Probably the worst thing to have to cope with at school is the sudden onset of the cramps. Most girls try to stay at home on really off days, providing they can predict when those will be. The trouble is, periods aren’t always predictable, especially when they first start. So there may be times when you are at school and the pain catches you out. If you have been practising relaxation and breathing, you’ll need somewhere quiet to lie down and cope. That’s easier said than done because so many school buildings, even new ones, aren’t equipped with rest rooms, beds and hot water bottles. I know one brand new school where girls who faint are laid out in the general office, with the office staff stepping over their bodies until they come round.

So what to do about it? I should start by finding yourself an ally on the staff — a housemistress perhaps, or a year head, or your form tutor or a subject teacher — somebody you like and know you can trust, who is sympathetic and knows how tricky period pain can be. Explain what you have been doing and see if she (or he) can help you. Don’t forget, lots of the women who teach suffer from period pain themselves. So most of them will be sympathetic and if they can help you, they will.

If you start your period with a fainting fit, it’s good sense to check whether you’re eating enough. If you haven’t had any breakfast, you are far more likely to faint during assembly or the first lesson. A lot of girls go without breakfast; in some schools it’s almost a crime to admit to swallowing anything more substantial than a cup of black coffee. The secret is to listen to your body. If you really need food, it will tell you. If you faint because you’re hungry, just the smell of that bacon sizzling will make your mouth water. You should go ahead and enjoy it. On the other hand, if you are one of those unlucky girls who start their periods by feeling sick and then fainting, you have a different problem. You certainly wouldn’t want to eat anything and it would be very silly to force yourself. You are probably better staying at home until the sickness and the feeling of faintness have passed and you can return to normal and go back to school again.

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Fear is one of the major causes of stress and yet we allow it to be part of our lives from day one. We teach our children, ‘Don’t do this, don’t do that. ‘We would be better to teach them in a positive way. Rather than instilling fear with phrases like, ‘Don’t go near the water,’ we could reinforce a safe action, ‘Stay near mum.’ ‘Remember to clean your teeth,’ is more effective than, ‘Don’t forget to clean your teeth.’

Educators have now found that to understand what is expected of us, we must first visualise the original command. In that way it is reinforced. When we hear, ‘Don’t touch the hot place!’ we visualise touching the hot plate and naturally the child will touch it to check if it is hot.

In adult life, we ‘fear to try’ in case we make a fool of ourselves or show our inadequacy. Yet we all have to start at the beginning in areas where we have no expertise. This requires us to step outside our ‘comfort zone.’

While we all understand that there have to be laws of society to provide the parameters so we can exist together in harmony, we are sustained in fear by our institutions and beliefs. There are times in our lives when we must release this fear, and have the courage to strike out on our own, if we are to discover anything new.

Fear is our greatest enemy as it freezes us in time. Stepping outside our comfort zone is not easy for any of us and we often need help to do it. Do you realise you can’t have two thoughts in your head at once? Crowd out the fears that cause you distress with enthusiasm and love producing ideas that support your mental world.

There was a girl who suffered breathing trouble every time she found herself in a stressful situation. She underwent therapy where it was revealed that she feared her father was going to belt her as he did her brothers and sister. Although he never did, she always feared that it would be her turn next. Years later only the fear remained, the original cause being long forgotten. It was only through a special therapy called ‘Healing the Inner Child’ that her internal tension and fear were released and the emotional health problem cured.

Fear is all encompassing. There are quite a few Bach Flower therapies covering many situations of fear. Let me list them:

Clematis, mimulus fear of life-threatening illness.

Aspen, mimulus fear of the dark.

Aspen, mimulus,

rock rose fear of death.

Agrimony fear of the future.

Heather, mimulus fear of health.

Cherry plum fear of insanity.

Chicory, heather,

olive & mimulus fear of losing friends.

Aspen fear of no known reason.

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Chiropractors solve restless legs and cramping at night by correcting the pelvis. Adjusting the sacrum or sacro-iliac joints if they are out of alignment always fixes the problem.

The ‘clicking’ sound of a chiropractic adjustment is fun and after the first surprise usually gets a laugh.

To a practitioner, the most important physical action is to check the pelvic balance. You wouldn’t believe how often this is the only treatment required.

Do yourself a favour. Have a pelvic check up and see if that is the problem. Your chiropractor/osteopath will speedily tell you, yes or no. Not being able to settle in bed, or sit down without the jerking, is not funny.

Acupuncture works well for leg tension too. Nutrition: tea drinking can be a culprit. Iron, folic acid, vitamin B or E deficiencies all need checking in restless leg syndrome; and remember to use homoeopathic causticum if this is suitable for you.

