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• A flood is when a river or the sea rises so much that it spills over the surrounding land.
• River floods may occur after a period of prolonged heavy rain or after snow melts in spring.
• Small floods are common; big floods are rare. So flood size is described in terms of frequency.
• A two-year flood is a smallish flood that is likely to occur every two years. A 100-year flood is a big flood that is likely to occur once a century.
• A flash flood occurs when a small stream changes to a raging torrent after heavy rain during a dry spell.
• The 1993 flood on the Mississippi–Missouri caused damage of $15,000 million and made 75,000 homeless, despite massive flood control works in the 1930s.
• The Hwang Ho river is called `China’s sorrow’ because its floods are so devastating.
• Not all floods are bad. Before the Aswan Dam was built, Egyptian farmers relied on the yearly flooding of the River Nile to enrich the soil.
• After the Netherlands was badly flooded by a North Sea surge in 1953, the Dutch embarked on the Delta project, one of the biggest flood control schemes in history.
• Even when no one drowns, a flood can destroy homes and wash away soil from farmland, leaving it barren.

• Lemurs are small furry creatures with long tails and big eyes. They are primates, like monkeys and humans. Lemurs live only on the islands of Madagascar and Comoros, off the east coast of Africa. Most lemurs are active at night and live in trees, but the ring-tailed lemur lives mostly on the ground and is active by day.
• Lemurs eat fruit, leaves, insects and small birds.
• The ring-tailed lemur rubs its rear on trees to leave a scent trail for other lemurs to follow.
• Lemurs are small furry creatures with long tails and big eyes. They are primates, like monkeys and humans. Lemurs live only on the islands of Madagascar and Comoros, off the east coast of Africa. Most lemurs are active at night and live in trees, but the ring-tailed lemur lives mostly on the ground and is active by day.
• Lemurs eat fruit, leaves, insects and small birds.
• In the mating season, ring-tailed, lemurs have stink fights for females, rubbing their wrists and tails in stink glands under their arms and rear – then waving them at rivals to drive them off.
• Lorises and pottos are furry, big-eyed primates of the forests of Asia and Africa. All are brilliant climbers.
• Bush babies are the acrobats of the loris family. They get their name because their cries sound like a human baby crying.
• Bush babies are nocturnal animals and their big eyes help them see in the dark. Their hearing is so sensitive they have to block their ears to sleep during the day.
• Tarsiers of the Philippines are tiny, huge-eyed primates which look like cuddly goblins. They have very long fingers and can turn their heads halfway round to look backwards.

Native to the Mediterranean region, the globe artichoke is finding increasing popularity among gardeners in the damp mild coastal regions of this country. Generally three to five feet tall, this coarse, herbaceous perennial has large, lobed leaves to three feet long and good-sized heads that take on a violet shade as they ripen. The base of the scales of the unripe flower head, along with the bottom part of the artichoke, is eaten either cooked or raw.

Artichokes are best planted as started seedlings in trenches eight inches deep, lined with one inch of compost or rotted manure. While it does best in rich sandy loam, the artichoke will grow on any kind of soil, so long as it is trenched, pulverized and well manured. Plant roots five to six inches below the surface, cover with soil and tamp firmly. When plants are six inches tall, mulch heavily to preserve moisture. Cut away all but six of the suckers that develop at the base when plant reaches eight inches and transplant the suckers to make a new row. Plant these singly two feet apart, in rows at least four feet apart, or in groups of three in triangles, at least four feet apart in the row. Protect the young suckers with hot caps, evergreen boughs or some other protecting material. Cut plants back to the ground in fall. In cool areas, protect through the winter with an inverted bushel basket with leaves.

During dry weather furnish artichokes with copious amounts of manure water or compost tea. Deep, thorough watering is best, followed by a liberal mulching of half-rotted manure between the rows.

