There are no easy answers to the many potential difficulties, some major and others apparently trivial but nonetheless important, that accompany the blending of two families. A sense of humour helps, along with a commitment to respect individual needs and styles of doing things. Sometimes family therapy may help to clarify issues and suggest strategies for resolving problems.

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If such an approach is recommended for you, ask exactly what is involved, how long you would have to spend in hospital, how likely it is to relieve your pain and for how long, and about the nature and likelihood of any side effects as well as how long they might last. The cost/benefit balance may well be worse than you can reach with painkillers. I certainly would not recommend these sorts of methods before you have tried using painkillers as I have described.

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NEVER use CREAMS or OINTMENTS where the skin is blistered. They stick and delay the healing process. If the doctor has to remove the dressing, he will also have to remove cream and ointment to get to the burn, and that is painful.

Large blisters need de-capping and proper dressing. Never just prick the blister; this lets out the fluid but lets in the germs.

MAJOR: Again, cold is the best treatment. Apply cold water immediately. Cover the area with a wet, clean sheet. The water which evaporates from this sheet keeps the part underneath cool, lessens fluid loss and prevents further tissue damage. Shock always accompanies burns to large areas of the body.

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Stones made from bile pigments comprise about 12 per cent of the total. They are black and vary from multiple minute particles (biliary mud) to irregular larger stones covered with small projections.

Pigment stones make up the bulk of gallstones in some communities, such as Korean and Japanese country dwellers, but 80 per cent of stones are the mixed type and contain both cholesterol and pigment as well as calcium salts.

The presence of calcium in the stone makes it opaque to X-rays and so is visible on an X-ray film without the need for contrast medium. Mixed stones are nearly always multiple. Usually dozens, sometimes more than a hundred, are present and, by rubbing against each other, tend to be faceted.

Not all gallstones lead to symptoms. Some are found at autopsies or operations without the owners ever being troubled by them.

This is more likely with a solitary cholesterol stone. The commonest symptom is a flatulent dyspepsia. The person has a fullness after food, frequent belching and heart-burn. These symptoms are more common following a fatty meal.

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But don’t think that every woman with a fine moustache is about to develop muscles and a deep voice. For most women, an excess of hair is the only sign of the effect of these androgens and they are otherwise fully feminine.

The overactivity of the male hormones may come from disorders of the ovaries or the adrenal glands, where there will usually be other signs and symptoms.

The increased facial hair often seen at the menopause is due to the reduced output of oestrogen, the female hormone, allowing the androgen to act unrestrained but sometimes the problem originates outside the body.

Anabolic steroids, derived from male hormones, are chemicals which retain the ability to build up muscle tissue but from which is removed the virilising or male action.

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A relapse or recurrence means that the cancer is growing again after a period of being dormant. If you were in partial remission, the growths, which had temporarily got smaller but not disappeared, have started to grow again. If you were in complete remission, and have now relapsed, this means that tiny seedlings were actually there all along. They have now reactivated and grown to a size that is detectable. The remission duration or length of remission is the time between diagnosis of remission and diagnosis of relapse.

The seriousness of a relapse depends on your type of cancer and what previous treatment you have had. If you have a type of cancer for which radiotherapy or chemotherapy is potentially curative and if you have previously been treated only by surgery, you could still be cured completely. If you have one of these types of cancer but have already been treated with chemotherapy or radiotherapy, it is very unlikely that you would be cured by using the same treatment again. Usually, a temporary remission would be the most that you could realistically hope for. The first remission is the easiest to achieve, lasts the longest and is really the only one that could eventually prove to be a cure. Unless a completely different form of treatment is used, second remissions are harder to achieve, last a shorter time and very rarely prove to be complete cures. Bear this in mind if your doctor recommends treatment for a relapse.

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Consider the energy balance paradox that exists in our bodies. For most of us, even without much conscious effort, our bodies maintain a constant weight. This is despite huge variations in how much we eat. For a proportion of people who are overweight this apparent bal despite every fad diet, every exercise program, even operations and medications, body weight can steadily increase over the years, regardless of all apparent efforts to control it.

It has always been said that our weight is a result of how much we take in and how much we burn up. So, if we take in too much (overeat) and don’t burn up enough (don’t exercise) we are likely to put on weight.

The question is: how much, of what, is too much? The answer is not a simple one: not all foods that we eat are equal and no two bodies are the same.

