in society and the degree of confidence in myself.   The loss of a spouse can be noticeable shorten the life of a man; women   This   grief is much easier. Unhappy men often get sick and,   it happens, cum with themselves, and degree such events increase in proportion to the age, but women are persistent continue to fight   against   fate.   In this age group, medical Service begins to play   a noticeably greater role in maintaining health than in the previous one.

   Despite some external signs aging during this period men remain relatively healthy, with the exception of persons who are distinguished by unbridled and risky behavior.   Smokers     Most   Affected infarcts and cancer. Even the most   an inexperienced   doctor will suspect alcoholism in healthy patients in other ways if his attention will be attracted by disorders in the liver or chronic diseases of the digestive tract. For most men at this age, unhappy Cases and murders continue to remain   leading   causes   of death up to about 50 years, and then as such begin to be dominated by cardiovascular diseases and cancer.

   Priorities

   1. Diet

   2. Physical exercises

   3. Habits

   4. Condition of the Spirit (model of thought)

   5. Medical Surveillance and Maintenance

 

   PAY ATTENTION TO THE DIET

 

   While you are healthy, good food   will bring   You're   more   useful,   than a doctor. Your goal is to, If   possible,   not   change   compared to young people: stay thin and maintain   low cholesterol. Reduce salt intake.     At the end   a day  , especially spent on the legs, you may notice swelling on   ankles   and maybe you will think that these are traces of Rubber on the socks.     In fact, such swelling appear because veins on the legs are tested high pressure when you stand or walk, and with age weaken and become thinner, leading to the outflow of fluid to nearby tissues (retardments). In the morning, getting out of bed, you will find that The swelling is gone. This is not   a sign of deterioration of health and no symptom of an increase in blood pressure   (it   affects the arteries, not the veins). You can reduce swelling by   consuming less salt (and not water!). Sounds like paradoxically,   but   superfluous   the amount of water does not cause edema, since the kidneys immediately Remove   it.   And in excess of salt Kidneys are forced to retain water     in the body   for   its dissolution.

   In adulthood, it often increases blood pressure, and many other indicators may exceed the norm, so that reducing salt intake, you will probably kill with one blow Two birds.

 

   PRODUCING GOOD HABITS

 

   Alarmed by the appearance of the first signs growing tummy,   wrinkles or baldness, men who led mostly a sedentary lifestyle, often rushing to the other extreme, after which they barely crawl to my office with dislocated or stretched ankles, muscle ruptures or back lesions. And they do the right thing by addressing me.

   At the initial stage, treatment usually requires a little time,   and besides  , I can encourage them and give an incentive to further classes. Still, I advise everyone to start with walks or jogging.

   Fortification marks the last period, Released to you for   best results from a health care program.   None   The amount of sports can not return those at first, imperceptible but   irreversible losses that the bones and muscles of any person carry from about   35   years. Regular physical training Exercise slows down the process.    At this age, smokers develop chronic pulmonary   diseases; tests Respiration Detects a Decrease in Lung Volume   and   increased resistance to air flow in almost all of them, including those who do not yet have visible symptoms. So if you smoke, leave it now.

   For those who do not smoke, safe driving Machines and   Safe   Sex Are Best Opportunities to maintain good health before   onset of middle age.

   Continue to clean and rinse regularly teeth and do not overheat on The sun.

   During this period, you begin to think about the price of your life. Probably more likely All, she was not continuous triumph, and, since men, as   rule, focus on your shortcomings, you may come to The conclusion that life failed. In relation to men, such feelings   are usually called "A Midlife Crisis."   Women   call   it   Depression, which, in my opinion, is more correct.

   Emotional pain weakens a person no   less   physical,   and   try to live by adapting It is as   unreasonable   as   Trying to walk on a dislagged leg or ignoring Chest pain. As with   many physical diseases, you can try "home"   methods   treatment, but if communication with friends and attempts to pull yourself together not Help, professional help is needed. To get out of the crisis, men could turn to their strength of spirit, but in such This is usually   useless, as well as treatment of physical illness. Moreover, medicine today copes with the adjustment   Psychological   disorders   are better than treatment cardiovascular and other serious diseases.

   Be honest with the doctor. Don't go to him only for   the sake of a physical examination from the head to the toe. If you feel emotional discomfort, you   say so.   Many   Doctors   are really   testing   difficulties, meeting with heavy emotional disorders, and   are   incompetent in the treatment of diseases of the average Gravity.   In any   case,   your doctor will certainly recommend to contact to a specialist and will help   to find him.

 

   FIND A GOOD DOCTOR

 

   If you still don’t have your own doctor, find a suitable candidate and arrange a meeting for a preliminary Examination (see   chap.   12). Your most important goal is the assertion of yourself in   the quality of   a regular patient of this doctor. Doctors are usually more   attentive     to such patients, and this is exactly what you want.

   The first examination will allow the doctor to make your anamnesis (history of the disease), Determine and Describe Your current condition.

   From 40 years to the end of their days Every year you examine the rectum. It is from this age that the risk increases Get the most   common among Non-smokers disease with a deadly   outcome is     rectal cancer. V the range of the doctor's hand is only 10% of these tumors, but he can take a smear from the finger special plate and drip on it with a reagent that detects the presence of even a very small amount of blood in the stool. Many tumors rectal provoking small bleeding, and this test contributes to the early detection of such situations. The doctor also probes your prostate (prostate) in search of seals, which may be malignant tumors - an unlikely find at this age, but quite possible in the future.

   Only a very meticulous doctor at the first acquaintance will be ordered to conduct laboratory tests (only one is necessary - Cholesterol), so you may have to go through several sampling of blood and   urine samples, X-ray of the chest and ECG.

   Justifying your love for excess tests and tests, doctors usually   claim that they you need some basic information about the patient, the record   from which they could be checked upon Detachment of changes.   For example,   if the patient feels the tightness in the chest and in its ECG will be found deviations, then if it coincides with the previous one, they say, there are no grounds for   special   Anxiety, but with negative dynamics, there is cause for   concern.   The disadvantage of such arguments is that the patient should always and Carry copies of these records with you everywhere.

   You should visit an   ophthalmologist   for   normal   inspection   vision, including a glaucoma test and then undergo further examinations with the intervals that he will indicate. Glaucoma the Result of Pressure Lifting Intraocular fluid - causes progressive blindness, without giving   No other symptoms.

   The medical examination will continue by your examination testicles. Cancer tumors   of the testicles are the most common in men aged about 35   years,   but   after 40 too are a serious threat.

   You can buy one of the pharmacy Hardcovering kits for detecting hidden blood in the stool (symptom of rectal cancer). It is very simple to use it: if there is at least a small amount of blood in the stool, reagents     on a card Change the color. Check yourself three times a year. Do not panic  , detecting a change in the color of the indicator. Anything that can   bleed (including hemorrhoids, benign polyps and ulcers) gives   a positive test result, but cancerous tumors are confirmed   in   5-10%   of cases   and usually small and curable.

 

   IF YOU ARE IN 50

 

   Do you smoke very little and on occasional only? (Turnche of yourself.)

   - You smoked more, but now you quit?

   Do you drink often?

   - Brush your teeth and rinse your mouth Every day? Do you regularly visit a dentist for Examination of the oral cavity?

   Do you play sports as much as I recommend it? (Check twice.)

   - Are you normal? (Check Twice.)

   Is 180 Your Cholesterol Levels Below? (Check twice.)

   Is your cholesterol level between 200 and 180?

   Do you have a permanent doctor and do Is the annual medical examination? (Check twice.)

   - Are you married (or have a permanent cohabitant)?

   Do you think your life is at least Measure, satisfactory? (Think twice.) Unhappy cases, road violations and   sexual relations are excluded from the questionnaire, but do not try the fate in relation to these moments.   Medical   care   has become     much more; has increased and The Role of Public Life, as well as the Emotional   state.

   Some middle-aged men Make a sudden decision   completely follow my advice: improve nutrition, quit smoking, start   practicing   Sports,     etc.   Must   with   regret   Most    of them take a delayed measure  .     Many   have already   There was   at least one heart attack. Now they are led by fear for their lives,   and , although all the actions will benefit them, early   Prevention is much better. Think about it until It's late.

   Your body shows natural signs aging, but do not   draw from this conclusion that everything rolled under the mountain. Men of this   age group are less likely to suffer from common colds and viral diseases of the upper respiratory tract, perhaps because they are caused   approximately   Hundreds of viruses, and by this age you have acquired immunity to most of them, after pain before. Many unpleasant diseases to this age are overwhelmed by themselves - allergies, migraines (headaches), pimples, acne and other chronic Skin diseases.

   At one of the first places in the scale of priorities medical   care is provided, so How diseases have a more serious impact on your body.

   If you have followed my advice, then in this period you will begin to feel the results, but never forget the fact that the human body is not perfect, but life unpredictable, and in many     of its inconsistencies your guilt is not.

   Priorities

   1. Diet

   2. Medical Surveillance and Maintenance

   3. State of the Spirit (thinking warehouse)

   4. Habits

   5. Physical exercises

 

   DIET AND MEDICAL STUDY

 

   The diet we discussed in Chapter 2, the best, regardless of age. The main thing is to follow at the level of cholesterol.

   When you turn 50, agree   on     Sigmoidoscopy. If your doctor does not follow this procedure, visit   the gastroenterologist who will enter into your rectal through the anus flexible tube with a diameter with a little finger to a depth of 50-60 cm for the search for cancerous tumors and precancerous polyps. This is a good test for early Diagnosis of tumors.   Specialists still are arguing how often it should     be carried out;   Most doctors are advised to do this every 3-5 years. After passing such   an examination,   I found it quite Tolerant. You   must   continue   annual   rectal surveys as well as regular   Measurement of   blood   pressure   and cholesterol levels.

 

   PREVENTION

 

   Aspirin pill, taken daily, reduces the risk of a heart attack  almost all men for 50, however,   at the expense of   a small increase in the number of strokes. Contraindications: low cholesterol (below 180), stomach ulcers or Dubohysical intestine.

 

   DANGERS OF TOO DETAILED EXAMINATIONS

 

   Even if it means,   during the   the annual   medical examination   should not pass all Possible tests. A few simple measurements (temperature, blood pressure) have 100% accuracy, while more complex, using chemical reagents or devices, less often provide reliable result. Accuracy of the ratio of 95% is considered acceptable. In other words, the test may accidentally identify deviations in   Verification   of Completely Healthy a person, as well as to give a normal result in a sufferer serious disease. If you think about all this, it turns out that the worse you feel, the better the test will work.   Conversely, the stronger your health, the less reliably and   adequately   Tests   will reflect your objective state.

 

   PERCEIVE LIFE CORRECTLY

 

   Many men are convinced   that     They   have   Opportunity to   become a superman. As a result, they are beautiful     Feeling   when   everything goes as they want, but any A misunderstanding can completely   knock them out of the rut.   Men   for   50   to endure   life     failures (collapsed career, dismissal, divorce, financial losses) are much more painful than in their youth. There is less time left to restore the destroyed, and if the same failure fails you several times,   you   start   thinking as if over you There's a curse. (In fact, you simply did not draw the proper conclusions from previous mistakes, and this is an undoubted sign of   belonging to the human race.) Several failures in a short time can be convinced   of   own   imperfection.   And   if the   only alternative to the ideal is the path of deception, injustice   and   other charms, then this man Really in trouble.

   A man who begins to perceive himself as The mistake of nature is   actually seriously ill, and in this case, the doctor can provide him with effective   assistance. Depression has no specific bodily signs, but   nevertheless is a physical ailment - a brain disease.   Medications   cure   of most depressions for several months (the electroshock acts faster, but it is not in fashion now). Consultations with a psychotherapist   will help to relieve the soulful pain, healing powers of your own body, too   will play a role.

 

   HABITS

 

   In this age group, people already well-established life, so you need to develop useful habits earlier. In this Age begins   to show results as positive (absence of abdomen, good,   and own, teeth, endurance), and Negative Habits   (heart attacks, diabetes, hypertension).

   Think about the contents of the first-aid kit in which You had to rummage   at the last party. In my youth, I sometimes had such a need, and   there was rarely something more interesting than contraceptives, scattered pills or Medication of headaches. Today in the first-aid kit   You can find whole collections sleeping pills, tranquilizers, laxatives, stool softeners, skin creams and remedies to improve digestion and not Because all the inhabitants of the house   Seriously   ill.   Usage   These drugs are an attempt Combating   Ageing of   the Body   in the hope of making him work as much as before. Despite     some effectiveness, long-term The use of such means   forms Habits that     are hard   Get rid of it.   Good   habits   not so much contribute to the conservation and prolonging life as much easier to live. You will never have constipation and Insomnia.

   If all your life you have been passive and slow, then take care of the first four priorities. Think about About   Golf   -   this   is not a physically developing game, but energetic enough to activate organism. Deciding to play sports, buy one of the books dedicated to walking or bicycle, and appreciate your strength: will you be able to regularly implement programs. I AM I do not insist here for more energetic   sports like tennis or jogging, but if they still   attract you, do not start classes without consulting a doctor.

 

   IF YOU'RE FOR...

 

   Do you smoke very little and on occasional only? (Turnche of yourself.)

   - You smoked more, but now you quit?

   Do you drink often?

   - Are you normal? (Check Twice.)

   Is 200 Lower Than Your Cholesterol Levels? (Check twice.)

   - Do you have a regular doctor and pass Is the annual medical examination? (Check yourself twice.)

   - Are you married or have   a permanent   Cohabitant?   (Ask   yourself three times.)

   Do you think your life is at least     satisfactory? (Think twice.) You can't prevent all the troubles,   so   medical supervision and maintenance are on the list of priorities First place. You must have a permanent The attending physician, and you   must   undergo a medical examination every year. There are many things with us troubles that can be corrected if you take up it's on time, and the sooner   they'll find them, the easier it is to deal with them.

   Priorities

   1. Medical Surveillance and Maintenance

   2. Condition of the Spirit (model of thought)

   3. Diet

   4. Habits

   5. Physical exercises

 

   MEDICAL SERVICE

 

   If you still have not Cardiovascular disease doesn’t mean you can Allow yourself to do whatever you want. Many   doctors   do not prescribe blood to the elderly for cholesterol for the   reason,   that they can not accept those who reduce it the level of the drug and should pay special attention to food. On the other hand, doctors are usually more willing to   A lot of other laboratory tests are prescribed to the elderly, despite Lack of evidence of their effectiveness. Try to understand that.   Your doctor is probably younger than you, and young people are convinced that   old people are always more unhealthy than at the case.

   The only indisputable study for All doctors   are   an annual urine test. The laboratory immerses himself in a urine sample a long strip of   paper, covered with chemicals. Each section of the strip changes color in   the presence of blood, sugar, protein, bile and several   other   substances. This test quite reliably reveals the early stages of renal   diseases, urethra cancer and Uncompensated diabetes (more detailed reasoning You will find a urine analysis in the head. 12).

   Although the rectal examination is still be sure to all other stages of your annual medical examination will   depend on   from     the decision of the doctor.   You have to understand why I am in this case I put     medical care and supervision in the first place. The reason for this is not the prevention   of diseases (We, of course, are still trying to prevent the emergence of new problems) and not even early detection of diseases,   Although   its   role is increasing.

   You need the services of doctors mainly Because at this age timely diagnosis and Treatment can save lives.

   Because your doctor is likely to prefers to act as a healer, do not deprive him of - such an opportunity. My elderly   patients are not doing the right thing in this sense. One of them, for example, calls   me several times a year with complaints of abdominal pain that lasts for a week. He stubbornly says only about constipation, dietary advice   or medications that are immediately will help. I insist that he necessarily came to the reception, because this person about three times during the time that I was flying him, needed surgery    about the gangren of the intestine and can in the case of Relapse simply cannot survive.

 

   STATE OF SPIRIT

 

   Man who has reached the age of 65, with equal odds can live     to 80  , so old age often   It is the     longest   period of life. And although old age can be as satisfying to a person, Like other stages of life, however, at this age, completely special types of stress are possible.

   Some of them are best avoided. According to my experience, few old people are concerned thoughts of death, but much   more   worried   about diseases, pain and impossibility Serve yourself, that is, all   that of death precedes. I can't promise that all this will   not happen to you, the same, How can I not assure a 50-year-old man that He'll never be a heart attack. However, following the advice   given in     this book, and maintaining a good relationship with the doctor,   you   can   be sure that you have done everything to facilitate   your   future.   Now focus on the present.

   Avoid loneliness. If you don't have spouses or companion,   get acquainted with suitable person. Try to,   to   your   work   or other day-long activity took place in The environment of people.

   Women tolerate loneliness better, although do not like him, but   men are heavier They're doing it. Ice men or widowers are more   prone to heart attacks than married men. Number suicides among them are 3 times more than among married, and 19 times higher than among   married   women. You can assume that for Maintenance of health for a man   is necessary a wife providing normal food, hygiene in the house and general   psychological support, but even the presence of   a male companion   already   changes the picture. Even those who have wives die (The most   stressful   situation   in the life of men), able to preserve Health if they don’t live alone.

 

   DIET

 

   If you haven’t followed a diet, Protecting from atherosclerosis,  It's not too late to start. At the same time, it should be realized that the main cause of the violations diet in older men - it's mostly   the only,   erroneous considered general and for all   other   groups,   the reason:   Poor   food. Usually this is accused of a lack of funds or the absence of a woman   who would cook food, because Most men   who have   difficulty with diets have no money, no wife.

   There is a certain truth in these statements, but   the mentioned   factors   very moderately affect the quality of food, Because   the best   diet   Usually inexpensive and does not require much trouble. Two Hours Spent on   Cooking from natural, whole products, will provide you with   lunches or dinners for a week. Fruits and cereals are great breakfast. Elderly people   begin to suffer from poor nutrition, if A long-time student not   to pay   attention to it or Slowly adapt to changing life circumstances.

 

   HABITS

 

   We don’t even know how everyday life is full of habitual actions, and we begin to notice it only then, When with    Age, the body functions less intensively and   irregularly.   Son   becomes shallow and intermittent, digestion and metabolism slow down, the intestines are emptied less often. The ability to erection decreases.

   Don’t try to force your body work with   the same   clarity. Go to bed when you want, eat, feeling hungry, go to the toilet when there is a need. Do not try   to observe the former usual schedule, if there is no real desire   to lie down   sleep, eat, etc., wait until it will appear.

 

   EXERCISES

 

   After the Second World War, doctors are still very Long-term treatments for many   childhood diseases (such as rheumatic polyarthritis   or   polio), for months holding the patient on a strict bed rest mode. Now we   understand how harmful it is, but Fortunately, children are usually easily adapted and can withstand long periods immobility without harmful consequences. However, if you are over 60 and you are forced to Be in immobility, special measures are needed.

   During these years, any incident leading   to   prolonged   immobility, may be the beginning of the end. From time to time one of my elderly patients Receives a very curable hip fracture. Such fractures heal themselves, and if this does not happen, a femoral prosthesis is installed,   which works perfectly. And yet Most of the elderly   who have suffered a fracture the hips become forever weakened,   and   the reason   for this   not injury, but several weeks of forced Staying in bed.

   In old age, exercises are not needed as a preventive   measure, and as a necessary tool to maintain bones, ligaments and muscles in the working condition. Without gymnastics,   without   activity   muscles   dry,   ligaments harden, from the bones Calseum is washed out, and the intestine becomes sluggish. Therefore, conduct less time in bed.     Move more,   Walk more often.

 

   MANAGE YOUR EMOTIONS

 

   From time to time, every man is probably Looking back at the the way and trying to get Answers to questions like: "What have I spent my years on? What did I get? What is the value of my life for society and my loved ones?” He is constantly trying to compare himself today with   the person I dreamed of becoming.

   Men make up only 30% of the total Patients   seeking psychotherapeutic help. Maybe there are actually more. Many men who are not satisfied with life burn their own emotions with which they Unable to cope. As compensation, they often choose not the help of a doctor, and other common (and malicious) methods   Getting rid of stress. Men abuse alcohol and drugs in 3 times more than women. Number of suicides among them also 3 times higher,   and more than 90% of serious offenses are committed by men.

 

   HOW TO AVOID SOME STRESS

 

   In the areas of priorities for   We   discussed five main areas leading to the goal. I checked them on myself. My excellent health in far from a young   age is not yet proof of the correctness of my advice (personal   statements are worth nothing, although there are very the colorful). However,   you   have the right to expect from the adviser, to follow his recommendations,     And that's what he's talking about.

   My philosophy is that life really full of pain and Disappointments, but good in She's bigger. Because the main   Sources Emotional Difficulties Are Relationships with   people   and   Success in  I have identified two tips in separate   subheadings. Of course, there are a lot of others recommendations     on this matter,   but these are easy to assimilate and perform without prejudice The self-esteem of most men.

   Learn to answer "no", not Feeling guilty. Relationships with others are often accompanied   by the most   strong   emotions,   and   Most of these relationships,   as a rule,   It is written   (  verbal). Almost everyone feels here Difficulties, the consequence of which   is many books and psychotherapeutic schools,   designed to   learn communication. In the lists of bestsellers of the XX century you can always   find very attractive Titles - from "How to get friends and   attracting people" to "Little book with instructions, how live.” Such publications are too optimistic, but usually very realistic.

   But avoid the authors who tell you, How to Win the Controversy,   to Do Successful Negotiations and so on. First, these things are almost   It is impossible to learn, and secondly, and this is the main thing, Productive Interaction in No Way includes the concept of victory or   defeat.   It is much easier to choose the average - honestly express your desires, not allowing to manipulate yourself. Almost every person experiences discomfort, denying a request, unexpectedly changing their opinion, allowing yourself mistakes, causing criticism or creating inconvenience to   it,   who   has   to serve it. Authorities in this area advise how   to overcome such discomfort, but I I am convinced that this is best taught in   Schools   of Behavioral Therapy, Where The course is dedicated to self-confidence training.

   Plan your life goals in advance. Show the will and firmness in     their Achievement and Fast Rebuke when they change. Men who want to achieve execution their   desires are   faster,   often   become criminals or drug addicts. Those who are ready to wait, turn to books and seminars explaining the ways to achieve the goals. Their Attraction For men, such is the attractiveness of dietary guidelines for women.

   It is no exaggeration to say that everyone The Man Who Puts   Before Him reasonable life goals, may well   to achieve   them,   although   This will require a lot of effort.

 

 

   Chapter 6

   AGEING CAN BE OVERCOME

 

   No animal and almost no man They die of   old age.   We Dying from Diseases or injuries sustained from the outside and internal.   But  , although the functions of our body with age gradually   slow down,   Physiologists It is believed that the main bodies could Support life for up to 120 years.

   Changes in the body accompanied   by discomfort   or   loss of functions, such as sexual, people blame the aging   process, most often considered as a steady and merciless path   to general destruction organism. This   is an exaggeration.   Most   failures of the functions of the body are caused by diseases and Almost always     averted. You already know about the increase with years of age infarction and     strokes caused by hypertension and   cholesterol accumulated on the walls of blood vessels. Ageing in these cases is innocent. But with age, the number of cancerous tumors also increases, which, on the one   hand, is associated with environmental toxins and unhealthy    life,     and on the other - weakening immune system, characteristic of the senile organism.

   In this chapter, I will try to talk about, What surprises are there Waiting with age. But in First of all, you   should   know,   which   of these phenomena can be considered insignificant.

 

   THIS IS A SIGN OF GETTING OVER!

 

   The idea that the body with age wear,   -   not   More than a myth. Only teeth are worn out and joints. When this happens to the teeth, modern comes to the rescue technology that perfectly   protects   them (sfills, crowns and T. p.).

   Much more complicated replacement procedure joints also gradually   become Acceptance. Replacement of the knee and femoral joints     to date, it has become a common practice, and in part of other joints  , the research has advanced far enough.

   Skin, bones, nerves, eyes, heart, kidneys, intestines, etc. are less   susceptible to wear with constant use of them for natural use. It is impossible to accelerate the loss of vision by intense   reading,   and   the heart will also not give up ahead of time if you force him to pump more than   the average volume of blood.

   Let’s see what’s going on with the data organs, how to slow age-related changes, and in cases where it impossible, how to deal with the consequences of aging most effectively.

 

   WHAT HAPPENS TO THE SKIN

 

   Despite the popular opinion, the external   surface of the skin   (epidermis, see Chapter 9) changes with age quite moderately, so   wounds heal not as quickly as in a while, scars after wounds are thinner and less noticeable. The skin becomes drier as dead   surface   The cells do not pass moisture.

   After 30 years, the inhabitants of the Caucasus, for example, Lose about 20%   of pigment cells (melanocytes) over a decade.   Melanocytes   scattered   in   the lower layer of the epidermis of each person, for the exception of albinos, as a result of exposure to solar radiation, are divided - This is tan. With a uniform distribution, they form a pigmentation of the skin and hair color, and   their accumulation leads to the appearance of freckles and birthmarks. About it   and   other skin conditions read in more detail in Chapter 9.

   Because of   Deficiency of   melanocy   senile   the skin    becomes    more sensitive to adverse effects of   the sun   (increases   risk of skin cancer), hair There is a gray and eventually gray. But early gray hair is not a sign of premature   Old age and often observed in quite young and healthy people.

                                          Table 3

Inevitably and irreparably inevitable, but can be corrected    Not related to age

Hairborne                       Osteoporosis                 Atherosclerosis

 

Farsightedness (Rest of    Tension to Increase            Shaking

Glasses for Reading)         of weight

 

Replacement Muscle           Loss of Endurance              Loss of Dental Loss

Fibrous Fabric

                                          Baldness                                       Zapod

 

Slowdown Passage

Food by intestinal        Decrease of erection and for -           Impotence

                                          Slowness Ejaculation

 

Increase Protest                               Wrinkles from the impact

Glands (prostates)        Senile stains on Skin of        the Sun

 

                                          Deterioration Short-term       Hypertension

                                          Memory

The Appearance of Wrinkles the   Loss of Heart Reserve       Decreased Intelligence

Abnclosure Connective tissue

 

Deterioration of Memory      the Cancer Tumors              Infarctions

Names

                                          Deterioration                       Slepomot's vision

 

Loss Skin Elasticity Deterioration of          Deafness

Cataract            Decline Immunity             Strong Immune

                                                                                            Insufficiency

   Most of the age-related   skin changes   occurs   under   the epidermis. The dense connective tissue loses its elasticity and cringes, creating wrinkles on the surface. Elderly people easily appear bruises and   visible subcutaneous Hemorrhages. This is due to the fact that the subcutaneous blood vessels become thinner, and the blood flows out at minimal   damage to their walls. Subcutaneous fiber also decreases     in volume.   This   tissue consists mainly of fat and serves   as a heat insulator for the body;   that is why the elderly More sensitive to cold.

   Decreased immunity increases susceptibility of   skin cancer,   reduces the inflammatory response to solar radiation. Most   of the   Sunburn is the result of this reaction, Not a burn as such. Elderly people can be in the sun longer young, without the risk of getting The burn, but not to do it should, because it may occur   other   skin damage.

   Older residents of Sweden look younger Italians of the same   age. A person who has been wary of the sun all his life could slow down skin aging by 70-80%. However, if you haven’t avoided the sun before, it’s not too late   to start doing it today. Authoritative specialists advise patients   maintain moisture of the skin, use good soap and after washing   to apply mitigating creams and emulsions on the body. These measures do not slow   too much skin aging, but reduce its consequences (dry skin, itching, etc.).

 

   CARDIOVASCULAR SYSTEM

 

   A few years ago, physiologists abandoned it is generally agreed that the minute volume of the heart (i.e., the volume of blood, pumped in one minute) from 30 years of age begins to decrease by 1% per year. Corona   atherosclerosis was so common in a weak degree that their findings were based on studies of the mass of people of almost sick   people.   Recent studies of a healthy heart do not reveal almost no reduction of minute volume associated with   by age.     Reduces only   the maximum possible frequency of his impact: you can calculate it, subtracting from 220 its age (see chapters. 3).

   Like the skin, the arteries contain rubber-like connective tissue, which over the years hardens, reducing the elasticity of the vessels and increasing their resistance to the flow of blood. As a result, it slowly decreases volume   of circulation. The 80-year-old stream Blood through the Kidneys Decreases   twice,     and through the brain - by 20%.

   If the flow of blood through the kidneys and brain falls before   the   above values, you will not even feel it, Because all the functions of the body have a huge natural reserve. The Man, working with an average load, almost needs only in a quarter of the work performed   heart.   The other three quarters allow it, for example, enough   Actively   engage in physical exercises, as well as used with additional loads as a result of certain diseases, accidents and   even surgical operations. Ageing has little effect on everyday activity, but noticeably reduces the ability to withstand stress.

   Active Exercises Lower Tempo Volume the heart at   rest from 25% to about 16% of the maximum.

 

   LUNGS

 

   Like the tissues of other vital organs, lung tissue with   age also slowly decreases in weight and volume. Healthy lungs of an elderly person It is about 20%   lighter   than     In his youth,   and   Their size   is smaller.

   Due to the elasticity of the lungs process air inhalation is similar to pumping a balloon. In the expansion of the breast cells are involved   muscles, while the air is absorbed into the lungs, but exhalation does not require   any   effort, you just relax, and at the expense of   your own     the elasticity of the lungs are compressed, expulating the exhaust air outward. Age affects    elasticity of the lung tissue as well as on all other tissues of the body. Breathing requires more effort, and oxygen is slower diffused through hardened lung tissue. In combination with a reduced volume of the lungs, this leads to a slow decrease in the oxygen content in the blood.

   Ability to physically   work     70-year-old   man   half less than a 20-year-old, but still It's pretty big enough.

   From Chapter 3 You Learned That the Feeling Lack of   air   in the   Exercising exercise indicates that the heart is not able to deliver to the muscles the necessary The amount of oxygen. However,     the lungs   They continue to supply oxygen more than enough. But at some   point the   light of an elderly person is already Sports are young. The active muscles cringe more slowly, so never should not stop the exercises,     It’s never too late to start them. Maybe it's   and   will not   extend   your   life (women play sports less, and live longer), but, in any   case, will make her standing in order to live.

 

   BONES

 

   Muscle cells increase in volume, shrinking, aging and   dying, but not multiplying in the number. Bones behave differently. From   birth   and to death they constantly absorb various   substances,   dissolved   and because of this are reformed (meaning and size), so the cells that make up the bones, There's no time for ageing. The process of formation prevails until late adolescence (absorbing exceeds the resorption), so the skeleton increases in size. During the early adult life period, the mass of the skeleton remains more or less unchanged, and then, after about 40 years, the resorption begins to exceed formation, which leads to a gradual decrease in the total mass of bones (this process is called osteoporosis) by 0.3-0.5% per year. Man       By old age, about 20-30% of the skeletal mass is deprived, women - up to 50%. They have this process begins Previously and proceeds faster. Men must also take into account this factor, because as a result of   Osteoporosis   increases the number of fractures in the elderly.

   Do exercises, do it on your feet at least 3 hours a day and follow your diet.

   Bones, like muscles, from exercises Strengthening,     and   Long term Lack of loads atrophy. V different   from   muscles,   Bones   need only in exercises with weight load (swimming, for example,   does not bring them any benefit). Bed Rest The regime   can   become   Disaster   for bones, especially in the elderly. Studies have shown, that patients who remained in bed for 9 months were lost   during this time The bone mass, equivalent to the usual loss in 10   years.   Being   relatively young and healthy in others relationships, they restored the lost bone mass, but it went also 9 months.

   Exercises for people chained to bed, given in     some manuals, strengthen the muscles and help improve blood circulation, but do not help bones. Scientists, finding that astronauts in the conditions of Weightlessness lose bone mass, prescribed them daily physical exercises, but they turned out to be useless. The skeleton, like   many   other organs, functioning normally, only   doing   the work,     for which it is intended - support of the body when resisting the force of gravity. This implies vertical position of the body, in which men must be at least three hours a day to ensure the necessary strength of bones. However, even a lot of young people do not comply with this important condition.

   During discussions about bones and   diet   on   the mind   immediately   The thought of calcium comes in. It is certainly better to have healthy bones, which requires the production of an appropriate amount of calcium. However, although   calcium   favorably affects some diseases Bones, this     does not apply to osteoporosis. Reception increased doses of calcium in youth not will make the bones stronger than ordinary, as well as excess calcium   in   passive   lifestyle will not slow down the natural loss of bone mass.

   Bones and calcium, which is part of them, perform another,   non-strugger, function in the body - they serve as an "acid   buffer",   so, apparently, the intake of excessive amounts of acids contributes to   a faster dissolution of bone mass. Juices of citrus have little effect on the total content of acids in the body, the main determinants here can   be a diet high in proteins    and   increased   consumption of acid phosphates - the main ingredient   Non-alcoholic   soft drinks.

 

   DIGESTIVE TRACT

 

   Like skeletal muscles, the main function which - movement of parts of the body, the smooth muscles of the digestive tract with age   weakens, so the food moves on it more slowly. Prostitized food reaches the stomach later, the time of emptying the stomach can double, and the pushing of food through the intestines are more sluggish.

   Despite this, digestion in general remains   normal,   but the assimilation of drugs becomes less predictable.

   Separation of gastric juice with age worsens,   falling   probably to zero in people aged 70 years and above.       The process of digestion itself   does not require acid gastric juice, and its Absence does not give   any   characteristic symptoms. In addition, in The absence of gastric juice   cannot be formed by ulcers.

   On the other hand, the absence of an acidic environment in the stomach is one   of the factors, contributing to the occurrence of cancerous tumors in it. Being   the main malignant education in many countries around the world,   stomach cancer   in the United States was the leading disease until 1930, but   Time gradually moved to the eighth place. Perhaps the responsibility for this is the general changes in the diet - the most Probably the   main   role   played an addiction to canned food and Love for Convenience. Americans have big in their homes refrigerators, and maybe that's why they prefer to buy packed semi-finished products containing chemical preservatives. Nations that have the highest number of   cancers   the stomach, prefer smoked, pickled or Salted food.

   I can't give you any new advice, but Let me remind you that     ageing   the digestive tract will not affect the people who will adhere to   a full diet, described in Chapter 2. Although with   age,   the functioning of the rectum is weakened to the same extent as the rest   of the digestive tract, this does not lead to constipation. Like atherosclerosis,   constipation is a consequence of the wrong   nutrition,   and   rational   The diet eliminates the risk of both. The greatest inconvenience   that interferes   with normal eating in old age - Absence of   teeth,    It is also   a consequence of diseases, not aging. Regularly   clean   and   rinse your teeth. Every six months, visit the dentist.

 

   GENDER ORGANS

 

   With age, the testicles slowly decrease in sizes, and     the release of testosterone is reduced to a minimum, but not One of these changes   should not affect a man’s sex life. Spermatogenesis for a period of 20 to   80 years decreases double, but it remains within the norm.   Age should not reduce sexual desire, Impotence is never  A sign of old age is usually a consequence of the disease.   A healthy man is capable of reproduction before very respectable age.

   Lead   Regular   sex   life.    The general    age-related    slowdown of most functions also affects complex nervous and vascular interactions, Providing the possibility of communication. Achieving an erection will require more time, and for ejaculation requires a long   stimulation - such changes could improve Sexual abilities of even some impatient young   people.   Man   leading   the regular   sex life, usually easier to adapt to This.

   However, with sexual passivity for 10 or more than more years, the unexpected detection of such changes may become for a man with shock. Many, being in such a situation and not understanding that happens, immediately     surrender, lose faith in their strength and live with the belief that old age has destroyed their sexual abilities. Despite all the efforts of medicine,   the sexuality of most such men is never restored.

 

   KIDNEY

 

   Men for 50 kidneys also cringe, blood flow in them decreases, and also worsens Filtration abilities. Kidneys   80-year-old   man usually loses them half,   but   the remaining   Half     is quite capable of ensuring normal functioning:

   Although residual residual function of the kidneys in the state ensure normal   health, not It should be forgotten that the reserve that you had     in youth, decreased, and therefore be careful with those loads on the kidneys that   were previously perceived for granted. The kidneys maintain   a balance   between the number of salts and liquids, in particular, creating your feeling   thirst when the body needs more    water.   Over   the years   their sensitivity and ability to cause Responding to   the needs of the body decrease, so in old age you can   do not   react accordingly even with significant dehydration of the body.

   Some popularizers of a healthy image life encourages people   to drink big the amount of water, however     Proof that   this brings benefit from young people, no. After 60 years, drink   at least 1.8 liters of water per day, but - no more. Do not give in to fashionable conviction,   that abundant urination will strengthen your health, insofar as,   they say, harmful substances from the body are excreted. Increased urination Beneficial is no more than increased   sweating,   frequent   defecation, excessive release of gases or earwax. And although the belief in general is harmless, in old age, excessive water consumption can bring harm, overloading the kidneys, intensively trying to rid the body   of excess fluid.

 

   BRAIN

 

   By the age of 80, the brain is losing about 20% of its normal weight, but this   loss Occurs more due to intracellular fluid, not the brain cells themselves. Apparently, in most cells of the body   with   age The amount of water is decreasing.

   The nerve cells in the brain are not regenerates and do not divide,   so that the brain of a 90-year-old man consists of the same cells as   at birth, minus dead. When we Receiving   maturity,   in     50-100 thousand nerve cells die daily for our brains. Experts are convinced In that it is rather "threuttenance" of extra chains, not important   engaged neural cells, and what decrepitude and loss of memory with   this   process are not related. In fact, the functions the brain deteriorate slightly with age:  slightly increase only the time spent     to the comprehension, and the time of response reactions. In general, a healthy brain does not have a certain nature "Surrency of Service."

   What do you really lose? General memory loss does not occur, but we can expect some difficulties with memory in Names.   If   you have noticed this yourself, Don't worry, it's good   Sign.     This is when the relatives and friends notice the forgetfulness of a person   before     he realizes himself, Something serious happens to him. Does not have to   expect a loss of knowledge or facts, ability to   calculate   or   other specialized intellectual skills inherent in your   profession. Age does not change the mental and creative abilities of the brain,   but they somewhat lose flexibility - the ability to manifest themselves in new situations or adapt to the rapid change of course and   Accepting   radically new ideas. Verdi, Goethe and Titian created their brilliant   works at the age of 80, but all their creations were the development of previous ideas.

   Although people draw a parallel between Psychological Training and   Physical Training exercises, they are not identical. Rats grown in   a stimulating and developing environment, not only faster master the   labyrinths,     they have more weight of the brain, and the nervous system is more complex and more extensive, than individuals living under normal conditions. Encephalograms   of volunteers who agreed to a long time stay in bed,   showed the same results that appear due to aging.

   Because the brain is ageing with a smaller Speed   than   the rest   organs, benefits from the attention and care given to it Maybe a lot more. Any discussion about the aging process sooner or later Ends with the names   of the brilliant old people like the ones I mentioned earlier. And   Almost   inevitably , the wrong conclusion is made - that creative enthusiasm increases interest in life in old age. It is more logical to assume that with age-related   changes, people who cope better with The young were active in life. Titian, Verdi and Goethe, being geniuses already in 20 years old, they remained until their death.

 

   WHAT HAPPENS TO THEIR EYES

 

   Long before the old age, about 40-45 years - the elastic lenses of the eye hard so hard that the germ   muscles   and   ciliary   ligaments can no longer focus them on nearby objects.   Men with normal vision or Farsightedness begins   to catch   themselves   that when reading, all the papers are reposed further and further from the eyes.   Correct The situation helps glasses. Nearsighted, taking off his glasses, often do not experience Difficulty reading even when hardening   Crystal (  which   naturally leads to correction to the side of farsightedness).

   Receptor cells located   on   the retina of   the eye,   with   age decreases, so visual acuity It also     decreases a little.   The pupils narrow and react more slowly to light. It is difficult to move the eyeballs, and Unexplained reasons are not many elderly people   can   raise your eyes up. All this, with the exception of the general deterioration of vision, does not   cause much inconvenience.

   Cataract (crowding of the lens) and the degeneration of the yellow spot (atrophy of the central part retina) in elderly patients   ages   occur quite often, and doctors usually say that   this   the consequence   of ageing. Experts in this field are not entirely sure of the veracity of such   a conclusion - some of the forms of the two mentioned Violation of   vision   is   the results of diseases, in particular diabetes.

   Next, I will give several in common, usually Exactly obvious   changes that may cause you unreasonable anxiety:

   1. "Arcus senilis", or senile arc (crowding on   the edge   of the cornea), - gray or whitish ring around Cornea. It consists of fat material and, Appearing in people younger than 50 years, indicates   a high level of cholesterol. But such a ring is formed in almost every person, and in these cases it is not necessarily an indicator of excess   cholesterol.

   2. Blood-crushed eyes. With age on Eye proteins appear outward more and more blood vessels. If This phenomenon is not accompanied by any symptoms, then it is harmless.

   3. Yellow spot on the proteins of the eyes (pinguecula) - yellow visible convex spots that appear more often on proteins closer to nose, less often on the opposite side. Can appear at any age, but much more common in the elderly and People working in the open air. Spots increase slowly, and doctors do not take no action until then,   while   they do not reach the cornea; in this case, the name of the phenomenon changes to   "winged bulge on the horny shell" (pterygium   or   terthygia),   which is subject to removal.

   4. Pterygia (pterygia). Noticed the fleshy tissue, partially   covering the cornea, many mistakenly take it for cataracts. Ophthalmologists   easily remove it, but ptery has a tendency to relapse, so such treatment is not necessary, Unless the film interferes with vision.

   5. Floating spots. Spots moving through your     field of view is the shadows thrown on the retina, discarded   Cells or other foreigner bodies   floating   in   Intraocular fluid. Almost everyone who had   to   watch for a long time   on   a smooth light surface, noticed several such spots or points.   Small transparent spots are not terrible, but if there was at least   one   opaque, permanent and clearly visible, immediately Go to the ophthalmologist.

 

   How to Slow the Age Indestruction of Vision

 

   Maintain health and do not smoke. U Smokers are more likely to note cataracts and retinal atrophy. Solar radiation, apparently, affects the eyes to the same extent as the skin, Provoking, in particular, the appearance of   cataracts, Protect your eyes from the sun. And don’t worry about your eyes wear out faster from working closely with small ones items or when working with poor lighting. These conditions, of course, cause fatigue of the eyes, but does not cause irreversible harm. As   with fatigue the rest of the body, after rest, the fatigue of the eyes   passes. Naturally, from time to time   you need   Visit an   ophthalmologist to   see Absence of problems requiring treatment. Glasses are not   correct the deterioration of vision caused by ageing;   virtually   any   changes in   the doctor's instructions given to the elderly,   indicates     an eye disease.

 

   THE HEARING IS CHANGING TOO

 

   Like vision, auditory   abilities     Over   time   gradually worsening, but in the absence of Diseases of     the Hearing Organs   This   process proceeds very slowly and does not lead to complete hearing loss. Deterioration , called senile deafness, begins after 40 years with partial loss Perception of the highest sound frequencies. Probably,   this   the   musicians notice mainly, since the most important frequency range, covering human speech, lies in the band of medium frequencies. At the age of 65, more than 50% of men find that they hear worse than before.

   Prolonged exposure to loud sound, especially high tones, leads to irreversible deterioration of hearing, causing identical age deafness to high frequencies. In so many cases, that doctors consider an age-related change is the result of chronic noise   injury, which means that this violation can be avoided, taking the appropriate protective measures. Representatives of primitive cultures are noted in a relatively Less age-related hearing impairment.

   Any unpleasantly loud sounds damage rumor: very loud   music, shots, noise from trains, subway trains, powerful electric - and   pneumatic tools, electric motors and factory equipment. For   preservation It is best to avoid all this.

   When the loss of hearing becomes Obviously, visit an otolaryngologist. With really age-related changes Your doctor will give you   recommendations that will be more or less consistent with what I will list   below.

   In the end, you probably will have to resort to the hearing aid, but in the initial period you can adapt to Deterioration of hearing,   more attentive Listening to the speech of the interlocutor, watching his lips and face and, if possible, becoming opposite the walls reflecting the sound. Avoid the noisy places, because people with senile deafness hardly distinguish   speech against the background of noise (with other forms of hearing loss are not so.)   Others can help you by looking into your face and clearly articulating when talking, but do not hesitate to explain to people, That you   don't   hear well. You may need to buy amplifiers for radio, TV and phone, or maybe you will help you out in these cases.

   If you ask a person what is worse is blindness or deafness, almost   everyone will answer that it is worse than the first, since the deaf person can lead a more independent life. On the other hand, it is easy to talk to the blind, and a deaf person can Gradually being alone. In my family it   happened that with a deaf relative greeted, and then completely ignored his presence when communicating with other members of the family. To involve him in the conversation, I had to scream exhaustively and repeat. That's why I disagree with the doctors who advise Deaf people are   not asking interlocutors Talking to them, and writing words on paper. If you are   deaf   to exchange information, you need to apply special Efforts,   some will surely count communication with you is too tedious. Better buy a hearing aid.

 

   REDUCTION OF THE CAPABILITIES OF THE IMMUNE SYSTEM

 

   The ability of the elderly to combat Bacterial and   viral   infections are reduced. In addition to the fact that age-related reduction of the reserve of internal organs reduces the body to confront certain stresses, the immune system itself also loses part of its   energy   and the speed of reaction to infection, more slowly producing antibodies.   Lymphocytes are cells that should attack strangers, do not decrease   in the number,   but react to Intrusion is less active.

   In addition to the destruction of invading from the outside microorganisms and viruses,   immune the system should destroy the cells of the body itself, subjected to malignant changes. Age deceleration of this process increases risk of cancer in the elderly.

   Lead an active lifestyle. Exercise. Peace   brings   the body more harm than we imagine. In healthy volunteers held in bed for several months, not only Weaken (or - good analogy - subject to premature Aging) heart, muscles and   bones, but also The immune system is deteriorating.

   Advice to pick up diseases to preserve health   may   seem paradoxical, but your immune system also needs    training, like muscles and bones. You must be heard of "children   under   the hood", born with a complete absence of immunity, which have to grow   in sterile capsules, Where no infectious organism can enter. Such a child is very soon die from the first     infection,   When, after a failed recovery attempt The immune system is extracted from the capsule. Many readers will be surprised to learn that   a normal   newborn if it is placed in a sterile capsule and isolated   from possible infections, In five years, immunity will be completely deprived of immunity.

   Early Beginning with the Many and   a variety   of pathogens gives confidence that for an old immune system, meeting them will not Suddenly. Measles and influenza weaken children, but rarely become the causes of their death.   The disease of measles in childhood provides immunity to it for life.   Relatively healthy 80-year-olds regularly die from the flu. Maybe   they would die of measles, but I've never heard of cases of measles of the elderly.

   Viral infections of the upper respiratory tract children are infected about 6 times a year. They also annoyed many adults, but   with   age   their susceptibility to a person decreases, because every time you   recover,   you acquire immunity to another virus. Number of these   viruses   seem endless to us, but almost only about a hundred of them, so you   probably have already acquired immunity to everyone, and You are no longer afraid of a cold. Healthy non-smokers Men in old age very rarely suffer   from   upper respiratory tract infections.

   Someone, after reading these lines, for sure will try   to draw an analogy with other infections, but you need to know that some   of them   (TB, sexually transmitted diseases) provide permanent immunity; we still do not know how to train The immune system is better   to resist Cancer. Over time, I am sure, a solution will be found to find these issues.

   Despite all efforts, it may happen that You will not keep your health until the last day of your life. Next The section may not have a relationship with you, but still read it and think about it.

 

   HOW TO SURVIVE A TERRIBLE DIAGNOSIS

 

   Sooner or later, the doctor can announce that you Seriously   ill.   Your first thought for sure will be that from now on, life roll under the mountain. It's not really true.

                            Table 4

Men (thousands. Man)            Women (thousands of people)

Name     Quantity       Name     Number Name Number

 

Prostate         165.0    Breasts                182.0

 

Light     100.0                 Thick and direct    75.0

                                Intestine

 

Thick and straight 77.0            Light 70                .0

Intestine

 

Uchevaya bubble    39.0          uterus                   44.5

 

Lymphoid tissue 28.5               Lymphoid Fabric    22.4

 

Mouth cavity      20.3                OVEN 22              .0

 

Melanoma (Crachn 17   .0     Melanoma            15.0

Skin)

 

Kidneys             16.8     Pancreas       14.2

                                                         Iron

 

Leicemia (cancer    16.7           Urinary Bubble      13.3

blood)

 

Stomach           14.8     Leukemia            12.6

 

Pancreas    13.5            Kidneys                10.4

Iron

 

Larynx 10.0     Cavity Mouth          9.5

   The most frightening news is the diagnosis "cancer." Most of the men Similar Message It's terrifying, and   Distracting   factors,   as Pain or therapeutic procedures, do not soften the blow. Disasters such as an accident or heart attack Immediately stun the victim, and   The man,   having recovered from Initial shock, must learn to live   with   his   illness. The tips you read next relate to cancer,   but This Line of Conduct Applied to any serious illness.

   In contrast to injuries and heart attacks, when you Immediately aware   of what happened to you, the diagnosis of a cancerous tumor usually takes a long time and Looks like a slow torture. Here's a traditional script: you or your doctor notices something unusual; the doctor says that it is perhaps a tumor, but maybe not; the doctor’s voice sounds encouraging, and you really want to believe him; the doctor adds that additional tests and   consultation with a specialist will give more information. You have   several   days of hope, and then you will know that you have found something more than suspicious. You are in despair, but you can again to regain the spirit when the doctor begins to assure you, That many men with   similar   symptoms   Cancer was not confirmed. Additional Analyses   and   probably   biopsy, will give a final answer. This will require another visit to   the doctor,   and therefore, more a few days filled with fear and anxiety.

   Although the result may be Depressing, many   patients feel a huge relief on the day of taking the biopsy, being convinced that they are now finally getting to know the final diagnosis. They are very   discouraged by the message that it will take a few more days while a pathologist study the tissue sample. Add a   couple more to this   days, because pathologists, as a rule, do not work on weekends.

   So, another visit to the doctor. Time in Expectation   of reception stretches   as a rubber one. Finally, You are told that the diagnosis was confirmed. Your heart falls, but you expect to hear in subsequent explanations something encouraging - doctors   always   try   to emphasize   the positive aspects, you hope to hear that this is a very small tumor and it was discovered Just in time, you are interested in whether there is   Metastases?   The answer to   this question requires new studies and, therefore, additional delays, in some cases This can be found only after the operation   or after the metastases are really will appear.

   Obtaining evidence that you have really,   cancer often   turns into a consistent series of blows. Three-four such strikes in a row It is quite possible to knock out any person from the track. The patient is plunged into hopeless despair. His life moves to the corridors of clinics and   reception of medical specialists in anticipation of all New and new   bad   news. Your belief that normal productive life is over, with   the beginning of treatment, may even increase when you will see an oncologist or radiologist in the company of other cancer   patients,   who   really   look terrible. Po A few months of great Some men are requisite some taste for life, but they rarely   avoid    feelings of irretrievable loss - even if everything goes for the best. I   have experienced   this   from my own experience.

   Despite the statements of some authors,   diagnosis   of "cancer   The tumor is really bad news. And all This   is not   the most   The worst   disease that can Afflicting a man. People who have lived   10   years   after the first heart attack, Less than survivors in the same period   after   many varieties of cancerous tumors, and yet the victims of heart attacks take themselves   into the hands and continue to live by adapting to new conditions. Cancer patients should do the same.

   Table 4 provides comparative data on Cancer incidence among The Americans in 1993.

 

   TELL US TO EVERYONE, THEY WILL HELP YOU!

 

   Tell about your illness to family members and relatives,   as well as friends and colleagues, with whom you regularly communicate. It's   still early   or later they will know about it, and when they hear about it From you, they will understand that you trust them.

   Cancer patients, especially men, most often hide this, but it is very difficult to carry such a load on the soul. Thought about The disease does not leave you. Serious illness as if Isolates you from others, especially from strangers.   You   look bitterly at other, obviously happy people - at   that time   How you have such a heavy burden that Sometimes you wonder   why No one notices anything. But they just can't   do that   See, you have to tell them yourself.

   In this case, you are not just reporting news, to evoke   sympathy, although, of course, you will get it   enough   Sometimes   it will even be Annoying you. You share your trouble with   others, as they would tell about any other large event   in   your   life; people always exchange news, and you must maintain a continuous connection with society.

   Don’t try to predict how or so People will take your message. Many, at first shocked and performed Compassion, later there will be maintain the same relationship with you, As before, from time     to time interested in your well-being and possible progress in treatment. You can expectantly thoughtless encouragement like: "I'm sure that in the end   you have everything will be fine ... ", and tedious stories about acquaintances who have Also There was cancer. Even if you are not interested in it, politely Listen to everyone.

   Be prepared for the fact that some People will start to disappear from   your life! Their The first reaction may   not   be   different   from what has just been described, but soon their behavior will begin   to alarm   You. They will not sit down if possible next to you   during   lunch,   And friends suddenly for some reason will stop calling and go to visit. In response to your invitation they Refer to other plans. Realizing that an old friend is avoiding you is not easy, but you should know what cancer patients are It happens all the time.   Such   behavior,   of course,   heartfelt (if it somehow comforts you, know that your friend almost   certainly torments the conscience), but some people Severe diseases of others are horrified to such an extent that they prefer Escape from them away.   After a few months, you,   Possibly   won   again   Get   close to someone and restore your previous relationship. Accusations and reproaches here is useless, you just need to forgive people for their weakness.