Crops are produced in spring in warmer areas; in summer farther north. Halfway through the growing season, apply a small handful of fertilizer around the base of each plant, and repeat after harvest. When harvesting, cut with one inch of stem. The preferred method of preparing artichokes is to harvest a head while still green and unopened, when it is about the size of an orange. Heads are placed in a pot of cold water, salted and cooked for 45 minutes after the water has begun to boil. Individual leaves are then picked off and eaten one by one, starting at the outside. The thickened bottom portion of the leaf is dipped in melted butter or basil vinaigrette and its fleshy part stripped between the teeth. When all the leaves have been eaten and the hairy “choke” at the heart removed, the meaty and delicious artichoke heart—the best part of the plant—reveals itself.

The variety most commonly grown in this country is large Green Globe, which normally buds in its second year.

Although it bears a slight resemblance in taste, the globe artichoke is completely unrelated to the Jerusalem artichoke (Helianthustuberosus), a North American sunflower.

The electronic computer used universally in business offices is a relatively modern invention. Each year they are becoming smaller, cheaper, more efficient, and requiring less sophisticated electronics. Indeed, today hardly a school student is without a computer at school (or at home, for that matter), and they have long since become as much a part of the daily human scene as transistor radios and television sets. However, the idea of the computer is nothing new. Indeed, the basic ingredients have been around for as long as the human race.

In fact, every human possesses one of the world’s finest computers. It is quick, reliable, requires minimum servicing, and flashes out the answers in record time. We refer, of course, to the human brain, and the intricate apparatus known as the central nervous system.

This is basically a complex communications network and, fortunately for the human race, because it is so specialized and so efficient, it makes living a relatively easy pastime.

Housed in the protective bony vault of the cranium is the nerve centre of this computer system. From here, branches radiate. Some nerves go directly to certain specialized areas providing specific functions—such as the optic nerve caring for vision that goes to the eye, and the auditory nerve attached to the ear structure that cares for the sense of hearing.

There are 12 so-called “cranial nerves” leading directly from the brain itself. A massive ropelike structure of nervous material then leaves the brain via the stem, and courses through a canal made up of a central hole in the vertebral bones of the spine.
Depending on their location, the vertebrae have been given different names, purely for descriptive purposes. Those in the neck are referred to as the cervical vertebrae. Those in the chest region are the dorsal or thoracic vertebrae. In the lower part of the trunk, they arc large, having to support the body, and these are the big lumbar vertebrae. Then comes a series of fused vertebrae located in the pelvic region, called the sacrum. Finally, at the very tip, there is a series of tiny, apparently unimportant bones collectively called the coccyx (or tail). In animals, the coccygeal bones are for the tail structure. As the spinal column of nervous tissue descends through this strongly protected (but movable) canal, nerves are given off at each side, between successive vertebrae. These supply structures on each side of the body.

In the lower cervical, upper dorsal region, several major roots (as they are called) are given off, and these join, divide and redivide in a maze of nervous tissue called the brachial plexus. In turn this gives rise to the major nerves of the upper limbs. In this manner each part of the arms, hands and fingers is supplied with nerve fibers. They are all part of the total nervous network.

Further down, in the lumbar region, massive nerve roots are given off on either side to form the giant sciatic nerve. This supplies the lower limbs, including feet and toes. The large nerve gradually divides into smaller and smaller branches until every part, skin, blood vessel walls, muscles etc, receives a nervous supply.

There are many functions of the nervous system, but only the chief ones will be pointed out.

Motor Function

This part of the brain controls the action (or motor function) of the various parts of the body. It acts by producing electrical contraction of the muscle fibers that make up muscles. Contraction causes a shortening of the muscles. In turn this produces active movement.

If we desire to move the upper limb, the conscious idea goes to the part of the brain (called the cerebral hemisphere) governing limb movement. Electrical impulses are channeled along the correct nerve that goes to the muscle groups involving the upper limbs – a fraction later, the muscle fibers contract. The limb moves, or bends, or does whatever activity is required.

Similarly, if we desire to bend it in the opposite direction, impulses are sent to Micrograph of human nerve cells. There are two types of branching processes: an axon extends from each cell body to transmit nerve impulses away from the cell body, and dendrites receive incoming impulses and act as sensory receptors for the cell, the opposite muscle groups. The first set of muscles relax as no more impulses are sent, and the opposite ones then carry out a similar function, so enabling an opposite movement.

