О язве двенадцатиперстной кишки-About duodenal ulcer

The best way to disinfect a cut or wound is to bathe it in a sterile solution of salt (saline). The easiest way to do this is to take a cup of boiled, cooled water and dissolve a teaspoon of salt in it, then wash the wound gently with a clean or sterile dressing. This is a very effective antiseptic.

For convenience, you can buy from a pharmacy sterile saline solution in sachets (Normasol or Steripod). These are handy for first aid kits, for workplace or school, or for travelling.

Be careful to use water (for solutions or for drinking) which you tolerate well. You can be sensitive to tapwater, and this may make you react when you use it for medicinal purposes. Use filtered, mineral or distilled water if you are not sure.

Boric acid, dissolved in boiled, cooled water, can be used as a stronger antiseptic. It should not be used on young children, nor on broken skin. You should consult your doctor or pharmacist before using it.

Calendula, a homeopathic ointment or tincture, is antiseptic. Some allergy sufferers tolerate it well. Patch Test or use with care, to see if you tolerate it.

If you have a persistent infection or sepsis in a cut or wound, you should always consult a doctor.

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You can relieve the effects of a strong reaction by taking alkali salts. This works for food intolerance and chemical sensitivity, as well as for allergy. In a reaction, the environment in the body becomes acid; alkali salts neutralise the reaction and can relieve its effects, or even stop them dead. The simplest way to take these is to dissolve a teaspoon of sodium bicarbonate in a glass of water and drink it.

Some people find that sodium bicarbonate on its own does not suit them as well as other mixtures of alkali salts. You could also try the following mixtures; ask your pharmacist to mix them for you:

• Sodium and potassium salts

Mix two parts sodium bicarbonate to one part potassium bicarbonate. Dissolve one teaspoonful in a glass of water.

• Tri-salts

Mix three parts sodium bicarbonate to two parts potassium bicarbonate and one part calcium carbonate. Dissolve one teaspoonful in a glass of water.

The salts mixtures can be laxative. Do not take more than three times a day, and preferably only once a day. Consult your doctor if you are on a low-salt diet before using.

Vitamin C also helps relieve reactions. Take a teaspoon in a glass of water. You can also add a teaspoon of vitamin C to a glass of any of the alkali salts mixtures above. Ask your pharmacist for pure vitamin C powder (ascorbic acid).

Some people find that taking a salts mixture regularly each day helps to deter and control reactions. This could be worth trying as a controlling measure.

If you have an attack of nettle rash (hives or urticaria), or other local skin reactions, bathing the area in an alkaline solution will help relieve the discomfort. Use Boots Cream of Magnesia Liquid; Boots own brand does not contain flavourings, or bathe the skin with a solution of alkali salts.

To help control reactions, avoid extremes of heat and cold, or sudden big swings in temperature, as these can trigger reactions. Also avoid getting too hungry, as this can trigger reactions. Avoid swings, or excessive highs or lows, in blood sugar levels.

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Activated carbon masks come in various designs but all combine a fibre layer or web which will trap particles, and activated charcoal which absorbs a wide range of gases and vapours. They are designed to fit well around the nose, mouth and cheekbones to seal the areas where air can enter. They will protect against both small particles and chemical vapours.

3M make one which is made of a dense synthetic fibre web which traps particles effectively, and activated charcoal filter media within the fibre web. It is one of the most effective, and light and relatively comfortable to wear. It will not protect 100 per cent against chemicals and particles, and if you are extremely sensitive to synthetic fibres, you may react to the fibres of the mask, but reactions of this kind are rare and most people find it useful. The mask will need replacing every six months, or more often if you use it intensively. The 3M mask costs around £5-6 at 1992 prices and is available by post from Allerayde or The British Lung Foundation. A similar mask by Pirelli is available from Safety Equipment Centre.

One solution, if you react to contact with the materials of a face mask, is to line the inside of the mask with a pure cotton handkerchief or cotton muslin nappy, or with a silk scarf if you are sensitive to cotton. This helps protect skin in contact.

More expensive versions of charcoal filter masks are made by Respro. One version, the Respro Bandit (£10-12), is a 100 per cent cotton scarf with a nose clip, which incorporates a charcoal filter, laminated into the scarf. It is chemically treated to be fully washable; if you are exceptionally sensitive, you may react to the treatment. Wash it before use to try and avoid problems. The scarf looks more attractive than a nose and face mask, however, and may be more comfortable.

Respro also make the City Pollution Mask at £20 with a replaceable charcoal filter, which has a stretchable fitting to fit comfortably around the face. This fitting is made of neoprene, with a lycra lining, which again may upset you if you are exceptionally sensitive to synthetic rubber and elastomers.

Both Respro products are available from The Green Catalogue and Renaissance Design.

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Face masks come in three basic kinds:

• dust masks

• activated carbon masks

• respirators

which give varying degrees of protection against inhaled particles and chemical fumes.

You can use face masks to protect you in situations where you are unavoidably exposed to things which upset you – doing dusty tasks, vacuuming or household cleaning, doing DIY or car maintenance, at work, riding a bike, or even when driving a car.

