Even today, we have trouble asserting ourselves. We are all too familiar with being passive or self-denying. Many of us also understand what it means to be aggressive, or to get what we want at the expense of others’ needs, wishes or feelings. We usually become aggressive after denying our own needs for so long that we lash out inappropriately, and almost involuntarily.

There are three main reasons why self-assertion is particularly difficult for women:

We are biologically inclined to be caretakers and to focus on the needs of others.
Our culture gives women cues (sometimes subtle) about “not making waves.”
Girls are rarely taught how to be assertive, either directly or by example.
So how do we change what Mother Nature and generations of practice have fostered? I am happy to report that assertiveness is a skill that each of us can master, given the necessary tools and lots of practice!

Assertiveness Tools

Assertiveness formula — When you have to offer criticism or disagree, recognize the other party’s position first. Let them know that you empathize with them, that you agree in part with their stance, or that you assume that their motive is positive. For example: “The first part of your proposal makes sense to me and is well-written. I have some concerns about part two … ” By using this approach, you take the other person off the defensive, and allow them to hear your position.

Don’t let anger and resentment build up — If you wait too long to speak up you risk becoming aggressive instead of assertive. In this case the other party is immediately put on the defensive and will be unable to hear the validity of your concerns. Further, you will feel badly for engaging in just the kind of interchange you were trying to avoid!

Be sure your body language mirrors your words — As you speak assertively, do you appear confident? Are you making eye contact and standing tall? Nonverbal messages have at least as much impact on the listener as words do.

Be a good listener — Others are much more likely to consider our point of view if they know we have heard theirs.
Take time before committing to anything — Becoming assertive means learning to say no to undesirable requests from others. You can give yourself time to consider the request by simply saying, “Let me get back to you.”

Accept responsibility for your mistakes — You will find it easier to approach others with constructive criticism, or to disagree with them, when you readily acknowledge that you are fallible.

Practice makes perfect — If you wait to assert yourself until you feel confident, you’ll never do it! If you change your behavior first, and act “as if” you are comfortable asserting yourself, the feelings will follow!

Keep an assertiveness log — Keep a record of the times you are able to engage in assertive behavior. What were the circumstances, and what did you do differently? This record will boost your confidence by allowing you to see the progress you have made.
Most importantly, be patient with yourself. Changing lifelong patterns of behavior is difficult. You will make mistakes and fall back into old patterns, because you are human. But instead of wallowing in self-criticism, pour your energies into engaging in healthy, assertive behavior next time!

Without a doubt, the best therapy for colon cancer is early detection. However, the problem with detecting colon cancer is that patients often experience no symptoms in the disease’s earliest stages. When the disease advances, patients may report blood in the stool, weight loss, abdominal pain or other symptoms related to obstruction of the colon.

Because most colon cancer arises in polyps and because polyp removal reduces death rates from colon cancer, the current recommendation is to have sigmoidoscopic or colonoscopic screening to detect polyps beginning at age 50 (earlier if one has a family history of colon cancer). Also recommended is a yearly test for hidden blood in the stool (called a fecal occult blood test) to detect the slow bleeding that can be a sign of colon cancer. A positive fecal occult blood test is followed by a colonoscopy to look for the source of bleeding.

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R.H.V.

A.The outlook for people with colon cancer varies greatly depending on how advanced the cancer is when detected. The five-year survival rates are more than 90 percent for early disease localized to the inner portion of the colon wall, 80 percent if the cancer has invaded the muscle layer of the colon wall, 40-60 percent if lymph nodes are involved, and less than 10 percent if other organs (such as the liver or lungs) are involved.

A. Colon cancer almost always begins in a colon polyp. The cancer grows slowly in the polyp and invades the wall of the colon, advancing to adjacent structures in the abdomen, including lymph nodes. Finally, more distant organs become involved. Colon cancer is generally curable by surgery if it is localized to the bowel. Once it has invaded beyond the colon and into lymph nodes or adjacent structures, surgery alone will not suffice and chemotherapy must be used.

The chemotherapy regimens for colon cancer are not as effective as those for other types of tumors, and research is being done to improve the types of medications available to treat this disease.

Many accidents occur at work, home so it’s important to be ready and also to care for your friends and children. Obtain appropriate, reliable, safe industrial first aid kits from a large variety of specialize first aid resources.

Children between the ages of 5 and 14 are most likely to get fifth disease, and outbreaks occur most often in the spring and summer.

Once the culprit virus has taken hold, the rash may take up to 14 days to appear. Meanwhile, your child, who may have the symptoms of a cold, can spread the disease to other children through the air.

When is your child contagious? Your child is contagious before the rash is present, but not while he or she has the rash or after the rash disappears.

When friends hear that my 6-year-old daughter was recently diagnosed with type 1 (juvenile-onset or insulin-dependent) diabetes, most respond by saying how much easier it must be for us since I am a long-term type 1 diabetic myself. They assume my experience would be purely advantageous when it comes to my daughter’s diagnosis, but this is not entirely true.

