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Male potency is one of the last sexual topics in America left in the closet. Men who have trouble getting an erection have told us over and over that no one knew about their problem. «I’ve never even told my best buddy,» says one man. Confides another: «I discussed it briefly with some male friends. But I couldn’t carry it any further. Men just aren’t comfortable discussing it.»
If s not surprising that most men don’t discuss sexual potency among themselves except to brag about their exploits or their size. For many men, being potent is an essential, basic ingredient of their self-image: what makes a man a man. But men should have a reliable, accurate source of information about potency. They should know that impotence, whether temporary or long-term, is a very common problem. That being «normal» isn’t being a superstud, able to perform on command. That few men get great erections every time. That if there is a long-term problem, there’s a 90 percent chance it can be treated successfully.
Most changes in potency aren’t a problem, but do require some adjustment. «When I was in college I could play a couple of games of soccer, run a few laps around the track and make love three times in the same day—no problem!» says Gene, a stocky, muscular 40-year-old man. Smiling a bit wistfully at the memory he adds, «Of course, that was 20 years ago. Times have changed and so have I.» Joseph, a divorced college professor, says, «When I was in my 20′s, I could take a woman out after a long day at work, have dinner and a few drinks, go dancing and then go home with her and make love.» He shakes his head incredulously and says, «Now, in the same scenario, 25 years later, there’s a big difference. By the time I get her home, I’m exhausted from work, dinner and making a good impression—never mind the dancing. I just want to go to sleep! But,» Joseph continues, grinning, «the next morning I’m ready. Really ready.»
Joseph’s behavior is common among men, and nothing to worry about. A man’s sexual response changes as he matures, along with other physical attributes like eyesight, hair color and skin tone. But the emphasis is on the word «change,» because with good health and a willing partner, a man should be able to enjoy sex no matter what his age.
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Each year, middle-aged and older individuals spend fortunes on creams and lotions, massage, hot packs, wax and mud treatments, and special soaps in the quest of wrinkle-free skin. For the most part these treatments are more beneficial to those supplying the treatments than to the individuals receiving them. Although moisturizing creams and lotions may help you look and feel better temporarily, they have no permanent effect on the skin’s texture or appearance.
During the past few years, there has been some evidence that tretinoin (Retin-A ®) cream may be effective in decreasing the wrinkling of the skin and improving its texture and appearance in a more long-lasting manner. The changes noted in the skin of some people treated with this agent have been subtle but measurable and a great deal of enthusiasm has been generated about this product. Some users develop redness, irritation, and swelling where tretinoin cream is applied but this eventually subsides. The skin may become more sensitive to the sun during treatment, so it is recommended that sunscreens be used diligently during this period.
The cost of tretinoin treatment is considerable but many people feel it is worthwhile. Whether this particular antiaging, antiwrinkling skin treatment will withstand the test of time is not yet clear. Meanwhile, if you (with medical supervision) choose to try this treatment, it does not diminish the need to eliminate cigarette smoking, cut down on sun exposure, and use protective sunscreens in an attempt to avoid further skin damage, which ultimately results in wrinkling and a more aged appearance. Prevention will always be preferable to cure; it is best to begin to care for and protect your skin as early as possible.
Some people, as part of their quest for youth, undergo many cosmetic surgery procedures. There is no doubt that such surgery can improve the wrinkled appearance of the skin, may relieve the baggy look around eyelids, and may change the sagging appearance that sometimes accompanies aging. For some people these results are very important. Such surgery does not improve the quality of the skin or make it younger, although it may improve one’s appearance.
It is possible to inject small amounts of collagen around the wrinkled sides of the mouth or sides of the eyes to decrease the appearance of wrinkling. This procedure is relatively easy and safe and can be readily done in the office by a dermatologist. If such wrinkles are very bothersome to you, it is something to consider.
Whatever procedures you carry out to improve your appearance, remember that the protection of the skin from the harmful effects of the sun’s rays and proper cleansing and moisturizing should be part of a total program of good skin care.
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Blood consists of plasma, a fluid that carries red blood cells (erythrocytes) and white blood cells (leucocytes). Red blood cells carry oxygen and carbon dioxide, which are necessary for respiration and metabolism, whereas white cells protect the body from infection. Many elements are contained in the plasma, including important salts, proteins, antibodies, nutrients, and many by-products of metabolism. Platelets are small cell-like particles that help the blood clot when there is an injury to a blood vessel.