Dust Masks

Dust masks are the simplest of all masks. They do not protect against chemical vapours, but will protect to some extent against irritant dusts and particles. The most common type, found in DIY shops, has a pure cotton gauze filter pad held in place across the nose by a light aluminium face-piece. Another type, also found in DIY shops, made of a cotton/synthetic blend, is a moulded white mask.

No guarantee is given of the size or type of particle which these masks keep out. Dust masks are not helpful in protecting against most chemical vapours, but they do offer some (but not total) protection against dusts, and against allergens such as house dust mites, moulds and animal allergens.

They are cheaper than other masks (£1-2 at 1992 prices) and unless you are very highly sensitive to inhalant allergens, such as house dust mites, they will offer you sufficient protection to allow you to do most tasks.

These masks are widely available at DIY stores or by post from Safety Equipment Centre. Safety Equipment Centre has a small-order charge for orders less than £25.

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Reaching the end of your cancer treatment can bring tremendous relief – but also new and different uncertainties. For the duration of your treatment you have the framework in your life of hospital visits, check-ups and progress consultations. While this can be far from pleasant, it can provide a kind of reassurance, a sense that you are being constantly looked after and that your cancer is being attacked. The check-ups will continue, of course, but some men do find it difficult to adjust back to a life in which the focus of treatment is no longer present. This may be mixed with a huge sense of relief that you have arrived at the end of this stage and that you have coped with this experience.

If you were able to continue a relatively ‘normal’ life during your treatment, then you may feel less impact when it is completed. If you had to stop working or give up your normal routines, and found that your life was largely dominated by your cancer, then you will be facing a further period of transition. Going back to work or looking for a new job or picking up the threads of your life before cancer may feel like a huge task. You may in any case be limited by the advice of your medical team to take life gently for a while.

Some men find that living with cancer has given them a new or different outlook on life. Perhaps your sense of priorities has changed, or issues which previously seemed very important have become less so. Perhaps there have been subtle changes in relationships which cause you to value friends and loved ones more consciously. This does not imply that you have changed for the better as an individual – or changed at all.

You might see the end of your treatment as an opportunity to explore new directions in your life or to change the emphasis. Perhaps you feel that your career has a different significance now and that you want to spend more time pursuing other activities. This does not mean that you will always feel this way, but rather that your cancer has prompted you to reassess certain aspects of your life. If you do feel strongly that your priorities have changed dramatically and that you intend to make significant changes to your life then take the time to think these through, discuss them with your family and friends, and work out how you plan to use your time and energies.

It is not uncommon to experience doubts and fears about how well you will cope. Will you manage to fulfil your role as husband/ partner/father/son/friend as you did before your cancer? Will people regard you differently now? There will obviously be continuing concern for your well-being, and you may feel frustrated that people still dwell on your cancer for some time.

You may also experience fears about the recurrence of your cancer. This is an issue which will not go away, and while doctors would dearly like to give you watertight guarantees for the future, this is just not possible. You may feel that you simply want to put the whole experience behind you, forget about it and get back to ‘real’ life again. You would not be human if you did not have fears and doubts, though. You are allowed to be worried and anxious, but it is important not to bottle up your fears unnecessarily. Talk to those close to you – they are almost certainly sharing exactly the same anxieties, and will welcome the chance to say so and to let you know that they are willing you on to a full recovery. If you find that you are becoming over-anxious or depressed about the future, then do not hesitate to contact your GP or ask at your hospital about counselling. Specialist cancer counsellors often provide continuing support – after all, the end of your treatment does not mean that your experience of cancer simply comes to an abrupt end. If you need to talk further, then allow yourself to do so.

Gary was surprised by feelings of guilt after radiotherapy treatment for his brain tumour proved more successful than was originally anticipated. He felt guilty that the treatment had worked for him, but that others around him were less fortunate, and began thinking, ‘How is it that I have survived when others are dying?’ He had undergone regular counselling throughout his treatment, and found it useful to discuss his feelings with his counsellor.

You may experience an unexpected sense of frustration, as Neil found:

I began to feel intensely frustrated soon after the final chemotherapy session of my initial treatment. It was late in the year, and I decided to give myself to the end of that year to recuperate and decide ‘what to do next’. I had previously been running my own business, practising as a chartered accountant, but sold the practice soon after my diagnosis. The first few days of the following January were not easy because there was no obvious new path to take, yet I was feeling strong and well and wanted to start working on something positive and constructive immediately. I knew, of course, that it can take time for new projects to emerge – which, in fact, they quickly did – and in the intervening period, I felt as if I was treading water when I wanted to be swimming the Channel. All I can say is try to hang on and be patient (I wasn’t, particularly!) – it is frustrating.

Life does go on after cancer. It may have caused big changes in your life or it may have had less impact. There is no right way to view your experience – some men choose to try to find some constructive element on which they can draw in the future and others want to try to forget about it as soon as possible. Returning to ‘normal’ may be a long process, and ‘normal’ may mean something different to you now.

Any journey through cancer treatment is hard, and inevitably it will leave its mark. But it is possible to make a positive difference by resolving to manage with determination and, together with family and friends, to confront and take what control you can of such an unwelcome situation. Above all, be aware of your achievement in coping with your cancer and congratulate yourself on reaching each milestone in your treatment.

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