Comprehensive men's sexual health information, tips and news about men's sexual health.

TAKING PRESCRIPTION ANTIHISTAMINE-DECONGESTANT MEDICATIONS SAFELY Seldane-D Extended-Release Tablets is the only non-sedating antihistamine (terfenadine)-decongestant (pseudoephedrine) combination. These tablets combine terfenadine (60 milligrams) and pseudoephedrine (120 milligrams) in an extended-release format designed to be used on a twice daily dosing schedule. The terfenadine component is contained in the outer coating of the tablet and is released immediately upon ingestion, which is fine, because its effect will last up to 12 hours. The pseudoephedrine is released in two stages. Ten milligrams is present in the outer coating and is released for immediate action along with the terfenadine. The other 110 milligrams of pseudophedrine is contained in the inner portion of the tablet and is made available slowly over several hours. The recommended dose for children over twelve years and adults is one tablet each morning and evening. The same cautions one observes in the use of either component alone should be observed when using the combination. Seldane-D carries with it the same warnings as Seldane: it should not be taken with any erythromycin product, Biaxin (clarithromycin), Zithromax (azithromycin), TAO (troleandomycin), Nizoral (ketoconazole), or Sporanox (itraconazole). Because of the close similarity between antifungal medications, it should not be used with Diflucan (fluconazole), Flagyl (metronidazole), and intravenous Monistat (miconazole). It should not be taken in the presence of liver disease. It should be taken only in the dose recommended by your physician.*46/322/5*

ASTHMA IN CHILDREN: THE INHALED ALLERGENS – OUTDOOR ALLERGENS -FUNGI ALLERGYNext to pollens, spores of different fungi present in the air are the most common cause of allergy.During the rainy season, a green or white fibrous growth often appears on bread left unused for a few days; this also happens on shoes left unused. These fibrous growths, which appear in humid weather, are known as moulds or fungi. Fungi are simple plants, very small in size. They have no chlorophyll. They generally reproduce by means of spores.Most fungi perform a useful function in nature. They act as scavengers, converting live and dead material into basic chemicals, which in turn nurture new life. Antibiotics, like penicillin and streptomycin are made from them. Alcohol, wine, cheese and certain bakery products are made by using fungi.Controlling Indoor FungiAvoid basements for storage of food.Walls should be plastered and painted so that they do not absorb any moisture and remain dry.All rooms and spaces inside the house should have effective ventilation.Potted plants should not be kept indoors.28\260\8*

Sheila was a healthy woman in her early forties, who drove a delivery van for a chemical manufacturer. Her problems began when a chemical drum in the back of her van sprang a leak, and filled the van with fumes. She never discovered what chemical it was, but the immediate effect was to produce a headache, sore throat, and intense irritation of the nose and eyes. She had to continue driving the van all day, and again the following morning. By lunchtime the next day, her eyes were so sore and swollen that she could hardly see. She was also short of breath, and her whole face was beginning to swell.

Despite hospital treatment, it took a long time for Sheila to recover. In fact her sight was not back to normal for three months. Even after that, she continued to have headaches almost daily and felt nauseated most of the time. A host of other problems added to her discomfort, including extreme fatigue, itching skin, pains in

the stomach, constipation, and aches in her muscles and joints. These symptoms were present most of the time, but became much worse if Sheila drove the car, used certain aerosol sprays, or had to sit in the same room as someone wearing perfume or aftershave.

When tested by a doctor with various synthetic chemicals, Sheila’s symptoms reappeared. Exhaust fumes made her drowsy and brought on a headache and pains in her eyes. Sulphur dioxide produced a severe headache, while chlorine resulted in sneezing, itchy eyes, a runny nose and a sore throat.

By ridding her home of aerosols, solvents, chipboard and most cleaning materials. Sheila has managed to reduce the severity and frequency of her headaches, and her nausea has gradually subsided. She is now reasonably well as long as she is at home, but car journeys and other people’s houses usually bring her symptoms on again.