   Few of others will be truly Saints   will   be   very attentive, not showing a tearful Pity, no thoughtless   optimism. Later they will want to know the details about your treatment, and   you   Find that it is easy to talk to them about their feelings and fear. You     will need such people, but Who will be this man, Absolutely unpredictable.

 

   IF YOU HAVE A TUMOR, YOU HAVE TO GO TO THE ONCOLOGIST

 

   Oncologist (doctor specializing in cancer tumors) will again review your medical card, the results of tests and   biopsy,   After   that offer some further action. Be sure to visit this   specialist, even if you have a small and Easily curable tumor.

   The doctor who gave you a diagnosis in the first The queue is a surgeon. If necessary, of course, it will recommend other Types   of treatment,   but   the most familiar and preferred for him is an operation, especially   in doubtful cases.

   Naturally, you will want to discuss and other opportunities.

   In addition, it may be that cancer Tumors   are not   the most   a well-known area for your doctor, or it just doesn't He likes to do it. And the oncologist specializes in such Patients   whose   fears   and   the questions coincide with yours. Based on their experience, they can say   that oncologists are more attentive to patients. For almost all cancer   patients   visit   to the oncologist is quite a common thing; the attending physician   is certainly   advise   you to visit it and will not object if such an offer   is prompted   You yourself .

   Ask if you can participate in Clinical trials.

   Many people participate in clinical tests, trying   on new methods of chemotherapy, modern synthesized hormones and (very   rare) new surgical or radiological methods. If   you   want to take part in such tests, then your goal is primarily to help to themselves, not to all mankind.

   Patients are almost always reluctant when I   mention    Clinical trials. "Why do I owe Trying on yourself untested   “Prepared,” they ask. I explain that Clinical   trials   are different   from clinical studies. Medications or Methods that get to clinics for testing, already Early stages of research. Specialists know the spectrum of their action, They know that these drugs are relatively   safe and more effective than used. To receive Official Approval of New   Methods Creators and Researchers     treatments and medications should compare them with the best analogues and win in this competition, that's why each participant   receives the tests   Best treatment.

 

   JOIN THE SUPPORT GROUP

 

   Your wife (or girlfriend) and close friends will support you, but   no one   will do it better People who share the same trouble with you. Doctors and   Clinics involved in the treatment of serious diseases, such as The groups   are known. Men much less They speak of their feelings than   women, but believe me - in such groups no one Forced to such,   conversations, you You can just be quietly present. I AM   I always   insist that   my patients They tried it, and many of them then thank me.

 

   BEWARE OF PEOPLE WHO DEMAND YOU TO BE HAPPY

 

   Many patients and doctors are eager to desire share with you   experience and give advice. I usually recommend that patients listen to everyone. Any heavy The disease changes life forever, but you are not alone. Knowing   how others handle diseases like this, you will feel better.

   Read everything you can. However, I warn you that have   one   annoying thesis, constantly present in Popular Literature and   Others Medical publications. It sounds like this: "Furious or   die!" In the old Hollywood films, the heroine was    the verge of   death because, as the doctor explains to the audience, that "has lost the will to life."   Here with the inevitability of rock appears a hero, thanks to which the lost will recovers, the heroine opens his eyes and, immediately revived, rises from the garden.

   Enthusiasts are probably shocked by this Characteristics. They sincerely believe in their wonderful advice, exclaiming that Medicine can fight cancer, but you are also obliged to confront the disease. This, by   their   the opinion,   much more effective and more important than drugs, surgery or radiation, and you should   maintain a combat mood, firmly believing in Victory.

   Cancer patients are always with trembling, learn about self-healing. Moreover,   many people get the impression that it really   works.   A few weeks later, when the first shock from   the diagnosis,   almost   Everyone is emotionally improving. Conducive to   the fight   against   disease, no matter what treatment the doctor uses. But if Something goes wrong,   the patient, depressed morally, begins to blame himself: "I   must   I didn’t   have to try it, but I didn’t have enough willpower.” Exactly how it can Be one   of the possible comments.

 

 

   Chapter 7

   WHICH MOST CONCERNS MEN: SYMPTOMS AND THEIR MEANING

 

   Any person, sick, immediately wants Determine the name of your disease - whether it's the flu, heart attack or hemorrhoids. Such a desire inherent in human nature and it is impossible to overcome it, but you should not rush to the diagnosis.

   Medical students are very proud of the speed, with which   is carried out   diagnostics, but over time, accumulating experience and gaining   wisdom,   they understand that you need to collect more information, concentrate and   think carefully before Take responsibility for the accuracy of the diagnosis.

   Ill, you feel pain, chills, Indigestion of the stomach, etc.   Before making obvious connections (for example, vomiting is a symptom of food poisoning), Consider the symptoms and related circumstances. As a rule, each wants to make sure that he has a mild disease that can be cured at home.

   In using the information below, you You can almost always   do it, but If there are any doubts, it is better   Go to   the doctor.

 

   CHEST PAIN

 

   Sixty percent of all deaths Infarcta occurs before the victims get into hospital, so a quick estimate of the value of chest pain can save your life, as well as   the affected   part   heart   muscle. The doctor will introduce you a medicine that will have time to dissolve blood clots that have blocked the coronary artery before   The affected   part   of the myocardium will die. But this is possible only within the first few hours after the onset of the attack, and the sooner the   more   chances   that   The medicine   will work. Below I describe absolutely the wrong approach to pain   in   the chest, as it occurs quite often.

   One evening after dinner, a middle-class man I felt unpleasant pressure in the chest. At this age already it is difficult to   reduce   cholesterol, and, of course, it Worried   about   the possibility of heart attacks.

   "Probably it's heartburn." He's thinking. Pain of this kind, as if   it bursts with gases, and after eating it Several   times   was   burp.   To check his condition, it rises several times and   descends   on the stairs - discomfort in the chest is not increases. "If it's the heart,   I   wouldn’t have walked through the stairs so many times,” he told his wife. Again burp. "Bad digestion," he concludes, rushing into bathroom  , where with the help of a toothbrush causes vomiting. It seems that the pain has decreased, but for complete confidence, he is taken to do gymnastic exercises - It is clear what the result is. By this time, the wife is called to the doctor, which, in turn, calls the ambulance; she takes the unfortunate husband to the hospital, where he experiences his first heart attack.

   This story helps to explain that curious The fact that   married men They live longer than bachelors.   Many   men   Insufficiently   waste precious time, in every possible way exploring the pain in the order in order to   assure yourself that this is not serious. I'm in The principle is not against   various studies. But, unfortunately, most men   follow   accepted primitive ideas or Unnecessary heroism. Instead,   it’s better to follow my recommendations that will help you   identify a serious heart disease before it turns   into   Real threat.

   Here is another illustration: man, trimming   the lawn   in front of   home, feels pressing pain in the chest. Since after a few   minutes of rest, the pain disappears, it does not attach importance to this. A little later, playing golf, he feels the same feeling and reports this to his partner.

   He's terrifying. "Like to       "I've had the same thing before the first heart attack!" But, since the pain is again passed, our character shrugging his shoulders scourges the diagnosis of a friend and insists on the continuation of the game. He later met with a doctor who   prescribes   an ECG with a load, after which the pain returns.

   "It's not a heart attack, but your friend was   on   The Right   Path  ,   - Infarction occurs when the artery   that supplies   the part   heart muscle with blood, partially clogged and not provides to     it   access of oxygen. For the death of part of the myocardium can it takes   a few   hours, and all this time a person feels A marked pain. Until your coronary arteries are not blocked, - continues the doctor, - but the ECG shows     that at least one of them is very narrowed. When you are at rest, it passes through it enough blood, but during exercise or physical work, it does not provide sufficient blood flow. Oxygen starvation causes the same pain as with a heart attack. When you stop working   or   exercise, the work of the heart slows down, the supply of blood   Regenerates,   and the muscle stops hurting and remains alive. This common   disease is called angina pectoris, and you risking,   ignoring   him.     People with angina has an increased risk of heart attack.”

   In most cases, chest pain is symptom of not so ominous diseases as a heart attack, but insignificant Deviations often   lead to serious discomfort. Every few months among my   patients there is a person who It hurts to breathe. This phenomenon   begins with acute pain, which   becomes   painful   with   Attempted breath. After examining the breasts and audition I am     convinced of the heart again   in what   Patient   Pleurith   -   inflammation   of the pleura,   shells   lungs. Most pleuricles are accompanied by a small viral infection   like a cold, although it can manifest itself in its pure form. In such cases,   doctors prescribe aspirin, and   painful   condition   Passes   in   a few days.

   It happens that chest pain does not signal serious illness, but still deserves the assessment of the doctor, and sometimes goes away on its own and   does not require medical intervention. Here's what you need to know.

 

   WHERE EXACTLY IS PAIN?

 

   Let's remember the description of the heart attack, which In   the textbooks: severe abrupt pain behind the sternum, lasting up to 20 minutes, sometimes giving to hands, less often - in the lower jaw, neck, back or upper abdomen. To You're better at remembering all this, I'll explain it in order.

   The pain is strong. Unclear discomfort in breasts may not be     so threatening; many men insisted that they did not experience pain, but hesitation in the chest or even heartburn, as indigestion of the stomach. But what     If they didn’t feel, the feeling was strong.

   Pain in the heart always manifests itself in the middle breasts, i.e. behind   the sternum , in the center of the chest, although the heartbeat you feel on the left.

   Pain with a heart attack is prolonged. Significant discomfort may   be felt behind the sternum, but if it passes in a few   minutes,   It's   more angina, not a heart attack.

   Pain in the heart sometimes radiates (gives to other parts of the body), but   not always. Men suffering from shoulder bursitis or muscle stretching   sometimes worry In vain. Pain in the jaw or in the hand may indicate a heart attack, but not on its own, but only if   there is   severe   pain in   the chest. I never heard the opposite.

   Pain in the lungs. Let me just say that this is not It happens. The lungs do not   have nerves of accepting pain. Symptoms of purely pulmonary diseases are   cough and difficulty breathing. The Only One the part of the lungs   that can   give pain is The pleura.     Characteristics of   lesions of the pleura - increased pain when it is sprained. Since the pleura is a membrane of the lungs, it stretches at each inhalation,   And therefore even    with a small viral pleurisy occur Acute stabbing pains that stop when trying to hold your breath.

   Occasionally pleurisy accompanying serious pulmonary diseases - pneumonia or thrombosis, but in such cases of pain accompany other   signs   of cough, chills, difficult intermittent Breathing.

   Damage to the skeleton or muscles. Anyone who had to break   the rib, knows how painful it is to breathe after that, although it is obvious that the defeat of the pleura has nothing to do with it. Even minimal inflammation or damage to the bones, muscles, chest ligament cause severe pain when breathing, but at the same time the pain manifests itself and when changing the position of the body - inclinations and torso turns. Diagnose in this case is easy - the affected area hurts with pressing your finger. This information will save you from the immediate call of a doctor in cases of trivial causes of chest pain.

   Inflammation of the ribs of cartilage - a simple form arthritis, inflammation of the joints. Not everyone knows that each of us breasts - 14 joints, 7 on each side, in the places of attachment of the first 7 ribs to   the sternum. Provening them fingers, you will easily find   Thickening.   Knee or brush can hurt from the most minor injuries or at all   for no apparent reason - the same happens with rib-cartilaving joints, and   the pain can be dull, as with a heart attack,   and   spicy,   characteristic   for pleurisy. But if you click on one of rib joint   points pain   increases, which means that It's inflammation of the rib joints,   which   is treated with aspirin or other anti-inflammatory drugs.

   Pain from gases. The thick intestine reaches the level of the chest. passing through the upper part of the abdominal cavity behind the stomach, it reaches   the top at the bottom the left part of the chest, then rotates by 90°, descending to the rectum. This turn is behind   the spleen, why is called the spleen bending of the large intestine. Gases   have the property of rising up, so they accumulate in   this   top point. Compressed with powerful muscles of the colon, caught   in     gas trap causes severe pain; it happens so often that the phenomenon has received own name - the syndrome of accumulation of air (gases) in   the spleen bend. There are people with such syndrome brought to hospitals with suspicion heart attack or kidney stones. After finding out the true cause of the pain patients experienced great moral relief, while doctors who made the wrong diagnosis felt so      A strong embarrassment and shame. Pain from the accumulation of gases in the spleen   bending of the large intestine manifested to the left of the sternum or in the left   the upper   part of the abdominal cavity, and an experienced doctor in this case will immediately make a correct diagnosis. But do not self-diagnose if the pain is severe and acute.

   Other pains of the gastrointestinal tract. A person can take   painful sensation from increased acidity, ulcers, bile   disease or inflammation of the liver for chest pain. President of the United States   Warren   Harding   died in 1923 the "acute disorder   digestion"   before   the doctors recognized disease of the coronary arteries. But even these days, many patients and   some   Doctors   Explain   the Pain       Breast sensations with disorder digestion, although the reason is different. Nausea, vomiting   and   belching is often observed with a heart attack. Gastrointestinal pain rarely radiates to Jaw or hand, but it is not convincing   proof enough. Always remember the main thing in the diagnosis of heart attack:   if   The pain   is severe   and prolonged - Contact your doctor immediately.

 

   ASK YOURSELF THE MAIN NECESSARY QUESTIONS

 

   Places of manifestation and nature of symptoms indicate     the severity of the disease, but, nevertheless, ask yourself this:

   1. Has there been something similar to me before?

   You can diagnose yourself Muscle pain   or   pain   from gases, if it has happened to you before and The doctors explained what happened. But do not try make a diagnosis, experiencing new sensations or the previous, but in the worst form.

   2. How serious is that?

   Heartcridges and angina pectoris so   rarely     are noted among   non-smoking men under 35 years of age, that such cases are even considered curious from the point of view of medical vision, but smokers over 30 should be on guard.     By the time Achieving the average age you must   Be   a thin,   active person with low cholesterol and do not smoke. And even in this case, there is a small risk that decreases to zero only if your cholesterol is below 150.

 

   WHERE CAN I GET HELP?

 

   The answer to this question is not so unambiguous, As it seems. If you   are pre-in-- Ask for help,   best    Consult   with your doctor. If you urgent need, you need to get to the reception department the nearest hospital, as soon as possible.

   If you come to the hospital without accompanying, do not say     that you have a heart attack Do not ask for an immediate arrival of a doctor. You must inform the staff that You're having a sharp chest pain. These   words   usually cause a quick Reaction from experienced medical professionals.

 

   PAIN IN THE STOMACH

 

   In textbooks for future doctors state, called "acute   abdomen", is interpreted as much more complex than pain   in   Breasts.   The latter , as a rule, affects the only organ (heart), and pain   in   Abdominal cavity can be caused by a disease various organs located in it. Although the pain sensations in this case do not require such urgent measures as heart attack, the correct diagnosis here is no less important. After the first heart attack, your life will never be the same again. But   the surgeon,   remover your gallbladder or inflamed Appendix, destroyed the   disease with them.

   Men experiencing abdominal pain, usually Afraid of   appendicitis or ulcers. It would be better for them to worry about stones in the gallbladder and diverticula. Now ulcers and appendicitis are not as common   as   in the years of my training, although they are quite common.   Po   unknown causes of both diseases in our time   appear   twice   as often   as   representatives of the previous generation, and the tendency to decrease them continues. About stones in the gallbladder and diverticula Unfortunately, this is, unfortunately, You can't tell me.

   Unlike chest pain, severe pain in   the stomach   almost   never   requires immediate response. Even with a perforated ulcer   the delay for   several hours is not fatal (although the patient himself never   thinks so). When you are late for a few days patients either die or sue the doctors. K Fortunately, in most cases, abdominal pain are symptoms of minor disorders. To better   understand     in them, use the following advice.

   Determine exactly where it hurts

   The button serves the boundary between the upper and lower parts of the digestive tract (although the colon is higher  ,   severe   pain     in it is usually localized at the bottom). Curled by the noose thin intestine is located in the center of the abdomen behind the navel and It is extremely rare to serious diseases, so I will not discuss them here. The most important sources The pain can be:

   - Stomach located above horizontal the line passing   through the umbilical cord under the chest ribar (this place is called the upper-end area). Although even in school, children are explained that the stomach mixes   and digests food, Its main function is its accumulation and storage. A person deprived of stomach, can normally     digesting food,   but its consumption in large quantities will cause unpleasant sensations.

   - Duodenal intestine - the first the     Intestines Department   about 25 cm in length, in which food from stomach. Ulcers occur here more often than in the stomach, but pain in Ducent-perpent in the intestine is not   Distinct   from the gastric.

   - Bile bubble - a bag   size   with   a thumb,    in the lower part of the chest. Oily bile continuously   arrives from the liver to the gallbladder, where it accumulates and   Concentrated. After eating, the gallbladder serves it in the duodenum to   improve Assimilation of food fats. Pain in the gallbladder   can   occur   for different reasons. The most common of these are stones   formed from hardening bile, which due, by the way, to the presence of cholesterol in bile, which first begins besieged at a strong   concentration and dehydration of bile. While the stones lie motionless in the gallbladder, they Harmless. Problems begin with them   movement   and   blockage of the bile duct leading to the small intestine.   Pain,   arising   when pushing the stone through the duct, can last   to   A few   hours. However, in general, pain in the supraventricular   areas   are so   frequent,   What is obvious only one thing: not all pain in the center of the abdomen   owes its origin to the stomach.

   - The liver. This is the largest organ in the abdominal cavity located in   its upper right part. Liver Diseases   Rarely are a     source of acute abdominal pain.

   - The pancreas. It is located deep in the abdominal cavity behind the stomach and duodenal intestine and develops a secret   containing a number of enzymes, which then enters   the small intestine on a separate duct. Pancreas inflammation glands (pancreatitis), as a rule, causes pain in an extraordinary area, sometimes felt on the left.

   - A thick intestine. Pain in the colon more often all occur in     the lower left side of the abdomen (diverticulitis, spasms, constipation and diarrhea) or in   the lower right side (appendicitis). The most   serious     Colon disease   rarely cause pain higher than the navel, but do not forget about the pain in the upper   left side of the abdomen with gas accumulation syndrome in spleen bending. The gut has another 90° bend under the liver   (right),   but   with   a smoother radius, so the pain of gases It is not celebrated so often here.

 

   DETERMINING THE NATURE OF PAIN (BURNING, BREAKING PAIN, PAIN FROM GASES),   TRY ABSTRACT FROM IT

 

   Textbooks describe pain in ulcers as burning,   pain   from   clamp of the duct stone as colic, increasing to maximum and immediate   downwards; pain from   gases   Compared   to   Move   in   the insides of the big ball. All these descriptions may not   correspond to     your feelings, because nerves that transmit pain signals from internal organs are too primitive in Difference from the skin   nerve   endings.   Your life sometimes depends on many   as many   catchy   sensations,   obtained, say, fingertips or soles,   but   The signals   from the inside   of the body are only rough Warning. Acid burns to the stomach can cause aching, and roasting, and dull, and acute pain, as well as not cause it   at all.

 

   WHEN THE PAIN IS FEELING

 

   Think about the connection between pain and food. Food neutralizes the acid, so with ulcers often feel "hungry pain”, which disappear   after   eating, but keep in mind that This is not a tough rule.

   Gas pain occurs one hour or two after food, but not because they are released by food, getting into the stomach (it is not has such a property,   as   you will learn later), and because the intestines  , starting   to digest   food, intensively reduced, compressing already available gases.

   The pain that waked you up in the middle of the night, deserves attention. Nocturnal pain in the stomach, as rule, signal the ulcer, because after midnight the stomach is already empty, and The release of acid is increased approximately   in two hours. Such pain may appear with almost any violation of the functions of the stomach, including various indigestion and dyspepsia.

 

   WHAT OTHER SYMPTOMS ARE PAIN

 

   Infections are usually accompanied by heat; high temperature can   be expected appendicates, diverticula and catarets of the stomach, but not   with   ulcers, stones in the gallbladder or gases. The presence, absence and even   slight rise in temperature do not indicate the severity of the violation. (Neigh of it , you will learn more about it.)

   Vomiting begins when something overlaps exit from the stomach, but it also happens with a chronic ulcer. Blocking the exit from the stomach may require surgical intervention. Vomiting is often   accompanied by   severe pain, for example, with exacerbation of ulcers or stones in the bile   bubble,   but   in most cases vomiting is not a specific signal of   malfunctions in the digestive tract. The same goes for diarrhea.

 

   WHAT IS YOUR DEGREE OF RISK

 

   Diverticulitis develops in middle age and later.   A diverticulus   is a small hernia, often occurring on The fat intestine. After years of eating, poor with coarse fibers, walls     weaken it   and the weakest areas are bent, Protruding outward bags-diverculities. Old people can be found   Dozens of diverticula that   don’t bother them before until they start bleeding   or   do not   break through the wall of the colon. Perforation (breakthrough) provokes a painful infection (diverticulitis), which Doctors usually treat   antibiotics   and   a liquid diet, but sometimes this disorder   requires   surgical   intervention. If you have always eaten a lot of coarse fiber-optic food and have not   suffered   constipation, then your colon tested less stress and risk of   diverticulitis Slightly small enough.

   Appendicitis is dangerous at any age, but in The main is adolescence   and early adult period of life.

   Stones in the gallbladder in women are noted in Twice    more often   than   men, but I'm afraid This statistic is disappointing if you are suffering from gallstone disease.

 

   WHAT IS YOUR GENERAL CONDITION

 

   People can enjoy life even with serious   lung diseases, bones, eyes and other organs, but disorders in the   digestive tract are able to completely Depriving you of joy. Pain in the right lower abdomen, accompanied by nausea, General painful condition   and   small   Temperature  , usually   indicates     Appendicitis. Severe pain in the same area in people who otherwise feel normal, Possibly associated with gases or intestinal irritation.

 

   HOW STRONG PAIN

 

   Moderate pain is more often indicated Unserious disease.   Painful pain is not necessarily a symptom of a   life-threatening disease, because it can even accompany ordinary gastroenteritis (  stomach cathars), But still pay attention to it.

 

   HOW TO GET HELP

 

   As you may have noted, all These tips are weak in terms of diagnosis, as it is - The   Doctor's Case.   But   Identification of your illness is important from the point of view of Decide: whether to see a doctor or not fearing the consequences, heal yourself   and   wait for the results.

 

   TREATMENT FOR PAIN IN THE UPPER PART OF THE BELLY

 

   First of all, consider the section again about chest pain and make sure you don't lose sight of something important, related to a heart attack. Secondly, if your stomach is empty, fill it   with something,   But   do not drink milk - it neutralizes the acid no more than water. If   the pain disappears within about 5 minutes, it is means that it is caused by acid, i.e. you either ulcer or general irritation of the stomach   -   gastritis. Both cases do not require urgent measures, but you should see a doctor.

   If the pain does not disappear,   avoid   painkillers     that can damage the stomach - and they include everything that is sold   in   Pharmacy   without a prescription, with the exception of acetaminophens such as tilenol and panadol.

 

   WHAT TO DO WITH PAIN IN THE LOWER ABDOMEN

 

   Medications sold without prescriptions, this Cases are useless. Do not take laxatives under any guise funds. Constipation causes         bloating         by severe pain, and powerful contractions   intestines   provoked   by the action of laxatives can increase the sharpness of Possible serious colon disease. You are mistaken in assuming that the complete emptying of the intestines will bring relief.

   If you are tormented by diarrhea, take drug   type   donagel.   Stay away from those containing narcotic substances   of opposite   monstrosics, if, of course, you can endure pain. With discomfort and pain in the lower part Do not eat a belly; if you want to drink, drink only   "pure"   liquids like soft drinks.

   The following decisions you must make, based on     their   level of tolerance. If the pain becomes too much strong and accompanied by nausea, vomiting or elevated temperature, better Go to     the doctor.   Don't pretend to be a hero; I've been a long time ago I bring morphine to patients tormented by gallstones. With Uncomplicated   appendicitis   requires a small surgical intervention, and if perforation occurred, surgery It'll be more difficult. Wait-and-see position with diverticulitis can turn violation, quite curable by antibiotics, in   serious   surgical problem, Requires partial excision   the large   intestine.   During the first several   hours   of complications     rare,   but   with severe abdominal pain, you can not wait more than one night or from morning   to the end of the day. If you have there is no way to talk to the doctor, go to   The nearest hospital or call an “urgent”.

 

   NAUSEA AND VOMITING

 

   First, as a rule, a person experiences nausea - the feeling   that he is about to veil, arising in the throat or in the chest. Simultaneously with the appearance this feeling of the digestive tract imperceibly subsides - stomach Relaxing, the secretion decreases. Autonomous nervous system that controls the digestive tract ("autonomous" in a given case   means "automatically It is active,” because you are not   can   control   it), affects the other organs, so the person who is sick, usually pales, is covered Then it secretes a lot of saliva.

   Relaxed stomach does not spew its content. This process Requires a strong reduction diaphragm and muscles of the abdominal wall. For muscle contraction is needed   Team     in the form of   nerve   impulses;   the corresponding nerves belong to the central the nervous system, so     the act of vomiting is controlled brain, not the nerves of the digestive tract.   Irritating drugs to the same extent as the toxins of infections or   spoiled food can stimulate The gutter center of the brain. Medications   that weaken nausea and vomiting, suppress the work of this center.   The sensitivity of the brain in different people is different, so Some are more likely than others.

 

   CAUSES OF VOMITING

 

   Victims of such an unpleasant disorder Usually   blamed   for   all   the troubles last visit to the restaurant, but   This   is true   if those who have been with them are also sick. Homemade food, by the way, causes more food poisoning. An adult man,     which   began vomiting, most likely, was affected by a common viral infection, which causes acute, but short-term   a disease   that rarely   lasts more than a day.

   From time to time someone wakes   up with   dizziness,     vomiting or vomiting, which take place under full rest.   For healthy adults in other ways A person   with a diagnosis   in   This is usually a sharp Labyrinthitis - inflammation of   the labyrinth, an organ located in the depths of the ear, which controls a sense   of balance. With too much or sharp stimulation of this organ   occurs dizziness, accompanied by nausea. It is most likely that this   is another viral infection: the disease caused by it also rarely lasts more than one day, but It is better that the doctor did the diagnosis.     In this case, the call of a doctor at home is quite justified.

   Naturally, any obstacle to throughout     the digestive tract leads to vomiting. If it occurs above the stomach, the patient   spews undiverted food. Vomiting Masses from partially digested food signals an obstacle located immediately behind the stomach in   the duodenum. If the obstacle appears below   the length of the intestine, More likely pain and bloating than vomiting.

   Vomiting can signal the disease any body participating in the digestive process, - appendix, gallbladder,   liver,   stomach; often There is pain. For unknown reasons, vomiting can accompany severe pain in other parts of the body, which happens with heart attacks, kidney stones or headaches caused by migraines. Diseases the brain, such as tumors or meningitis, also provoke vomiting, perhaps because of their effect on the work of the vomit.

   Drugs that cause direct irritation of the stomach   (aspirin, erythromycin, ipecacacacan -   gag   root,   alcohol),   also   stimulated vomiting center; depending on your sensitivity, such a reaction can Give other medicines.

   To vomiting leads to general metabolic disorders,    Therefore,   it is usually   accompanied by diseases of the endocrine glands (thyroid gland,   adrenal glands), diabetes and significant changes in the volume of blood or the level of minerals in it: in the case of dehydration or excessive consumption   liquids, kidney diseases, sodium or potassium disorders balance.

 

   TREATMENT

 

   Real men usually do this: vomiting, they quickly   swallow the good portion of alcohol "for compensation for the lost   liquids”,   they vomit again, they drink again, and so on as long as in    the state of   complete devastation will not call me and say: "What a hell, nothing I can keep it inside!”

   Don't do   that.   Fill   something   annoyed   The digestive tract means irritating it even more.

   Leave him alone. Grind up the Cubits ice and put a vessel with them near the bed. Lie down calmly with a piece of ice in   the mouth,   Keeping   next to A bucket or pelvis. If there is no more vomiting during the hours,    Start sucking through the straw of non-alcoholic A drink   like   ginger   Elya or Coca-Cola. Sweet water - The main   component   part   Non-alcoholic Drinks - calms the stomach. Not Drink   mineral   water.   Nothing  Eat until you're hungry. Medications,   sold   without   a prescription,   in Moderate Degree   Neglected   nausea,   but   if     vomiting has already begun,  act badly, Therefore, take them after hours after   the attack.

 

   FOUR COMMON MYTHS ABOUT VOMITING

 

   1. It is very important to prevent dehydration and Eating well

   This is true for infants and old people, but a healthy man without any danger for the body may experience bouts of vomiting for a whole day and Refrain from eating   for several   days.   If   doctors hospitalize a patient with gastrointestinal disorder, he   is usually prescribed a prescription "nothing through the mouth" and begins intravenous   fluids. If vomiting is not will stop,   you   too   you will need   such a procedure, and before it begins, do not put anything in your mouth, except a piece of ice.

   2. Vomiting is a natural way, with the help of which   the body   gets rid of poisons

   This is a bright sample of the popular, almost religious view of   nature. Yours the body is a wonderful mechanism, but it is far from   perfection.   Diseases regularly cause   meaningless   and   even   the harmful   behavior of internal organs. If you eat spoiled food, the toxin   passes   in the blood, causing stimulation of the vomiting center in the brain. By the time of vomiting, the toxin has already been completely detached   from   the digestive   tract,   therefore, vomiting is now completely useless in terms of intake of poison, but it will continues until the toxin is removed from the body by the liver or Kidneys.

   3. Vomiting empties the stomach; vomiting, continuing with an empty stomach (vomiting urges) - Sinister Sign

   I repeat, vomiting causes the brain. All will stop as soon as he stops sending these signals. Availability or the lack of content in the stomach has no Meanings.

   4. Bile vomiting is a bad sign

   Bile is introduced into the digestive tract immediately behind the stomach,   so when blocking the tract below this   Places     can   to be present   in the gag masses.

 

   KNOW WHEN YOU SHOULD ATTRACT ATTENTION MEDICAL

 

   Within 12 hours, 90% of vomiting attacks pass by themselves. It's   Enough reasonable point of reference to which it is not possible   raising   anxieties, but if you’re really sick, call a doctor earlier.   Elevated temperature or diarrhea is not a reason for concern, but if they   are accompanied by severe abdominal pain or other parts of the body, visit the doctor as soon as You'll just wake up. When vomiting with a large   The amount of blood is necessary emergency treatment, but, if you notice only a few blood inclusions in the vomit, do not Frightened.

   Certain cases of abdominal pain require hospitalization, but to vomiting It doesn't apply. You can try to get to   the hospital   where   You will be helped very quickly, but not because, that the disease requires   urgent measures - Just staff usually don’t want to   Wash   the floors   after such a visitor.

 

   DIARY

 

   Like vomiting, diarrhea rarely signals Emergency problems.   Medications that sold without a prescription, help well, so you   can cope with this violation independently.

 

   NATURE OF DIRAY

 

   By definition, diarrhea occurs in those cases where the stool increases in volume or is made too watery.

   If she bothers you occasionally, This   indicates   that   High suction capacity of the digestive tract, because   every day in   the small intestine receive about 8 liters of various liquids: slightly less than 1 l of saliva, 1.5 liters with food and drink, about 2 liters of gastric juice and about 4 liters of bile and secretions of the pancreas, as well as the most small intestine.

   After absorption of about 7 liters of liquid the small intestine moves the remaining 1 liter into the colon, which absorbs from This number is about 80-90%. If anyone   asks to suggest,   what is   the daily volume of its excrement, then almost everyone gives an overestimated assessment, and at the A healthy person allocates only 110-250 g of feces daily. And even this quantity is mainly water, and the residue consists of bacteria of the large intestine, bile, mucus, intestinal cells and   a small   amount of unprocessed food residues (most food that a person does not absorb, Consume bacteria of the large intestine).

   Medical students are always told the difference between     thin diarrhea   and the large intestine. In reality, these   phenomena   interrelated,   and   this question presents rather a purely   academic   interest,   Doctors don’t give him much importance. However, you can use this information, to understand the symptoms.

   Every day your body releases about 1 Tea cup   of liquid,   while thin the intestines sucks about 32 of these   cups.   Diarrhea of the small intestine is accompanied by a large volume of watery stool. Subtle the intestines can be affected by many toxins: a classic example is cholere, causing massive diarrhea. Death in this case comes from dehydration of the body, but treatment is enough   easy. If the victim takes the fluid inside the amount sufficient to compensate for losses with stool, then   the disease   Passes     during   A few days. Taking antibiotics is not mandatory, but   Contrasiding agents   for cholera are effective Badly. The small intestines   are attacked    and   many other, less severe toxins.

   Processing the only one he gets a liter of fluid,   large   intestine with impaired function can not produce large volumes of stool. Diarrhea Fat intestines manifests itself in the form of small   volumes   of soft stool, which is a typical sign of serious disorders like   ulcerative colitis, diarrhea of stress origin, irritation of the colon and some infections.

   Do not forget that   it is thick   the intestine   controls   the mechanism of excretion, therefore, in case of violation of its functions, a person feels   the need for defecation much more often than usual. The closer the focus of the disease is to   the anus, the more persistent and irresistible such a feeling, so inflammation of the last part of the colon (direct intestine) can lead to   a complete loss of control Defection, despite the   small   volumes of stool. In diseases of the small intestine, the need for defecation is enough easily controlled, but the allocated volumes of stool are large.

 

   CAUSES OF DIARRHEA

 

   Unlike vomiting diarrhea almost never does not   indicate    disorders that have arisen outside the digestive tract. It usually signals lungs of viral infections. Travellers who suffer from diarrhea,   Usually   afraid of dangerous diseases, but even the disgusting "Resin of Montezuma" (It   is caused by a bacterial toxin Infection) after a few   days   passes   without treatment. Cholera and Bacterial dysentery, accompanied, in addition to diarrhea, high temperature and pain in Abdominal cavity, in the United States is rare.

   Patients are also worried about the intestinal parasites, and this is not   without reason: except for those parasites that are imported   by tourists,     in the American water there are and their own,   like   lamblia,   There are many diseases that cause. However, Despite the general Persuasion, abundant diarrhea in such cases is not Typical. Parasitic   microorganisms and worms usually cause inaccurate digestive disorders, weight loss and soft stool, but the general state of health practically does not suffer.

   Fruits and Vegetables are found in fruit undigested fibers,   increasing volume and softness of the chair. Consumption of large amounts   of this   food can significantly weaken the stool, but Exquisite   diarrhea   is not   Calls.   Caffeine also stimulates the digestive tract (therefore coffee   is useful   drink   in the morning, but do not abuse it.   Similarly,     some   drugs: antacids, antibiotics, digitalis (furney) and dry   thyroidine.

   Here is a paradox: diarrhea can be a sign... constipation,   especially   the old people. Every doctor meet with such cases.   Residues   of fluid entering the large intestine can suddenly stumble upon a blockage created by the feces (i.e. constipation), or   (which)   Much   worse)   the tumor. Accumulating during some time, they can   then   find a loophole and pour out Outside, as a result of which the patient begins to complain of diarrhea.

 

   TREATMENT

 

   Unlike behavior in vomiting, try   to replace   the amount of lost fluid, although this is not the most important measure for an adult   man (serious diarrhea in children and the elderly requires rapid   medical intervention). It is best to drink apple juice or soda.

   All products containing narcotic substances, cause constipation, so to relieve diarrhea people before took   opium,   even   before discovered its intoxicating properties. Yes and Now it is the best treatment.

   Usually   works very well   subsalicylate   bismuth   "PeptoBismol", better in the form of a mix, than in   pills.     In comparison   with   aspirin  , it is less annoying the stomach, but can paint the chair in black - this should not be frightened.

   A long time ago, the tool has been known "Cathopectate" - a mixture of kaolina (rotated in powder of special clay) and pectin (sticky carbohydrate obtained   of   the fruit). These substances should, in theory, make the watery stool more   dense,   But they don’t always meet expectations. You can use activated charcoal for diarrhea, although it is much more effective works with gases.

 

   KNOW WHEN YOU SHOULD ATTRACT ATTENTION MEDICAL

 

   Typical viral diarrhea continues 3-4 day, so   if   you   don't experience severe discomfort, be treated at home. If you are healthy   in other ways and feel good,    Take     as   control period of maximum one week, but with   bad   Feelings   after 3-4 days consult a doctor. If diarrhea is accompanied by severe abdominal pain or vomiting, visit the doctor the next day.

   No need to warn you about the danger bloody diarrhea -   no   reasonable man his will not ignore. Fortunately, it is usually not as scary as the frightened are imaginary   patients.   Bacterial   infections of the colon, as well as   its   inflammation   type   of ulcerative   colitis,   cause heavy bleeding, but these diseases Quite curable. Men are less likely to pay attention to a soft black stool, but this is   a sign of   noticeable bleeding in the upper department digestive tract, in particular in the stomach. When black (not dark brown) stool immediately go to the doctor.

   People (in this case I do not mean doctors) spend a lot of time on the fuss with frankly useless device - thermometer, ignoring   much more necessary and important for home medicine is   good   scales. Temperature, even high, is rarely    A threatening   sign   that cannot be said about Unexpected weight loss. Weight fluctuation of each person during the day is within about 1.5 kg,   But,   finding a loss of 2 kg or more without a special diet, go to the doctor. The scales will have the best help with a long, but not very strong   diarrhea. Men with minor diarrhea Stressful   origin   should eat well for Compensation for   weight loss.   Parasitic   infections   and serious diseases can cause only moderate changes in   stool,   But there is a continuous loss Weights.

 

   IF YOU HAVE GAS...

 

   No respectable guide to Maintenance does not   apply to this themes, and yet it is a common nuisance, which is rarely talked about the doctor and with which they do not cope well. Since excess gases are almost never a sign of the disease, doctors do not   study this phenomenon during the period training, but they should     replenish their knowledge, as from gases   Many   patients suffer.   Almost every man is convinced that he is emitting gases too often, and other forms of manifestation Excess gases are very depressing. Doctor   can   help   (and sometimes even cure) each patient with the help of consolation, dietary recommendations and drugs.

   Studies have found that three fundamental symptoms   -   belching,

Bow bloating and   abundant   education   and     gas emission   -   indicate separate diseases, the methods of treatment of which are different.

 

   BIENCE

 

   People who suffer from belching are usually blamed for Excess gas is poor   digestion. However, scientists have examined the reguls of gas and found a composition similar to Atmospheric air.   Therefore,   belching   -   it's just   an exit   out   swallowed   air.   Everyone   A person   swallowing something, certainly captures a small amount   of air.   Even more air gets inside with containing it (or other gases) with food whipped cream, soufflé, beer, carbonated   drinks   or   cakes-going. During the usual meal, a person can swallow up to 0.5 liters of air. Hasty and Troubled People Swallow the air without even noticing it.

   The gases tend to go up, Most   of the air comes where it comes from.   Only   very   small   the amount goes down the digestive tract, causing additional   violations. The researchers proved this by pumping air into the stomach of the examined individuals and observing its exit back.

   Traditional tips include the process chewing   food   with   closed mouth, the exclusion of food containing gases; In addition, food is not   recommended Talking and drinking plenty of fluids. None of the medicine   gets rid of the swallowed gases.

   These tips will help men who cherish After the meal. Those who swallow the air unconsciously and not only during food, my   explanations are unlikely to seem convincing. And yet I   I recommend   them   to try to keep their mouth closed for four hours,   and   Then   watch, did not decrease If the belching. No one has yet managed to swallow a lot of air with your mouth closed.

 

   BLOATING A BELLYONE IS A COMPLETELY DIFFERENT MATTER

 

   Usually in the intestines of a healthy man there is about 170180 cm3   of air. V intestines of people who are concerned about swelling - exactly the same its amount, and discomfort does not occur at all from the excess of gases. Intestines such people are usually too sensitive, and   therefore     the normal volume of gas and liquid gives hyperreaction, expressed in spasms, Moving the contents of the intestine. When researchers pump into thin intestines air, healthy people feel only strong bursting pressure, and Those suffering from chronic bloating are also pain.

   Bloating is probably One of    the form of   irritable bowel syndrome - the leading gastrointestinal disorder, which affects 20% of the population. This The violation is not threat to life, but quite tedious for those who suffer from various combinations spasms, gases, constipation, diarrhea, indigestion   and     bloating. If you are constantly not satisfied with the work of your digestive tract, you can suspect at home Irritable bowel syndrome.

   Changes in diet play a small role in treatment bloating, as it is a muscle disorder. However, patients often attribute the deterioration of their condition with some kinds of food, so I encourage Experiments with the selection of food. Exercises tone all muscles, including   muscles intestines, so active people are usually less   complain of   the gastrointestinal tract. Try walking quickly after eating. 

   Centuries a year ago, treatment specialists Herbs discovered the properties of belladonna. Since then, medicines have been for her The basis is used   for   bloating. Belladonna extract contains an active anticholinergic   -     Chemically, blocking transmission of signals from cholinergic neurons (part of the autonomic autonomic   nervous   system,   the management   digestive tract and some other organs).   Signal Blocking   from   these nerves relaxes the intestines.

   Theoretically, that's right. The reality is not so satisfactory. Cholinergic nerves control many vitally important organs, so an effective blocker is not only Relaxing   the intestines,   but   and,   for example, abruptly reduces the release of saliva and sweat, affects the   bladder, stopping urination, slows down the speed of thinking,   causes   drowsiness and expands Pupils. (By the way, a small digression: bella donna in Italian     means   "beautiful   woman."   In   the Age   Renaissance Italian men highly valued in women extended   large   pupils, because Italians and Drunk in the eyes of the infusion of grass, expanding them).

   Concerned about these unpleasant side the phenomena   of medicine,   manufacturers are trying to use in ready-made   drugs   so small doses are belladonna that popular anticonvulsants,   apparently, in this The case does not work at all.   More   effective   Small doses   Antidepressants   such as   amitriptyline   (Elavyl)   or   imipramine (Tofranil).

 

   GAS AND MILK

 

   Men release gas during the day Volume from   0.5   to   1.8   l,   average about 12 Once a day. This happens more often with vegetarians. As mentioned above, the swallowed air tends upwards, and gases   emitted through the anus are formed in gastrointestinal tract due to the work of bacteria the large intestine or   undigested   carbohydrates.   People learn protein and fats with almost   100%   efficiency,   but   most of the carbohydrates obtained from food, passes into the colon,   without   undergoing changes. They are consumed bacteria, producing gases: mainly hydrogen, methane and carbon dioxide (all without odor), plus a small amount of more complex gases that smell.

   The highest content is bad digestible (or unabated) carbohydrates - in grain (almost all varieties of bread, for the exception of white and   bread from whole wheat), corn, legumes (beans, peanuts,   peas),   dried fruits, bananas, apricots, carrots and onions.

   A specific disease that causes the formation of excess gases in a healthy person, no, but many adults lose the ability   to   absorb lactose (milk sugar - carbohydrate contained in milk). If   you think about it, milk is a child's food.   Look   at   adult animals - they do not drink it, and nature gradually, as the body matures, removes from the digestive tract lactase (enzyme that breaks down lactose). Humanity Consumes Milk only   a few   millennia, so perhaps we did not have time adapt to him.

   When a person with lactase deficiency drinks milk, lactose enters the colon, where it quickly begins break down bacteria by producing gases. In some cases, this process accompanied by spasms and diarrhea. People who are devoid of lactase to the greatest extent, They quickly understand what to avoid, but actually everyone, who is tormented by gases, you need   to try Refrain from dairy products for a month.   The transition to     low-fat or removed milk will not give any effect, since there is little fat in these varieties, and not carbohydrates.

   If you have found that milk does not increase formation of gases, experiment - exclude from the diet of certain types   of products   (free of gases only meat and eggs). You may be lucky and you will   install "offends," and if not, treat your gass philosophically.

   In spite of the seemingly rich choice, neither One medicine     can not get rid of already available gases. I suggest that patients use   activated carbon - a safe remedy, Available without a prescription.

 

   DISCORSORS IN THE ANAL FIELD

 

   Anus (anus (anus) - area, from which   men   are usually   do not   expect trouble, and their occurrence is extremely reluctant to tell the doctor, having spent before that a lot of time on useless attempts at self-medication.   In their happiness, the most Terrifying anal symptoms   usually   accompany small curable disorders.

   Pain in the anus means the same as pain in any other   part of the body - damaged or irritated tissues. The pain aggravated by   defecation usually indicates anal crack - a cut or rupture of the skin, formed, perhaps due to a special hard or volumetric   stool   -   in many men, unexpected pain occurs with difficult intestinal attempts. Some, on the contrary, do not associate pain with a violation of   the stool.   Doctors still can not confidently name causes of anal fissures in the anus in the anus relatively healthy people.

   Breaks in such an active area seem people   with a serious   problem, but anal fissures are healed as quickly as wounds on any other parts of the body. Despite the presence of the stool, infection is quite rare. Doctors treat cracks, prescribing stool softeners, softening ointments and sedentary hot baths. All these measures are reasonable, but   the effectiveness   They   are not entirely clear. However, such treatment takes patients at   that time,   as long as nature does its job. Similar medicines and ointments are sold     in any pharmacy, try Cure on your own. But, if   pain     does not pass within a week, Go to the doctor.

 

   IF YOU HAVE DISCOVERED THE TUMOR

 

   A tumor in the anal area, accompanied by It's pain. Men who experience discomfort in the anal area are most often accused in all hemorrhoids. However, when I ask them that this No one   can even   answer. Probably, Popular Idea of Hemorrhoids   Includes     any discomfort in Anal area. Medical     Definition   this disease - varicose veins in Anus. This is the price a person pays for what is upright the creature, because the vertical position of the body creates a higher blood pressure in   the veins of the legs and anus, than in creatures moving on four limbs. With age the thin walls of the veins weaken and stretch, which leads to their swelling and lethargy (variocosis of the veins). Arteries are not susceptible   to varicose veins,   because their walls consist of a denser fabrics.

   Hemorrhoids have almost every adult, Although he may not   notice it. Moreover, the pain is not among the symptoms of hemorrhoids even   of moderate severity. The exception is cases when in the anal veins unexpectedly formed a blood clot (thromb). It is not known why this happens, but every victim immediately feels when. When     blood circulation   in the anus is blocked, then in the vein increases pressure, blood begins   to burst it, causing pain and forming a sensitive tumor that   the patient may detect on to feel.

   Despite such unpleasant manifestations, thrombosis for hemorrhoids is not malignant and does not require treatment. The body is not able to long tolerate   the presence of clots in vessels. Almost immediately, certain elements of blood begin to dissolve them, and most of the blood clots disappear into   three to four days. Resolving is facilitated by a sitting hot bathtub for an hour twice a day. In contrast to the cracks that    usually   are deep enough, swollen veins are located, as a rule,   within reach of hot water. Ointments and candles for varicose veins do not help.

   To relieve pain immediately, the doctor can Open   the vein   and   Remove the blood clot that has arisen in it. Hearing this Advice,   most   men   immediately decide to wait for natural resorption. But it's very   easy and almost painless operation, and its results   are radical.   I   always encourage my patients with   Strong   pains   to allow   the surgeon   remove the clot right on the spot.

   A tumor in the anus without pain    often   is a common wart, no different from warts appearing in other places. Warts have the property of growing and   spreading, so they require treatment. The doctor will smear   them   corroding them   liquid or freezes with liquid nitrogen.

   Large hemorrhoidal lump can be severe Speech,   but   to be sick   should not , unless it is harpered. You, Of course, they would rather remove it. If the bump is not Reaches Extremely Large   sizes,   this   operation is performed quite easily, right in the doctor's office.

   In conclusion, I will mention the rarely encountered Cancer tumors   of the anal region. They are almost painless, so when such See the doctor immediately.

 

   WHY ITCHING APPEARS IN THE ANAL AREA

 

   When anal itching appears, do not rush Blame this bad hygiene. As well as a hole on the opposite end of the digestive tract -   mouth, the anus strongly resists the local microorganisms and pollution. Attempts to cleanse cause much more severe irritation than rejection of them (with irritation of the rinsing rinse is also useful).

   First of all, make sure that the itching Not related to   food.   Of all food The best itching causes coffee.   Try   to do without it A couple of weeks. If this does not help, exclude for   two weeks of dairy products. Other possible sources of itching are beer and large   amounts of vitamin C (more than 1 g per day). A Maybe you have started   to use Some new food, give it up. Exclude   from the diet of spices - they were considered the main   irritant   digestive   tract   from the time of its occurrence humanity.

   If, looking at the buttocks in the mirror,   you   Detect     small pink spots on the inner parts, then most likely you have a regular fungal infection. In this case, use antifungal ointment twice a day, for two weeks. If itching subsides, continue treatment for another month and a half. If after two weeks of treatment itching   is not   It passes, then, the reason is not in the fungi.

   Common and excruciating anal itching Stressful origin is very difficult to diagnose. In this do not rush to   conclusions, as a sensible doctor will exclude other possible reasons   before putting such diagnosis. Improve the state of the ointment based on   cortisone, but before the exact diagnosis is not worth it apply them, as they facilitate the itching of any origin, and do not eliminate its   cause.   Cortisone will relieve itching that accompanies the fungal infection, but the fungi themselves will continue to grow; reduce itching from skin irritation with poor soap or chemicals, but Skin damage will remain and may increase   as you won’t understand what’s going on.

   Anal jeopardy is usually alarming, But not always   indicate serious diseases. Anal fissures can bleed slightly, and slightly leaking hemorrhoidal vein can also paint the contents of the toilet. Although both situations are not dangerous, all Let me know about this doctor. Tumors of the colon bleed quite often, but in such cases the blood is released in such quantities that it is impossible Detect the naked eye. Noticeable bleeding in a young man can be caused by infection (dysentery) or inflammation   (for example, ulcerative colitis). In the elderly The usual source of   bleeding is artery in the wall of the intestine or diffuse   bleeding from ischemic colitis - blocking blood circulation in the colon  . In this case, you need to hurry to the doctor.

   Although I mentioned a liquid, black stool (medical term for him melena) in the section on diarrhea,   this   The moment   is worth   a repetition. Blood remaining in the digestive tract darkens to black    within a few hours and is valid as Laxative. A typical case leading to the appearance of melancho, is   ulcerative   bleeding,   This   always requires emergency intervention.

 

   WHAT TO DO AT INCREASED TEMPERATURE

 

   Waking up in the morning broken and feeling fever,   a person usually assumes that he has the flu. Not wanting to succumb to the lung,   in his opinion, disease, he begins to gather for work and   from   pure curiosity, the thermometer is hidden under the arm. It shows 38°C. Man instead of work goes to the doctor and is convinced that his initial diagnosis   is correct. Treatment consists of admission various mixing, aspirin and   stay in bed.

   In the "Flu Season" I'm a few I   explain to   patients once a day,   that the temperature of 38° can not damage healthy adult man   and   often noted with acute Diseases   similar   to   The flu.   Men   almost always exaggerate Danger of high temperature   (  Except when they are undervalued). They try their best to knock it down and are very worried when it fails, despite my   assurances.   That such treatment is hardly necessary.

 

   THE BODY IS A THERMOSTAT

 

   Deep in the brain area called Hydolatum,   coordinates   the main    physiological    functions:    appetite,    thirst,    emotions,    sleep-wake cycle, and It also regulates body temperature. Reacting to the temperature passing nearby blood flow, special nerves send signals, thanks to which heat or persist (by compression and reduction at this expense, the surface of the blood vessels located in the skin) is either dissipated (by increasing sweating and vasodilation). These actions are performed continuously to keep body temperature in certain Limits.

   All mammals and birds have this The thermostat located in Hypomalmus. Normal Temperature for mammals varies in   range between 35.5 and 39.5°C; the most "hot" creatures - birds - the average body temperature ranges from 38.8 to 43 ° C. Maintenance of such high temperature gives them the possibility of greater activity    compared   to cold-blooded low-temperature creatures, especially in winter. Anyone who has visited the terrarium at the zoo knows how boring it   is to watch its inhabitants capable of watching Staying for hours without movement.   Price for Our high body temperature is an excellent appetite.   A person weighing 60 kg should Eating 20 times more food per day than   The crocodile is the same weight.

 

   MYTHICAL "NORMAL" TEMPERATURE

 

   When in the middle of the XVIII century appeared relatively reliable thermometers, scientists came to an agreement that the temperature the body of a normal   adult, measured in the mouth or in the anus (one of   the usual methods for the western countries), should be 37 ° C. However, the average   The temperature is 36.6° or even even a lower temperature. This confirmed by all the latest research.

   The body temperature   of each person during   The day   fluctuates     in small range - from 35.5 to 37.2 ° in normal conditions. Following the circadian rhythm, the lowest body temperature is observed in the morning,   near   6 hours, and the maximum value is achieved evening. Like many   other biorhythms, the temperature follows the daily cycle of the Sun, not the level of   our activity. Men, working at night and sleeping during the day,   demonstrate the   same cycle of temperature changes as the rest.

   Temperature level below 35° indicates Presence of a serious   illness (usually This is the result of irradiation). Victims of hypothermia fall into   a stupor if Their body temperature decreases to 32.2°, most lose consciousness at 29.5 ° and die at a temperature below 26.5 ° C. The survival record in the conditions of hypothermia is 16 °, and with experimental studies - 8.8 ° C.

   The temperature is affected by gender and age. U Girls' body temperature   stabilizes at the age of 13-14, and in boys - about   at   18   years old.   The average body temperature of men is about 0.5-0.7° is lower than that of women.

 

   CAUSES OF TEMPERATURE INCREASE

 

   The temperature rises when the hypothalamus, In technical terms, “circumcises the thermostat.” For example, The hypothalamus   can   be established   for the body "normal" temperature 38°. If the temperature of circulating blood is 36.6 °, neurons react as if your body is in the cold, and will begin to send signals that amplify muscle activity. As a result, you will begin to shake until the temperature rises to 38.9 °.

