Many doctors recommend that women should take hormones only if their menopausal symptoms—especially vaginal soreness, hot flashes, and night sweats—are severe enough to cause extreme discomfort. Other doctors believe that most women should take hormones to protect themselves against the effects of osteoporosis, and other benefits (see chapter 10). The therapy is generally not recommended for women who have a history of breast and/or uterine cancer, stroke, pulmonary embolism, liver disease, or deep-vein thrombosis.

If you are taking hormones, you should follow your doctor’s instructions exactly—have regular medical checkups, including pelvic examinations; Pap smears; blood pressure checkups; and mammograms. In order to eliminate symptoms such as hot flashes, most women need to continue treatment for at least one year. If a woman stops her treatment abruptly, the symptoms can reappear in just a few months. Hormone replacement as a treatment to prevent osteoporosis may need to continue for five to ten years or longer.

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THE MOST OFTEN

There are several factors which can affect a doctor’s ability to diagnose a patient’s symptoms. Sometimes a doctor’s lack of knowledge of a disease can place certain limitations on his or her ability to diagnose a specific problem. At other times the elaborate array of tests doctors now have to help in making their diagnoses aren’t always conclusive, and doctors sometimes have trouble interpreting them.

To further complicate the process, the specialist may not have a complete medical history and physical exam to refer to. There are also many diseases that have similar symptoms, making their diagnosis difficult. As a result, diagnosis is not an “exact” science. Here are several of the most commonly misdiagnosed, or hard to diagnose diseases and illnesses:

1) Osteoporosis— in a study conducted at the University of Kansas in Kansas City, researchers evaluated 180 women who had either had or were suspected of having osteoporosis. The researchers learned that in 46 percent of the women involved in the study, there were other health factors that could cause or worsen the disease but that had gone undetected by their doctors. Among those factors: menopause before age 40, thyroid disease, asthma or other lung diseases, and a loss of calcium through the kidneys. The researchers recommend that women should furnish their doctors with a complete and detailed medical history.

2) Food sensitivity— this involves an abnormal reaction to food or a food additive. It may or may not be caused by a food allergy. The illness can cause vomiting and/or diarrhea; hives; headaches and stomachaches; fatigue; respiratory problems; and severe cases can result in a life-threatening allergic reaction.

The symptoms are vague and may be hard to diagnose because they can suggest any number of illnesses. It is also difficult to track down the precise food causing the problem.

The American Academy of Allergy and Immunology, 611 East Wells Street, Milwaukee, Wl 53202, can furnish you more information on food sensitivity. Write, or call, 414-272-6701.

3) Rheumatoid arthritis— this is an autoimmune affliction that causes inflammation of the joints. Its symptoms may include pain when moving; swollen, tender and painful wrist, knuckle or finger joints; stiffness; and difficulty forming a fist.

The problem can be hard to diagnose because blood tests may produce false-negative results. The symptoms are also similar to many other autoimmune disorders.

To get more information, you can write to: Arthritis Foundation, P.O. Box 19000, Atlanta, GA 30326, or call, 800-283-7800.

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According to a recent study conducted in China, a relatively small drop in blood cholesterol could mean a significant drop in the risk of having a heart attack— even if your cholesterol level is already within the safe range. Results from the study indicate that a 4 percent drop in cholesterol level may mean as much as a 21 percent drop in the risk of having a fatal heart attack.

The key words in the Chinese study appear to be “relatively small”. Research conducted in the United States suggests that those people with extra-low cholesterol levels are more likely to die in later years from a variety of causes, including certain cancers, liver disease and lung disease, than those people with “normal” cholesterol levels.

The latest findings do not question the standard recommendation that people with high cholesterol should go on diets or, in extreme cases, take drugs to reduce their levels. The concern is for people with extremely low cholesterol- -160 units or less. The research appears to indicate that to reduce certain health risks an individual’s cholesterol level should be neither too high nor too low.

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If you are not alone with the victim, have someone call for an ambulance while you apply pressure to the wound. Place a thick, clean compress, such as sterile gauze or a soft, clean cloth directly and firmly over the entire wound. Don’t try to remove any objects that may be embedded in the wound, because that could worsen the bleeding.

Unless doing so causes the victim pain, you should elevate the wounded area. Cover the cloth or gauze with a bandage, tying or taping it in place. If blood soaks through the compress, do not remove it— instead, add another pad over the first compress, and continue to apply pressure.

