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Take special care when things are new. Air or wash whatever you can. If you air things off or wash them before you use them, you may have no problem at all. If you buy new furniture or furnishings – such as curtains, beds, cushions or rugs – always leave them in a spare room, or get the supplier to air them for you before delivery. Even if they are of materials that you can tolerate reasonably, airing will help. Let new shoes or bags air before using them to get rid of fumes. Wash new clothes before wearing, especially if they are pure cotton, polycotton or viscose, as they may have fabric finishes.

Air a newspaper, magazine or book before reading it. Keep newspapers and magazines in a drawer when not in use; their fumes can be very bothersome. Use an old plastic bag rather than a new one. Put new paper, stationery or sticky tape into a drawer or box to air before you use it. Air a new plastic appliance – a radio or audio equipment -before you bring it into the living-room for constant use. Air and wash new toys before use.

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Stabilisers and sealants are used to stabilise the surface of flaking or crumbly walls or plasterwork. Polyvinyl acetate (PVA) without fungicide is relatively problem-free. You can use Polycell Super Bond or Evobond Building Adhesive as a stabiliser and sealant; these are available in DIY stores. You can also use Cuprinol Stabilising Solution, a water-based acrylic solution without fungicide, available to order through the trade or DIY shops.

Paving

Stone slabs, bricks, concrete and gravel used for paving will not cause sensitivity. Take care with tar or asphalt paths and drives; the asphalt can give off persistent fumes, especially in hot weather, and is best avoided if possible.

Putty

Putty is made either of linseed oil and chalk, or of acrylics. Use the linseed oil version for preference. It can irritate the skin, and gives off mild fumes at first but is unlikely to cause reactions over time. Vapours from linseed oil evaporate fast and putty is usually problem-free. Brands of linseed oil and chalk putty include B & Q, available from their stores, and Vallance, from DIY stores. Livos sell a linseed putty by post.

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There is much that a parent can do in the first two to three years of a child’s life to help prevent allergic disease or sensitivity developing later in life, or to minimise its effects. Care taken in early childhood can improve your child’s chance of not developing sensitivity, and help his or her resilience if they once become sensitised to something.

Statistically, a child with one or both parents with a history of sensitivity or allergy is much more likely to develop the tendency – called ‘atopy’. Babies can be born with allergies and intolerance; they can be sensitised already in the womb, particularly to foods. Preconceptual care and care in pregnancy can sometimes prevent or minimise this and are worth finding out about if you have the opportunity.

There are things you can do to your environment by way of preparation in advance of the birth; and precautions you can take with toiletries, nappies, clothes, soap powder or any equipment you use for the baby which can minimise the load of substances that potentially cause trouble.

There are also ways of feeding and weaning babies that give them the best possible chance of not developing food sensitivity. It can be hard work sometimes, but it is much less hard (and much less distressing) than the work involved in caring for a baby or child with severe eczema, asthma, colic or other symptoms. If there is a history of food sensitivity in either parent, or in an older brother or sister of the baby, special care taken when feeding and weaning is valuable, especially in the first two years of a baby’s life when you have much more control, and you can establish eating patterns for the future.

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Beds, bedding and bedtime toys are also prime triggers for house dust mite reactions. Humans lose on average half a litre Oust under a pint) of fluid overnight, so beds are invariably damp, unless thoroughly dried and aired. Not only do house dust mites love the damp, warm dark of mattresses, pillows, blankets or duvets, with their abundance of human skin scales, but they thrive in other places such as teddies, soft toys, padded headboards and bed-bases.

A damp environment encourages house dust mites. Living close to damp areas significantly increases mite populations: it has been shown that even living over an underground water course can correlate with increased incidence of house dust mite allergy. Rising or penetrating damp in the structure, using humidifiers, drying laundry indoors, having a lot of house plants, using heating such as gas fires or paraffin stoves which create water on burning, can all contribute to an increased population of house dust mites.

Poor ventilation, or failing to ventilate also contributes. Fixed windows, or keeping double glazing or windows tightly shut to conserve heat will stop through draughts, circulation of air and hence drying of the environment.

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Histamine

Some foods are naturally rich in histamine, one of the chemicals produced by the mast cells (see page 15) and responsible for some of the unpleasant effects of allergic reaction. Histamine is produced in foods that have been allowed to ferment, such as cheese, or in well-ripened foods, such as salami and sausages – especially if they are not kept very cool. Certain fish, particularly those of the mackerel family, also produce histamine if they are kept in too warm conditions. The symptoms that can be caused by histamine include vomiting, nausea, diarrhoea, rashes, headaches and reddening of the skin. These are due to a reaction to high levels of histamine acting directly on the body, not to an allergic reaction.