   In some cases, body temperature changes in the absence of   diseases. When   digesting   food   The temperature   rises   approximately   on 0.5-1 °; in women after ovulation - on 0.5-1° and remains     on this   level up to menstruation (the result of the increase level of   progesterone).   Marathon players can finish with temperature about 40.5°,   as   the runner produced heat faster than it was removed from the body.

   High temperature accompanies bacterial and   viral   infections, immune reactions (allergic or   reactions to     vaccinations),   inflammatory processes in tissues (colites, arthritis), tissue death (heart attacks, bleeding, postoperative phenomena) and Even the Effects of Natural   Hormones (thyroid hormone, progesterone).

   Listed hormones induce cells release special chemical compounds (interleukins, prostaglandins, interferons) with a wide   spectrum actions, and one of these actions   is   "Rebursement"   Hypothalamus. Antipyretic drugs, for example aspirin, block this effect.

 

   HIGH TEMPERATURE: IS IT GOOD?

 

   Most of the authoritative professionals Respond affirmatively, leading as an argument The Argument That Every Action of the Immune System   should to serve the body.   V   Time of   experiments   was revealed,   What cells of the immune system at high Temperatures kill   bacteria   faster. One of the most important cells, T-lymphocyte, works best at a temperature of 39.5 °. Cancer researchers Diseases   Reduce   Tumors   in size by warming them up. At the beginning of the XX Centuries doctors have used   high temperature for the treatment of syphilis and some forms of chronic   arthritis: The patients were placed in a heated box. Some doctors practiced   infection of patients with malaria.

   Experiments on lizards (very informative, as   researchers can change their temperature at will) gave even   more   Evidence. The warmer the lizard, the better resisted the infection. The introduction of   infected lizards of aspirin increased mortality.

 

   WHEN THE TEMPERATURE IS A THREATENING SIGN

 

   With a normal immune system High temperature is a sign of good health. Very old   and old   weakened people usually devoid of heat poorly, so the increase in   Temperatures require close Attention. The same is true of people with weakened immune system. People with AIDS or leukemia (white-blooded) and those who have been exposed Treatment of   chemotherapy cancer    or radiation therapy, should inform the doctor about Any   increase in   temperature. The unripe immune system of newborns reacts   to   the impact   is unpredictable; High temperature during the first month   Life   should always be seen as a serious signal.

 

   CAN I KNOCK DOWN THE TEMPERATURE YOURSELF?

 

   Yes, if it makes you feel better. Answer sounds like I'm   contradicting Authorities, which he himself mentioned, but it should be noted that    They do not give an exact definition of this, How   important   is high   Temperature as an immunological factor. Previously Used methods   of treatment   with high temperature were quite dangerous and not   always   effective.   Medical journals for about 20 years published data on Good Results   of Hyperthermian cancer treatment, but no one took on   courage   to advise practitioners to widely use these methods. You can,   of course,   to consider experiments with lizards seriously, but at the same   time   Doctors   did not note that people with infectious diseases become worse   from antipyretic funds.

   The most important element in attempts to knock down The temperature is   not the medicine - you need to try to cool down. Wrapping in blankets is   a bad idea, although such the desire to resist when you are shaken from chills (remember, by the way, that at this time and increases   temperature).

   Drink plenty of fluids to reimburse water that is released from   later through the pores of the skin. Dehydration not only worsens well-being, it contributes to increase in temperature, because it reduces the amount of fluid that is needed the body for self-cooling.   Drink   more   juices, carbonated or mineral water to The volume of urine excreted has become a little more than usual.

   The best antipyretic agents with moderately elevated temperature are ordinary aspirin or acetaminophen ("Tylenol", "Datril", "Panadol").

   About an hour after admission Medications you can   start   to sweat. Despite the popular persistent the belief that this is useful, sweating simply signals that      that the body   is cooling.   The heat always rises, then falls, so by himself      the fact that   the temperature drop does not mean that everything is fine, but that   it   increases, respectively, does not mean that everything is bad; just with the body what happens, and Nothing more. When the effect of drugs   end, chills can come back - it's not bad either and not a good symptom, but just a way in which the body generates heat. To avoid unpleasant   throws "it in the heat, then in the cold", try constantly maintain a low temperature, taking antipyretic every four hours.

 

   WHEN YOU SHOULD CONSULT A DOCTOR

 

   Elevated temperature is hardly in itself may be the reason for going to the doctor. Many patients, hearing these from me words,   are indignant, but ... here is a model of dialogue, quite often occurring between doctors and patients:

   Patient: "What if I have a temperature "Will it rise to 39°C?"

   Doctor: "Is that really bother you?"

   Patient: "Of course!"

   Doctor: "Then... do not measure it."

   I suggest healthy men to follow One simple rule: knowledge of the disease makes us sick. Go to the doctor, if you're   really sick. But if you are   normal    feel,   then  , rather   In total,   do not get sick, regardless of the fever.

   When I am asked for advice, I suggest patients:   call a doctor, if the temperature has risen above 39.5 °. With this heat, the patient is actually Feels sick. I consider a dangerous temperature of 41 ° - a level that begins to affect brain function, and   the most common first sign of this is convulsions. Irreversible brain damage occurs very quickly   after   reaching   42-42.2 °.   The above can, of course, frighten, but Adult Men Rarely Rises Above 41°, and It Usually Occurs with a disease of the hypothalamus, heart attack, encephalitis or stroke. Victims of the Influenza and other   common infections can - don't worry. Remember that   These   recommendations relate to relatively healthy people, except   No     need to count them Insane truth. I ask my patients   call   me   at any time if they Something is worried about; all good doctors do the same .

 

   PAIN IN THE BACK

 

   The authors of medical work adore Leading   Primitive   Cultures   as samples of healthy behavior, and I In this sense, there is no   exception. Representatives of such cultures do not suffer from increased   blood   pressure, since very little salt is consumed; there are almost no constipation, appendicitis and intestinal diseases, as they eat a lot   of rough   food; their obesity is too a rare phenomenon, because it is not easy for them to extract even the amount of food that is barely enough to feed them and their parasites.

   In addition, it turns out that the representatives of There   are no primitive crops   and problems associated with pain in the back, because they:

   - sleep on the ground;

   - more are on the legs than they sit;

   lead to an active lifestyle.

   All these actions are preventive   measures, so I want to consider in more detail why   back pains appear   and how to treat them.

   The size of the leg muscles is comparable to the thickness of the arm, and the back muscles can   be compared except with The thickness of the finger. Clearly uncreated for heavy   work, the spinal muscles of a person are too weak, to support   it   in   vertical position. Four-legged animals do not need strong   dorsal muscles, and the person got on his feet only a few million years ago, so his dorsal muscles have not yet managed to adapt   to the big   loads.

   We are due to the fact that the vertebrate The pillar rests right in the pelvis. While our torso balances, relying on the surface size   with a silver dollar, the muscles of the back regulate posture, allowing us to turn and bend, i.e. perform the same function, as for the four-legged. But it involves a certain risk, Because people are wrongly straightened, they lean too much, then for     one or another   the reasons are displaced the torso too far from the center, forcing the spinal muscles to maintain a very large weight for them. Usually the muscles the backs still cope   with such a load, but at the limit of their strength capabilities. That's why People regularly suffer from pain and various injuries associated with the dorsal muscles. In a relatively healthy man, back pain can be caused by the simplest muscle damage.

   Vertebrae, strong enough to to hold     the upper body weight, need in pillows-ramzengers located at intervals of the vertebral length column, for mitigation and acquisition energy in shocks. For this purpose, the purpose is intended well-known discs - the subject of so many accusations. The young spinal disc is   a gorgeous hydraulic system (its core 80% of     water)   and can flatten, swell and other how to deform   in response to the load, very quickly restoring the original form.

   Like all other tissues, discs with Age hardening. Although it deprives the back a certain share of flexibility, worn and hardened disk   itself does not get sick Maybe because it does not contain pain nerves.   Problems arise when it becomes fragile the disc cracks or breaks (  in fact, it can not "shift", as   usual   they say).   The broken part and causes pain when pressing on sensitive tissues, for example Ligaments. If the pressure occurs near the nerve,   in some cases there is pain that gives to Foot. This is the neuralgia of the sciatic nerve, or sciatica (the sciatic nerve begins in the lower part of the spinal column and goes in the leg).

   And finally, like all bones, every vertebra connects   to   the adjacent joints, lined with cartilage tissue and filled with lubricants liquid that allows them to move relative to each other. Joints of the Lower five vertebrae (lumbar) thanks to   their   shape   and   angle allow only inclinations back and forth. The joints located immediately above them 12 thoracic vertebrae do not allow to lean forward   and   backward, but allow turns and slopes in   parties.   The old   joints wear out and rude, so in the elderly the cause of pain     arthritis is most often in the back, but back muscle damage remains an equally important factor.

   After 35 years, the bones begin to slowly lose minerals. This disorder, called   osteoporosis,   more often   observed in     women   -   in most of them after 60 years, the vertebrae become so   fragile that from time to time one of them shrinks (solved) under load. This phenomenon is called a compression fracture -   sounds   catastrophically, but its usual consequence is only pain. Men in the years also suffer from osteoporosis, but in less  ,   and   It happens   later. Doctors suggest that the loss of bone mass   in   women   accelerated the drop in estrogen levels during menopause, but it is also possible that men less prone to osteoporosis due to a more active lifestyle (physical exercises strengthen not only muscles, but also bones) and also because the male bones are larger than female ones.

 

   HOW TO TREAT PAIN IN THE BACK

 

   Even in the absence of any treatment 90% of the pain They pass in the back themselves in a couple of weeks. None of the means speeds up the process healing.   The correct treatment should prevent possible interference with healing and   Reduce the pain.

   If your back hurts, even very much, Try   to take   it calmly, though Consult with the doctor is worth consulting. Men for   back pain most often cause an "emergency" that brings them into Emergency room where they receive unnecessary dose of X-ray, drugs that could be bought in the nearest pharmacy, and the advice to lie calmly. Even with a rough "shift" of the disk should not to go to the hospital, if there are no signs of nerve damage,   weakness   in   the legs   or difficult urination. Reel   for   several   days   will remove most of the pain in the lower back, no matter what their cause   -   damage, "displacement" of the disc or inflammation of the joint.

   Painkillers remove pain Syndrome, but does not affect   the process Healing (I am very sorry   if   such   Elementary   explanations hurt your intelligence, but I   I have to   do   this,   because   most of my patients confuse, say, antibiotic treatment with symptomatic, That is, pain-relieving treatment. They are deeply convinced that    aspirin treats headache, potions that suppress cough, - colds   that soften ointments - hemorrhoids, etc.). To reduce pain, take   ibuprofen and its derivatives (“Brufen”, “Nuprin”, “Motrin IB").     The instructions attached to them restrict the reception of one or two 200-milligram tablets, But I recommend taking three.

   If you go to the doctor about the pain in back, then, most likely, Get a prescription for similar drugs. But no means     will be Better than sold everywhere and without a recipe ibuprofen!

   To reduce acute pain during   the first   day,   take   cold lotions, but then you need to use heat - it relaxes the muscles and   anesthecinates. Bottle with hot water acts no worse than the heating pads, good and   hot Baths. Massage without lubricants also warms up and can   alleviate your condition.

 

   HOW TO PREVENT BACK PAIN

 

   Let’s go back to the three useful features of life representatives   of primitive cultures.

   1. They sleep on the ground

   Victims of chronic back pain prefer to sleep on the floor, and experts approve of it. Of course, not worth it to go   to extremes,   but   Ability to sleep properly can prevent Many difficulties in the future. You need to sleep on a hard a mattress that does not subside under the weight of the body. Any mattress can be made more rigid by laying a wooden shield under it. It is best to sleep lying on your side with his feet bent, the head should rest on   the pillow. Sleeping on your back is also not bad, but with The legs   are bent   in the knees. Bending of the legs relaxes the muscles   of the back;   to achieve   This   can be done by putting a pad under the knee folds. Sleep on the stomach creates an unnatural bending of the back, straining the joints and ligaments. Orthopedic beds or special mattresses are not required.

   2. They are instead of sitting

   Standing position is completely natural The position in which   the spine balanced relative to the pelvis. The sitting posture does not remove the torso   from the balance. Representatives of developed crops are unlikely to destroy their chairs, but they should treat them more cautiously.

   - Avoid chairs and benches without a back.

   - The seat backs should be stiff and with   quite   low   the edge, so that it touches the lumbar for Preventing the burries of the buttocks back.

   - Sitting, lean on your back. Nyclin forward   strains   the muscles   backs. It is very difficult to resist the call of a loved one a long-sufficient chair in   which such Cozy pit for the buttocks, but it's the same as "empty food" very delicious, while eating it, but with unpleasant consequences.

   - Sev, make sure that the knees are a little above the hips, and the feet are completely on the floor. If the knees are below the hips, the lumbar will move away from the seat back, increasing the voltage Muscles. With a small increase, put something under   your feet   (at least     a few   old   unwanted books. All these principles are attached to the standing position. Army stand with back-throwed shoulders and protruding   Breasts   are   the same   unnatural as the sitting position. To stand in the most correct position, lower the chin and pull the buttocks. This gives the ability to back (which is never direct) to accept the most natural bend. African shepherds spend on the legs are all day, but stand on one leg, alternately changing your legs. If you have to stand for a long   time,   put   one leg on a chair or other support and change your leg every   5-10   minutes.   When the muscles of the hips get tired, the pelvis tilts forward, increasing the curve of the lower back   and forcing the pain lower dorsal, muscles. Bending your feet relaxes them.

   3. They lead an active lifestyle

   If you already suffer from back pain, Special exercises should be performed, recommended by the attending physician or physiotherapist. If all is in order, Check your health priorities (see chapters. 2). Any A professional athlete knows that champions   Often   suffered severe back damage. Therefore, experts traditionally warn about the possible harm of excessive enthusiasm for sports, lifting   weights,   volleyball, skiing, etc. Of course, these   sports   risky,   but life is so short! Therefore, I do not forbid any exercise relatively healthy men.

 

   HEADACHE

 

   Although headaches are considered mainly female problem, in a year it leads to a doctor Approximately every eighth man (for women, the ratio is 1: 5). Medicine It's good to deal with   this   trouble,   if   the patient is quite persistent in his desire to get rid of pain. Since   the headache occurs occasionally, many do not consider it necessary to visit a doctor during periods of relief. Don't do that   if   the attacks     Headaches become tedious, and the available drugs do not   help.     During the first visit to this, the doctor will conduct an examination and, not finding visible deviations from the norm, will surely prescribe some prescription.   Do not   do hastily conclusion that doctors are no longer able to do anything. It's   not like that: there's a lot Opportunities to save the patient from torment   on   the first   attempt. Developed various methods of treating headaches,   And   if one of them didn’t help, let me know about it and try   the other.   Eventually you will find the right one.

 

   WHAT IS A HEADACHE FROM VOLTAGE

 

   The first action of an alarmed animal - Raise   your head   and   Looking around in search of danger. People can't do that, because   our heads are already located high, but the reaction remained   in the genes,   so when we are alarmed and tense, the muscles The necks and heads are tense.   Head, of course, remains in place, but muscle tension leads to pain in   its back part and temples (sometimes in the frontal part). That's what it is   A headache from tension. Without treatment, she can last from one hour to several days and very rarely accompanied by other symptoms.

   Most headaches are related to this Categories.   Severe   pain patients prefer to call "migraine" - apparently,   This   diagnosis is highly respected. Diagnosis of "headache   from   tension" in an ordinary person causes an idea of neuroses,   weakness and   inability Resist stress. However, many are good   adapting to the situation men experience just such headaches. If the medications sold without a prescription bring relief, Doctors   have nothing more to offer. Otherwise, we can help, for Beginning with more powerful painkillers funds, and then training prevention measures,  which I will tell you more about.

 

   IF YOU HAVE A MIGRAINE

 

   For unknown reasons, migraines are more likely to affect women, but men   make up 25% of her victims - a fairly noticeable value. This disease is also called Vascular headaches.   Patients   are usually   describe migraine as pulsating or rhythmic pain, in contrast to the constant headache from tension. According to   the traditional   explanation,   migraines occurs when the arteries of the scalp relax and strain, painfully inflating and contracting the work of the heart. Everything that dilates the blood vessels (cirogates, alcohol, hunger, fever, certain types of food), can Provoke such a headache, but often migraines   manifests itself for no apparent reason.

   The main source of pain is the temporal artery, vertically on the side of the head. You can feel her pulsation before   the ear.   Since 80% of attacks affect only one artery,   migraine   more often   Total is pain in half of the head (the word "migraine" is   of Greek origin and means "half of the skull"), accompanied by   nausea, vomiting and intolerance to light. It lasts from several hours to one or two days, rarely affecting the victim more than twice a week. Those who have Daily headaches are unlikely to suffer from migraines. Most   patients know that flashing lights or other visual phenomena may inherit seizures migraines, but this only applies to 10-15% of its victims.

   Although the painkillers are more or less   help   with   migraines, means that strengthen the arteries,   act   Better than that.   Doctors for     most of our century prescribed ergotamine for this purpose, and it   is still the best A means to stop the attack.   The patient   should take it as soon as he feels the approach of an migraine attack; in the midst of an attack is not so   effective.   Ergotamine   acts faster than sub-language pills or inhaled remedies, but   many patients prefer tablets or suppositories, which, along with the means sealing the vessels, includes caffeine.

   If, despite the treatment, migraines continue, so   you   need prevention: daily Medications     for Decrease   Frequency attacks. There are many good drugs This type, and you should   choose The most suitable. These are medicines that affect    Blood pressure, small doses of antidepressants, Nonsteroidal   anti-inflammatory drugs, low doses of ergotamine, taken daily, and   some antihistamines. If Receiving one of them for several months did not give satisfactory Results, move on   to the next one. Not Surrender and do not let your doctor give up. In the past Experts have diligently explained to patients that migraine and headaches from tension - various diseases that require specific treatment, but now it is obvious that many migraine prophylactic drugs   help with chronic headaches from tension.

   If you have tried everything without success Preventive   means,   go to complex, but sometimes very effective   methods   of treatment,   such as biological feedback, Acupuncture or chiropractic.   Although such methods are considered simple, natural and less expensive than drugs, in this case all   The opposite   is true.   Treatment   Migraines will require many visits and (in the case of bioenergy   treatment)   intensive practice and concentration.

 

   MIGRAINES FROM MEN: "GROUP" PAIN

 

   This type of migraine affects men in 90% Occurred cases. Typical Victim of this migraine variant wakes up in the middle of the night from   the severe   continuous pain localized around one eye and the temple of   the same   side of the head. The pain lasts from a few minutes to   several   hours,   often accompanied by a feeling of congestion in Nostril and tearing on   the same side. Attacks occur almost every night within a few   weeks, and then stop for months or even years - hence the name   "group." "Group" migraine is not so common as usual, so some doctors do not remember it. One of my   first   medical triumphs was to inform about this local version    a doctor   who wanted to diagnose a "brain hemorrhage" to the patient.

   The attack begins suddenly, so Preventive measures are not   presented possible, but inhaling ergotamine sometimes stops the development of an attack. Can help inhaling pure oxygen, so some patients are constantly keep the oxygen cushion or even a cylinder with oxygen and a mask.

   Lithium and other anticonvulsants act as preventive as other drugs, used in regular migraines. Because a person often does not experience attacks   for years,   daily prevention begins to Eating out. In this   case,   the doctor   can reduce the intake of   preventive   measures,   usually   prescribing   large daily doses cortisone, and then gradually reducing the reception to zero for two weeks.

 

   OTHER HEADACHES: CAFFEINE LACK OF

 

   Caffeine narrows the blood vessels. Adults Men, for some   reason not drinking in the morning their cup of coffee, not only deprive themselves   of its stimulating   effect,   But   soon   begin      irritating pulsating headaches. Those who drink a lot of coffee at work can Feeling so much pain at home on weekends. S     Headaches   of this kind of caffeine make wonders.   He   enters     In   the composition of many   painkillers.

 

   HEADACHES FROM FOOD PAIN

 

   Some people experience headaches, eating chocolate,     in others they begin with cheese, dishes of Chinese cuisine or sausages.

   These products can cause migraines, Because they contain      substances that relax the blood vessels, in particular nitric   additives (there are many in sausages or canned sausage minced meat), as well as sodium glutamate (Chinese dishes). Easy exception to the diet of additives   and processed products may not be solved problem, since some natural substances act similarly, thiramin in cheese, nuts and red wine and phenylethylamine in chocolate.

 

   LACK OF OXYGEN IN THE AIR

 

   This factor relaxes the blood vessels, preventing the transfer of sufficient oxygen to the tissues. Mountain tourism or travel in unsealed aircraft often Provoke headaches   of this kind. Working in poorly ventilated rooms, in particular     in garages, suffer from headaches, which are, in fact, the only symptom Chronic carbon monoxide poisoning. Carbon monoxide   binds erythrocytes, preventing them from carrying oxygen. Increased smoking   can also cause headache due to the same carbon monoxide, and not only the smoker himself, but also in others.

 

   HEAD PAINS FROM OVERHEATING AND HIGH TEMPERATURES

 

   The body is cooled on its own, increasing blood flow to the skin of the body, in number and skull, so everything that causes overheating of the body (increased temperature, enhanced exercise, even hot weather), in sensitive people can cause headaches. The condition is facilitated by lowering the temperature of the skin with with aspirin, acetaminophen, cold baths or compresses.

 

   OTHER TYPES OF HEADACHES

 

   Some circumstances are generally considered the cause of headaches, but It's actually wrong. K Such circumstances include:

   - High blood pressure

   Men and women with constantly elevated Blood pressure affects   headaches no more than all   population     as a whole.   The only way to determine increased   pressure   -   measurement of   tonometer,   This is confirmed by fairly conscientious Research, but   nonetheless The vast majority of patients and, oddly enough, doctors believe     otherwise.

   - Diseases of maxillary sinuses

   In acute infections of the sinus in this   Areas are   strong   pain, why people immediately rush to   the doctor.   Chronic   infections   lead   to a strong constipation, but does not cause painful   sensations.   With   the clogging of the sinus lays the nose, but also does not happen Sharp pain.

   - Allergies

   Hay fever leads to a blockage of the sinus and to the feeling

   "heavy" head, but strong A headache is something else.

   Certain types of food, smells, smoke can   provoke   headache   due to direct exposure to chemicals. The only   tactic is to avoid them.

   - Brain tumors or strokes

   In the absence of other symptoms (weakness, mental changes, convulsions) the chances that your The headache is caused by a brain tumor, very small. Brain hemorrhages are usually accompanied by acute   pain,   Therefore,   their victims rarely linger on a visit to the doctor.   Head   pain caused   by a serious ailment is very rarely moderate, but there is a good rule - to give the doctor the opportunity to evaluate any new or different from the previous headache, like any pain that will seem stronger to you already experienced.

   - Eye tension

   The tension of the eyes causes sensation discomfort, disappearing immediately after they rest. If you need with glasses or available glasses poorly selected, then you Lose your normal visual acuity, but it’s unlikely to cause persistent headaches. Before   the visit     visit the optometrist.

 

 

   Chapter 8

   PURE MEN'S MEDICAL PROBLEMS

 

   Many men - but not prudent women! -   reach   the middle age, never having visited a doctor, and this difference   in   Behavior   is almost entirely due to the difference in the genitals. Female genitals need constant and regular attention.   The woman   even   with   Excellent health should visit doctors every year for checking the mammary   glands   and taking smears from vaginals. Venereal and other diseases,   sexually transmitted , affect women in greater Degrees than   men.   But   Even Women's Safe Sex Prries suffer from   many   non-infectious diseases of the genitourinary organs provoked   or   sexual   intercourse , or mild wound to the genitourinary tract (see   chap.   10).   And   finally, healthy women still visit the doctor in order to either   prevent or interrupt or preserve pregnancy.

   Looking at the obviously endless need their girlfriends in medical   services, young people thank fate for having   a genitourinary system that requires very little worries. In some ways, they are right, although their hour will break later (see in this chapter is a section on prostate diseases).

   Yes, for such "lucky" will have to pay. After decades   of carefree life or visits to the doctor for such “respectable” occasions as   respiratory infections or injuries, the first rectal examination, which   must   be held at the age of 40, seems to a man A milestone celebrating the end of youth. Moreover, this inspection is not usually Attach great     importance.   In any case, most men decide "a little more   to wait."   For women, all sorts "not having much value" checking is   a habitual matter, so doctors find them tumors of the large intestine and genitourinary system at an early stage, when Chances   of   The cure   is quite great.

   In men, we detect tumors of the testicles It's terrifying too late,   even though   they should have long ago themselves to notice them. Three sections from this chapter   will enlighten you with respect to the prostate in the greater Degrees as   you   wanted   would,   but the prostate is only the second after heart of the object from the whole   spectrum   Factors that deserve and require attention to physicians throughout the The life of a man. Two more sections contain more Pleasant   information   -   male penis and breasts are brought relatively less trouble, and yet you know about them much Less than it should be.

 

   TUMOR OF TESTICLES

 

   Finding a common wart on   the floor   Member,   the man   immediately goes to the doctor. However, a painless tumor on the testicles can   grow to an impressive size, but it is unlikely will cause     the same   concern. Almost all such tumors are harmless, but still approximately   for thousands of Americans annually develops testicular cancer - the most common malignancy in men from 15 to 34 years. If   you   find yourself Something similar, consider that you are lucky, Since almost 100% of the cancerous tumors detected at an early stage, the testicles   are successfully cured. With late detection, the prognosis is usually not so favorable.

 

   BASIC CANCER

 

   Risk factors and prevention. Sex himself themselves and   sexually transmitted diseases The way, has nothing to do with cancer.   U   men born with unresolved testicles, risk Cancer      Ten   more   compared to the others. Surgical Correction   does not   reduce   danger, although it facilitates the detection of a tumor. Since only 10% of men with testicular cancer suffer from this congenital disorder, the rest are at risk no less.

   Men usually say that at first transferred some   injury to the testicular and only then found, the tumor. Such   an association   Injuries   with subsequent tumor development   There was   almost   a century   (Some women with breast cancer have similar relationship).   Most   doctors have to do this skeptical, although several researchers   and   were able to cause the appearance of cancerous tumors in rats and rumors, causing injuries to   some organs. One of theories (also) Existed for almost 100   years) explained such a coincidence,   What   patients   have given   the injured place is more attention, so the probability of The tumor was   reviving there. This explanation does not seem very convincing to me, but at the same time I do not see the reason why the injury should lead   to   the appearance of a tumor. On the other hand, scarring and tissue atrophy occurring   at the site of the injury can cause changes   that contribute to   malignant cell transformations. Men with testicular atrophy and those who   have suffered mumps followed by inflammation of the testicles - orchitis, appear to   be at greater risk.

   There is no method of preventing cancer of the testicles - The only defense is early detection.

   Diagnosis. Blood tests and x-rays nothing do not give. Currently, doctors identify approximately 50% of cancerous testicular tumors during   a routine scheduled inspection or after   The tumor   is starting   to grow.   This should not be the case, because every man is obliged to monitor   your   health and conduct a monthly self-examination.

 

   SELF-SEXUALITY

 

   Ordinary questions that men ask about the testicles, do not   concern the tumors, and yet I will answer them.

   1. The testicles should be approximately the same. If one     of them   not abnormally small, then, most likely, atrophied after a long time Infection.

   2. One testicle always hangs below the other. V Otherwise  , you   could not put The legs together. Examine yourself monthly, but   only in a warm place - in the cold scrotum strongly cringes.   It is ideal   to carry out an examination, taking a bath or shower. Ride the testicles between the thumb and the other fingers. They should be felt as boiled hard-boiled egg   (without shell, of course) about 3.5-4 cm in diameter;   dimensions     should not differ by more than 5-6 mm. Feeling the back top    testicle, you will find the appendage of the testicle - thin rope thickness with spaghetti. If you find it easily, can immediately be released - any mass attached to the appendage or free lying next to him, almost certainly   beneficial (unfortunately, this can not be said about the formations, related   to the testicle itself). Inside the appendage there is a winding duct connecting the upper part of the testicle with a thicker seed-bearing duct.

   If you find an unusual swelling, bump   or   other   anomaly, carry out a simple diagnostic Verification. Go to     the dark   room. Turn on the pocket light and arrange his behind   the scrotum.   If   light passes through it, then formation, in all likelihood, is filled with fluid - a symptom typical of harmless dropsy of the testicle or cyst of the seed rope, which I'm talking about I'll tell you later. But such a test in any case can not to cause the refusal of a visit to the doctor. If   you felt the testicles carefully, they are not sick should, therefore,   obvious   soreness during the examination should Consideration as a deviation, although it is   Also not typical of malignant Entities.

   Very few neoplasms of testicular are malignant, but doctors are considering They treat any of them as cancerous,   until     they receive evidence The opposite. Fortunately, an experienced urologist or surgeon can confidently diagnose Most of the Beneficial Entities Immediately when you check in your office. V Doubtful cases the doctor will open the scrotum for a more detailed examination testicles. If there are doubts after that, doctor can remove the suspicious testicle and its a vas deferant duct. In cases of suspected testicular cancer Doctors do not do a biopsy  , because the chances The spread of malignant cells is very large.

   Symptoms. Although some patients are complaining pain and a feeling of heaviness in the scrotum, almost all cases Testicular cancer begins with the appearance of   Painless education. A man who conducts a self-examination is unlikely whether   he will feel other symptoms (back pain, cough, weight loss),   because   they are all usually It is already evidence of the appearance of metastases.

   Stages. To determine the degree the spread of the tumor every man is subjected to computed tomography and   X-ray   of the thoracic   cells,   and also donate a blood test, which makes it possible to check most of the organs, Especially the liver. As well as prostate cancer, produced malignant cells of the substance - "tumor   marks"   -   indicate the presence of cancer.

   The following stages of development are noted Tumors:

   1) the tumor directly in the testicle;

   2) The tumor has spread to nearby lymph nodes;

   3) remote distribution (metastase).

   Treatment. Progress in the Treatment of   Tumors   The testicles   are so   fast that when you read my book, this section may become obsolete. However, General principles will still remain in force.

   Testicular tumor is different from prostate tumor The fact that several types of cells can become malignant in the testicles, and Therefore, the treatment in each case will be different. Of course, in all cases,   the affected testicle is removed surgically.

   Radiation therapy of the abdominal cavity and groin patients with the most common form of tumors - seminomina, or a   seminal tumor, provided it is found in the first or early second   stage. With advanced tumors, radiation therapy not so effective, but after 1980 and in this Progress has been made on the area. Now the degree of curability of the seminar exceeded 80%.

   For other types   of cells,   grouped     into non-seminome   tumors, the usual form of treatment in the first stage is a surgical operation to remove   nearby   lymph   nodes;   degree   Currency here is also close to 80%. With Today’s   state   of chemotherapy, many doctors generally refuse surgical methods. Most men have relapses, but for the group   that gets   chemotherapy, the percentage of cure is superior. Chemotherapy with surgery or without it cures most developed non-seminomic tumors.

 

   BENIGN EDUCATIONS IN TESTICIALS

 

   Varicose enlargement of the seed veins The cord.   It is unlikely     that you will confuse this bloating of the varicose veins in the upper part of the testicle (usually on the left) with a solid mass, but this can also   happen.   Smoking   is formed   with the expansion of the veins caused by high pressure, and can   drop sharply   or disappear if you take a horizontal position.

   Dropsy of the testicle. Often in   the scrotum     liquid accumulates,   forming a solid rounded formation, located separately from the testicle and   ahead of it; large dropsy can surround the testicle   completely.   These   education is harmless, but the diagnosis must confirm the doctor, because the blisters   sometimes hide tumors. Treatment is not necessary, but   for   diagnostics the doctor can pump out the liquid (it should be transparent and yellow) with the help of a syringe or send you   to   ultrasound  ,   which very accurately distinguishes Solid masses of liquids.

   The seed rope cyst. Smaller by the size of the dropsy, the cyst is usually located at the top of the testicular appendage. Most of these formations are easily shifted; their diameter is less than 11-12   mm.   Treatment   is not   necessary, but the doctor may squeeze the cyst with aspiration   (sucking),   as a result of which There will be a liquid similar to milk containing   dead sperm.

   Hernias. In accordance with the medical terminology, hernia is     the penetration of tissues through the abnormal hole, which means that hernias can occur in almost any part of   the body,   you   It may   seem strange to discuss this issue in the chapter on   neoplasms in the testicles, but it is here that most hernias form in men.

   Chapter 1 mentioned that the embryo at 8 weeks of the testicles   are formed in the abdominal cavity, gradually descending into the scrotum for 8 months. When the testicles come out of the abdomen  ,   very   It is important   that   they Never back again there, so the passage into the scrotum should be closed. K This is another bad natural structure,   and therefore   In about 20% of cases, it remains open. It's almost no one's Creates problems throughout life, but sometimes There slips part of the intestines. This phenomenon is called inguinal hernia.

   Usually men notice an inguinal hernia after lifting   weights - quite explainable connection, since any action that increases   the pressure in the abdominal cavity (physical exercises, vomiting, constant   constipation), able to push the insides into any   hole.   With   age, the likelihood of hernia formation increases, as the general weakening of tissues leads to an increase in all holes and passages.

   Organs located in the abdominal cavity, prone to inguinal hernias on 90%, as they are in close proximity to two potential holes.

   Painless inguinal hernias in general Harmless. A man   can only note a lump or thickening in the groin or soft mass   in   the scrotum, which disappears when pressed, Especially in the supine position.   Sometimes in   the scrotum in the form of a hernia A surprisingly large number of intestines:   photos in textbooks show a man with a scrotum   in size   with   a football. If the patient can easily correct   a hernia,   the need   in urgent measures to eliminate it, but in The principle of all hernias must   be eliminated. If the sloping part of   the intestine   strongly clamped by the edges of the hole (this is called and the supply of blood to it stops, Emergency intervention is required, as in this case it develops rapidly gangreen of the intestine. If you suspect a hernia or experience pain in the inguinal region that occurs with physical   stress and quickly disappears after removal load,   be sure   to consult a doctor, even if not noticeable No tumors.

 

   WHAT DOES PAIN IN THE TESTICLES INFLAMMATION APPENDAGE OF TESTICIBAKA (EPIDIDEMIT)

 

   In this disease, the testicles look like It's okay. Pain   occurs in the appendage of the testicle, forming the beginning   chewing   duct   (the appendage begins at the bottom of the testicle and bypasses   it's   in the back).   Because of   intimacy of the appendage and testicle of a man suffering from this Ailment  , always   complain   pain in the testicle.

   Reason. Usually the culprits are bacteria, as a rule, gonococcus or chlamydia, urethritis, in addition, urethritis (inflammation)   urethra). Experts suggest that the high pressure in the urethra causes infected urine to move around the venomous duct back to the appendage. The main cause Increased pressure in this area   is sexual arousal, but inflammation of the appendage occurs in the elderly, when Bacteria spread from an infected prostate.

   The usual course of the disease. Inflammation the appendage of the testicle   is almost   always observed only with one side. The pain increases gradually, within one to three days. Sudden pain is more likely to indicate   "twist" testicle (see below). A man can celebrate others symptoms of infection of the urethra   -   increase in   temperature,   spontaneous urination or burning in The Canal.

   Diagnosis. Medical examination detects normal testicle, but like a rope appendage behind it swells and becomes sensitive. If the patient is stoically postponed a visit to the doctor, then swollen and   The whole scrotum may be painful. The urologist will prescribe a urine test and  , perhaps, sowing culture to search causative agent of infection.

   Treatment. When the gonococci is detected Appropriate   medications are prescribed. V other cases doctors prescribe antibiotics,   influencing   both gonococci and chlamydia: doxyccycline, tetracycline or   erythromycin. Elderly men on suspicion on prostate infection as a source of inflammation of the testicular appendage, prescribed trimethoprimmsulfamexacraz (Bactrim, "Septrine", "Biseptol").

 

   STROKE OF THE TESTICLE

 

   Testicular cheating, being a frequent disease in adolescence, in adults there is much less common than inflammation of the appendage, but when pain occurs, both possibilities should be taken into account. Do not   show   unreasonable "heroism", postponing a visit to the doctor, since refouled The testicle dies in a few days.

   Reasons. Testicles and ovaries begin formed from   one   and     the same primitive tissue in the depths of the abdominal cavity of the embryo (see   chap.   1).   With the development of the girl, the ovaries remain there     And where   and   formed  , but   in boys the testicles descended into the scrotum gradually (so that they   later it was better cooled, as sperm with body temperature dies, and that is why men with unrelented testicles sterile).

   Each testicle hangs on the so-called   seed   a rope   that includes arteries, veins and nerves, and a tube    the vas deferensive duct. This design allows the testicle to move forward and backward, as well as in Certain Limits   Turning   around   your own   axis,   but sometimes it can turn to too much corner and remain     in this position. Reasons for this phenomenon are unknown; physical activity here seems to have nothing to do with it, since torsion often occurs in   a dream. Cold weather For some reason, it increases the risk,   which means   that a certain   The role here can   play   Reducing   local   muscles.   The frequency of   this disorder decreases rapidly after 30 years (albeit some   kind of winnings   from the total loss of tissue elasticity, coming with age).

   The usual course of the disease. Typical toss makes itself felt by sudden excruciating pain, often accompanied by vomiting. No one   who has experienced this will linger with a visit to the doctor, but,   unfortunately, in one third of cases acute pain does not occur immediately, but   increases gradually. Twisting blocks blood access to the testicle, so it is required Urgent intervention. Feeling severe pain in the testicles,   consult a doctor immediately. Recovery blood flow within   the first   hours saves 80-100% sex glands. With a delay of up to 2 days, this   The rate drops to 20%.

   Diagnosis. With typical symptoms, we immediately Let's   start to suspect . The examination is difficult, since the affected side swells and is done Too sensitive. Increased and   painful   appendage of   the testicle further convinces of correctness of the diagnosis, especially if   this testicle is shifted relatively normal Regulations.   But   the most   Reliable tests are ultrasonic Diagnosis or scanning   with   radioactive isotopes, as both methods measure and show actual blood flow. With torsion in the affected testicular it     is absent,   and with inflammation of the appendage or other inflammatory processes blood flow is either normal or even slightly enlarged.

   Treatment. When twisted the left testicle, like rule, turns   against the sentry arrows, and the right - on the contrary,   Therefore,   an experienced   doctor   can just turn the affected testicle into the right the side, but even with the successful conduct of such Procedures   are still   necessary   surgical   intervention. The surgeon installs the testicle in   The normal   situation,   and   then fixes both testes in the scrotum of such in order to prevent their   torsion in the future.

 

   ORCHIT

 

   Orchitis (inflammation of the testicles) is A rather   rare   disease,   Except for complications after umbilical cords. Many adult   patients   are afraid of this diagnosis, believing that     the complication   will lead   them   to   sterility (infertility). I explain that it happens, But less often than they think.

   Reason. Memarian mate virus (pigs) usually affects the salivary glands of children, forming a strong swelling for lower jaw and causing fever and general painful A condition     that lasts about a week. Virus Infects other organs,   among   them most often (by unknown reasons) testicles. But this   It almost   never happens before puberty.

   The usual course of the disease. Pigs in adults It is not more difficult   than in children, and orchitis affects only 20 to 30% of patients.   Only     in 10% of these cases, the lesion of both testicles is detected. Symptoms appear   suddenly, on the third or fourth day after swelling of the salivary glands:   rises sharply temperature, and the testicles swell and become painful. The disease lasts a week or a little less, and then (approximately 50%   Inflicted testes shall be crededed during the next two months. Atrophied testicle usually produces less sperm, but a man with one   normal testician is not loses its ability to fertilize. Even bilateral orchitis does not necessarily lead to infertility if the atrophy of both sex   glands has not gone too much Far away. There is no cure for this disease.

   Prevention. Vaccination from mutton works   very   well.   Adults who do not remember if they are ill Pigs in   childhood,   better   Get vaccinated.

 

   THE MALE SEXUAL BODY

 

   Although the penis seems to the necessary male organ, Many animals do without him. Male and female birds, for example, use the same for both a hole called   a cloaca, which is intended for all excretory and sexual functions. Through the cloaca pass seed, eggs and excretion of the body - and   Everything   works perfectly.

   Unlike other typically male organs, For example, prostate,   penis throughout the whole life of a person requires   Remarked   little   worries. Infectious microorganisms can enter the urethra, but spread Basically, sexually, and therefore are easily prevented.

   It's not like a nose or mouth that deliver a lot of trouble, easily transferring to the body a lot tedious,   inevitable   and   Sometimes   very serious infections. Penis - a more convenient channel for urine than its   female equivalent; it also provides almost 100% protection against   bladder infections, constantly Women in the Aftermath of a shorter urethra - urethra. As a fertilizing   organ, the penis is almost always acts perfectly; impotence is rarely   the result of its disease itself. And, Finally, the cancerous tumors   of the penis are not only extremely rare, but in most cases we prevent.

   You can read about infections in Chapter 10, (section on   sexually transmitted diseases). The problem of impotence is discussed in Chapter 11, which includes the greatest amount of information on penile anatomy and its functions.

 

   EXTREME FLESH AND DIURE DISPUTES ABOUT IT

 

   If you are 80% of Americans who have made circumcision of the foreskin in   adolescence, then this issue may only interest you   on the condition that You have sons. For all   Other   Americans   and Majority foreign readers extreme flesh is a source of   excessive number of problems associated with penis, and in addition - the center is unusual Emotional disputes.

   Ancient rituals of Jews and Muslims, prescripting circumcision of newborns, for non-religious purposes for the majority of countries are not normally executed, but the United States constitute an exception to the rule. For most of the century, doctors have considered circumcision of the foreskin as one of the hygienic measures designed to prevent infections and cancerous tumors of the penis.   This belief based only on a common sense, i.e. everyone believed that   it was useful, and not He was bothering and gathering evidence.   The reasons for the Mass removal of tonsils in children.

   Since 1970, many doctors have started Oppose the routine operation of this operation. Medical organizations, who took the circumcision for granted, fell into   somewhat   difficult   situation.   1971 Academy of Pediatrics announced that there are no special medical indications for circumcision of newborns. Doctors took this into account, and the number of circumcisions began to decline from almost 90% in 1971 to   less than 70% in 1990.

   Ironically, it was at this time that There is   convincing   evidence   of the benefits   Circumcision.   The study   has been identified,      that uncircumcised boys are susceptible to infections of the urethra in childhood   10-39 times more often, and in the period from adolescence to mature   age - 2.5 times more often cut. Although such infections are curable,   but   However,   a small percentage of them leads to irreversible lesions of the kidneys.   Moderate infections, along with most     Sexually transmitted    diseases are also more likely to affect uncircumcised men. V As a result, some   experts began public Circumcision Campaign, and in 1989 the   same American The Academy of Pediatrics changed its mind and this time announced the undoubted benefits of circumcision.

   In this debate, both sides have changed basis   for their   argument.   Those who are now in favor, refer to scientific Evidence.   Opponents   turn to a sane person the meaning, insisting that the correct     Penis hygiene prevents all predictable complications in the future. Pages   of thick medical journals periodically are filled with sarcastic exchange of replicas in which Doctors accuse each other of conservatism and unscientific way of thinking.

   I treat the moderate   supporters   circumcision   carried out by   an experienced doctor under the local Anesthesia in a short time after the birth of the boy. However, people in a more mature I don't recommend   doing   this,   until the boy or man celebrates too much Frequent symptoms of extreme flesh infections. But with all The conditions of this area should be washed daily.

 

   CRASH OF SEXUAL MEMBER

 

   Being one of 250 species Malignant   neoplasms   in   U .S. Men, Penis Cancer is the Highest Healthcare in Others parts of the world, accounting for more than 10% of male tumors in China and other countries the Asian region. Israel can boast of the smallest number - 1 per 1000.

   Factors and prevention. Does it help Circumcision. There is almost no penis cancer among Jews.   Circumcision   provides   almost   100% prevention of this disease, since most   penis tumors occur on the head or the inner surface of the extreme   The flesh.   Specialists have nominated The theory   according to   which   common   causes of tumors are chronic inflammation of the foreskin caused by poor hygiene and possibly provoked by viruses (penis cancer, like uterine cancer, can be transmitted sexually). This theory suggests that men, regularly washing the foreskin, can reduce   the degree of   risk, but research on this issue seem to be quite difficult.

   Symptoms and treatment. Any red spot, pimples, eel, scab or   bump, not disappearing within a few weeks, especially on   the head   or on the foreskin, deserve attention The doctor. Most likely,   the listed phenomena will be minor disorders or   infections,   but they can be early signs Cancerous tumor.

   I had to see only one man with   a tumor like this  ,   The penis of which was half eaten large ulcer, -   very   unpleasant   for me experience and an even sadder result delay on the victim. Despite the defeat Organs with   very   rich   blood flow,     penis cancer usually lasts for a long time localized, so   doctors   treat   most tumors identified at an early stage, and retain the penis with radiation therapy or minor surgical interventions.

 

   WHAT MEANS "OFFICIENT ERECTION"?

 

   Deviations leading to a long erections,   are rare, but cause great curiosity, so I will mention two of them.

   In the first, called priapism, erection does not stop, becoming Usually more and more painful. In 40% of cases, the patient or suffers   A clear disease affecting the system blood supply to the penis (for example, anemia with sickle erythrocytes, or   This   is the action of   infection, injury, leukemia, spinal injuries or the result of taking cocaine.   The remaining 60% of cases are manifested in healthy men, often   after   prolonged sexual stimulation, but not always.   Most   experts are convinced that such a long erection is due to difficult venous outflow of blood, which leads to the accumulation and increase in blood viscosity in the cavernous bodies (see Chapter 11,   which   is described   anatomical structure and blood supply system of the penis).

   Priapism requires urgent measures - during several days scarring and fibrosis (education) fiber tissues), which began inside the penis, lead to impotence. Powerful sedatives,   accompanied by icy enemas, can weaken erection. If it is does not help, the doctor removes stagnant blood with a needle inserted   through   The head of the penis.

   The so-called   "Peyrony's disease"   is   the second   reason   Abnormal erection. It affects middle-aged and elderly people It   develops more slowly than Priapism. Erection becomes painful, and the erect penis bends, and sometimes at such an angle that sexual intercourse is impossible. Man   can   feel   solid   The swollen   area of the penis trunk is fibrous calcified plaques. The reasons for their   appearance are unknown, but they are similar to plaques that occur in other parts of the body, for example in palms (they make the finger bend).

   Approximately 50% of Peyronie's disease goes by itself, so the doctors, prescribing hormones, vitamins, cortisone injections or   other   medicines, report cure, but all the funds listed in   This is no better than placebo. Surgical removal of plaque   sometimes leads to impotence, but in difficult cases it may be necessary.

 

   WHAT TO DO WITH PROSTATE DISEASES

 

   Serious genital diseases in men (except     for venereal) are not particularly common. Penis and testicles with age function less intensely, but the probability of their failure     and   The cause of   serious inconvenience is quite small.

   This does not apply to the prostate (preventable iron) - an organ sized with a small walnut, located under the bladder  .   Prostate is a sex gland, but does not produce hormones and does not   play   Roles in sexual intercourse. She produces half of the ejaculated   liquid   and injects it into urethra, which contributes   Passage   through     it Department of the urethra.

   In an adult, the prostate is exposed to bacterial and other   infections, and also depressing inflammatory diseases. Over the years, men have increased the risk the emergence of   benign   and   malignant neoplasms of the prostate gland.

 

   LONG-LIVE PROSTATITIS

 

   1. Acute bacterial prostatitis

   Man who has suffered an acute bacterial prostatitis, will never   forget it. Amazing mostly young people, he   begins   unexpectedly, accompanied by high temperature, chills, pain throughout   the body   and   sometimes - in the prostate, felt in the lower back or   around   the anus. Bacteria are often penetrate and into a nearby bladder,   causing symptoms experienced by women    infections     of the bladder ("trio", which every medical student remembers): rapid urination, uncontrollable urge to urinate and burning when   urinating. Diagnosis and treatment. When we suspect an infection, we are looking for   confirmation by rectal examination, which should   identify   the painful   and enlarged prostate. In contrast to   the inspection     on chronic   prostatitis (describe further), we do not conduct     Prostate massage   for   Extrusion of pus.

   It's too painful a procedure, and Bacteria can   also be found in     the urine sample. Usually these are microorganisms living around the genitals and anus, so, most likely, infection occurs when   they   Moving up the urethra up to the prostate. Measures for prevention of acute bacterial prostatitis is unknown, but established, It is not     sexually transmitted .

   Some patients feel so much badly     needed   hospitalization and intravenous Infusion of   antibiotics.   V     Easier cases of patients quickly   React to     oral   taking   antibiotics, usually from   the group of   trimethopimsulfamechexazole   ("Septrine",   "Bactrim", "Biseptol"). If the culture of bacteria in urine samples manifests   Within two days, the doctor will replace the antibiotic to reduce the resistance of bacteria to zero, but this happens quite rarely.

   Prostate infections are more stable than infections of other organs,   therefore treatment should last at least a month. Some   patients   for several months after treatment continue to complain of burning when urinating, but in the end it happens.

   2. Chronic bacterial prostatitis

   Although it is caused by the same bacteria,   what and   acute   prostatitis,   but the symptoms are not so expressed. Worse, they appear repeatedly. This disease affects Adult men of all age groups. When the infection is present only in prostate, patients or feel relatively good, or only note annoying pain in the lower   parts of the back, anus or testicles. If the infection spread to the bladder, then the symptoms described above are observed: Probable urination with Insurmountable urges. Elevated temperature or strong   The ailment is rare. Sexual abilities do not   decrease.   Medications   used in acute prostatitis also work in this case, but not for long. Diagnosis. Most often, a simple urine test is enough. Fortunately,   chronic bacterial prostatitis is not as painful as   acute,   Therefore, for   a more informative analysis, the doctor massages the prostate with a finger to isolate from it a certain amount of liquid in the urethra.

   After several recurrence of the disease make sure that     the patient does not have hidden violations in the urethra,   The traditional "analysis with three the glasses." It is not carried out in acute   stage of the disease, because during this period bacteria is everywhere and   the analysis will not reveal the localization Infection. When you take a course of antibiotics and feel good, your doctor will be able to determine exactly where the bacteria are concentrated. As a preparatory measure for 5 days, refrain from sexual Media to the prostate accumulated The secret in sufficient volume. You also need to come to the analysis with full Beverage bladder.

   First glass: urinate directly in the container, to wash off the infection   that is present in penis, and give the doctor the opportunity to determine if you have subacute urethritis (see chapters. 10).

   The second glass: until the bladder will be emptied   by half,   urinate in the toilet, and then direct a little urine   in   container.   Contents this portion will give an idea of the state of the bladder and kidneys.

   Then the doctor will massage the prostate. Any liquid that     will begin To get out of the penis, will be immediately assembled in a separate container.

   Third glass: finishing urination, Gather   the last   portion of urine in the container. V It contains the secret of   the prostate.   Sometimes,   if   the massage contains enough secretion, this stage of analysis is missed.

   The rest of the tests are less informative, but, If you have moved a few Infections will be made to you X-ray examination, called   intravenous pyelography (an ureter and renal pelvis)   when   contrast agent administered intravenously, is quickly excreted Kidneys,   revoking the whole urethra. Sooner or later, a urologist uses his tools to look inside the ureter in   search   narrowing (they favor infections) or for Examination of   enlarged   prostate. Narrowing of the urethra is rarely found.

   Treatment. Primary treatment is reception Large doses of antibiotics in within three months and longer. Therapy can be disappointing   slow process, as in chronic bacterial prostatitis The prostate is not very inflamed. Severe inflamed prostate   with   the acute   form causes the patient torment, but the inflamed tissues become more permeable, as a result, antibiotics from the blood easily penetrate there and quickly enough Killing bacteria. And in the victims of chronic infection, this   does not happen.

   Good funds are trimethoprimsulfamexazole and   doxycycline (Vibramicin). One course of treatment with doxycycline provides   a persistent cure approximately in 30% of cases. A few courses after a series   Recursions increase this statistic to 50%. Disappointed patients   talk about surgery. Sometimes it is inevitable - for example, if in the prostate formed a stone that has become a hotbed of infection. In general, the chances of surgery success Compared to 1: 3.

   In the late 80-ies appeared a new class antibiotics called fluorocvinolons. They are very expensive, but the most effective in many   infections, including prostatitis.

   If no remedy can completely to eradicate   the infection,   doctors prescribe daily intake of small doses of antibiotics for the rest   of life.   But first you need to make sure that you   chronic   bacterial prostatitis, as its symptoms   similar   to   prostatitis   non-bacterial origin - and in this case Antibiotics are useless.

   3. Non-bacterial prostatitis

   Unfortunately, this disease suffers A lot of men. Symptoms are similar to those described above, but the infection is not found.

   To explain this phenomenon was put forward Lots of theories.   Some experts blamed microorganisms like chlamydia (see Chapter 10), but no evidence could be obtained. True, non-bacterial prostatitis is striking mostly young, sexually active men,   And   such   a theory is still popular. Other scientific schools claim that   disease in the prostate is caused by stagnation, perhaps due to the fact that The exit is blocked. Finally, there is the opinion that non-bacterial   prostatitis   is   nothing more than an autoimmune disease in which the body attacks itself , like some forms of arthritis.

