In order to establish meaningful contact with other humans, you have to learn how to talk-openly. Learn how to communicate in ways that let others hear you better. A key, says Dr. Ornish, is to practice expressing feelings rather than thoughts. Feelings connect; thoughts-particularly judgmental ones-isolate us, he says. Here are some of Dr. Ornish’s communication tips.

•     Express a thought-»I think you’re wrong,» for instance-and your listener may feel attacked and argumentative. Express a feeling, though-»I feel sad about what you said,» for instance-and the listener is more likely to hear you, Dr. Ornish says.

•     Express feelings and you make indisputably true statements. No one can argue about how you feel. How you feel is how you feel.

•     Express feelings and you exhibit a bit of vulnerability that people generally recognize and respond to in kind, raising the level of the communication.

•     Feelings-that is, emotions-are more effective than thoughts in influencing people.

It is just as important to express negative feelings as positive ones, Dr. Ornish says. Just learn to express them as feelings, not as judgments or attacks. Add the words I feel to your vocabulary. One caution, though: Dr. Ornish says that if you add the word that after an I feel, you probably are not truly expressing a feeling but, rather, a thought.

One way to encourage more expressions of feelings rather than thoughts is to rid your language of the phrases «You should,» «I think,» «You ought,» «You never,» and «You always.» Instead, add the phrase, «I want.»

We communicate more intimately when we acknowledge what we hear other people saying to us, making it clear that we really listened and really heard what they said and making sure that we understand their meaning, Dr. Ornish notes. Try it and you’ll see that people warm to you as they feel more understood. And you will warm to them, too, because you will be focusing on their feelings and expressions, rather than paying more attention to what you’re going to say next.

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Eczema

Eczema of the nipple may sometimes occur as a result of irritation caused by the rubbing of clothes – contact eczema – or of a general skin infection. Some people are born with eczema, and it can occur on the nipple as on any other area of the body.

Once the diagnosis has been confirmed by a specialist, which may, rarely, be done by means of a wedge excision under local or general anesthetic, and the cause of the irritation has been removed, a short course of steroid cream may be necessary. Infection can be treated with antibiotics.

Paget’s disease of the nipple

Paget’s disease normally occurs in women over the age of 45, and is caused by a ductal cancer growing onto the areola. It is quite a rare condition which may be confused with eczema, but which spreads over the areolar region far less quickly and may destroy the nipple completely over a long period of time. If left untreated, it never heals and eventually forms an ulcer.

Wedge excision of the affected area, or the cytological examination of scraped cells under a microscope, will confirm the diagnosis. This is a far more serious disease than eczema and treatment may involve complete removal of the breast. A woman with persistent redness or nipple discharge should always report it to her doctor even if she has eczema elsewhere on her body as the cancer associated with Paget’s disease is not palpable.

Infective ‘mastitis’

This can occur in women who are breast-feeding their babies. It may be caused by the transfer of micro-organisms from the hands to the breast through a cracked or inverted nipple, by an infection passed on from the baby’s mouth, or by blood-borne infection such as a sore throat.

If the ducts become blocked when a woman is lactating, the milk may stagnate within them and an infection can develop. This may cause a dull pain with inflammation, tenderness and swelling or engorgement of the breast, and sometimes an infective discharge from the nipple.

Treatment with antibiotics is usually effective if given early, but breast-feeding will have to stop while these are being taken. Breast milk can be expressed with a breast pump, but, as the milk will contain traces of the antibiotic, it should not be given to the baby. Your midwife will be able to advise you in this situation.

Ulcers

Rarely, ulcers can develop on the nipple during breast-feeding. The baby’s sucking can irritate the skin, leading to pain and bleeding from the affected area.

Washing and drying the nipple carefully after each feed, and the use of Calendula ointment can help to prevent ulcers forming, but once present, frequent washing with a sterile solution and breast-feeding using an artificial nipple should help. If necessary, breast milk can be expressed with a breast pump.

Ulcers are more common in fair-skinned women, particularly those with red hair.

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Many-if not most-people believe that they should have ‘a thorough check-up’ now and again. There is a widely held misconception that a doctor (usually a general practitioner) can do a kind of 10,000 miles service of everything that really matters and do it in a few minutes. This is totally untrue. Even a very lengthy clinical examination by a highly expert physician might well miss even quite obvious disease which cannot be picked up by his or her bedside diagnostic skills. The problem with such examinations, even if they are very well done, is that if given an ‘all clear’ patients imagine themselves to be well and may as a result actually take less care of themselves because their current lifestyle, they argue, appears to be doing them no harm.

Young children and the elderly need more regular professional examinations because they get ill more often and can go downhill very quickly once something starts. Physical examinations in middle age are more worth while than in younger people because of the higher rates of heart disease and cancer.

Obviously it makes sense to limit physical examinations to those periods of life at which they are most likely to produce results. A thorough physical examination at birth and periodically throughout early childhood makes good sense because so much is going on developmentally that it is reasonable to try to pick up abnormalities so that they can be dealt with quickly. It is probably sensible to have a physical examination every five years after this up to the age of 40 and then every other year up to 65.

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Pete Falk never sets foot in a grocery store without a plan—a menu plan, that is. Writing down exactly what he needs to prepare each week’s meals keeps him away from all of the high-fat, high-calorie temptations that line supermarket aisles. It’s the key to how he lost 63 pounds.

Pete, a 35-year-old computer engineer from Denver, got in the menu-plan habit while attending a medical clinic specializing in weight loss. At the time, he weighed 257 pounds, too much even for his 6-foot-1 frame. «I had been heavy since I was a kid,» he explains. «I wanted to slim down, and I had tried numerous times on my own. I didn’t get really motivated until my allergies and asthma started getting worse. Then I knew that I needed help.»

At the clinic, Pete went on a physician-supervised eating plan for the first couple of months. Then, he worked with the doctor and a nutritionist, learning how to make smart food choices on his own. «They gave me sample menus, which I took to the supermarket with me so I’d know what to buy,» he says. «Eventually, I realized that by sticking with the menus, I was filling my cart with healthy foods, not the junk that helped me gain in the first place.»

The menus encouraged Pete to make other healthful changes in his eating habits. He stopped skipping breakfast, he started packing his lunch on workdays, and he tried to have dinner at about the same time every evening. «Because of my job, I had been eating really late some nights—around 10 o’clock,» he says. «I was so hungry by then that I’d stuff myself.»

As Pete’s eating habits improved, his waistline shrank. He joined a local gym, where he worked out 6 days a week. Within 4 months he was 63 pounds lighter.

That was more than 2 years ago. Pete has since started lifting weights, which has added some bulk—all muscle—to his physique. He’s holding steady at a fit 200 pounds.

While exercising regularly has helped Pete get in shape, eating healthfully has kept him trim. These days, he writes his own menus, but he still takes them to the grocery store. «My menus help me shop conscientiously,» he says. «I get the right ingredients and buy only what I need—no junk food.»

WINNING ACTION

Get a plan. If you’re prone to straying down the wrong supermarket aisle, like Pete, get a plan. Decide on your meals for a full week. Write down what you need to make each meal. Use that as your shopping list. This

way, you’ll leave the supermarket with exactly what you §. went in for, and you’ll minimize impulse buys.

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