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Ulcers are basically white, craterlike holes that form in the glossy pink lining of the stomach or duodenum (the upper part of the small intestine, just below the stomach).

Duodenal ulcers are more common than stomach ulcers, although both can occur in the same person. Typical symptoms of ulcers are gnawing pain, ‘coffee ground’ vomit, black stools and weakness.

A bland diet, free of coffee, chocolate, fruit and spices, plus hourly feeding of milk and cream, was once the standard treatment for ulcers. That seemed to heal ulcers at first. But in most people, the ulcers eventually returned. Because dietary treatment failed so often, drugs and antacids are now the mainstay of ulcer therapy. But hourly milk is still prescribed for the immediate and acute stage of ulcer attacks, especially if there is bleeding.

Could milk be the cause of many ulcers?

Some doctors think so. Dr James C. Breneman, now chairman of the Food Allergy Committee of the American College of Allergists, first noticed a connection between ulcers and milk allergy several years ago. He was treating a man with a ten-year-old duodenal ulcer. On a hunch, Dr Breneman put the man on a typical food-allergy elimination diet – devoid of milk, wheat, eggs and other common food allergens.

‘Within three days his symptoms disappeared,’ says Dr Breneman. ‘They did not reappear until milk was added as a test food, whereupon he was seized by abdominal pain, vomiting and weakness. After the milk was again removed, his symptoms subsided.’

The agony returned with wheat and pork, and disappeared when they were avoided.

Sixteen years later, the man was still free of all ulcer symptoms. That, says Dr Breneman, virtually proves that he was cured and not merely lapsing into one of the symptom-free periods that are typical of ulcers whether they’re treated or not.

Anyone who has an ulcer and is allergic to milk will continue to suffer as long as he or she continues to drink milk, asserts Dr Breneman in his book Basics of Food Allergy.

When a bland diet does work, it’s probably because people stay away from some of the foods that so frequently cause allergy: chocolate, coffee, condiments and fruit. Since those foods also tend to cause mouth ulcers, Dr Albert Rowe, Jr, coauthor of the book Food Allergy, treats stomach and duodenal ulcers much as he treats mouth ulcers: by eliminating those troublesome foods, plus other common food allergens such as wheat and eggs.

But even with an allergy-control diet, an ulcer cannot be expected to heal overnight, says Dr Rowe.

‘Since it usually takes two or more weeks for foods to leave the body, and a longer time for tissue changes from chronic food allergy to decrease, strict adherence to the diet is required until relief has continued for one to two months,’ says Dr Rowe. ‘After that, individual foods are gradually added.’

As for antacids, Dr Rowe says that people find they need less as relief from food allergy occurs. ‘If antacids are used, the unflavored tablets and fluids should be used,’ says Dr Rowe.

People with ulcers should also avoid aspirin and aspirin-containing drugs. Aspirin corrodes the stomach lining and aggravates duodenal ulcers. And since smokers are twice as likely to develop ulcers as non-smokers, avoiding cigarettes, cigars and pipes is also wise.

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Food allergies affect the digestive system more than any other part of the body because of the close and repeated contact of food with the stomach and intestines. Many people with food allergies suffer from sour stomach or abdominal aches and pains, especially if they’re allergic to milk, eggs, wheat, corn, fruit or other frequently eaten foods. Aside from the annoying and disabling discomfort, digestive problems can be demoralizing – if your doctor doesn’t know you’re allergic, he or she is apt to think you’re a hypochondriac. And you might start to believe it! (Incidentally, the word hypochondria comes from the Greek word for the upper abdomen.)

Indigestion is hard to define precisely. Basically, it’s what happens when your food doesn’t get proper treatment after it reaches the stomach. And that can cause various sorts of problems: heartburn, queasiness, or fullness and bloating.

Heartburn is simply a colourful way of describing a burning sensation (that sometimes feels like angina) underneath the sternum, the bone in the centre of the chest. Food allergy is often the cause.

A related problem is the sensation of having a lump in your throat after you eat. That is caused by a spasm in the oesophagus, and has been relieved by control of food allergy, says Dr Albert Rowe, Jr. who has treated people with food allergies for thirty years.