   Diagnosis and treatment.   This   the disease   is diagnosed   by the method of exclusion. Usually X-ray and urological Examinations. Analysis of prostate secretion reveals leukocytes - a sign Inflammation. But inflammation is the usual reaction of the body to the indignant Factors. Leukocytes are detected in infections, but and with allergies, autoimmune reactions, general irritation and even injuries.

   Considering the possibility of chlamydia or   other   hidden   infections, you will probably be prescribed a monthly course Antibiotics are most likely     doxycycline or tetracycline. Erythromycin can act on the same   microorganisms, but the necessary dose (500 mg 4 times a day) is heavy for     the stomach. And trimetepromymsulphethocazole does not destroy chlamydia.

   Urologists traditionally recommend Emptying   the prostate regular   sex. In addition, prostate massages are prescribed. Research   proving that massage is really Helps,   do not   seem   impressive  , but some of my patients are convinced of this.   Hot is also recommended   baths, antispasmodics, sedatives and the same anti-inflammatory, which women take during menstruation: ibuprofen and its derivatives.

   All this is not as hopeless as it can Seems to be. Provided that both the doctor and the patient persistent in     use   transferred   funds,   in most cases The victim of the disease receives some relief.

   4. Prostatedine

   This is due   to the diagnosis when     All   of the listed   above symptoms, but with analysis of urine and massage Prostate no anomalies are detected. Some urologists say,   that the cause of   soreness is muscle spasms, and prescribe hot baths along with   taking a preposin ("Minypress"), baclofena ("Lieroresal") and other drugs, Relaxing muscles. No sensible doctor will make assumptions, that menstrual spasms have a psychosomatic basis,   but   with pain in male genitalia, experts recommend both tranquilizers   and psychotherapy. Because an experienced psychotherapist is capable of   to alleviate   any medical problem, you can follow this path. But first, try   simpler treatments.

 

   INCREASED PROSTATE

 

   Strictly speaking, an increase in the prostate -   no   disease,   and   the inevitable consequence of aging. During puberty of the prostate   under   the influence of male hormones grows to sizes   inherent   in adults.     In a man of 20-25 years, the size of the prostate remains unchanged, and then the second stage of growth begins. By the age of 80, almost every man has benign prostate hypertrophy (DGP). The reasons are not clear to the end.

   Regardless of the degree of increase, Aging prostate     should not be created problems, if   not   blocked   channel   of the urethra: the urethra passes through the prostate surrounding it from   all sides - the way, guaranteeing you trouble.

 

   SYMPTOMS

 

   Trouble begins unexpectedly when enlarged   prostate   completely covers the urethra. Acute delay Urination is easily facilitated by a catheter. In a few days prostate usually   shrinks, and Urination is restored. Being   accidental   complication of prostatitis, acute urinary retention   usually   noted   as the first symptom of BP in about 10% of men, and the rest begin   to notice some malfunctions as an increasing   prostate   Slowly squeezes the urethra.

   After 60 years, a man discovers a weakening pressure when   urinating. The jet is no more It flows far and looks thinner than before. You may have to even have to hurry before the bladder, overcoming the resistance the squeezed urethra, begins to be emptied. If   its   pressure is not enough, urination almost stops, often   continuing in the form of drops or splashes.

   Weakening of urine stead pressure irritates, but not   necessarily   a sinister sign, and BCP does not always progress. Many men   adapt to these changes and do not Go to the doctor. But it is better to do this, because Similar symptoms appear in infectious   diseases and cancers.

   If the urethra continues to narrow, men prefer to   urinate   sitting on the toilet, partially to give the bladder   more   time   to create pressure, Partly because the sedentary posture relaxes the pelvic muscles around the urethra, reducing its resistance to flow. But in the end, the capabilities of the bladder reach the limit, and from that   moment,   Despite the maximum effort, it can no longer be completely emptied.

   If a man with DGP has a residual urine, its problems   are increasing. Stagnant urine favors infections, but even   without   their life of such a person is concentrated around the bathroom and toilet. Full bladder usually itself includes the urge to urinate,   Therefore, a person whose bubble is partially filled will feel They are   much more often. The situation can to worsen, because the overstrained bubble is often irritated, shrinking, even being almost   empty,     Why the patient is forced to constantly run in   To the toilet     to   It is difficult to   squeeze out a little urine. This finally convinces him that the situation is   much worse than he thought. As the frequency of the urge increases at night,   He may have to wake up hourly or approximately every 2 hours (night urination).

   Under such circumstances, few people have will get stubbornness to refrain from visiting the doctor. And fortunately, because the pressure from the enlarged bladder in eventually overcomes the resistance of the valves in the ureters, which Remove the urine from the kidneys. The reverse flow of urine covers the outflow of fresh urine from the kidneys, applying them irreparable damage. Once men with BP died precisely because of kidney damage, but   today this does not happen should.

 

   DIAGNOSIS

 

   In the absence of infection, urine analysis Useless.     In the most   severe cases of blood test are determined Damage to the kidneys.

   The best evidence gives rectal Examination. When   probing,   the normal prostate is felt by the doctor as A rubber bump with a groovan in the middle - like the tip of the nose. Increasing, the prostate reaches the size of the baseball, and the groovka disappears. However, the doctor feels   the back of the prostate, adjacent to the rectum - the rectum. Any increase here is safe, Because the urethra   is   surrounded only   The front   of the prostate. Determining the degree of compression of the urethra requires   more   complex checks.

   Residual urine in volumes of more than 150 cm3 is a deviation from   the norm. Traditionally, its volume was measured by the introduction of a catheter after urination, but today it can be done more convenient for the patient in a way - ultrasonic research.

   An experienced doctor could assess the degree squeezing   of the urethra,   watching,   how sick urinates into a measuring cylinder, and Measuring the minute volume with a stopwatch. Today, the flow rate, and pressure in the bladder   is measured with the help of electronic devices.

   Intravenous pylogram delineates the whole The urethra     can be found in this way enlarged   kidneys,   stones   and   a closed urethra.

   Sometimes people with BCP have blood in Urine.   It's   right away   causes a cystoscopy - the procedure, performed under   local   anesthesia. The urologist inserts a flexible tube through the penis and examines the urethra, prostate and bladder. Blood in the urine   in   this   The case   is not    a sign of a serious violation, but the urologist should make sure that its   source   did not serve another A disease like a bladder tumor.   Cystoscopy - not the most necessary procedure with   an average   enlargement   of the prostate,   but is prescribed often, urologists for obvious reasons   I want to take a closer look at what you have to do.

 

   TREATMENT

 

   Don’t count that the operation is inevitable. Only 10% of men aged   40 to 80 years require surgery  , so your   The chances of being among them are small.

   Having noticed a weakened stream of urine, Immediately    Visit the   doctor.   At an early stage of GHP visit to the urologist is not required, but the attending physician   should make sure that you have this Disorder. Although   BCP   and   is considered the main cause of the weakening of the jet, but this Symptoms of various diseases.

   Going to the doctor, expect traditional advice avoid spices, excessive Alcohol consumption and Annoying food.

   Convincing Evidence of Efficiency these measures are not, but   they   are harmless and bring the patient comforting A sense of self-control.     In fact, the man, Having difficulty urinating,   It   quickly determines what makes it worse. So experiment a little with food and develop your own rules.

   But don't experiment with fluids! Reception Less amount   of liquids in the hope of Avoid frequent travel to   The toilet   is favorable to infections. If you drink more than usual, to "wave" urethra, then already overloaded urinary tract The bubble will behave even worse. Drink about 1.8 l liquids per day.

 

   MEDICATIONS CAN INCREASE URINATION

 

   Hypertrophy of the prostate - natural the   ageing process,   therefore   It cannot be completely stopped, but you can only facilitate or   mitigate   consequences.

   To date, medicines, designed to reduce the prostate,     acted or   weakly,   or   satisfactory,   but   caused serious side effects. For the last A few years   in this area there has been some progress.

   Alpha-blockers. These medications do not reduce prostate, but   relax the smooth muscles of the urethra and exit from the bladder.   Early   samples of these drugs, relaxing the smooth muscles of the arteries, very effectively reduced the pressure, but they relaxed the same muscles in all other organs. Patients tested dizziness, drowsiness, they have   constipation began, impotence arose, ceased Sweat and saliva. Elderly hypertensive patients, these drugs are contraindicated, and Therefore, it is also useless for the treatment of BCP, characteristic of the elderly.

   Over time, new antihypertensive drugs with   fewer side effects. But they did not relax smooth   muscles   internal organs, so also not suitable for   treatment   BP.   The exception was a class of drugs called alpha-blockers, developed at the beginning 80's. Drugs of this group   type   of prazine   ("Minipress", "Haitrin") or doxazosin ("Kadura") in sufficient degrees   increased the flow of urine and reduced the frequency of urges, including the night. Side effects, Mostly dizziness, were not so common.   In contrast to hormones (see below), alpha-blockers   act   quickly     Improvement becomes noticeable within a few days.

   Hormone therapy. The Emergence of BM prevents castration. Modern experts do not practice this treatment, but the doctors   of the XIX   century were, apparently, Much   more   amateurs   adventure.   A study conducted in 1896 with 61 men found that 50 of them had a significant improvement after the removal of the testicles. Despite such encouraging results, today less heroic methods of blocking are used hormones produced by the testicles: with the help of drugs. Leuprodiman ("Lupron") reduces hormone levels pituitary glands that stimulate the activity of the testicles. Flutamide (Zulexin) Blocks The effect of male hormones throughout the body. Both Means help   to reduce prostate, but they are very expensive and lead to impotence and decreased libido (sexual attraction). They are mainly prescribed for   prostate cancer,   Not at BP.

   How   showed   the history of    antihypertensive    drugs,    Medications work better and with less side phenomena when the place of their   application narrowing. In 1992, urologists began   use   finasteride   ("Proscar") - the first medicine, which did not   reduce   the level   testosterone,   and prevented its transformation into   Dihydrotestosterone.     To date, this is the best tool, although it acts slowly, to minimize the prostate - by about 28% - it takes 3 months, and 90% of men   to maintain   the effect   should   take   it   Constantly.    Side effects, including impotence and loss of libido, are very rare.

   Blocking the conversion of testosterone to Dihydrotestosterone promises in Further Opportunity treatment of male baldness   and   acne   (inflammation of the sebaceous glands) and probably excessive hairiness in women, as well as   prostate cancer. Research is underway.

 

   Overcoming compression of the urethra with the help of cylinder

 

   Since the early 80-ies cardiologists have learned Injected into the coronary arteries patients long tube with cylinder at the end, and then, inflating   the cylinder, dilated the arteries, thereby Rebuke their lumen. These days, angioplasty has become a routine practice, and Patients prefer   surgical operations for bypass surgery of coronary vessels.

   Introducing a tube into the bladder requires Much less skill. However, despite Widse advertising in the mass of the media   information, the procedure is not very effective. Arteries Respond to It better because they are lined with hard as a stone with   cholesterol plaques   -   being once stretched, they remain so, and the elastic   prostate tissue   Not so “agreed.”

   Researchers who measured the flow of urine after expansion of the urethra with   a catheter with The cylinder was usually found   slight   temporary improvement. However, a certain part of urologists widely practice this method, and their patients, almost always feel better. I always   advise patients to try his.

 

   Hyperthermia

 

   When heated, the enlarged prostate   is reduced,   but   the   required amount for this Heat damages other tissues.   With   development   Surface cooling devices, designed to protect the urethra, some urologists began to use the so-called transurethral (i.e. injected through the urethra) microwave probes. The treatment session takes one hour and requires only local anesthesia.

   This method is in the experimental Stages and at present Passes clinical Testing in all medical centers   countries.   The results look Nunnies.

 

   Tubes and expanders

 

   In previous centuries, the old people carried with them straws or   metal tubes to use them in cases where urination has become Impossible. Such "catheterization" favored infections and injuries. Variety of Modern Mechanical     innovations suggest that a   long-stayed metal tube has already been developed - the expander (perhaps even with a check valve) to maintain the urethra in an open state regardless of the degree of prostate increase. At first glance, it is quite simple, but   foreign bodies in the urethra,   not even   provoking   infections, lead to the formation of stones, inflammation and rapid   deposition   Calcium precipitation. Research in this direction continues.

 

   WHEN THE OPERATION IS RECOMMENDED

 

   Today, surgery - The best method of treatment BCP in case of kidney damage or full Blocking the urethra.  Men have to make a decision on this.

   Prostate operation: TURP. 95% of all Prostate operations     on the BC the so-called transurethral resection of the prostate (TURP), which has become popular since the early 40-ies. This procedure is subject to 400 thousand people a year, and it is most common among men over 65 years old. In contrast to more early methods of prostate operations, the surgeon does not open the abdominal cavity to Get to her access, so as the   operation itself,     and   the recovery   period   takes less time.

   What does "transurethral" mean? The surgeon-urologist inserts a   special tool into the bladder through the urethra - a respectocope. Thus, seeing the object of the operation, the surgeon with a metal loop that is part   of the tool, cuts off the pieces of the prostate ("resection" means   "Removal").

   Heated by electric current of the loop (electronic) cuts the fabric and   at the same time "breez" the blood vessels to prevent bleeding, the No less blood flows out fairly. To maintain   the field of view of pure flow the injected liquid washes away the blood and the cut parts of the prostate in the urinary Bubble. After completing   the operation,   surgeon   removes   removed tissues, pumps out the liquid and for 2-3 days   insert a     catheter instead of a resectoscope. The operation takes no more than half an hour and is often performed under the local or Spinal anesthesia (ask the doctor if he does not tell you; some prefer during   surgery   sleep,   but local anesthesia is safer).

   Surgeon-urologist sends deleted pieces Prostate Pathologist for Microscopic studies - as a result in 10% of cases   A cancerous tumor is detected.

   If this figure frightened you, remember,   that most   TUP surgery is subject to old people, so this is probably nothing more than the expected risk.

   Complications. TURP is not an extensive operation, Therefore, serious complications It's rare after her. The Good Urologist mortality is approximately   one case for 250 people, at first glance, for routine operation is   high, but not It should be forgotten that most patients under   70   or more, and people at this age have many other medical problems. TURP itself causes much less deaths than those   heart attacks or strokes that it provokes. If a person has good health, then the risk is close to zero.

   During the operation, each patient receives about a liter of irrigation   liquid. Patients usually cope with this, but   In general,   the absorption of such a quantity of liquid   can   lead   to   Complication called   TURP Syndrome. In case of moderate severity, the syndrome causes brain disorders with nausea and vomiting, sometimes - an increase in pressure, interruptions in   cardiac activity and convulsions. Reduction   of operating   time   reduces the risk. If the operation lasts more than an hour, Most urologists   stop it and switch to other methods.

   After a few days, the blood in the urine disappears, but within a month after the operation may periodically appear. From time to time to me comes to the reception frightened Patient who has been in a few weeks normally urinated and suddenly saw the blood in the urine again. If he does not   have clots with urine blood or such a clot has not blocked   urethra,     there is no need for treatment, but bleeding will stop after 2-3 days by itself myself.

   Consequences. TURP satisfies more than 90% patients. Their   urination becomes as free as 20 years ago.   Some   men may feel insurmountable urge to urinate or lose   control over them for several weeks, but constant incontinence is observed rarely, in less than 1% of cases.

   The surgeon works inside the prostate, so Probability of accidental   damage The nerves that go to the genitals are low. The risk of impotence   is 1-2%. However, the operation affects the walls of the urethra, making the path of ejaculate (prozed sperm) unpredictable. Approximately   50%   of patients   after TROP ejaculated towards the bladder instead of the head of the penis (retrograde ejaculation). This does not affect the erection and does not Deprives the feeling   of orgasm. A man with such ejaculation usually becomes infertile, but the doctor can separate sperm from urine for subsequent artificial insemination.

   After a few (or even decades) years later about 20%   of men   need a second TURP - as to expand the urethra because of the scar on   the site of the previous one operations, and in order to remove excess prostate, if it continues to grow.

 

   ALTERNATIVES TURP: OPEN PROSTATECTOMY (SECURITY OF THE PROSTATE GLAND)

 

   Because of the dangers associated with absorption a large amount of liquid, TROP should not last more than one hour. Therefore, if   the patient has a severely enlarged prostate, the urologist performs an open prostatectomy through the incision of the lower abdominal   cavity   or   perineum.   Such an operation is also practiced in   the event,   if   simultaneously   with   resection of the prostate it is necessary to correct the pathology   of the bladder or   if the hole of the urethra is too small for the passage Resectoscope.

   Open prostatectomy occupies more time and is associated   with   greater blood loss, and Catheter   after   it   Left     at 7-10   days   (instead of two or three after TURP). In all other respects, this operation is as good as TURP and has the same long-term effect.

 

   TRANSURETREL INCISION

 

   This is a simpler operation: urologist surgeon Makes   two   incisions   along the prostate of the bladder. Cutting the muscle of the prostate in this   area weakens the clamping of the urethra, as well as TURP, with less complications and a shorter period of hospitalization.   The operation   is less   effective   with a large prostate or with an increase its average share, but it is very suitable for certain patients.

   Complete removal of the prostate during the operation   about   BP   could   be of some benefit, because it eliminates   the risk of     Prostate cancer. However, this is too complex surgery, and with benign hypertrophy It's not done. The presence of DGP is not   increases   the risk of   the tumor,   but     does not diminish it, Pay special attention to the next section.

 

   WHAT TO KNOW ABOUT PROSTATE CANCERS

 

   The most common malignant disease among   non-smoking men is   prostate cancer   that occupies   Second   place in    The mortality rate after colon cancer. Like most malignant tumors, cancer prostate - an age-related disease that rarely affects   Men up to 50 years. However, with the age increase Above this threshold, the risk   increases. 30% men for 50 who died from other diseases, pathologists have detected prostate cancer.

   Among men from 70 to 79 years of such cases - 40%, and among 8089-year-olds - about 66%. It's not so disturbing, It seems that since   cancerous prostate tumors develop, usually very slowly.

 

   RISK AND PREVENTION FACTORS

 

   Some malignant tumors (mild, It is not difficult to prevent skin, but prostate cancer does not apply to this, since I don't understand its reasons. Research to identify who is susceptible   to the most   risk, gave too little results.

   Diet. Despite the above, Revealed a few very   curious facts. Among the blacks   American   mortality rate    almost twice as many as whites, The ratio of mortality of black Nigerians in comparison with black The Americans are 1: 6.

   Mortality from prostate cancer in Japan is one-seventh of   the same indicator in the United States, but when the Japanese move to the States,   the mortality rate among them increases sharply. Many suggest   (stort   evidence is not) that the reason is in the differences diet. Japanese and   Nigerians   consume few animal fats, but eat Lots of greens and ripe   vegetables. Americans have the opposite, with blacks, even more   so.

   I agree with     cancer prevention specialists   Diseases that call for less   fat   and   more   vegetables.   If   you   want to take a serious approach to Actually, completely exclude meat from the diet. U   The risk of most cancerous tumors is minimal.

   Chemicals. Prostate cancer is to a few   malignant formations, Not related to smoking at all. Among the industrial chemical pollutants The leading carcinogen   is   cadmium.   Men working in production nickel-cadmium   batteries   and   some types of batteries are susceptible to the most risk.   Work on    the production of rubber, textiles and fertilizers increases Risk, but not too much.

   Hormones. Alcoholics with cirrhosis of the liver less susceptible to   prostate cancer, possibly Because     liver damage   contribute to   reducing the level of testosterone. This fact clarifies the essence of the question purely theoretically.

   Men with prostate cancer are   more   Sexually   active   and prolific Compared to the average level.

   This may mean that they have strengthened hormonal activity, but   the same is observed in infectious diseases (see below).

   Infections. Symptoms of uterine cancer in women similar to the manifestations of sexually transmitted disease, and the most It is likely that its   causative agent is virus. The more a woman has sexual partners,   the higher the risk. With the study of malignant tumors of the prostate under an electron microscope traces of viruses are also detected, but this is true for many other tumors.

   What promises the future. Knowing more, we can Acting better. Writers Love to Discuss Basic research, future discoveries and opportunities when they do not have a positive information about the present. This is what things are today with prevention of prostate cancer.

   Over the past 20 years in theoretical studies of biochemistry and genetics of tumors occurred A big shift. This is disappointing   residents  , more interested in practical recommendations and cure, but the   greatest scientific progress is achieved only When scientists   understand The nature of what is happening. During the 19th century     The main problem of health care was infectious diseases. By the end of the century, researchers It has become clear that their cause is bacteria. Thanks to this understanding, appropriate measures were developed, and by the middle of the century, infections has already become the object of least attention from medicine.

   As soon as we find out what exactly are caused by tumors (not only the factors that favor them the appearance, like   fats   or hormones), a real There will be an opportunity to get rid of them.

 

   EARLY DETECTION TESTS

 

   In the late 80-ies urologists who conducted   the diagnosis     prostate cancer, had a well-defined opinion about transurethral ultrasound   and blood test Prostate-specific antigen   (PSA).   These methods were considered excellent for assessing the development of prostate cancer and reaction for his treatment, but were useless for people with asymptomatic course diseases - did not reveal a lot of small tumors, gave erroneous results in the study of healthy prostate, etc.

   Transurethral ultrasound seemed very an attractive diagnostic method, being harmless and more objective than Recreational examination. The device inserted into the rectum (straight intestine) radiates Ultrasonic   oscillations in the direction prostates, and any changes in tissue density   lead to the reflection of the echo that falls on the sensor. Reading the echogram, the doctor can   determine presence of a neoplasm in the tissues.

   Unlike computer tomography or magnetic resonance   study, ultrasound - a fairly old technology that originates from   hydroacoustic locators (sonars) of the Second World War. Po Compared to X-rays, it is an excellent tool for detection of gallstones   and quite safe when checking the condition of the fetus in pregnant   women. Cardiologists too began to use ultrasound (echocardiogram)     to determine deviations in the work of the heart.

   Urologists have long been using ultrasound for Identification of   the area of cancer spread prostate, as well as to fix changes   the size of   the prostate as   a result of treatment. If these devices become   more   sensitive,   we will get the opportunity earlier detection of tumors. There are many research.

   Prostate-specific antigen (PSA) is    protein   produced exclusively by the cells of the prostate; in cancer, its level usually rises. The wider the common tumor, the higher the level of PSA - and again   we must apply The word “usually.” After treatment     PSA levels   decrease, so doctors check it in patients regularly.

   Since the opening of the PSA in the early 80-ies researchers are exploring the possibility of its use for early   detection     Prostate cancer. The results look quite intriguing. When   Presumably Healthy Men Moderately elevated PSA levels were found (up to 2.5 times higher than normal), a biopsy in 22% of such cases confirmed   the presence of a cancerous tumor. With its growth more than 2.5 times against   the norm, cancer was confirmed in 75% of cases. During a purely rectal examination was not found 32% of these cases. However, in 20% of men with prostate cancer -   a normal level of PSA, but in 30-50% of patients It was increased by the usual GHP.

   Using PSA for Early Detection Prostate cancer today   would lead patients to undue biopsy, but   Many   doctors   practice this test in addition to a rectal examination.

   I went through it myself and always Give   patients   a choice .

 

   RECOGNITION OF SYMPTOMS OF PROSTATE CANCER

 

   There are no symptoms at an early stage. In contrast to hypertrophied prostate, squeezing the zone around the urethra, the tumor grows on the periphery   and can reach large sizes before it affects   urination. In the later stages Symptoms include weakening   moist stitches , frequent urges, nocturnal urination and sometimes blood in the urine, as well   as with BP, but in the latter case, the symptoms develop quite quickly (several months instead of several years in cancer). Approximately a third   of patients go to the doctor because of progressive weakness, loss   weight   or pain in the bones - symptoms of the spreading tumor. To   make sure that you are not one of them, pay attention to the next section.

   Diagnosis. Malessically reborn the fabric is compacted, so with palpation of rubber-like The doctor will easily detect the solid tissue of the tumor (or other, but also different   texture to the touch. About 50% of detected seals are malignant   tumors, and everything else can be   stones,   manifestations   Infectious Diseases or Areas benign hyperplasia). After   the doctor takes tissues for biopsy, injecting in   a suspicious area of the needle, or through the rectum, or through the lower part of the abdominal cavity.

   Hear the diagnosis of "prostate cancer" After an inspection, this is  , of course, impact, but the chances of a cure for early detection are significantly higher than if you waited for the manifestation   Characteristic   symptoms.   Starting   from 40 years of age, pass annually Recreational examination.

   Obviously, treatment of a small cancer tumors should be different   from the treatment of the overgrown, so each patient passes through   the whole   a series of analyses and examinations to assess the size and the prevalence of   the tumor,   as well as for verification, Has it gone beyond the prostate, in   medicine is called metastases.

   The simplest blood test detects, along with with deviations from the kidneys, liver and bones, signs of anemia. The doctor is usually gives a direction and for another analysis, revealing "tumor marker," - most likely it will be a blood test for PSA. As well as Most simple   analyses, all These provide the doctor with hints rather than certain answers. Getting normal results after all   tests - an encouraging sign, but some number of tumors   -   despite   On that, continues to grow.

   Each patient also passes through an X-ray chest  ,   transurethral ultrasound and intravenous Pyelography to obtain   a clear   picture of the urethra Tract. The routine procedure is and   Bone scanning when the injection is made radioactive isotope that is concentrated in high bone zones activity. This analysis is more informative than X-ray, but a positive answer, do not less, does not confirm the presence of metastases in the bones, since other abnormalities (injuries, infections and arthritis) also cause an isotope accumulation. But the negative answer   definitely proves the absence of metastases. This should be good   news for the patient, because when the tumor of the prostate is spreading in 75% of cases Bones.

   Despite the impressive entourage and   high   cost,   computed tomography and magnetic resonance scanners do not play a big role in assessing the condition of the prostate; some doctors use these methods to   determine the size of the tumor, although Transurethral ultrasound in this   the case   seems more appropriate way.

   Doctors usually worry about whether it has struck tumor nearby   lymph nodes, Therefore, sometimes patients are also sent to lymphangiography, when the sensor Injected into one of the lymphatic vessels     on the leg,   and X-rays Describe blood vessels and lymphatic   Glands     as the sensor passes the pelvis area.   Simpler   technology   -   this is absorption with the help of a long needle samples of tissues from   the lymph nodes;   one of the complex and risky - surgical autopsy of the abdominal cavity and   direct Taking samples. However, it must be admitted that none of the techniques can detect all the affected lymph nodes.   Some   experts miss this stage of the examination, for Except when the patient is a real candidate for total prostatectomy (more on that).

 

   TUMOR DEVELOPMENT STAGES

 

   A. These are tumors that are detected in prostatectomies,   but   not   can be felt during a rectal examination. V Doctors, detecting   small tumors in small quantities, did not prescribe any treatment,   but studies showed that in 16% of such cases, the tumor grows   in 8 years, so that we Now more radical towards Relatively young patients.

   B. Tumors detected by rectal inspection, but hidden   in the depths of the prostate, without evidence of metastases.   Some     of them apply to nearby lymph nodes, but In most cases, curable.

   V. These tumors come from the outside Prostate Capsules Without   Evidence Availability of metastases. Lymph nodes are affected in 50% of cases.

   Mr. Distant metastases, usually Affecting the bones. Lymph nodes   are affected always.

 

   BEST TREATMENT: OPERATION

 

   Used in stages A and B surgical intervention provides 15 years of survival, which is equivalent to the average life expectancy of men of the same age, but without cancer Prostates. Although   it sounds   like   very encouraging, but in fact everything is not so It's easy. Prostate tumors develop slowly, and most patients are old, That is why   many   are dying   for other reasons, and the tumor remains with them. Today, evidence that  treatment of prostate cancer both with surgery   and   radiological methods prolongs the life of life to a sufficient extent, to pay for possible risk and side effects, surprisingly shaking. The urologist   can discuss everything "for" and "against" both methods of treatment, but it is necessary to   consult with an oncologist   in order to   hear the   most   objective opinion.

   During the operation,   called   radical   prostatectomy,   surgeon removes the prostate whole, seed bubbles and part of the seed   The cord. Dating in the beginning of 1900, this operation safe (mortality is 1%), but the subsequent impotence is almost Uneasy. Almost everyone in the postoperative period experiences incontinence of urine, but approximately   through For six months, urination becomes manageable for almost everyone.

   In the 80-ies of the surgeons modified radical prostatectomy     in an attempt to avoid damage to the nerves of the penis.

   This reduced post-operative impotence about 20% without   obvious Increased recurrence. However, before the expiration of the 15-year period of   observation of cured prostate tumors It is too early to draw conclusions.

 

   RADIOTHERAPY (RADIATION THERAPY)

 

   Radiation destroys the tissues and the most Harmful to   active   tissues. Cells the most active at the time of division, so rapidly dividing tumor cells are more sensitive to radiation than those that   reproduced more slowly. After all, radiation damages all tissues   within   certain limits, so radiologists should be as careful   with - their rays as surgeons with scalpels.

   Practiced   various   radiation       exposure technologies,    But most patients are faced with irradiation from outside. The device   that resembles X-ray, emits radioactive   radiation that     focuses carefully on the target. Onocologradiologist calculates   the necessary dose of radiation for each individual tumor, and   techniques   According to   this calculation, sequential irradiation of patients is carried out. Typical course of treatment Includes three irradiations per week for 6 weeks.

   Radiotherapy is used in stages A and B.   Surgery   is more effective   at stage A and with small tumors in the stage B, so we recommend radiotherapy only when the patient is too old or For   some   reason, it can't have surgery. Radiotherapy is preferred at stage B   and with large tumors in the G stage, since in these cases the tumor is likely to have already struck lymph nodes. Radiotherapy can affect wider areas, including more lymph nodes than the surgeon is able to remove.

   In some special cases, when tumors in stages B and B are localized, the surgeon removes nearby lymph nodes, and then implants granules with iodine-125 into the prostate. The time of its half-life - 60 days,     this means that it emits radiation not too much, but for a long time: more than a year.   This method, called intratissue radiation, helps   to avoid   extensive surgical intervention and gives fewer side   effects   ( especially refers to impotence) than when exposed to the outside.

   Finally, a combination is possible intra-lane and   external   radiotherapy. In this case, the surgeon implants in the prostate not iodine-125,   The   gold of 1998. Having a period half-life of about 3 days, this isotope is characterized by much greater radiation power   at   duration   action in   a few weeks. The use of only the isotope of gold can   lead   Too much general tissue damage    and     practiced only   to provide a certain part of the dose,   and   The rest   is in    share of external exposure.

   Side effects. During the first weeks Patients do not notice anything special. Then at the site    external   radiation skin begins to itch and burn. These manifestations disappear at the end of the course treatment; usually in such cases, cortisone ointment is prescribed.   As with intratissue, and with external irradiation of the structure,   located next to the prostate, receive a dose much less, but Still    Sufficient for the occurrence of side effects in a number of patients.   Irritation of the bladder leads to frequent and unstoppable urges. One-third of   patients specifies pain in the rectum or Diarrhea.

   Acute side effects are temporary Character and irreversible   damage equivalent to the consequences of surgery. In 12% of patients , chronic inflammation of the rectum is noted, in about 10% - damage bladder, leading to blockage of the urethra with the appearance of the symptoms described above.   Urinary incontinence   -   rare   consequence, impotence manifests itself in 30-40% less than   with a radical prostatectomies.

 

   HORMONAL TREATMENT

 

   Lost the male hormones, the prostate cringes. Although   the removal of   testicles is unacceptable with a benign hypertrophy, the state of affairs changes if we are talking about a cancerous tumor. When adopted by in the 40-ies, this method remains the best in development of tumors to the stage of G. In 80% of patients after surgery, there are improvements - weaken pain in the bones, anemia stops, urination is restored. Compared to many years hormonal treatment, surgery to remove the testicles simply relieves side actions of hormonal agents and require everything several days in the hospital.

   However, many men reject even the thought Removal of testicles. Therefore as an alternative we depriving the prostate of male hormones     with the help of medicines. This task is performed by estrogen - not directly, but by suppressing hormones The pituitary gland that stimulates the secretory activity of the testicles. In the past for this Large doses were used, which led to Complications experienced by women who took   old highly-dose contraceptive pills: retention of urine,   heart attacks and the formation of blood clots. It turned out that lower doses are quite effective, and cause fewer side effects.

   Side effects decrease to almost zero with the use of the latest synthetic hormones, also suppressing   the activity   The pituitary gland.   Patients prefer these drugs, despite the strong hot flashes that are not caused Reception of estrogen. In addition, after   Treatment in     some   Impatience develops patients, but it also happens When taking estrogen. All new drugs are used in the form of injections.

   Another Alternative to   Estrogen   are   anti-androgens.   They   not only suppress testosterone, but also block its effect on   the prostate. To date, for these purposes the first approved antiandrogen is used in the combination with one of the means blocking the pituitary gland, to provide more Complete   suppression of   testosterone. Separately, anti-androgens, like other   hormonal   agents,   while   rarely used, except for clinical trials.

 

   CHEMOTHERAPY

 

   Chemotherapy agents, as opposed to hormones are simply killed by cells. Like radiation exposure, these Drugs Cause   the Most Damage dividing cells, but their action may not be   focused on a particular object, as when irradiated, so they Affect the whole body.

   Despite the fearful reputation, Chemotherapy cures   some malignant diseases (for example, childhood leukemia). It also helps with other forms of cancer, but is ineffective in prostate cancer.   The exception is special cases when hormones stop acting. Discuss with the oncologist all the "for" and "against" this method and Ask him about   the clinical Tests.

 

   DO NOT FORGET ABOUT THE SUBSEQUENT MEDICAL OBSERVATION

 

   Although many malignant diseases are considered cured if within 5 years not given recurrence, some forms of prostate cancer develop so slowly that The patient is     advisable to   Stay under surveillance for the rest of your life.     A 15-year period is considered to be generally accepted in such cases. The typical inspection schedule includes quarterly visits in the first year, then every six months for the next 5 years, and then one Once a year. The doctor should always conduct a rectal examination and   check the blood for the level of "tumor the markers.” from time to time you   will carry out scanning of the bones along with X-ray of the chest and   abdominal cavity. The role of the transrectal ultrasound and remains uncertain, but   this examination is so It is popular that you will be appointed and it.

 

   BREAST GLANDS

 

   At some point, about 50% of men note an increase in the mammary glands, it would seem, is not peculiar to them.

   Rudium-companionable to female breasts, the chest of a man has not just symmetrically located nipples, on which Most   of us   hardly even turn Attention - in contrast to the increased interest in other reproductive organs. Under each nipple there is a very   peculiar fabric, including the milky ducts of the mammary glands, as responsible for the production of hormones, as well as Women's. This Fabric Can   Grow and malignant rebirth. Sometimes excessively   stimulated male breasts begin to produce fluid (and the people call it "witch milk"), but, despite many legends   on this   count, a lot of milk male breast glands is not Produced.

 

   INCREASED THINNING OF THE CHESTS

 

   This phenomenon is called "Ginecomastia." At an early stage, a man usually notices the elastic mobile formation the size of a button,   located under the nipple. Later, the bulge becomes noticeable; Often only one breast is increased. The pain usually signals infection  , although moderate pain sometimes appears and   gynecomastia. Do not   confuse   gynecomastia     Increased   Size   the breast   due to obesity. With obesity, the breast tissue is enriched with fat and becomes to the touch softer than usual (in mind,     that obesity   contributes to the development of gynecomastia).

   Reasons. Breast glands increase due to estrogenic stimulation, in particular in men taking Estrogen in     treatment     Prostate cancer. Amazing paradox: the body syntheses female hormones from   male, and therefore, athletes taking additional male hormones develop Ginecomastia. Because fat is usually involved   in   the conversion of male hormones into female, obese men also sometimes suffer from gynecomastia. Such a disorder can lead to   and   serious   liver damage type alcoholic cirrhosis, perhaps because normal cells liver is usually inactivated estrogen.

   Lowering the level of male hormones against the background normal estrogen levels indicate an increase in the relative level Estrogen. This   is the case as a result infections or diseases of the testicles, as well as after   castration. In relatively healthy people, swelling of the glands   can   call certain medications, sometimes by changing hormone levels,   but more often for unknown reasons.

   Physiological gynecomastia. Throughout Three Periods of   Men's Life His Breasts glands are swelled as a result of normal (i.e. physiological) hormonal changes. Doctors do not consider this disease,   But many men such phenomena No pleasure is good.

   1. In newborn boys during the First Few Weeks of the Mammary Age increases under the influence of maternal estrogen.

   2. During puberty increases The level of both men and female hormones, but The latter may prevail. As a result,   Many teenagers and young men are observed gynecomastia, sometimes sufficient  , to disturb them and their parents,   Forcing   to   consult doctors repeatedly. Treatment in such the situation should serve first of all the clarification of what is happening plus Consolation that in a few years everything normalizes.

   3. Upon reaching the 65-year mark of 40% men notice gynecomastia, perhaps due to a decrease in   the level   Testosterone   with   more   speeds that the estrogen level drops. The tendency to obesity also plays a role.

   Diseases leading to breast augmentation irons. Although   they include dozens of genetic, malignant and hormonal disorders,   which manifest themselves very rarely, the most common cause is alcoholism. Not necessarily, to be damaged   liver;   alcohol in itself suppresses production   testosterone,   so   everyone who regularly drinks, can find   Gynamomastia.   If   a person suffers cirrhosis of the liver,   then   an increase in   The glands     are almost always inevitable.

   Estrogen in the environment. Chickens, Estrogen-fed to   accelerate growth caused gynecomastia epidemic among Costa Rican Boys. Similar cases have been observed in other regions. In the American Estrogen meat production is not a permanent   component, but cheapness encourages their use. V   Medical   literature   has jokes, narrating about the development of gynecomastia in a man who used enriched estrogen cream for baldness.   After   sexual   intercourse   with a woman, he also treated himself with vaginal estrogen.

   Medications and gynecomastia. As well as impotence, gynecomastia -     extremely unpopular side effect, and therefore doctors very rarely mention it, writing Medications. Medicinal gynecomastia is not   It is especially common, but still occurs and caused   by many   drugs. The process is quite easy to reversible, Therefore, do not refuse   a good treatment, unless something better appeared.

   Digitalis, widely prescribed for   cardiovascular   disease, has some weak chemical resemblance to estrogen and at times   causes the described side effect. One from the active ingredients   of marijuana too It looks a bit like estrogen, although its structure is not similar to   digitalis. U Chronic Addicts Using Marijuana   and   hashish (anasha), also develops gynecomastia.

   One of the oldest and cheapest Anticonvulsants -   phenytoin ("Dylantin") - popular due to what does not   cause   drowsiness, and numerous side effects, although irritating, but   quite tolerable. In addition to suppressing convulsions, Dilantine stimulates Conversion of testosterone to estrogen.

   Cimetidine ("Tagamet") - the first an effective drug   that reduces   the acidity of the stomach, released in the United States, quickly gained   popularity,   but not because of the sharp Reduced ulcerative syndrome. All the main advanced drugs such as penicillin, vitamin B 12, thyroid hormone   glands   or cortisone were widely prescribed for the treatment of diseases   from which   They   don’t really help.   A for    a huge   number   of digestive disorders that do not depend on excess acidity,   stomach,   prescribed "Tagamet". No other drugs that reduce Acidity  , could not oust it from the market. "Tagamet" suppresses and Testosterone   in   small limits.

   Two really important drugs Affect     the level   testosterone: new and effective antifungal Antibiotic ketoconazole   ("Nizoral") and spironolactone ("Aldactone"), often used in combination   with   antihypertensive agents and diuretics (diuretic) to reduce Potassium loss with urine. Other daily funds, gynecomastia: relanium ("Valium"), metronidazole ("Flagil"), ranitidine ("Bandotic") and theophylline ("Theo-Door", "Theo-Bid").

   Treatment. Active treatment is required in rare cases, because mainly gynecomastia passes or   over time,   or   after   the reason that caused it. Sometimes a small swelling   remains;   If   someone thinks it's Aesthetically   unacceptable,   it is possible   Use plastic surgery.

   Some medications block the action Estrogen.   Doctors   prescribe women tamoxifen and danazole for the treatment of painful   sensations   and   breast cancer. Men who have gynecomastia do not go away for a long time due to hormonal disorders, can take advantage of these funds, but in most cases Their reception involves the risk.

   And men have breast cancer. Men make up 1% of the total number of cases Cancer of the breast. Because it is the leading   malignant disease among women, which is 150 thousand. new   cases per   year, 1% in this Case cannot be considered trivial   number.   The ratio of breast cancer in men and cancer of the penis is 1: 4. Mortality rate for this disease in men above, because they do not show   concern about the state of the breast, which is almost All women. Relatively soft thickening under the nipple - most likely, gynecomastia, a harder one can be a tumor. In both cases It is best to see a doctor.

 

 

   Chapter 9

   THE SKIN OF MEN

 

   Losing compared to a woman in others areas related to medicine, a man wins when it comes to skins.   Smooth,   soft skin plays small role in male sexual attractiveness, so men save Bolly and often useless energy that women spend in pursuit of eternal youth.

   Men are more tolerant of some rudeness his   skin,   but   wrinkles, peeling, pimples and bumps of various kinds are not They like as much as women. All The described troubles are surprised   easily   prevented; Skin care requires less effort than for muscles, bones   or   cardiovascular system.

   An ordinary person believes that the skin is only the epidermis, i.e.   the outer layer. The upper of the two layers that make up the skin - a layer of   the epidermis - notes the boundary between Your body   and   external   Peace. The main function of the epidermis is protective. its thickness is 1.5 mm on the palms and soles, several tenths of millimeters on the face and only 0.1 mm on   the eyelids.

   Epidermis is formed from one layer living   cells   that make up   his base. Cells filled with rough protein - keratin (which   also forms nails and hair), - moving from the inside out, die off, flatten and finally reach the surface. Contact with the environment   leads to erasure many of these cells, but even protected from the contact of the surface, too, of their They're constantly   losing.   Ordinary   the time   of existence of a normal epidermis cell is from 4 to 6 weeks. Epidermis   is not   Contains no nerves, no blood vessels. All its   fabric,   for   exclusion of   the basal layer, dead. Hair, sebum and sweat pass   through   it, but their source is the glands and follicles located deeper.

   Everything that happens with the epidermis, including And within it, temporary   phenomena. Injuries and burns heal without scars. Skin   diseases   leave no trace, and any cones and other defects   removed   Doctor,   they won't show up at the same place again.

   Under the epidermis lies the layer of the dermis, which It is about 20-40 times thicker. Here are the glands and Hair that feeds on   A rich   flow of blood. The basis of the dermis is collagen - a fibrous protein that   also forms ligaments and tendons. Collagen is also called connective tissue, since it combines most of the body's structures and fills   the intervals between them. Healthy Connecting   Fabric   of the loose   and   mallepit; aging, trauma and solar radiation make it   hard   and   forced to decrease in size. You will remember this when you read about wrinkles. Damage to connective tissue is irreversible, and the healing process leads to scarring. Ointments, superficial curetts and   other ways of treating the epidermis are not Affect the dermis.

 

   CLEANLINESS AND SKIN

 

   For unclear reasons of evolutionary nature Residents of the East are different The weak smell of the body. They were always I am convinced   that from   white     Strongly and It smells bad. Representatives of the white race did not   give   this   meaning until the middle of the 19th century, when tap water became   available Everywhere. However, even after that, “educated” people time   maintained the purity of the hands and faces, but rarely washed the whole body.

   In matters of persuasion and practice Usually   go hand   to   Hand. A century ago, bathing required several hours of hard preparatory work - it was necessary to inject the wood, Heating the water on an open fire and fill it with portable Iron bath.   It was   very   tedious occupation, and if the house did not keep many servants, usually all washed in turn in one and the water.

   At the end of the 19th century, Western doctors believed, washing in the bath is harmful. Only the rich could afford regular Swimming, and doctors   have traditionally been I am convinced that whatever they do   rich,   -   excesses and luxury, which do not bring benefits health. Today, the Americans   are washing daily, which can not be said about many Europeans, shocking the smell of North American tourists.

   The fact that Americans are washed so often, not fearing to damage the skin, indicates its strength and rudeness. Washing   (for   Excluding   the foreskin ) is relatively small for the health of a man.   Washing the visible dirt, the man does not become much more attractive. Soap and water are harmful to the skin Much more than dirt.

 

   HOW TO TAKE A BATH

 

   Although a daily bath or shower with washing hard   wash is   deadly for the skin surface, most men never feel consequences, however, the skin requires care, so   Get acquainted   with   the following advice.

   To avoid the unacceptable (and inadmissible)   in the society of   smells, Wash the soap only armpits, feet and perineum. Does not have to Wash in the bath or in the shower for a long time. Dry the skin, slightly welass it towels. Women constantly use moisturizing creams after washing. Although it does not look like a man, it is not superfluous to follow their example, since with age, the skin becomes drier and prone to   the     Itching and   combs. A man of 60 years old should wash in the bath or under the shower once or twice a week, daily washing the area with soap, mentioned above.

   We are too often my children. Children's the skin is very delicate and is not oily, because the skin lard is not released before 8 years of age. Wash your children up to 6 months with soap once a week,   wiping   them     On other days wet sponge.

 

   HOW TO GET RID OF THE SMELL

 

   Sweat contains water, salt, glucose and several Other Simple   Chemical Compounds – All without smell. To the characteristic smell leads to the action bacteria living on the skin of the skin on the skin of the skin and dead surface   cells, Especially in more warm areas - under the muscles, in the crotie and on the feet.

   The smell of the body is not inevitable. Many Men that are washing   the mentioned areas and changing underwear     every day,   have     no problems and not They need deodorants. To find out if   you are in this category, Ask the person who   Trust.   No one smells like a smell (as well as   smell of   their own   breathing). Every doctor knows hundreds of patients with an unpleasant body or breath. Such people, of course, are not concerned about hygiene. But dozens of other   patients complain of a terrible smell or Stupid breath, although it is not  . The belief that you smell of is a serious mania if   it   does not confirm the surroundings.

   Use of deodorants and funds from Sweat. Deodorant is a type of flavored liquid like spirits Or   cologne.   Such substances have been used for centuries to give the body a pleasant fragrance. Means to remove the smell   sweat   contains   salts   metals (usually aluminum chloride) that compress Skin pores and block   the release of sweat. When buying such funds, read the label carefully.   The container on which is written only "deodorant" does not   contain   components that suppress the release of sweat, so such a tool will not prevent sweating.

   If you prefer deodorants, Use them only     in the morning. The man, using anti-potential agents, should wash the sweating zones at night and apply it before bedtime. At night, the armpits almost do not sweat,   so the chemical will have time to penetrate the skin. If you apply this tool in the morning, when the production begins, then a large    Some   of the chemical   will be washed later.

   A good remedy for sweat should eliminate smell for   a long   time, without causing irritation that can   cause   salt   metal that gets on the skin for several years   of use.   K   Unfortunately, there is no perfect product of this kind.

   Increased sweating and heavy odors. A man with increased sweating in the armpits, palms or feet doctor can prescribe   concentrated Aluminum chloride solution. With sweating of the legs   would   also advise daily immersion of the feet in the solution of formalin (one   teaspoon standard a formalin solution for 0.5 liters of cold water).

 

   DRY SKIN

 

   The skin is dry from a lack of moisture,   and   not   fat   (skin   fat). The dead epidermis contains water that formed by   evaporation of natural fats. Dry skin mainly affects the hands (landwork),   forearms and lower parts of the legs. Epiderm of the face so thin that the water   contained in the dermis, can maintain its humidity. The man who notes that his skin the face has become dry, probably suffering from seborrhea or suffered a sunburn.

   Dry skin in most cases cause:

   1. Age. Less than years is produced sebum, so moisture evaporates from time to time faster.

   2. Washing. Soap and other detergents washed away the protective layer of sebum.

   3. Low humidity. Air-conditioned Air and central   heating reduce The humidity in the rooms is so,     that the skin   dries even in spite of Enough natural fat.   Do not   apply moisturizing creams to dry skin.   First   you need   to reimburse   Lost moisture and only then apply the protective Coverage. It is best to do   this after washing, when the skin is still wet. Even bath oils are better off, if you lubricate them directly with the skin. If you pour them into the bath, most of them will remain there.

   The best protective coatings should be Enough tight enough   to be completely prevent the evaporation of water. Lyard (smelt pork fat) and other animal fats in this regard is good   Proven   themselves   on   for centuries. Also good (and do not smell) fat like Vaseline, but many   people don't like them because of their feelings of oily. Clean fats or oils protect the skin best, but cause the same sensation.

   Chemists working with emulsifiers agents, opened the ways of mixing oils with water for production of lubricating liquid with cream consistency, which is much more pleasant in use. The suspension of water in oil is called a lotion, and on its The basis is based all   modern   cosmetic "air conditioners" for skins.

   If you have very dry skin, never Wash with water and   use dehydrated cleaner: apply it to the face, rubbing to   the foam, and then remove the foam soft A rag.

 

   FATTY SKIN

 

   On normal skin there is always a layer fat (skin fat). If your main problem is purely External   effect   too   oily skin, wash more often. The soap washes Skin lard. Avoid moisturizing creams, better use binders, usually containing alcohol.   Impose them on the skin after washing - they remove fats and dehydrate   the skin, sometimes temporarily tightening it. This causes a pleasant tingling or tingling, which then pass.

 

   HOW TO TAKE CARE OF THE SKIN OF THE HEAD AND HAIR

 

   Unlike washing the skin of the body and face, Visive washing   of the head   is quite permissible, because Skin and   hair   are contaminated   very   fast. Washing your head twice a week is enough, but even daily   washing with shampoo is not damage the normal scalp.

   Wash your hair with the same soap as the body. If hair after that looks good, do not bother with the choice and Buying a shampoo. Advertising warns us about a thin film, Covering Hair After washing with soap, as a result of which they become dull   and   sticky.   This   really: soap reacts with   minerals   hard   water,   creating a film. However, it can always be washed off with   sour   rinse, adding to the water vinegar or lemon acid. If it’s   too difficult for you, try the detergent. Almost all shampoos are detergents. Buy any you like, but not forget that the features listed on the label are no more than, than exaggeration. Even special shampoos for dry, normal or fatty The skin   is not much different   from each other. People, who were interviewed, which shampoo is better, not could indicate no difference.

 

   BEARD

 

   Shaving removes a thin layer with bristles epidermis,   but   it   does not cause harm, and the removed layer quickly   Recovering.   A man   can shave all his life, not damage to the appearance and     Skin condition.   On the other hand, a few minutes a day spent on shaving,   summing up throughout life, constitute a significant period of time can be spent on more productive activities.   Beard   almost always decorates young men, and with The appearance     of the groom becomes   Even more attractive. Care for it requires less minutes - cutting   sticking hairs with scissors and quickly shaping the boundaries to maintain a neat species.

   Before shaving should be mitigated as much as possible Hair. Moisten   the beard   and apply a cream on it for shaving, better than usual, not in aerosol   packaging. Do it during daily   washing,   shaking     last . Shake up your hair growth and do not stretch your skin with the other hand. Using a good razor, you can choose   completely,   Without   going through the same place twice. Never forget about the period of use Blades. When shaved with a new blade, a simple touch of the skin already shaves, in the future it has to drive them on the skin with more   and more and more   Pressure. Use the blade as long as it    Stripping   all   the hair   on the site in one pass.

   Lotions "after shaving" is pleasant smelling, but     they don't   Necessity. Alcohol included in their composition is not disinfects the skin   and   does not   prevents infections, and the burn obtained after the use of such lotion,   means, that you took off too thick layer of the epidermis when shaved.

   Electrical razors serve people well with thin and blond hair, as well as those who have hair curls   after   shaving tend     to grow, punching into the skin and leading to   The appearance of   acne.   Possible   try to comb and spread after shaving residual bristles with a toothbrush or straighten such hairs on One with     a little hook. A radical solution to the problem is to let go of the beard.

 

   HAIR IN THE NOSE AND IN THE EARS

 

   These phenomena, as well as the heavy body odor and   the body   mouth,   considered   very unattractive. Buy a small   razor   designed   specifically for the ears, and small scissors for Hair trimming in the nostrils.

 

   SINKING

 

   My grandfather had a baptized gray on his head Hair until his death, and he died at the age of 86. K Unfortunately, it was my father's father, and the tendency to baldness is transmitted through the mother's genes. And Although my father also had beautiful Hair, the grandfather on the part of the mother bald already at the age of 40 - the same thing happened to me. If you don't know if it was bald   your   grandfather is   from his mother, the state of the scalp of its relatives - men,   Of course, it can predict your future.

 

   REASONS

 

   Eunuchs never bald. It is known that Castration     of a Man to   how he starts baldness, guarantees him Preservation of   hair,   because   for baldness of a man, it is necessary that There were testicles. Men bald from the fact that testosterone is wrinkling   Hole follicles.   Po   Incomprehensible reasons, this action is directed only on the follicles of hair of the upper part of the scalp, and on the hair of the temporal parts or The beard does not affect.

   Despite the common belief, Baldness in men is not the result of hair loss. Each of us Loss a   day   about   100 hair, because normal hair fall out every few years,     and in their place grow New ones. Because the follicles of a bald man   reduced, then the growing new hair from them is shorter and thinner than Lost, and even on a completely bald head there is always an imperceptible cannon.

 

   DIAGNOSIS

 

   Within a few years of work in I have repeatedly met students who are convinced that their hair He takes away a   sinister   disease. Usually the examination gave normal results, but sometimes I noted thinning of hair on the crown or thinning of the hair at   the front border - typical for men baldness. I asked them state of health, about medications they take and their usual manner to comb (excessive heating of the hair dryer   or   some   ways to styling hurt the hair).

