Medsarticles. Medical Weblog

Stop using chemicals that you commonly use on yourself, or around the home. For best results, get a box or bag and go around your home, putting in it anything you find – such as toothpaste, soap, deodorant, shaving gels, the contents of your bathroom cupboard or shelves, talc, all perfumes and aftershaves, bubble baths, hair gels, sprays, mousses, cosmetics, baby wipes and lotions. Include all cleaning products -soap powder and liquid, fabric softeners, bleaches, disinfectants, toilet cleaner, bath cleaner, oven cleaner, washing-up liquid, polishes, shoe polish, everything. Remember to include air fresheners and toilet fresheners; remove any that are stuck to surfaces. Collect up any DIY products, gardening chemicals, and glues, sticky tapes, felt-pens or similar stationery products. Take anything you see. You will probably be amazed at how much there is.

Put the box or bag in a shed or outside the house where the fumes will not reach you. Open the windows and doors and air the place right through for a short while – a few hours or longer, if you can. Keep it well ventilated.

Use only basic personal hygiene and cleaning products as listed below for the length of the programme. Persuade people who live with you to use the same things if you possibly can, to reduce your exposure still further. The same things can also be used on babies and children.

• For tooth powder, use sodium bicarbonate or table salt

• For soap, use Simple Soap or Kay’s Vegetable Oil Soap

• For shampoo, use Simple Shampoo or Crimpers Shampoo

• For shaving gel, use Simple shaving gel or soap as above

For names of products that chemically sensitive people tolerate well for laundry, dish-washing, general cleaning and toilet cleaners. Use the products recommended there for the elimination period, or:

• For laundry, use Borax, or sodium bicarbonate or washing soda

• For dish-washing, use washing soda

• For general cleaning, use washing soda

• For toilets, use Borax

Only use drugs and medicines during the programme that you absolutely have to have. Consult a doctor about whether you can leave out or change any medication before starting the programme. If you use emollients or ointments for eczema or dermatitis, try to do without them completely during the test period – you may actually be sensitive to them. Do not use home medicines. If you cannot do without a painkiller, use Paracetamol rather than aspirin or other compounds.

Avoid doing tasks that use strong chemicals if you can, such as DIY, car maintenance, or using glues and solvent-based writing materials. Do not use garden sprays or chemicals. Avoid solvent-based felt-tip pens and white correction fluid.

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Paint strippers are of two basic kinds – organic solvent-based ones which dissolve paint, and caustic strippers which are applied as a paste, allowing the paint then to be peeled away. Avoid using solvent-based strippers as significant fumes are given off on use. Using caustic strippers is probably preferable to using a blowtorch, where you will have to deal with the fumes of the blowtorch and of the paint or varnish being burnt.

Caustic strippers are based on caustic alkalis, and can burn the skin on contact, but do not cause sensitivity. Take all usual precautions with face, hands and body when using irritant materials and handle all waste carefully.

Langlow make Safer Paint and Varnish Stripper which is water-soluble, and does not contain caustic soda, or methylene chloride. It is less irritant than other caustic strippers, but still requires careful handling. It is available from DIY shops, and Do It All.

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No independent test reports have been done for air filters and cleaners. The following assessment is based on the judgement of doctors and nurses, and the experience of a range of users with allergies and sensitivity.

If you are exceptionally sensitive to particles, such as dusts, moulds and pollens, or if you are very sensitive to chemicals, you should only consider higher efficiency machines.

Smaller filters

If you are not sensitive to chemicals, nor very highly allergic, most of the smaller filters will be sufficient to take out a high level of particle allergens and will be fine for most people’s needs. Some of the best small filters include the Trion Electrion, the NSA 1200A, the Medivac F400 and the Mountain Breeze F400. These all have a thin layer of activated carbon filter which takes out some chemical vapours, but they are not highly effective against chemicals. For filters which are, see below.