This all happens in a fraction of a second. In an incredible manner, our computerized system knows which messages to send to which muscle fibers, merely by a conscious thought. It surely represents the finest coordination and smoothest working ever devised.

Sensory Function

Apart from the strictly motor activity, the nerves have a sensory function as well. Most parts of the body have receptors to the various sensations. For example, we are able to appreciate heat (or lack of heat, which equals cold), pressure, pain, the awareness of space. The hands and fingers are plentifully endowed with sense end organs (as they are called), for this all forms a part of nature’s inbuilt protection system of the body.

The cranial nerves also have specialized senses, such as being able to appreciate vision, hearing, the sense of smell and taste.

When stimulated, similar electrical impulses are conveyed through the nervous system back to the brain, and an awareness of these different sensations is possible.

When the two systems are coordinated, it will be seen that they are basically operational for our own welfare. We may see, hear, feel and sense danger. This will immediately give us the message consciously to set our motor system into action and take appropriate steps.

If we are exposed to excessive heat, we quickly move from the spot. We immediately remove any part of the body from a source of pain. If we see danger approaching (whatever the form), our legs immediately work and bodily remove us from this threat.

The gradations may be on a small scale (such as pulling the finger from a hot stove) or a more major one (when we run across the road to escape an oncoming vehicle, or flee for our lives in the event of a more ominous life-endangering threat from hostile foes). There are many degrees. But the essential basic principles are the same. The nervous system is geared to keep the body protected and in first-class working order at all times.

Just to make the total operation more effective, there are certain actions that are governed by so-called “reflex” movements. This circumvents the brain, and acts at the same level as the activity. For example, if the knee is tapped just below the kneecap, a “reflex” movement occurs and the foot jumps forward.

Many such reflex circuits occur in the body. They are automatic protective devices geared to preserve the body.

Sympathetic Nervous System

This is another silently working system that is also operating at all times. It is basically geared to carry out many unconscious functions necessary to the normal everyday wellbeing of the body. For example, the sweat glands of the skin are under the control of this system. Nobody consciously tells the sweat glands to start to work when the weather becomes hot, and the body desires to lose fluid. It just happens. This is because the sympathetic system automatically operates when stimulated by certain situations (e.g. temperatures rising). Sweat is produced, and pours onto the skin surface.

Here it dries, and in so doing, takes a lot of heat from the body. The result is that the body cools down, and so does not reach dangerously high levels that could have an adverse effect on the general function. As the temperatures (internally and externally) reduce, so the need for sweating is reduced, and we perspire less. Once more this is an entirely automatic, computerized function and result. It occurs in the specialized tissues of the brain cells.

This simple example is multiplied thousands of times so that every activity and possible function is covered. Fortunately, this is quite out of conscious control, for if we had to think each time we needed the assistance of one of these functions, we would be hard pressed.

The circulation of the blood, the production of hormones and chemicals by the internal glands, the beating of the heart and in fact nearly every part of the system is, to a greater or lesser extent, under this automatic nervous system control.

• Constellations are patterns of stars in the sky which astronomers use to help them pinpoint individual stars.
• Most of the constellations were identified long ago by the stargazers of Ancient Babylon and Egypt.
• Constellations are simply patterns — there is no real link between the stars whatsoever.
• Astronomers today recognize 88 constellations.
• Heroes and creatures of Greek myth, such as Orion the Hunter and Perseus, provided the names for many constellations, although each name is usually written in its Latin form, not Greek.
• The stars in each constellation are named after a letter of the Greek alphabet.
• The brightest star in each constellation is called the Alpha star, the next brightest Beta, and so on.
• Different constellations become visible at different times of year, as the Earth travels around the Sun.
• Southern hemisphere constellations are different from those in the north.
• The constellation of the Great Bear — also known by its Latin name Ursa Major — contains an easily recognizable group of seven stars called the Plough or the Big Dipper.

This is caused usually by injury to the front or back of the head. It produces a tear of the lining of the brain or of the vessels as they enter the brain substance. Blood accumulates between the brain itself and the bony cranium. It occurs mainly in older people in the 50-and-over age group, but may also occur in younger persons. The blood clots, and later the internal parts liquefy and may absorb additional fluid from the brain fluids. The mechanical pressure of this mass on the brain will ultimately produce symptoms.

