welcome to in good shape coming up. hernias why the only solution is surgery. chronic bad breath the causes and the cures. and when compulsive behavior interferes with everyday life. here's your host dr catherine lekota step on this don't smudge on the spaces in between what's a nice game for kids can turn out to be an obsessive compulsive disorder in adults and what this is all about this is what i'm going to talk about this dr tom shaw the head of the department of psychiatry here at the clinic in berlin next to this wonderful campus welcome to good shape. and it's nice.

to see. o.c.d. is ready a prevalent and painful this or that however can be treated effectively if the person overcomes his or her shame and gets the adequate treatment. by the way many famous people who are set to have suffered from o.c.d. like charles dolphin or martin luther what they have in common repetitive rituals they are fully aware of what they can stop. just one last check to see of the doors locked or the stove is off lots of people do this but for about 2000000 people in germany these habits are compulsion sufferers feel enormous pressure to perform certain behaviors again and again. people with obsessive compulsive disorder wash their hands repeatedly for extended periods of time or check or clean things over and over again for hours on end until they're completely exhausted or. actions

dominate their lives and. he was dr shaw he's the head of the department of psychiatry of the 1st place and thanks for having me today. i think everybody knows the situation that he has to doublecheck of the doors shut more of the government's turned off but but when there's obsessive compulsive behaviors he lives absolutely right most people know these kind of behavior and that question is rather simple to be answered because. the disorder starts when the subject is suffering and it is and i do able to. perform the daily life it typically is any more than what the typical symptoms we have that kind of obsessive routines that have been have to be performed like checking if the door is locked if the still is turned off or washing cleaning bringing things in a certain kind of or down and we have elise obsessive thoughts

coming into my mind and. people are fighting against the thoughts because they are of. sexual or any kind of disgusting nature and told us obsessive compulsive behavior occur with some reason for it actually we don't know the full reason of course there are genetic compounds. as a kind of risk factor it's not a genetic disorder at all childhood plays a role in how what does we learn about cleaning about hygiene but there remains a big question mark about the real the. real reasons and how it comes to obsessive compulsive disorder or higher risk for o.c.d. because i'm used. to store of the office i would say so because it's rather normal . behavior and in

a way it makes sense to double check things because we're wired lot of trouble and problems and that's typical of most. men and women as such kind of behavior as their daily routines you order it told us there that there are different kinds of impulses options sessions and actions and christmas is out again what with the difference between the impulses and the actions instance impulses of kind of thoughts in the people fear that they might do something be chorus of a lot of control over their self for example jumping out of the window this has nothing to do with suicide ideas it's just the fear to lose control or to take a different heard someone someone laughter typically this never happens it's very painful to have these impulses but there's no higher risk that somebody is taking

a massively night and this should not be mixed up with suicide risk because these people don't want to die. and in total friends and family react to patients with o.c.d. . normally if they're not informed about this disease or they just think come on this is a racial it's a racial or to wash 20 times in our your hands or to clean up everything or to check the door 30 times and though they say stop it and don't do it this is not helpful this does not help the people so we need to integrate the relatives and the friends into the psychotherapy to inform them that it is a disorder and it does not help to just say stop so it really affects both the patient and absolutely it brings problems into interpersonal relationship typical reason why people seek help and come to us because there's a lot. a lot of shame. associated with obsessive compulsive disorder as it's

hinders the patients from going to a doctor or therapist there's a lot of shame and a lot of good work for the patients who suffer from. just check up on its report. sometimes i wash my hands 20 times in an hour. i use up a bar of soap within 5 days so. there was a time it's now been a year already when it was so bad that my skin was very badly affected by it it got totally red roar and dry. afterwards it got so bad that i had to go to the dermatologist. my dermatologist said it looked like 2nd degree burns and he wanted to send me to the hospital. she can regain it gets into the shower again although she already washed herself thoroughly just 2 hours ago. she

can't do anything about her compulsion the washing ritual goes according to strict rules 1st she blathers herself up from head to toe then she cleans the water faucet and finally she cleans the entire shower stall. obsessive compulsion it's like a prison i'm knocked in and i don't have the key i can't free myself from this prison. sometimes regain ascribes her apartment until late at night the compulsion dominates her life a job is out of the question now she lives on welfare. what can someone with o.c.d. do to say stop washing their hands professor shore and his colleagues are trying out what's called exposure therapy. weaker than expected. and dirty are ok. i'm a bit afraid of what's in there. ok ok so now you're going to open it.