Abdominal bloating, or gassiness, is so characteristic of food allergy that many allergy doctors automatically suspect food intolerance in people who complain that they have to loosen their belts after meals.

Abdominal pain, on the other hand, is harder to analyze. It can be dull or sharp, and can spread over the whole trunk or focus on one spot – under the rib cage, behind the navel or in the lower abdomen. Food-induced abdominal discomfort can easily be confused with menstrual pain, stomach ulcers, diverticulosis or gallbladder disease. When other causes have been ruled out, investigation and treatment of food allergy can lead to complete relief.

Dr Rowe reports many cases of allergy-related abdominal pain. One man, for instance, had pain in the lower and middle-left abdomen every night around three or four a.m., which was relieved by avoiding foods to which he was allergic. A woman experienced pain across the upper and middle abdomen for six weeks until wheat was excluded from her diet.

If the allergy is severe, the slightest dietary infraction – often from an unsuspected source – can trigger an attack. One of Dr Rowe’s patients who was allergic to eggs had a severe ache across the upper abdomen within one hour after eating candy that contained a trace of egg. The pain lasted eighteen hours.

These abdominal symptoms are best explained by allergic inflammation and muscle spasms causing disturbances in the stomach, oesophagus and other digestive organs,’ Dr Rowe points out as the co-author of the book, Food Allergy. ‘Burning, bloating and belching, for which antacid tablets and liquids are used by thousands of people daily, can be controlled when the offending foods are eliminated – thus making those medications unnecessary.’

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Does your family repeatedly ask you to turn down the volume on the TV or radio? Do you frequently have to ask people to repeat what they’ve said? Do people seem to mumble a lot lately? Do you have trouble understanding what’s being said from the pulpit or stage? Do you lose the thread of conversation at the dinner table or at family gatherings?

Are you afraid that you’re going deaf?

If so, don’t write it off as old age. If you smoke cigarettes or have allergies to foods or inhalants, your hearing loss could be reversible.

Cigarette smoking seems to hasten deafness. A doctor in Cairo studied the effect of smoking on hearing loss in 150 smokers and 150 non-smokers. ‘Average hearing loss in smokers was significantly higher than in non-smokers,’ says Amal S. Ibrahim.

Cigarette smoke has a number of damaging effects on the delicate structures that make up the inner ear, and all of these effects contribute to hearing loss. One of them is an allergic reaction in the mucous membranes of the eustachian tube and the middle ear, says Dr Ibrahim.

Allergy to tobacco smoke may cause Eustachian [tube] blockages symptoms of sinus trouble and postnasal drip,’ says Dr Ibrahim (World Smoking and Health).

In a similar way, allergies to foods and inhalants can also impair hearing.

Nasal allergy from pollen or . . . airborne inhalants or dusts can also cause oedema [fluid retention] in the Eustachian tubes, middle ear or cochlea [hearing structures], resulting in impaired hearing,’ says Albert Rowe, Jr, co-author of the book Food Allergy.

If you lose your hearing, you live in a vacuum. So no effort should be spared to restore it – and that includes an investigation of allergy.

Incidentally, people who take high doses of aspirin daily for years – such as people with rheumatoid arthritis – may lose their hearing as a side effect of the drug. Hearing returns when aspirin dosage is reduced or discontinued.

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Most causes of acne have nothing to do with allergies. However, there’s one type of acne – acne cosmetics – that doctors blame on use of makeup, creams and moisturizers. People most often affected by this type of acne are women in their early twenties and thirties, many of whom have never had acne before in their lives. In those people, ‘makeup is the culprit unless proven otherwise,’ says Susan Elliott, a professor in the department of dermatology at the University of California at San Francisco. Foundations, blushers and powders tend to be comedogenic (acne-forming), she told us. Those labelled ‘non-comedogenic’ are okay.