People are overweight for many different reasons. Some people believe they only ‘have to look at food’, others put on weight from ‘just walking past the patisserie’, others blame themselves because they eat too much. It is clear that a combination of social, genetic, dietary, metabolic, psychological (and emotional) factors combine to influence our weight.

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Since many of the physiological adjustments are dependent on changes in body composition, we will first examine that before considering the adaptations themselves.

Body composition. Major changes in body composition occur with loss of body mass. Lean and fat tissue are almost inevitably lost together, although the proportions of each will differ widely. The greater the energy deficit and the lower the initial body fat level, the greater will be the percentage of fat-free mass (FFM) or muscle mass lost as the percentage of total weight loss.

For a very fat person, on the other hand, dieting is likely to be more effective for fat loss because of the greater stores available.

A more restrictive diet (500kcal v 1200kcal) will result in a greater proportion of lean mass being lost because the body simply cannot pull large amounts of energy out of the fat stores in a hurry. The lean mass represents the ‘quick release’ calorie compartment of the body so more energy is taken from the breakdown of muscle tissue. General estimates for ratios of lean to fat mass loss by obese people on reasonable diets according to English obesity expert Dr John Garrow, are about 25:75, i.e. 25 per cent lean body mass (LBM) to 75 per cent fat loss. This is used as the standard estimate for big people.

Myth-information. Individual foods such as grapefruit have been claimed to have special fat burning’ potential. There is no physiological reason why this is so, nor any positive evidence to this effect.

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more body water than women.

These proportions change with age, degree of muscularity, fitness levels and a range of other factors, but they generally represent the difference between the sexes. Each gram of fat is the equivalent of around 9 kcal of energy. Hence, a person with 15kg of body fat will have the equivalent of 135 000 kcal of potential energy. To put this in perspective, for a person who weighs 70kg, it requires about 100 kcal of energy to walk 1km. It also requires around 2000 kcal of energy to keep the average sized person alive for a day. This is called the resting metabolic rate (RMR). So theoretically, fat stores provide enough energy to keep the average person alive for around 60-70 days. For the average person to perform normal daily activity and to meet energy requirements of metabolism, a daily consumption of around 2000-2500 kcal of food is required.

Glucose (a basic form of carbohydrate) is the other main source of energy used by the muscles. This is a more immediate source of fuel than fat in that it can be used in the absence of oxygen. An analogy would be the difference between using paper (glucose) and wood (fat) as fuels in a fire. Paper is quick to start, but also burns out quickly. Wood is slower to get going, but is a much more effective form of fuel over a longer period.

Glucose is present in the body in three main locations: liver, muscle and blood. In the blood it circulates as glucose and in the liver and muscle it is stored as glycogen, which is a series of glucose molecules joined together. Total storage volumes in each of these locations is shown in

In contrast to fat, glycogen has to be stored with water. Each gram of glycogen is stored with about 3 grams of water, making it very bulky as an energy store.

Although this storage capacity can be increased, and perhaps even doubled through various nutritional techniques such as carbohydrate loading, glucose stores can’t be relied upon for long term survival in times of food shortages. Indeed, if we were to store as much glycogen as provides the equivalent energy of fat stores in the body, humans would need to be the size of elephants to accommodate the volume of glucose and water! Fat, therefore, is a very efficient and valuable store of energy.

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Cut white cabbage heads into narrow strips with a large knife or grater, and place in a barrel. When the layer of cabbage is about four to six inches deep, sprinkle a few juniper berries, cummin seeds and/or black currant leaves on top—use your favorite or whatever you have available. A few strips of carrots, green peppers, and onions can also be used. Add a little sea salt—not more than two ounces for each 25 pounds of cabbage. Then add another layer of grated cabbage and spices until the container is filled. Each layer should be pressed and stamped very hard with your fists or a piece of wood so that there will be no air left and the cabbage will be saturated with its own juice.

When the container is full, cover cabbage with a clean linen canvas, place a wooden or slate board over it, and on the top place a clean heavy stone. Let stand for three to four weeks in a warm place, not below 70° F. Now and then remove the foam and the possible mildew from the .top, from the stone and from the barrel edges. The linen canvas, board and stone should be occasionally removed, washed well with warm and then cold water, and replaced. After three to four weeks the sauerkraut is ready for eating. It can be left in the barrel, which now should be stored in a cool place, or put in glass jars and kept in the refrigerator.

Sauerkraut is best eaten raw—both from the point of taste and for its health-giving value. Drink sauerkraut juice, too. It is an extremely beneficial and wonderfully nutritious drink.

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