Pollen allergies and eye irritations on aging population

 The eyes are irritated and reddened, and tears flow. Some hay-favorites have a daily cycle, awakening with symptoms in the early morning, experiencing relief from late morning until late afternoon, then becoming discomfited again. Some patients notice that symptoms are affected by environmental factors such as humidity, heat or cold, strong sunlight, or wind. One patient, very sensitive to high humidity, noted severe aggravation of symptoms whenever he took a hot bath. He improved greatly by changing to sponge baths. 

Air conditioning helped his attacks, too, by reducing humidity as well as by filtering out pollen and dust. Usually, the symptoms and their seasonal nature are all that are needed for diagnosis. In addition, the doctor tests for sensitivity to a large variety of allergens, by injection or scratching them into the skin.

 These tests help determine the substance or substances to which the patient should be de- sensitized. The outlook for hay fever is varied. At best, there may be only minor symptoms easily controlled by filtering air in the bedroom and perhaps by occasional use of one of the medicines employed for hay fever. At worst, there may be severe symptoms which prevent enjoyable living and working for weeks; danger of sinus blockage with headaches, middle ear pressure, or infection (especially in children); development of nasal polyps; and appearance of asthma. 

Most cases fall between, with several weeks of annoying symptoms during which the victim is uncomfortable and unable to work or live at his usual productive level. With most patients, the end of the season brings an end to all symptoms, and the malady may be forgotten until the next season comes around.

Doctors often warn hay-feverites to avoid, at all times, house dust, fumes, heavy tobacco smoke, etc., because these may set off a hay-feverlike attack between seasons or aggravate attacks during the season, Effective treatment will frequently prevent the formation of the little benign cystic tumors in the nose called polyps. Also, such therapy will help prevent development of asthma. One form of preventive treatment is to avoid the allergen.

 People who can afford it, or whose work is not de- pendent on a special locale, may go to an area in the United States or abroad where the particular sensitizing pollen does not occur. While this is not possible for most people, many can take their two- to four-week vacation at places away from the pollen or where the humidity and other atmospheric factors are pleasant and helpful. Another form of prevention is to remove the pollens.

There are effective filters for ventilating and air conditioning units; also, there is a special device which precipitates out pollen. Your doctor or a specialist in allergy (allergist) will tell you where you can purchase these and what rooms to use them in. For homeowners who can afford it, a central unit that filters out pollens and controls humidity makes life comfortable; sometimes the cost of such a unit is not greater than the loss of time from work or the expense of distant vacations. Those who do not have such methods of removing pollens some- times prevent serious attacks by going to an air conditioned movie, theater, or restaurant when they feel symptoms coming on. Desensitization treatment is often effective. 

For this, the doctor administers small, gradually increasing amounts of the offending allergen by injection before the season starts in order to build up tolerance. Even after the season has started, desensitization treatment may sometimes help symptoms, at least to some extent.  

Sometimes, there is obstruction to breathing because of a deviated nasal septum or the presence of polyps. At present, there is little need for electrical or chemical cautery of the nasal membranes, but occasionally cautery may prove helpful. Other Inhalant Allergies Symptoms similar to those of hay fever may be caused by many allergens other than pollens. Such allergy is called inhalational allergy, perennial hay fever, or perennial allergic rhinitis. 

House dust is a common cause. House dust is not simple dirt or dust or sand but has been described as a mixture of "cotton, bits of wool, Feathers, animal hair, pesticide, powder, insect scales, mites, shreds of kapok, shreds of cellulose, and other foreign material, and colonies of mold (mildew) and bacteria." Other causes of year-round hay fever include hair and dander of pets, horses, goats; wool; feathers; cotton- seed (from mattresses and furniture stuffing); pyrethrum powder; flaxseed; orris root; and such miscellaneous items as gums and resins, soybean, glue, castor bean, flour, jute, hemp, sisal, coffee, and sawdust.