Other Chemicals in Foods

Histamine is a ‘vasoactive amine’, a type of chemical that affects the blood vessels. Other vasoactive amines – particularly tyramine, phenylethylamine and octopamine – are found in many foods and can cause direct adverse reactions – notably headaches and migraine, but also flushing and urticaria. Like histamine, tyramine is present in cheeses, and fermented and pickled foods. Other foods high in vasoactive amines include yeast extract, chocolate, bananas, avocados, wine and citrus fruits.

Another, more familiar, chemical, that is present in foods and can cause adverse reactions, is caffeine. It is found in tea and coffee, and in lower doses in chocolate and cola drinks. Some painkillers also contain caffeine. Caffeine can affect some individuals more than others. It is a powerful drug that affects the nervous system and can induce a wide range of symptoms

Eating too much fruit can also be the cause of adverse food reactions, such as diarrhoea and stomach pain. Many fruits are naturally laxative. Some are well known, such as prunes, figs or rhubarb, but many others can also have this effect, especially if eaten in large quantity.

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After a recovery period, the doctor will instruct you to slowly and gradually pump up and deflate the implant. This is only to make sure the prosthesis inflates evenly as healing progresses. You should wait until your doctor gives the okay before attempting to have sex. If s important not to jump the gun and try inflating the implant too soon. Some men are so tender they don’t even want to think about doing this for several weeks.

Typically, a man has to wait six weeks before he can have intercourse, and even then it’s important to proceed slowly and gently. It will be a lot more comfortable, at least at first, to inflate the implant to about 75 percent of capacity at the most. It’s important that the implant be completely deflated most of the time. If it remains partially inflated, scar tissue can form around the reservoir and prevent it from filling completely. The end result can be a penis that is partially inflated all the time.

Surgery is necessary to correct this avoidable and relatively uncommon complication.

Of course the inflatable implant has drawbacks. A leak in the system is probably one of the most common problems. It takes just a tiny hole to sabotage the prosthesis. Usually, removal and repair is necessary—requiring additional surgery. Twisted tubing which prevents the fluid from traveling between the reservoir and the cylinders is a rarer occurrence. But if it does happen, surgery is necessary to straighten out the kinks. A weakness in the corpora cavernosa can result in a lopsided erection—because the implant balloons out to fill up the space. When most of the fluid ends up in one area, less is available to go elsewhere. The man finds himself with a mostly soft penis that has a big, stiff lump. Again, surgery can correct this condition; the physician replaces the cylinders with specially designed ones which won’t balloon, but also aren’t quite as big in diameter.

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Although flaxseed has been best known as a source of linseed oil, this ancient food which contains both soluble and insoluble fiber is also the richest known vegetable source of omega-3s. A food with incredible heart-protecting properties, flaxseed contains the highest levels of alpha-linolenic acid, a variety of omega-3 fat. Flaxseed oil is another option. Its omega-3s promote the formation of prostaglandins, the hormonelike substances that help to relax capillaries, decrease cholesterol levels, and lower blood pressure.

If you decide to use the seeds, sprinkle a few tablespoons on your cereal, mix them into yogurt, and, if you wish, grind them and add the powder to food. Use the oil as you would any salad dressing. You should be aware that this highly polyunsaturated oil has a shelf life of less than a month and that exposure to heat, sunlight, and air can turn it rancid. It should not be used for cooking. However you use flaxseed or its oil in your diet, just make sure you do so a few times a week in order to get your optimal dose of omega-3s.

Another heart-healthy ingredient, olive oil has been found to be especially helpful in transporting LDL cholesterol out of the body while at the same time guarding HDL cholesterol levels. It is the HDL which protects the heart. This has been observed in coronary disease studies of Italians and Greeks in their native countries. While these people consume about the same amount of daily fat as do Americans, their choice—three tablespoons of olive oil a day—has shown to be very beneficial to their health. (In this country, Americans average three tablespoons of olive oil a month.)

My recommendation is to cut out any butter and margarine you may be using and substitute the best olive oil you can buy instead. Your body will thank you for it.

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Developed more than fifty years ago to block the release of histamines from cells, these drugs are widely available in both prescription and over-the-counter forms. They work by counteracting the body’s reaction to allergens, the ordinarily harmless substances which trigger the immune system to produce antibodies to destroy them. When you’re prone to allergies, a special type of antibody, called IgE, is produced, making you super-sensitive to the allergen. Each time you’re exposed to the offending substance, it combines with the IgE antibodies, releasing histamines that bring on sneezing, watery eyes, and runny noses.

