An often overlooked component of good health and fitness is proper posture. Posture is the balance struck between the unrelenting force of gravity pulling down on you and the valiant effort of your body structure to hold you up. The path of least resistance between these forces is what we call posture. Good posture causes no pain or problems and helps you use your muscles, tendons, and bones optimally. “Bad” posture actually uses more energy, though it is often thought of as laziness. That’s a mistake, because poor posture may indicate an underlying structural problem that is not your fault at all. And if you try to correct a structural problem without knowing exactly what it is, you will probably exacerbate the situation.Say you have one leg that is significantly shorter than the other. To compensate, in an attempt to keep your eyes level (a real priority for your brain), you’ll probably hold your shoulders unevenly, creating a scoliosis in your spine. Your mother’s advice to “straighten up” will be useless—you literally can’t. A doctor without appropriate training might advise you to do some back-strengthening exercises to even out your shoulders, but getting stronger while you are still uneven will just exaggerate the tilt. If you made an appointment with me, your checkup would reveal the different lengths of your legs as the cause of your problem, and I’d prescribe a gradually adjusting series of heel lifts and several sessions of osteopathic manipulation to fix the cause of your problem. Now you have a physical support to help keep you level, and your muscles and bones will no longer have to contort themselves. Of course, this is a very simplistic explanation and an exaggerated example, but I think you get the idea: address the cause of the problem, not the result.Your posture is your posture, and you can’t will it to be different. If your shoulders are rounded, no amount of throwing them back or thrusting your chest out is going to “fix” them. You can make your posture work as well as possible for you, but you can’t make it into something it is not. So make sure your posture is maximally efficient, and get any permanent “bad” posture evaluated to discover if there is a correctable underlying problem. You’ll need an appropriate therapy program to make any changes necessary for optimal body positioning.Simply maintaining good posture no matter what you are doing in the course of your day is an excellent defense against kyphosis, the spinal curve commonly called “dowager’s hump” or “hunchback” that is a hallmark of osteoporosis. Keeping the head, shoulders, spine, and hips in alignment protects the spine, so you need to be conscious of how you walk, stand, sit, lie, climb stairs, sleep, drive, type, and everything in between. Stick with the natural curves of your back. If you stand against a wall, your heels, buttocks, upper back and shoulders, and back of your head should touch the wall. With a side view, you should be able to draw a straight line from your ear to your shoulder to the middle of the curve of your lower back to your hip, knee, and ankle. From the front, it should be clear that your eyes, shoulders, chest, and hips are all level and parallel to the floor.That is the alignment you should strive for at all times. If this is not your normal or comfortable posture, you may have a structural problem that should be evaluated by a professional. I recommend an osteopathic structural evaluation, as most nonspecialists tend to recommend strengthening exercises that may be good for posture in general but will actually exacerbate a structural problem. But for most people, conscious effort and increased strength will be able to help posture, barring a medical issue.A major pitfall to good posture is working at a desk. Proper alignment is crucial when typing or working at a computer in order to avoid carpal tunnel syndrome or other repetitive motion injuries to nerves and joints—and just to eliminate the achiness you feel at the end of a long day at your desk. When you’re at your desk, not using your computer, prop your work on a stand at an angle in front of you, so you don’t have to hang your head forward over flat papers to read them. Use a footrest, especially if you need one in order to keep your thighs parallel to the floor when your chair is otherwise adjusted to the proper height. Your chair should support the curve of your lower back, and if it doesn’t, use a pillow or rolled-up towel to do the job. When you are driving (which puts you in much the same position as sitting at your desk), use the headrest.Lifting anything without injury also requires proper posture: bend at the knees and hinge at the hips, not the waist, so your legs, not your back, are taking the heavy load.Sleep on your back or side, as sleeping on your stomach places a strain on your lower back.The first key is to be aware of your body position no matter what you are doing. It may require conscious attention at first, but eventually you’ll develop good habits and will align yourself properly automatically. The second key is to build your flexibility, balance, and strength (particularly of the front of the thighs, buttocks, and stomach), all of which are important to support good posture.*121\228\2*

Ageing causes changes in the facial contour, especially hollowness of the cheeks caused by fat loss and accentuated by fat accumulation in the jowls. In addition, movement creates creases, especially between the nose and mouth. The lips shrink over time, producing lines about the mouth and loss of lip ‘pout’. Facial implants can be surgically inserted or injected to remedy many of these problems.
Collagen injectionsCollagen injections have become increasingly popular over the last few years. Collagen, which is derived from calf skin, is injected into wrinkle lines, scars and lips.Two types of collagen are used, called Zyderm and Zyplast. Zyderm is a very fine collagen and is useful for fine lines around the eyes and mouth. Zyplast, on the other hand, is a coarse, dense collagen which is more suitable for deep furrows and acne scars. It is especially useful for lip augmentation.Although collagen is a safe and effective filling substance, it only lasts for four to six months. Allergic reactions are possible so collagen must be tested twice before being injected into the face. Because collagen implantation is very simply performed, many people request collagen rather than a more appropriate procedure such as face-lifting or chemical peeling. Collagen is certainly not a substitute for some of the other cosmetic operations.To try and overcome the cost and allergic potential of calf collagen, several techniques are now available to remove a person’s own collagen and then inject it into his or her own wrinkle lines. This technique is still very new, so the long-term results are not yet known.
Silicone implantsAlthough silicone rubber is still the major material used in cheek and chin implants, liquid silicone has largely been abandoned as a filling material for facial wrinkles and contour correction. Although pure grade medical silicone was excellent and safe for facial augmentation, the recent media publicity concerning breast implants has created such adverse reaction among health officials that its use is becoming increasingly prohibited. If silicone is used, it is important that only microscopic amounts of silicone are used. If too much silicone is injected, beading can occur, and if impure silicone is used, severe reactions such as lumpiness of the skin are possible. The main advantages of silicone are that it is inexpensive and permanent.