The Trion Electrion has an electrostatic filter, a thin carbon filter and a permanent ioniser (see above). It is small, unobtrusive and very portable. It is very quiet to run and has three speeds of operation. It has a marked effect on particles and dusts, according to people who have used it. Its price (at 1992) is quoted between £80 and £100. Its electrostatic filter can be washed; its carbon filters need replacing every six months, costing £7 each. It is available from Air Improvement Centre, Beta-Plus or direct from Trion (addresses below).

The NSA 1200A is larger than the Trion Electrion but still light, unobtrusive and portable. It has an electrostatic filter, a fabric filter and a thin layer of activated carbon. It has an optional fragrancer which you should not use if you are chemically sensitive. It makes as much noise as a quiet fan heater. You can buy a carrying bag for it which is useful if you wish to carry it around with you. It has good reports from users and samplers, but it is more expensive – about £150 at 1992 prices. (At this price, a more effective, but less portable, medium-size filter [see below] would be a better buy.) Filters (£20 each) need replacing every six months. The NSA is available from Beta-Plus or NSA distributors (addresses on pages 241-2).

The Mountain Breeze F400 and the Medivac F400 also receive good reports from those who use them. (These two are virtually identical machines.) They are generally viewed to be less effective than either the Trion or the NSA devices, but nonetheless make a difference to air quality and are worth considering. They are cheaper in price (about £70), with replacement filters (£6) renewable every six months. These devices have an ioniser built-in, an electrostatic filter, and a thin activated carbon filter. They have an optional fragrancer, and three speeds of operation. They are as small and unobtrusive as the Trion, but noisier in operation. They have a stronger smell of plastic when new, but this does wear off. These are available from Air Improvement Centre, Beta-Plus, Medivac or Mountain Breeze.

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If you are extremely sensitive to a food or foods, you may react even to the smell or vapours of the foods, or to handling them. You may also be affected by other people eating them in your presence, or if you go into canteens, cafes or restaurants.

To protect your hands when preparing foods, wear gloves. Use cooking methods that minimise cooking times and fumes. Ventilate well. Keep chopping boards separate if necessary to keep juices off your own food.

You may have to avoid public places where food fumes are found if you are badly affected. Members of your family or household may have to modify their diet and leave out things that upset you. Avoid situations that you know upset you.

Tiny traces of moulds adhere to cut or just prepared food, vegetables and fruit, and in refrigerators and freezers. These may upset you if you are highly sensitive to moulds.

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Most people who display symptoms of the classic allergic diseases (i.e. asthma, eczema, hay fever, urticaria, perennial rhinitis and anaphylactic shock) show raised levels of IgE in laboratory tests. (>DETECTING YOUR ALLERGIES for further details of these tests.) However, this is not true of everybody who suffers from these diseases. Generally speaking, if there is an identifiable trigger (such as pollen, dust mites or animal fur), and the patients display the classic symptoms of allergy, their illness will be diagnosed as allergy even if the tests are negative. Conversely, some people have a positive result to tests for allergens and raised IgE levels but do not actually react and show symptoms.

It is not known why the body’s normal defence mechanism goes wrong in this way, although it is known that the tendency for it to happen runs in families and can be inherited. This inherited tendency is known as ‘atopy’. This means that if you or your partner suffer from allergies, your children are more likely to suffer from allergies, too, although they may well escape totally. If they do inherit the tendency, however, they will not necessarily inherit your precise symptoms or react to the same specific allergens. For example, you might be allergic to cat fur and get asthma, but they might get perennial rhinitis and be allergic to dust mites. This suggests that the fault in the immune system lies in the controlling or recognising mechanisms.

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Here’s what to expect from the semirigid implant surgery. To avoid infection, some doctors ask patients to shower with a special antiseptic soap for several days before the operation. This procedure helps to decrease surface bacteria and may reduce the chance of infection. For the same reason, some doctors put patients on antibiotics for a period before and after the operation.

Although infections with prostheses are rare, caution is in order, because anytime you have a wound with a foreign body in it, like a penile implant, it takes fewer bacteria to cause an infection than in a simple incision without a foreign body,

With semirigid implant surgery, you might have a general, local or spinal anesthetic, depending on your general health and the preferences of your doctor. In any case, you won’t experience pain during the procedure, although with a local anesthetic you might feel some pulling and pressure.

