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PRACTICAL MATTERS: LEGAL RIGHTS AND OBLIGATIONS-FEDERAL LAWS THAT APPLY TO HIV INFECTION

Section 504 of the Rehabilitation Act of 1973 protects all citizens of the United States against discrimination on grounds of race, sex, creed, color, or handicap. Handicap includes AIDS, and people with AIDS are consequently protected from discrimination. This antidiscrimination law applies to all service providers and organizations—employers, providers of health care, and providers of social services—that receive federal funds either directly or through state and local agencies. The Americans with Disabilities Act of 1990 extends federal protection against discrimination to all people with HIV infection; and this newer law applies to all service providers and organizations, regardless of whether they receive federal funds or not.     Your rights to employment under federal law include protection against discrimination in recruitment, hiring, job assignment, sick leave, or other benefits. Your rights to health care include protection against discrimination in services offered by hospitals, chronic care facilities, or other health care providers. Your rights to social services include protection against discrimination in receiving welfare, Medicaid, Medicare, and other social service programs. Additional information about civil rights under federal law may be obtained by calling the Equal Opportunity Specialist in the Office for Civil Rights, United States Department of Health and Human Services, in Philadelphia, at 215-596-5195.     People who feel that their rights under the federal antidiscrimination laws have been violated should file a complaint within 180 days with the Office for Civil Rights, United States Department of Health and Human Services, P.O. Box 13716, Philadelphia, Pa. 19101, or call 215-596-6109. Complaints should include     your name or the name of the person filing, the complaint on your behalf;     the service provider or organization that is the subject of the complaint;     a statement that the complaint is based on HIV infection as the basis for a handicap;     a description of the complaint;     the time of the incident;     a description of any attempt to resolve the complaint;     a telephone number where you can be contacted for follow-up information.     The representative of the Office of Civil Rights will begin an investigation. If discrimination is found, the Office of Civil Rights will ask the service provider or organization to correct the complaint voluntarily. If this request is unsuccessful, the service provider or organization may have its federal funding terminated, or other legal action will be pursued. If the complaint is not covered by law, the representative of the Office of Civil Rights will attempt to refer the complaint to the appropriate agency.*197\191\2*

REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: HIGH BLOOD PRESSURE – WHAT CAUSES HIGH BLOOD PRESSURE?

Although increased output from the heart, such as occurs normally with exercise, may elevate blood pressure, the usual cause of abnormally high blood pressure is a persistent increase in resistance to blood flow through the small arterioles (the smaller branches in arteries). The arterioles can be compared to a hose.It takes less pressure to push water through a hose with a large diameter than through a narrower hose.The cause of the abnormal increase in resistance in the arterioles remains unknown in 95 percent of people, and they are said to have primary, or essential, hypertension. Hypertension runs in some families, although the problem may never develop in many relatives. Men and women are equallyaffected. For women who take birth control pills and smoke cigarettes, the risk of developing high blood pressure increases. High blood pressure is more common in blacks than in whites. Everyone’s risk increases with age. Additional factors that promote the development of high blood pressure include lack of exercise, excess weight, and alcohol use. A high intake of sodium in the diet increases blood pressure in some people.About 5 percent of people have high blood pressure caused by some other problem in the body (secondary hypertension). Blockage of the arteries leading to the kidneys or excess production  of hormones normally involved in  blood pressure control are uncommon causes of high blood pressure. Your doctor may want to determine whether one of these unusual disorders is the cause of your high blood pressure so that it can be corrected.*257\252\8*