C) Seal your lips around the victim’s mouth and give two full breaths of 1 to 1 1/2 seconds each. Remove your mouth after each exhalation and take a deep breath.

D) Turn your head toward the victim’s chest, with your ear just above his or her mouth. Listen for air being exhaled and watch the victim’s chest. Continue breathing into the victim’s mouth at a rate of 12 breaths per minute for an adult, 15 per minute for a child.

If you are alone with the victim, call for an ambulance after one minute and then resume resuscitation efforts. Check for a pulse and breathing every minute.

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DON’T WANT TO

Millions of Americans have learned the hard way that collecting on insurance claims can be a nightmare. The procedure features a myriad of confusing forms, numerous phone calls and letters, and an intimidating bureaucracy. What can you do when your insurance company doesn’t seem willing to pay your claim? Insiders say that the key to getting your insurance claim(s) paid is in knowing how to cut through all the confusing red tape.

Here are several insider tips for getting your insurance claims settled to your satisfaction:

1) Try to stay one step ahead of the bureaucracy. One way to do this is to make sure that you fill in every blank properly when filing a claim. Some companies will reject your claim simply because you omitted your date of birth.

2) Do not take “no” for an answer. Insiders say that every medical procedure has a code and that claims are sometimes rejected because of a computer mistake, resulting in the wrong code. It is estimated that as many as 30 percent of insurance claims are rejected because such minor details are incorrect.

3) Know what your policy covers before you undergo any treatment. You need to know how much your insurer has agreed to pay.

4) If all else fails, turn your claim over to a firm that files claims for policy holders who haven’t had any success in getting their claims paid. These firms can usually cut through the red tape and get the insurance company to pay the claim, or call your state’s insurance department for free help or advice.

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At the 1986 meeting of the American Psychological Association, psychologist Janet Lapp, Ph.D., of California State University, Fresno, reported the findings of a study which showed that restful or pleasant music could be successfully substituted for the autogenic phrases used in conventional biofeedback training.

By merely listening to popular tunes or to any kind of pleasant, relaxing music, participants in the study actually had fewer migraine headaches, and they could abort a migraine more swiftly than those who used verbal phrases and suggestions.

Listening to music, combined with deep relaxation and visualizing a pleasant scene, is believed to stimulate release of natural endorphin painkillers in the brain. By using music, there is also less need for monitoring equipment. And music also works well for tension headaches.

In another study at Royal Victoria Hospital, Montreal, classical music worked so well as a painkiller that many terminal cancer patients were able to stop taking analgesic medication. Interestingly, the authors of this study found mat the more you enjoy a piece of music, the deeper and more slowly you breathe and the more relaxed you become. A tempo close to your heartbeat rate can be very relaxing. Disturbing music like rock’n'roll is useless. But soothing New Age music, yogic chants, dreamy Hawaiian songs, or classical or popular tunes seem to work well.

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Acupressure, or shiatsu massage, is an ancient Oriental method of pain relief that can often stop a minor headache in just a few minutes. Given a Hole longer, it has been known to subdue the most stubbornly resistant tension or migraine headache.

Scientifically, acupressure has been found to excite small nerve fibers in muscles, causing nerve impulses to be transmitted to the spinal cord and midbrain and on to the pituitary and hypothalamus glands. These glands then release endorphin and enkephalin. While acupressure won’t remove the underlying cause of headache pain, it often provides startling relief. All you do is apply gentle but steady pressure on certain “pressure points” on the body using the bails of the tips of both thumbs, or sometimes the fingers. While applying pressure, you also use thumbs or fingers to provide a rotating massage. Pressure is usually applied for 7 to 18 seconds, then withdrawn. You can return and repeat the massage a few minutes later. And you can give any number of acupressure applications. Frequently, however, two or three applications are all that is required.

Be extremely careful not to use the nails. Women with long nails may be unable to perform acupressure or any other type of massage. Naturally, you can also use acupressure on anyone else.

These are the principal points favored by acupressurists for headache relief.

1. By far the most popular, is the Hoku Point, the fleshy web between forefinger and thumb on each hand. Place the fingers inside the hand with the thumb on the outside of the web. Using the thumb to press and massage, work around the middle part of the web.