There are still others which doctor and patient may have to track down in individual cases. Desensitization to these allergens is more difficult than to pollens. There- fore, avoidance or removal of an offending substance becomes important and is usually fairly easy if there is clear-cut recognition of a single allergen. For example, the person who sneezes only in the presence of a cat can have another pet. A voidance of house dust is more difficult, but the doctor will discuss various ways to reduce it in the home. 

Pollen and skin allergies on aging people

Allergens hit their body "target organs" in different ways. Airborne or inhalational allergens strike the nose ,IIH.1 bronchi and lungs; food allergens M" absorbed through the intestine and distributed to various parts of the body, frequently showing their effects of the skin; contact allergens affect ski 11, lips, eyes; allergenic medicines also may affect the skin. 

Some persons have physical allergies, developing typical allergic responses to sun lights, heat, cold, or humidity. The symptoms ofallergy depend upon the target or shock organ affected. If it is the nose, there may be congestion, watery discharge, and sneezing, as in hay fever; if the skin is I he target, there may be rash, hives, or eczema; if the bronchial tubes are the target, there is the wheezing of bronchial asthma.  

 Allergies affect both sexes and may appear at any age. There is a strong hereditary factor. One patient with severe hay fever has a son of 21 who had asthma from age 6 to 14 and has had almost no attacks since, as the result of avoiding cats; and a daughter who had hay fever for several years as a child and then "outgrew" it; the remaining child has not been allergic. It is important for any person with allergy, or with even a family history of allergy, to mention the fact to any doctor or nurse who is treating him. 

An allergic or potentially allergic per- son usually will not be given penicillin or certain other medicines known to commonly produce allergic reactions unless the medication is absolutely necessary.

Hay Fever Chief among airborne allergic diseases is hay fever. Curiously, it has nothing to do with hay but is caused by pollens of trees, plants, and weeds. The typical case is seasonal except in a few parts of the South where there may be pollen in the air all year. In the northern United States there is spring hay fever caused by pollens of trees and grasses, and the summer- autumn variety caused usually by ragweed pollen.

The symptoms, which develop, when pollen contacts nose and eyes, include congestion of the nose, watery discharge, tickling and irritation, and sneezing

Aging and Allergies understanding the problem and prevention and treatment

The older person needs a good, understanding physician to help him with the more numerous illnesses and minor annoyances to be expected with aging. Also, as friends and relatives die, the doctor becomes a needed friend. What of so-called rejuvenation operations and other methods purporting to stop or even reverse aging? As far as medical science can determine, there is no validity to the claims for any of these methods: e.g., transplantation of animal glands, injections of Novocain. We are very much in the early in- fancy of biological and medical research into aging. 

It is entirely possible that some "Peter Pan" substance may yet be found to keep us young longer. We have to learn why the white rat rarely lives more than three years, a dog no more than twenty, and man seldom more than one hundred. Possibly out of such research, with animals as well as man, will become new knowledge to provide clues to longer, youthful life. Until then, we can only learn how to prevent the diseases and ravages of the years so we may enjoy to the full a near century of life. 

Note: Problems of the later years- e.g., retirement change of location, hospitalization for surgery, choice of physician-are discussed in additional detail in a book by one of us: The Complete Medical Guide, by Benjamin F. Miller, M.D., published by Simon & Schuster, 630 Fifth Ave., New York, N.Y. 10020. ALLERGY With all the talk about it, one might assume that nearly all Americans are allergic. This is not true, but allergic ailments are common enough if one considers all the people who have hay fever, asthma, hives, and sensitivity reactions to medicines, pets, foods, cosmetics, and industrial substances.

The term allergy means altered reaction. A person with allergy has become sensitive to a specific sub- stance which is perfectly harmless to the non-allergic population. The word specific is a key one because an allergic individual may have a violent attack of asthma, for example, when exposed to cat dander but may be perfectly comfortable with dogs, hamsters, canaries, or other pets. The offending substance is called an allergen and is protein in nature or has the capacity to combine with protein in the body. 

Thus a person may be sensitive to such proteins as those in milk, egg white, or lobster but be able to take fats, such as butter, and starches and cane sugar in any amount without symptoms. When a person becomes allergic to a non-protein substance such as iodine or penicillin, it is believed that the offending substance is itself a partial allergen and becomes. 

