OUR MARITAL HEALTH/SEX AND PROBLEMS OF DAILY LIVING: MOVING THROUGH LIFE AND KEEPING SEXUALITY MOVING- ADOLESCENCE: FEELING IT VS. DOING IT
Adolescence is so sexually problematic not only because of resistance to allowing our young people to enter our adult world, but because the first three stages of sexual development are difficult for most children. When adolescence is taking place, the focus can be on “doing it” if the sexual self-concept and emotional response to sexual feelings have been disrupted or delayed. In a society that values action over feeling, doing over thinking, acting over reflecting, it is difficult to come through adolescence with an integration of love and sex. We teach our teens to be a man or woman rather than experience their own personhood and the personhood of others. We teach them to fear anything but the strictest of gender division lines.
You have already learned to read your love map and I have discussed these adolescent concerns, but reconsider now your own ability to unite sex with love. Would you say, would your children say, that love and sex are the same? They are, but our society teaches that they are different because our society seems stuck at this developmental phase itself, continuing to separate doing from feeling.
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Say you have a cancer that fulfills all the conditions I have described—one for which cure by surgical removal seems possible. Perhaps you are prepared to pay any price at all for any chance at all of cure. If not, you still need to weigh the likely benefit against the likely cost before agreeing to the ODeration.
Check the questions I listed at the beginning of this chapter. What is the chance of cure? What other ways, if any, are there of achieving a cure? Some cancers which can be cured by surgical removal can also be cured by radiation treatment. Surgery has certain advantages—diseased tissues are actually seen, removed and examined under the microscope for completeness of removal. There is no equivalent way of being sure that radiation treatment includes the whole of the primary cancer. Surgery takes a few hours and a week or two in hospital, radiation treatment can take six to eight weeks. On the other hand, radiation treatment can be less mutiliating. For example, patients with cancers of the tongue, lip, throat, larynx (voice-box) and breast are likely to be much less disfigured if treated with radiotherapy than if treated with surgery.
Ask whether your chances would be improved by combining surgery with other forms of treatment. Radiotherapy and chemotherapy are very specialised types of treatment so your surgeon will probably not know a lot about them. Ask to be referred to these specialists if you suspect or know that they could play a useful part in your treatment.
Make sure you have answers to all of the questions at the beginning of this chapter before making your decision. Surgery aimed at curing cancer should not be rushed into but, rather, carefully planned. This means there should be plenty of time to get all the information you need.
Consider every aspect of the possible ‘cost’ and benefit that is important to you, not just what your surgeon accepts as important. You are the one who will be stuck with any disfigurement, discomfort or inconvenience, not your surgeon! Anything you think is important, is important. Don’t be talked out of what you know about yourself.
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Surgery remains the main form of treatment for hydatid disease in humans. Care is necessary in removing the cyst, as rupture may cause spillage and seeding of further cysts.
Although the mortality for such surgery is low, the morbidity is high. This means there is a high rate of complications and recovery may be slow. The decision to operate on a patient with hydatid disease is not always straightforward.
Healthy patients with cysts in the liver should be operated on, as there are few risks.
Those with cysts in the brain, the bones and the spine may demand operation because of the risk to life or proper functioning.
Elderly, unfit patients, especially if the cysts show evidence of calcification, indicating the contents may not contain living parasites, are usually best left alone.
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Early infection may result in marked changes.
The resulting damage may be so severe as to cause an early abortion or the death of the foetus during later pregnancy or during or shortly after birth. Some infants are born blind or mentally retarded. The infection can affect the brain, the liver.the eye or other foetal tissues.
The child may be born, appear normal and then, in the first few weeks of life, show signs of infection. Involvement of the brain may lead to convulsions or muscular twitchings. Obstruction to the flow of cerebrospinal fluid through the brain can result in the condition of hydrocephalus, where there is enlargement of the head.
Treatment of this condition is effective in acquired cases but gives poorer results when damage to various tissues has occurred where the infection has developed in the womb.
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Although we wish him to be heroic, loving, compassionate, wise, available to us at any time of day, fascinated by our particular case, skilled in matters of medicine as well as accomplished in the subtle manners of handling people, brilliant diagnosticians, chatty, charitable, and good-humored, we may find we are on a quest for the doctor who only rarely exists, if at all. We want a doctor who is a good person and a caring practitioner, but we may also be asking for him to be a god.
Many doctors incline toward a role as a lesser god. This can cause some conflict between such doctors and the patient who is a reluctant worshiper. Doctors who live the god role may be exemplary diagnosticians, dazzling surgeons, insightful theoreticians, awesome innovators—but they may not be able to talk simply, directly, and kindly to a patient. With a deep need to be sure of themselves, they can dismiss a patient who asks questions that require more information or explanation. Women doctors are not exempt from the god complex, even though we somehow expect them or wish them to be.
The most effective method of deciding if a doctor is right for you is if you can say yes to the following statements after discussing your case with him,
1. Is my doctor a partner in my health care? This is the critical question to ask yourself after first consulting with a doctor- Do you feel as if he cares about you? Or do you get the distinct impression that he expects you to do as he suggests, without question, including Options for surgery?
2. Can I talk openly about nay medical problems with my doctor? You should feel an immediate rapport with your doctor so that you are not intimidated into silence, thereby omitting what can be essential information to treating your case. If you cannot speak freely with your doctor, you are doing yourself a disservice. Find another with the right chemistry for you.