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Try the mineral tablet magnesium phosphate from your health store. Combine it with lecithin (from soy powder) and potassium phosphate. I give that combination for night cramps, two tablets before bed.

If the cramp is in the calf, stretching the cramped muscle against the contraction and walking around the room is preferable to just massage. Applying heat relaxes the muscle, but to prevent it happening, don’t stand on cold floors. Watch this with little boys when you march them half-asleep to the toilet at night. Poor circulation may be involved with cramping.

Acupuncture is clinically useful for cramp.

Homoeopathics suggested for cramps:

Calcium carb for cold knees and cramps in the calves.

Colchicum for hot arthritic feet with cramp.

Cuprum met for severe cramp in palms, calves and soles of feet.

Magnesium phos for cramps in leg muscles.

Nux vomica for night cramps with no special cause.

Make sure the cramp is not a disguised sciatica if in the legs or a brachial neuritis if in the arm. See your chiropractor for an assessment. Cramps are also due to nerves that are being irritated near the spine.

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Five lumbar vertebrae make up the remainder of the twenty-four movable bones in the spine. They are thicker than the others because they take more weight. They have no lateral support mechanism, however, only muscles to strengthen their position, so they are susceptible to strain. Poor posture simply lets them down.

The plexus of nerves in the lumbar area makes strains and sprains here a painful business. Nerves radiate from this area down the legs into the feet.

This forms much of the chiropractor/osteopath’s workload, and we give it a great deal of attention. The weight-bearing sacrum moves with the pelvis, the pelvic girdle protecting the bowel, bladder and sexual organs. Therefore it is easy to see how conditions arising from the lower back will reflect in the function of the internal organs in the pelvic basin. Urinary, reproductive and eliminative systems depend on the good working order of the spinal nerves coming from the lower back.

This will help you understand the symptoms listed in this section.

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on the cause of the pain. Many a colicky baby is eventually found to be lactose intolerant.

A study carried out in Denmark by Dr Neils Nilsson claimed that 91% of parents reported improvement in the condition of babies after an average of two to three adjustments and one week after the start of chiropractic treatment. This gentle treatment for infants works by loosening the joints that have reduced range of movement.

In general, the therapy follows the same principles as that used in adults with one important difference: the noise which accompanies the adjustment of adults is rarely heard in the adjustment of infants. Cranial chiropractic has also been successful in babies who have suffered a difficult birth.

Laser acupuncture is often used in children to good effect while adults with flatulence benefit most from needles.

Homoeopathic remedies recommended for colic are:

Bryonia When nothing soothes.

Chamomilla Cranky, and has one red cheek, one pale.

Colocynthis More comfortable lying on abdomen.

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A benign tumour in the pituitary can also be removed, in an operation going through the top of the inside of the nose and approaching it from underneath.

Often it’s not possible to tell whether a tumour is benign or malignant until, at operation, bits of it can be snipped out and looked at under the microscope (a biopsy). Even if the tumour is malignant, all is not lost. Removing the area containing the tumour may be enough to get out all the cells, particularly if it is the primary site. Giving radiotherapy or chemotherapy afterwards may also help to kill off any remaining malignant cells.

Where the cancers are secondary treatment is quite different. Once a tumour has moved to the brain, it is likely to have spread elsewhere; and there won’t be just one growth within the brain. There will probably be a number, scattered throughout the brain tissue, all growing independently of the others. Clearly it’s not possible to remove all these secondary deposits in an operation. Therefore, we usually try to kill off secondary growths with radiotherapy or chemotherapy.

Radiotherapy involves shining various types of high-powered electro-magnetic rays (or in some cases, nuclear particles) at the tumour. Chemotherapy involves giving anti-cancer drugs, which are often very potent and also very toxic to normal body cells. Both these therapies work because cancer cells grow much more rapidly than do nerves (in fact nerves hardly grow at all). So, by specifically attacking those cells that are rapidly dividing, we target the effects of the chemicals and the X-rays on to malignant cells rather than those which are normal.

Chemotherapy and radiotherapy do, however, have the disadvantage of interfering with rapidly dividing normal body cells, such as the gut, hair follicles and bone marrow. This is why chemotherapy can make you temporarily bald. Both types of therapy can make you feel nauseous and generally unwell.

The big advantage of chemotherapy is that it attacks the cells that are rapidly dividing wherever they are. It doesn’t matter if one or two little groups of cells have seeded off and stuck in a part of the brain, well away from the other growths. The chemotherapy will get to those cells and will kill them off just as effectively as if they were part of the main group of malignant cells.