Aging -disease and treament

AGING

 You may be surprised to find aging included in our list of diseases. Doctors really do not know whether or not aging is a disease or a natural phenomenon. The scientific study of aging (gerontology) and of diseases of the aged (geriatrics) is still in its infancy. It may be many years before scientists learn enough about aging mechanisms to answer the question of whether aging is normal or abnormal. In the meantime, most of us assume that aging is part of the divine or natural scheme of life. In our country, when a person is not afflicted with a grave disease, he still rarely lives be- yond age 100, and usually 110 seems to be the limit, although there are reports from India and Siberia of some people living as long as 150 years. So-called normal aging brings changes in many parts of the body.

The skin becomes less firm and elastic and develops wrinkles; vital organs such as heart, kidneys, and brain lose some of their cells so they have less reserve capacity; bones tend to thin out and lose strength and resilience; the endocrine (including the sex) glands tend to become less active. In women, the ovaries stop functioning, the uterus decreases in size, and the vagina tends to lose its softness and elasticity. In the male, the prostate gland enlarges. Fortunately, the muscles hold up rather well throughout life if exercised adequately. 

Despite the many changes, there still is adequate function left to sustain a good life in almost all aged people. However, the man of 85 should recognize that his heart cannot respond as quickly to sudden demands and the brain is not quite as finely tuned an instrument as it was in younger years. Older people learn to adapt by cutting down physical demands, reading more carefully, paying closer attention to names when being introduced. Few people live to 100 or 110. Atherosclerosis (especially its effect on the heart) and cancer are the deadly enemies of the aged. High blood pres- sure, diabetes, kidney diseases, tuberculosis, emphysema, pneumonia, accidents, and liver disease also claim too many victims. Many of these diseases are preventable or curable, and it is a pity that so many older persons succumb unnecessarily.

This book has been written in the hope that the information it provides, especially the stress on prevention of disease and disability, will bring many more people into the older years free of illness and able to enjoy living. We suggest that everyone read the sections on the ill- nesses just mentioned. There seems little point to living to advanced age if one is chronically disabled or handicapped. Every effort should be made to keep the eyes in good condition, hearing at its best, and to avoid the unpleasantness of hernia, backache, find other nonfatal but annoying and sometimes disabling conditions. 

The skin should be kept in good shape and the hair as lustrous as possible (see our chapter on skin and hair). Some older men feel happier with a hairpiece, some when they dye their hair; many women tint hair, one use wigs to make their hair seem more abundant. If these supplements 10 nature add to happiness, why not use them? There are some medical conditions that make a person age prematurely. Among these are hypothyroidism (low function of the thyroid gland), pernicious anemia, and a vitamin deficiency called pellagra. At your regular medical checkups, your doctor can watch for onset of any of these and correct them if they occur. 

How to handle tension and treatment for it?

 Go on to one or more of the following exercises, working slowly, smoothly, without jerking. Start by doing them for just a few minutes a day; then work up to perhaps as long as half an hour. Seated comfortably, raise your arms slowly overhead-and let them drop suddenly. Do the same with the legs. After each drop, pause several seconds to appreciate the relaxed effect. Breathe deeply, exhale slowly. Lie on your back on the floor. 

Close your eyes. Take a deep breath. Exhale slowly. Tighten all muscles in your body. Then let go. Breathe deeply, exhale slowly. Still on the floor, shrug your shoulders up to your ears-and then let them fall back. Turn your head far to the left, then to the front, and relax. Repeat to the right. Breathe deeply and exhale after each movement.

Lying on your abdomen, rest your head on your folded arms. Tighten buttock muscles, then let go. Repeat several times. If you find these exercises helpful, you may wish to consult two books written by Dr. Edmund Jacobson: Anxiety and Tension Control," which is primarily addressed to physicians, and You Must Relax,t primarily written for lay people. Many other physicians today believe that the key to relaxing tension is muscle control. 