PERICARDIAL DISEASE: INFLAMMATION OF THE PERICARDIUM

The pericardium is the sac that rounds the heart and portions of great vessels. It anchors the heart in place in chest, protects it from nearby inflammation, and reduces the friction that caused by your heart’s beating.The pericardium can be a site of disease caused by inflammation, fluid accumulation (effusion), or stiffness (constriction). These forms may occur singly or in combination.INFLAMMATION OF THE PERICARDIUM. Inflammation of the pericardium is called pericarditis. It occ most often in men between ages and 50 years, sometimes after a respiratory infection.Causes of Inflammation of the Pericardium. Causes of inflammation the pericardium include infection, usually from a virus, or widespread inflammatory diseases such as lupus (systemic lupus erythematosus). Pericarditis may result from cancer or radiation to treat some types of cancer. However, in most cases the cause is unknown.Symptoms of Inflammation of the  Pericardium. Inflammation of the pericardium produces a fairly characteristic set of symptoms and findings on examination. The main symptom is chest pain, but usually it is very different from angina. Typically, it is a sharp, piercing pain over the center or left side of the chest. The pain can extend up to the left shoulder and worsen when you take a deep breath. It can be lessened somewhat by sitting up and leaning forward and worsened by lying down.Although this is the classic pattern, the pain can also be insidious or dull. You may have a low-grade fever, and in general, you just feel sick. Some people have pain with swallowing.How Serious Is Inflammation of the Pericardium?  Acute inflammatory pericarditis usually lasts 2 to 6 weeks and does not lead to any further problems. About one in five people has a recurrence within months or, rarely, within years. Each recurrence tends to be less severe, until the episodes finally stop.*216\252\8*

UNRESTRICTED ENTRANCE – INVESTIGATION

As a lifelong advocate for women’s health, scholar and author D. Lindsey Berkson has been investigating the effects of hormone disrupters on the fetus.She writes, “During critical times such as pregnancy, a mother’s body has high levels of estrogen. Fortunately 99 percent of the estrogen a pregnant woman makes is attached to sex hormone-binding globulin (SHBG). When estrogen rides i piggyback on these blood proteins, it is said to be bound. Estrogen that is bound does not cross the placental barrier, so the estrogen cannot enter the body and brain of the developing child. The estrogen that is not bound is referred to as free estrogen as it is able to pass freely into cells and bind with receptors.Free estrogen is thus the biologically active estrogen that can get into a cell and send a signal to start estrogenic activity. Only 0.2 or 0.3 percent of a mother’s estrogen is free and can get into the fetus.*7/165/1*

DIAGNOSING MENISCAL PROBLEMS: LABORATORY TESTSX ray.

An X ray will only show whether a joint space has narrowed due to the almost complete destruction of articular cartilage; it will not show meniscal damage per se. However, it may reveal calcification of the cartilage—a disorder called chondrocalcinosis—which is usually indicative of a degenerative meniscus, which may be prone to tears.MRI. An MRI is the test that is most often used to diagnose meniscal injuries. It has a 90 percent accuracy rate for the meniscus, which means it is good but not perfect. On an MRI the meniscus should appear absolutely black. A tear or injury to the meniscus shows up as tiny dots. A tear that is incomplete is classified as a grade 1 or 2. A complete tear through the top and bottom, such as the parrot beak or bucket handle, is classified as grade 3. An MRI should be interpreted by an experienced knee surgeon or orthopedic radiologist; a general radiologist may not be able to distinguish between a grade 2 or 3 tear with the same degree of accuracy as someone who performs a lot of knee surgeries. Generally speaking, a grade 1 or even a grade 2 tear is not considered serious, nor is it apparent through an arthroscopic examination. This tear is probably insignificant as far as causing any symptoms. If the patient is no longer in pain, the physician may conclude that the meniscus has a stable tear that may not be causing any symptoms. Therefore, the physician may decide to forego surgery in favor of a good muscle-strengthening program. If at a later date, the tear worsens and the patient experiences pain, surgery may be reconsidered.Under the best of circumstances, the MRI is not infallible, and about 10 percent of the time, an MRI will show a grade 2 tear that is actually a more serious grade 3 and vice versa. Therefore, it is very important for the physician to consider carefully the patient’s symptoms before making the diagnosis. If the physician is convinced that the patient has a serious tear that will require surgical repair or resection, she will probably decide to arthroscope the knee.Arthroscopy. An arthroscope by an experienced arthro-scopist can achieve an accuracy rate of about 100 percent. From the arthroscope, the physician can determine if a tear is significant and whether it needs surgical repair.*23\185\2*