Subdural Hematoma Symptoms

There is nearly always a history of injury, but it is emphasized that this is often trivial. Considerable time may elapse, with varying symptoms often difficult to interpret, before the suspicion of a hematoma occurs.

It may take days to weeks or months before symptoms occur. The time lapse is shorter in younger people and the symptoms are often more dramatic. Usually there is a definite history of accident often in sports or falls.

Headaches are the most common initial symptom, often severe, on wakening in the morning or after exertion. Other symptoms develop, such as lapsing into stupor or coma, to awaken with almost normal feelings. Mental confusion may occur. Gradually the symptoms increase in intensity

New diagnostic techniques may quickly identify the trouble. Brain scans, ultrasonograms and the CT scan or MRI can quickly and accurately give a diagnosis and localize the lesion.

Unless diagnosis is made and treatment undertaken, the outcome is often fatal. Newer techniques, if available, may assist in the diagnosis. Treatment (and perhaps diagnosis) involves repeated tapping of the cranium with trephine holes through which the blood clot may be sucked out. Sometimes a flap of bone is lifted from the cranium and the clot removed in this manner. Recognition and treatment of a subdural hematoma is usually dramatic and curative.

A variety of other conditions may occur in this category, but in principle they are covered, and for practical purposes the chief ones have been described.

Hypertensive cephalopathy may take place. This happens when the blood pressure in a patient already suffering from high blood pressure rises still further. A stroke does not result, but headache, sickness, drowsiness and maybe coma could follow. A crisis lasting from hours to days may occur, and then the patient may recover again. This is an emergency measure that must be treated in hospital.

• Meteors are space objects that crash into Earth’s atmosphere. They may be stray asteroids, tiny meteoroids, or the grains of dust from the tails of dying comets.
• Meteoroids are the billions of tiny lumps of rocky material that hurtle around the Solar System. Most are no bigger than a pea.
• Most meteors are very small and burn up as they enter the atmosphere.
• Shooting stars may look like stars shooting across the night sky, but they are actually meteors burning up as they hit Earth’s atmosphere.
• Meteor showers are bursts of dozens of shooting stars which arrive as Earth hits the tail of a comet.
• Although meteors are not stars, meteor showers are named after the constellations they seem to come from.
• The heaviest showers are the Perseids (12 Aug), the Geminids (13 Dec) and the Quadrantids (3 Jan).
• Meteorites are larger meteors that penetrate right through Earth’s atmosphere and reach the ground.
• A large meteorite could hit the Earth at any time.

What is Hemolytic Anemia?

This type of anemia is due to a premature destruction of the red cells. Generally speaking it is fairly uncommon, and as care in the use of drugs looking out for situations in which it is likely to occur (such as Rh incompatibilities), and taking the necessary precautions increases, the risks are now far less than they were a few years ago. Apart from some of the usual symptoms of anemia (sometimes a feature. sometimes not, depending on the degree of anemia present), other typical symptoms are associated with it.

Hemolytic Anemia Symptoms

Jaundice (yellowing of the skin and whites of the eyes) can occur. This is due to the excessive breakdown of the red cells, and the production in large amounts of a chemical called bilirubin. The urine and feces may become severely pigmented also, as large amounts of bilirubin are excreted through these systems.

The blood picture (when examined under the microscope) shows typical changes. The bone marrow makes increasing efforts at stepping up red cell production to cope with the rapid rate of cell destruction. For this reason, red cells that have not matured properly are pumped into the general circulation.

These immature cells appear in profusion. The level of actual anemia depends on the body’s ability at balancing the rate of cell destruction with the rate of new cells being made available. In this way, the symptoms of typical red cell anemia will vary from case to case.

Also, abnormal by-products of red cell destruction are usually found in the urine. There is an extensive battery of tests available to help doctors decide which type of anemia is present, and to help pinpoint the probable cause. Most of the others are rarely seen by doctors in the ordinary routine of practice, and the majority is only diagnosed upon investigation in a large hospital equipped to deal with the full range of investigations.