With every type of nervous stress, they note, there is muscular expression-sometimes as obvious as drumming with the fingers, sometimes as subtle as a mere flick of the eyes. If you can develop muscular control, you can help prevent buildup of tension. For that you will need to recognize delicate sensations most people are unaware of, distinguishing the slightly different feeling of a muscle performing useful work and a muscle tensed uselessly. Then it is necessary to control the unused muscles, turning them off.

The objective is differential relaxation in which muscles in constructive use stay in use while others are relaxed fully. As an example of how to go about this, close your eyes and silently repeat to yourself the names of three states or Presidents of the United States. Though you are not speaking, notice the small, almost imperceptible tentative movements that take place in your tongue, lips, jaw, cheeks, and throat. Then see if you can relax these muscles completely. o. Jacobson, Edmund, Anxiety and Tension Control. 

Female Sex Glands and Mensturation - Ovulation

THE FEMALE SEX GLANDS

 Like the testes, the two ovaries have more than one function. They produce the ova, or eggs; they also secrete hormones needed for both reproduction and feminine characteristics. The ovaries lie in the front part of the abdomen, below the navel, and each is connected with the uterus by a fallopian tube. 

The ovarian hormones are estrogen and progesterone. They are produced in small amounts before puberty and after menopause, and in abundance during the childbearing years, the period when a woman has her regular monthly cycles.

MENSTRUATION AND OVULATION

 Menstruation involves the discharge of the extra blood and tissue built up in preparation for conception but not used. Cycles vary among women and even in the same woman, but generally the time from one menstrual period to the next averages about 28 days. Doctors customarily count the first day of menstruation as day 1 in a cycle. During the first 14 days of the cycle, the ovary contains a follicle, a small hollow ball about the size of a pinhead. Within the follicle is an egg. The follicle grows during the two weeks until it becomes about as large as a pea. 

As it grows, it produces estrogen. Follicle growth as well as the menstrual cycle in general is under pituitary gland control. On about day 14, stimulated by the pituitary, the follicle bursts and the egg is discharged from the ovary to enter the fallopian tube on its way to the uterus. If sperm are present in the tube at this time, fertilization may take place in the tube. The fertilized egg then continues its journey to the uterus where it implants itself on the wall of the uterus.

Meanwhile, the ruptured follicle from which the egg carne is transformed into a yellowish, solid ball, now called the corpus lute urn, or yellow body. The corpus luteum produces a second hormone, progesterone. Scientists now know how to make synthetic hormones to control ovulation. Contraceptive pills imitate the natural body processes in preventing ovulation, as discussed elsewhere in this book. 

Estrogen and progesterone help build up the lining of uterus, making it thicker and providing it with a rich blood supply to feed the unborn baby. During the last 14 days of the cycle, the two hormones are produced by the corpus luteum. The fertilized egg secretes a hormone that causes the corpus luteum to persist in producing estrogen and progesterone from the fertilized egg is necessary because at the end.Pregnancy has not occurred, the corpus luteum degenerates and its retions stop. 

With cessation of hormone production, the rich blood supply built up in the uterine lining sloughs off and menstruation occurs. Menstruation and menstrual difficulties are discussed in detail elsewhere in this book.

MENOPAUSE

 Menopause, or change of life, is as natural for women as menstruation is. There should be no dread of it: nothing more disastrous occurs than the tapering off and cessation of the monthly cycle. True, some changes, natural ones, occur. Estrogen secretion is reduced. The follicles no longer release eggs. Menstruation stops, suddenly or gradually. 

After menopause is well established, in about a year, there should be no more bleeding. Be certain to consult a physician immediately if bleeding or spotting occurs, since this may signal cancer or an- other disorder requiring prompt treatment. Actually, unfounded fears are to a large extent responsible for the emotional disturbances some women experience during menopause. 

Certain physical symptoms may occur because of the glandular changes taking place. If they become troublesome, they may be relieved by hormone treatment. We discuss menopausal symptoms more fully elsewhere. 