Experience has shown that a single 15-second application here can relieve most minor headaches. By repeating every few minutes over a half-hour period, a persistent tension or migraine headache may disappear. Hoku point massage seems most effective in relieving tension headaches or migraines that center in the eye.

Most acupressurists recommend alternate massaging of hoku points in both left and right hands. However, if the pain is focused on the left side of the head, they will usually massage the left band twice as often as the right.

2. Gently pinch the lower part of each earlobe and maintain a circular massaging motion.

3. Pinch the bridge of the nose between ringer and thumb of one hand and massage. Stay far away from the eyes or eye sockets.

4. Bend the wrist of one hand at a right angle. With the thumb of the other hand, press and massage the side of the arm facing you approximately half an inch above the bend of the wrist. Work around and massage this entire area. Repeat on the other wrist.

5. Clasp the hands on top of the head, with fingertips meeting over the crown. Using the thumbs, massage the hollow in back of the neck, at the base of the skull and level with the ears. Press and massage all around this area.

6. Press and massage the temple areas down to the level of the eyes. Stay on the flat, bony side of the face and stay far away from the eyes or eye sockets.

7. For a tension headache, gently press and massage the points at the hinge of the jaw just below the ears on each side.

8. Using the tips of the forefingers, gently massage the hollow area underneath each earlobe. Remember, we said gently.

9. Locate the median line running from the crown of the head down to the bridge of the nose. Along this imaginary line, and on each side of the line about one inch parallel to it, are a cluster of headache-relieving acupressure points.

Using three fingers of each hand, begin at the hairline and work up and back towards the crown. Gently press and massage the area along the median line first, applying pressure for onló seven seconds at a time. Then move fingers one inch away from the line. And once again press and massage points all the way from hair line to crown.

From the crown, you can continue to press and massage all along the median line down to the back of me neck. Next, do the same thing along an imaginary fine leading from the crown down the scalp to a point in front of the ears. Finally, press and massage along another imaginary line running from earlobe to earlobe around the back of the neck.

Acupressure points on the scalp tend to be about one inch apart.

10. Place the hands on the back of the skull with fingertips touching. Use the thumbs to press and massage points on die outer side of die neck muscles all the way from the base of the skull to the bottom of the neck. Using acupressure on this area often provides fast relief from tension headaches.

11. Massaging the feet to stop a headache sounds like reaching the attic through the basement door. Yet the feet bristle with nerve endings that respond well to acupressure-type massage. When acupressure is used on the feet, it is known as reflexology. In reflexology, however, both thumbs are used together, side by side, to press and maintain a circular massaging motion on one foot at a time.

Nor is pressing and massaging the feet limited to 15-second bouts. One may continue to massage the feet for as long as desired. After massaging one foot, the other foot is usually given the same treatment.

For headache relief, begin by pressing and massaging both sides of each big toe, then massage the fleshy underside of each big toe. Give these areas a thorough working over. If you feel any tender spots, concentrate these points. They are often the key to headache relief.

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After reading the results of two university studies made during the mid-1980s, thousands of women migraine sufferers have diminished their migraine symptoms by taking daily magnesium supplements.

In the first study, at East Tennessee State University, 500 selected women with migraine were each asked to take 100 or 200 mg of magnesium in supplement form daily. For some, relief came within hours. Most felt much better in just a few days. Some women, who had had splitting headaches for two straight weeks, quickly became symptom-free. Overall, seven out of ten women had no migraines for as long as they continued taking the magnesium.

In a similar study reported from Case Western Reserve, headaches stopped in 80 percent of sufferers after they had taken 200 mg of supplemental magnesium for two or three weeks. In another case, a Chicago woman who had suffered migraine attacks several times weekly for over ten years, had had to take increasing amounts of drugs to control her pain. Agony and depression were wrecking her life. Yet after taking 200 mg of supplemental magnesium daily for four weeks, her headaches had almost completely disappeared.

It has been suggested that, through causing the smooth muscles surrounding each artery in the body to relax and dilate, magnesium effectively blocks Stage 2 in the migraine sequence.

Other studies have shown that four out of every five Americans are deficient in magnesium reserves, especially those who drink soda or alcoholic beverages. Many drugs also bind with magnesium and prevent its absorption.