Certainly, there are advantages. On learning the news of my daughter’s diabetes, I did not have to learn the basics of the disease. Thirty-five years as a diabetic had already given me that knowledge. No diabetes educator had to show me how to administer insulin or treat hypoglycemia, and no dietician needed to explain food exchanges or dietary restrictions. I am as familiar with the disease as I am with a well-worn, tattered old t-shirt.

A less obvious advantage is that my daughter can practice life as a diabetic using me as her guinea pig. She can give insulin injections and run blood sugar tests on my body before trying it out on herself, and she can meet some of her future physicians by accompanying me on my appointments with various specialists.

The biggest advantage of our twosome is that neither one of us needs to be alone with our disease. My little girl need never feel unusual or uniquely handicapped. Whether it is mutual insulin reactions (hypoglycemia) that we have experienced together while running errands, or the time-consuming ritual of blood sugar testing and insulin injections before a meal at a restaurant, the two of us present a pretty flashy medical extravaganza. We are the dynamic diabetic duo.

But there are problems with drawing too tight an association between my diabetes and that of my daughter. I try to remind myself that she might not experience the same problems I have, but I cannot help being concerned about her future.

When first describing a medical condition to patient and family, physicians usually do not emphasize the frustrations of the disease. Diabetes creates responsibilities that linger — and hover. “Control” is difficult to achieve and harder to maintain, and there are often complications even with strict adherence to a diabetic regimen. I think I worry even more than most parents whose children have been recently diagnosed, because I am aware of what was unspoken, but implicit, in my little girl’s diagnosis.

Similarly, when we were first told that my daughter would be diabetic, no one mentioned the practical difficulties she might face as time passed and she matured. These difficulties include maintaining employment strictly for health insurance benefits, choosing a community in which to live based on its medical facilities, and limiting job options to those occupations that provide ample time for doctors’ appointments. We were not warned of these future issues, but I am concerned nonetheless. I wonder if these problems will burden my daughter just as they have haunted me.

Finally, and most frightening to me, what happens if my half of the “diabetic duo” develops life-threatening complications? What if I die? My little girl identifies with me, and this is beneficial — but only as long as I stay healthy.

Having developed such strong empathy for one another, I fear my daughter will see me struggle and worry that the same fate awaits her. This is the most troubling threat of our sharing the same disease.

Our diabetic connection continues to evolve — sometimes troubling, often helpful. At times I cast a shadow of worry over my daughter, but the successes come when we simply mirror one another’s condition. I do not know what changes lie ahead for us, and suspect our relationship will change as we each get older, but I am prepared for the continuing ebb and flow of the diabetic bond we share.

It is important to fill the jar literally to overflowing with the liquor. Allow the liquor to run down the lip of the jar, then cap it tightly. Leaving air space at the top of the jar sometimes allows molds to grow. If this happens, discard the tincture. The plant material will settle some over the first few days, and may oxidize some air of its own. This is fine as long as you’ve overflowed the jar before capping it.

Label the jar as soon as its capped (and cleaned off). Include the name of the plant along with parts that were used and whether fresh or dried. List the type and proof of the liquor used, the date the preparation was made, and assign a lot number to it if you’re preparing it for gifts or retail sale. You may want to add the date the tincture will be ready for use.

Store your jar in the cupboard, away from heat and light. Turn it upside down a few times every day to ensure the alcohol comes into full contact with all the plant material. This will boost the plant’s energetic response as well (loving care from the Earth Mother).

Tinctures should sit for a minimum of 6-8 weeks before being considered for consumption. This will give you optimally nourishing tinctures. Keep the main jar in the cupboard for storage and pour small, usable amounts into dark, glass containers with medicine dropper caps. You can find these in herbal and aroma therapy stores and catalogues. Label each individual bottle you fill.

If you wish to burn off the alcohol, do so in the small bottles as you pour them. If you burn the alcohol from the main jar, preservation may be lost.

The same basic process is used when dried plants, or roots, seeds, and berries are put up as tinctures, but less of the plant product is needed. Again, fill the jar to overflowing with the liquor before capping it to prevent air space.

Try to keep with the 1 ounce dried plant to 1 liter alcohol ratio if possible. If you use the mayonnaise jar and add 1 ounce of dried plant, you may not be able to fit the whole liter of liquor in. This will result in a stronger tincture, which is acceptable, but you may want to decrease the amount you take as a “dose.”

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Most tinctures are a 1:1 extract which means 1 ounce of plant to 1 liter alcohol. The extract can be a different ratio, if more plant or more alcohol is added. The alcohol must be a liquor, the kind you can drink, never rubbing alcohol!

Any liquors may be used to prepare tinctures. For particularly bitter tasting plants, using a fine flavored brandy, for instance, adds appeal. Grain alcohol is sometimes used as are various whiskey’s. For home use, 100 proof vodka is what many Wise Women use because of its balance of water and alcohol. Using 100 proof liquor gives you a 1:1 extract, which is what most “dosing” is based on. Extracts with 25% or greater alcohol content will preserve indefinitely.

When making home tinctures from fresh plant, the content ratio is less important than in commercial “standardized” products. Find a big glass jar (a clean mayonnaise jar works well enough) with a tight-fitting lid. The jar and lid should be absolutely clean and absolutely dry. Moisture allows mold growth. If there’s any question of moisture, set the jar in a low oven for 4-5 minutes.