   Everyone said they were stressful and   Eating wrong.   But   this is not the reason for hair loss. Abuse of shampoo or, conversely, complete rejection of it, cramped football helmets or intensive   combing of hair crests is also innocent   in this.   People   who have suffered   a stroke do not lose their hair, therefore, Poor blood circulation has nothing   to do with it. Bacterial and fungal infections to the same   extent,   like   skin diseases, can destroy the hairline, but in such cases The surface of the skin is also affected.

   In medical textbooks described a lot of diseases   that can cause hair loss, but they are so rare that in 20 years of practice I did not have to face any of them. If you are healthy and the skin of the scalp looks normal (danded not count), then the refinement or thinning of the hair indicates the beginning of baldness.

 

   HOME DIAGNOSIS

 

   Calculate the number of deaths per day Hair. Do not use   shampoo at this time, carefully collect all the hairs from the pillow in the morning and those that will remain on the comb during the day. Put them in an envelope.   After a day count "harvesin" - more than 200 fallen hair signals serious disease that increases hair loss. Sometimes the cause is obvious - the current disease or fever, but in any case, you should see The doctor.

   None of my patients collected the amount Hair, indicating disease, but also proof that they are simply balding, too   They   weren't happy. Only you will grow up, they complained, as you already receive   the first signal that You're starting to get old. I reassureed them that   baldness is not a sign of old age, but complete sexual maturity.   Twenty-year-old men may not notice a decrease in the density of the hair for a year, and rarely who looks at A mirror on your top.

   If my explanations have not comforted the patient, I   let       in the course of the last weapon, almost always hitting the target, explained   that women   Usually have nothing against a   man's bald spot.   It   bothers   and   upsets only for themselves. Among the qualities that repellate women, we can call   lethargy, physical weakness, formless oily ass, bad posture,   hair, Stuffing from the nose, bad manners or dirty clothes. But   I   has   not yet met women who seriously believe that baldness is a sexually   unattractive phenomenon.

   You can draw a parallel here. Women are spending a lot of time and energy, choosing shoes, and very often they They are amazingly uncomfortable. However, men never turn attention to women's   shoes   and   do not judge by it about the attractiveness of a woman.

   After all, most of my patients agreed with this, but many, nevertheless, wanted to appear as a dermatologist. However, almost   no dermatologist has a special experience in treating men from hair loss.

 

   TREATMENT

 

   In the mid 80-ies there was a remedy for baldness   is   minoxidil. In the 70's, doctors knew,     What this   drug   promotes hair growth. But, being a very powerful   tool,   Influencing     blood pressure, minoxidil caused many side effects.

   Around 1980, some bald in the past cardiologists suddenly became the owners Slightly noticeable hairstyles. They were silent   about   the reasons, but we suspected them of taking large doses of minoxidil. Despite the     fact that the brilliant effect of hair growth on the scalp was there, they said that in the morning "fresh-haired" cardiologists had   to shave   not   only the cheeks and chin, but also the nose, forehead and ears.

   All this attracted the attention of the company "Updong Company" - manufacturer   Minoxidil is a sensing goldmine. In 1989, the lotion was based on it was approved by the Food Authority and Medications. Minoxidil is effective when the top appeared Only the first signs of baldness. The use of lotion twice a day in 50% of cases Helps   to grow the bald spot. Changes notice after 6 months after the start   treatment. But the less often and thinner the hair, the worse The drug is in effect. It   is useless with full baldness of the top, but with regular   use   can   prevent loss Other hair.

 

   PREVENTION

 

   Rubbing twice a day into the scalp Minoxidil lotion (until   expiration Patent Term at   the Beginning   of the XXI   Centuries     is –   "Rigain")   is blocking The effect of testosterone on hair follicles. Popularizers of such   methods usually bypass one aspect of silence: This is often a boring and annoying activity. If the person has already moved his first heart attack, I can easily convince it to radically change the diet or Start   regular   classes Physical education, but Young and Healthy Man   Shows   much   less Enthusiasm in these questions. Prevention of baldness also requires   constant effort: start rubbing   the     Lolon Head   with   minoxidil in  18 years of age and Keep up for the rest of your life.   Predisposition   to baldness is a good stimulus, but with preventive measures you can     be late. Minoxidil turns backwards   the process of   shaking   follicles only if they are not yet too reduced, so prevention Eating should start the ground.

   Use a 2% lotion throughout the year. If the result   does not   satisfy you, ask the doctor to prescribe Recipe for a 5% solution.

 

   EATING AND INFLAMMATION OF THE SEBLE GLANDS

 

   Together with the guarantee against baldness and increase the prostate eunuchs also receive a guarantee that they will not have acne - this disease does not   occur in the absence of male hormones.

   Almost all teenagers have eel, and Heredity plays a role here. A child whose parents suffered from eels, has 10 times more risk than The child of people who are not subject to them.   Acne   affects both sexes, but the worst cases are observed in men. After 20 years of acne mostly disappear, but sometimes they remain in adulthood. Some men notice the first acne after 20 years, after which they are forced   to fight them all their lives.

   This disease is characteristic of the developed of Western   society.   Residents of poor countries less often suffer from acne, but not because there are fewer chemical additives, sugar, fat and other unhealthy   components in their food - they often lack the food itself. Starvation suppresses the activity of the sexual hormones that contribute to the appearance of acne. That is why women with no (losses) appetite on the nervous soil is always smooth skin and no menstruation.

 

   REASONS

 

   Acne is a disease of hair follicles, containing, in addition to   the root of the hair (onions), the gland that produces sebal - natural lubricant skins. As you might have guessed, they are on the face, neck, back, chest and shoulders.

   Follicles are affected by male hormones. The boys give   up little   sebum. With the increase in level male hormones to     8 years   The age of   the follicles increases, and the release of fat increases. Unfortunately, they are among the imperfect “details” of the human body.   Most   the weak point is the channel that removes hair and Skin lard on the surface.   It is lined with the same epidermis that covers the entire   surface   the skin,   and these dead cells are peeled off from time to time. In the usual   case   Scars are carried out out with sebum, but with age (starting with early adult) canal walls swelling and dead cells get stuck and start to accumulate in it. As a result, many times clogged. This is where all the troubles begin.

 

   THREE FORMS OF ACNE

 

   1. Ecide (salary plugs). Scored It's time   to look     like a little bulge. That's the eel. In everyday life, they are sometimes referred to as "cookings with a white head" (medical term - milium) or "cooking pimples with black head" (comedons) - depending on the color. Often follicles   themselves   accidentally released from sebaceous traffic jams.   In the past   widely   used a small tool - an extractor of sebaceous plugs, which   was sucked   their time. Today some doctors open acne the tip of   the blade of the scalpel, but more often prescribe ointments that perform their   purpose quite well. You can't squeeze out the acne. Sometimes This procedure   is possible,   but   often damaged the follicle, leading to the next, worst form of acne.

   2. Papules and pustular eels. Skin The fat accumulates in the damaged follicle. As a result, the living here The bacteria begin to multiply. This does not cause harm until Annoyed or   squeezed follicle does not burst, releasing the accumulated bacterial   material on the surrounding epidermis and infecting it. Mild Infection leads to the appearance of protruding red (or bluish color) bulges - papules, but the most traditional red bulge with white pus point in   the center - papula with pustule in center. Usually papules and pustules remain in the epidermis and are healed without scars within one to two weeks. Squeezing of pustules Increases the risk of wider   spread of   infection   and the appearance of nodules and The cyst.

   3. Nodules, cysts, abscetizing and phlegmosome Axe, Some   men suffer from too active sebaceous glands. Their   damage   leads to   the formation of large nodules and cysts that grow into abscesses, abscesses, Boilers, striking the dermis. Abscending acne is softened   and revealed with Reproduction of mucous-purulent   liquids   large   papules or papolo-pustopy acne. Phlegmonous acne - soft   flattened   bright red painful formations with a diameter of up to 1 cm, when opening which there is a lot of pus. After all these varieties,   scars remain.

 

   THE MOST COMMON MYTHS ABOUT ACUTE

 

   After considering the facts, you will understand that Failure to comply with hygiene   can not Calling acne. The pores are clogged from the inside, not because of the dirt covering the skin from the outside. The black dot on the top of the pimple is not dirt, but the result of chemical changes in fat traffic jams. Maintaining the cleanliness of the skin, undoubtedly, but, if you cross it with a bitterness, it will only increase the likelihood of acne as a result of damage to the hair follicles.

   Fatty of the skin also does not affect education Eat, although many   are sure of the opposite. So far, the skin lard is unhindered   Comes     to the surface, there will be no acne. Salah on the surface of the skin does not cause harm, so flushing it with water or other funds will not protect against   eels. Surface drying agents for alcohol do not reduce the release of fat. Dermatologists insist that patients do not use creams and   moisturizing ointments for the face, but this expressed by ordinary common sense;   Convincing evidence that cosmetic   mitigating   Means   contribute to the appearance of Eam, no. Men working with lubricants   materials, more affected by acne, but   This   is rather   a result   Effects of irritating substances that are part of Industrial   oils   than   The oils themselves.

 

   TREATMENT

 

   Medicine successfully copes with acne, and many   men,   having made moderate efforts, may not have them at all. If you have common   acne, start treatment with benzoyl peroxide 5%   -   powerful   antibacterial agent that kills bacteria in the follicle.   Produced     in the form of an ointment or gel for several decades.

   Wash with regular soap, then dry the skin and apply the ointment to the affected areas. Do it twice a day.   With   Irritation   use the ointment once a day; if the irritation does not pass, lubricate the skin   without washing, or Try 2.5% ointment. Action   benzoyl peroxide   is aimed at suppression of bacteria, and not to destroy existing acne, so do not expect large visible changes in appearance.   Take a close look at the acne before starting treatment and forget about them for six weeks,   and then look closely at the affected skin again.   If   the result will not satisfy you, ask the doctor prescription for another remedy, such as tretinoin (retinic acid, "Retin-A"). This   Vitamin   A derivative, the best drug for   prevention of   clogging   follicles.   Ointment (or gel) thins the layer of the epidermis, accelerates peeling and   reduces   the possibility of stuck dead superficial surface cells in the canal. As a result, the allocation is increased Podwood salad and plugs in the form of white or black dots are pushed out.

   When applied to the skin at night "Retin-A" can cause inflammation of healthy skin. Some men can carry it only when consumed every other day, and sometimes (such as Sufficiently   small)   at all     can't   use it. Eels disappear after a few weeks of treatment,   individual patients - after 2 months. Skin, treated with "Retin-A", becomes more sensitive to the sun, so   should   use   protective visors or wear a hat with wide fields.

   Antibiotics.   Oral   antibiotics   can    be    an excellent means of combating bacteria in the follicles, so with   strong   forms of papulo-emptal acne, it is better to start with them. Drugs   are often   prescribed for moderate forms, since both patients and doctors themselves are convinced that the pills act better than ointments. In addition, some patients do not   want to process a person ointment twice a day.

   Treatment begins with taking large doses antibiotic, usually tetracycline, most popular in the treatment of acne. The drug does not   affect the existing rashes, so for   It   takes   several weeks to improve. Then the dose gradually decreases. Therapy with small doses   is quite long, but the side effects are rare.

   Local antibiotics are usually erythromycin or clindamycin   in the form of an ointment - act weaker, but in combination with   "Retin-A",   applied at night and supporting the follicles open, their application in the morning is enough Effectively for most forms of acne. In this case, the pills are not needed.

   Isotretinoin (Accutane). Entrance until the 80's all     acne treatments suppressed them occurrence only at the time of reception. Being another derivative of vitamin A (which doctors once prescribed for acne in ultra-large, toxic doses), "Accutane"   poisons   Scarce   glands. They cringe forever, which leads to a decrease in the fat separation.

   "Akkutan" usually works wonders in the worst form of acne is cystic. Four-month course slowly destroys disgusting cysts and   knots, and improvement often continues and after cessation of treatment.   Approximately 30% of patients need a re-course. "Akkutan" is used and for the treatment of persistent extensive papulo-pustoles eel.

   Do not use "Akkutan" with mild forms of   the disease,   since, drying and compressing the sebaceous glands, It drains   the entire   surface of the body. Almost every one of the receivers   the patient   cracks   lips, the skin begins peeling and itching, eyes watering, sometimes   There is nosebleeds and hair loss. Side   effects   on   The end of treatment disappears, and most patients agree to such discomfort, because the final The result exceeds all their expectations.

   Other treatments.   In the past   Dietary   restrictions   helped the patient to allegedly control the disease, and doctors were given a suitable   reason for accusations if The treatment didn't   work.   No   Convincing   evidence of that, The appearance of eels depends on the food consumed. Researchers engaged search for new ways of treatment, will be grateful   Anyone who can prove such a connection.

   Many drugs sold without a prescription in any   pharmacy,   adversely affect the skin: cause dryness, peeling, itching, etc. Their   ingredients include alcohol, sulphur, resorcinol, salicylic acid   and   various strong cleaners. According to popular theories, such   aggressive   effects on the skin should be unlocked clogged pores, but greasy traffic jams, in all likelihood, break through out themselves,     not     as a result of these funds.

   Artificial ultraviolet irradiation increases rashes,     as well as natural sunlight, and also     contributes to   cancer of the skin, so it is now used much less often than before.

 

   WRINKLES

 

   Highly immoral women and many modern feminists do not   like wrinkles - and Reasons: They are often evaluated as   traces of the turbulent past. However, to the men it For some reason it doesn't. Our gray hair or balusters do not repel women, and the weathering face is evidence that the man "seen peace.” Aging Actors, starting with Gary Grant and ending with Sean Connery,   even   in   70 years old   looked very attractive.

   Advice on the prevention of wrinkles, mandatory in publications for   women, at first glance, in this book are somewhat inappropriate until you   understand that wrinkles can be a consequence of two independent   processes:   normal aging and skin diseases.

 

   WHY THERE ARE WRINKLES

 

   Some people are considering the process Ageing as   a Dehydration Process (dehydration), as a result of which the body loses moisture, groping and wrinkled like a withering palm tree. This is a bad and wrong analogy. Although the aging skin is really easier to lose moisture, drying out, it peels and peels off, but does not wrinkle. Maintaining the moisture of the skin It is in any case, but it will not prevent wrinkles.

   Remembering the description of normal skin, you realize that wrinkles   cannot occur on the epidermis, because its cells are constantly   separated   from the surface. Any localized The change in the epidermis disappears in about a week. Permanent Changes begin with the underlying dermis.   washed by body fluids and provided   with large   The number of   blood vessels of the dart never dries. Wrinkles appear when   the connective tissue is compressed (creubten) Dermis, wrinkling the epidermis attached to it.

 

   WRINKLES THAT CAN BE AVOIDED

 

   English schools   of the Victorian era taught   The young   ladies   are not   laugh loudly, do not smile broadly, do not frown, do not wrinkle the face in grimaces,   etc., based on such requirements on the fact that any increased facial expressions contribute to the emergence and development of wrinkles. And there is in this   A certain   amount of truth. Chronic schizophrenics and mentally retarded people who have an expression the face changes very   rarely,   before   deep   old age   retain the smoothness of the skin. A person who presses his face to the pillow   in     sleep time, in the middle of the cheek, a constant is formed   Fold.     Smokers   much earlier than non-smokers, around the eyes There are wrinkles   called   in everyday life "Bird's feet." This is probably due to   the fact that smokers are constantly squinting from the smoke that gets into the eyes. Chronic   diseases accelerate the appearance of wrinkles, and smoking can be considered as a chronic disease no less harmful than diabetes or hypertension.

   For most men staying at the open sun is the main cause of irreversible Aging of the Skin. Ultraviolet radiation, passing through the thickness of the epidermis, damages the living   Dermus  , causing   her   Climbing and getting tougher. When studying under a microscope skin    old man is no different from the young skin A person   suffering from   chronic sunburn.

 

   WARNING OF WPICS

 

   Looking at the old photos with the image Crowds  , you can   very   It is easy to determine when they were made: 1960 or later. Until 1960 , almost all men wore hats, but President Kennedy, "one left" put on the shoulder blades the entire hat industry of the United States, because   he walked with his head uncovered. Since then the incidence of skin cancer   has crawled up. It can be assumed that the same   The     number of people with early wrinkles.

   Of all health measures and Prevention of Early Ageing   Wearing A wide-seaed hat is probably the cheapest and most   effective means. Hang it at the door and Put it wherever you   go in the day. Ultraviolet rays pass through the clouds, so carry your hat in any weather.

   Some UV rays is reflected from water   surfaces, snow and buildings,   so   one   The   hat is   not   will provide 100% protection. Every man   during the day   protective     anti-sun creams should be used. Men rarely use them. because the cream's face is glossy. But the brilliance disappears in an hour or two,   Therefore,   apply the cream in advance, before breakfast, and then at work you will appear quite in a decent type.

   Traditional Protective   Creams   contain   para-aminobenzoic   acid that blocks the action of that part of the ultraviolet section of the spectrum,   which is accused of sunburn.   V   Over   the past decade,   experts have suggested that another part of the ultraviolet spectrum, which has not been previously given importance, plays a more significant role. The result was release of new creams that block both parts of ultraviolet   radiation.

 

   WRINKLES, SUNNY BURNS AND "Rettin-A"

 

   "Retin-A" made a splash at the end 80-ies, when the researchers   reported, that it improves the skin and perfectly destroys wrinkles typical of   sunny impact. However, shortly after the beginning of this   the Downward   Insulation Doctors Prompts with serious warnings about   that   the information about the benefits of "Retina-A" is greatly exaggerated, that he does not   act on wrinkles from old age and is generally harmful. All this was close to the truth, but passed by the target, since the drug turned out to be very effective for   the treatment of acne in both men and women.

   "Retin-A",   in addition to   influence on     acne,   smoothes   the superficial folds-wrinkles caused by the sun. Men who appreciate the smooth skin   can try this remedy. However, the skin he processed becomes more sensitive; flip the surface layer will require   moisturizing creams, and the use of sunscreens will become mandatory.

   I don't use Retin-A for the sake of appearances, but because 10 years ago I started cancer skins. The Dermatologist insisted on the regular use of Retina-A for prevention. Many specialists come   to conclude that "Retin-A" (and other derivatives of vitamin A,   including   and   "Accutane"), eliminate the early precancerous skin changes. This will be further described More details.

 

   DAND-AND-FIGHT AND SEBORING

 

   Crushing the teeth in the morning, many men rinse the toothbrush and scrape her face to clean the scales that every morning   appear   on the sides of the nose, around eyebrows, at the boundary of hair on the forehead, by the sideburn and   Sometimes around the beard.

   These are the consequences of seborrhea - harmless,   but   annoying   disorders, which, apparently, sooner or later overtakes   everyone   man, and many begin with the onset of sexual maturity. There is no prevention of seborrhea, but with Continuous efforts can be kept at an acceptable level. I mentioned the unusual use of toothbrush    because   too many can not resist this, not realizing that the brushes, nails and other improvised means will save them from scales only   on   day,   and doing so regularly, you can damage the skin and bring an infection. You   can do something better.

 

   WHY THE SKIN IS LAYED BY SCALES

 

   Although everyone suffering from dandruff and seborrhea, I am convinced that   the reason is dryness The skin is the opposite. Normal skin   is peeled so small the particles that     their   It's impossible to   see. When the surface of the skin becomes too greasy, the particles   stick together   in the plates that form the scales dandruff or seborrhea.

   Seborrhea got its name from the Latin the names of the sebaceous glands   of the skin , directing their products to the hair follicles. Of   them   Skin   fat gets to the surface of the skin, providing a protective lubricant. Areas rich in sebaceous glands get a lot of lubrication, so   successfully   resist drying, but they often occur seborrhea. This usually zones of scalp, beard, ears, armpits, groin, crotch and around the belly button. For unclear reasons, the cells of the epidermis of the skin affected by seborrhea, are divided Much faster. In combination with large   the amount   of   sebum this leads to Continuous formation of scales. On hair-deprived   areas (nascorded folds or upper part of the cheeks under   the eyes),   you   you can not notice the scales, but the strong Redness.

 

   TREATMENT

 

   Moderate dandruff is observed in almost everyone, but daily washing of the head with the most common shampoo often cleans the scales So good that special treatment is not required.

   The formation of dandruff is best suppressed Ordinary tar, but   it is black and odoruch, so the producers had to work to obtain more pleasant forms of tar-containing detergents, diluting it and mixing it with various flavors. Divorced tar, which is part   of shampoos, too It works, but worse than black and more concentrated.

   For constantly inflamed, itchy skin with A doctor can   prescribe drunkenness an effective remedy is a cortisone lotion or aerosol. When   seborrhea on the skin of the face, in the areas of the eyebrows and   ears   Rub   a 1%   cortisone ointment twice a day. Such ointments can be purchased without a prescription. Redness or peeling will pass in about a week, after which   it can be reduced to once a day or stop treatment while Again, there will be no need.

   Hydrocortisone drugs are very   effective   with   seborrhea.   Therefore, the remaining peeling, rash and itching can be caused by another cause in this case Show me the doctor. Never use more   concentrated cortisone ointments for the face and head.   Skin     the face   is so thin that ointments freely penetrate through it. Excess   cortisone   very much suppresses hyperactive cells seborrhea, while   atrophic   and greatly thinner Skin. All concentrated cortisone ointments   should be prescribed by doctors who know about the danger of them Applications. Therefore,   my   warning refers to the ointments left over   you have   after   treatment of   other skin diseases.

   It seems that the best treatment for seborrhea is antifungal antibiotic from the family of griseophulin, which   will go   Speech in     the next section. Tablets or ointments with this tool not only eliminate   dandruff and rash, but also reduce Probability of relapses.   Possibly in    the occurrence of seborrhea of a certain role is played by fungi, but this has not been proven, although studies of antifungal agents have begun in 80's.

 

   SKIN FUNGI

 

   Itchy rashes can appear in many causes, one   of which is   a fungal infection, especially if itching areas   that are constantly   exposed to high humidity: perineum, feet (including   between   fingers), sometimes the armpits. Fungi can hit any part of the body, but in dry places itching is much less. A very itchy rash on breasts, shoulders, other dry areas of the skin may be the result of local exposure to irritating chemicals, and severe general itching is likely to indicates allergies. Both cases require the attention of the doctor. A Many fungal infections you can try to cure.

 

   WHAT IS FUNGI AND WHERE THEY TAKE FROM

 

   Ordinary skin fungi (epidermophytia, Inguinal epidermophytia,   epidermophytia or Mycosis of the feet) affects only people. These   Microorganisms   are so It is common that almost every one of us wears    several bills of fungi living on the skin in Neighborhood   with   permanent   The bacteria living there. Understood health, Poor nutrition and hot weather reduces resistance.

   Epidermophytes - harmless microorganisms,   who feed on   dead surface cells of the epidermis. Like all   mushrooms,   It is best     they grow in warm and humiliated conditions, penetrating quite deeply and   touching the pain nerves, which is why itching occurs. On dry areas of the body fungi develop most often without symptoms.

   Inguinal epidermophytia affects men upper and inner   surface of the hips, sometimes spreading back to the anus, but   rarely   capturing a scrotum and almost never a penis. It all starts with a small red spot, Perhaps with a little sharply outlined boundaries.   Scales, scabs and   even can appear   small   bubbles,   but   The central part will remain clean as the rash spreads - characteristic of inguinal epidermophytia.

   The treatment is quite simple, but Self-medication   is rarely    effective. The usual cause of self-medication failures - improper self-diagnosis, but   in the case of inguinal epidermophyte, this is not so, because, unlike the itching   rash in other places, the greatest itching of fungi cause   Perimeter.   Treatment of inguinal infections is not effective if it is stopped too quickly. Antifungal Ointments should be applied for at least 2 months. Excellent ointments, once Receptive sold were allowed for over-the-counter sale in the 80-ies. Among them, we can mention miconazole ("Mikatin") and clotrimazole ("Lotrimin", "Micelex"). Apply thin layer of ointment on the affected area twice a day (thick layer will not speed up the cure).

   As far as possible, support the affected the area is dry and cool to avoid reactivation of fungi.   Wear   Free   underwear    and spacious trousers. After washing, sprinkle Affected skin with   antifungal powder Or pure talc.

   Epidermophytia (mycosis) feet - the most common fungal   infection. She probably sooner or later is assaturated   all   men,   remaining imperceptible in the intervals between exacerbations, because during these periods   it does not give symptoms. Feeling itching between the toes (especially the third   and   fourth), men hastily They're trying to get rid   of   him.   If   relief occurs due to fierce combing or   rubbing     towels during washing, then moist infected skin bursts,   and   Itching   is replaced by painful cracks. On the feet, fungi can form   scaly spots, sometimes located in the form of "nucks", with bubbles and Strangers. In such cases, men are usually blamed for dryness of the skin, because they see only scales and peeling and do not experience Other inconveniences, but   it's a mistake. A rash seen on the upper legs may not be   of fungal origin.

   In the textbooks of dermatology of infection of the hands and feet usually discussed   together, but hands can be amazed by so many common   Skin Diseases That You Can Hardly Diagnose them on their own. The exception is a typical rash that covers both legs and only   One hand is almost certainly a fungus.

   Treatment with ointment for several months works well on fungi between the toes and small areas on other parts of the body;   The situation is worse if large areas are captured. In fact, if   affected   and toes, no means will not   help.   Most   men put up with scales on their feet until then, As long as itching can be tolerated. If he becomes painful, you should   take   orally   Gripeophulvin   Antifungal antibiotic, suppressing only dermophytes, but not   bacteria or other fungi. Because   the surface   of your   skin   dead,   the medicine does not affect on it, but new cells going to the surface from the depths already contain griseoulvin, becoming   inaccessible   for fungi. Because the epidermis has the highest thickness on the soles   of the legs and palms and, accordingly, the time of change of cells in these   areas   longer, treatment should continue at least 3 months.

   Griseofulvin, available since the 60's, has Good Glory to the Safe Means.   Some,   accepting   it,   Complaining     of Head   pain   or upset stomach, usually passing with time. There are   new   antifungal antibiotics, but they have more side effects, so Doctors prescribe them to treat infections that are not amenable to griseophulvin.

   Nail infections. With age, many men Note that     the nails   on the toes become thick and yellow, sometimes brittle (begin to crumble) or loose. Unfortunately, men rarely Go to   the doctors for   this, considering, that bad and ugly nails are a sign   old age. But the nails on their feet can not grow old, Because they're already   dead. Fat yellowed nails signal a disease,   the leading cause of which is most often fungal infection.

   Local treatment does not affect Infected nails. Only oral can help Reception of griseobulin. He enters into living cells of the nails under the skin, after which, as the nails grow, the fungi   can no longer germinate inland. V Eventually, the nail will consist entirely of cells containing the drug. The nails on the legs grow   rather   slowly,   Treatment should continue more years, and you may   not   notice the improvement during the first 3-4 months. V   my   practice   Griseofulvin was triggered in 50% of cases. He helped me, but on the third try.   The first two times I took medicine for 8 months, and A year later, the infection returned again. After the third course   of treatment during the   14   months (it was 15 years ago) my nails were cleansed of the infection forever.

   Mycosis. Mycosis, or fungal infection Hairless areas of the skin, affects adults less often than children. Manifested in the form of Pink spot,   which spreads is widely used and characterized by a convex scaly   border and clean center. Typical mycosis itches weakly or not Itching   at all. The ointment can destroy infection that captures a small   the site,   and large affected areas require at least a month of taking griseophulvin.

   Universal fungi: multi-colored Li.   It's   Medical   the name of fungi that change their color. Itself The Latin microorganism     is called Pityrosporum orbiculare and is another harmless fungus among the usual on the human skin. Being especially active in hot weather and in countries with hot climates, it nevertheless affects a sufficient number of people at any time of the year. As in the case of   infection   nails on the legs, men often do not turn to his attention, since the rash   does not itch and does not appear in noticeable places (on the face or limbs).

   I constantly watch men with yellowish spots   on   the chest,   back, abdomen and shoulders that do not disappear for years. Spots can have     a variety of shades of brown Colors are the name from here.   When   hit     on the skin of the sun, they grow more intensely, and in winter they fade. Moderate the degree of infection is expressed in several spots in the middle of the chest, but The spreading infection can cover the human body from neck to the buttocks. Man with such a rash, who came to me on   Reception,   complained of mild itching, but I suspect that this is only because anyone   suffering from a skin disease, Subconsciously expects scabies.

   Multicolored lichen is harmless and probably non-contagious.   He is   not   requires special treatment, but its attraction to relapses makes treatment a lifelong prescription.

   Antifungal ointments help well, but With a large degree of defeat becomes   Useless.   Griseofulvin   with   This   disease   does not work, but A short course of the newest antibiotic   ketoconazola   (Nizoral) can destroy the infection.

   In case of moderate severity, treatment over-the-counter means   include the use of selenium sulfide and sodium thiosulfate (the usual   photographic fixer, known under the name of hyposulfite). Apply   any of these funds to the body after the day shower, leave for 10 minutes, and then Wash it off. Do this every day for two weeks. This treatment kills fungi, but spots can persist for months; sometimes   solar light contributes more rapid restoration of normal pigmentation. Recurrence is too tedious, carry out two weeks of treatment, and then do the described The procedure once a week for the rest of your life.

 

   SKIN DISEASES THAT NEVER LEAD TO SKIN CANCER

 

   Men whose school years are long behind, Beginning to find There's something on the skin that didn't happen before. Perhaps from how much   you will be attentive to the next section, will depend on your life. But we should not forget that if peer into every scratch or   swelling, daily life can become quite tedious, although some phenomena can be ignoring without fear, unless, of course, you are concerned with purely cosmetic considerations.

   Looking around on the beach or in the locker room sports club,   you can   see that almost every man is older 35 years on the back   and   chest   There are brown convex spots. More elderly people on the skin of a dozen such spots that can be extended to the face and scalp. On     they can look unpleasant, and one can only wonder why their   owner still has not tried   from   Get   rid of them.   Rather   All of all,   the doctor explained to him that the spots are benign, and the removal is associated with   too much difficulty. This is often It means that the difficulties   are mainly Concerning the doctor himself.

 

   SEBORRHEIC KERATOSIS

 

   After 30 years, small appear on the back brown spots with a rough surface. Because they do not give any   symptoms,   Most men don't even notice them, but after 40 years of such spots protrude   on   the back of the hands. This is a manifestation of seborrheic keratosis that occurs on the very surface of the epidermis. At an early stage, they   are called   "old slicks" and easily removed.

   Over the years, the spots increase, become rougher and begin to resemble warts, but, unlike them, do not disappear themselves in itself.   Some spots increase in diameter up to 2.5 cm and even more, varying   Colored from bodily to black. Typical spots of seborrheic   keratosis located on the very surface of the skin and sometimes accidentally break off or scraped with nails. But it's not always possible, so don't try to remove They're like that.

   Treatment.   Seborrheic   keratosis   is absolutely    benign.    Removal large spots require skill and effort. Because   such   spots   -   almost Universal phenomenon, you can plan your   Actions   by early enough to remove them to avoid spilling.

   Noting a small patient on the face keratosis,   I'm   immersed   a special tool in a cup with liquid nitrogen and in For 5 seconds, I freeze the spot. After a few days it disappears, and this The place heals   without   a trace. Because almost all men for 40 on the face there are several such   Spots, doctors rarely mention their treatment until she herself is alarmed patient.

   Any brown spot that appeared on after 30   years,   most likely, will not disappear and will grow. Doctors will certainly consider their   the mission made on what will inform you about   the benignity   of education. You have the right to demand that it be frozen for purely cosmetic   reasons.

   If the stain of keratosis has increased and compacted, the doctor can   scrape it with a scraper-like tool - a curette (after the injection of   novocaine). The scraped area will heal without All sorts of traces. If there is no suspicion of malignancy, No surgery is required.

 

   DERMATITIS OF PAPULOUS NEGRITICK

 

   Blacks and Easterners Nations usually   develop on cheeks Dozens of small (with a pinhead) papul. Despite the name "papulial dermatitis", they are identical to seborrheic keratosis. For their elimination is applied already described above,   but   the results   are often less satisfactory, as damage to the skin in   black races gravitates to healing with Changes in skin pigmentation. Even   the minimum freezing of papule with liquid nitrogen can leave a speck different color. Therefore, any representative of   color   Races   wishing to remove anything on the face should consult a dermatologist.

 

   CHERRY ANGIOMA

 

   Almost every man has over 30 a few   small   red   or purple papules on the torso, chest or scalp (on the face is extremely rare). This is the cherry angioma - beam bloated blood vessels in the dermis. The cause of occurrence is unknown. Angiomas benign, but their number with age increases. Removal is not practiced, but liquid nitrogen, curett curett and other methods of small   surgery   In a desire, they are quite applicable.

 

   MILIYA

 

   On the face of men who were over 40, often appear   pearly white cysts (mile) with a diameter of several millimeters, located around the eyes and on Forehead. They are formed when small   Pieces of Growing Epidermius "captured" by the underlying dermis. Many   men ignore them, but the doctor can remove each such cyst, cutting off   surface with a scalpel and extracting a small amount from the incision It looks like   a cheese.

 

   FREQUENZERS

 

   Freshnesses are indiscriminately Scattered specks   of tanning color formed on the skin areas exposed to sunlight. They appear in humans, genetically sensitive to the sun, usually red-haired or   with     sand hair   Colors.   Freckles are harmless, but their appearance signals that your   skin   Particularly sensitive to the sun. Freckles can remove with acids or liquid nitrogen, but they tend to Reconstruction. Like   gray,   with them better Reconcile than to fight.

 

   LIVER SPOTS

 

   They are like freckles, but they are the result of a longer exposure to sunlight. The name refers to their color, not   to the liver as the organ responsible for them. The most common places of appearance - forehead and back of the hands. They never get enough   of   The joints of the fingers. The skin with hepatic spots has and other signs of damage caused by the sun, - dryness, depigmented spots and Actinic keratosis (see the next section). Hepatic the spots are smooth, but otherwise resemble the early seborrheic keratosis and is removed by the same methods.

 

   SKIN DISEASES THAT SOMETIMES CAUSE CANCER SKIN

 

   At an early detection of all cancerous tumors Skin –   including   the terrifying of each melanoma – are easily curable, but on the basis of my experience I can To say that cancer treatment even at very early stage is enough It's not nice. You can reduce your risk by closely monitoring benign but alarming changes in the condition of the skin, which are easy to eliminate.

 

   PREDICTING STATES OF THE SKIN

 

   Pink flaky spots on site The skin exposed     to the sun - usually on the face or neck - most often turns out to be the so-called actinic keratosis. In men, it is more often than   women,   appears on   the ears. The affected surface to the touch may   seem   rough, much less - similar to a wart or convex; spots, usually small, can spread quite widely. In 5-10%   of cases   they degenerate into squamous cell skin cancer (See below).

   I'm treating actinic keratosis (including   my own)   liquid   nitrogen, freezing the spot for about 7 seconds. Anesthesia is not needed. Frozen the area is exfoliated and disappears within a few days,   the treated skin heals without scars. V Good old doctors     used electric spark   or   Scalpel.   Some     are still   using them, and Surgical removal   -   the best option if the doctor suspects malignant changes and   wants   Send the tissue to the study.

   With common keratosis, prescribe ointment containing fluorouracil ("Efludex" "Fluoreplex." Rubbing the ointment twice a day causes inflammation affected skin and destroys keratosis - including   Invisible   spots. Treatment takes from 2 to 4 weeks, healing - a few more weeks.   At this time the treated area of the skin is covered with red spots,   which is usually not liked patients.

   Larger and denser red plaques with Notable large scales called "disease Bowen." This disease most often affects   the sun irrigates the sunbathing of the skin of the elderly white people. It is less common, but more pronounced than the actinic keratosis,   and   often     misleads the doctors who take it for   psoriasis   or   eczema.   You will probably have to remind the doctor that psoriasis rarely manifests itself in   the form of one affected area, and eczema usually itches. About 5%   of cases   Bowen's Disease Ends with Development Squamous cell skin cancer.

 

   HARMLESS AND SINISTER BIRTH

 

   Fear of the moles, although in a smaller Degrees   than   Fear   before   AIDS, makes you contact doctors many generally healthy men. Everyone knows that growing   or   dark   The mole   may   represent   It is terrible and often deadly malignant disease - melanoma, so doctors often remove obviously Harmless moles only for   the sake of reassurance patients. Removal of all moles without exception   It is almost   impossible because A person has an average of about forty.

   The mole consists of a tangle of cells, among which most are melanocytes (cells that create a skin pigment). Their color varies from gray   to black with tanning and dark brown   in the middle   color   schemes; at the same time, black is not always a sinister sign.   Pigmentation is not necessary at all - Many moles have a bodily color.   The shapes are as diverse as the colors: a flat spot to   the obvious cone, and the surface can be both smooth, so   and   uneven.   Some are growing Hair is also not a threatening sign. Moles are not a consequence of sunny radiation, but more often occurs on sun-inf likely parts of the skin and rarely - on the buttocks,   internal   parts of the hands and others protected places.

   In newborn moles or not at all, Or they are very few; they   start appear in the sixth month of life and   continue   to increase   in number until A man of 20-25 years. Later new moles   there is little, and existing with age age and fade (after 50 years).   By the age of 80, moles disappear (this does not apply to other   colored   Spots on the skin).

   Signs of a benign mole: uniform coloring, smooth flat boundaries, not changing color and size.

   Signs that should cause anxiety: increase, change of color (including red, white, bluish and black) and any changes in structure surface - cracking, formation of scales,   fluid expiration, bleeding or Thickening. Color Spots at the borders   of the mole Considered a particularly ominous sign.

   Benign moles usually grow slower, but often also increases and become convex. In fact, if   Looking into any mole for a long time, it will eventually seem to you diabolically unpleasant and suspicious. In this case, it is better to go to the doctor and ask what to do and when to come to the next examination.

 

   SKIN CANCER

 

   Skin cancer, which can be called the most common malignant disease, annually affects more 600 thousand Americans, mostly men, as they are more time is spent in the sun and   by the nature of activity more often experience the effects of   tar,   resin,   turpentine, creosote, arsenic and radiation. Smoking   contributes to     skin cancer in places, Exposed to tobacco smoke are mostly mouth and lips. And finally, the risk increases heredity, diseases of the immune system, in Particularly AIDS.

   Light-skinned men with Celtic or Scandinavian roots get sick more often, especially blondes and red-haired Blue eyes.   White Skin Cancer 25 times more common than blacks, and   They     have a 15% higher risk. These The numbers double ascending to the equator for every 412 km; a Texas resident has a 7.5-fold more risk   of skin cancer than     A resident of Minnesota, located to the north. Accommodation in high-mountainous terrain with greater intensity   Ultraviolet   radiation   also   Increases the risk of disease. Incidence of cancer The skin is constantly growing.

 

   THREE TYPES OF SKIN CANCER

 

   The most common and curable -   Skin epithelial -    annually affects about 500 thousand Americans, in Most men in 40 who are exposed to the sun. In 90% of cases the epithelioma appears   in the area between the upper lip and the boundary of the scalp. Cancer of the lower lip - This is usually squamous cell carcinoma, which will be discussed later.

   Ordinary epithelomania appears in the form of the Vosquiazical   Pink   Pinnacle   with sore throat and thin blood vessels visible   around   its translucent boundaries (Pearl-pink dadule). As it grows, it can be covered with scabs, begin to bleed or form a temporary   crust. Although the description of the signs is quite clear, any neoplasm on   the skin is better to show the doctor, if it does not disappear within a month.

   Epithelium almost never gives metastases and does not kill the patient, but does not pass by itself and slowly increases. Each textbook of dermatology considers it its duty to place A photo of the victim of this disease with a disgusting gap hole on the face. Cancer   on the skin Usually painless, older people with more obvious   medical problems often ignore They are, therefore,   care more closely about your elderly relatives.

   Squamous cell carcinoma of the skin occurs once   in 10   less often   epitheliomas,   but more Serious illness. Flat cells from which the name of the disease is formed, constitute the outer surface of the skin. Their   shape and dense structure provide the most good protection from injuries and injuries, but too much severe exposure to   radiation   or   Chemicals   can cause malignant rebirth.

   A little deviating from the topic, I will say that flat cells also appear     in places where they It should not be, but this happens as a result   chronic irritation - most often in places of exposure to tobacco smoke (mouth, throat, lungs, esophagus, bladder), and are always precancerous. Lung cancer and other cancers caused by smoking usually develop from malignantly converted flat cells.

   Lucky (assaken to have been caused by tobacco) tumors easily spread throughout the body), Smoking plays a minor role in   cancer, except for the lower Lips. Being in a far-reaching second   the place   of cancer of basal cells on the rest of the face, flat cells are the basis of almost all cancers of the lower lip, with 90% of cases occurring in men (maybe some protection for women is provided by lipstick). For unclear reasons, squamous cell skin cancer manifests itself on the back sides of the hands 3 times more often than cancer of basal   cells.   In addition to the described exceptions, both cancer diseases are manifested in   identical areas exposed to the sun. Flat cell cancer, unlike basal cancer, most often develops from clearly visible precancerous changes in the skin (especially from the actinic   keratosis)   and   less   -   in areas with obvious skin lesions of old scars   and   traces   of radiotherapy and Chemotherapy.

   At an early stage, squamous cell carcinoma looks like   a small   tumor or bulge, which expands, ulcerated, covered with scraps or grows into a nodule similar to a wart. And again, go to the doctor in any skin formation that does not disappear by    for a   month.

   In 1971 I gave students a lecture   malignant   melanoma. Professors like to illustrate their lectures with the most striking cases   from practice, and I followed this custom. I showed a white woman slide, at the time of   diagnosis   that looked   Completely   normal.   The second slide made a year later, after the spread of the tumor,   Showed the only change: her skin turned black. Third Slide He showed that she turned black and urine. Subsequent Slides the results of   the posthumous autopsies: black liver, black brain - all the tissues of the deceased acquired a carbon black color. A few weeks after that, students   in crowds   made a pilgrimage to a dermatological clinic for examination their moles.

   Although patients rarely black from   melanoma,   she   deserves attention. Number of newly patients double every   decade   and disproportionately It grows rapidly among young people.

   Sunlight is certainly playing a role, but the   total exposition in the case of melanoma is less important than in other types of cancer skins. In men, the most likely place of damage   is the back, not the face, although in general Melanoma may   appear   on   anywhere in the body, including the eyes and mouth. On the back is usually more moles, and in addition, the back - the place of the greatest manifestation of sunburn; studies show that Received in childhood sunburn with blisters dramatically increase the risk of melanoma.

 

   MOLENS AND MELANOMA

 

   Despite the frightening associations, only in One case of three   melanomas develops from a mole. In most cases, it occurs on normal skin, How is somewhat different from other skin   cancers. Watch your moles, But if you are concerned about or have   a factor   risk   (light   skin,   Trends   in   the Sun   burns, relatives who have melanomas), Better   to be   yours   The skin will   be examined by a doctor.

 

   TREATMENT

 

   Despite many new methods,     The best treatment for most skin cancers remains   operation.   After   the injection   Novocaine doctor removes the tumor along with a part of Healthy skin. In   cancer   of basal or flat cells, the carved area is usually approximately 2.5 cm2, but   not with melanoma with its desire for distribution. Doctors   usually determine the carved the section, counting 12 mm from the boundaries of small tumors, but at larger ones melanomas this field doubles or even   it trips, which requires hospitalization and transplantation of the skin.

   For all its flaws, fragile   skin   The elderly     are healing   with a smaller formation of scars (scars), and Cancers occur on it are less aggressive. Therefore Doctors often treat skin cancer the Elderly Electrodiathermia and   scrolling.   Under   local   anesthesia doctor scraps the tumor   curette,     and then   cauterizes   its   base with an electric discharge and removes the curette burnt fabrics. This is suitable method for those who hate the thought of surgery itself   (provided that the tumor is small and superficial). In large formations, it is better to use radiotherapy (this also applies to tumors   on the nose or on eyelids).

   Be careful with these methods of treatment, how laser therapy, freezing and treatment with chemicals - no matter, lubricate whether they are a tumor or give an injection into it. Although the freeze tumors have been used for 30 years, and lasers - from the 70s years,   results   far away   not   so   impressive,   How to announce the popularizers of the newest Super Scientific Methods.

 

   IF YOU HAVE SKIN CANCER, LOOK FOR A GOOD SPECIALIST

 

   Best to use the services dermatologist, if only because he constantly has Skin cancer and has a great experience.

   Although the cure for cancer surgery the skin is approaching 95%, in fact this figure should be smaller due to relapses, large   formations, tumors with blurred boundaries and tumors on the nose,   eyes   and ears. Very effective so-called "Operation Moss." But because the positive result is most often achieved through a normal operation, you are likely to will appoint it, unless, of course, you object.

 

   "OPERATION OF MOSA"

 

   Hundreds of dermatologists during the year study the technique   of operations, developed 50 years ago Dr. Mohs (Mohs) to deal with severe cases Skin cancer.

   Doctors prefer to excise a large area skin around   the tumor for   full confidence in Removal of 100% malignant cells. This   reasonable measure for a tumor on any part of the body, except for the person where after such an operation there are ugly traces. When deleted Fewer areas can be not to be hurt, but some malignant cells   will remain   on   its place, leading to relapse.

   Moss Technique Envisages Forecasting and calculation of the size of the removed area. The surgeon excise a small segment   of the skin   around   the tumor, marking its orientation. Then the edges of the remote flap are carefully studied under the microscope. If only normal cells are observed at the borders, then The tumor is completely removed and the operation is almost   complete. In the presence of malignant cells, the surgeon excise   more   one   small segment around the already remote area. It may take quite a lot travel from the operating table to the microscope and back, before the surgeon makes sure that all malignant cells have been removed. Using the described technique, the surgeon removes the minimum amount of skin, and the degree of curability is close to 100%

   In what case to prefer "Surgy Moss." If the tumor is on the face. However, this very expensive operation, like any other plastic area surgery. Therefore, I will give a few practical   advice.

   1. After the operation, Moss almost does not happen Recurrence. But radiotherapy is   no less effective, but the second traditional operation does not give   good results.

   2. This is the best treatment for tumors, which can grow   not only in breadth, but also deep, which is not visible to the naked eye. A dermatologist can report this after examination and biopsy, and you   will have to trust its decision.

   3. This is the best operating equipment for tumors located around the eyes, ears and nose. Here the dermatologist has to do what other doctors do constantly, - Reasoning. Which method is better? Is it possible to use conventional surgical Methods? If so, how much   skin   will you have to remove? Qualified doctors make excellent conclusions, but none They can't be perfect.

 

   COSMETIC SURGERY

 

   Cosmetic surgery has previously used success in women    , but since the 80's men have become A significant number of patients.

   - Advising my patients, I usually I tell them the following: this surgery is so expensive that it intercepts from prices breathing;

   - plastic surgery can in some way Degrees to improve your   appearance, but not Expect to be a young man after her.

   - Correction of cosmetic defects often   give   men   the opportunity to feel better and more confident, and This is a reasonable     reason to take such a step. But plastic surgery will not help you to purchase Great popularity or improve sexual life.

   Naturally, you should choose a surgeon with good reputation.

   The most popular cosmetic procedures:

   1. Facelift - smoothes sagged features and deep wrinkles. To have an idea of what you will look after operations, put your palms on whiskey, pull the skin back and Look in the mirror.

   During the typical operation, the surgeon does a long incision through   the top from one ear to another. Lifting the skin on the forehead, the surgeon cuts   off the muscles that make you frown, and others, Creating   wrinkles.   Continuing the incision from the ear below to free the skin of the cheeks, chin and neck,   the surgeon separates the skin from the underlying tissues, and then, cutting off the excess, creating dishesion, stretches and sews the skin on the edges of the incision.   The postoperative scar is mostly under the hair and therefore imperceptible.

   Most surgeons prefer to work. using local anesthesia and powerful sedatives because   it is   safer   and   does not require input to A trachea of a breathing tube that prevents you from seeing the face during the operation. Immediately after the operation, the person swells, and the patient has feeling tight, but pain rarely bothers. Depending on   the preferences of the surgeon, the patient is released home either on the same day, or a day or two. Subcutaneous Bleeding is manifested in the form of   distinct   blue-black spots, resorbing in about a month, so that some patients prefer not to appear in humans during this period.

   As with any other surgical operation,   Patients   with   Good health results are better. Sometimes surgeons refuse to operate   on smokers, Smoking worsens the blood supply to the face. Masculine men are also not the most successful candidates, because all the subcutaneous   Fat   cannot be removed, and therefore The result of the operation is unpredictable. In some men, especially in dark, form rough thick,   very   noticeable postoperative scars. Of course, the scar will also be seen     in men with thinned hair.

   2. Plastic Surgery at Centuries (blepharoplasty) - removes the excess skin on the upper and the lower eyelids; it is often held in combination with a lip of the skin of the face. Men after the correction of the looming   ages   do   not look so harsh and tired and even seem younger. Sometimes lowering   of the upper eyelider complicates vision, but more often The eyelids depart from the lower eyelid,   while the eye, left unprotected, is irritated and watered. The surgeon makes   incisions through the folds of the century and next to eyelashes, excise the excess skin and removes subcutaneous fat, and then imposes Stitches. Since   the stitches   are among the natural folds, the post-operating scars are usually barely noticeable. The operation is carried   out under   the local   Anesthesia,     against the background of   Soothing tools.

   After surgery, bubbles are applied to the eyes with ice, reducing swelling and reducing subcutaneous bleeding. Most patients leave the clinic on the same day, but until the full The disappearance of visible   traces of the operation may take a month.

   3. Removal of wrinkles - used for elimination of small wrinkles, which are not covered by a lift of the skin of the face, Removing   only   large wrinkles and folds. To remove small wrinkles, you need to remove   the surface layer of the skin - or scattering by means of a rotating abrasive tool, or the destruction of this layer a solution of phenol (chemical dehumidification). In addition to these procedures rid of some skin defects and surface scars from acne or chickenpox. Although the dermatologist or surgeon always discusses with patients are all in favor and   "Oth" and both of the procedure, men in mainly prefer abrasive treatment of the skin, because after Chemical     peeling skin   becomes more brilliant than the men's understanding of   attractiveness.

   When processing small areas of the skin well There is a local   anesthesia, and for Operations in large areas are usually needed   general   anesthesia   and hospitalization. The procedure is painful, in addition, during   The   patient must remain completely immobile. On the treated area is formed A crust that lasts at least a week. Then a   new bright pink skin appears from under it, fading to moderately   pink   in a few weeks (women in this situation can fix the case with makeup). Pink color will disappear in about 6   months,   but     In any case, the new skin will be a little more paler.

   Plastic Surgery Using the scalpel is very complex and   requires a special Qualifications. Treatment with abrasives and chemicals   is easier to learn, but to perform these procedures are not necessary    less skill and skill - if it is inadvertent to remove A little more than the epidermis,   there will be scars. If scrolling and peeling are not carried out on the entire   surface of the face, the face will become spotted. You be sure that you have chosen an experienced qualified specialist. Best of all   Look at his former patients.

   4. Reconstruction of the nose (rhinoplasty). A person who thinks that his   nose is too large, hooked, long, rash or otherwise different   from normal, can decide on this operation. It   is safe   for almost any healthy human, although surgery can aggravate other   problems associated with the nose - that's why doctors dissuade from   such   correction of patients with hay fever or other types of allergies.

   Using drawings and mirrors, Patients   choose   the right   shape of the nose. During the operation, the surgeon is usually makes incisions from inside the nostrils, in order to avoid visible Postoperative scars. Correction of pine-like or hanging nose requires only cutting cartilage,   and     the bones   of the nose remain intact, but the correction of the large, hooked or crooked nose will require Lots of work with bones. After the operation   the surgeon   puts   a dressing on the nose, tamping it to block the bleeding, and in this form the patient has to Walk for about a week. The patient leaves the clinic on the same day or next, but should avoid physical exertion of approximately month. As with other types of facial surgery,   The scars last for several weeks.

   5. Removal of fat by suction - available in The U.S. has only since   1982,     and today it has probably become the most popular procedure. She attracted many doctors who are eager to find their own gold mine, in connection with which   you need to choose a surgeon with caution.

   Suction removes fat forever, but in small amount   -   only a few pounds, Therefore, do not consider the procedure as a simple weight loss. It is good for removing localized fat deposits. Men are often dissatisfied his   puffy breast,   double   chin,   saggy buttocks, fatty hips and fat folds on the abdomen. The operation is better everything passes in men with fairly elastic skin, able to   rebuild and stretch after removal Underneath the fat. If the quality of the skin unimportant (or surgeon is not too skillful), then its surface after the operation will become bumpy and   Uneven.   Obviously,    the best candidates are young people, although many middle-aged men are also quite acceptable characteristics of the skin. Elderly people can also remove fat, although the surgeon is likely you will have to   perform   additional plastic surgery to excise excess skin.

   The surgeon makes a small incision, through which injects metal   under the skin a tube with a pointed end. Moving tube under the skin   leads to cutting off pieces of fat from other fabrics. The device attached to the tube periodically sucks Cut   off pieces   of fat.   Within a few weeks of the Vomiting is diminished, and   undesirable The bulges disappear. The changes received are constant. If   a person gains weight again, fat will accumulate in any   other   place without reproducing Remote Local Defection. The operation causes swelling and formation scars that disappear within two months.