UNRESTRICTED ENTRANCE – TEST TUBE STUDY

A recent test tube study reveals that Roundup can severely | reduce the ability of mouse cells to produce hormones, Roundup interferes with a fundamental protein called STAR  (steroidogenic acute regulatory protein). The STAR protein is the key to the production of testosterone in men thus controlling male characteristics, including sperm production and also the production of the adrenal hormone (essential for brain development), carbohydrate metabolism (leading to loss or gain of weight), and immune system function. The authors point out that “a disruption of the STAR protein may underlie many of the toxic effects of environmental pollutants. In the womb the steroid hormones play a vital role by directing the development of the reproductive organs as well as influencing the development of the thyroid gland, liver immune system and brain. Critical times for breast development also occur before birth. This development requires an impeccable time sequence of events. Any alteration of that sequence can have disastrous and permanent consequences.*11/165/1*

HOPE IS NOT DODGING REALITY

The words on an American Greetings card say it all: “Hope is not pretending that troubles don’t exist. … It is the trust that they will not last forever, that hurts will be healed and difficulties overcome. … It is the faith that a source of strength and renewal lies within to lead us through the dark to the sunshine of His love.”*You see, we just can’t go through life pretending that griefs don’t happen, and acting like the hurt and pain aren’t really there. Faith is knowing that troubles do exist, but it is also the trust to know that they’re not going to last forever and that you will feel better.Hope is the essential ingredient to make it through life! It is the anchor of the soul. But you say your hope is gone? Don’t worry, it can be rekindled. The Lord is good to those who hope in Him.You can regain hope; you can refocus your view and wait on the Lord to renew your strength. Those without Christ may see only a hopeless end, but the Christian rejoices in an endless hope.*16\316\2*

SKIN TROUBLES: PLAN OF TREATMENT

We may speak of the treatment for a certain condition, as, for example, skin disorders; but we never permit ourselves to apply our treatment to the symptoms only. The constitutional factors that are at the back of all such conditions must always be considered.In setting forth a plan of treatment we must therefore try to visualize the whole life of the individual, so that we may try to eradicate the various habits and practices that tend to undermine the welfare of the whole person. We say person rather than body or the part of the body that may appear to be involved, because health and disease are truly indivisible; every factor in the life of the patient plays some part in the bad adjustment from which he is suffering. At the risk of constant repetition we say that the disease cannot exist without the person, and the person and his disease are the entity. To try to separate the two leads to a faulty conception of the basis on which rational treatment should be laid.If we are to make any distinction between the patient and his disease we must reverse the general idea and declare that the patient is more important than his disorder. To formulate the right kind of treatment, knowledge of the particular sufferer is all-important. To a large extent the person himself must be encouraged to turn an analytical eye on himself. In this way he, better than anyone else, can delve into his own being and learn of the things which are undermining his integrity. Let him try first of all to think about the things that agitate his mind. Are they real or are they of his own imagination? Something that happened, for instance, in his childhood may still be a real problem to him, causing him some kind of tension that he carries on to his more mature years. Or he may have developed the habit of allowing some little thing to act as a kind of reflex to bring fear and the resultant tension into his mind. Some such thing may set up a train of worry, making him anxious and fretful. Perhaps he has allowed ambition to make a slave of him, or it may be that in early life he has developed a competitive spirit that still keeps him on edge. A disappointment may have made him bitter towards certain people, and, of course, towards himself. All these things, and many more, which the individual will think out for himself, are associative factors which from time to time set going the health-destroying nervous tensions.Merely to think about them is a good thing which tends to release the mind and refresh the spirit. In fact, they lose much of their power for ill if they are periodically brought into the conscious mind and given a good airing. By doing this one may, as the poet said: “clear to-day of past regrets and future fears.” Many people live their lives under great tension in the nerve-destroying atmosphere of past regrets and future fears, and there is nothing more health-breaking.Those who suffer from chronic skin complaints will do well to think these things over very carefully as a preliminary to other forms of treatment, because it will help them to adopt a more rational attitude towards the other essential measures. It may, for example, help them to understand some of the dietetic errors that such people fall into, and sustain them also in the self-discipline that will be required to change these errors. In planning the diet suitable for such people it is not wise to lay down hard-and-fast rules as’ though the individual is of no account. It is true that certain food elements are required to keep the body in good condition, but not all foods suit all people. Personal likes and dislikes come into it, and sometimes deeply rooted objections to certain foods may be a very useful guide both to diagnosis and to effective treatment.
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FEMALE ANATOMY AND PHYSIOLOGY: MENOPAUSE