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Your doctor should ask detailed questions about the specifics of your problem. He’ll want to know when your problem started, how long it’s been going on, if it’s always present or sometimes not. He may ask you to photograph your erection, so he can get an idea of how it looks. He’ll want to know if you get erections when you masturbate or when you wake up, and if so, what the erections are like.

It’s relatively rare, but sometimes a man finds himself with a penis in which one part is erect and another is not. The shaft of the penis may be erect, but the tip is flaccid. The penis may also curve to one side when erect. Such specific descriptions will help your doctor focus on the possible causes of your potency problem.

Be sure to tell the doctor about any circumstances in which you can obtain a full, firm erection. A man with the “pelvic steal” syndrome may be able to maintain an erection if he lies on his back and is less active during intercourse than if he is on top of his partner. A man with this syndrome has diseased arteries. When he’s very active, the muscles in his legs and buttocks rob the blood from his penis, leaving it flaccid.

How you feel emotionally is also an essential part of your story. How is the situation affecting your life? How do you feel about yourself?

How your partner is handling the situation is another crucial piece of information. A supportive, involved partner can be immeasurably helpful in treatment and make a successful outcome more likely—and pleasurable. On the other hand, a hostile partner can make successful treatment difficult or impossible. Remember that many women feel they are somehow to blame for the situation, and need a lot of reassurance and support. You can help your partner and yourself by keeping her involved and informed whenever possible.

If your relationship is on the rocks and you can’t seem to get back on the right track, we recommend you and your partner seek help either before you resolve your potency problem or at the same time you are undergoing treatment. Simply curing your potency difficulty will not, by itself, heal a damaged relationship.

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It’s important not to let the situation fester for a long time without talking about it. Be honest and up-front about how difficult it is for you to discuss it—and then start talking. The longer you wait, the more opportunity there will be for bad feelings to develop.

This happened to Walt, a field supervisor for a large private utility, and Becky, his wife of 20 years, who ran her own crafts business. They were a happy couple with three children in high school. Walt, a muscular, physically-fit man spent his free time on family activities and kept his small farm running smoothly. Sex was very important to him, and he took pride in the fact that he and his wife had an active, satisfying sexual relationship. Walt was the kind of man who never was sick, but after his

42nd birthday he developed a severe infection in his bladder. Excruciating pain forced him to go to the doctor, but the infection proved stubborn and remarkably resistant to treatment. In rare cases, such a condition can infect a testicle, and that’s what happened to Walt. Although he was given an antibiotic that ultimately cleared up the bladder infection, the infected testicle could not be saved and had to be surgically removed.

The removal of just one testicle does not affect a man’s ability to have an erection, or reduce his chances of fathering a child. The other testicle simply picks up the testosterone-producing and sperm-manufacturing functions of the missing organ.

But for Walt, who took such pride in the appearance of his body, losing one testicle was an enormous shock. Physically, he recovered from the operation, but he was beset with anxiety and fear. Walt felt that a vital and essential part of himself was missing. For the first time in his life, this man began to have trouble maintaining an erection. When Walt started to have intercourse, his erection would disappear.

Becky was totally unprepared for this turn of events. Sometimes she became very disappointed when Walt lost his erection while she was sexually aroused. She didn’t understand the reasons for the sudden change in her husband (neither did he), and sometimes she became angry.

Even now, several years later, Walt becomes upset when he remembers what happened. “My erections went away overnight.” He became more and more troubled and increasingly fearful of trying to have intercourse.

This was an enormous and painful change for Walt and Becky, who considered sex a major and important part of their relationship. But even though the problem continued, they didn’t talk about it. Instead, Walt put his energies into avoiding sex— and his wife. He put in long hours at work, and when he was home became extremely creative in finding reasons to stay away from Becky. “I didn’t want to start anything I couldn’t finish,” he says,

It seems clear from Walt’s story that his erection problem was psychological, not physical. When his anxieties about the loss of his testicle first surfaced, he could have been helped by some intensive, short-term counseling aimed at reassuring him that he was just as capable of having an erection as he ever had been. Perhaps Walt needed to mourn the loss of a part of his body that was important to him. He also could have had his missing testicle replaced by a lifelike artificial one which would have given him the appearance he valued so highly.