 

 

   Chapter 10

   WHAT SEXUALLY ACTIVE MAN SHOULD KNOW

 

   Many men gynecological functions women seem to be a   secret and maybe even something so unpleasant that it is better   and   Do not   try to study. In the past Times   this   attitude   created   a lot of inconvenience for women, making them think (this is not always It was true that it was men who contribute to the occurrence of any gynecological diseases.   When   The doctors   began   to show   interest in      contraceptives, men were happy to get rid of   condoms and allow women to take advantage of the wonders of science.

   Today, women no longer want to impose Men are fully   responsible for unpleasant consequences of sexual intercourse, and men find   it fair. In any In the case of illness transmitted     sexually,   for our generation    the   Source   of the Infinite   Anxiety. Simple Justice and Curiosity Demand that a man still   knows something about a woman: how she is protected and what   role     He plays himself in the main gynecological diseases.

   Sexually transmitted diseases, distributed mainly during sexual intercourse, less often with other love contacts like   kissing and are not transmitted through Inanimate objects such as toilet seat. V   The past   among   homosexuals   was observed   More sexually transmitted diseases   than   among   heterosexual   men, because they are more cravings for   casual   relationships,   But   this   figure decreases rapidly for reasons now known. Heterosexuals , on the other hand, he is increasing.

   Starting your medical practice for 20 years back, I could literally   count venereal diseases on the fingers of one   hands.   They   were   Exactly five. Gonorrhea and syphilis are still with us. Three   other   steels   So rare that I didn't have to have with They're doing it, so I'm not going to mention them. But in return Many other diseases have emerged. When I open a medical journal, I every time I am waiting for a report of another disease that has never been associated with sex life, but today definitely belongs to the category of venereals. You, You will be amazed, When it is a person's hepatitis dysentery, warts, uterine cancer and,   Possibly, penis cancer is sexually transmitted.

 

   CONTRACEPTION

 

   Men should understand that      Lately    many   women use the latest achievements in the field of contraception - in our   century there were half a dozen new methods and funds intended for women, but none New for men. Knowledge of it, on   what   is the basis of the choice of women, will help to assess your degree of responsibility for   possible consequences.

 

   ORAL CONTRACEPTIVES

 

   I don't think about why A pregnant woman   never   gets pregnant again. It hasn't endures the baby yet. Although in the uterus in   the   first few months There is still enough room, woman     can not conceive secondarily because the fruit   stimulates   the production of   maternal hormones, and this suppresses the further formation of eggs. In the 30's,   shortly after the identification of the hormone estrogen,   contraceptive researchers Bent to women in an attempt to prevent   pregnancy. As a result, it turned out that, As in the case of male   hormones, Estrogen is unreliable. Addition of the second hormone - progesterone - produced Furnul: one hundred percent effective contraceptive was obtained.

   The first contraceptive pills imitated the state of pregnancy, causing nausea, Weight gain, weakness and soreness   Breasts.   Despite these inconvenience, everyone considered the pills a real miracle. Independent Women of the 60's only oral contraceptives were chosen, and   It is very difficult to imagine a sexual revolution without them.

   As usual, it happens with a significant progress along the path of   progress, doctors enthusiastically accepted all the positive qualities of the pills,   leaving an assessment of unpleasant Consequences for later. After about 10 years, doctors   began to mark some of them users of thrombus, strokes, heart attacks, gallbladder stones, hypertension and elevated blood sugar levels. When this unhappy news became known not   only   professionals, the media, coupled with the general public fell on the pills with the same passion as a decade Recent admired them.

   Compared with drugs 30 years   ago   modern   oral contraceptives do not contain pure hormones, but their fractions,   thanks to   What is caused by less   side   Phenomena   and   even   bring   some   benefits (reduced bleeding during menstruation, spasms become   weaker   and less often, the risk of uterine cancer is much reduced and   ovaries).   Today   The pills have regained popularity. However, many Women   continue   to experience uncertainty and anxiety about oral hormone intake.

 

   INTRAMN DEVICES (VMU)

 

   Throughout the history of mankind Women   tried   to introduce   in the uterus wood, metal and other materials both for the purpose of protection and interruption Pregnancy. Doctors began to practice the introduction of intrauterine devices (VMU) from about the beginning of the 20th   century;   researchers   expressed interest in this issue only in the 50's, When   the   idea of birth control gained popularity. The result was a whole collection of rings, cups, coils and spirals, which, being   decomposed   On   the pharmacy shelf, looked very scary.

   Early models of the VMU functioned as a typical foreign body, causing inflammation of the inner surface of the uterus, Deployed Fertilized Eggs. WMU more the size of severe inflammation and   better contraception, as well as more   pain   and   bleeding.   However, many Users found these symptoms quite endurable and appreciated the convenience of contraception without pills or the introduction of ointments and gels into   the vagina.

   These days, VMM still more popular than oral   contraceptives. The new devices are much smaller in size and are able to   allocate small doses of medicines into the uterus. Side effects have decreased to   moderate ones. However, modern women are less willingly perceive the idea of introducing foreign objects into their internal organs, if there is at least Some alternative.

 

   DIAPHRAGMS

 

   In the 70-ies of women revived in life so called diaphragms - devices dating from the end of the Second World War and out of use due to the appearance of lighter and   comfortable   methods of   contraception. Diaphragms that were rubber caps   surrounded by   elastic ring, available of different sizes; doctor or an experienced nurse   picked up a woman the diaphragm in the size of the uterus and was trained in effective use.

   Proper use means selection of the desired size, filling the cap   a substance   that kills   sperm,   the skill   correct to enter the diaphragm into the vagina and install on the cervix immediately before sexual intercourse. Subject to all rules The diaphragm provides a contraceptive guarantee of about 95%.

   In the few minutes that the partner spends in the bathroom,   rising   with a diaphragm, a man Wouldn't hurt   to think   about   Amenities   of using a condom, the wrapping of which requires only 5 seconds.

 

   SPERMICIDES.

 

   Substances that kill sperm (spermicides) used without   a diaphragm, act a little less efficiently, but it   is much faster and more convenient to enter them. They are sold without a doctor's prescription and are available in the type of ointments, foams, gels, candles and impregnated liquid sponges.

 

   METHOD OF MENORITAL

 

   This method is not as unreliable as criticize him,   but   less convenient than According to his enthusiasts. Be that as it may, with the correct approach, the method of menorship is effective in 95% of cases, but   with   provided that   the menstrual cycle of a woman is very regular.

   To begin with, a woman must carefully determine the duration of your cycle and the time of ovulation, which will have to Spend a whole   year.   Before ovulation temperature the body of a woman usually decreases slightly, and over the next day again increases by 0.5-1.0°.   This   the change   is often very small, so the rectal temperature will have to be measured daily, at the same time, usually immediately after waking up.

   After registration of menstruation during the year (there will be 13), you need to highlight the shortest and longest cycles. Then The “safe time” is calculated. The experts agreed that the egg   lives   5-6 days after ovulation, and spermatozoa - within 3 days after ejaculation. This means that the shortest possible “dangerous” period is   9 days. Most couples should abstain from sex for 10-14   days   every month.

 

   CONTRACEPTION FOR MEN

 

   Although this chapter discusses contraception for women, I believe it is necessary to include in it something about preventive measures, used by men to consider the problem of choosing contraceptives. For   ordinary "average" men by contraception is meant only a condom, and so it will be, Probably continue in the next century. Research in the field contraceptive pills for men are conducted, but   to get rid of sperm was a much more   difficult   task,   what was supposed to be. Easier to reduce the number sperm.   For   this   It is enough to take male hormones additionally (athleet-environmental athletes produce less sperm), but reliable Men's pills should   reduce the number sperm to zero, and it required     dangerously   high doses of hormones.

 

   INTERRUPTED SEXUAL INTERCOURSE

 

   This long-known method is unpopular in America, but traditional for   France, which seems to be associated with chronic   complaints   The French Government on the Low Fertility.

   A man conducts sexual intercourse as usual, It does not feel that ejaculation becomes inevitable. At this point, he removes the penis from   the vagina, erupting The seed is outside.   Not   to speak   About   some   others   inconvenience of this method (you can be late with the excretion),   he   dangerous   with repeated consecutive sexual intercourse, since the fluid remaining in the penis can contain sperm from the previous intercourse. This technique requires both very strict self-control and full confidence on the part of the partner, but Acting   well enough  .   The French   are proud of their skills, and we probably could learn something from them.

 

   CONDOM

 

   Although this product is called in England "French merchandise", it gained popularity   in   The 18th   century   thanks to   Italian   Casanova.   He used condoms made of intestines of the lambs, such   products can be purchased now. Invention in the XIX century   vulcanized Rubbers reduced the cost of condoms. Since then   they   have become   the most popular birth control tool worldwide. Suppliers   of condoms from infraolates claim that when   using   them   the product is provided with maximum   sensitivity.   Possibly,     This is true, especially that the intestines protect against pregnancy no worse than rubber. Intestine products are reliable protects from bacteria, but   viruses   can penetrate through them walls. Because     of viruses     are the cause of two sexually transmitted diseases - AIDS and hepatitis   -   any, having sexual intercourse with unfamiliar partners, risks   his life if not A rubber condom.

   "Blade the condom" - often explain the women, having come to   the doctor   for unexpected pregnancy or for contraception after   sexual intercourse. I hear this explanation So often that it has ceased to   believe in His truthfulness and is convinced that   Really     or   condom jumped during sexual intercourse, or Protection measures     in general   did not think about what many are embarrassed about to speak. The fact is   that condoms Reliable enough.

   Use condoms with a drawn end small diameter for collecting ejaculate. Wearing a condom ordinary design, leave at the bottom of 1.5 cm for the same purpose. If your partner is excited, the need for   There's no lubricant. If a woman produces a small amount of vaginal secretion or you are dealing with a prostitute, Use a lubricated   condom. By the way, with a prostitute, I would advise to wear two   condoms at once.

   Some experts recommend withdrawing Vaginal penis   immediately after ejaculation, but men prefer to extend this moment. However, do not wait longer for a few seconds and hold the condom with your hand, so that it does not slip at the time of extraction of the penis. If this happens, the woman   should   immediately   Use   contraceptive ointment. If this happens in the middle of it   cycles,   when   an undesirable pregnancy becomes quite real, you can prescribe a doctor pills from those that are called "in the morning and after all"   and   contain   a large dose of hormones. They should be taken within three days.

   Wearing condoms in your pocket means Protect yourself as much as possible. The period of their storage is equal to several years, and the body heat will not damage them. Do not keep condoms in very warm places, like a "glove" his car. In underdeveloped and poor countries, men are washed with condoms and They are used for a second time, that   Completely   unreasonable.   Sperm   amazingly viable and energetic - holes the size of A pin   is enough for Intrusion into the vagina. Do not use the same condom even during the evening.

 

   SELECT THE EFFECTIVE METHOD

 

   Be sure to wear a condom with sexual intercourse with any unfamiliar woman. When it comes to constant partner, the decision to choose a suitable and reliable method of contraception should Accepted   as a result of joint Discussions.

   Almost all the couple who came to me for Advice, they talked first of all about the safety of sex, and then about Efficiency of protection against pregnancy and Amenities. Despite the ongoing debate, it is still   unclear what the method is most safe, and with the accumulation of experience, couples gradually learn to appreciate both the effectiveness of contraception and convenience. And here's why.

   Efficiency. Contraceptive pills, taken regularly, the best prevent pregnancy. Women, who   know   sin and course Forget   about   admission   tablets,   it is better to   use injections or implantable hormones, although new VMU will also   suit them.

   Safety. Barrier contraceptives are not cause serious   side effects. Most people are convinced that they are safer   than VMU and hormones. But If you think about the problem deeper, such a conclusion begins to seem not so obvious and even erroneous.   Many   Women using barrier contraceptives, Pregnant,   and   pregnancy is risky states.   In fact,   healthy   women have a much greater probability die during   pregnancy  , than a woman who uses VMU or taking   hormones.   Abortion   ensure security only to some extent.

   For a couple who is not only concerned short-term,   but   also   long-term security, the best strategy, Probably, this is: a man uses a condom,   and   woman     uses at the same time   one     of the barrier and knows that she should immediately consult a doctor for the appropriate pill if the condom during sexual   intercourse   It's gonna break. This combination of contraceptives is the Compromise,   which can be Safer (but it may not be!) Hormonal   contraception.

 

   GYNECOLOGICAL DISEASES ABOUT WHICH YOU SHOULD KNOW THE MEN

 

   Men are not only ignorant of the fact that Refers to women's   problems, - more that, quite often they   shy away from them in fear or disgust and rush to the doctor to Make sure they are not   personally infected. In fact, most minor female diseases   are not contagious and do not require from you a mandatory visit to the doctor, but   This   does not apply to all infections.

 

   VAGINAL INFECTIONS

 

   They cause itching, burning and abnormal the secretion of whites without   a feeling of general malaise, heat or pain in the abdominal cavity. Like   most small infections, they eventually go away on their own, but   medicine can offer such a good treatment for such cases that it is foolish to wait for self-healing.

   Blastomysis (thornmy mycosis). The woman, Itches, often   puts himself this diagnosis, since the term "threat fungus" is a very   popular synonym for all vaginal Infections. In fact,   the yeast fungus Candida causes only 30% of infections   (candidiasis).   Another microorganism - Candida albicans - very similar to a fungus that causes inguinal epidermophilia in men or epidermophitis feet   of both   sexes.   Of all vaginal infections, yeast   fungus   causes     the most severe itching, and sometimes white abundant discharge, similar to cottage cheese. For treatment, a variety of antifungal ointments or candles are used.

   Like many microorganisms, Candida lives in the vagina, without causing harm until for some reason will not begin to multiply more actively. This can happen if women take antibiotics that Destroy bacteria in the vagina, but Does not affect fungi. Diabetes and other diseases affecting     the immune   system,   also stimulate the growth of Candida fungi, but more often   The obvious     cause   Their rapid growth cannot be found.

   The role of men in fungal infections. Man Doesn't play a role here. Women suffer from their own fungi. If your partner is   such an infection, you do not you need to go to the doctor or take medication.

   In men, Candida manifests itself quite rarely, So   you are   easy   Make yourself a diagnosis. This disease leads to education on the penis (most often - under Foreskin in uncircumcised men) red   swelling, which is either slightly itching, or do not   itch   At all.   You can be treated with antifungal ointments, sold without a prescription, Imposing twice a day for two months. If in     several   weeks   will not improve, you need to see a doctor. If the partner has no complaints, then she does not need treatment.

   Trichomoniasis. Unlike Candida trichomonas -   single-celled   simple microorganisms - do not live constantly in the vagina and, apparently, is sexually transmitted, although in There   are no symptoms of   men. Women notice unpleasant discharge, usually accompanied by   itching,   but not as strong as with yeast fungi. Antibiotics are used for treatment Metronidazole.

   The role of men in trichomonas infections. We probably wear this   microorganism somewhere in the urethra, because   Women   whose partner has not been treated are relapses of the disease.   After the diagnosis, I usually write two recipes - for men   and   for a woman, and almost all other doctors do the same. Testing men for trichomonas does not give results, but we always treat both partners.

   Bacterial vaginitis. Despite the fact that This diagnosis is made in 50% cases of vaginal infections, The nature of the disease is completely unclear, so doctors call it non-specific vaginitis, and   gardnerellosis, and hemophilic vaginitis. Apparently, Bacteria that are presumably   living in the vagina, begin to multiply rapidly, leading to fetid discharge and irritation of tissues. The disease is treated with metronidazole, but the course of treatment is longer than with trichomoniasis.

   The role of men in bacterial infections. We We   have no   certainty in this matter. Most often   Sexually active women suffer from this infection, but a similar condition is observed in virgins. However, In men, such an infection is not noticed. In the past, doctors have treated both partners, but this did not reduce relapses.

 

   BLADDER INFECTIONS (QISTITIS)

 

   Although they do not belong to vaginal infections, symptoms often   coincide, so That a man does not bother to know about them.

   Cystitis affects mostly young women. According to their short urethra, bacteria, usually living on outdoor surfaces, get inside and   rise up to sterile in normal conditions of the bladder, where they begin   to multiply.   A few   additional   centimeters   of urethra provided for the length of the penis, protect men from   such   a scourge, so a similar infection in young men   rarely  ,   although in   middle age it helps   an increasing   prostate that   overlaps the urethra (see Chapter 6).

   Infected urine leads to irritation bladder  ,   so sick women feel almost   a minute,   sometimes   Sudden need for urination. As a result   At one time very little urine is released, but after a short time the urge is repeated. When the infection is spreading to the urethra occurs Burning during urination. Suffering from vaginal infections also Feeling a burning sensation, but Test it all the time. If a woman is diagnosed with cystitis, she   should   Immediately resort to antibiotics.

   The role of men in bladder infections. The cause of   cystitis   is women’s own bacteria. Men do not tolerate infection and do not need treatment. However, they can be the indirect culprits of the disease, since the active movements of the penis during sexual intercourse move bacteria with external genitalia of a woman in the bladder.   Other types of genital activity (washing or masturbation) can   lead to to the same result. Many women suffer from cystitis after sexual intercourse so regularly that doctors prescribe them   to take one dose of antibiotic Immediately after the intercourse.

 

   UNDIASED INFECTIONS

 

   The role of a man. If a woman is constantly   worried   irritation   of the sex organs, and an accurate diagnosis to establish   It is impossible,   doctors   offer   Her Give a partner to “check.” If you don't see     at yourself   suspicious symptoms, call your doctor and tell me about it, and Then   specify if it is still necessary Your visit. If the answer is affirmative, You will have to go to the reception, at least out of respect for a friend.

   The term “undiablooted” in This case means an infection that the doctor, according to his own recognition, can not   Classify.   Another thing if the infection does not know anything by itself   A woman   is    occurs so often and causes so much Useless visits to the doctor that   you should know how to behave in such a situation.

 

   HOW TO BE, IF YOU ARE CALLED WOMAN

 

   Almost any sexually active man can call one of his Former or current Beloved with a dissinolete   The message     that she has a venereal disease or infection, and the lady will be convinced that he infected her, he and no one else. I will try to give some   tips on how to get out of this with dignity Regulations.

   1. Do not deny this possibility. First, it will anger her Even more, secondly, Probably you're really guilty, because a man can be great feel and still be a carrier of infection.

   2. Fascinate her. Think about what it's like will be for you if your   genitals will afflict Such a disease.

   3. Ask about the details. Necessary Find out the specific   name of the disease. General terms such as "veneuretic disease", "vaginal infection" or "vaginitis", will not give anything. If She'll   say   that the doctor did not put Accurate diagnosis, ask him to clarify it. If it is waiting for the results of the analysis or sowing of bacterial culture, you will also have to   wait. Your doctor can take action, exactly Knowing the diagnosis of your   friend. The description of the symptoms of her disease is usually useless.

   4. Use the information provided in this chapter. If     she has a yeast fungus or bladder infection, explain that you are here   Nothing to do with it. The doctor can ask bring     it all   partners for   verification. If you want to save with this   A woman   has a good   relationship, you have to obey.

   5. Don't feel guilty. A woman   can   call   You   as soon as the symptoms notice. Considering herself a victim, she will insist that you go to the doctor and find out how exactly her "rewarded."   Politely and gently explain that since you don’t have symptoms of the disease, your tests will be uninformative if it has only a minor infection. If she has a serious disease like gonorrhea, then by sowing your urethral culture can confirm this, but such an analysis   will not take   less than   two days, and she needs to start treatment immediately (doctors prescribe women   treatment without waiting for the results of the test). Use   this   information   as an explanation and cover.

   This advice is not necessary if you use a condom - in this case, the chances of becoming a carrier The infections are approaching   zero. If you have neglected it, now you will understand   that   should always be done.

 

   WHAT CAUSES THE DISCHARGE FROM THE PENIS OF GONORRHEA

 

   The oldest sexually transmitted disease - gonorrhea (Tripper) - is   the most common contagious disease (2 million   cases     in a year). Gonorrhea affects people of both sexes more often AIDS, syphilis and   even   herpes (bubble lichen), but never called fear as     these diseases. In the meantime, this ailment very destructive, especially for women.

   Most Gonropored Men Notice the symptoms   within a week after Infection. Before the advent of penicillin after   the Second World War, a man had to grit teeth and   wait   -   Gonorrhea   is usually It goes away in about a month. Treatment was injected into the urethra catheter and infusion through it antiseptic. The procedure was painful and did not help much. Immunity from this infection has not been produced,   but   because The man could get sick again. Before the Arrival of the Era penicillin men grumbled and complained about their infection with a tripper, but deep down it was considered as a sign Masculinity.

   Gonorrhea was not considered a dangerous disease, but from time to time men developed local abscesses, arthritis or meningitis, and sometimes even infertility. Such complications in our days became a rarity, because now no one is ashamed Such diseases, and their victims immediately go to the doctor.

   Gonorrhea can also affect the throat and rear passage, causing inflammation of the tonsils (angina, tonsillitis) or anal pain, Accompanied by discharge. From 5 to 10% of patients do not report any symptoms, while remaining contagious.

   In former times, rectal gonorrhea was     a disease of homosexuals (from the official point of view, there was no homosexuality before; doctors became Reckon with this phenomenon only in the 60-ies).   Today because   of   AIDS "blue" take appropriate measures, and, since the mid-80's, their incidence of sexually transmitted diseases is reduced. You can't say that about heterosexuals. When a person with   a sexually transmitted disease comes to me, I do not try to to guess about his (or   her)   sexual orientation and do not make a conclusion, that anal infection is necessarily a consequence of anal sexual intercourse (usually   patients   swear that they not only did not do so, But it didn’t happen to them.) Although experts say that the anal infections   stem from anal sex, there is no evidence that they do not spread After vaginal contacts.

   Diagnosis. I regularly diagnosed Gonorrhea when a student is a student, When in 1970 worked as a laboratory assistant     in free   Clinic of   New York. The patient squeezed a drop of discharge on the glass, which I attributed to our primitive laboratory, lowered methylene blue into a solution and   studied under a microscope.

   Gonorrhenic allocations are pus: a mixture of leukocytes and bacteria they fight. Gonococci look as   small   dots, squeezed in pairs, and Always inside the leukocytes. Studying   glass with a positive analysis, I could count from 90 to 99% of   normal leukocytes, but sooner or later in the field of view appeared at least one, filled with Pairs   of Small   Blue   points   (we   used   methylene blue; other dyes give others colors). Few serious diseases are diagnosed so easily.

   Treatment. After the Second World War Gonorrhea   was cured   by a single dose of penicillin. Over time, the dosage has increased many times. In the late 80's, gonococci acquired such resistance to penicillin, The doctors had to give it up. Now     another antibiotic is used - ceftriaxone ("Rocefin").

 

   DON'T BE TREATED WITH ANTIBIOTICS ON YOUR OWN!

 

   If you destroy   everything   their   infectious   microorganisms,   they   will not bother you anymore. But if you kill only some of them,   then   the remaining WILL BECOME STRONGER!

   That is why penicillin became useless with gonorrhea. In the majority Countries of the world can be bought antibiotic without a prescription, and people are trying to be treated for everyone Diseases. As a result,     it is in these   countries have appeared the causative agents of gonorrhea, malaria, Tuberculosis and other infections   with increased resistance, from where they gradually spread   everywhere.

   I am very concerned when a patient with angina or cough comes   to the reception, having previously taken a couple of tablets of the antibiotic. It still doesn’t help (a chance that you will put yourself   Correct   diagnosis   and   take an adequate dose of the drug during the required   period   of time is almost zero), especially if you realize that 95% of angina   and cough are not amenable treatment with antibiotics.

   Taking antibiotics on your own Repaired,   you   put   above   yourself a very dangerous experiment, similar to those conducted by   researchers to get bacteria with increased resistance.

   They Add to the Bacteric Accurate Culture small amounts   of antibiotic, after What only the   most   sensitive to    drugs microorganisms, and the rest continue multiplying. Then the dose of the antibiotic increases slightly, and everything repeats It's again. After many repetitions, everything (repeat - all!) The bacteria continue to live and Multiply   regardless of the quantity Antibiotics in their environment  .   You   Do you really want to do all this with you?

   Never take antibiotics independently, and if they   are prescribed by a doctor, use the package to the end. Your goal is to kill all 100% of contagious bacteria. Destroying 99%, you will ask for trouble.

 

   NON-HYCOCOCC URETHRITIS

 

   In the 70-ies of doctors began to disturb the The fact that many patients with discharge are not treatable. These cases were clearly not related to gonorrhea with increased resistance to penicillin (although this was observed), since even very large doses did not help. In the end, scientists have identified a new sexually transmitted urethral infection caused by another microorganism - chlamydia. Penicillin doesn't destroy it.

   Before the detection of chlamydia, the disease managed to Get the name   "non-noticoccal urethritis" (NGU). It is still used now, because among the pathogens, In addition to chlamydia, there may be a few more   microorganisms.   NSU quickly became one of the leading urethral infections, spreading   to such an extent that 45% affected by gonorrhea   At the same time,     there were victims of chlamydia. V the result began to treat patients with gonorrhea of both diseases at once.

   Four million cases a year could put NSU in   the category of epidemic diseases, but against the background of much more frightening ailments,   it remained in the shadows. NSU is a dangerous infection   for   women   (one   of the main causes of female infertility), but       for men represent   It’s just a lot of inconvenience.

   In general, NSU causes less severe Urethrit than gonorrhea. The incubation period lasts longer: from one to three   weeks.   There   are not so many discharge, and sometimes they do not In general. Burning also Not always noted. In general, with NSU, an asymptomatic course is observed more often than with gonorrhea. The leading complication is damage to the spermatic cord (epididiitis - inflammation of the appendage of the testicle) (see chap. 6).

   Diagnosis. Despite the apparent differences, Doctors trying to diagnose NSU only by symptoms are often mistaken. We need to be examined under a microscope. If the laboratory technician is not   found   leukocytes   with   paired dots inside - this is NSU. With minor discharge, the doctor may   maupon the urethra and make sowing of culture to determine Chlamydia.

   Treatment. A weekly   course is used   doxycycline,     which should be taken twice in day. There are other alternatives, but any form   penicillin, including ampicillin, does not work.

   Prevention. Prevention of urethritis and All sexually transmitted   diseases are Use of condom. Forget everything you’ve heard about his unreliability. They are quite effective, although, of course,   not   perfect. Among the hundreds of sexually transmitted patients I   I can     only remember   One or two, who swore that they used a condom.

   Specialists with more   "romantic"   views   Persuades  constant (mone-mone) connections. Who   would   with   this   Arguing?   Many would prefer to find a single love, but its search often ends Disappointment. In addition, monogamy is not   guarantees   safety, Because many   sexually transmitted    by   disease   is present in the body in the hidden (latent) form for years. Despite these "underwater Stones, Monogamy Remains the Least   Risky form of relationship.

 

   WHY THERE ARE ULCERS AND SHOES

 

   All men at the same time with the examination of the testicles should be periodically   inspected and Genitals. Most of the deviations about which you usually go to the doctor, Not significant. But two diseases that you   can find themselves, very serious: this herpes (bubble lichen)   and   syphilis.

 

   HERPES

 

   Being a common virus, herpes can affect   any   organ. It is the main the cause of viral encephalitis - destructive brain infections. Herpes Eye can cause blindness if   it   is not   Start treating immediately. While the immune system functioning normally, herpes rarely affects the internal organs, but the victims AIDS and other immune diseases suffer from herpes-complicated pneumonia. hepatitis and   inflammation of the mucous membrane of the esophagus.

   In almost all cases, the infection manifested in     the form of   blisters   and   small ulcers on the skin. Herpes distributed with   direct contact, and genital herpes - during sexual intercourse.

   The usual course of the disease. The first sign - acute tingling around the genitals. In the beginning, there are no visible manifestations, but through A   day or two there are several bubbles (Volshypes). They burst quickly, leaving   shallow itchy itchy sores that heal in a couple of weeks. In   sensitive areas (for example, on the head of the penis), herpes may be accompanied by noticeable Painful sensations. When rashing on the trunk of the penis   or     The discomfort on the hips is insignificant.

   Elevated temperature and general malaise usually accompany the first an attack of herpes, because The virus is in the blood and spreads   blood flow throughout the body. Then the organism begins to produce antibodies that quickly destroy his.

   Complications. After most of the virus diseases (measles, mumps, polio, hepatitis, yellow fever, smallpox) a person   acquires     lifelong immunity to them, but herpes has the peculiarity of stay latent in nerve cells. He can be more never get into the blood, but regularly activates, spreading to the ends of nerve endings, where it kills skin cells and then subsides again. Almost every person who has One day, genital herpes are relapsed.

   Skinial nerve endings can contain and Chickenpox virus - also in a latent form. Relapses this disease is not   so   common, but if this happens, you will get a painful   rash   -   zoster lichen.

   Recurrence of herpes occurs in places local scuffs or   injuries, after diseases, sun exposure or emotional stress, but often - for no particular reason. Some   Patients   experience   short-term relapses every two-three months. In general, the recurrence of herpes is not   as severe as its first manifestations. They gradually become less and   usually stop Completely in a few years.

   Diagnosis. I'm diagnosing   herpes,   Examining   the ulcers   and   Listening to the patient's story about the symptoms. If The description and ulcers are typical,   I   declare to the patient that it looks like herpes. Some perceive the news   calmly, but many require analysis.

   A blood test for antibodies to herpes,   but   he   Not sufficiently informative. If you have already been ill herpes, then in the blood such antibodies will be all your life. Therefore, a positive result   The analysis   indicates   a previous infection. This analysis is positive for 80% of prostitutes and up to about 3% - in nuns.

   The seeding of culture gives more information only with the active form of   herpes. Best of all take an analysis for fresh rashes. The doctor opens the bubble and sends fluid in the laboratory. Cultivation of the virus culture takes from one to two days. K Unfortunately, most patients come to the doctor after the appearance of ulcers. K This time the virus may   disappear and The cultivation of culture will not confirm anything.

   Treatment. During the first years "herpes   hysteria",   rampant   In the early 80's, a lot of completely useless   treatments - from vitamins and ether to   really   good   antiviral drugs, in this case ineffective.

   As a rule, people who have noticed an ulcer on the skin, rash or pimples,   test An insurmountable desire to rub any   ointment into the affected skin. Such a desire arose in a person from time immemorial, and all   healers, healers and doctors understood and understood That's it. The progress of medicine has not   changed human psychology. Patients are rarely   satisfied   with my assurances that the rash will disappear on its own in a week or   two   and   that no treatment in this case will speed up the case. They are politely interested, Will there be an ointment? Usually I prescribe them an ointment based on acyclovir - "Zovirax", although the benefit of it Not much.   It   only slightly facilitates the state at the first outbreak, but does not prevent relapses.

   Taken at the first symptoms of herpes acyclovir   (clips   "Zovirax") significantly reduces duration of the disease. However,   it   only suppresses the virus and also does not affect relapses.

   Prevention. In direct contact herpes can only be infected one (first) time, so Prevention should begin simultaneously with the beginning of sexual life. Herpes victim can transmit the virus between relapses, so the sexual Intercourse with such a person   without precautions is quite risky. Condoms also protect against viruses.

 

   SYPHILIS

 

   One of the main horrors of mankind on for   centuries   –   Syphilis , called "white The plague,” still remains among us:   50   thousand registered cases in a year plus   enough   many   unregistered. Declining in terms of the level among homosexuals, he is increasingly   broad spread among heterosexuals.

   Before the Era of Antibiotics, sifilis sowed among people the same   panic as AIDS today, and many then also stated that   the victims   syphilis is paid for their immoral behavior - Another    parallel   with   modernity. So what happened with Caligula?

   Historians and doctors have at least one point   of contact - both of them like to find Diseases of the Famous people. And here , in their opinion, Syphilis shows its terrible face. Why   Beethoven and Goya were deaf? Why the poet Milton and the composer Bach Blinded? Why composer Schumann, Roman Emperor Caligula and King   George III of England crazy? Of course, because of syphilis! Here, claim   They,   it is impossible to be mistaken, because that its last stages have many forms.

   But it's nonsense! Almost until the end of the 19th centuries, medicine has taken too primitively consider complex diseases. Old descriptions   of patients with such ailments are very funny (in every large   library   there are   medical journals XVIII-XIX centuries - read and see), but   Far   from the truth.

   Syphilis develops as a result infection with a cornice-shaped bacterium - spirochet (more precisely, this bacterium is called pale treponema. Approx. trans.) Like gonococcus, it is amazes mucous membranes   of the genitals, anus or mouth, but can penetrate   through   small   skin damage, so the first signs of infection can appear on   the penis   or on the lips. In contrast from gonococci, which usually remain   localized, spirochetes spread quickly throughout the body.

   Risk. Tracing sexual intercourse of patients syphilis, health workers found that only 50% of patients   were   infected.   This means that the risk in single sexual intercourse is possibly below   the expected. On the other hand, the early stage syphilis causes less   discomfort, than the early stage of gonorrhea; many infected are passed   on,   Not even though they were sick.

   The usual course of the disease. Incubation period varies from a few days to 6 weeks, in Dependence on quantity   obtained     by contact of bacteria. When the researchers introduced a million spirochets to volunteers, visible Signs of infection were manifested for three days. Introduction of bacteria 60 Volunteers were caused by syphilis disease about half of them.

   Traditionally the first sign   of disease   the     so-called chancre is considered - a painless sore on the genitals and in the anus, sometimes on the lips (painful ulcer most likely to indicate herpes or other   infection). Shankr persists   throughout   A few   weeks.   At the same time, nearby inguinal lymph nodes (usually also painlessly) and   then decrease.

   Do not notice the chancre   very   Easily.   According to   one   From   studies, only 42% of gay men put the   right one   diagnosis     at this stage; among Homosexuals are only 23%; women are 11%.

   Shankr signals primary syphilis. Almost every patient goes to the second stage after 1-3 months. Spirochetes widely   spread much earlier. Infection appears   in the blood before    Chankra formation.

   Secondary syphilis usually begins with striking almost the entire body pink rash, including even the palms and the soles. Through   a few   days   or weeks on the spot rashes are formed acne or cones (furunccies).     In 5% of patients, there is a focal hair loss on the head, beard or   eyebrows. Approximately 10% is similar to bulging warts in     the perineum zone, merging with each other. If There is only   one   or two, and in the There may be warts, but the sight of a large number of doctors Probably suspect syphilis. In the cavity   mouth,     on the lips or on the genitals in 15% of cases appear painless   Grey   spots. All formations or ulcers are painless and if itching, then not much. Simultaneously with a rash, almost all victims note an increase in inion,   armpit and cervical lymph nodes with both the parties.

   Many signs of secondary syphilis coincides with the signs   of ordinary viral diseases: angina (from 15 to 30%), fever (10%), as well as fatigue (25%) or headache (10%) All this makes it very difficult to diagnose. If you have flu symptoms accompanied by a rash, then   the diagnosis may be the flu. But if you doubt your   sexual partner (or partners) for several months, tell your doctor about it.

   Unusual course of the disease and complications. Less common   are cases when secondary syphilis leads to hepatitis, colitis, nephritis,   gastritis, arthritis or other diseases of literally any organs. After recovery Two-thirds of patients never suffer from these ailments,   despite the fact that blood tests are still Positive. Untreated   secondary Syphilis in one-third of cases goes into tertiary syphilis,   in which destruction tissues entails cardiovascular   diseases, paralysis, madness or blindness.

   "Knowing syphilis, you have known medicine" - once said   A   wise doctor. Many medical books are devoted to   this   only   topic.   In former times, skin specialists diseases were called dermatologists-veneurologists, since this is one The disease provided   them   with universal practice. On this disease Both     individual doctors and entire clinics specialize. Syphilis was the main diagnosis of patients of psychiatric hospitals. But from the moment the appearance and introduction into     practice of penicillin incidence has sharply decreased.

   Diagnosis. Men often ask to make them blood test after   a stormy night, carefree with whomever got. I hear such   a request during the usual Medical examination when a man wishes   Make sure     that there is no in his body Hidden infection. Unfortunately, no analysis   gives immediate result. Shankr appears, as a rule, even before receiving a positive response from the laboratory.

   To detect syphilis, there are several analysis.

   The most common is   VDRL analysis   (identifying   the presence of antibodies resulting from interaction of spirochet with body tissues). Because antibodies are produced in large quantities, they are easy to detect. Therefore, the negative result the analysis is quite convincing, except for the first few weeks after Infection.   Positive result is not a final verdict (this is not a diagnostic test). There is A lot of conditions that can provoke   the immune system in the shortest period, in particular, acute infections   along with influenza and pneumonia. Repeated erroneous   Positive   results can observed in 25% of drug addicts, 10-20%   victims of   autoimmune diseases (wolf, rheumatoid arthritis) and 10% of people over   70   years. With a positive result in the laboratory should do the following:

   1. Measure the strength of the reaction by Repetition of   the analysis   after   Serum breeding in a ratio of 1: 8. Positive The result in this case almost definitely means the presence of syphilis. V laboratories should make a note about the breeding On the form of the conclusion, so that the doctor will explain this to you in detail.

   2. Perform diagnostic analysis, called "examination for     fluorescent spirochet (treponemic)   antibodies"   (FSA).   Negative   FSA indicates the absence of you   syphilis.   Error   (false positive) result of the FSA is possible in very rare cases.

   To produce antibodies to the immune system   is required   a few   weeks, so at an early stage, no analysis will be reliable.   If   you   do not want to walk around with a suspicious ulcer, ask you to prescribe a   skin scraping test. Spirochety is hard see under   a conventional   microscope, this requires special illumination equipment, and the doctor   or   The laboratory technician should be able to use it. Today, such   an analysis   scraping   can be done in any clinic or medical center, and if   the result   will be positive, you will be immediately informed of This.

   Treatment. One injection of penicillin   extended   actions   cures the primary or secondary stage of syphilis. We assign three injections with a week interval if a person has syphilis for more than a year.   Penicillin in tablets Does not work! If the patient is allergic   to   penicillin,   it is prescribed tetracycline or doxycycline.

   Fortunately, spirochetes are still sensitive to penicillin, as well as 50 years ago. No other common   bacteria   do not   show such “compliantness”.

 

   BENIGN TUMORS OF GENITALS, SEXUALLY TRANSMITTED THROUGH WARTS

 

   In animals, cancer is caused by viruses, and scientists It is also     true for most human malignant   neoplasms. Clear and compelling evidence of this would be a wonderful help in the fight against cancer. Research does not stop, but so far   it has been possible to identify only viruses that cause genital warts.

   The warts are benign tumors. Unlike   malignant, they do not metastasize and do not affect the whole body,   but   spread only when you yourself or someone else “rules”   the virus into a healthy skin area.

   Risk. Approximately one in ten men There are warts. Like many Other Infectious Diseases, they are more common among   young people disappear with age.

   In 5% of adult men are found Warts on     the genitals   or   in an anus. They are no different from warts in other places, except that their spread is facilitated by sexual contact. If   your partner has such formations, your risk is approximately 64% (incubation period lasts about a month).

   The usual course of the disease. Virus of warts acts slowly. After its introduction in a living cell can pass from a month up to   a year,   before there is a bulge of body color the size of   a   pinhead. After a few weeks, an elevation with   a characteristic   The coarse   surface. Convex with the smooth surface may not be a wart, but, for example, a mollusk (see below). Warts on wet areas of the skin grow, resembling color Cabbage.

   Despite the popular belief, warts -   temporary   phenomenon.   Within 6 months may disappear a quarter of them, for the year - half, in two years two-thirds.

   Unusual cases and complications

   1. Anal warts in children are Proof of sexual perversions.

   2. If you have anal or genital warts, undergo a   syphilis test. Most doctors can not notice the difference between such warts and similar to them are condylomas of the secondary stage of syphilis.

   Treatment: Physical Destruction. Researchers are looking for softer treatment paths , but The results are not impressive yet. In the press, notes about the next new way appear every now and then, Destroying all the warts. Don't believe it. A skilled dermatologist can treat persistent   cases   with repeated injections of interferon or anti-cancer agent, but   this is   Doesn't   always work.

   To remove warts these days apply:

   - Burning;

   - freezing;

   - corroding chemicals;

   - surgery.

   Getting rid of warts is relatively easy, But to ensure     that they are never again was almost impossible. So let them   appearance does not upset or anger you. I spend more time   warning wargodainophobia, what is the treatment of the warts themselves, because   increased attention to them can immerse a person in the atmosphere of fear and   hatred. If the warts are too They bother you, remove them.   A   of   genital warts should be disposed of as soon as possible in order to avoid Infection of sexual partners.

   mechanism of treatment. For the treatment of warts on dry skin try to apply unprescription corrosive products, Sometimes there   are   quite effective. But never heal self-anal and genital warts! In these cases, doctors   use   subophylline   -   black caustic liquid Colors derived from plants. With the help of   the tampon   the doctor lubricates each wart, carefully avoiding getting on healthy   skin. If this is your first treatment attempt, then in 4 hours rinse   the dried liquid water with soap. Some   patients   with   Increased   Sensitivity Feel the burning almost immediately - then the liquid should be washed off immediately. Most patients do not feel discomfort.

   If 2 weeks after the first session 50% of warts   disappears, I think The result is satisfactory. Medium   The degree of   damage by warts requires several sessions. If   after   four   lubricants remain at least one of them, the doctor should think about   using   other method.

   Liquid nitrogen - my favorite remedy against warts, and I use it almost all parts of the body. Although it is excellent in the   genital warts (usually destroys in one session), many patients refuse to let me in their most valuable organs with a cup   full of smoking liquid. However, polophylline is no less destructive and   differs from nitrogen only in that it leads yourself in your dishes quietly.

   Wet in liquid nitrogen gauze tampon, I'm on for a second I put it to the wart, I dip it again and repeat procedure.   Warts   the size   with a pinhead need 15 seconds   of freezing,   and   A 1 .3 cm-diameter wart may require 45 seconds. When the frost reaches a healthy skin, you will feel it, But burning is quite tolerable. Penis and even anus less sensitive than some other areas of the body all who have to freeze the warts, for example, on the tips of the fingers, transfer the procedure with tightly grinded teeth.

   Prevention. In order to avoid the appearance of warts in most   parts of the body should not walk barefoot in places such as common   locker rooms,   and use other people's hygiene items -   razors,   combs   and   so on. Condoms protect against genital and anal warts.   If   you deleted them during the first months After that, be sure to   use condom, because under the skin may   not remain   Developed warts.

 

   OTHER ENTITIES

 

   Contagious mollusk - another tumor of viral origin  , reminiscent of smooth dome sized with a pin   head,   with   dimpling   at the top. Often appears on the trunk of the penis or in the perineum,   but   can occur in any other place and, unlike warts, rarely happens in the singular. The size of the mollusk very rarely exceeds 3 mm.

   Contagious molluscity spreads during Direct contact. But,   infected once, a man can spread it throughout the body (  autoinculation - secondary infection from available on     the body of the hearth).   Incubation the mollusk period - from 14 to 60 days, and It is held on the skin for up to two   months.

   Methods used for excretion warts,   also   suitable   and   for mollusks, and frost with liquid nitrogen within 10-15   seconds   sufficient to destroy the formation of the average magnitude.

   Pearl papules on the penis - the name,   usually   the   sucking laughter   of all who hear it, Except for the people who found it in their own. Such education, always located immediately behind the head, look like a ring zoning the penis, consisting of dozens of small whites   similar to   warts bulges. They are difficult to notice even attentive inspection, but sometimes they grow into a dense mass, always limited   by the ring zone in the immediate vicinity from the head of the penis.

   Pearl papules on the penis are not contagious and not are a skin   disease; more likely in all, this is a slight innate deviation from   the norm, which manifests itself after the sexual ripening, as well as   birthmarks. They are also harmless. Treatment gives encouraging results.

 

   PARASITES SEXUALLY TRANSMITTED

 

   Infection with parasites most often caused by non-compliance with hygiene rules. This is the case all over the world, in the first queues of homeless and some other categories of people who, They will probably     never buy this book. But sometimes parasites affect the respectable representatives of the average class.   Discovering   at   like     such a dirtyness,   people shudder against disgust and with all their feet rushing to the doctor. Fortunately,   the data Diseases are easily cured.

 

   VSHI

 

   Unlike bedbugs (who do not live on body) or   pathogens   of scabies (animals (living under the skin), lice clearly seen at any time. Therefore, the person who noticed on some insects, rather   Everything   was found in lice - and it is human lice. Although infection is often   accused of   Pets that live on them insects-parasites, as a rule, prefer them, without switching to other species of animals or   humans.

   There are three kinds of human lice, Each     of which is inhabited by a certain part of the body. By sucking blood, they secrete saliva, which can cause Allergies. This factor in combination with purely mechanical damage to the skin (snack) causes itching, although there are cases when some, People showed amazing tolerance for lice.

   Usually the person who found himself lice, almost certainly notices first of all pubic lice (squapers, pediculosis is pubic). Hearing This diagnosis, most of them Men   Begin to   Scold   sanitary   system of hotels, in response to which I sympathetically nod. Unlike lice, living on the torso and freely on it moving, pubic lice   firmly clung to the skin, dying within a few days, if they are separated from it. Close contact between pubis during   sexual   intercourse   can contribute to   the transfer   parasites,   although   clothing   and   bed   linen still remains One of the possibilities.

   Diagnosis. The pussy of the louse prefers dwell on the genitals and   lower part abdomen. For unknown reasons, it can also live on   eyelashes and - less often - in the armpits. V the different size of the other two     varieties does not oblong, and   rounded   body,   equipped with three legs on each side, which does her crab is like a crab.

   Being almost bodily color, squares look on the skin with small brownish or yellowish spots, due to What is difficult to see   and identify them. In this regard, I am lucky   more   than   patients,   since I can consider a possible area of their habitat from   a closer distance. In addition, I touch the suspicious spots of wooden pointed A wand to find out if they will move. Postponed Eggs (nits) are also noticeable - small white ovens attached to the hair near the surface of the skin. Having learned this information, patients with pediculosis instantly begin to find nits   everywhere, taking for them and dandruff, and just dirt, and some scales on the skin. But real nits are always firmly attached to the hair.

   Treatment. Most doctors prescribe gamma benzen-hexachloride, known to gardeners as linene, but distributed Pharmacists under other names. The patient should be washed by Lindaine Shampoo, wait Five minutes and then wash off the foam. Lindane It is also available   in the form of   an ointment, which is applied to skin for a period of at least 8 hours, and   Then   it washed off. Hairy people should treat themselves from neck to kneeb. After   the use of any means must   be combed     nits   combing with   Frequently Teeth. Lice on eyelashes are destroyed   by   Applying   a thick   layer. Sexual partners Must necessarily be subjected to the same   treatment. Clothes and underwear should be washed, given to dry cleaning or just not to   use them during the week.

   Sometimes a simple antibiotic helps - sulfamethoxazole ("Septrine", "Bactrim"), taken orally.

   How to deal with lice on the trunk, and on Head

   Two other varieties - paid and Head   lice   -   Outside of   very similar and may even intertwine, but each   has   individual features of food. V   different   from   pubic,   These   lice   are larger Part of the the result of poverty and poor personal and public   hygiene. They spread   through   Clothing   and   bed   underwear;   general the use of the comb contributes to the spread of head lice. Sex in This is a less likely source of infection.

   Diagnosis. Pay lice do not live on the body, and in the seams of clothing, especially in places where warmer and clothing Closer to   the body.   Inspection   the patient's skin detects small pimples and traces Intensive combs that can lead to damage to the surface   of the skin and   infections.   Pay lice are more likely to hit the top of the back, Maybe it's because it's harder for the victim to get to them.

   Head lice live in the hair heads, but they are more difficult to   find, Because there may be only a few of them. In this case, more reliable Proof of parasites are nits.

   Treatment. Against the described varieties Excellent   means that are used against pubic lice. If clothes and bed linen were cleaned, then a patient infected with lice does not   need insecticides, but doctors for all The case   is still   prescribed at least one of them.

 

   SCALES

 

   Scabies - the result of infection with the smallest scabies   the size of printing point, ending   This   is the offer.   Female   The tick is inserted under the skin, leaving the masonry of eggs. Allergic reaction to the tick itself, its eggs and feces cause itching, but It may not appear immediately, but a few weeks after Contamination of parasites.

   Sexual contact is very conducive to Mites transfer, but not less Efficiently they distributed in overcrowded people   premises,   public places and at home among family members.

   Diagnosis. When infected with a scabies mite Itching is quite   painful, typical of its strengthening at night. Ticks can leave traces - so-called scabies. On the brushes and wrists, they have the appearance of thin grayish stripes, straight or curved, up to 7.5 mm in length, with a bubble at   one end, where the female is located. On other areas of the skin, the passages look like slightly protruding pink rollers with The same bubble at the end. Men are often noted large scratching papules around the genitals and on the penis. In addition to genitals, ticks prefer   buttocks,   Lower   abdomen, forearms, hands, nipples, navel and skin between the fingers. Textbooks usually describe the method of careful cutting   possible   section of the introduction of the tick with a scalpel with   Subsequent   consideration of   the material   under a microscope for finding the tick itself or eggs.   Although   this,   Undoubtedly, the best way to diagnose, it is very complicated, so   it is used by only a few doctors.

   In the presence of genital papules or lines Pimples can be put   more a diagnosis, but, unfortunately,   These   signs   are often   absent, and the doctor sees only multiple small   rashes   and   traces of combs. Therefore, often the diagnosis is carried out according to the consequences of treatment (i.e. if treatment for scabies mite   helps,   then,    the patient is really a tick, if not, Observations continue).

   Treatment. Probably the best means is permethrin, although lindane also helps. Ointment is applied from the neck and below (inchs   have never    affect the head), leave on the skin no less than on the 8 hours, then   washed off. Clothes are washed or left unused for 10 days. Treatment should be subject to anyone who shares housing with a patient or has sexual intercourse with him.

 

   KLOPS

 

   Since they live in beds, it is quite may be in   yours, Therefore, there are some reasons to associate them with sex.

   Diagnosis. The bug is bigger than a louse, and easy noticeable. It's a flat   brown oval-shaped insect, about 0.5 cm long. Bedbug bites   in appearance is not different from the bites of other insects. During the day, bugs are hidden in cracks, and at night come out to get food. The bite at first is painless, victims can even I can't miss it. They wake up in the morning with itchy pimples; especially Sensitive people suffer from severe itching and rash. Sometimes bites bleed, so finding   blood stains     on the skin or on bed linen, check whether the bedbugs have started in the house.

   Treatment. Bites disappear within a few   days,   and   Treatment   does not accelerate this process. However, easing   lotions   and   creams   with cortisone relieve itching. If you want   to sleep   on   this   bed   and   in the future, how to process it, the surrounding furniture, walls   and   floor with a remedy for bedbugs. You can use the services of a professional.

 

   LET'S TALK ABOUT AIDS

 

   I thought for a long time what to include in this Head. AIDS prevention is generally easy; to tell about it, You will need no more than two offers. However, if you start To list all       the problems associated with this disease and methods of their treatment, there will not be enough and a whole book. More wherein the topic is regularly covered in the media information and almost every one of us knows at least one victim, AIDS It poses a slight threat to most readers. It is unlikely that you are injecting drugs into a vein or often You have sex with someone. Because blood banks check all     the blood coming to them     on the AIDS virus, your chances of picking it up when transfusing are almost zero. Homosexual readers have long been able to learn how to behave.

   I decided to use my doctoral experience. My patients are   working and representatives of the middle class. During the year   I   do not   have to see more than one of the newly sick, but many have   positive results of the analysis, and some Take   medications for AIDS. For Excluding a few homosexuals who are concerned about the recent frivolous actions, most people do not need anything like this. However, my patients are often worried because   they have joined   in connection with a suspicious woman or met   with   my mistress,   which could have changed them. I explain that they is unlikely to be infected, and there     is no need for analysis, and They are very carefully me Listening. I used to think they were satisfied with my explanation, and you can talk about other things, but now became wiser. I tell them that, although the result   The analysis will certainly be negative, I still    I'll give   direction.   Then my gratitude Patients are limitless.

   This chapter talks about what is needed Know about AIDS   and   why most of you are not Must be worried. In addition, you will learn why AIDS is the worst epidemic in the history of mankind, the end of which   is not visible.

 

   BICH VIRUS

 

   The disease begins with the fact that a person Coverage of HIV-1 (  Immunodeficiency Virus the first type of person). There is also HIV-2; it occurs   in African countries and is less   contagious.   Contrary to   popular   belief, HIV-1 is not A secret to science. This virus, well known   scientists since the beginning of the century, was widely common among animals. The first person infected them was not AIDS, but Rare form of leukemia.

   HIV-1 is a prisoner in protein shell of an ordinary chromosome (long a molecule in the form of a spiral,     containing information   about the education of this virus), which is thousands   of times   smaller   The microbe.   Fully inert for the area of the cell, the virus does not breathe, does not eat, moves and does not multiply, and Scientists are arguing about whether to consider it alive   organism. When the virus is related to a certain cell, protein glued   to its surface and lets the chromosome into it. On the way to the nucleus of the chromosome of   the virus is lost among the chromosomes of the cell. Some time (from a few   hours to A few years) nothing   Occurs.   Then the   Cage   ceases normal activities and begins Produce viruses on its own.   Finishing this process, the cell dies and is destroyed,   release of   viruses that continue to work.

   The simplicity of the virus device makes it very difficult its destruction. It can be avoided with boiling or strong acids,   but   such methods are not suitable for the treatment of people. Safer funds,   for example, antibiotics that poison bacteria by participating in their activities, can not help in the case of the virus, not Proporting   no   activity. The drug can act only when the cell produces   new viruses, but an antiviral drug will also affect the cage. Do this without poisoning it, very much difficult;   modern   antiviral drugs are much more toxic than antibiotics. However,   to   to debug the production of antibiotics, scientists took 60 years, so We just have to wait.