Whatever the cause of the stimulus, sudden pain has three effects. Firstly, it triggers an avoidance response by reflexes which are controlled in the spinal cord, e.g. we take our hand out of the fire before we even feel the pain; secondly, the impulse travels to the brain, where it causes activation of a particular area in the brain which localizes and clarifies the pain; and thirdly, the whole brain is activated and thrown into a state of readiness.Long-standing (chronic) pain differs from acute pain in that the avoidance response does not occur; the specific response with appreciation of pain still takes place but the activation of the brain is variable, possibly because the persistent stress of chronic pain produces chemical changes in the body.
The pain thresholdIn pain appreciation, another important factor is attention. It is common experience that a toothache is worse at night on going to bed; as soon as the mind is occupied and engrossed, the pain subsides into the background. Experiments show that this applies to other sensory inputs, e.g. a cat will cease to show its usual electrical response to sound when it is shown a mouse. (This point is taken to extremes by certain forms of meditation and by hypnosis, where the conscious mind can be distracted or ‘shut out’ entirely.) This aspect is important, as the appreciation of chronic pain varies not only in the same person, but from person to person, depending on the state of mind. The person who is depressed, either because of the debilitating effects of chronic recurrent pain or for other reasons, is less likely to put up resistance to the continuous attack on his sensorium.People have different responses to pain, not only in their conscious reaction, but also in the amount of pain required to impinge on consciousness. This pain threshold can easily be tested by, for instance, asking the patient when a certain temperature applied to the skin becomes painful. One such experiment was done as follows: a 100 watt lamp was focused on to the blackened forehead of a subject. The intensity of the lamp could be varied and the forehead was illuminated for three seconds by a shutter. The lowest level of illumination producing a minimal pain (prickling sensation on the forehead) was taken as the pain threshold. There was a remarkable similarity in this value as long as the subjects concentrated on the task in hand. Distraction, suggestion, and hypnosis could raise this threshold by 35 per cent as could pain-killing (analgesic) drugs. The pain thresholds vary greatly and become unpredictable in subjects who are tired or anxious. Scientific, objective methods of measurement and analysis are very necessary in the study of what is, in the final analysis, a subjective complaint.People tend to suppress the memory of unpleasant events and, for this reason; it is often difficult to give an accurate account of a previous pain. The suppression is partly due to unconscious forgetting, but partly because the chemicals produced by the pain dulls memory.Response to pain is also to some extent dependent on sociological factors. People in social classes I and II are more likely to complain of headache, a tendency that has given the false impression that they are more prone to get headaches.Brain substance itself is insensitive to pain; neurosurgeons can operate on it without general anesthesia. The structures within the head that feel pain are the blood vessels and the coverings of the brain (the meninges). The pain felt in migranous headaches is due to pressure of swollen blood vessels against the sensitive membranes that sheath the skull.

It appears that almost everybody in America—regardless of race, ethnic background, class, or income—wants to be slim. When this desire becomes an overriding obsession with achieving bone thinness, it can translate into the distorted eating patterns of anorexia or bulimia. Estimates of the scope of these disorders necessarily involve guesswork, but some say that more than 35 percent of American women and over 75 percent of American teenage girls have at least flirted with either bulimia or anorexia. The incidence among males has not been adequately studied, but it appears to be rising.Anorexia nervosa is a condition of self-induced starvation tied in to a fear of becoming fat, poor body image, mental stress, and biochemical imbalances. A person loses a minimum of 20 percent of her or his body weight and still perceives her- or himself as fat. Every pound lost is seen as a victory and gives the person a feeling of greater control over his or her life.The effects of anorexia go far beyond a person’s looking emaciated. Starvation, whether involuntary or self-inflicted, affects mental function, so what the person can no longer think clearly. This does not help the person deal with or comprehend the seriousness of the physical problems that develop. These include fatigue, loss of menstruation, constipation, and hormonal changes, including increased levels of cortisol, the stress hormone. One of the many problems of this progressive condition is that when the person’s electrolyte balance, particularly in relation to sodium and potassium, becomes disturbed, it can lead to life-threatening complications, including kidney failure, heart rhythm abnormalities, and cardiac arrest.Bulimia nervosa, which describes a binge-purge cycle, is not as obvious a disorder as anorexia. Here a person eats uncontrollably and then purges the food in one of several ways. She or he may vomit; take laxatives, purgatives, diuretics, or enemas; sit in a sauna; or even cover her-or himself in plastic wrap. Whatever the method, the goal is the same: to avoid the consequence of eating too many calories. After a person takes several laxatives a day—and in rare instances as many as 100—over a period of time, the body loses its ability to eliminate on its own. Other serious medical consequences of bulimia include loss of tooth enamel and tooth decay, rupturing of the esophagus and stomach, throat muscle enlargement, dehydration, low blood sugar, and personality changes. As with anorexia, bulimia can result in severe chemical imbalances, leading to abnormal heart rhythms and even death.*60\233\8*