Likewise, fresh plants should not be washed before tincturing. There is no way to fully re-dry that plant and this will cause invasive molding. Plants that are organically and wild-grown are not contaminated as are fruits and veggies from the common supermarket. Brush the dirt off as much as possible, but a little will only add to the whole.

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To some people, alcohol-based tinctures are undesirable. For those who prefer not to imbibe alcohol, keep in mind that since tincture doses are small, medicinal tinctures have no more alcohol in them than your favorite night-time cough syrup. Some people with chronic liver or kidney problems don’t need even miniscule quantities of alcohol. Be assured that the alcohol itself is easily burned off by placing the finished tincture in a pan of hot water for about 5-7 minutes. It’s much like cooking with alcohol, where the flavor is desired but not the alcohol itself.

Many of the healing plants used as tonics, or toners and strengtheners, are most effective in tincture form. They are “dosed” by the drops or dropperfuls (a dropperful is the amount of liquid sucked up in one squeeze of the dropper bulb). They can be taken straight on the tongue, or dropped under the tongue, although they can taste pretty nasty. The preferred way is either in water or other beverages, including the nourishing infusions.

During wellness and stability, tinctures are chosen for the support they give to body systems that may be sluggish or at risk for disease. No more than 2 tinctures are generally needed in wellness states. They can be taken daily, although 3-4 times a week is adequate for most people.

During illness/injury or in recovery periods, up to 4 tinctures may be needed to support the whole body. And don’t forget to continue taking the nourishing infusions daily as well for the vitamins and minerals.

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First-stage symptoms occur 10 days to three months after infection:

painless open sores on or in the genitals, rectal area or mouth
enlarged lymph nodes in the area around the sores
Second-stage symptoms occur three weeks to several months later:

mild fever, rash, patchy hair loss (if untreated in the first stage)
sore throat, which may recur
Third-stage symptoms occur five to 30 years later:

Loss of balance, paralysis and dementia numbness in the legs and — though rarely — blindness. Antibiotics can cure syphilis in some cases.

If any of these symptoms appear, call your doctor for an immediate appointment for yourself and your partner.

There are two types of bone in the body: trabecular and cortical. Osteoporosis is especially associated with loss of trabecular bone. The most rapid decrease in trabecular bone density occurs in the first five to eight years after menopause onset. This is called type 1 osteoporosis or osteoporosis resulting from decreased estrogen. However, decreased estrogen is not the only risk factor for post-menopausal osteoporosis.

If you know you are at increased risk for low bone mass, you may be more likely to get early detection and treatment. If you have any of the following other risk factors for osteoporosis, please discuss your risk and possible management with your healthcare provider.

Risk Factors for Osteoporosis
Genetic factors:
family history of osteoporosis
Caucasian/Asian race
Menstrual status:
menopause
history of lack of menses (may be due to eating disorder, high prolactin, or excessive exercise
Environmental factors:
cigarette smoking
more than three to four alcoholic drinks per day
prolonged immobilization or sedentary lifestyle
decreased exposure to sunlight without vitamin D supplementation
excessive use of caffeine
Disease states:
multiple myeloma
Cushing’s syndrome
thyroid disease
primary hyperparathyroidism
rheumatoid arthritis
chronic obstructive pulmonary disease
eating disorders (anorexia and bulimia)
chronic liver or kidney disease
malabsorption syndromes
Medications:
corticosteroids (greater than or equal to 7.5 mg per day for more than six months)
anticoagulant agents (Coumadin and heparin)
some anticonvulsants (eg. phenytoin)
Depo-Provera
lithium
immunosuppressive drugs (eg, cyclosporine)
some thyroid medications (eg. levothyroxine)
Are there any physical signs of osteoporosis?
When a woman is in her 50s, the vertebrae of the spine are often the first sites to be affected by osteoporosis. Wedge-type fractures may occur and cause the “dowager’s hump” with loss of height and possibly back and leg pain. Later on, in her 70s to 80s, the hip and wrist are common sites for fractures for a woman.

Are all measurements of bone density equivalent?
No. Currently the preferred technique to measure bone density is called the dual-energy X-ray absorptiometry (DXA) of both the hip and spine. This gives an assessment of bone loss at the sites of the body most susceptible to osteoporotic fractures. While other bone density measures are available, they do not alone adequately assess bone status. For example, measurement of heel bone density does not assess spinal (vertebral) bone status as well as it does hip bone status. Since vertebral bone is often affected before hip bone, a wnl heel bone (calcaneus) assessment does not guarantee a wnl vertebral bone status.

How often should DXA be repeated?

If a patient has low bone mass (osteopenia/osteoporosis), then yearly DXA scans may be appropriate. If a postmenopausal woman not on medication has a WNL DXA, then repeat tests may be considered about every two years.

Does a DXA test hurt?
No. You lie still on a non-enclosed table, and an overhead machine will scan over your body.

What about urine tests for bone status?
Urinary tests for bone turnover are sometimes used as a method to assess bone loss more frequently than yearly DXA in order to monitor response to therapy and bone loss.