 

   TRANSMISSION OF THE VIRUS

 

   HIV is transmitted through blood, seed and breast Milk. Saliva, sweat, tears, discharge from the nose, urine and feces are not carriers of the virus. Even one serving of sperm to transmit the virus not enough; to become infected   from a man, a woman should have sexual intercourse with him repeatedly.   After a single Sexually An AIDS Infection Is Unlikely –   It’s Much Easier to Pick Up hepatitis, gonorrhea, syphilis or warts.

   In America, AIDS first appeared in The homosexual environment, apparently,   therefore, that the "blue" are much more promiscuous in their connections than heterosexuals. Now they are trying to live in stable pairs, and   Probability AIDS infection has decreased for them. More All today are at risk of   drug addicts, used by one needle. Although cases of AIDS through heterosexual bonds make up only 5% of the total, this   figure Continuously Increases mainly at the expense of women. Victims of drugs - most often Men, therefore their wives and mistress suffer.

   A man can get infected from a carrier virus, because in its   vagina quite often there is blood, but such cases are less   common than infection of a woman from Men. Prostitutes   suffer from   AIDS   not mostly because of indiscriminate sex, but Because they use drugs.

 

   CLINICAL COURSE

 

   Most of the patients after infection feel excellent,   although some after 3-6 weeks get sick something   like   The flu.   In   a few weeks the temperature rises, there are pains in the body and head, rash, diarrhea. Since such manifestations are characteristic of other viral   diseases, no one suspects that this AIDS, and most people, They think they have the flu, Really get the flu.   Positive HIV test result at best can be   obtained   through   2-3 months after infection. 95% of patients   It doesn't happen   before,   than in 5 months, and some - after A few years. Researchers are working on tests that will allow to detect infected earlier, and by the time you read these lines, they It can be successful.

   Within a few years after infection The patient   remains   healthy. Even studies of the immune system show normal results, but After 3 years, the picture changes radically. Most often, doctors measure the number main blood cells - lymphocytes   T4   (normal   number - 800 by 1 mm3). (Although Recommendations on this   matter   are changing,   at less than 500 doctors prescribe zidovudine to stop the fall. If there are less than 200, then the immune the system is so   weak that   medications are needed to prevent common infections,   For example, pneumocystis pneumonia.) During the decline of immunity patients can feel good. Some significantly increase   lymph nodes, which can be considered Attempted body (usually   ineffective) Fighting the infection. If you read these   lines,   felt their glands and were frightened, read more and   Remember.   When   infected with the AIDS virus, the lymph nodes should be probed in two or more places   on the body constantly in for more than three months - and inguinal   The glands   are not counted! One enlarged knot under the jaw or under the arm is also   not   counting.

   AIDS (acquired immunodeficiency syndrome) is not a certain disease, but is a consequence of severe immune deficiency. Before the advent of AIDS, cases of immune   deficiency   were rare and usually were a consequence of genetic defects, medication   or severe illness.

   Usually a person with weakened immunity susceptible to infections caused by weakly pathogenic microorganisms   that   easily   suppressed by the body with normal resistance. The most famous   of   Such infections       Pneumonic    pneumonia is considered,    caused    by the fungus Pneumocystis carinii, and it affects about 80%    victims   of AIDS. These fungi are widespread in the environment,   and   Most   of us wear a number of them in our   lungs.   Other   infections   from this series are caused by unknown   persons in the past   microorganisms   such as cryptosporides, cryptococci, toxoplasma and (atypically) mycobacteria.

   Their close relatives are infections type   of herpes,   warts   and Mycosis, which almost all of us have it is easy, but with a weakened Immunity can Lead to extensive infection.

   AIDS victims suffer from hidden infections and little susceptible to common viral and bacterial diseases, capable of   overloading and a strong immune system - streptococcal angina, staphylococci diseases and so on. This is partly due to themes,     What if   the man   already have antibodies to some infection, then AIDS It doesn't destroy them. In most adults, previously acquired   immunity. Therefore They are not   susceptible   to   Bacterial   infections so   common among children streptococcal angina and ears   infections. In addition, there are effective means for treatment of such ailments - they   are even good for AIDS patients. Hidden infections   it   is difficult to treat,   since they were very rare and only Few researchers have paid attention to them. This provision has to be corrected.

   Victims of AIDS are susceptible to Virulent   infections.   The incidence of tuberculosis in the United States has decreased significantly over the past 100 years, but since 1985 the number of cases has been slowly increasing due to AIDS. Moreover,   tuberculosis among AIDS patients has become a rather unpleasant phenomenon, because it is bad Succumb to conventional antibiotic treatment. If you   have no damaged immune the system, the   probability   of     that you will   become infected with pneumocists pneumonia or another of the described hidden infections is very small.   However,   healthy   People   are quite   receptive   to   tuberculosis, salmonellosis, many bacterial pneumonia and a number of other virulent infections. And if they overtake AIDS patients, they can begin to spread and among us.

   HIV affects the brain to the same extent as The immune system. Half of its victims suffer from neurological diseases, most often -   multiple sclerosis. The disease begins with apathy, lethargy and mood variability and progresses (proved to   The patient   does not   die earlier from others Complications) to   severe   decrepit   and   paralysis.   It's very similar to senile sclerosis of the brain" - more   one   poorly   studied disease, the cause of which some experts also consider viruses.   Scientists do not some opinion and why AIDS victims are so   susceptible to malignancy: tumors of lymphoid tissue or   earlier Rarely found sarcoma Kaposi.

   Treatment. No other disease could would   be better   Illustrate the prevention advantage over treatment. By 1985, we already knew   how to prevent AIDS. However, despite impressive progress in its treatment, AIDS is still a deadly disease   with   100%   death .

   Medications used to treat infections, The greatest triumph of   medicine of the 20th century. V over the next few decades, the efforts of scientists and doctors should be Focusing on improving the treatment of hidden   infections; the first 10 years of research in this area have already yielded   impressive results. Unfortunately, a patient with impaired   immunity,   getting rid of the manifestations of any infection,   in the future   still   retains susceptibility to it, as well as to others. Many infections give a 100% chance of recurrence, so   The patient   has   to continue treatment until the end of his days.

   There is a limit to the number of preventive   drugs,     which a person is able to accept. It is much better if the treatment starts early. The Appearance of Zidovudine (AZT, ZDV) in the mid 80-ies became a significant advance. Very toxic and very expensive   antiretroviral drugs slow down the reduction in the number of T4 lymphocytes and are likely   to be able to provide the patient with a tolerable life before How the inevitable end comes. For the time being these drugs remain the best, and this situation will continue for quite a long time.

   Several are currently being tested Vaccines, others   are in the stage of laboratory tests. K   misfortune,   as long as   it is not clear,   how exactly the body fights retroviruses, and This complicates and slows down the work. Traditional vaccines used against polio and tetanus, give the body to feel "light Taste of these diseases.   In response The immune system produces many cells that quickly   produce antibodies, which immediately begin to destroy   pathogens  , whenever they appear.

   Apparently, antibodies are powerless   against   Retroviruses.   A positive blood test that detects antibodies against, say, measles or poliomyelitis, indicates that a person has successfully overcome the infection.   A   a positive HIV test, also based on   antibody detection,   means exactly the opposite.

   Using modern vaccines The strategy is common -   either harmless retrovirus or particles of the AIDS virus are injected in an attempt to provoke a protective reaction. Specialists Regularly make encouraging statements about new vaccines, but scientists -     Just   people:   They are   always in love with their latest development. And while you’ll read these lines for at least two or three years after they were written, I don’t think an effective AIDS vaccine will be received by that time.

 

   Prevention

 

   Everyone knows about condoms. Chances of getting infected AIDS with a single sexual contact with a woman is low, but not equal to zero. I do not recommend trying fate.

   Sexual activity can be divided into Category according to the degree Risk of HIV infection. Here are examples of this division:

   The practice of dangerous sex

   1. Anal sex without Condom.

   2. Vaginal sexual intercourse without Condom.

   3. Swallowing sperm, menstrual blood and vaginal discharge.

   4. Oral-ananal and manual-vaginal Contacts without   precautions.

   Practice of risky sex

   1. Fellation without ejaculation.

   2. Oral sexual intercourse.

   3. Stimulation of orgasm between the hips or buttocks.

   4. Contact with urine.

   5. Anal sexual intercourse with Condom.

   6. Patch-analical sexual intercourse without The barrier.

   7. A clery with ejaculation into a condom.

   Practice of safe sex

   1. "Dry" kisses.

   2. Accepting a bath alone.

   3. Masturbation.

   4. Laying healthy clean skin.

   5. Hugs.

   6. Massage.

   7. Stimulation of orgasm by any external parts of the body.

   A few more tips: if you are traveling not in European   countries or in Japan - do not use any blood-based drugs

- any vaccines, gamma-globulin, etc. Do not be transfused with blood and plasma. Do not even agree to injections, not being sure   for sure that the needle before you was not   used.   Do   all   necessary vaccinations and injections before departure. By the way, some countries before   issuing an entry visa, Insist on the mandatory immunization of those who wish   Visit them.

   The Future: What We Can Learn by Looking at Africa. Many   experts believe, that AIDS in Africa can serve as a lesson for the United States and   therefore you should do something Know about it.

   Black Africa is engulfed in AIDS. Since the late   70's     (approximately   then the epidemic began and in The virus spreads to the   the continent   is much wider and faster, and today 10-50% of the population   affected   by this   disease   (In America, 20 times less). In contrast to Developed AIDS in Africa manifests itself as a typical transmitted heterosexual means disease  , Ill-destroying men and women equally. Experts do not know why    AIDS     is distributed   here with    that    speed,    but most are convinced, that poverty and the presence of other genital infections on the genitals Africans.

   By the end of the 80's, AIDS had established itself in Thailand, India and other Asian countries, quickly spreading in this area. Obviously,   that by the end of the century the poorest nations of Asia AIDS will suffer as much as in Africa.

   The future of America. In 1991 there was More than a million people with positive HIV response. More than 250 thousand people already Sick. Both   indicators are growing slowly.

 

 

   Chapter 11

   MEN'S SEXUAL PROBLEMS AND WAYS THEM SOLUTIONS

 

   Throughout almost the entire century, the Among the population, the surveys   showed that list of stresses related to marriage,   led   the money. Public opinion researchers simply did not ask people about sex, and the respondents themselves did not give such information. When   the list began to include sexual questions, monetary problems have gone to   Background  . Even among happy married couples about 50%   of men   Mentioned     any sexual difficulties (among Women were even less satisfied - about 25%).

   Contrary to the beliefs of some men, sexual Communication is not so   necessary for Maintenance of health. Ascetics who adhered to abstinence for philosophical or religious reasons did not suffer from poor   health; in the same way, the refusal of   Delicious   food   or   physical comfort. On the other hand, being one from   the pleasures of life,   full sex contributes to the good emotional attitude   in those who   do not avoid earthly Joy. Sexual   disorders   often   cause people a lot of unnecessary suffering - unnecessary Because there are many   good ways their adjustments.

 

   WHAT TO KNOW ABOUT IMPOTENCE

 

   In the early 60's, experts came to   the agreement that    90%   of men experience impotences emotional difficulties. Elder general practitioners usually prescribed such patients in testosterone   injections, Which, apparently, was useless. Younger and well-trained Therapists looked at this practice as a variety   of witchcraft and   directed their patients for physiotherapy, which also did not help.

   In the mid 70-ies of the doctors began to identify more   purely   physical causes of impotence, and 10 years ago, with this trouble began to   slowly cope. Experts are now convinced that in most cases,     purely organic (i.e. not psychological) causes. Some of these patients are treated by family doctors. Most of the rest fall into the hands of urologists.

 

   NORMAL SEXUAL INTERCOURSE

 

   1. Anatomy. Although the penis is similar to the tube, in fact it consists of three cylinders with   a common   fleshy   bulb   (head)     at the end.   For the most part of their It consists of two cramped   adjacent     to each other tavern bodies, called cavernous bodies. Under them passes the third tube - spongy body, inside which is the urethra. If you squeeze the penis tightly fingers, then feel all three bodies-tubes.   The names "pong" and "Caverents" exactly characterize   them,   since the cylinders are permeated with large veins, almost Empty until the onset of erection. Subtle cylinder of brocademic   muscles   is   shell of all three bodies. Reduction of this muscular shells and allow you   to get rid of the last few drops of urine after urination, but in   the mechanism of erection it Doesn't play   a big   role.     Paired syricaveral muscles begin on the pubis and are connected to the base of the penis. By contracting   and blocking the veins, they contribute to erection, stopping the outflow of blood from   Penis. However, these muscles themselves do not produce an erection - it occurs when filling the penis with blood. This condition requires healthy blood vessels and healthy nerves.

   2. Nerves. Nerves that control the erection, start in the nerve   centers, located at the bottom of the spinal column. Impulses from   the head the brain (thoughts, pleasant sensations) can pass along the spinal cord   and cause erection, but are not a prerequisite.

   Experts determine three forms erection:   reflex   -   occurs when the genitals are stimulated. Like the other reflex, for example, the knee,   it occurs with the participation of the spinal cord. A similar form of erection can   be observed in paraplegic (paralysis of the lower limbs) with a vertebral   injury;

   Psychogenic - the result of the thinking activities or sensory   stimulation of any kind (sounds, visual images). This type of erection requires a healthy nervous system, since only a few patients with damage the lower parts of the spinal cord can reach it;

   Night - for unclear reasons arises in sleep or when   waking   in all men, starting with Childhood. It is evidence that   The basic mechanism works normally. Impotences for psychological   reasons or due to lack of male The hormones continue to be restructured during sleep. Lack of night erections indicates physical impairment.

   3. Hormones. Being necessary for the sexual maturation, male hormones (testosterone and dihydrotestosterone) enhance Erection, but not necessary. A man with hormonal insufficiency loses   interest in sex, the amount of his ejaculate decreases somewhat, but   he   capable of all three types of erection. Introduction additional hormones   to a man   with normal levels increases sexual desire, but it becomes more irritable, and the level of cholesterol in the blood increases, without correcting mechanism of prevention of erection.

   4. The mechanism of sexual intercourse. Erection arises   with   an increase   blood flow to the penis: a network of empty is filled veins running in cavernous and spongy bodies, penis thickened and lengthens until it is filled with blood to failure. At the same time, shyocavernous   muscles, squeezing the base of the penis and blocking the outflow from it blood,   which is provided Stiffness of erection. During this period, urination is difficult, and in the penis almost not Blood is coming. Such situations are fraught with gangrene, but, fortunately, this phase does not last long. Ejaculation occurs   with   muscle contraction along the appendage of the testicle, the vas deferensive rope and prostate; at the same   time , the seminal fluid is pushed into the urethra. Neck of   the urinary   the bubble   also shrinks, preventing the reverse flow of the liquid, then   abruptly   and   rhythmically contract the muscles of the penis, throwing out from 2 to 5   cm3   Ejaculate.     At this time we are experiencing the imminent feeling that called orgasm.

   Then the muscles of the penis relax, the blood It flows and the erection   weakens. Man loses interest in sexual intercourse, and erection and ejaculation for some time become impossible. Refractory   The period   usually   lasts only a few minutes, but can vary widely depending on the state of health, Motivation and Habits. With age, it lengthens,   like all sexual phases.

   The term "impotence" meaning "absence   of power,   fortress"   can refer to any disease that prevents sexual life, but usually people associate it It is with the weakness of the penis. Those whose penis too quickly becomes soft, or lost ability   to   Erections consider themselves impotent - this Humiliating   condition   of men   feared throughout the history of the human race. Even in the Current   of the Victorian Puritan period when in popular literature   could not be met   and   a hint of     sex,   Doctors   advertised   tonics and drugs that restore male power.   All,   Of course, they understood what was meant to be.

   The most common male sexual disorder - impotence - seems so shameful that Patients try not to say the word. Men can ask for a doctor Assign     injections to increase them energy" or conduct a full inspection, hypocritically claiming that nothing like this has ever happened to them. For 20 years of practice, I have never met a man who called myself impotent,   and   I suspect that many of them have never discussed This question. Such people should know that medicine in this area is not as powerless as they   think.

 

   CAUSES OF LACK OF ERECTION

 

   The most basic reason is, That every man has time There are misfires from time. Anxiety, general fatigue, cold, scandal with a partner and other stress can negate the most titanic efforts to cause Erection. Doctors do not consider such failures to be impotence if they are irregular.

   Medications. Medical guides give huge lists of funds that can provoke failures, in There are dozens of those that I am constantly and without I am wary of   my   patients.   But   some   medications are temporarily reduced sexual ability.

   Several groups of antihypertensive funds   often    cause temporary impotence. Doctors even Warn the patient about this, writing him a prescription. This warning itself in itself can     cause impotence of a psychogenic nature, and surely most men,   thanking the doctor, will leave the office and They will never go with such a prescription to the pharmacy. And because without treatment high     blood   pressure   can lead to catastrophic consequences, I always explain to my patients, What:

   - these drugs act on sexual The ability of very   few people;

   - some antihypertensive agents never cause   impotence, so The doctor will easily adjust your blood pressure   without   additional difficulties.

   Alcohol and marijuana along with sedatives means,   tranquilizers, antidepressants and other drugs affecting    the brain (antihistamine, anticonvulsant and anti-missiles)   can also Leading to a Temporary Loss   erectile   abilities.   Stopping the reception restores potency, and switching to another class of such drugs sometimes helps and maintain potency, and continue treatment.

   Circulatory insufficiency. With Sufficient     blood flow   The penis increases slowly or not increases at all. Deposits on the walls of blood vessels of cholesterol, reducing blood flow to the heart, can do the same and with a penis; manifestations of impotence along with   diseases of the coronary arteries increase with age. Atherosclerosis,   being the leader disease of Americans, in most cases, causes impotence.

   The diet described in Chapter 2, along   with   prevention of   atherosclerosis sharply reduces this risk. If a man has suffered such   a misfortune,   I recommend this diet as general measure of maintaining   health, but not a quick way to restore an erection.   For this purpose, some may be needed Artificial   tools   described by   Further, although X-ray studies in In some cases are identified local blockade of the arteries of the penis, which can be Remove surgically .

   Nervous disorders. Any disruption of work central nervous system - from a brain tumor to displacement of the spinal disc - can   upset the sexual "function, Although the ability to erection   Remains     in many people with enough serious damage.

   Diseases in which they are affected peripheral nerves often cause impotence. Diabetics are usually accused of all increased blood sugar, but in fact the cause of damage Peripheral nerves   are   poorly studied The consequence of long-term   diabetes  , which occurs     50% of cases. Pronounced hypovitaminosis also leads to impotence, but   American doctors rarely have to deal with it to collide. Surgeons   mostly learned to avoid damage to the nerves of the penis during   operations   on   the bladder , prostate and rectum, but some risk remains.

   Hormonal disorders. With these words Men immediately think   of   testosterone, but about 90% of cases Hormonal impotence is caused by   diabetes. According to one theory, maintaining a normal   level   Blood sugar prevents both impotence and others complications of diabetes (dumbral and kidney damage). Strict control of sugar requires strict adherence to the diet, maintaining a normal weight   and,   if   necessary,   several injections of insulin per day. Complications of diabetes are irreversible, so everyone, having learned his diagnosis, should immediately take the described measures.

   Other hormonal disorders (Notebook insufficiency     and   other hormones as a result of   diseases   thyroid   gland   and   pituitary gland)   not only affect the erection, but also reduce sexual desire.

   Other physiological causes of impotence. There are many such reasons, but They are rare. So, impotence 50% of patients in need of hemodialysis, but most of them function is restored   after   a successful kidney transplant.

   A full erection requires a relatively Normal functioning certain organs, therefore Victims of serious   chronic   diseases such as cirrhosis of the liver or cancer are experiencing noticeable   difficulties.   Disorders occur after heart attacks, but this occurs rather as a result of the action of drugs and stress. Men with high blood pressure are often worried about it, but hypertension in itself to impotence is not leads.

   Psychogenic Causes. Severe depression or Stress -   the main   causes of psychogenic impotence. Patients suffering from depression, lose the   ability to enjoy, and this is a powerful Barrier for     erectile   functions. Such people lose self-respect and hope for the future, we are convinced that they, they say, deserved their humiliation and in any case can not change the attitude to life. Suffering from other serious mental   illnesses (shizoflakes and maniacs) lead to the bewilderment of others and attract the attention of doctors, but suppressed Your behavior can't be called. Depression is depressing painful condition, sometimes even   Healthy life   is more dangerous because it can lead to suicide.

   Many people consider depression to be excellent an example   of a purely   emotional disorder and believe that it should be treated with kindness and psychotherapy,   and not with medications. This Opinion is wrong. Serious mental disorders   are actually diseases of the brain. Traditional psychotherapy in such situations works Badly. The best results are achieved with   use of drugs and electric shock.

   Doctors no longer make conclusions that Every impotent experiencing   anxiety or fear should blame these feelings for their   problems.   Both anxiety and fear can cause itself impotence. In addition,     increased anxiety - a normal state for some   people.   Convince them of anything It was not difficult - precisely because of   their   inclination to   the Intensive experiences. Every man under the influence of stress   can temporarily become impotent, but to make this state manifested   regularly or has become permanent, serious troubles are needed - loss of work, large   family Conflict, etc.

   People who consider everyday sex The duty, not the joy of   life, also risk being in trouble. Impotence is often affected by very   religious people, as well as those who have been exposed violence and men with distorted ideas about their sexual possibilities. Some   men   in the first   did not show much interest in sex, but Abstinence from intercourse is not a disease, unless a person himself is mentally from it does not suffer. And finally, there are men who need non-traditional Sexual Relations: Some Homosexuals (active), coming into contact   with   a woman,   are impotent.

   Diagnosis. The doctor must be sure, absolute impotence of the patient or not, and only then resort to complex and   expensive   research. Erection requires such good coordination of the nervous and vascular   systems that a person who achieves the desired the result of at least   1%   of their attempts, most likely suffers from psychogenic impotence.

   A man who has only night erection, from a physical   point of view, is healthy, so the doctor needs to know whether they have a place.   The urologist will probably send you home by providing special pressure gauge with   cuff and a self-painting, but you can check on their availability yourself, wearing a thin paper ring on the penis enough before going to bed. If during the week in the morning the strip will remain intact, then   there are no no night erections.

   Every man who suspects himself impotence, must   undergo   a thorough examination. The doctor will measure   the testicles.   Their   length   is less   3.5   cm   indicates a lack of men hormones,     the same     Incorrect growth and location of pubic hair, and   also   their   absence.   In order to detect a possible blockade of the arteries the pulse is measured; then the strength of the muscles, reflexes, pain Sensitivity   and   Availability   minor neurological disorders. In addition Knee reflex doctor   will check   another little-known the reflex is a bulbocurrynogorous, which   with   neurological impotence most often absent: when squeezing the tip of the penis, the anus should be compressed. You can do it at home yourself.

   Of all possible blood tests, most violations reveal a   sugar test, Even early diabetes can cause   impotence. In rare cases, a diagnosis can be made on the basis of   other   analyses, but nevertheless, everyone is assigned a full set of them along   with   several samples of hormones with mandatory verification testosterone levels.    Sometimes, with insufficiency pituitary hormones, the patient is prescribed computed tomography to find out its causes.

   Up to the 80's check   Blood circulation   in   the penis   required the use of arteriography - the introduction of a contrast agent into   the artery of the penis and tracering its passage with with X-rays. Despite the high accuracy, arteriography is   technically difficult,   expensive   and   somewhat risky, so doctors are not Inclined to use it   without   serious testimony. Fortunately, the latest testing methods are simpler.

   Today, urologists check the circulation, making Injection of   vasodilators (papaverine or phentolomin) directly in   Penis.   Normal erection, occurring within 15 minutes, indicates a good arterial-venous blood flow. Because in nerve patients   erection may not occur, the negative result is not   so   Definitely.

   Another simple way is measurement   Blood pressure in    penis   (using   a child cuff for measurement pressure). Under normal   conditions, it shall be approximately 90% of the pressure measured in the usual manner on Hand. Indications equal to 75% or less presuppose   a deviation; less than 60%   indicate     for a serious   violation of circulation. Specialists can use a variety of other safe methods, based mainly on the use of ultrasound,   which give useful information about blood circulation, but rarely   reveals minor violations.

 

   TREATMENT

 

   Impotence with depression, diabetes or prostate infection may not hope for relief before they are cured of these Ailments. Therefore, the first task of doctors is to find out Which of them can be in good effect. Quitting smoking and refusal Alcohol   rarely can be recovered from alcohol Potency, these measures Necessary. Type Medications aspirin or vitamins are not seen in a negative effect on sexual function, but stopping them so easy,     What is worth trying and seeing what will come of it.

   Testosterone   is treated,     Testosterone   deficiency, of course. The drug in tablets is absorbed by the body unevenly,   in   resulting in liver damage. Doctors prefer to prescribe testosterone in injections (one injection in two weeks). During treatment, spots may appear on the skin.

   Treatment with male   hormones   accompanied   by significant   side effects. Their excessive intake stimulates the formation of   benign and malignant tumors, Therefore, patients have to undergo a rectal examination every six months. Suppressing the hormones of the pituitary gland, testosterone reduces the ability to fertilization. At the same time, it enhances sexual desire, which with impotence gives a very sad effect.

   Like testosterone, other drugs sometimes cure impotence,   but in most cases do not cope with it. Although experts often   consider the appointment of drugs useless, Most men find alternatives, to put it mildly,   to be unattractive.   Foreseeing   the need for surgery, implants or Goldberg devices for "pumping" their penis, everyone prefers to start with drugs, and doctors are right, assisting them.

   Medications that help with impotence

   Yogimbin   (Jokon,   "Yogimex")   is widely   known   as   an "underground" tool - it is not the products of Western researchers   and   pharmaceuticals,   and an extract from Chinese herbs. Although a certain   part   The population   believes   in the amazing the possibilities of alternative medicine, its means are still   less effective than we would like. The Chinese are not have our   passion for   all mechanical things and wise   technology   (read   section   on penis implants) - their solution of such   issues   based on knowledge coming from ancient times. Every wildlife researcher or hunter knows that rhinoceros horn or penis tiger can   Bring   20 thousand dollars of profit if you sell them in China for use   as     Afraids that significantly   increase   potency.     The Chinese themselves are looking for ancient plants, which in the rest of the world have either disappeared or have been crossed with more modern   species. These rarest Plants are sold to pharmacists who make on     their basis for the medicine.

   Statistically significant evidence No, yohymbines   can still help with impotence, perhaps by slowing the outflow of blood from   the penis. The required dose is 5.4 mg 3 once a day.

   Zinc. Everyday meals contain the required amount of zinc,   but some people are at risk of its insufficiency:   those on hemodialysis, diabetics and those who take Diuretics. The diagnosis is made   by a blood test. The result of the analysis is usually normal, but it   is possible to resist the desire to "treat" It's hard. Try taking 220 mg   zinc sulfate or 420 mg of zinc gluconate daily within two months.

   Bromocriptine (Perlodeel) counteracts   excessive   production of prolactin - hormone   The pituitary gland.   Overproduction   of prolactin can be provoked by both tumors and various drugs,   diseases of the kidneys and thyroid gland; sometimes manifested in   the post-operative period.

   Pentoxifyline (Trental) - 400 mg 3 times a day - a medicine   usually prescribed for aging. It increases blood flow to the brain, similarly can also affect the penis.

   Nitroglycerin increases blood flow to heart. Accepted   or or under the tongue, it slightly affects the potency, but the time from Time there are reports of his good action when applied in the form of paste applied to the penis.

   Papaverine or phentolomine in injections directly to the penis   useful when diagnosing, but at the same time became a popular treatment, effectively Acting with all types of impotence: arterial, neurological and psychogenic. A man should consider these medications if the only The alternative is surgery. Before sending the patient home   with ampoules and syringes, the urologist should train his injection technique   with   a thorough explanation Possible side effects (formation of scars   with long-term use, accidental prolonged erections).

   External devices

   A condom-like device consists of Silicone shell (case) with double walls. It's worn on the penis, then the     air is sucked from the cover with a syringe (or mouth), as a result, he presses the penis, drawing it inside the shell   and   At the same time  , drawing blood into the depths of the penis. To ensure tightness of the suction tube wrapped around the base. Other similar devices consist of   hollow plastic a cylinder connected to a small pump.   Putting on the cylinder on the penis, the man uses manual pump for   air removal. When the sucking is complete, you need to move   the rubber ring at the base of the cylinder to the base of the penis to prevent blood outflow.

   Some types of surgical implants. Although cutting   the penis   to insert inside the core seems dangerous, urologists have been doing it successfully since the 70's, With all the best results. If the other methods have not worked, implantation provides an acceptable erection.

   There are three types of implants. In order increases in complexity they are divided into semi-rigid, intermediate and   inflatable.   Simple   implants are more reliable, complex ones are more convenient. U every urologist has   its   favorite type, but the final choice must stay with the patient.

   Vague devices often Exquisient enough     to     to implant them under local anesthesia. Usually their task is   to provide rigidity when straightening, but be able to bend when in an erection There's no need. Because they do not provide   for moving   parts, they rarely fail, but do not increase them length, no diameter of the penis; in addition, when using the penis, it is difficult to hide under the clothes.

   Intermediate devices also fully are inside the penis,   but most of their length is flexible   Cylinder.   Multiple   contraction of the end of the device inflates the cylinder.   The flexion of   the erect   penis in the middle releases air from the cylinder. These devices lengthen the penis to a greater extent than semi-stice, and the penis is easier to hide when the device is not used for its intended purpose.

   Fully inflatable prostheses provide   the most   similar to     a natural erection by increasing as length and diameter of the penis,   allowing after use, lead the size to the norm.     In one   of   such devices the implant is connected tubes   with   tank   with   liquid hidden in a scrotum. The compression of the scrotum fills or emptys the cylinder in   the penis.

 

   PREMATURE EJACULATION

 

   With this term, we define ejaculation, the previous man   or his partner desires. Anybody will agree that ejaculation   is premature if it occurs earlier than penis is injected into the vagina; some specialists take from 30 seconds to two minutes as   the upper limit time after the penis is entered. There is no general opinion on this matter, but with such a disorder, the patient himself makes a diagnosis. If   the man   or his partner is convinced that ejaculation Premature, that’s probably   how it is.

 

   DURATION OF NORMAL SEXUAL ACT

 

   Scientists have found that from the moment when a man begins   to think about the relationship and reaches an erection, enough for ejaculation   on average   Three minutes. Time from excitement to achievement orgasm in a woman on     average is thirteen minutes. Studies have shown that premature ejaculation is so common, that it can be classified   as   normal behavior of a man.

   In a purely "zoological" sense, it's That's right. Animals spend a lot   of time on marriage ceremonies (dances, demonstration of appearance), but the intercourse itself occupies Just a few seconds. People tend to think about   sexual intercourse as an extended and giving pleasure to action, but since it is not instinctive to them, men and women should learn how to seek The desired result.

 

   HOW A WOMAN REACHES ORGASM

 

   Women approach orgasm slowly, although its mechanism is similar to the mechanism of male orgasm. When she is excited, increases blood flow to the vagina, leading to swelling of the external genitalia and the clitoris   (female equivalent of the penis). Simultaneously small glands   Beginning   to highlight the secret for Lubricants. Well-lubricated (histurled)   The vagina   is easy felt by a man;   without   it     Women's Factors   Rarely     Enjoy the sex Act.

   After the release of the woman's lubrication become   more   malleable,   Therefore, many men try to immediately introduce Penis. I   would   say,     that this is a risky step, as the lubricant appears at an early   stage   female sex cycle, about 10 minutes before the   real   possibility of achieving an orgasm.

   Rhythmic contractions of the walls of the vagina provide a woman with   an orgasm similar to a man's, but the female refractory period is much shorter than the male, Therefore, after the first orgasm, it is able to quickly experience   several more. In Polynesia, for example, a man is not Feels like a man   if his partner for one relationship does not reach several orgasms. We do not practice this in our country; moreover, in fact, only   20 to 30% of American women At least one orgasm is during the relationship.

 

   WHY YOU EJACULATE TOO EARLY

 

   In contrast to the physical Disorders here almost never play a role. Doctors during for a long time was considered the cause of premature ejaculation stress or conflict relationships. This is hard to object because stress can poison   the pleasure   from any activity. Some premature ejaculating men worry if they are too Sensitive to erotic stimulation.   Doctors do not discard this cause - before in such cases prescribed circumcision, reducing the sensitivity of the penis.

   In most cases, men Ejaculation too early not because they can not resist pleasure - They do not know how to control the sensations that make ejaculation inevitable. Samsans Animals are instinctively ejaculated quickly. Young Americans usually experience the first erotic stimulation through masturbation, when no motives for There is no delay in ejaculation. When young men practice early sex with prostitutes or in inappropriate situations, such as the back seat of the car, sexual intercourse takes place in a hurry, which also leads   Premature   ejaculation. In social formations, where young representatives of both sexes   have the opportunity to have free sex, girls quickly give   to boys   To understand that hasty ejaculation is not the best action.

 

   TREATMENT

 

   No medication can Reliably   delay   ejaculation. Sometimes antidepressants and Antipsychotics, possibly due to the ability to slow down the nerve transmission. Doctors   begin treatment with 25 mg of antidepressant type amitriptyline ("Elavyl") or antipsychotic agent such as thioridazine ("Melleryl") in 3 hours before the relationship. If necessary, the dose is increased   before   receiving   acceptable   result or until the manifestation of side effects   (dryness   in   the mouth, dizziness, drowsiness).

   Some publications describe   good   results of   the use of fenoxybenzamine and tranquilizer of lorazepama ("Ativan"). Possible Try them too.

   To delay ejaculation there are good technical techniques, but they   require Coherence of actions between a man and his partner. Can   help and several the simplest methods, although a man will have to sacrifice some share Pleasure.

   Traditional complaints that   condoms   reduce the   ability   to perceive sensations, In this case, they become   advantage.   If for an acceptable reduction in the sensitivity of one   condom   Not enough, use two or three at the same time.

   Premature ejaculation is usually   so   spoils   the mood that   few men after that, they test the fate again, but having tried it, they find that The second erection is much more   long-lasting, and the third is better. Some take by law   at the beginning of a love date, apologize and retire to the bathroom, where   they masturbate, and then return   to   Partner   and   continue   Interrupted overture. This method of "second ejaculation" is never mentioned in manuals and no is advertised   by those who    use,   but   he is quite capable Ensuring sufficient masculinity to a person who does not want to resort to sexopathology.

   Sexopathologists can teach you techniques, which requires a certain practice, but can give Man   Opportunity to   Detain   Ejaculation of   your own accord. However, this field of medicine is a vast   field of activity for many charlatans, Choose   a   specialist carefully.

   A qualified consultant, of course, will help you to achieve good results, but it is worth trying to learn something and on their own.

   Compression technique. Here is   active   The role   belongs to   a woman,   which should play a love game while The man   is relaxed.   If   it has increased sensitivity, should easily caress his genitals until he feels early Signs of   readiness   to ejaculate. As soon as he says about it, the woman covers the fingers   of the sex   the penny immediately behind the head: the thumb from below, point-by-species and medium - top, and rigidly clamps penis, continuing compression until the man   gets the feeling The proximity of ejaculation. In this case, the erection may disappear, and can remain. Then the woman continues to caress,   and   the man   tries to extend the time until the appearance of readiness to ejaculate.   Specialists   recommends a man to ejaculate after the third or fourth compression,   repeating classes several times   in a week     to achieve   normal   the result, but such a statement, in my opinion, sounds too   optimistic. Based on my experience the result possible only   after   a few   weeks. In addition, six or more compressions per night are absolutely harmless.

   Both partners should be practiced. The Man do not focus too much on suppressing ejaculation, because then He, as a rule, will not have time to give a compression signal in time. Initially,   men,   as   rule, late with this and very quickly find out, What is the pain from   ejaculation in   a clamped penis? A woman must learn to clamp the penis quickly and   firmly, although a man is usually Doesn't find it nice.

   Eventually a man learns maintain an erection until it is boring both partners. On the next stage of the woman   goes to more intensive stimulation. Applying on one   palm   Lubricant   type Vaseline, it covers the penis of a partner   and   stimulates   it by movements Up and down, clamping the man's signal with the other hand. A man who, with such stimulation, manages to delay   ejaculation     Within a few minutes, it may assume that it has made progress.

   In conclusion, the woman sits on the rider    At a grand   partner, inserts a penis into the vagina and sits motionless, waiting for a signal through   which the penis quickly removes and clamtes it. When a man can with   an injected person vaginal with a penis to hold ejaculation for a few   minutes, a woman begins lungs and slow movement with the pelvis, still removing and clamping the penis on the signal of a man about Approaching   ejaculation.   After several dozen Most men learn to delay ejaculation so that Both partners could have   Enjoyment   of sexual intercourse.

   Studies show that premature ejaculation   tends to relapse, So the man should not stop there. With relapse, another course of compression practice helps. I advise men, masturbating, to   compress   myself.   True,   according   to observations, most men do not cope well with this task alone; they   get so much pleasure that they are delayed, until they're late for compression.

   The Start-Stop Technique. Because the main role in the practice of compression is played by a woman, a man, who wants to achieve success on their own, usually   chooses the technique of "start-stop". She more difficult, but brings a longer result. The man, feeling approaching ejaculation,   gives   the partner the team to stop, deep Translates breathing, focuses on relaxation and rests while the desire to ejaculate   will not   decrease.   In the initial stages A man can be practiced by masturbation.

 

   INFERTILITY

 

   This problem is experienced by about 15% of couples (in   1973   year   -   10%).   The sexual revolution and the related the spread of infectious diseases, as well as the growing trend in young people   the Resistance   of the First   Pregnancy.   Among   the couples   older   less infertile .

   After a year of trying, 80% of couples reach Concealment, so doctors   should not Examine a couple earlier. Although among the remaining 20%, half still   seeks to conceive in over the next year, it makes sense to undergo an examination if after a year There was no life together.

   In previous years, the lion's share of surveys About infertility   was obtained women, but today it is the same   The degree   concerns   both partners. Masculine Infertility is the cause of     one-third   cases, another third are infertile women, and the remaining third   are families in which both partners are infertile. The man   not   only   obliged to accompany a woman to the doctor - moreover, it   is checked   First,   because male tests They're done much faster.

 

   ARE YOU DOING THE RIGHT THING?

 

   To achieve maximum chances of   conception   Experts   recommend couples to have intercourse through the night from the 10th to 18th day of the menstrual cycle - during this period, the in vitro of a woman is most likely   (for   The first day of menstruation is taken). One   ejaculation   through   the day maintains the concentration of sperm on the very high level. The pair should not use the lubricant, but A woman   should   be avoided at this time   douching or washing after intercourse. Position with The relationship  , in all likelihood, does not play special role, but   experts   are usually   Recommended   use so called the "the missionary's position", adding that within   20 minutes after the sexual Act a woman should remain lying down     on the back   with raised and bent in the knees with their feet.

 

   REASONS

 

   Congenital disorders. Men are always Worried about whether they were born with a minor Physical defects. But   usually   his   It's not   found. Infertility can be caused by a whole bouquet of congenital   disorders,   but   they are not so common and almost always accompanied   by chronic diseases (cystic fibrosis, anemia with sickle erythrocytes) or underdevelopment of genitalia, chromosomal abnormalities, as well as hormonal insufficiency. Man with good health, typical male appearance, in time Relatively normal   maturity,   most likely, lost the ability to fertilize at some   stage   Adult life. The exception is men with Congenital absence of   a seed duct.

   Unabsolved testicles in 1% of newborns are another birth Causes of Infertility. Sperm are not able to survive at body temperature. In addition, such testes are not functioning well. Made   in   Early   childhood surgical correction   to a certain extent improves   spermatogenesis, but after the onset of puberty It is usually below normal. This trend manifests itself in both testicles, even if not   Only   one omitted   of them.

   Hormonal disorders are a noticeable share among the causes of infertility - from 5 to 10% of cases. They are often associated with diseases   of the pituitary gland (tumors, cysts, infections, congenital hormonal redundancy or, conversely,   insufficiency).   Symptoms   Hormonal   disorders    are usually very serious, in The best case of men who have fallen ill   after   maturity, a decrease in libido is noted. Other signs are more likely - atrophy testicles, headaches or swelling of the mammary glands. In childhood disorders in the production of sex hormones lead either   to premature maturation, or to its Total absence.

   Medications and the environment. Medications, overheating, some   chemicals (lead, chlorvinyl, gasoline) and radiation can inhibit the ability to fertilize. It is usually not difficult to trace these reasons, but sometimes   the doctor has to Explore the environment in which the patient lives or works. Ability to conceive drugs also reduce, including cocaine and   marijuana, increased smoking and alcohol consumption, Mostly     as a result of their overall deterioration of health. Among the drugs   prescribed by doctors, the greatest (and irreversible) infertility   is caused by   Chemotherapy agents used in cancer Diseases.   Few   other drugs can also cause a temporary deterioration that occurs after stopping their reception.

   Anabolic steroids are likely to be applied the greatest harm - athletes and bodybuilders almost all secretly accept them, trying to hide this fact even when infertility leads them to The doctor. Moreover,     because it is natural to assume that      taken   male   hormones should increase Ability to fertilize, men always   are surprised to learn that in practice everything is the opposite.   Production   sperm stimulate the hormones of the pituitary gland, and not Testosterone. As the main gland of the pituitary gland regulates the production of testosterone by testicles. And if a man additionally takes male hormones, the pituitary gland immediately determines their excess and compensates for it, suppressing the activity of the testicles. As a result, the testicles are lost activity eventually atrophies.

   Infections. Any serious illness, Infections and even a severe   cold at times suppress sperm production, but after 3 months its amount, as rule, it is restored (remember that it takes 72 days to produce sperm). Irreversible sterility as a result of the disease It is much less common than Usually counted men. Mistills instills terrified of the sick, but rarely leads to infertility   (see   chap.   6). Among other infections should be noted syphilis, leprosy (lept) and tuberculosis, sometimes affecting the testicles. More common infections, gonorrhea and chlamydia, leave behind a heborn and blocked   blond duct.

   Antibodies to sperm. Their presence is observed in 3-7%   of infertile   men. They are not always lead to complete sterility, but by all   does not   promote fertilization. The immune system attacks invading organisms with the help of special blood Bodies and proteins called antibodies. Naturally, they are not attack our own cells (for   Except in cases of autoimmune diseases of the type rheumatoid arthritis or   lupus). We protected from such attacks, while still in the womb,   as the developing immune system is “trained” to recognize everything Our   developing tissues are safe. Then it ignores them, but it turns   on and actively acts when any unfamiliar cells appear.

   The baby is born without sperm, so The immune system considers sperm as Strangers. Fortunately, they develop in the testicles,   being isolated   from   blood flow,   where   continuously   Circulation   "patrol" cells of the immune system. If the blood comes into contact with sperm as a result injuries, surgery or chronic infection,   Antibodies attack it immediately. Sperm with   The antibodies attached to them move more slowly and can stick together, but this is not an inevitable consequence. Many men with antibodies in semen are capable of fertilization.

   Expansion of the veins of the spermatic cord. Starting Examination, doctor   first of all will look for this disease - and, perhaps,   will find   him. They are affected by 10 to 15% of healthy   Men   and   30%   infertile,   therefore, the relationship Between disease and   infertility   is obvious.   Urologists   are more likely to consider the expansion of the veins of the spermatic cord cause of infertility than   doctors of others specialties.

   This disease is essentially varicose veins (extension and   weakening) a vein moving away from the testicle. Blood from the left and right testicles is given by separate vessels, but in 90% of cases   the   vein of   the left testicle is affected, because, Before reaching your destination, passes through the upper part of the abdominal cavity. The vein of the right testicle takes place at   a shorter distance. As with vein varicose veins legs and anus (hemorrhoids), the disease develops when thin   venous   the walls   do not   withstand blood pressure. Probing the top of the testicles you can diagnose independently. The zone, felt as a ball of worms, is a varicose veins of the spermatic cord. When performing the "study" Valsalva (breath delay and simultaneous strain) venous The pressure rises and the veins appear more strongly. Many men with this   disease   remain infertile, others have a partial weakening of the ability to fertilize, since the sluggish outflow of blood causes an increase in temperature in the testicles, and this is detrimental to sperm.

 

   DIAGNOSIS: INSPECTION AND TESTS

 

   Every man who   is concerned   infertility,   deserves   a detailed medical record and a thorough   Examination.   The doctor   should   Learn more about past   medical   problems   of the patient,   operations   and bad habits. When inspecting, special attention is paid to the proportions of   the body, the location of the hair (for evidence of hormonal insufficiency or chromosomal abnormalities), and also by genitals. If the length of the spread hands is 5 cm or more exceeds the height, a man belongs   to the eunuchoid type: he did not go through puberty.   Size   the testicles along the long axis should be more than 3.5 See A thorough examination should reveal the presence of a vas deferant duct, the appendages     of the testicles and   Seed   bubbles: although this is Rarely happens, but sometimes they are not from birth.

   The doctor can refer you to general tests urine and blood. More complex Analyses may be required After the semen analysis.

   Sperm Analysis

   After two or three days of abstinence from sexual life man masturbates in a sterile laboratory utensils heated to body temperature.    Content is examined within two hours after receiving sperm, and preferably no later than an hour. Results of the analysis too important,   so the doctor may require two tests.

   The laboratory makes the following records:

   1. The volume of ejaculate should be from 1.5 to 5 m3 (5 cubes is     about a teaspoon). Deviation within These limits do not   play   a big role. Every day Abstinence increases the volume of ejaculate by about 0.4 cm3, but during the week the produced volume is leveled and does not   exceed 5 cubes. More than 95% the seed fluid is the secret of the prostate and seminal vesicles, the presence or absence of sperm are not too noticeable in total amount   of ejaculate.   Here is   Why   men who have undergone vasectomia do not notice changes in the volume of ejaculated   fluid. Small amount of secred sperm indicates blockage or   absence seminal vesicles; an infected prostate can give   excess fluid.

   2. The ejaculate should be opaque, with pearl tint, similar to   egg white. Normal sperm thickens quickly, and in half an hour   it is liquefied. When this happens, it will Drilling with heavy drops. Slow liquefaction or its Absence does not provide conditions for   Rapid   movement sperm.

   3. Number of sperm in normal Ejaculate should range from   20 to 150 million per cm3. The calculation is quite simple,   and   A small amount, apparently, is not as important as thought before. Lower,   limit in the last decade is considered 20 million, although some   experts still prefer Figures from 50 to   60   million   at least. Men with sperm count Less than 20   million   not   necessarily sterile, because doctors today have the method of collection and sperm concentration for subsequent artificial insemination.

   4. The most important indicator of quality sperm - sperm motility - can compensate for their low Number. Laboratory technicians write down two indicators: the number of movements sperm, the norm   is more 50%;   quality   characteristics   of mobility   -   how fast and straight they swim in the seminal fluid. To avoid the influence of individual Perceptions of   laboratories   are used   video cameras,   lasers, computers and special counters.

   5. Sperm morphology: more than 60% Sperm should be normal. Sperm can exist in the astounding variety of sizes and shapes, including multi-headed and Many tailor copies  .   Normal sperm should have an oval head, proportional to the middle and an active tail.

   6. Fructose: if the volume of sperm or   quantity   sperm are   small, the laboratory should be analyzed for this sugar,   which is implemented in the seminal vesicles. The absence of fructose indicates    Blocked duct.

   7. Cultures: Although infections lead to infertility, they disappear long before a person Go to the doctor. But if the study of sperm detects suspicious cells or squeezed sperm, the doctor prescribes sowing culture for the search for pathogens, especially     as Security measures before   artificial   insemination.

   8. Antibodies: Most Infertile   Men   with     the problem of immunity, sperm have normal tests; a minority has molded sperm or obvious deviations in their movement. Because of the direct There is usually no evidence (and because immunology is attractive field of activity for   many   interested   researchers), specialists are increasingly an antibody test is prescribed for infertility examination, and some always do it.

   Best Analysis - After Sexual Intercourse

   Isolated analyses have limitations. V After all, only pregnancy is an irrefutable proof of   that sperm   does its job. Although it is practically achievable, tracking the attempts of sperm Fertilizing the human egg is still a purely research method. Observations of eggs of hamsters give valuable information, but this is a difficult and expensive occupation. Therefore,   the analysis immediately after   the intercourse   remains   the best   and   easily accessible means of proving the ability of a man to fertilization.

   The couple should have sexual intercourse approximately during ovulation of a woman. On the same day, the doctor takes a sample from the mucous of the cervix for microscopic examination. Detection in the field of view of five or more   active spermatozoa provides better   Proof   of a man’s ability to fertilize than any isolated test. Abnormal result shall not be regarded as a final sentence, as in this case Play the role of purely female problems.

   Assessment of hormonal activities

   Because endocrine disorders are not often cause infertility, doctors   do not search them until the tests and the results of the examination   cause suspicions of their presence or will not be found that     sperm   has low density, or when, to grief doctor and patient, routine tests will not give results.

   In addition to measuring testosterone levels, a doctor prescribes   a blood test for   the content of two hormones of the pituitary gland, which control the functioning of   the testicles: follicle-stimulating (FSH) and luteinizing   hormone   (LH).   Abnormal results usually add up in three typical pictures:

   1. Low testosterone and   high   Levels of     pituitary hormones indicate testicular defects. Reacting to low testosterone, the pituitary gland   produces excess FSH and LH in a useless Attempt to stimulate the testicles.

   2. Low testosterone, FSH and LH indicate the disease   itself The pituitary gland. Testosterone remains low despite normal   testicles, due to insufficient pituitary gland stimulation. At least this situation   is found Rarely, such diseases   the Central   Nervous   System   It is quite easy to heal.

   3. Normal or a little overestimated   Testosterone level   along with   with inflated FSH and   LH levels     is a sign of   reduced   Sense of testicles for androgens: hormones are adequate, but sex The cells refuse to respond to them. Occasionally there is an excessive production of another hormone of the pituitary gland - prolactin, whose The action on men is still unclear. It has to do with   Rarely   encountered   tumors   pituitary gland   along   with the effect of drugs and other hidden diseases. Excess prolactin is able to suppress other hormones, so Doctors can measure your   and level.

   Just as the body produces a small amount of   male hormones, men produce estradiol,   The female   hormone.   Men   with reduced sensitivity to androgens produce it too much; the same action have rare cases of tumors of the testicles or adrenal glands, but the main culprit There are liver diseases. Normally functioning liver reduces the level of estradiol, and the patient   works   more slowly, why and its content increases in the blood. Alcoholics   with         cirrhosis       

   More Complicated Assations

   Chromosomal analysis. One of the 500 man born with an extra X chromosome: its chromosomal set - XXY   instead of   XY,     which is called   Klinefelter syndrome. Being in the rest relationships by healthy people, such men outwardly may be no different from others, and sometimes look a few feminine, but they all have small testicles and they are always infertile. For Diagnosis of this and other rare laboratory deviations are grown cells such a patient on the tissue culture, then processed them for visualization chromosomes and count (a person has 46 pairs) under a microscope. Similar anomalies are sometimes detected in people with   small testicles or small quantities sperm. Physically normal people are very rare.

   Treatment may improve appearance or potency, but infertility in   men with chromosome disorders is incurable.

   Testicular biopsy. It's simple "Cubit" procedure, when   the doctor   takes a sample in the form of a small piece and directs its pathologist for examination under a microscope. In contrast to the priority of this procedure when looking for a tumor, in the treatment of infertility, it stands     at the end   of the list   all sorts of tests and tests. If in    Ejaculate   of the patient   number   normal spermatozoa is enough, the probability A certain pathology   of the testicles   is very low.

   If a man with normal testicles produces sufficient sperm volume, but containing few sperm, doctor will consider the possibility of a biopsy. If microscopic analysis does not detect signs of sperm production, then, most likely, a man was born with that   defect.     In this case, no treatment here will help.

   If the study shows that sperm normal, so somewhere on the Fracture The duct is covered.

   Check for blockage: vasogram. Making vasogram, doctor, as with   angiography of the coronary arteries, inject     in the traction   of contrast   substance (after a small incision in the scrotum) and monitors its   passage   with   the help of X-ray machine, noting the place of blockage. In principle,   vasogram is a simple procedure, but a doctor must be   very   skillful,   to get into a thin vas deferred duct, not damaging its delicate   walls   and not touching anything Ways. A well-trained and experienced surgeon performs this procedure, with a number of tools and an operating microscope to quickly eliminate the detected blockage (and correct any   damage caused by the procedure itself).

   Some experts are looking for a blockage, doing   in the duct, a small   hole for the purpose of taking sampling of the liquid. The presence of sperm in the sample confirms that the blockage is further. The doctor can Inject a   physiological solution into the duct: If it runs to the end, then the duct is free.   Otherwise, the doctor can insert the thinnest catheter into the duct and   Entry to find a place of blockage. The vasogram is made only then,   if the survey data do not give results.

   Grass test. If the sperm looks Normal and other   studies both partners did not reveal anything suspicious, doctors suggest that Sperm has hidden defects. Although monitoring of the introduction of a sperm in an egg became routine in clinics dealing with in vitro fertilization, the usual   Doctors     are not   Smiling perspective to collect   from women   eggs   exclusively for     analysis. The practical replacement for it was the eggs of the female hamster of ordinary.