From the practical point of view, it is essential that any of the telltale symptoms mentioned receive prompt medical attention. Your doctor will very quickly have you referred to the appropriate centers for total assessment and treatment. Treatment of these disorders has no place in home medicine, and trying simple home remedies and following the advice of well-meaning relatives and friends is a total waste of time and could be harmful in precluding vital medical attention.

Jaundice, an important symptom in this type of anemia, warrants immediate medical advice from a doctor.

Some of the more probable types of hemolytic anemia include:

Hemolytic Disease of the Newborn

The most likely situation in which this may occur is when an Rh-negative mother produces an Rh-positive infant, and the cells from the baby stimulate the mother to form anti-Rh (usually anti-D) antibodies.

These antibodies can then cross via the placenta and become attached to the baby’s red cells, causing their destruction (hemolysis).

Generally there is a history of a previous pregnancy or miscarriage in the mother, and during the birth of the first baby (who usually comes through unscathed) the release of fetal cells into the mother’s circulation takes place, and sets up the antibody production that will affect later babies.

Each subsequent baby will tend to be affected more severely It may be lethal to the baby, and a condition called hydrops foctolis can develop unless immediate steps are taken soon after birth. Formerly the only method of treatment was to give a prompt exchange transfusion to the baby. In this way, the diseased blood was removed, new blood replacing it completely.

It was a time-consuming and arduous undertaking and a marathon event for a newborn infant. However many lives were saved in this manner. In the late 1960s it was found that if the mother were given a special single injection of anti-D antibody within 7 2 hours of the birth of her Rh-positive infant, this effectively stopped production of the antibodies, and the risk to subsequent babies was greatly reduced.

As a new generation of mothers is growing up, and with routine blood tests being carried out before and at the time of birth (on the mother and infant), treatment is now effectively cutting back on this form of anemia. In time it will most likely disappear altogether.

However, a miscarriage, abortion or blood transfusion (with Rh-positive blood in an Rh-negative woman) may lead to similar complications later on in pregnancy.

Incompatible Blood Transfusion

The most obvious example of hemolytic anemia occurs when a patient is given the wrong blood during a transfusion. This is termed “incompatible” blood. In 1900 Karl Landsteiner showed that there were four main blood groups that could destroy incompatible red cells. For example, if a patient of group B is given group A blood, the group A cells will be destroyed by the anti-A in the recipient’s plasma. That is why great care is taken to type and cross-match blood before every blood transfusion. Only group 0 blood may be given in a dire emergency without cross-matching with relative safety, for it contains no antigens.

Symptoms that may occur when the wrong blood is given include acute hemolysis, the appearance of hemoglobin in the urine, fever and severe back pain, and frequently renal disorders. Most of the mistakes that occur causing this reaction have been found due to administrative errors at the hospital (wrong labels on bottles, failure to check labels correctly etc).

Hemolytic Anemia Due to Drugs and Chemicals

Certain drugs are well-known for their ability at reacting on the red cells and causing their premature destruction. This may occur almost at once, or in others it may occur about 10 days after administration of the drug, the first dose apparently sensitizing the system and later doses having an immune type reaction. But the result is the same, irrespective of the cause—red cells disintegrating and possibly causing a medical emergency.

Other Causes

A variety of other causes have been incriminated. Certain bacterial infections appear capable of producing bone-marrow depression and red-cell destruction.

Mechanical trauma of the red cells can cause their premature breakdown in others. Apparently healthy young men doing a lot of marching or running particularly on hard surfaces for prolonged periods of time, may damage the red cells in the blood circulating in their feet.

Hemoglobin is later passed in the urine a frightening experience. It is harmless and wearing rubber insoles in the boots should correct the problem.

Burns may have a similar effect, the red cells becoming directly damaged or else suffering damage as they flow through injured vessels. They subsequently tend to fragment and hemolyse. In these modern times, when Teflon is being used in cardiac surgery unless the prosthesis is completely covered with normal cells, red cell damage can occur similarly leading to cell destruction.

Other prosthetics can cause similar cell damage, a problem of modern surgery limited to the second half of the 20th century. It will probably increase as does the rate of surgery of this nature.

