When the brain’s learning/unlearning cells are being over-stimulated and the circuit breakers are beginning to switch off overloaded circuits, the brain’s normal capacity for inhibition is seriously impaired. Consequently, the ability to tolerate things previously tolerated begins to be lost.

This loss began in the second stage, with loss of the ability to use the will-power to inhibit emotional display. Now the situation has become worse, and the person begins to lose the ability to ‘put the lid on’ reactions which were previously suppressed. In stage three stress breakdown, people will suddenly become intolerant to things they previously accepted. Common statements made during this time, include:

‘Henry,’ (she is speaking very quietly, through clenched teeth), ‘if I hear you slurp your soup just once more, like you have been doing for the last thirty years, so help me I’ll throw it over you!’ or ‘The next time you squeeze the toothpaste from the top of the tube will be the last time you’ll ever do it!’ or ‘If I find your dirty overalls just thrown on the floor behind the bedroom door just once more, they’ll be thrown out into the yard, and I hope next door’s dog rips them to shreds!’

I have found that an adult audience will often warm to providing examples such as those above, indicating to me that many people can recognize this aspect of stress breakdown, and one which is very often misunderstood. Men are often quite perplexed at finding that their wives are no longer willing to put up with their little faults and bad habits that the wives were able to tolerate for years. ‘What’s come over her, doctor?’ ‘I think she must be going through the change of life!’

*32/129/5*

Once the cancer penetrates a couple of layers of skin, its wild cells break loose and travel the tiny canals of the body to lodge in the liver, brain, kidneys, and other sites on the skin. There they settle and form ever larger clumps, choking the organs they have invaded.

For early detection, Dr. Rigel and his colleagues have developed an “ABCD” system to help you locate a cancer or a potential cancer on your body:

•   A stands for asymmetry, or irregularity of shape, meaning that you cannot draw a line through it to create matching halves. Non-cancerous pigmented lesions usually are round and symmetrical (when cut down the middle, their halves have matching shapes), but early malignant melanomas usually are asymmetrical.

•   В is for an irregular border – common to cancerous growths. Benign growths usually have regular margins.

•   С is for color. A harmless growth generally is one color overall and flat. Cancerous growths, however, harbor various shades – from tan and brown to black, sometimes mixed in with pink or with red and white.

•   D is for diameter. If the growth measures more than 6 millimeters across (about one-fourth of an inch), it is dangerous.

The Skin Cancer Foundation recommends regular self-examination of every inch of your skin – from the top of your head to the soles of your feet and between your fingers and toes. (Be sure to have a dermatologist examine you annually.) To do it yourself, stand nude with your back turned to a full-length mirror. Then look into a hand-held mirror to examine the back of your neck, torso, rump, and legs as reflected in the full-length mirror. Anything you see that doesn’t clear the ABCD test requires a medical exam. Even if you find skin spots (dysplastic nevi) that almost fail the ABCD test, they may be warnings that you have a genetic predisposition to melanoma. Watch these carefully and see your doctor immediately in response to any change in them.

In addition to self-examination, all of us – black-skinned to fair – need sun protection. The sun’s ultraviolet light harms our skin, including the soles of our feet and our palms. Evidence suggests that damage done during childhood and the teen years creates the greatest risk, so we must teach small children caution.

To avoid trouble, heed these pointers from the Skin Cancer Foundation:

•   Avoid the sun, especially between 10 a.m. and 3 p.m.

•   Wear a broad-brimmed hat to shade the face; wear long pants and long sleeves.

•   If you must expose your skin to ultraviolet light, use sunscreens rated 15 or higher – it will take you 15 times longer to get sunburn. Sunscreens do not filter out all the ultraviolet rays, however, and doubts have been raised about the toxicity of urocanic acid used in some of them. It has been found to suppress the immune system and allows tumors to grow. The Food and Drug Administration is reviewing a petition to investigate.

*3/266/5*

In all patients with rheumatoid arthritis, the wrists are affected. In fact, if the wrists do not appear to be involved, I would not diagnose a person as having RA. The knuckles and the middle finger joints are’ usually involved on both hands. Some changes that may occur in the hands include what doctors call ulnar deviation, which is the bending of the fingers toward the outer part of the arm (where the ulnar bone is located). The so-called “swan-neck deformity” is very typical in hands affected by rheumatoid arthritis. Here, the middle joint of the finger bends down and the joint nearest the tip of the finger bends up, giving the finger the appearance of a swan’s neck. This deformity is very typical of the rheumatoid hand. The hand can also have what are called “boutonniere deformities,” in which the middle finger joint pops up, resembling a boutonniere.

Swelling of the various ligaments around the wrist can result in trapped nerve syndromes like carpal tunnel syndrome, where the median nerve that goes through a closed space into the wrist is compressed. Another syndrome, also the result of nerve entrapment, is ulnar-nerve compression syndrome at the elbow. This causes extreme weakness of the pinky finger.

Sometimes rheumatoid nodules form on the tendons of the hands and may rupture. Tenosynovitis, inflammation of the tendons and the linings of the joint and tendon spaces, can also affect the hands. This can result in a rupture of the tendons and loss of mobility of fingers or, in severe cases, of the entire hand.

*12/141/5*