The diseases of the blood that can affect older people are the result of a decrease in the red or white blood cells or an increase of blood cells that may not be working normally. Another problem includes a disturbance in the clotting ability of the blood, which can lead to abnormal bruising or bleeding. Sometimes the blood may clot (thrombose) within normal blood vessels for no apparent reason and deprive a part of the body of its blood supply.
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The endocrine glands, distributed throughout the body, produce hormones, which help to control the chemical reactions of the body’s cells. We often use the word metabolism to describe the different cell processes. The most important endocrine glands are the thyroid gland, the two adrenal glands, the pancreas, the four parathyroid glands, and the pituitary gland. The sex glands (ovaries and testicles) also produce hormones, but they are usually considered separately from the endocrine system.
Each of the endocrine glands produces its own special hormone or hormones, which help keep the cells of the body functioning properly and efficiently. When an endocrine gland becomes diseased, it may produce too much or too little of its hormone and upset the body’s metabolism. In most cases the diseases that develop are treatable.
The thyroid gland, found in the neck just below the Adam’s apple, is shaped like a butterfly; the two «wings» are called the thyroid lobes. The thyroid gland produces thyroid hormone (thyroxine), a substance necessary for metabolism.
Certain blood tests measure the amount of thyroid hormone in the blood and help in diagnosis of thyroid disorders. It is sometimes necessary to do a radioactive thyroid uptake and scan in order to diagnose some disorders completely. In many instances thyroid disease requires repeated tests. Unfortunately, disease of the thyroid gland can be very subtle as you grow older. Both overactivity and underactivity can be confused with other conditions, which means that diagnosis and successful treatment are too often unnecessarily delayed.
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Arthritis and rheumatism describe many different diseases, but the features that they all share are pain, swelling, and interference in the normal movement of either one or more joints. Some kinds of arthritis affect only one joint, whereas others affect many simultaneously. Some are more common in older people, and others are rare in people of all ages. Many older people often assume that their aches and pains are the result of arthritis, and that arthritis is a natural consequence of aging. Both of these assumptions are far from the truth.
The most common type of arthritis in the older individual is osteoarthritis, which usually affects one joint at a time, although many joints can gradually become involved. Some studies suggest that this condition affects from 15 to 25 percent of people over the age of 65. Osteoarthritis is caused by a gradual but progressive wearing down of the usually smooth covering (cartilage) of the joint bones. The cause of the destruction is not completely known: in some people it appears to be the result of a previous injury or trauma; in others it appears for no apparent reason. The end result, however, is that the joint surfaces become painful when they move. Often, the large joints that support much of the body’s weight become affected first, frequently the hips, knees, and back. Sometimes it affects the smaller joints of the hands and feet. The joint becomes swollen as opposing bones become widened and fluid accumulates. If the joint is badly damaged, it may not move or support weight properly, and this can interfere with walking or bending. Sometimes a joint that is affected but not uncomfortable may suddenly become swollen and painful as the result of inflammation or infection. This must be treated immediately.
Rheumatoid arthritis occurs less commonly for the first time in the older person, but if you have suffered from this illness during your younger years, it may continue to afflict you as you grow older. This illness can affect many parts of the body simultaneously, in addition to the joints. More than one joint is usually involved, often the smaller joints of the hands, wrists, feet, neck, and jaw. Some people with rheumatoid arthritis develop fever, loss of appetite, weight loss, and heart and lung problems. The joints, however, are the most obvious and painful focus of the disease.
The course of rheumatoid arthritis varies: some people contract a severe case in the beginning; for others it may be mild and create little disability. The symptoms may come and go, with severe bouts followed by long periods of comfort, which are again aggravated by episodes of pain and poor health. Unfortunately, self-diagnosis and treatment for arthritis symptoms is common. This can interfere with a proper assessment and a well-designed plan of treatment, which often results in great improvement and relief of symptoms.
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Light enters the eye through the transparent cornea, located at the very front of the eye. It then passes through the pupil, the black center of the eye. This in fact is the aperture in the iris, which gives eyes their color. The iris can open and close, thereby causing the size of the pupil to change. By varying the size of the opening, the amount of light entering the eye can be controlled. If the light is very bright, the pupil is small and, when it is dark, the pupil is wide open.
After light passes through the pupil, it is focused by the lens, behind the iris. The focused light rays are directed to the retina, which is located at the back of the eye and contains special cells that translate the light images into nerve messages. These are carried by the optic nerves from the retina to the brain, where they are interpreted.