Enlarged Spleen

The spleen is an integral part of the reticulo-endothelial system of the body apparatus that deals with red cells once their useful life has come to an end. They are disposed of quietly, and their place taken over by the ever-proliferating number of new red cells produced in bone marrow.

However, if there is splenic enlargement from any reason, the organ may overreact and increase in its rate of destroying the red cells.

Many disorders can lead to splenic enlargement, even simple viral infections such as a glandular fever or viral hepatitis or any other mild viral infection. But some of the infections and conditions producing an enlarged spleen are rarer and more bizarre.

If it can be shown that normal red-cell production is taking place in the marrow and that destruction in the spleen is excessive, its removal could be the choice of treatment.

Gigantism starts in childhood and is usually quite apparent by the age of 10 years. Acromegaly develops in adulthood, becoming apparent usually in the third decade. It is slightly more common in women.

Gigantism Symptoms

Gigantism is caused by a growth in the pituitary gland, causing a massive overproduction of the body growth. The bones simply keep on growing, and the epiphyseal plates, the growing points that normally close, fail to do so.

Excessive secretion of growth hormone in the prepubertal period produces excessive growth—chiefly of the long bones. Parallel with this is greatly increased muscular development, which makes the patient appear strong and well-proportioned physically. There may be features of sexual precocity, which may suggest the underlying abnormality. Later on, the features of acromegaly may set in as well. Associated with these may be indications of involvement of certain nerves, most likely the optic ones. This may suggest the nature of the basic lesion probably a growing tumor in or near the pituitary.

Acromegaly may come on insidiously, and close relatives may be unaware of the slowly developing alterations until they have become well-established. The face tends to become elongated, with coarse features. The skin and underlying tissues become coarse and thick: the facial features, lips, tongue and nose enlarged. The lower jaw typically becomes prominent, and the teeth are often separated as the jaw grows. The sinuses (spaces in the bones) in the frontal region (above and between the eyes) tend to become large and cause prominence of the brows.

The hands may enlarge, and some patients may find it necessary to alter the size of the wedding ring quite frequently in order to make it fit. The feet also continually enlarge, necessitating constant need for new, larger shoe fittings. As the voice box hypertrophies, the voice tends to become deep and husky. Excessive sweating is common.

Often there are odd feelings in the extremities, such as tingling or numb sensations. Carpal tunnel syndrome is common (this also produces tingling fingers due to pressure of the nerve in the wrist as it traverses a cartilage tunnel). The thyroid gland in the neck may enlarge. The ability to concentrate is often impaired. Overweight rarely occurs, but diabetes mellitus (sugar diabetes) develops in about 30 per cent, producing intense thirst, and the desire to void often. Frequently these are the first signs. It is more common if there is a family history of this disorder. All internal organs increase in size, especially the heart (often enlarging to two to three times its normal size), and at a later stage it frequently fails and is often the cause of premature death. In women there is often a reduced sexual drive, with reduction or total cessation of normal menstruation. In males libido wanes and erectile capacity reduces to the level of impotence in many cases.

If there is a pituitary tumor causing the overproduction of hormone, then added symptoms arising from this may also be present. This could include headaches or defects in the visual fields, as already described.

Diagnosis is often made on appearances alone. However, X-rays or CT scans may show bony changes, including alteration in the pattern of the skull in the area of the pituitary gland indicating the probable presence of a tumor.

Specific diagnosis is now possible by the use of radioimmunoassay that can measure accurately the serum level of human growth hormone (HGH).

Excessive production of growth hormone by the anterior pituitary gland may give rise to excessive growth rates. If this occurs during childhood, a condition called gigantism may follow. If it occurs after the normal growing period has finished, a condition called acromegaly may take place.

On the other hand if there is deficient production of the hormone during the childhood growing time, the reverse situation occurs, and inadequate stature, called dwarfism, may result. These conditions will now be considered.

Gigantism Treatment

It depends on the exact cause. Surgery may be required. In recent years a drug called bromocriptine has been used with considerable success in this disorder. Once more this will be organized at a major hospital.

Diagnosis and treatment is in the domain of the specialized endocrine clinic usually found as part of a major hospital. Most large cities are equipped with these centers and are available for diagnosis and treatment.