Creams and moisturizers, used to prevent drying and aging of the skin, may also contribute to acne formation in allergic people. Not only can the extra oil plug pores, but fragrances, lanolin, cocoa butter and other ingredients are common allergic triggers.

If you feel you need a moisturizer (and most women do, at least in winter), choose a bland product. Look for non-greasy, light-textured, unscented creams and lotions with as few ingredients as possible. Dermatologists to whom we spoke recommended Vaseline Dermatology Formula, Nutraderm, and Nivea lotion, all available at chemists.

When you wash your face, be thorough to remove as much oil and bacteria as you can. But be gentle. Acne-prone skin is sensitive. Use a mild cleansing bar, free of potentially allergenic fragrances, dyes and preservatives. And be sure to rinse your face thoroughly afterwards. Soap residue left on the skin can block pores and encourage acne.

Astringents wipe away surface oil, but don’t really decrease deep-down oil production. In fact, one doctor says that an astringent may actually stimulate oil production if it contains irritants (fragrances, dyes or preservatives) to which the individual is sensitive. So for acne sufferers, astringents are dispensable.

And how about diet in general? Why can some people eat whatever they want to and never break out, while others are forced to give up foods they crave? Individual susceptibility. It’s a combination of allergies, heredity, hormones and sensitivity to bacteria in sebaceous glands. If that combination hasn’t worked out in your favor, cut down on chocolate, other sweets, cola drinks, soft drinks, beer, wine and alcohol, and fatty foods.

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For the pregnant woman or nursing mother, drugs for allergy symptoms must be used with special caution, and never for relief of minor allergic symptoms. In a review article for Annals of Allergy, Dr Wallace R. Pratt says that present knowledge of the safety of drugs used during pregnancy or breastfeeding is incomplete. Doctors know that some drugs – including iodides commonly found in expectorants – cause problems in the developing foetus when taken during pregnancy. Other information suggests that epinephrine, brompheniramine, promethazine, diphenhydramine, hydroxyzine and phenylpropanolamine also present some risks to the foetus. While epinephrine should not be withheld in the event of a life-threatening attack, Dr Pratt emphasizes that the limited and uncertain safety of many drugs during pregnancy and breastfeeding calls for prudence in prescribing allergy drugs for expectant and nursing mothers (Annals of Allergy).

While most of the precautions demanded by allergy drugs apply to classic conditions such as asthma, hives and hay fever, use of drugs for any allergic symptoms should not be pursued casually, whether you’re pregnant or not.

Because of the potential risks of drug therapy, it behooves doctors to take two things into consideration when prescribing allergy medication:

1. Does the allergy persist in spite of earnest attempts to avoid the offending food or inhalants? We’d be the last to deny a life-giving drug to an asthmatic. But at the same time, the individual (or parent) should make every effort to control allergic asthma non-medically – getting rid of the dog, installing an air filter, controlling diet, breathing correctly, learning to relax – to prevent emergencies from arising.

‘Certainly, the answer is to find the cause rather than just take pills,’ says Dr Falliers. ‘If you get a headache every time you eat a certain type of fruit, instead of running for aspirin, try to find out: Is it the fruit? Is it the way it was sprayed?’

2. Is the risk of not taking the drug higher than the risk of potential side effects? Intermittent use of bronchodilators in asthma that’s acute, chronic and resistant to all other forms of therapy is preferred over the risk of permanent lung damage from uncontrolled asthma. And, of course, if an individual lapses into anaphylactic shock – loss of consciousness, extreme drop in blood pressure and respiratory arrest with the threat of death – drugs may be the only way to prevent these problems.

‘Drugs require the proper attitude,’ says Dr Falliers. ‘Some families are totally dependent on drugs. Their houses look like a pharmacy, and they take one drug after another. Others are so afraid of drugs they don’t take their medicine even when they really need it.’

It all boils down to one excellent piece of advice: do all you can to control your allergies before you turn to drugs.

‘Not waiting until the damage is done, but preventing it – that will be the secret of success for allergy treatment,’ says Dr Falliers. ‘And if it will put us allergists out of a job, that’s just fine.’

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