Asthma gets separate billing from COPD in the rogue’s gallery. But it’s also a lung disease. It’s also chronic. It’s also life-threatening. And about five million American men have it in one form or another.

Asthmatics have hyperactive bronchial tubes in the lungs that can be triggered into breath-robbing spasms by allergic reactions to things such as animal dander, mold spores, or pollen, or by environmental irritants such as smog, cold air, or tobacco smoke.

It doesn’t go away. If you have asthma, you live with it. But there are ways to make living with it a lot easier.

Pull the triggers. Asthma attacks don’t just happen. Something triggers them, and those triggers vary with the victim. They can be anything from dust to gases to allergies to viruses. The best way to get control over asthma, according to the American Lung Association, is to discover what conditions set off the attacks. Then avoid those conditions.

Stay out of the ozone.

Ozone takes a particularly heavy toll on asthmatics, according to Dr. Bill McDonnell of the U.S. Environmental Protection Agency. “Asthma tends to be worse for several days following high-ozone days,” Dr. McDonnell says. “That might be manifested in more symptoms of asthma, more medication use, or more trips to emergency rooms.” But you may be able to avoid trips to the emergency room by limiting periods of outdoor exercise to times when ozone concentrations are low in your area, typically early mornings, adds Dr. McDonnell.

Take a dip. Exercise can sometimes trigger asthma attacks, but you can still exercise if you have asthma. Swimming might be the best way to do it because breathing warm, moist air at a pool is better for your airways than cool, dry air, says Dr. Mostow. Or you can try warming the air you breathe by wearing a scarf over your nose and mouth as you exercise. Longer warm-up-at least 15 minutes- might also help.

Milk magnesium. Long known for its ability to relax the muscles lining our breathing passages, research shows that magnesium may even help fend off an asthma attack, says Richard J. Wood, Ph.D., associate professor at the School of Nutrition at Tufts University in Med-ford, Massachusetts, and laboratory chief of the Mineral Bioavailability Laboratory. Get your magnesium from seeds, beans, nuts, and dark green vegetables such as spinach and Swiss chard.

Have a cup of coffee. The caffeine molecule is a lot like the molecules of the compound in the sprays that asthmatics use to relax the bronchial spasms. A cup of coffee isn’t as effective as a bronchodilator, of course, but it goes a lot better with the morning newspaper.

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Of course, features of any one particular illness often occur in other conditions as well. Colds cause runny noses and watery eyes, but so do allergies.

The same principle-the crossover of symptoms-applies to eating disorders. In fact, one expert referred to anorexia nervosa as one of the “great pretenders.”

An endocrinologist might conclude that weight loss results from hyperthyroidism or Addison’s disease (a malfunction of the adrenal glands that results in inadequate supplies of hormones). A gastroenterologist might suspect a disease of the bowels that prevents adequate absorption of nutrients, a neurologist might wonder about a defect in the hypothalamus or the possibility of epilepsy, and so on.

As a biopsychiatrist, I look for signs that some organic illness or abnormality is causing the patient’s eating problem. A physical examination and lab tests will usually reveal whether some underlying illness, perhaps a tumor or some other condition, is causing the weight loss, the swelling of the ankles, the low blood pressure, and the extreme sensitivity to cold.

Many psychiatric and physical illnesses cause weight loss. With other illnesses, however, the patient usually complains about the problem, or is at least indifferent to it. In contrast, the anorexic takes inordinate pride in her thinness.

Depression-a symptom of anorexia in a certain number of patients-is also widespread. Depression can exist as a disorder of its own, with its own defined set of features, or it can arise from many organic illnesses. Sometimes feelings of depression are a natural, even healthy response to a troubling situation, such as the loss of a loved one.

Prolonged depression can lead to weight loss. But depressed individuals do not usually experience disturbance of body image or fear of fatness. Such attitudes signal the presence of anorexia.

People with schizophrenia often experience warped beliefs and behaviors related to food and eating. Typically, schizophrenics might maintain that their meal has been poisoned, or that “Martians have put aphrodisiacs in the water supply.” They might also eat in weird ways that resemble the bizarre habits of an anorexic. But a schizophrenic usually will not meet the full set of criteria for anorexia. In rare cases, however, both disorders can be found in the same individual.

The behavior of the anorexic often suggests the presence of an obsessive-compulsive disorder. To illustrate, let me tell you about an anorexic patient named Sonya.

The day Sonya arrived at the hospital, I stopped by her room and saw her unpacking her suitcase. I saw that she had wrapped everything she had brought-toothbrush, underwear, books, a favorite cuddly toy-in aluminum foil. She had then placed each foil ball in a separate plastic bag.

Sonya noticed the somewhat startled look on my face. “Germs,” she said tersely.

