but. the lack of water is equally dangerous. based on keep you see people moving south so they can plant crops and trying to meet the system. floods droughts with climate change become the main driver of mass migration you could not write any apocalyptic scenarios you want and probably more typical of. climate exodus starts september 5th on g.w. . will come 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

kirsten lekota step on the stone smoked 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 last part clinic in berlin next to this wonderful campus welcome to good shape. and it's nice to. see you. as. o.c.d. is ready a prevalent and painful this autumn that however can be treated effectively if the person overcomes his or her shape and gets the adequate treatment. by the way. many

famous people are said 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 but they can stop. just one last check to see if the door is 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 their compulsion to dominate their lives. he was dr shaw he's the head of the department of psychiatry of the most likely cure and thanks for having me today and i think everybody knows the situation that he has to doublecheck of the door is shut or a thing of that's turned off but when does obsessive compulsive behaviors in that

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 is unlike the able to. perform the daily life it typically is anymore and then what are the typical symptoms we have that kind of says if ect routines that have been have to be both performed like checking if the door is locked if the stove is turned off or washing cleaning bringing things in a certain kind of or down and we have a lean obsessive thoughts coming into my mind. people are fighting against the thoughts because they are of. sexual or any kind of disgusting nature. and told us

a sense of compulsive behavior occur with some reason for it actually we don't know the full reason of course there are genetic components. as a kind of risk factor us it's not a genetic disorder at all childhood plays a role in 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 high risk for o.c.d. because i'm used to double checking my office door 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 such kind of behavior as their daily routines your who told us there that there are different

kinds of impulses options sessions and actions and criticism out again what with the difference between the impulses and the actions for 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 sewage silent ideas it's just the fear to lose control or to take a now i haven't 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 them absolutely not and this should not be mixed up with suicide risk because these people don't want to die. and then told 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 are to clean up everything or to check the door 30 times and though they say stop it 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. it's just a step so it really affects both the patient and that of absolutely it brings problems into interpersonal relationship and that's typical reason why people seek help and come to us because there's a lot of shame. associated with obsessive compulsive disorder as it's hinders the patients from going to a doctor or to a therapist where there's a lot of shame and a lot of good for the patients who suffer from. just check up on extra or.

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. talk 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 oh yes she. 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. it's fun as 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 line 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 short his colleagues are trying out what's called exposure therapy. and sleeker than i expected you. and dirty are ok. i'm a bit afraid of what's in there. ok ok so now you're going to open it. the lid with the whole surface of your hand ok so now what you want to talk about it was nothing because 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 curable of all 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 calm politicians are 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 the 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 meet the patients yes yes just author a p 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 psychotherapists in the 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 of the hands that they have. 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 they have in every region of the world be corsets and natural behavior to control things which might be helpful if it's within an anomaly. and the prevalence is between one and 3 percent of the population in all countries we have some. 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 i believe read so if you live in another country and you don't have access to psychotherapy 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 they 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 there's self-help program here 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 ok here we go to view christian from el salvador. wants to know where this is also an indication for other psychological younger sons oh yes that might be a very have a lot of co-morbidity as we call it that means that it is together within our psychotic disorder fall example schizophrenia are or addiction does order and 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. and it coming sure we'll be talking about alcohol it's consumed all over the world mainly in the form of wine and beer what effect does it have on the body sending your questions to in good shape but d.-w. dot com just write out the hole in the subject line looking forward to hearing from you. ernie is a very common especially among men they become visible when you lift something heavy or when you cough and then this is typical peters and then it's high time to see you doctor. i lump bolch all swelling in the abdomen or growing area maybe a honey 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 and this afternoon. after you will have his i'm able to go out or 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 and plain to see so at 1st i was a bit worried. that he will mess moments of the synagogue he was too worried to carry on doing his favorite sport and missed the whole scene is a new kite surfing. that's why i'm on it kept bothering me my body just didn't feel healthy. clothes 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 but it wasn't nice . abdominal surgeon. sees

thousands of hernias every year. 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 chris young call has finally decided to have the lump checked out. using ultrasound his doctor is able to see that the hernia has reached a critical stage. this is a large inguinal honea as a large hernia sac in the scrotum containing intestinal loops several of them including the coal on if that gets 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 hind the abdominal muscles the sensitive inner organs in a hernia the connective tissue weakens and tear 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 janklow 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 the operation. 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 in her. he said the minimally invasive surgery is unlikely to pose any major risks to foretell 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 odd leon's 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 fire and biscuits and closes up the hernia from the inside. cartilage open honey a surgery has also gone smoothly. of course i was very relieved to wake up again. at city to say or fear that i had before has vanished i'm glad i've got out of the way of. adelanto part it has a little bit of pain for a few months i thought it took a while before i could feel confident about my body again for. now he can finally

