The year long fight over whether to pass a bill reforming the healthcare industry has just come to an end. President Obama has signed it into law. Now all we have to do is sit back and wait to see whether it will deliver a better and fairer service to more of the population. At this point, a little honesty is in order. The US healthcare service has been broken for some time and anything that improves it is to be welcomed. The GOP do, however, have legitimate concerns about cost. We are just starting to recover from a deep recession. Unemployment is still at a record high. Public debt is mounting as big government tries to keep the banks afloat and encourage business to start hiring again. So, if this reform pushes up debt, the cost may come to outweigh the benefits. The various supposedly independent government agencies claim the reforms will actually reduce public debt. Unfortunately, guessing what will happen in the future never produces reliable results. All we can do is wait and see.

One of the key selling points for reform has been the number of people without insurance. The Democrats have been standing up for social justice – the idea that the state should provide health care for the maximum number of people. Various numbers have been thrown around. There are apparently some 45 million uninsured adults. About 31 or 32 million of these people may now get some kind of coverage. Where do all these numbers come from and how reliable are they? We start of with the census. That is supposed to tell us how many people there are in the US so the government can make sensible plans to provide all the services and amenities they need. Unfortunately, the census data is now old and not completely reliable. Not everyone wants to be counted or, if cornered, not everyone tells the truth. But it does give us a starting point. We exclude children and seniors already in Medicare. This is the number of adults who could have health plans. The insurance companies report the number of policy holders and of those enrolled in employers’ plans. A subtraction sum gives us an estimate of the uninsured. So who will be entitled to coverage? Well, big government is expecting some 24 million people to buy coverage through the new insurance exchanges. A further 16 million are expected to join Medicaid. More children whose parents do not qualify for aid will join CHIP. Except no one actually knows for certain who these people are. The only clear cut assurance that has been given is to ensure illegal adult immigrants will not be allowed into the health market.

Put simply, none of the numbers you see in the news media can really be explained or justified. Everyone who wants access to affordable health insurance coverage will just have to stand up and agree to be counted. If they meet the criteria on income and do not have insurance provided by their employer, they are potentially eligible for assistance. If the healthcare costs can be controlled, more people will no doubt be brought into cheap health insurance plans. It will still be short of universal coverage but, in a capitalist country, we do not want anything so socialist. There must always be losers so the rest of us count as winners.

Whatever you do, there are always benefits and costs. It’s exciting to drive a fast car but, the faster you drive on a busy highway, the more likely an accident. Tearing yourself away from the television or PC screen can reduce the risk of short-sightedness, but lead to boredom unless you find something like reading or knitting exciting. Making choices is a chance to see what you find interesting, what abilities you have and how you want to spend your free time. So this week’s burning question is what your decision would be if you are about thirty years old and you find yourself showing early signs of male pattern baldness.

For many, hair loss is a frightening prospect. Although the majority of men are married or in a stable relationship by the age of thirty, there’s considerable embarrassment. Society has managed to persuade young men they must all have thick hair sprouting from all visible surfaces (and then some). Rather like the rites of passage involving large quantities of beer and throwing up in your best friend’s car, men have been brainwashed into thinking themselves less than manly if their hair thins and falls out. In fact, the younger they are, the worse the apparent “crime” against their gender nature. This means everyone would immediately start popping the pills to stop the loss – right?

Well, perhaps you might want to slow down the panic reaction. The research world works by looking at the evidence. Whichever side of the argument has the better facts in support wins the day. The “traditional” view is men who start losing their hair earlier have a higher risk of prostate cancer. The reason is the way testosterone works in the body. The evidence suggests men lose their hair early because they have too much testosterone. When this turns into dihydrotestosterone and builds up in the scalp, hair thins and, when it falls, it does not regrow. This same high level of testosterone is also associated with the development of growths in the prostate. Some are benign but the majority are malignant. But the precise cause and effect is uncertain and complicated by the fact that growths in the prostate seem to affect an increasing number of the male population as it ages. Perhaps all men are at risk of growths simply because they are getting older.