Male Impotence

MALE IMPOTENCE

 Inability to have sexual relations is a complex problem. It may result from a disease of the testes or of the pituitary. Some nervous .system disorders cause impotence. In most cases, however, the testes and entire endocrine system are normal and the problem is trace- able to emotional disturbances or psychoneuroses. Such men may be helped by a family physician who understands emotional disorders. 

If necessary, the family physician may suggest help from a specialist in psychotherapy. Sterility, the inability to beget children, occurs in some men who are not impotent. It may be due to failure, for many possible reasons, to produce enough sperm or sperm active enough to reach and fertilize the female cell. 

While only one healthy sperm is needed for fertilization, and 300 million or more are usually released in an ejaculation, the journey to reach the female cell is so hazardous that many lively ones are required to ensure that a survivor gets to the right place at the right time. Ways have been found to help many men with sterility problems, as discussed elsewhere in this book. 

Eyes - Cross eyes

Eyes That Cross

The belief that crossed eyes in a child will straighten themselves is a tragic misconception; a child does not outgrow crossing. If an infant's eyes "float," momentarily turning in or out, there is usually nothing to worry about. It may take the first three months of life for eyes to become coordinated. After that, however, crossing (strabismus) warrants immediate attention. Without attention, there may be loss of vision in the turned-in eye. When eyes cross, each views an object from a different angle. The brain then receives two different images. Since seeing double is highly disturbing, the cross-eyed child will squint and tilt his head in an effort to combine the two images. 

Finally, he will give up, resort to using just one eye, and the sight in the other will deteriorate for lack of use. When a child is helped early, simple treatment may be effective. One cause of crossing is farsightedness, which may lead to such excessive use of the eye muscles that the eyes overconverge. Sometimes glasses alone, to correct the farsightedness, may be enough to straighten the eyes.

A qualified orthotic technician in an eye doctor's office can help many children by teaching them eye exercises and how to use them at home. Special devices allow each eye to see only half a scene; the eye muscles are strengthened while the child practices fusing the two images into a whole picture-for example, putting the dog he sees with one eye into the doghouse he sees with the other. 

Even when surgery is necessary, the operation to bring the eye muscles into proper balance is virtually free of risk. A muscle that does not pull enough may be shortened; or excessive pull may be reduced by reattaching the muscle at a different point on the eyeball. In most cases, the child experiences little or no pain, is up the day after operation, and goes home in another day or two.

Lazy Eye Lazy eye, or amblyopia, affects children who are cross-eyed and also those who have one normal and one nearsighted or farsighted eye, or one nearsighted and one farsighted eye. 

Here again the brain gets two dissimilar images and may shut out one. Even when sight in one eye has deteriorated to a considerable extent, there is a good chance it can be restored. But it has been estimated that as many as 100,000 children a year in this country are on the way to joining the untreatable ranks. Amblyopia is a major reason why every child should have a thorough examination of the eyes by the age of four, f or the learning ability of the eye is at its height up to age seven, and thenfails off. 

Treatment for lazy eye before age seven-and in some cases, later can be effective. Eyeglasses and a patch over the good eye may be needed. The patch forces use of the weak eye so that, with increased work, its vision builds up. Glaucomaoften insidious, glaucoma is a leading cause of blindness. The most common form develops when the fluid that normally fills the eyeball, the aqueous humor, fails to drain properly. Ordinarily, the fluid is produced continuously within the eye, and excess amounts drain off through, the small duct near the iris. 

But aging, infection, a tumor, congenital defects, and other causes can constrict or block the drain. Fluid pressure then builds up and the pressure, if great and of long duration, may damage the optic nerve. In the acute type of glaucoma, vision may dim suddenly, the eyeball becomes painful, and the victim feels quite ill. But the insidious type of glaucoma causes no pain, injuring vision very slowly. Sometimes it may make itself known by the appearance of colored rings and halos about bright objects or by dimming of side vision. Much can be done to preserve vision in most cases, provided glaucoma is diagnosed in time. Surgical enlargement of the drainage ducts may be used, or medicine may be effective in constricting the pupil enough to allow the canals to open by themselves. Glaucoma is easily recognized by an eyedoctor.