go kitesurfing again everything has healed nicely and he's back in the water. with our leeward hardly smell i'm talking about mouth odor not the one when you eat raw onions or garlic i mean the one that doesn't go away what's it all about check this out. turn has an important appointment with his dentist this piece of equipment will show whether or not his hala ptosis has been cured. it's big enough we're taking america sample from the back of the mouth above the tongue and we'll have a look at the result of this in spite. 4 weeks ago going to one to see his dentist having spent a year trying to cure his back breath. he also. what's with patience so he was very self-conscious about it. the whole thing started when my wife

had a word with me she said my breath and started to smell but it was a big surprise at 1st i was shocked i also deal with patients so it's really embarrassing because i'm sure i have a good dental hygiene you know i use an electric toothbrushes laws i clean my teeth after meals are you. but i realised it wasn't enough because i know i missed. the dentist uses this holly meter to measure the levels of salt 1st. breath. bacteria excrete sulfur compounds that cause the unpleasant smell. it can be a difficult subject to broach we asked members of the public if they told someone about that bad breath. and it was mono you can't do that you just have to ignore it . my math teacher has been bred but i don't dare tell him because i don't want to risk migrating. to i wouldn't say anything because they usually already know this

and feel like they might worry that you think that. china forked over he was the odor is caused by anaerobic bacteria. 95 percent of them sit in the space between the gum and the truth. and sometimes they're at the back of the tongue. for you can use a tongue cleaner to get rid of them. and between the chief it's very important to use an intraday into a brush that's the right size that so you can get the bacteria under control the odor comes from areas in the mouth that's hard to reach with a normal toothbrush even with the most thorough cleaning there are easy ways to gauge your own hygiene. and you can floss between your teeth and smell it or stroke the back of your tongue and smell your finger breathing into a bag over your head. is it very effective when you can't smell your own breath that well. i mean i'm. going to has been using into dental

brushes under tongue cleaner. he managed to clear up his how to use x. . just over and that's a really fantastic result you're well within the normal range down we're not seeing those big build ups of sulfur anymore because we've reduced the levels of oral bacteria it's flawless and this is. i'm so pleased thanks for the information might never have known. you'll be able to kiss your wife again. how ptosis can affect anyone so it's good to be open and speak freely about the condition it's certainly paid off for going into. one of the most dangerous any moves in the world is the most kito worldwide it transmits a lot of diseases some of them even fatal lucky me not here in germany bites can still be very nasty especially if you scratch.

they bug you even if you just want one it's already too late it itches and swells and mosquito bites are often more than just annoying. in tropical countries many species of mosquitoes such as the asian tiger mosquitoes are vectors of disease that's long been known but nowadays many people in germany are visiting their doctors for mosquito bites as the bites become severely inflamed. just only we see a lot of patients with mosquito bites they come in and we can send them home quickly. within 9 days we had 6 people with infected mosquito bites who all had to receive antibiotics. was bitten on the foot by a mosquito 3 weeks ago her leg swelled up severely when it got to the point where she could barely walk she sought medical help. i thought going to the doctor for

a mosquito bite seemed pretty stupid i didn't want to go but i called when it got really swollen and they said i should come by. if an infected insect bite turns red and gets his biggest a pall of your hand. or if you have a fever and you want shore then you should go to the doctor. and among the. bacteria can enter the bloodstream through the mosquito bite from there they spread throughout the body and multiply near the vessels that transport the tissue fluid from the leg toward the heart the bacteria clog the lymph vessels the fluid cannot get through the leg swells up and the infection spreads. and that's why i called spock prescribe 10 days worth of antibiotics for free. and now the swelling in her foot has gone down and whether the bacteria entered the womb through scratching or the mosquito transmitted them is unclear the mosquito saliva

plays a big role in determining how irritating its bites are and it can vary widely. why there are more reactions in some years than in others likely depends on the composition of the saliva changing from year to year no one knows why it could be climate or weather changes. another guess many mosquito bites become infected if farmers use liquid manure on their fields the mosquitoes come into contact with the fecal matter and when they bite aggressive microbes enter the womb. that something new about god knows believes last year his hand swelled up so massively for 2 days after being bitten by a mosquito that it didn't look like his own hand anymore. and i couldn't move it any more not even my fingers then i went to the hospital and the pain was excruciating i felt my hand would explode to my non plotzed. apart

from that a red line formed an inflammatory reaction that indicated blood poisoning. i was lying in bed with a huge i.v. containing antibiotics. he was treated in the hospital for 3 days if he had waited just 24 hours before going to the doctor it would have been too late. experts say to treat any mosquito bite don't scratch it but cool it. is a good idea it lessens the blood flow naturally and also reduces the chance of the germs being able to spread quickly and it helps to stop the itchiness. cortisone can help if it gets worse you can also take anti histamine tablets if the bite stays swollen and you get a fever then show your mosquito bite to the doctor. and

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