In my years of experience with eating disorders, I had never seen anything like it. She seemed to be laying in a year’s supply of foil-wrapped baked potatoes. It’s possible that even before her anorexia struck, Sonya, like some other eating disorder patients, may have had an obsessive-compulsive disorder. This is a very hot area of current research, and there seems to be more of an overlap than was previously thought between anorexia nervosa and an obsessive-compulsive disorder (OCD). Medications that are useful in OCD, such as Prozac (fluoxetine), may prove quite helpful in treating anorexia nervosa. It is important to remember, however, that starvation itself will increase obsessional thinking.

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LisaKay Wojcik was so overweight and out of shape that even 2 minutes’ worth of exercise left her so breathless that she feared she’d have a heart attack. But finding the way to breathe correctly helped put her at ease to do the exercise that eventually helped her lose 215 pounds and regain her self-respect.

LisaKay, of Romulus, Michigan, watched her weight climb to 325 pounds through two tumultuous marriages. The combination of personal upheaval and unhealthy weigh gain left her an emotional wreck. “I had no self-esteem left,” she says.

But LisaKay believed in an old but true cliche. When things get that bad, there’s only one way to go: back up.

“I wasn’t emotionally prepared to tackle the problem with my marriage, but I believed that I could improve myself,” LisaKay says. So she went out and bought a low-impact aerobics tape, slipped it into the VCR, and started following the instructor. “After just 2 minutes, I was sweaty, beet red, and breathless,” she says. “I thought I was going to die.”

Convinced that she was having a heart attack, LisaKay called

911. “When I got to the hospital, the emergency room doctor tersely told me that I was merely out of breath,” she recalls. “And he told me to warm up next time.”

Too embarrassed to try aerobics again, LisaKay switched to a seemingly simpler activity: walking. Her first time out, she walked one-quarter mile so slowly that it took 40 minutes. Three months later, she could do 1 mile in an hour.

Six months later, LisaKay was ready for a more intense challenge: a “fat-burner” aerobics video. With her legs kicking high in the air and her arms moving nonstop, she was unaccustomed to such high oxygen demands—and that heart attack scare returned. Back to the hospital she went.

This time, a different doctor told her that she was breathing incorrectly. “He told me to breathe in through my nose and out through my mouth while exercising,” she says. “He said to exhale harder to force a deeper inhale, since this sends more oxygen to muscles.”

That simple tip did the trick. LisaKay continued exercising, gradually adding light weight training and toning and stretching exercises to her workout routine. She made some dietary changes as well, trading in fatty fried foods for salads, steamed cauliflower, and water-packed tuna. Within 1 year, she had lost 75 pounds. Two years later, she had shed a total of 215 pounds.

Today, at age 33, LisaKay is holding steady at 110 pounds. She has joined a fitness club, where she works out on the treadmill and weight machines. At home, she does lots of marching in place, along with exercises to strengthen and tone her body.

Determined to use her life lessons to inspire other overweight women to improve their lives, LisaKay has become a motivational speaker and counselor. “I learned that I matter,” she says. “My message to others is that they matter, too.”

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Nigel, aged forty-nine, started taking Librium twelve years ago when professional worries were making him anxious. Two years ago before surgery for a hernia, he decided to stop taking the pills. The surgery was straightforward, but his recovery was very slow. By the time he left hospital, he was suffering from severe insomnia, palpitations, anxiety worse than he had ever experienced before, and a feeling of tightness in his chest. He was puzzled by how ill he felt, but thought it was weakness after the operation.

During the same year, he complained of nausea and severe abdominal pain. Hospital tests proved negative. He had his spectacles changed three times, trying to correct visual disturbances. So many things were going wrong, he thought his wife must have been right when she said, ‘It is all in your mind,’ although the severe pain he then developed in his right shoulder and in his neck, seemed real enough to him.

Now, eighteen months later, he feels better, but still has some symptoms. Insomnia, palpitations, headaches, and irritability are still a problem, but very much less than they were. He was never tempted at any time during those eighteen months to go back on the pills. He tried alcohol in the evenings, but it did not seem to help.

The experience has changed his attitude to life. He now makes time to relax each day during lunch. What used to be a hurried sandwich and numerous cups of coffee, is now a salad with meat or cheese and fruit, and fifteen minutes lying on the office floor listening to a relaxation tape and being aware of his breathing. He is amazed by how different he feels at the end of the day.

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Accepting and sharing problems with other people has always been good therapy. It is essential to be in a relaxed setting where you can grieve, have a panic attack, or make frequent trips to the lavatory without embarrassment. By expressing exactly what you feel, you give others permission to do the same.

There are often amusing moments even in the most unhappy situations. Sharing these is good medicine. One group member turned the meeting into a pantomime when she described the panic attack she experienced whilst working as a sales demonstrator in a supermarket.

Another young woman announced that she had come to terms with the temporary incontinence, ‘All you need is to wear boots—you can slowly fill them up and nobody knows!’

Guard against endless discussions on how inappropriate or harmful your drug treatment has been. It is in the past. Air your views on the subject, then leave it behind.

If you are lucky enough to get through withdrawal without any drugs for symptomatic relief, be grateful, and do not scold those who cannot. They may be disappointed that they need anti-depressants or other drugs for a time. The aim is for everyone to be drug-free, but some people may need temporary medication to achieve this.