The other side of the argument comes courtesy of the University of Washington which has just published the results of a study of some 2,000 men aged between 40 and 47. It seems men who were balding by the age of thirty had the lowest risk of developing prostate cancer. Why does this matter? The most effective of the drugs used to treat male pattern baldness is called propecia. It works by preventing testosterone from acquiring the dihydro bit in front. If there is less dihydrotestosterone, the hair stays thicker and regrows when it falls out. Now here comes the kicker. What no one can tell you is which represents the trigger for prostate cancer. It could be the presence of more dihydrotestosterone is what slows the cancers down. Taking the propecia could therefore be increasing the risk you will get cancer. So which is more important? Do you want to keep your hair no matter what? Or do you want the lowest risk of cancer? Until there’s more research into the way testosterone works in a man’s body, this is all guesswork, but what you decide will tell us something important about you.

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There’s no such thing as a good or bad disease or disorder. Sometimes, you can be grateful a particular problem is not terribly serious. Other times, it’s just your bad luck you were the one to catch the particular disease. Yet, some disorders are rightly considered unfair. Among these are the nine variations on muscular dystrophy. Indeed, any disorder that comes courtesy of your genes is unfair. You can blame yourself for stupidity if you go into the jungle without taking your shots against the local diseases. But if your disorder is an accident of the way your parents’ genes came together at conception, it’s not your fault. All you can do is make the best of a bad job. The muscular distrophies are a form of wasting disease. They are progressive and slowly break down the tone and control of muscles. At first, this leads to weakness and bad co-ordination. As the disorder progresses, sufferers are restricted to wheelchairs and their general health is affected. At present, there’s no cure, but people can slow down the effects by exercising regularly to strengthen the musculature.

A team is working at the Cedars-Sinai Medical Center in Los Angeles. The research interest is in the Becker variant of muscular dystrophy which almost exclusively affects men and always affects sexual performance. A small, double-blind, placebo-controlled trial is proceeding to test the effect of tadalafil. There is good evidence to show the use of erectile dysfunction drugs dilates the arteries and improves the flow of oxygen-rich blood to the muscles during exercise. Indeed, sporting authorities around the world are increasingly concerned that men who use these drugs as a part of their training regimes may gain an unfair advantage when they compete. Tests are underway to decide whether their use should be banned in the Olympics and other major sporting events. In studies using mice training with erectile dysfunction drugs, the results show the mice were able to exercise more vigorously with less risk of damage to their muscles. If a part of the cause of muscle weakness among those with muscular dystrophy is poor blood supply, the use of erectile dysfunction drugs would seem indicated to improve the ability of the men to exercise for longer periods of time.

This research is at an early stage but the ability of cialis (generic name tadalafil) to dilate arteries in different parts of the body is now the subject of quite different FDA approvals for the treatment of erectile dysfunction and pulmonary arterial hypertension which causes severe pain in the chest. With this diversification an established fact, it will be interesting to see how these men with muscular dystrophy react to cialis (apart from the improvement in the quality of their erections). If the results are sufficiently encouraging, we could well see a major clinical trial launched in 2011 to see whether the results scale up to a statistically significant number of men. Being honest and optimistic, we hope to be able to report significant benefit to those who suffer from muscular dystrophy. Although this will not represent a cure – until scientists develop a way of repairing defective genes, no cure is possible – it may well slow the progression of the disorder and improve the quality of life.