Antihistamines, which dry mucous membranes, can also be responsible for ED as well as a drop in libido. I have had success with patients who switched from antihistamines to Nasalcrom or Flonase nasal spray. These medicines control allergic symptoms without affecting sexual function.

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Another view of personal gratification can be seen in the case of fifty-five-year-old Edward. Married for the third time, he was besotted with thirty-year-old Nicole, and his concern about aging motivated him to see me.

Running his hands through his steel-gray hair, Edward made his wishes known. “I’m not deluding myself. I know my personal sexual clock is ticking and it’s bound to slow down. I want insurance that I can count on. The last thing in the world I want to do is disappoint Nicole and have her look to a younger man for satisfaction.”

The fact that Edward was in my office alone disturbed me, and I told him so. In order to be a part of the trials, he had made an appointment for them both.

“Well, I don’t want Nicole to know that I need help,” Edward said. “Right now we’re in a really good place, sexually, for both of us. But once in a while I’m not as hard as I’d like.”

When I asked what Nicole’s reaction had been on those occasions, he shrugged his shoulders. “It amazes me, but she doesn’t seem to care. She had a really bad marriage when she was twenty—the guy was very abusive to her—and she says that feeling safe and loved is one of the biggest turn-ons of all, sex or no sex.”

After I explained to Edward that the oral intervention could bolster his confidence as well as his erection, I made another recommendation. Given his closeness to Nicole, and her comfort with him, I strongly suggested that he speak to her first. He did, and they came in for a second visit. I prescribed the drug, and now they are prepared to override any sexual glitches that may arise in the future. The emotional issues in this case were:

• fear of incompatibility arising out of age difference

• concern about a partner’s level of pleasure

• the desire for increased pleasure

• expectation of an even better relationship

Think about your own feelings concerning:

• how often you have sex and how satisfying it is for you

• restarting sexual activity where none has existed for a prolonged period of time

• whether your sexual expectations have diminished or risen

• keeping your sex-life status quo

The most fulfilling sexual satisfaction is based on an understanding of the other person’s needs and desires.

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Behind the penis are the testicles, two ball-shaped glands that are vitally important to erection, Normal testicles feel something like hard-boiled eggs when you touch them. Men usually learn at a fairly early age that their testicles are vulnerable and quite sensitive to pain. (Falling off a bike or being kicked in the groin during a game of touch football can reinforce that knowledge quite effectively.)

In the womb, a male fetus’s testicles actually change location. They form near the kidneys, but during the last three months of pregnancy descend into the bag that holds them, the scrotum. Ifs not uncommon for a baby boy to be born with a testicle that has not completely descended into the scrotum. During the first year of life, an undescended testicle may actually fall into place on its own. If it doesn’t, a simple operation can place the testicle in the scrotum. Still, two normal, functioning testicles aren’t essential for healthy sex. Men with one normally functioning testicle don’t have any more problems with potency than their doubly endowed counterparts.

If you examine yourself (or your husband), you’ll notice a soft swelling on the back of the testicles. This sensitive area is called the epididymis, and ifs the home for the sperm as they mature. Lots of things—injuries, infections (such as mumps), certain other types of disease—may cause problems with sperm production, thus affecting a man’s ability to father a child. But nature has done a good job of protecting the hormones that play a major role in a man’s ability to have a healthy, firm erection. The production of male hormones in the testicles is separate from sperm production, and far more resistant to damage. That’s why the vast majority of infertile men have no more difficulty with erections than their fertile counterparts. In fact, there’s a big difference between fertility and potency.

Fertility refers to a man’s ability to father a child. Generally, in order for a man to do that, he has to ejaculate normal sperm. Potency means a man can get and maintain an erection. Erection is a separate process from ejaculation, so erection and fertility do not go hand-in-hand. It’s fairly common knowledge that a man can have an erection and not ejaculate; however, many people are not aware that a man can have an ejaculation without an erection. Many men who lose their ability to have an erection still become aroused and, with stimulation, can ejaculate.

This means that a man with erection problems can still get a woman pregnant. He can father a child using artificial insemination. Or, if he ejaculates in the entrance of a woman’s vagina, ifs possible that she could become pregnant. The chances of this happening, of course, are significantly less than with intercourse, when a man ejaculates very close to the entrance of the womb.

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