Just as menarche signals the beginning of a female’s potential reproductive years, menopause -the permanent cessation of menstruation – signals the end. Generally occurring between the ages of 40 and 60, and at age 51 on average, menopause results in decreased estrogen levels, which may produce troublesome symptoms in some women. Decrease in vaginal lubrication, hot flashes, headaches, dizziness, and joint pains have all been associated with the onset of menopause. Since estrogen plays a protective role in women by guarding against heart disease and osteoporosis (loss of bone mineral density), postmenopausal women may not only reduce some of the symptoms associated with menopause but also regain some protection against heart disease and osteoporosis by going on hormone replacement therapy (HRT), or estrogen replacement therapy (ERT). Unfortunately, HRT is not without potential risk. Increased risk of endometrial cancer (the lining of the uterus), gallstones, and breast cancer has been reported in some women. All women need to discuss the risks and benefits of HRT with their health care provider and come to an informed decision. Certainly lifestyle changes, such as regular exercise and a diet low in fat and adequate in calcium, can also help protect postmenopausal women from heart disease and osteoporosis.*6/277/5*

OVERCOMING CANCER: OVERCOMING POTENTIAL PROBLEMS WITH THE MENTAL IMAGERY PROCESS

Some people are more visual than others; they think in images. Some people tend to sense things. Others feel things. Some think in words. Because of these individual differences, we have found that when we use the word “see” in our instructions to the mental imagery process, some people might instead “feel” what it is like to be well. When we would say, “See yourself becoming well,” they might have the “sensation” of energy and health. It has become increasingly clear to us that a person should stay with the process or way of thinking that he or she is most comfortable with, rather than trying to become primarily visual. In the long run, all types of thinking tend to intertwine. A person who is mostly visual will begin to become more feeling, and a person who is more feeling will begin to become more visual. Permit yourself to operate first in the sense that is most natural to you.
Another problem we have found to be very common during mental imagery is the tendency for a person’s mind to wander. This often represents a lack of concentration, which can be aggravated by certain medications, by pain, or fear. From time to time it is a problem that affects everyone using the process regularly. One of the most effective ways for dealing with distraction is to stop the process and ask yourself what is going on: “Why is my mind wandering?” Pursue that line of thought for a short time, perhaps five minutes. Then focus back on the exercise and go through it with whatever degree of success you can attain.
A third difficulty is the feeling that saying the cancer is “shrinking” is actually lying to yourself. We’ve heard statements such as, “I’ve got a cancer growing on my shoulder, I can feel it, it’s not possible for me to see it shrinking when I know it’s growing bigger.” The problem here is a confusion about the purpose of the mental imagery process. We are attempting to help the patient visualize the desired outcome, not what may be happening at the time. It is possible to picture the cancer shrinking even when in reality it may be growing; you are picturing in your mind what you want to come about. Understanding this distinction is very important. Mental imagery is not a method of self-deception; it is a method for self-direction.
Now that you know the basic relaxation/mental imagery process, the next chapter will help you interpret and develop specific mental images so that you can understand your underlying beliefs about cancer and create a more positive expectancy for recovery.
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