   Intact hamster eggs Accept only   the sperm of   the hamster. Laboratory treated them with enzymes that dissolve the outer coating   of zona pellucida. This cover is surrounded by egg   and   women,   and   any other mammal precisely in order to prevent fertilization with   foreign sperm, and also prevents penetration   into the egg of more than one sperm. After mixing hamster eggs with   human sperm, laboratory technicians write   percentage   of eggs,   in     which infiltrated sperm, as well as the amount   sperm who   successfully   attacked them.

   This is a complex test, so the experts in different laboratories are used to obtain results different methods. However, there is a general   agreement: fruitless Recognized sperm that is introduced   Less   than   10% of those treated protective membrane of hamster eggs. Successful passing of this test is good Sign, although some men and   a positive result is still almost infertile by   incomprehensible   More reasons. Negative result, at least and   dissatisses,   not   is a final sentence. From 5 to 10% such men are still capable of childbearing with the help of technologies of concentration sperm   or   in vitro in vitro.

   After all the tests. Despite the permanent growth of diagnostic capabilities, doctors are able to find causes of infertility Only 60%   of men. Over time, we will learn more, but for   remaining   40%   forecast   Not hopeless. If they continue Attempts, a quarter of them will be fathers.

 

   SURGICAL WAYS OF TREATMENT

 

   Cutting Extended Veins of Seed Rope - varicocelectomy. The most common surgical method of treatment Infertility     in men improves quality sperm in more than two-thirds of cases;   50%   of   these Men become fathers for the next few years.

   Compared to foot surgery for Varicose veins evaporative Sedition Scanning Operation It requires more skill. Urologists can choose one of the following methods:

   1. Traditional. Through an incision in the groin surgeon Access to   the seed rope. Carefully bypassing the artery, nerves, lymphatic ducts   and a vas deferred   duct,   He's   putting   on the ligament   on   a swollen    vein. Most urologists prefer this   method,   some   use of local or cerebrospinal anesthesia (this is always preferable to general anesthesia). The man spends several in the hospital days. The operation   takes about half an hour It is considered   safe,   although   Occasionally there   is damage to other structures of the vas deferens. As with any operation extended varicose veins, the main complication is relapses (10-20% cases). They are not serious, but they require a second operation.

   2. Microsurgery. Performing the operation through much smaller incision, the surgeon uses an operating microscope, receiving the possibility of much   clearer and close review of the cord, so that it can easily determine and cut small vessels without risk of     harm   surrounding structures. Complications and recurrence of more Rare than traditional   surgery. The patient can go home the same day.

   3. Blocking veins with a cylinder. Surgeon makes   a small   incision     in the groin (approximately 1.3 cm) to gain access to the large femur vein,   in which a long flexible catheter is introduced, directing it   up to    renal vein, and then down to the vein of the testicle.   Checking   their   actions   with   X-ray, he is convinced that the catheter in the right place, and inflates   the its end is a removable cylinder, blocking the bloated vein. Removing the catheter, surgeon Leaves the balloon in the vein forever. This procedure is carried out in the office under local anesthesia and is worth   it to use if you hate the idea of surgery. Conducting   a catheter to the desired point may take 1-2 hours -   much   More   than   traditional surgery, and the final   result is   the same.   Relapses   are about 10%. Sometimes the balloon bursts,   and   air   with   a stream of blood enters the heart, coming from there to the lungs, where and remains. At least that's enough a rare case, but it is very similar     the consequences   of pulmonary embolism or thrombosis is a serious complication.

   4. Cleaning the blocked ducts. Using an operating microscope, the urologist can remove or make a detour blocked area of   the testicular appendage and the vas deferensive duct.   Unlocking   the duct   allows sperm to reach the exit, but does not guarantee the ability to   fertilize. For example, the appendage of the testicle often blocked   due to   scarring   as a result of a disease transmitted sexually.    Surgeon   eliminates blockage, but the appendage of the testicle is usually already damaged by infection -   and   sperm for maturation should Be in a healthy appendage. Only   from   15   to 20% of men, who have suffered an infection of this kind, after the operation restore the ability to fertilization.

   The best results are made when ducts are healthy in all respects, except blockage as such. Damage ducts can occur after unsuccessful operations for hernias and are natural with   a vasectomy. In both cases The ability to fertilize is restored.

 

   MEDICAL TREATMENT

 

   Men and women produce the same male and female sex hormones, only their proportions differ. It follows that infertile men and women can treat the same hormones, only women respond to treatment better. A thorough defect of the glands can sometimes make a woman infertile, but more often she has changes in   the schedule of increase and decrease of hormonal levels, mandatory for ovulation. Adjust This violation is not very difficult. And here Men hormonal disorders are rarely simple and easily correctable.

   Treatment of hypogonadotropic decrease internal secretion   of the sex glands. Although in this definition, the tongue can be broken,   It   most   accurately characterizes everything cases of hormonal insufficiency. More simply   this violation can be Call a "weakened function   sex   glands   (gonadia)", which is the cause of different forms of infertility. Gonads are the sex   glands: the testicles in men, the ovaries in   women.   Definition   "hypogonadotropic" indicates the cause this disorder. The word "gonadotropic" means "influencing on the sex glands", "hypo" - "lowered"; This effect is carried out by pituitary hormones FSH and LH. Hormonal level analysis with a type 2 result (see section above "Assessment of hormonal activity") - with reduced levels of testosterone, FSH and LH - indicates a hypogonadotropic decrease in internal secretion of the sex glands.

   In men with such deviations, usually Underdeveloped testicles.   For correction follows taking CG -   human   chorionic   gonadotropin in   injections three times a week. Ideal would be natural    LH,   but its extraction - from the pituitary gland or urine of a woman in a state of   postmenopause - is very difficult. Genetic engineering has already derived a bacterium that produces   LH, so in the near The future will be its source. In the meantime, doctors use CG, produced in Large Numbers   of Pregnant   Women   and similar to LH.

   After 6 or more months, when the testicles will return to normal, the doctor will add the hormone FSH to injections to stimulate sperm production. Will pass more   many months before the number Sperm will become acceptable - from   2 to 5 million. Although it is, in principle, quite   low   Indicators,   sperm quality will increase so much that about 50% of these men will gain the ability to fatherhood.

   Clomifen (cloned). Often helping women, This drug   seems to be the head of a list of funds prescribed to infertile men,   although they have its effect Below. Klomiphei stimulates the production of LH and FSH. A few months after the start of treatment, almost all patients are observed increase in the number of sperm and testosterone levels.   Such   Improvement contributes to moral satisfaction and maintains   the unchanging   popularity of the drug, but, nevertheless, not has   a special   impact   the ability to conceive.

   Bromocriptine. The drug normalizes increased     prolactin levels   in the blood, restoring the ability to fertilization and potency. At   normal the level of prolactin treatment does not give results.

   Testosterone. Male hormones do not increase sperm production,     but , on the contrary, suppressed his; but men sometimes take a course   hormones   to provoke a "testosterone jump". After 3 months reception ceases; it is assumed that what will happen "leap" to the upper level in the production of sperm. The authors of the method, like many other "genital" Developers, at one time published the most brilliant results of research.     The rest of the The researchers success was much less, but   taking testosterone looks so justified, that it is still used, although   less and less.

   Vitamins, mineral preparations, zinc, food additives, exercises,   etc. Evidence that all these treatment options help are not yet there,   but they, unlike other funds listed, cheap and harmless. Many Disappointed Men accept them.

   Treatment of retrograde ejaculation. Ordinary funds from the common cold   (Sudafed, "Ornade", "Teldrin") reduce the swelling of the tissues of the nose, stimulate the corresponding nerve endings. Nerves of the same type control the   compression of the cervix of the bladder, so a course of anti-cold drugs   sometimes helps prevent the throwing of sperm into the bladder. Other experts   prefer to use small doses antidepressants (such as "Tofranila"), prescribing 50 mg daily.

   If the drugs do not work, doctors can Identify sperm from   the urinary bubble. In its usually acidic environment, sperm dies; to create an alkaline the environment of a man before ejaculation takes   high   dose   of bicarbonate   Sodium (Food soda). After extraction from the bubble Sperm is washed,   concentrated and used for artificial insemination.

   Sperm treatment

   Over the past decade, experts   have developed   good   ways to improve the quality of sperm both by extracting and concentrating healthy sperm, and by removing abnormal and   harmful   elements. Among these methods, we note the following:

   Selection of the best (active) part of sperm. The laboratory technician places sperm on the bottom of the test tube. The most energetic sperm float   up  , where They are collected for subsequent procedure of artificial insemination; less active remain in Vigol. Depending on     the   in   each clinic methods selected sperm can filter, passing through Fiber filters silicon powder, and increase its mobility by   passing through a mixture of proteins.

   Sperm washing. Sperm with additive special liquid is placed in   a centrifuge, where it is concentrated in a special receiver.   After   Distillation of the laboratory technician again dilutes sperm in A solution designed for artificial Fertilization. In the clinic can wash sperm   several times to completely remove chemicals, dead sperm,   blood cells and other pollution.

   Removal of antibodies. Because the antibody stuck to   sperm,   then they remain in sperm and after concentration, and after the primary   washed. If the sperm looks healthy, the doctor can   begin   to     Artificial Procedure Fertilization. If it is necessary to remove antibodies,   a man will have to take a course cortisone treatment to suppress the immune   systems - only after that he will be taken sperm for further processing.

 

 

   Chapter 12

   MAN AND HIS DOCTOR

 

   Approximately 50% of patients come to the reception with respiratory infections, cold, flu, stomach upset or other equally common lungs ailments. Diagnosis     in such   cases   are obvious as soon as the patient lists the symptoms.

   Beginners often immediately tell him   to the patient,   but   it is enough soon find that inexperienced people such a skill   of diagnosis is impressive   Much   less   than   colleagues.   Some   patients feel ashamed to learn that the situation is so   simple that it was hardly worth it to bother the doctor with his arrival. Others begin to doubt why the doctor is so quickly makes a diagnosis without evenking   no questions and not examining the patient - or he incompetent, or is he lazy to engage in a patient as it should, whether he is in a hurry and wants to quickly   get out.

   Therefore, a wise doctor even to   a routine experiment   Diseases   are taken externally very seriously. He asks questions   (more   than   necessary) conducts an examination (even if it is not necessary at all:   this   the procedure   also has a therapeutic effect) and only then announces a diagnosis and   prescribes treatment. If with a number of lungs Viral Infections   or   Small   Injuries doctor assures you that soon everything will pass You   don't   need to, he says the saint truth, but very few patients feel relieved in these words.

 

   THE WITNESS OF MUMBO-YUMBO, OR RITUAL

 

   Doctors save lives, cure diseases, Relieve suffering and perform many other equally noble functions, and   also   involved in   what cynic doctors call "mumbo-yumboo", and I   prefer   Named a ritual. By this term I mean actions of doctors not to improve diagnosis or cure of the disease, and only to the patient's sensation, What really does a well-known doctor in front of him.

   Almost every person who has come to doctor, involuntarily expects from him some action. Young Doctors are sincerely convinced that they perform their task well, putting the correct diagnosis and explaining to the patient what to expect in the future. Therefore They are always unpleasantly surprised,   When   most patients, leaving, very dryly, thank them very dryly. The fact is that many doctors are very sensitive to the expressions of gratitude and attach great importance to Patient behavior   at the end   of the reception.   A Clearly   Satisfied   Patient Always Demonstrates this to the doctor. And the polite and cold “thank you” usually serves as the only and convincing proof of deep   disappointment and discontent.

   Leaving the school, young   American   The doctor   is convinced that   encouragement and training Patients with the correct behavior are   the necessary part of the patient's care. However, patients are looking at work the doctor from a completely different point of view, and this is especially evident in the lungs Diseases. Patients like it when they are prescribed medications, so many doctors abuse prescriptions, as Western culture provides that at the reception you are required to prescribe a certain medicine - no matter what.

   Acupuncture specialist stumbles You   with your   needles,   the nutritionist will give a lot of nutritional instructions, and If you come to the shaman,   he will do what he should do to the shaman. In any   society   the healer must heal, which presupposes some actions. Traditionally, no doctor will say, that for some time you will be   feeling   unimportant, and then it will become better, and no manipulation of his manipulation will accelerate the course of events. Being a scientific discipline, medicine does not at all oblige   doctors to any actions, if they know that in this case nothing will help - but how difficult it is to resist the temptation! And the patient with strong cough, ugly rash or red   will not   believe the eyes   That's the   words of the doctor.

   I'm catching myself on what I'm explaining patient than   he   is sick, where he picked up disease, how it will proceed further, how to treat it with home remedies and etc., and at the same time I think to myself:   "Yes,   he's   not listening... He needs The recipe... Maybe write him   Anything   harmless? “Sometimes I do that. And - oh miracle!   the patient   immediately   becomes easier and before leaving, he rewards me with express expressions of the deepest   gratitude. Honestly, I'm not so generous to certain   medications, like most colleagues, and especially careful with antibiotics.

   Most often antibiotics act Exclusively as a placebo. Doctors prescribe them for colds, flu, cough viral origin and sore throats, and in such cases, antibiotics are useless. After reading   this   statement, the inexperienced skeptics will I am sure that I have only expressed my own opinion. I won't argue. But in fact, the appointment of   antibiotics for viral infections was so common   that   it can be use as a measure of the competence of the doctor. Even good doctors sometimes sin this.

 

   WHAT TO DO IF YOU’RE GIVEN TOO MUCH MEDICINES

 

   Doing nothing is a reasonable tactic. as, indeed, in the solution of many other problems.

   If you don't want to be discharged unwanted medications,     at the very beginning of the reception give the doctor understand that you are different from the "average" patient, and in Remind him of it from time to time. Talking about your disease, insert something like: "I've been coughing for   a week, and it's bothering me. I would like to know if there is a real reason for   worry, and anything can be done. If everything goes by itself I won’t need antibiotics.” If it sounds like a hint     of how   it should   Acting   Doctor in    your   case,   then,   You will achieve the desired result.

   Ask yourself more often, "Do I need it Is that really?" Aspirin takes off in a couple of hours Acute pain. Coughing does not   Heals   a cough,   but only suppress it. Antihistamines do not cure allergies, they relieve the severity of the attack. Cortisone facilitates almost everything in the world,   but nothing cures. Reduced severity of symptoms   -   quite   the legal   and appropriate effect of medicine, so symptomatic treatment   is not   will necessarily be an “extraordinary appointment”,   but   Doctors,   wanting   to facilitate   Your suffering, can overdo it. If The   symptoms you experience   are tolerable enough, tell the doctor about it, but   not   decide   for yourself whether to take a medicine or not.

 

   ANALYSIS

 

   For most of our century, when   the laboratory   received a test tube with blood, a laboratory technician sitting surrounded by bottles   with   reagents, weights and a few simple devices, performed any analysis   that the doctor ordered. It took 5 to 10 minutes.

   In the 60-ies in the laboratories appeared truly wonderful   equipment   multiphase analyzers, known for the name "Coult's counter", which at one end downloaded a portion of blood and passed it through any quantity chemical reagents using electronic and colorimetric processing of the sample, and then at the other end issued a printout containing   half a dozen to Dozens of data.

   Most prints are dotted with such comments,   since (see Chapter 5) of at least 5% of the results of the tests performed for   a healthy person always go beyond the tolerances.   As a result   Each   such patient is at the reception, shaking a printout, and I have to study   it, convince a person that:

   - he has too low urea, but it's does not matter;

   - leukocytes are understated, but it can be consequence of an ordinary   cold. However, we will repeat the analysis;

   - the alkaline phosphatase of his son is high, but for the child is normally   growing bones produce it in large quantities;

   - his lactate-dehydroginase is high, but This analysis does not accurately determine its level. Usually this is not It is of   great   importance. However, we will repeat the analysis;

   - the level of thyroid hormone of his wife increased because she takes birth control pills. When   used   Estrogen   data analysis is always overestimated compared to the real state of affairs;

   - the level of sugar in his blood is lower than the this laboratory   of norms, but according to other standards is normal;

   - phosphorus is low, but in healthy a person with normal   content Calcium probably doesn’t mean anything, but we’re going to   repeat the analysis. #5

   Over time,   doctors   Recognized   that   numerous   analyses   It is more likely to create problems than Help them solve them. We spend a lot of time explaining the trivial deviations from   the norm   and   Repetition of tests, not even finding minor diseases. Therefore   so popular in the 70's multiphase tests began to go out of fashion.

 

   WHY TESTS CAUSE SO MANY COMPLAINTS

 

   It’s easy to see why ordinary people perceive the results of the tests with such seriousness. First, the tests are performed   with   Help   from the road   and complex equipment, and The majority of Americans are deeply convinced that   information obtained through developed technologies is obliged to   deserve Attention and trust. Secondly, the actions of the doctor are always surrounded by   a certain   mystery, and therefore it is difficult for an inexperienced person to guess   that   they actually mean; printout Deciphering is not difficult. Doesn't the high sugar level indicate Diabetes?   Isn't   the ECG   does not   detect Heart disease? And the answer to both questions is as follows: sometimes yes, and sometimes and no! No analysis is able to respond   to everything   Questions.   Röntgen The stomach will not tell us all that should be known about it.   A urine test can reveal something, testifying to     kidney disease, but it is possible through sick kidneys secrete normal urine.

   Despite the natural Restrictions   and   abuse of opportunities, analyses have an important importance. I will explain to you what   follows Know about the most common analyses.

   Full count of blood cells. This   analysis   involves   measuring a lot of parameters, but the machine is controlled with them with so easily that no one orders a simple count of hemoglobin or   leukocytes. In fact, the electronic meters of blood components have significantly advanced us forward. In former times, when counting the components of blood, the laboratory assistant sat, buried in a microscope, and counted blood cells almost on his fingers. Machine Not only saves time and labor costs - it does this   work much more accurately.

   The calculation covers all forms (i.e. visible) elements of blood.   This includes red blood cells (erythrocytes),   with   half a dozen   types of   white blood cells (leukocytes), platelets and rare cases in the U.S., but   a source of great concern if they found - various   body parasites.

   Erythrocytes are transferred from lungs to tissues oxygen, in exchange, taking   from them carbon dioxide and returning it to the lungs. Men usually   have about 5 million red blood cells in 1 mm3 blood (from 4.5 to 5.7 million).   Counting also takes into account hemoglobin - protein in red blood cells, carrying   gases. The norm for men is 14-17 g on 100   ml.   Another     counting parameter - hematocrit - accurately calculated the amount of red blood cells   in   certain volume of blood (41-50%).

   It may seem that counting erythrocytes,   hemoglobin   and hematocrit measures the same size, but in fact, the knowledge of these three parameters allows in the future to carry   out certain   Calculations. For example, the division of hematocrit into The number of red blood cells gives the actual volume of one cell. Some diseases, such as iron deficiency, lead to formation abnormally   small   red blood cells;   vitamin B2 deficiency, on the contrary, too much of their size. Therefore, the actual corpuscular volume is very useful parameter.

   When the number of red blood cells, and therefore hemoglobin in the blood   falls below normal, anemia occurs (alaboria). The term "anemia", with my point of view, rather describes the result laboratory analysis, which serves as a diagnosis. Anemia can be provoked by good Hundreds of different disorders, and the duty of the doctor to find Exactly the one that leads     to her   each individual patient. Some cases anemia are congenital, incurable and sometimes harmless, others can Indicate the presence of serious diseases, such as cancerous tumors. Anemia never occur due to stress or fatigue, except In the United States, it is almost never   a consequence of poor nutrition.

   Anemia is an unhealthy state, but it is   And and   its   opposite, polycythemia (Increased number of red blood cells). Too many erythrocytes reduce blood activity and contributes to the formation of   clots (thrombi). The polycythem is emerging with   several   unprepared blood diseases, as well as in conditions when the tissues are not   received   sufficient amount of oxygen (accommodation on   a large   height,   for example, or severe lung or heart disease). But much   more often   hematocrit of order, say, 54, characterizes The faint smoker.

   Leukocytes are involved in immune reactions. V blood is usually   present at least half a dozen varieties of these cells,   in this   number   of monocytes, neutrophils, eosinophils, etc. Number   leukocytes   should   be 4-10 thousand per ml. During infection, this indicator can double or even triple, but sometimes drops to 3 thousand per ml - it means that either   the infection suppressed the production of leukocytes The bone marrow, or they   gathered in the focus of infection, as a result of which their concentration in   the bloodstream decreased. Low Levels of leukocytes are detected in immune disorders or in case of impaired function bone marrow (where they   are formed) due to infection, malignant formations or the effects of drugs.

   Some doctors are convinced that the high the level of leukocytes indicates a bacterial infection, and a low - Viral.   It's   not   It's all right. The level of leukocytes is I'm only interested if I'm not sure, Is there an infection at all. Abnormal level     the obvious infectious the patient does not prove anything and   does not   help   in the treatment.

   Leukocyte blood formula. Although the cars in Most cases   work better human, counting of different types of leukocytes     It still   remains the lot of laboratory technicians who consider them under a microscope.   In the majority   This is duplicate information, but sometimes It is useful to know the difference between the number of cells of different types. Too A large number of eosinophils clearly indicates a severe allergic reaction   or   parasitic infection. If the number of leukocytes is normal, but among them are dominated young (immature) cells, which means that the body is trying to fight     infection. When a laboratory assistant notices atypical   lymphocytes,   then    the patient is most likely infectious mononucleosis. More I repeat, the doctor should rely more on your head than laboratory   analysis.   Mononucleosis, as a rule, leads to the formation of a large   number   of atypical lymphocytes, but the same Occurs in some other   viral Infections.

   Thus, the difference in the number of types leukocytes,   which is called leukocyte blood formula, can serve as a hint of   the presence of various diseases, but rarely helps to put   A clear   diagnosis.

   Why you should not do tests without sufficient reasons. 20 years   ago, when I was a full-time doctor of the clinic, to us   The   young man with     a small injury. Although it was not required, his   The attending   physician   prescribed several blood tests, including a full calculation of blood cells. All results were normal,   except   for the latter,     which       terrified everyone. According to the calculation, the young man had leukemia (Clood cancer).

   Primitive bone marrow cells, Red and White   Blood body, usually not circulating in the bloodstream. With leukemia, they are divided into Extraordinary quantity and therefore   Frequently   in    blood flow,   which is usually found by a laboratory assistant that   determines leukocyte   blood formula under a microscope. Leukematic Cells can appear in the blood months or even years before a person feels   like   Sick.   And that young man felt great.

   You think he's lucky we found is he leukemia so   early? It's right! For the treatment of some forms of leukemia, there are effective   drugs, but there was no form of treatment for its form of treatment. Naturally, no one wanted   to tell him this news: neither his   doctor,   nor   the head of   the department,   not the main doctor of the clinic. Having suffered, they It was told to the patient that his blood test revealed "a certain deviation", and gave direction to the hematological Clinic. What happened to that guy in the future,   I   never knew.

   Platelets are small fragments of   cells,     which are collected   at the places of damage blood vessels in order to initiate   the formation of a clot (blood clotting). Because blood clot-related   diseases are not common,   the analyzer   usually   ignores platelets, unless it is programmed specifically for their calculation. When determining the leukocyte blood formula, the laboratory technician views the slide and writes a comment to it - as a rule, this is a standard formulation "throbleclowers in adequate quantity."

   Blood lipids: Triglycerides; low and High   density   of cholesterol. lipid analysis (the most useful blood test for   a healthy   Human) predicts a predisposition of a person Atherosclerosis   and   its   consequences.

   Triglycerides are the medical name for fats. U - each of us in the blood circulates a certain amount fat, the level of which increases after eating, so before handing over blood, should not be eaten from   the evening. 20 years ago at triglycerides from 150 to 175 mg per 100 cm3 was considered, The patient is at high risk. V   the difference   from   cholesterol, the norm of which was reduced, in relation to triglycerides, doctors   have shown much greater liberalism, and now we We do not worry until   their   level reaches 250 mg.

   Opinions in medicine are constantly changing. 20 years when finding out the risk of atherosclerosis Triglycerides were considered at least important   than   cholesterol, but today doctors are not so Convinced of this. Confirmation of doubts was given by some studies, although The results were not as comprehensive as for cholesterol. But, although not Doctors, no writers-popularizers spend much effort on accusing triglycerides, you better   keep their level not higher than 100. Reaching low triglyceride levels It is easier than lowering cholesterol. This is achieved through   diet   with low fat. Most men with high triglycerides are overweight and should Constantly fighting it.

   Cholesterol is that material, which is deposited   on the walls of blood vessels with atherosclerosis. Cholesterol   is contained   in animal (and not plant) tissues, but your body   also   produces it as a necessary ingredient for   cortisone synthesis   and   sex hormones. Food cholesterol plays a less significant role in atherosclerosis, than your own, so   Dietary   changes   are not   strongly affect the level of cholesterol in the blood. V communication with this donated   blood   for cholesterol is not Definitely on an empty stomach. The doctor should prescribe such an analysis at your first visit. If the level   exceeds   Norm (  i.e. above 200 - cm. g. 2), then the analysis should be repeated approximately every 5 years.

   Low and high cholesterol density. If You have already read something about cholesterol, you probably know about different   types   of types:   high-density lipoprotein cholesterol - "good" (HDL), and low-density lipoprotein - "bad" (LDL). In borderline states, measuring the level of subtypes can help in choosing treatment. For example, if total cholesterol levels 220 (not very good), but HDL high, things are not so bad: your risk is about atherosclerosis is approximately equal to the risk at a total level of 200. However, as soon as the overall level will be below 180, the level of components   will cease to play any role, and the risk It'll be abruptly down.

   Glucose (sugar in the blood). Normally, the level Glucose is within from 60 to 100 mg per 100 cm3 blood (coming on an empty-rise).   A slight   decrease (a little less than 60) probably doesn’t matter much. "Nazeshchak" in this case, it means that before the analysis, the patient did not eat for 8 hours, but even after a few days of fasting, blood glucose remains   in   the norm , since this level is necessary for Eating Tissues. In the absence of food, the body begins break down muscle tissue and fat to obtain   of   them glucose. After eating, the glucose level rises moderately, but   during the   3 hours should return to normal.

   Hormone, called insulin, allows glucose passes   from   the blood directly to Cells. When insulin is too little,   tissues     have difficulty groving glucose from the blood, as a result of which its blood levels after a meal rises stronger and returns to normal much later than   under normal conditions. In diabetes "hungry" glucose is higher   norms (fortunately, the brain and heart do not require normal operation of the mandatory presence of insulin and continue to eat normally even with severe diabetes). In diabetes of medium Degree there is no special   symptoms,   but   with increased sugar in blood kidneys intensively try to get rid of the surplus, and the patient notices that hesna urinates more than usual. If the kidneys are healthy, sugar does not appear in the urine until its level   in the blood exceeds 200 mg. Increased urination requires additional   fluid, Therefore, the patient has a feeling of thirst, and he   is more   Drinking. Tissues without getting enough of blood the amount of glucose, begin   to starve, The patient loses weight.

   Diagnosed and Rediscipitated diabetes. Being   the most   common hormonal disease, Diabetes affects 1 to 2% of the population, while the risk increases with age. With The presence of symptoms   of stabilization of the condition It's easy. Availability in one glucose analysis with a level above 200, accompanied by feeling thirst, increased urination and weight loss - conditions sufficient to make a diagnosis.

   The situation is more difficult if the patient is good   Feeling   (i.e.   in the absence of symptoms). Doctors often forget that it is impossible to diagnose a serious disease   on the basis of   the only   laboratory analysis in the absence of other evidence (which I mean by "Rediscipment"). Diagnosis of "diabetes" in humans, not Having   symptoms require at least the measure of two tests of "hungry" glucose, exceeding the level of 140. If glucose does not reach this level, but in both cases exceeds 110, the doctor should assign the so-called analysis for   "sugar curve" (glucose tolerability). Arriving at the Laboratory in the morning   on an empty stomach, the patient drinks a solution, containing 75 g of glucose, after which the laboratory technician takes from it within 2 hours Blood   with   half an hour   intervals. If 2 hours later (and at least one earlier glucose remains at the level of 200 and above - you can diagnose diabetes.

   Any level below 200, but above the norm,   indicates    Violation of glucose tolerance. This is not average degree of diabetes, and not early diabetes and not borderline with diabetes, but A sinister diagnosis that depresses many patients. Three-quarters of people with   violation     Glucose tolerances never get diabetes, but almost every one is overweight , increasing the risk of diabetes and some other diseases. Treatment of glucose tolerance disorder is   a weight loss: loss 4-8 kg often returns blood sugar to normal.

   Using Sugar Data in blood. This test   is prescribed to monitor the results of diabetes treatment. Because diabetes can   occur without symptoms, it is wise to include it in periodic   medical examinations,   and doctors often and do it. However, almost every adult,   A   diabetic suffers from Excess weight. Of course, full   Men   should   get rid of the surplus. When they have diabetes develops,     the best treatment is not drugs or insulin, but it is the loss of excess weight, therefore, the purpose of the analysis will not change method of treatment.

 

   URINE ANALYSIS

 

   Like a blood test, urine test is not reveals something special. According to the usual   analysis   urine   is checked   approximately   half a dozen   parameters.    In most cases Analysis is done by   the indicator   strip of   the plastic plate on which is pasted paper squares impregnated with various reagents that change the color of the immersion in   a urine test. Execution The analysis takes one minute.

   Despite the simplicity, urine analysis is not Justifies costs,   with the exception of fulfilling it for patients with increased risk of renal diseases - Diabetics and Pregnant Women.

   I will list the most important elements checked When analyzing urine.

   Squirrel. Healthy Kidneys Filtertain with   such   Efficiency that almost no large molecules, like squirrels, do not   get into the urine. Detection of large molecules in the urine   Indicates     deviations   from the norm, but not necessarily ominous   sign,   because   protein can also occur during viral infections such as influenza, and at high temperature, and even After a lot of physical activity. Indications of indicator strips always quite rough, and in case of detection of protein, changes in color indicate or on    Traces  , or   on   small,   medium   or large of it Quantity. Doctors often ignore the presence of traces and even small amounts of protein. If the doctor considers it necessary   to carry out   more   detailed analysis, The next step will be to collect "daily urine"   to measure the exact volume of the protein and determine his type.

   Glucose. The analysis is traditional, but surprising Useless.   As I   said, glucose is not gets into the urine as long as its level in   blood will not exceed 200, and therefore the indicator stripes are not able to   detect the early stages of diabetes.

   Blood. Blood in the urine can sometimes (but not Always!) appear   with   infections of the kidneys, bladder or   prostate,   with   internal   injuries, for example, from kidney stones, or in the presence of malignant formations in the urinary tract. Such education with   age   become more common, some experts encourage This analysis in elderly patients.

   Checking the presence of blood in the urine helps, If   I   I suspect   kidney stones   from a patient with Back or side pain. Infections analysis   less useful because the symptoms in most The cases are obvious.

   Nitrites, leicy esterase. These Substances are sometimes found in infected urine. They belong to the group of results that are useful only in the case of Positive response.

   Ketons. They appear in the urine when Tissues   begin   to break down   fat for energy production. Although it's occurs in typical cases of   diabetes getting out of control, I had to face this phenomenon and in patients with influenza or gastroenteritis, who   for some reason did not receive food. When starvation lasting even less than one day, the body manages to spend all the accumulated carbohydrates and begins to burn Fat.

   Bilirubin (bile). Spleen removes from blood of old red blood cells, breaks them down, returning iron to circulation,     and then   converts hemoglobin into bilirubin, which is also Returns to the blood. Bilirubin enters the liver that uses it for production of bile, secreted later into the small intestines for the best Assimilation of fats. Sick liver has difficulty absorbing bilirubin, so   its   level in the blood increases, and in the end The account falls     into the urine.   Urine containing bilirubin acquires   brown   color,   so   usually   I foresee the result of the analysis before, how the indicator will change the color to a positive, but in Anyway, it's a good, quick test for hepatitis.

   pH and urobilinogen. These figures, although are included in almost all indicator strips, almost useless. pH   (hydrogen   ) measures the acidity or alkalinity of urine,     which vary by nutrition and as a result many   diseases.   I AM   I don’t   remember the fact that the pH knowledge has helped me in any way.

   I also think that in my life I have about 10 times     paid attention to urobilinogen for the sole purpose of remembering   what   It   means. Having written these lines, I have to confirm that I forgot it again,   so I will have to go back to the directory. So, the bacteria   of the rectum   break down some the amount of bile and form urobilinogen,   which is then reabsorbed into the blood, after or     absorbed   liver or excreted with urine. Different Blood and liver disease   can increase the level of urobillogen in the urine.

   The share. urine is slightly denser than water, and Indicator stripe is easy Measures its density. If you consume a lot of liquid, specific   Urine weight drops; dehydration increases it. Diseases can lead to either increase or decrease in the specific weight of urine, but   this   Information is rarely beneficial.

   Precipitation, or "microscopic "Research." This study   is usually included in all types of urine tests and is   perhaps   the only useful for the doctor who suspects the patient's   disease   urethra. The laboratory assistant puts urine in the test tube, puts it in   the centrifuge, drives away the liquid component, and the sediment is considered under a microscope. Availability of more than several leukocytes increase the suspicion of infection and inflammatory disease. The presence of more than a few erythrocytes indicates bleeding, even if it is not opened by the indicator strip. Sick kidneys lose their own cells and other wastes detected in result of centrifugation.

   Under the microscope are also found bacteria, but we do not attach much importance to it, since the urine is taken for analysis very often is polluted. Usually the doctor prescribes treatment, When a patient   has symptoms infections, and the analysis of the sediment reveals leukocytes.   Confirmation of   bacterial   infection   requires   a few   days     Growing a culture of bacteria. When the urine is contaminated, the culture will detect either a mixture of   bacteria or those that usually do not cause infections of   the urethra. тракта.

 

   WHAT SHOWS THE ELECTRIC CARDIOGRAM

 

   Of all the tests and tests done on reception, the ECG usually   introduces for the first time patients with miracles of developed technology. No pain, no irradiation. The patient is conveniently arranged on the couch or on the table, to his wrists, ankles and chest attach electrodes with wires   going to a small apparatus that is attached to a small device that Quiet buzzes, squeezes and spits out the meter of paper tape, painted with bizarre squirrels. According to many inexperienced people, This tape records   all the secrets of their heart.

   Cardiogram really something writes, but, like other tests and tests, does not able to measure everything possible. In order of   measurement accuracy, there are three aspects of cardiac function, Doctors pay attention to first.

   The most accurate measurements: heart rate reductions   (electric activity, or rhythm). If your heart beats arrhythmically,   passing blows or, conversely, a high-rise rhythm, then an ECG very accurately and in detail  , that is actually happening. The doctor can determine   Source of   abnormal electrical signals, the way   of their   passage   through   the heart, the degree of seriousness in each individual case of arrhythmia (such   options exist hundreds, and some Trivial of them, and others can be fatal, and also pre-determine the effectiveness of   treatment of arrhythmia.

   ECG perfectly measures electric activity of the heart, because it is intended for this. Electrodes   are captured   weak   electrical signals, and the device amplifies them. Lines on the tape do not measure muscle activity hearts, and only show the way of passing through it signals. Even an invincible heart is capable of some   time   to give   out electrical signals.

   Any test to determine a   certain parameter   indirect   way   (i.e. , through something another), not impeccable. For example,   The best   way to diagnose a bacterial urine infection is to check the presence   of bacteria by sowing their culture. Detection in urine of leukocytes,   which are presumed must fight bacteria, much easier,   but   less accurate. The lightest and least accurate A test is   a immersion in     the urine of an indicator strip sensitive to suspicious chemicals.

   Remember this to have the right the information about the information, which the ECG gives Two more aspects of cardiac function.

   Less accurate measurements: condition   of the cardiac   Muscles.   Injured, dying or already dead tissue usually affects the passage   through   not electrical signals. I can easily   distinguish   Characteristic of     Ischemia ( lack of EKG pattern and warn the patient   about   the possibility heart attack. I can even determine by the ECG the location of heart damage Muscles. A plot of a carved dead tissue changes   the ECG in a different way, So I can tell the patient what he has,   Apparently, there was already a heart attack (some heart attacks are asymptomatic).

   But you always need to remember the rule: "The best way to test for   the disease Heart muscle is a search for a diseased area of the heart muscle.” In such a test, traces of radioactive isotopes concentrated in a sick or healthy   heart   muscle.   A special   camera that scans the heart area gives an image in which   suspicious and clearly affected areas are highlighted. K This method   takes too much A long time to be practical.

   Checking the passage through the heart electrical signals - fast   and often very useful way of diagnosing, but   all     This is   an indirect examination. In some cases, electrical signals successfully pass through severely damaged areas with a barely perceptible   delay,   giving at the output of the device a normal curve or, in better,   curved with   noticeable but undiagnosed deviations. The doctor who received a normal ECG entry of the patient with suspicion of a heart attack  , should   hospitalize it while repeated ECG or blood tests (detecting substances   secreted by dying cells of heart tissue -   more   one   indirect,   but quite reliable and accurate method of verification) will not be confirmed or   not   rejected the preliminary diagnosis.

   Least accurate measurements: general condition hearts. Although doctors   are constantly prescribing its verification, experts do not recommend using an ECG for this purpose, since the cardiogram is not able to identify early   coronary atherosclerosis. In fact, she is not fixes even moderate   atherosclerosis and rarely detects developed if there are no symptoms.   Cholesterol deposition can almost completely block the coronary artery, but while the blood leaks through it, the ECG will normal.

   Monitoring carried out during intensive physical activity,   can open ischemic changes mentioned earlier if the narrowed arteries are not able to Supposed enough blood to the tissues. Some experts Recommended regular ECG with a load   people with increased risk - hypertensive patients, Smokers and   high   cholesterol holders, as well as representatives of certain professions, such as pilots whose hidden heart disease can harm others.

   For a man approaching the average age, ECG with a load begins to represent a certain interest, and doctors This procedure is prescribed quite often, although there is a significant risk in it. Positive   result may be Devastating news for men,   He who considered himself healthy, is about the same as Bad mammogram terrifies a woman the same age. The difference is that   a woman   with   cancer   Breasts have a great advantage over him, so How doctors are good at healing it. But much less understandable what to do with a man, in general,   healthy, but with Abnormal ECG during load (see section   Priorities   of health for Men in 50" in chapter 3).

   X-ray research. Many men Deeply   convinced that     X-rays are able to look deep into the area of concern and quickly discover what has failed. If they suffer from headaches, they feel that they need an X-ray of the skull, and if Back hurts - give them a blinding of the back. However, both   surveys are ineffective in the plan of Detection of serious disorders.   Röntgen as a tool for research deserves   good   words,   but   Helps only in certain situations.

   X-ray image is not photo.     In contrast   from   the rays of light that can focus camera lens, X-ray radiation spreads strictly in a straight line from the source through the body to film. The denser   parts of   the body   (e.g.,   bones)   retain part of the rays to a greater extent than the less dense (e.g., muscles). The lungs, almost completely filled with air, almost do not retain rays. As a result, a set of shadows of varying degrees of density is obtained on the film,   which roughly repeats the contours of parts of the body.

   Using for the example of X-ray photography chest  ,   I   Let me tell   you what X-rays can and cannot detect.

   Shadows are where they shouldn't be. The tumor or infected   fluid in pneumonia in the lungs   It is   clear because    Malignant tissues and liquids are much denser light and give in the picture clearly distinguishable dark spots. A tumor in the heart or the stomach will   probably not be so Distinguishable or even   invisible,   because   The density   of the tissues of the heart, stomach and tumor itself is approximately the same.

   Broken shadows where they should to be   smooth.   Broken   The rib is usually clearly visible, especially if the ends on the fracture   diverged slightly, but a subtle crack can be indistinguishable. Generally x-rays   are unreliable for identifying any object with a diameter of less than 12 mm.

   Abnormally large or   small   shadows.   X-ray   is capable   Identify too enlarged heart or Sleeping   lungs.   Infarction   does not   change the outlines or size of the heart, an asthma attack does not change anything in the lungs, so a chest of drawback looks normal, even if the patient Really sick.

   Common diseases. Normal picture of thoracic Cells often encourage smokers. If he reveals the first signs of emphysema, someone   swears Quit smoking immediately. With emphysema   The lung   tissue   simply disappears, so the lung area looks darker than normal in the picture.   But X-rays are still a rough tool for   Show   the overflow sooner, not in the stage when   the majority   of lungs   The fabric is   no more . So the "first sign of emphysema" on the X-ray   on the very   It means a long-term disease. Bones affected by osteoporosis, also look in the picture lighter than usual, but before   the change will become noticeable, should disappear at least 50% of the bone tissue, so the primary diagnosis of osteoporosis by x-ray,   as with   emphysema, indicates a severe form of the disease.

   When tuberculosis was   a common   ailment,   Regular   chest x-rays were good enough to detect the disease in the early stages. Today, tuberculosis is rare (with the exception of the immigrant environment and HIV-infected), and X-ray examination has replaced   the skin tests. Using an analogy with tuberculosis, doctors used x-rays when examining smokers for Detection of lung cancer in the early stages. It had some success, but, unfortunately, lung cancer     progresses rapidly, and patients, whose diagnosis was established by a routine radiograph, died just as often, As well as those whose disease was detected after   The appearance of symptoms.

   Once traditional in periodic medical examination and when applying for work, x-ray no longer serves useful goals,   therefore,   should be abandoned Pictures  , if   you   Offer   to   do it.   A little more can give other methods Examinations. Despite all the achievements of the latter medicine years, only a few of them are capable of   to identify   hidden curable diseases in people feeling well - this is a check of   pressure, cholesterol, stool on hidden blood and, perhaps,   even   checks for prostate-specific antigen and glaucoma.

   For the study of the current disease or the consequences of   the X-ray injury is used quite successfully, but it, like other types   of instrumental studies, gives as a result the figures and   spotted   images of auxiliary   information,   which   the doctor   must collect and think. However, the most important source     information will be your description of what is happening to you. After thinking about your story, the doctor can get more information by prescribing various analyses and examinations, and, rather than his talent as   Diagnostics,   the fewer tests and tests you will have to pass. If   you   was lucky to find a good doctor and intelligibly explain to him your   problems   -   you have provided yourself with the maximum necessary for the best medical care.

   Below are the checks usually carried out doctors during regular medical examinations of men.

   It reminds us once again of an important rule, which doctors and ignorant People often forget: "The best check - check   That's exactly what     you need."

 

   RELATIONSHIP BETWEEN THE DOCTOR AND THE PATIENT

 

   In this respect, the position of both the parties. In recent decades, the opinion that the patient should Deem an equal   partner. In our relationships with patients the main role should play   the patient's trust in the doctor and other Medical staff. During my practice, I noticed that many patients are afraid of doctors, and should note that   The most miserable patients are such people. Especially if, for different   reasons, They are not trustworthy.

   I advise everyone as close as possible Get to know medicine and   science in general, reading books like this, and asking the doctor a lot   of questions about what he does. True, we never give sufficient explanations, and our hundredth answer     to the topic   "sometimes-I'll do-will-ow-your-self" will always be shorter than the first. But in the end, you will have to   believe   The doctor really knows that does it. Now I will   explain   to you how to behave, as a patient.

 

   YOU ARE A PATIENT

 

   Proud of his strength, men are beautiful cope with tasks that require some deprivations - but on one condition: They have to   manage the events themselves! V The result of a man is more successful than   women,   lose weight and   quit   smoking.   They     are much worse   look   in   circumstances controlled by others: taking pills, lying on the operation or recognizing that The disease is too difficult to cope with it on its own. Like any generalization, this conclusion is applicable   Not     to all men, but not even If you consider yourself an exception to the rule,   Still   read this section.

   The word "patient" comes from The French "suffering", and   This meaning has been preserved in it to this day. S the very emergence of mankind no healthy person even thought refer to the healer, and this situation remains Too far. The idea that a doctor is able to help a person who is already Feels well, was born in   the second   half of the 20th century in a few industrialized Western countries and has not yet spread widely.

   Paradoxically, but the better you are feel when   you turn   to   The higher your own responsibility. If your     leg is broken,   The doctor will not have any questions when staging diagnosis, but with   episodic pain in Breasts you will have to answer a few light questions, and   with ailments with Changes in weather doctor will ask you   More details. If you have excellent health and you   have     for a regular examination, then the doctor will need a lot of information that he can only get from your mouth. Having before a visit to the doctor some "research", you pleasantly surprise him with your reasonableness and organization. Therefore, before the first visit, do the following.

   1. Talk to your mother. She'll tell you, What diseases you suffered   in childhood (few people remember what he was sick at the age of three).   Especially ask about the diseases that required hospitalization, and the most   important issue should be: "What did the doctor say then?" But try   to memorize the facts, not her personal opinion about what happened. Take critically the constant Mentions that you had some specific   allergies - our mothers are usually very active in the diagnosis of allergies of one of the main problems of their offspring. For example I will say that 90% of adult men who declared, according to the mother, about their allergies   To penicillin, they were wrong. In addition to its healing properties, penicillin has almost no side effects. Its substitutes have much more   contraindications. Therefore, if your infection can be cured with   penicillin,   It   is better to use it.

   - Your mother can claim that you Allergic because:

   - Your father was a clear allergy agent;

   - you had asthma, and the doctor mentioned that would rather avoid the appointment of certain medications;

   - as a child you managed to accept too much some medicine;

   - from some drug you began Diabetes.

   All of these indiceta does not indicate Allergies, and if you haven't   experienced a typical allergic reaction, you can count   yourself   healthy   in this regard. Many cases of rash, in which penicillin was accused,   in fact, a symptom of the disease, but such The conclusion should be made by a doctor, not your mother. So ask her what the doctor said.

   2. Find out about the illnesses of relatives. V medical institutions of future doctors are taught that you should know about diseases in the patient's family, but during medical practice such records In the history of the disease , they become shorter and shorter. Tom is not Less, you should know the exact age of your Red-handed   grandparents,   parents   and   the next of kin, as well as their exact age at the date of death. The same information uncles and aunts are also useful; information about cousins   will be important Detecting a family disease.

   Try to learn more about the serious diseases of relatives, but do not theorize yourself and Don't let others do it -     Only facts are important. If, for example, your father says that the grandfather died of a heart attack, ask, How does he know that? If he says that his grandfather was sitting on the couch, suddenly he was murmured and died, then a heart attack will be only one of the two possible causes of his death.   Suicide,   alcoholism   and   serious   mental disorders in the history of the family - very important information, as well as current diseases and deviations, for example, high cholesterol in someone from relatives.

   3. Find out if you were vaccinated in childhood and from what diseases.

   In the past, tetanus and diphtheria were children's diseases, as they still remain in underdeveloped countries. V The United States today is sick with adults who for various reasons were not made Vaccinations in childhood.   What vaccinations Did you do it? Some vaccinations should be repeated   periodically, which, by the way, applies to tetanus, and diphtheria. And in this case, also do not theorize ("B I broke my arm as a child, probably   then I was given a pillar-drop-painted. If there are doubts, Ask your doctor to retrieve the vaccine.

   4. Be communicative with your doctor. Despite for all   the wonders   of technology, our knowledge about the patient by 90% consist of what he tells himself. "Talk properly with patient,” we are taught   Professor.   "They themselves They will tell you about their diagnosis.”

   But sometimes it doesn't work. Information sometimes have   to pull almost with ticks, as a result, by the end of the reception, the doctor feels   himself   No better than the patient. Here is an example of how a certain the patient complains of his anxiety:

   - What exactly's bothering you?

   - It all started when I moved to Chicago.

   - When? A couple of months ago?

   - Three years ago. I went straight to specialist.

   - So what?

   - He did the tests.

   - What were the results?

   - He prescribed me a cure, and it helped. You   can   write   I'm him again?

   - What did he write you?

   - Little white pills...

   - Do you remember the name?

   - No, but they were white and they were small. For The stomach... Here is a problem for you Communication in all The beauty! But don't think it's wine   lies   only on the patient - he could become a victim of poor communication skills of the previous doctor. If the information expected of you is very important, the doctor will be able to get it. Relieve life to him and   to himself,   Following   a few rules, based on a simple common sense.

   Be detailed and accurate. I don't think you'll be Repeat an AutoMechanic as Parrot: "My car Broke down... broke down on its     own...   She must have broken... ". Met with patient who says     that he does not feel, the doctor will try Find out the facts. Why   make it difficult to work? Think about what’s wrong with the following dialogue:

   - I've been a cold since last week.

   - Last week... So it's been seven days now?

   - No, three days.

   - A cold... You mean a cold and Sore throat?

   - No, cough and sinusitis.

   - Sinusitis means you mean pain in cheek area?

   - No, I got my nose stuffed...

   On average, the doctor has to repeat "You Mean" a Hundred   Once   a day. Describe exactly what is bothering you.

   Say, "My ear hurts," not "I'm infected with my ear."

   Say, "I have a rash, and she's Itches,   not   "U   I'm   allergic   to something."

   Say, "I'm in pain!" Only when you have even my hair hurts.

   And don't think that a doctor can "read. between the lines" - do not say: "My stomach did not allow me to sleep all night" (maybe he's all night played   you on a trombone?), better say: "I did not sleep all night because of nausea (or “Sin or vomiting.”

   Do not come with your own ready diagnosis. It is incorrect to appear   at the reception with a statement: "I think I have a nervous breakdown." I, for example, I know what a “feeling of fear” is or "untogether", but when the patient tells me about the "nervous breakdown", I'm lost - it's too popular and a general term that is for different people means different things, as well as     "conjunctivitis", "tonsiille", "infection" or "indigestion". Better say, "I was so depressed that I couldn't focus on work,” or “I have itching my eye, and in the morning there was a crust on it,” or “I have sore   throat", or "In an hour After eating, my stomach slices begin and gases are released.”

   Remember your own medical history. Not assume that in the plump history of the disease that lies on the table before The doctor, recorded all   that happened to you. This seemingly complete story is often  a set of fragmentary data. The best place for the basic facts is your head.

   - I see you were in the hospital in 1973? On what reason?

   - For the examination. (Absolutely useless response)

   - From behind. (Slightly better)

   - My back hurt and didn't go through. (Not bad)

   - the back became more sick than usual, and The pain even began to give   in Foot. The doctor assumed     that this could   to be   due to   the displaced   Disc.

(Very good)

   - The doctor sent me for an examination. It turned out   that    me   is displaced disc of the spine. A few days later I got better, so he said, What the operation does not need to be done, unless     will not   again   Worse.

(Perfect answer)

   Don't expect the doctor to "send request" and the problem will be solved.   The doctor, of course, can send a request to The hospital where you once went, but it will take a lot of Time, in addition, sometimes requests are ignored. So the words: "I don't remember... This is a long-standing story" - a very bad   answer, and I have to listen to this several times a day, specifying the name once prescribed to the patient medication   or   asking   his   condition a few years ago. Honestly, in such   forgetfulness   believe with difficulty. People usually remember what matters to them. How, to your opinion, how many inhabitants of Indianapolis or, say, Guadalajara   may   say, “Sorry, but I don’t remember what city I live in. This world is so Great..."?

   Encourage the doctor to be communicative with you.   If   today   you are   already the sixth patient, then the doctor's conversation with you, most likely,    will be   much shorter than the first. If you, leaving the office of something and did not   understand, it is the fault of the doctor, but   the only one       You will be the victims.   Before you leave the office, Try to get   clear   answers   to the following questions:

   What exactly is my disease? Not Satisfy in   meaningless   phrases type: "Weak back", "Irritable, nerve   stomach" or "Bad circulation blood." You would pay   Automotive,   who said that Your engine malfunction machine?

   Every disease has an exact name. If You will be informed   of this   long scientific term, You should know what it means. Many impressive scientific words simply useless - it is only a beautiful name for your symptoms. Examples can serve as   "dermatitis"   (rash),   "gastroenteritis" (supid disorder) and "arthritis" (inflammation of the joints).

   Every disease has a cause. Dermatitis can be   the result of   exposure to bacteria, fungi, chemicals or Allergens. Most   of the gastroenterites caused by viruses, but the cause may be   and   bacteria  , and spoiled food. Arthritis occurs for a good dozen reasons.   Never assume that the reason is known - you're probably wrong. About once a week One of the patients claims that he has   (or her) anemia. When I ask why they think so   (except   anemia, there is still a hundred diseases with similar symptoms), they are usually surprised: "How, Doctor, is there no malnutrition   Anemia?!”   Yes, it happens - somewhere in Bangladesh, but in America it is rare.

   Almost any disease is treatable. If there is no treatment, you have to tell you that. Many doctors get off Types   "None   of us is perfect" "This is   the body's response   to   stress.”   Some   people prefer to hear These are the conclusions, instead of a clear   Definition of disease. If you don't belong to them, ask your doctor how   you are sick, what treatment is needed and how long   it is   may   be extended. However, take into account: no serious disease is treated with tranquilizers or multivitamins.

   Do I really need it? Except that you will save time and money, such The question will allow the doctor to make sure that   You are     reasonable   and a serious patient.

   Most visits to the doctor are related to minor problems that medicine does not cure. Cough, colds, viral infections and stomach upsets continue as much   as   They   need to   pass by themselves, regardless of treatment. Small injuries also   heal at the time appointed by nature. Doctors   a generous   hand   prescribes a medicine to facilitate such States, because experience has taught them that  Most patients feel much better by accepting something prescribed doctor: injections, pills, bandages - no matter what.

   Prescribing a cough medicine for colds or cortisone   ointment   for itching, I explain that it's in some kind of the degree will help, but the patient will not recover faster. Rarely no one The patients   say that     in this He doesn't need that remedy. Therefore, if you do not seek a temporary relief, ask the doctor a question brought to the beginning of   the section, but in no case do not decide for yourself, Which of the drugs you don't   need.