Illness can affect one or many parts of the eye. Some problems, such as infection, affect people at any age, whereas others are more likely to occur as you grow older. In the older person a decrease or loss of vision can be devastating because it interferes with feelings of self-worth and exaggerates the effects of isolation, dependency, and loneliness. If you are not able to read or watch television, you may become cut off from the everyday activities of the world. You should have a thorough periodic examination by a physician or ophthalmologist to ensure that your vision has not deteriorated as the result of disease. Any sudden change in vision should be checked immediately, because many illnesses that cause blindness can be prevented or treated.
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The nervous system is made up of the brain, spinal cord, and nerves. The brain and spinal cord are protected from injury by the surrounding bones of the skull and vertebral column (spine). Nerves leave the spinal cord and make their way through small outlet holes in the vertebral column to supply the muscles and organs.
Motor nerves bring impulses, or messages, from the brain and spinal cord to the body. Sensory nerves convey messages from the body to the spinal cord and brain. The motor and sensory nerves sometimes travel together for part of their journey through the body but usually divide when they enter the spinal cord and brain. The brain and spinal cord contain nerve cells that interconnect with each other and send messages to different parts of the nervous system. Unfortunately, nerves cannot repair themselves once they have been severely damaged. However, some can be lost without significant impairment of function. If many are damaged at the same time, there will usually be some permanent interference in the working of that part of the nervous system. If the blood supply to the brain and spinal cord is disrupted, there can be serious damage to the nervous system.
Older people are more prone to suffer from diseases of their nervous system because of the increased tendency to degenerative disorders and blood vessel disease. These ill nesses account for a large number of the older individuals who require institutionalization. For many people, incapacitating nervous system disease is their greatest fear. Much of the thrust of present research is directed to avoid, postpone, or prevent disorders of the nervous system. Steps taken to control atherosclerosis, hypertension, and diabetes mellitus (diet, exercise, smoking, and alcohol cessation) may decrease some of the risks for some kinds of neurological disease.
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A great deal has been written about lung cancer. Almost everyone knows that a strong association exists between lung cancer and cigarette smoking. There are, in fact, a number of varieties of lung cancer. Those that originate in the lung have a very high correlation with cigarette smoking. Although an unusual type of lung tumor is sometimes found in older individuals who have never smoked, in general those who have smoked heavily for many years are the most susceptible.
Cancer from another part of the body can eventually spread to the lungs as metastases. This of course has nothing to do with smoking and may be one of the reasons that people have the impression that nonsmokers run the same risk of getting lung cancer as smokers. This is not so. If you smoke, your chances of getting lung cancer are many times higher than if you do not. It is too late to stop after you already have the disease. How often I have heard the lament, «I’ll never touch another cigarette,» when such a decision was no longer of any use.
Of the varieties of lung cancer associated with smoking, some are more lethal than others. If the diagnosis is made after symptoms of cancer have begun, the possibility of cure is small. An increase in the amount of cough or recurring chest infections are warning signs that something more serious than a simple infection is involved. The expectoration of blood may be the first sign of lung cancer. Weight loss, impairment of appetite, or undue fatigue may be early symptoms. Sometimes the illness first presents itself because it has already spread to other parts of the body, such as the brain or bones. Headaches, weakness of limbs, or fractures for no apparent reason may be manifestations of the disease.
If the illness is discovered early (as may be the case if it is found accidentally during a routine chest X-ray), treatment has a better chance of being successful. The first suspicion of the disease may be an X-ray that reveals a «shadow,» in which case the physician will take a sputum sample to see if the cells are abnormal. It may be necessary to perform a bronchoscopy and biopsy to see whether a tumor is present and whether it has spread. Very often, if surgery is considered, many X-rays and scans will be done to ensure that the cancer has not spread to other parts of the body.
The results may show no evidence of tumor spread, and the growth may be small. Especially if found by chance, there is a possibility that in some types of lung tumors surgical removal of part of the lung may be successful in curing the disease. Unfortunately, many people with lung cancer also have chronic bronchitis and emphysema, which makes surgery more hazardous.
In some instances surgery can be successfully performed, and occasionally it completely removes the tumor. All factors must be taken into account first, including the kind of cancer, the evidence of spread to other parts of the body, and the general health of the patient. But surgery should not be discarded as a possibility because of age alone.
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The bladder can store sufficient quantities of urine so that you normally have to empty it only four or five times a day. Nerves that come from the spinal cord, and which are partially controlled by the brain, stimulate the bladder to empty.