Many forms of therapy have been used. When visual defects are present, this calls for prompt, active measures. Treatment of the pituitary tumor by surgery or irradiation may be carried out. Several types of therapy are now available, and they seem to give relatively good results. Radioactive yttrium is often used. The steroid medroxyprogesterone has been reported recently as giving satisfactory results. A relatively recent medication called bromoeriptine may be the upcoming star for treatment.

It depends on the exact cause. Surgery may be required. In recent years a drug called bromocriptine has been used with considerable success in this disorder. Once more this will be organized at a major hospital.

Indeed, it is now well-established in the treatment of prolactin excesses and the symptoms attributed to this.

What is Hysterectomy?

Hysterectomy means removal of the uterus (womb). This is a common operation, especially in older women, and in many cases it can transform their lives from one of misery, into the way it was when in the heyday of one’s health and vitality. Although some claim too many hysterectomies are done these days, such reports usually come from chauvinist males, and rarely from women, especially those who have successfully undergone this surgery and had a return to normal living.

Growths, either benign (noncancerous) or cancerous ones, are notorious for producing uterine problems. Bleeding anomalies and many other disorders frequently mean the uterus should be removed. Sometimes there is associated disease of the tubes or ovaries, one or both. Depending on the state of these organs, various parts may be removed at the same time.

Surgery is very straightforward. It is usually carried out under a general anesthetic (the patient fully asleep). An incision is made above the pubic bones, the uterus located, and removed. The entire organ is taken away, including the cervix. In years past, the cervix was sometimes left, making it a less difficult operation, but as cancer of the cervix could still occur, it is now the universal recommendation that it be removed with the body of the womb. Sometimes the operation is carried out via the vaginal approach. This gives similar results. In younger women, every effort is made to preserve the ovaries, either fully or partially, for they will continue to produce essential female hormones up until the age of 50 or beyond.

When the operation is over, the lavers of the pelvic wall are stitched together and soon the patient is up and around. Her problems are usually over, recuperation is generally rapid and her health thereafter is usually markedly improved. Gone is the chance of ever reproducing again, but the operation is often carried out after the full family numbers have been achieved, so this is usually no big deal. In my view, hysterectomy is a valuable aid to making the woman feel better, have a greater level of self-esteem, and be filled with more energy and vitality.

Some women fear that it will detract from their love-life and make them a “neuter gender.” This is totally incorrect. In most cases, many women have an appreciated lovemaking capacity, for the causes of their previous pelvic ill health have been removed, and they feel so much better. Pain, discomfort, for whatever reason, also goes. They are still very feminine, still very much a woman. Sensations are frequently improved.

Do not let anyone dissuade you from this surgery, if it is indicated, on account of reduced libido. In most cases, it is simply not true. Most likely you will perform better than ever.

Pelvic Floor Exercises

Many women with incontinence benefit from pelvic floor exercises. Many physiotherapists supervise the exercises. They consist of regular contraction and relaxation of the muscles of the pelvic floor. This may be carried out 50 – 100 times, several times a day.

A suitable time is when standing, maybe washing the dishes, to gently and firmly squeeze the pelvic muscles. This is similar to the action when cutting off’ the urine stream midway. Contract tightly and hold for a few seconds then release. Repeat many times, anywhere from 50 to 100 times. Repeat the whole exercise several times during the day. It strengthens and tones up the muscle fibers.

Some suggest placing the fingers into the vaginal canal. Others suggest placing small balls inside (these are available commercially). Supervision by a trained physiotherapist is recommended. Incontinence Societies These exist in most states, and are conducted by skilled staff with a special interest in the problem. Advice on the various devices and treatment gear available can be given.

Laparoscopic hysterectomy, removal of the womb, is a common operation, especially in older women. Heavy bleeding for no apparent reason is a frequent indication that means no obvious disease can be found. Many women now respond satisfactorily to endometrial ablation, which avoids the need for surgery. However, womb removal is now often carried out with laparoscopy, the VDU screen, several small low pelvic incisions, and an internal camera. The womb is finally delivered through an incision in the upper part of the vagina. It is time consuming, but the patient is often out of hospital much more quickly.