3. Do I fact confidence in my doctor’s ability? You must feel that your doctor understands your condition and know that he is willing to explain it to you. Can he correctly diagnose and treat your problem so that it does not become worse over time? If you are seeing a doctor who repeatedly tells you that your symptoms are psychosomatic, when you know you are suffering from real pain—he may be missing the diagnosis. If you fed lagging confidence in your doctor, remember that you are entitled to a second opinion. Do not worry what the first doctor will think about this if he finds out. It is your body, your health, and your right to seek the best medical care.
4. Do I feel safe knowing that my doctor doesn’t rush into the more radical approaches to treatment? Among the most common complaints against doctors are the rash use of prescription drugs and unnecessary surgery. Endometriosis sufferers tend to be susceptible to such mistreatments. If your doctor appears eager to operate, suggesting that he will “save everything” he can, immediately seek a second opinion and, if necessary, a third or fourth. You want to save everything you can, too: your internal organs. And if you are taking prescription drugs that have ill effects or no effect, or if you think you are becoming addicted to a drug, tell your doctor. If he insists that you continue on the drug and dismisses your discomfort, find another doctor.
These are the key factors in selecting the right doctor. If after evaluating your answers, it is strikingly dear that you need a different specialist, be assured that you are not alone. Other women with endometriosis have had similar experiences. Fortunately; such women can be found, and they communicate!
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Another practice being used for stress relief, which is the polar opposite of encounter groups, is meditation. The most widespread and easily accessible technique is called Transcendental Meditation. It first caught the headlines in 1967, when the Beatles and Mia Farrow tripped off to the Himalayas to learn about it from the Maharishi Mahesh Yogi.
With T.M. the individual sits down and closes his eyes for two periods of 20 minutes a day, during which time he, in effect, leaves the stress battlefield, willing himself into a state called ‘restful alertness’. He does this by concentrating on the silent repetition of a word called a mantra, a soothing meaningless sound secretly assigned to each student by the instructor.
After commencing meditation, various things may occur. Frequently there is a marked increase in the number of dreams during sleep- This is thought to be very beneficial, since we all need to dream at night whether or not we remember our dreams the next morning. It has been demonstrated that people who do not dream enough become tense and anxious. Dreams, fantasies, trances, hallucinations, are all forms of consciousness expansion and are enriching experiences. Physiologists have shown that in meditation there is a marked reduction of oxygen consumption; the reduction is greater than that of a person after six hours of sleep. Similarly galvanic skin resistance, another positive key to relaxation, in some cases is increased fourfold. In this and other movements derived from the East, diet is often involved, a vegetarian emphasis being common. Almost always there is also a degree of deliberate detachment from the turmoil of daily urban life, and a surrender to a group. This erasure of ego can produce a calm and may ease many life stresses.
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A third influencing variable, interacting with biological and environmental factors in the determination of body fat stores, is individual behaviour. Behaviour is the net result of complex psychological factors, involving the effects of habits, emotions and cognitions. Habits are learned ways of responding. Emotions represent the affective state of consciousness. Cognitive processes involve patterns of thinking. All of these are integrated by our belief systems about ourselves and the world. A common example of interactions between these factors is the vicious cycle of diet failure, guilt, depression, lowered self-worth and counterproductive habits which result from and lead to repeated failures with weight loss diet plans. Although there is no evidence to suggest that psychopathology is a major cause of obesity, these individual psychological factors have to be considered as haying both a cause and effect association. Interventions designed to deal with these are a vital part of any overall strategy.
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Acupuncture is an ancient Chinese treatment which is thought to restore energy flows in the body, thereby alleviating pain and allowing healing.
Acupuncture usually involves placing fine, sterile, stainless steel needles in specific locations on the body depending on the site of the pain. The needles may then be manipulated and rotated by hand or stimulated electrically.
The depth of the needle penetration, the number of points on your body that are stimulated and the duration of treatment will vary according to the symptoms.
There may be a little discomfort during the treatment and you may experience slight bruising where the needles have been inserted.
Many doctors practising acupuncture now use single or disposable needles to eliminate the risk of infection.
Some women suffering from endometriosis have gained significant relief from their pain with the use of acupuncture.
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The newly recognised implants are often called atypical implants but they are probably younger implants which, as yet, have very little old blood deposited in them.
Atypical implants are usually very small and are sometimes difficult to see. They may occur alone or in clusters and may be clear, white, yellow, orange or red in colour.
Microscopic endometriosis-In the early stages of endometriosis the implants may be too small to be seen without the use of a microscope. This type of endometriosis is often referred to as microscopic endometriosis.
Endometriomas-Endometrial cysts on the ovary are also known as endometriomas. They are usually less than two or three centimetres in diameter but occasionally may be 10 or more centimetres in diameter. They may be embedded in the ovary itself or they may lie on its surface. They are sometimes referred to as ‘chocolate cysts’ because they contain old dark blood which often has the appearance and consistency of melted chocolate.
Adhesions-Adhesions are bands of tissue which bind or matt together organs of the pelvic cavity and they may be formed as a result of endometriosis. They may have the appearance of sticky toffee which has been stretched from one organ to another.
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The term comes up again and again in books about herbal remedies, but what exactly is a tincture? While the herbs in decoctions and infusions are boiled or steeped in boiling water, tinctures are fluid herbal extracts prepared when the active ingredient of a herb cannot be heated and is not water soluble.
Although not widely available in shops, tinctures are favoured by professional herbalists because they are highly concentrated and long lasting, being made with a base of alcohol. The chopped herb is placed in a 40-50% alcoholic spirit and left in a warm place to steep. After a couple of weeks, the alcohol containing the herbal extract is decanted and stored in dark glass.
The required doses and dilutions of tinctures vary greatly from as little as a few drops to 20 mls at a time. Because of the concentrations involved, great care should be taken to follow the herbalist’s instructions which are usually written on the bottle.
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