The bladder can be injured by urinary tract diseases, or by illnesses that interfere with its ability to empty completely and efficiently. When your bladder is not working properly, your health as well as your social life can be severely affected. Men and women have slightly different bladder disorders, but the results are often similar.
If a man suffers from prostate enlargement, he may develop an overstretched bladder until the blockage is corrected. If this is done early enough, the bladder can be retrained and made to work efficiently and normally again.
Both men and women can develop bladder tumors. These usually become evident when blood is seen in the urine. The color of the urine may be bright red or lightly wine colored. Although some of these tumors may be malignant and can spread, many of them are benign or minimally malignant. They can often be treated by fulguration (destroying by electrical current) through a cystoscope passed through the urethra into the bladder. The earlier the tumors are treated, the better the result. Whenever you see blood in your urine, report it to your physician immediately.
Occasionally the tumors are malignant. In this case the bladder may have to be removed and a «new bladder» made out of a piece of intestine. This procedure is usually done by a urologist, and it is often successful, especially if the tumor has not spread from the bladder to other parts of the body. Radiation can also be used successfully.
Women who have had many pregnancies may develop a weakness of the pelvic muscles that surround the vagina. Being overweight aggravates the problem. In such cases the bladder protrudes into the vagina and causes a feeling of something «falling down,» dragging, or pressing, especially when you stand or walk. This is called a cystocele or prolapse.
The cystocele may cause you to suffer from stress incontinence, which means that you lose control of your urine when you laugh, cough, sneeze, or strain yourself, as when pushing or carrying heavy items. You will be more likely to develop bladder infections if the cystocele is fairly large and the urine stagnates because it is not completely emptied.
The condition is treated by a gynecologist, either through the use of a pessary, doughnut-shaped device that holds the bladder in place, or a surgical repair. Many women can benefit from surgery and it should be considered if the prolapse is very uncomfortable.
Urethral Stricture In men the urethra passes through the penis, and in women it is just above the vagina. The urethra can become narrowed in both men and women and the results are similar. This sometimes occurs after injury, childbirth, prostate surgery, or infection. Urine builds up in the bladder and stretches it. This increases the tendency to infection and may lead to difficulties in passing urine or incontinence.
Diagnosis usually depends on a cystoscopy. Treatment consists of dilating the urethra gradually by passing instruments of increasingly large diameters through it. Sometimes treatment must be repeated periodically. Symptoms are often successfully controlled with this therapy.
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Antibiotics are effective only in the treatment of infections caused by bacteria and some other more unusual germs. They are not at all effective in the treatment of illnesses caused by viruses, and they should not be used to treat the ordinary cold or flu, both of which are caused by viruses.
Some people think that an antibiotic can prevent a cold or flu from developing into a more serious bacterial infection. In fact, the antibiotic may damage normal bacteria and result in a disease more dangerous than the one for which it was unnecessarily taken.
Antibiotics should not be taken without the advice of a physician, and they should be used only after it has been clearly established that the illness is caused by bacteria. And they should not be reused at a later date without consulting a physician. Some antibiotics lose their effect with age or even become dangerous. Except under special circumstances, such as if you suffer from chronic bronchitis, and have prearranged a treatment program with your physician, self-medication with these drugs is potentially harmful. Often, a specimen of your throat, urine, or sputum will be examined before an antibiotic is prescribed.
One elderly woman began to experience fever and weakness a few weeks after she had dental surgery Although she knew she had a heart murmur, she failed to mention this to the dental surgeon and therefore did not receive antibiotic therapy. When she eventually went to her own physician with a fever, she did not mention that she had received dental treatment a few weeks before. Her physician prescribed antibiotics because he found evidence of an infection in her urine. Within a few days she felt better and her fever improved. She stopped taking the antibiotics on her own.
About two weeks later she developed fever again and assumed that it was from the same infection. She took her remaining antibiotics without consulting her physician. Her fever decreased, and once again she felt well. A week later the fever returned. Fortunately, she had used all the antibiotics before and had to return to a physician, who found that she was suffering from bacterial endocarditis. The diagnosis and treatment had been unnecessarily delayed because she diagnosed and treated herself with antibiotics without medical supervision.
The way antibiotics are given usually depends on the severity of the infection and your ability to take the drug by mouth. For mild infections the antibiotic is usually quite effective when taken as pills or syrup.
If the infection is serious or if you are in shock or are weak, they will be given as injections or intravenously. It may be continued later by mouth. If extremely large doses of antibiotics are necessary, as in the case of blood poisoning or bacterial endocarditis, they are given intravenously.
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