Recently a group of academics in Scotland decided to run a piece of clinical research into the link between general health and sexual activity. The idea was simple. They proposed that people who feel fit and healthy are more likely to engage in sex than those who feel sad and depressed. The problem, as always with matters concerning sexual activity, was how to measure results. There are a number of internationally approved questionnaires designed to test attitudes and abilities in the different sexual activities. The researchers picked those that seemed most appropriate and set about recruiting a statistically significant number of older participants. They ended up with a good number of couples from 40 upwards, all of whom claimed they were prepared to talk honestly about their sexual experiences. The researchers began by dividing the group into those who claimed no current problems and those who admitted to some difficulty. They were then allocated to different groups. All received guidance on diet, seeking to reduce the number of calories consumed and improve the cholesterol levels in the blood. Some were introduced to the delights of regular dance sessions where they were encouraged to learn new steps and remember old favorites. A further group were already gardeners. They were given targets for growing a range of different fresh vegetables in their yards. The intention was to ensure they all spent a regular amount of time hoeing, digging, raking and generally turning over the earth. A final group were told to walk reasonably long distances with increasing enthusiasm – they were to aim at fully aerobic exercise. Allowing for this being Scotland which has a tendency to be wet, windy and sometimes cold, the trial began in the early spring and continued into the fall.

When the results of regular reports from the couples were analyzed, it was clear that those who engaged in the most demanding exercise found the greatest improvement in their levels of sexual satisfaction. After some three months, men who had previously reported some degree of erectile dysfunction were able to achieve an erection hard enough to achieve penetration. Couples who had no previous history of difficulty reported an improvement in their stamina which enabled them to enjoy longer periods of activity before sleep overcame them. Although it was not formally a part of the survey, all the participants lost a reasonable amount of weight and found a general improvement in mood. Even though many might have been sad to see the short summer go by and winter come early, they all remained more positive.

Although this may seem a slightly odd form of research, it is part of a general program to measure sexual activity against body types in different cultures. In Scotland, gardening, walking and dance are socially acceptable and popular. In the US, walking is considered eccentric and the opportunity to dance not always available. However, the general message emerging from research around the world is that older people who remain physically active and maintain a healthy body weight enjoy a more active sex life. Those who find the years are dragging them down rely on cialis, the best of the drugs to counter erectile dysfunction. Whether you choose the weekend or the once-daily version, buy cialis for a natural response to sexual stimulation in men of all ages.

Throughout our lives we often have to deal with pain in its various forms. It can be a small injury or a serious trauma, it can be a light headache or a strong back pain, it can wear off in minutes and last for years. Pain follows us throughout our lives and never leaves us to be careless about what we are doing. Of course, there’s nothing pleasant about pain but if we were unable to feel pain the world would be much more of a stranger place for us where surviving would be much harder for the whole humankind. Pain simply tells us that something is wrong, whether within our body or outside of it that is dangerous and harmful. Imagine world without pain – yes it would be a very good place for a couple of minutes until you are exposed to something harmful, not feeling it, and simply die. Yes, pain is that important.

However pain can certainly make you wish you were dead, especially when it’s severe and chronic. That is why people throughout centuries have been developing ways of treating pain. From herbs to Tramadol, from cold objects to cognitive therapy there are numerous ways you can manage pain. But before trying to overcome pain, you first have to understand what pain really is. It is not a medical condition by itself, pain is only a symptom, a signal that something is wrong in the body. And if in case of an injury the cause is evident, quite often pain signals that there are underlying health problems that have to be treated, which the person was not aware of. And this is one of the most effective ways to overcome pain – treating the condition causing it. Chronic pain is the type of pain that is most commonly observed in cases of an underlying medical condition. Acute pain usually results from injuries and typically fades away over a short period of time. Chronic pain, as you can guess from the name, persists for longer periods of time, which in some cases spread over days, months and even years.

Having two types of pain means that there are two different approaches. In case of mild or medium acute pain resulted from an injury you can simply use a cold object over the area of impact to calm the pain down. In cases of severe acute pain people usually take strong analgesics such as narcotics that act immediately and are not to be used repetitive.

When you deal with chronic pain, different types of pain management are employed. Suffering from chronic pains makes it impossible for strong narcotic painkillers to be used because of their heavy side-effects that make the remedy worse than the disease. Instead doctors usually prescribe drugs such as Tramadol to help patients cope with pain. Besides, as we already know, chronic pain results from various medical conditions within the body, thus treating them usually leads to pain relief. But in case that doesn’t help, there are numerous drugs and therapies you can use to overcome pain. Make sure to talk about it with your doctor who may recommend you with the most appropriate type of treatment for your case.