But unfortunately, Walt did not seek out and did not receive help. And neither did Becky. In fact, they went for three years without consulting anyone. That’s a long time to go without sex, and Becky and Walt were living together without physical affection of any kind, without much warmth or tenderness and with limited communication.

Going into the fourth year of the problem, Walt finally mentioned it to his family doctor. By then, however, the damage to the marriage was irreparable. Although Walt ultimately was able to regain his potency, he and Becky separated.

Even now it is difficult for Walt to talk about his experience. “My wife is a good woman,” he says with apparent pain. “But she couldn’t put up with my problems. If I had to do it over again, I’d get help sooner,” That’s good advice from someone who knows.

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In fact, it’s estimated that a million and a half American men can blame their erection problems on arteries and veins that don’t work properly. In one autopsy study, all men over age 38 had some narrowing of the arteries to the penis. Fortunately, however, that can largely be prevented with a healthy diet, proper exercise and general good health habits. (A small number of arterial-blockage cases occur when a man suffers a major trauma, such as an accident.) Some relatively rare diseases, like lupus, which affect the arterial system as well as other parts of the body, can also short-circuit erections by interfering with the blood-flow system.

Despite what you may have heard, even young men can have arterial disease, although it may take years before the damage presents itself in the form of erection problems or heart attacks. If you do develop blockage in the arteries supplying the penis, help is available. Usually, an implant will be the treatment of choice, but some patients can benefit from having a surgical bypass of the penile arteries.

Arteries, though, are only half the story—the way the blood enters the penis. But the blood has to stay there for you to be potent. For that you need healthy veins.

For years, doctors thought only malfunctioning arteries deserved the blame for blood-flow problems in the penis, but now doctors have found that many men suffering erection problems can place the blame on their veins. Why?

When a man’s penis is flaccid, the veins keep the blood flowing out of the organ as part of the normal blood circulation. But during erection, the veins, squeezed by the blood-filled sinuses, must shut down partially to keep blood in the penis so it will stay firm and erect. If the veins don’t shut down as they’re supposed to, a man will experience a disheartening situation. He may get no erection at all; he may find himself with an erection which just never gets really firm or he may get an erection that disappears before he and his partner have a chance to enjoy it. What causes this discouraging condition? Apparently, some men are born with leaky veins; their veins never or almost never function properly.

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As a man goes into his later years, he may find a difference in the firmness of erections. Men over age 60 frequently have slightly less firm erections. By itself, this small change usually poses no problem. Older women, however, often have less vaginal lubrication, another natural result of aging. The combination of a slightly less firm penis with a drier vagina can make intercourse difficult. But a solution is readily at hand: use of a water-based lubricant. The problem we’re describing is definitely not impotence.

Unlike men in their mid-years who ejaculate with less force, some older men may find they have intercourse with no ejaculation at all. Some men are bothered by this change; for others, it’s of little consequence. The plus to this situation, of course, is that these men can enjoy intercourse for longer periods of time.

After ejaculation, the older man will lose his erection more quickly than he did in his younger years. A young man might find himself with an erection even after ejaculation, but this is certainly not typical of a man in his 50’s or older.

One change which comes naturally with age is especially significant. The time period between erections increases. Noticeably. Understandably, this is probably the most disturbing and unwanted change. For some men in their 60’s, it may be hours between erections, even with stimulation. For others, it may be days. There’s a lot of individual variation, but the general trend is more time between erections. This is normal and does not mean the man is impotent. Try thinking of this as a resting time from intercourse, but not from other types of sexual activity,

These changes appear gradually in healthy men, overtime. For some men, they come on so slowly they are hardly noticeable.

So, for the most part, these changes shouldn’t pose a problem for the well-informed man and his partner. And understanding how the penis becomes erect can actually add to your enjoyment—and that of your partner.

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