Remember too that you cannot know the medical history of others in the group and there may be a very good reason why they are on certain drugs.

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We are what we eat—during World War II people were physically healthier when sugar and fats were in short supply. It may be that sugar is an even worse offender than fat. The Eskimos who lived on large quantities of animal fat did not suffer coronary artery disease until they introduced sugar into their diet. American research suggests that more people die from cirrhosis of the liver through over-indulgence in sugar, than from high alcohol intake.

Cut down on or give up sugar, all sugar products, and anything made with white flour.

Food allergies can cause or deepen depression. A diet of boiled brown rice and spring water for a few days has helped many people discover what foods they are allergic to. They can introduce one food at a time until they find out what is upsetting them. This diet also gives the liver and kidneys a rest, and enables the body to get rid of toxins.

You can be fat and yet still be undernourished. A healthy diet is essential in depressive illness.

You may still feel very negative, and feel that your efforts are in vain, but others may have noticed encouraging little signs in you.

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De-Realization

This means not feeling in touch with reality, and feeling

Depersonalization

This can happen when anxiety levels are high. People who have never had drugs can also suffer this. Perhaps this is the main symptom that induces feelings of going mad. People feel they are not real, not in touch with themselves, and worry that their mental processes are going to break down completely. ‘I look in the mirror I know it’s me, but it does not look like me—I don’t really recognize my image.’

strange in familiar surroundings. People say ‘I walk into my kitchen and it does not look like my kitchen’. Some people say ‘How can it be anxiety. I am happy about cutting down my pills, and there is nothing in my life to make me anxious’. Even if this is so, your body (and therefore your mind) may still be in a state of stress because of withdrawal. Learn to relax and these feelings will disappear.

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If inflammation occurs in the walls of the blood vessels, the vessels become more permeable as we have already seen. When the inflammation is not too serious, and mainly affects the tiny blood vessels (capillaries) in the skin, the result is likely to be urticaria or nettle-rash. In such circumstances it is mainly fluid that leaks from the blood vessels, with few cells making an escape.

If the inflammation is more serious, then the blood vessels can become much more leaky and even break open, so that red and white blood cells escape into the surrounding tissue, as well as fluid. This condition is known as vasculitis and it may affect larger blood vessels as well as capillaries.

The first noticeable sign of vasculitis is usually swelling, or oedema, due to water leaking from the blood into the surrounding tissues. If there is generalized oedema – a reaction that affects the whole body – there will be a marked gain in weight, as much as 5 kg (over 11 lb) in 24 hours. There may also be aches and pains, especially in the legs, that tend to come and go.

As the condition gets worse, the blood vessels become more leaky and eventually rupture. Red blood cells start to seep into the tissues and are noticeable externally as tiny reddish spots, which then turn purple or black, and finally yellowish before disappearing – the same sort of colour changes as are seen in a bruise. The condition is known as purpura. Larger escapes of blood produce spontaneous bruising.

If vasculitis is allowed to continue unchecked, more serious damage to the vessel wall may occur, and this can eventually lead to a vein becoming permanently inflamed or even completely blocked. Such damage is serious and often irreversible, so it is important to treat vasculitis at an early stage.

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Since beekeepers are usually good observers, it occurred to them to make an experiment of collecting this pollen and feeding it to the bees during inclement weather. The result was that after 8-10 generations the bees that had been given this pollen food had grown bigger, stronger and healthier. They even built larger honeycomb cells. Their tongues had grown longer in relation to their overall size, and this was also an advantage, for these bees were able to obtain the nectar from flowers that ordinary bees were unable to reach.

So the beekeepers were prompted to look at pollen more closely. Experiments were made with mice, giving them a supplement of pollen. This resulted in several benefits. It was noticed that the mice became less susceptible to disease, their fertility increased visibly, their coats became shiny and healthy, and they remained free from skin diseases. The rodents’ vitality increased noticeably, and they lived longer. These findings led to a further examination of pollen. An analysis showed pollen to be rich in vitamins and to contain nearly all the minerals and trace elements vital to man and beast.

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Raw, grated potatoes, mixed with a little milk, are an ideal remedy for the following conditions: slow-healing wounds or cuts, wounds that form proud flesh, infections or inflammations that secrete putrid matter, swellings, bruises, articular rheumatism and inflammation of muscles and of the periosteum.

Potatoes boiled in their skins, mashed when they are still hot and mixed with a little raw milk, can be applied as a poultice, like a clay pack. If you have a poor reaction to cold applications, use warm poultices. Those who benefit from cold packs, on the other hand, should use raw potatoes, grated or pulped.

A remarkable effect can be obtained by alternating three applications on three consecutive days. On the first day, apply a potato poultice; on the second day, a cabbage poultice; and on the third day, a clay poultice made with a horsetail infusion and a little St John’s wort oil. If you continue to apply these poultices for some time, even a severe swelling will yield.

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