It’s a common mistake to think that surgery is better than radiotherapy or chemotherapy ‘because you can be sure everything’s been taken away’. In fact, this isn’t true. Although surgery may appear to remove everything that is malignant, this is not always possible. When there is doubt, chemotherapy and radiotherapy can often mop up cancer cells which the surgeon has not managed to remove.

Hormone therapy can also play a part, especially in secondary cancers derived from breast cancer. Many breast cancers need oestrogen to survive and by giving the anti-oestrogen drug tamoxifen, oestrogen receptors on the malignant cells can be blocked.

What about treatment of the headache from a brain tumour? The method of treatment is entirely dependent upon whether the tumour is benign or malignant. The pain of a benign tumour is almost always due to a general pressure rise within the skull, whereas local pressure gives localised side-effects – such as inability to speak. (This is why headaches are usually a later symptom, while localised effects on the brain occur earlier in the illness.) Remove the tumour, and the pressure goes away.

With a malignant tumour, pain is also usually related to pressure; but, in this case, it may be much harder, if not impossible, to remove the tumour. If the tumour is so far advanced, or else in such a position that surgery is impossible, then there are several courses of action that your doctor might take. Anything that shrinks the tumour is likely to remove or reduce the amount of headache, so radiotherapy, chemotherapy, or hormone therapy may help. In addition, steroid treatment may reduce the pressure; in particular, the drug dexamethasone can be amazingly effective in reducing the pressure within the brain, thus reducing headaches and vomiting, and allowing the brain generally to work much better.

But what about those many cases where the primary tumour has spread too far, or else the tumours are secondary and have got out of control?

Surprisingly, aspirin is enormously important for pain relief. While ’strong’ drugs such as morphine are sometimes unable to provide adequate pain relief, simple analgesics such as aspirin can do the trick. The pain of secondary cancer of the bone is often markedly improved with aspirin, which can make all the difference.

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The large veins draining the brain can be stretched and broken, particularly by blows to either the front or the back of the head. It doesn’t need a particularly violent bang to do it, either – even a blow which isn’t enough to cause concussion or loss of consciousness is still capable of causing a sub-dural haemorrhage. In older age the brain sometimes shrinks, and a sub-dural haemorrhage is more likely to happen simply because the brain can move around more inside the skull: hence sub-dural haemorrhages are more common in older people.

Bleeding inside the skull compresses the brain, causing it to function less well; the higher the pressure inside the brain, the more it cuts off the normal flow of blood through brain arteries, and so the less oxygen can pass into the nerve cells -which therefore don’t function as well as they used to. Patients with a sub-dural haemorrhage gradually think more slowly, become less alert, and eventually become drowsy: they may go into coma. Typically, the degree of drowsiness comes and goes. In the worst cases the patient can develop a stroke-like condition. If untreated, a sub-dural haemorrhage may end in death.

Pressure like this is likely to cause a severe, continuous headache. A slow bleed into the inside of the skull is ultimately just as devastating as a fast one but is far less dramatic, and the symptoms come on more slowly. In the older person, where the brain has already shrunk slightly, the extra blood may create very little extra pressure at first, because there’s more space available within the skull. However, in younger people, excess pressure can develop to a much greater degree.

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Don’t worry alxnit those trigger factors you can’t avoid. Instead, concentrate on minimising whatever you can, especially when you know you’ll be exposed to one or more factors. For example, take a leaf from the book of the woman who says she can drink red wine, but not during the week before her period.

A number of medicines can be used to prevent attacks occurring. These drugs are not pain-killers, nor do they work during an attack. They work solely to prevent attacks occurring – by stabilising your systems so that trigger factors are less likely to provoke an attack. Preventative medicine is of greatest value where the attacks are frequent; it is inconvenient (and expensive) to take drugs for attacks that happen infrequently. It also exposes you to the possibility of side-effects for very little gain. A convenient rule of thumb is that if you get more than two attacks a month, preventative drug treatment is likely to be worthwhile.

Various drugs are used to prevent attacks; these include beta-blockers such as propranolol; anti-5-HT agents, such as methysergtde and pizotifen; calcium channel-blockers such as nifedepine; and occasionally tranquillisers and antidepressants such as amitriptyline, though amitriptyline may well be acting in a different way on migraines.

Drugs to prevent attacks have to be taken on a regular basis, and it may take them several weeks to have full effects. No drug is completely effective, but propranolol reduces the number of attacks in about fifty per cent of migraineurs.

In women, especially those with menopausal or menstaial migraine, attacks can be prevented using replacement oestrogen, either as tablets or patches. In menopausal migraine clonidine can also help.

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