Magnesium supplements in 200 mg tablets are readily available in any health food store. An intake of 200 mg a day is considered riskless by most nutritionists. However, if you have any kidney or other health problems, or are under medical treatment or taking medication, you should consult your physician before taking supplemental magnesium.

Alternatively, you can increase your dietary uptake of magnesium by eating more magnesium-rich foods such as avocados, soybeans, black-eyed peas, almonds, cashews, Brazil nuts and other types of beans and peas.

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After reading the results of two university studies made during the mid-1980s, thousands of women migraine sufferers have diminished their migraine symptoms by taking daily magnesium supplements.

In the first study, at East Tennessee State University, 500 selected women with migraine were each asked to take 100 or 200 mg of magnesium in supplement form daily. For some, relief came within hours. Most felt much better in just a few days. Some women, who had had splitting headaches for two straight weeks, quickly became symptom-free. Overall, seven out of ten women had no migraines for as long as they continued taking the magnesium.

In a similar study reported from Case Western Reserve, headaches stopped in 80 percent of sufferers after they had taken 200 mg of supplemental magnesium for two or three weeks. In another case, a Chicago woman who had suffered migraine attacks several times weekly for over ten years, had had to take increasing amounts of drugs to control her pain. Agony and depression were wrecking her life. Yet after taking 200 mg of supplemental magnesium daily for four weeks, her headaches had almost completely disappeared.

It has been suggested that, through causing the smooth muscles surrounding each artery in the body to relax and dilate, magnesium effectively blocks Stage 2 in the migraine sequence.

Other studies have shown that four out of every five Americans are deficient in magnesium reserves, especially those who drink soda or alcoholic beverages. Many drugs also bind with magnesium and prevent its absorption.

Magnesium supplements in 200 mg tablets are readily available in any health food store. An intake of 200 mg a day is considered riskless by most nutritionists. However, if you have any kidney or other health problems, or are under medical treatment or taking medication, you should consult your physician before taking supplemental magnesium.

Alternatively, you can increase your dietary uptake of magnesium by eating more magnesium-rich foods such as avocados, soybeans, black-eyed peas, almonds, cashews, Brazil nuts and other types of beans and peas.

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This is the dilation phase of the headache process. In all three headache types, actual pain occurs as arteries in the forehead, scalp and brain dilate. Fine nerve laments (nerve plexuses), which line the walls of these arteries, are extremely sensitive to being stretched. When the arteries swell and distend, these nerves fairly scream with pain.

At no time does the brain itself experience pain, for it contains no sensory nerves. All intracranial sensitivity exists in the membranes, or meninges, that line the inner wall of the skull.

Tension Headache. Most tension headaches occur as arteries in the forehead, scalp and brain dilate. Other pain signals may be generated by nerve endings located in the contracted muscles of shoulders, neck and scalp. Several hours after the headache begins, these muscles begin to relax and cease to generate further pain signals. But it may be 12 hours before the headband arteries return to normal size and the headache dissipates spontaneously. Throughout the tension headache, blood flow to the head remains constant and unchanged.

Migraine Headaches. Although observations at headache clinics indicate that common migraine may be more painful than the classic variety, from the beginning of Stage 3 on, the headache process is virtually identical for both migraine types.

Once the cerebral blood vessels dilate, the headache begins. Occasionally, the pain is mild and bearable; more often it appears as a throbbing, hammering pain that envelops the eye and nostril on one side of the head.

The pain can become so severe that victims are unable to walk straight, and may bump into furniture. During some attacks, the pain is so disabling that the person becomes incapable of coherent thought. Roughly half of all migraineurs experience nausea and vomiting. Others arc plagued by diarrhea, dizziness, or bouts of hot flashesalternated with shivering spells. It is not unusual to see the arteries pulsating on the scalp while veins on the forehead are also visibly swollen.

The pain may reach back and follow the temporal artery up and over the ear and back to the neck on the afflicted side. Rarely does migraine appear on both sides of the head at once. Gradually, what feels like army boots pounding on the skull gives way to a steady ache. The torment can last from three hours to three days.

Yet in most cases, the headache lasts only until the victim falls asleep. When the migraineur wakes up, the headache is gone. The sufferer may feel weak and washed out and may pass copious amounts of pale urine, but permanent physical damage is rare.

Migraine does not usually return until the supply of norepinephrine has been replenished. This normally guarantees freedom from another attack for at least several days.

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