to. the lady with the whole surface of your hand ok so now what you want to talk about it was cool enough to be i'm not allowed to wash my hands for 3 hours. what would actually happen if the patient wouldn't wash his hands that would be a cop penya to buy a therapeutic before and after that that could be helpful because the patient realizes that the in attention decreases even though he does not wash his or her hands so it's a little he most patients yes not in all of whom we see it that it's more prevalent in younger people around the age of 20 and 30 and in the older people around the age of 60 we have less frequently and who should seek professional help everyone who is suffering from his compulsion is our obsessions. or isn't able

anymore to cope with daily life. and the 3rd p. in a military setting always the right choice or that's a treatment of the 1st line treatment that's the treatment of choice not pills not medication it's psychotherapy and outpatient treatment however sometimes the disease is that awful that patients on a long able to go to a psychotherapist for example if they need to control their dog for let's say 5 hours before they can leave the apartment they have to come to a psychiatric hospital ok so you have to be the patients yes interest therapy there is a long term setting in the clinic it should only be as long as a patient is becomes able to go to an ambulatory ok and then you continue the ambulatory psychotherapist treatment of choice can you see they become really dangerous the patients for instance kill themselves. these impulsive thoughts i

could jump out of the window i could take a knife this never happens and the should not be mixed up with suicidal ideas because these patients they don't want to die they want to live out of it might become dangerous for example for the hands to washing 50 times a day in the hands of their. courses skin suffering if you widen the scope a little bit and look into other countries of the world to see the distributed of the countries we have in every region of the world be corsets and natural behavior to control things which might be helpful if it's in an anomaly. and the prevalence is between one and 3 percent of the population in all countries we have a. more low in taiwan and hong kong as i saw the figures and rather prevalent in canada and in germany and pretty. 3 percent is quite frequent yes

that's quite forgiven for a disease going right so if you live in another country and you don't have access to psychotherapy you treat o.c.d. then yes psychotherapy is a treatment of choice and medication isn't so that's not a good alternative medication without psychotherapy does not help much however there are quite good help programs in the internet so if you go to the head and look for o.c.d. and self-help you might find helpful programs and it's a safe self-help program yeah of course there's a lot of all i checked to look quite go to and use the riot strategies there might be some black sheep so ok here we go to view a christian from el salvador and his 1st ones to know where this city is also an indication for other psychological young souls oh yes that might be a very have a lot of co-morbidity as we call it that means that. together within our

psychiatric disorder fall example schizophrenia or our or addiction does so every therapist is asked to look carefully of there's a 2nd disorder as well thanks for answering all my questions and if you've got any questions please write me an email. on an upcoming show we'll be talking about. it's consumed all over the world bravely in the form of wine and beer what effects does it have on the body sending your questions to you in good shape but d.-w. dot com just write out the hole in the subject line looking forward to hearing from . her knee is a very common especially among men they become visible when you lift something heavy or when you cough and then that's typical peters and then it's high time to see you doctor. i lump bolch all swelling in the abdomen

or growing area may be a honey or this condition mostly affects men. mathematics student until poses a fitness enthusiast the 26 year old trains in the gym or at the beach whenever he can but one day he suddenly felt a slight stabbing pain in the septum and. after you will have his her exercising i look down at myself and saw a bulge i was kind of shocked because it obviously meant something was wrong it was pretty large in the plain to see so at 1st i was a bit worried. that he will mask the moments of the synagogue he was too worried to carry on doing his favorite sport and missed a whole season of kite surfing. that's why it kept bothering me my body just didn't feel healthy. had a lump in his growing he ignored it for

a while but eventually he became concerned so. i was afraid it was some kind of chuma whenever i tried to lift something heavy it would pop out it was nice. to. abdominal surgeon. see thousands of hernias every year. hundreds as your mind means there's a hole in the abdominal wall it won't close on its own so surgery is the only way to repair it so the hernia can heal permanently. now that he's retired question call has finally decided to have the lump checked out. using ultrasound his doctor is able to see that the honea has reached a critical stage. this is a large inguinal honea has a large tunnel sac in the scrotum containing intestinal loops several of them including the colon if that get. stuck it will need to be operated on immediately

to save the intestine and free it so the find. a so-called strangulated hernia is the most dangerous kind. the abdominal muscles the sensitive inner organs in a hernia the connective tissue weakens and 10 tissue slips through and forms a bulge if a stretch of intestine gets trapped it could be fatal if blood flow to the tissue is cut off. most hernia operations a minimally invasive because john karr has already suffered a heart attack and takes blood thinners that's why he recommends open surgery to reduce the risk of post-operative bleeding although he's frightened of general anesthesia. to go ahead with your permission. the surgeon makes a minor incision and pushes the lump back into the abdominal cavity.

then he inserts a mesh with an opening for the spermatic cord to close up the hernia. dr baggage checks. hernia he's otherwise young and healthy so the minimally invasive surgery is unlikely to pose any major risks therefore the advantage of this method is that you can assess the state of the interior of the abdomen so the surgical trauma and therefore the pain that might arise after the operation is pretty small. during the operation under general anesthesia 3 small incisions are made in adly hands abdominal wall and the surgical instruments are inserted the hernia is visible on the monitor here too and mesh is used it's pushed into the abdominal cavity by and a scope and closes up the hernia from the inside.