Dear Ann Landers,
t has been almost three years since you have had the article on an essay that put each child in his place. It was sent to you by a reader who found it in the library stuck between two books. I have had it on my refrigerator door and it's pretty tattered by this time. Will you please give it a rerun. The date was September 26,1974. Many thanks, mrs. t. in hialeah, fla.

dear friend,
Thanks for asking. The author of that lovely essay is my in-imitable friend, that talented lady Erma Bombeck. Isn't she the greatest? Here it is-with pleasure: dear first born: I've always loved you best because you were our first miracle. You were the genesis of a marriage and the fulfillment of young love. You sustained us through the hamburger years, the first apartment (furnished in Early Poverty), our first mode of transportation (1955 Feet) and the seven-inch TV we paid on for thirty-six months. You were new and had unused grandparents and enough clothes for a set of triplets. You were the original model for a mom and a dad who were try-ing to work the bugs out. You got the strained lamb, the open safety pins and three-hour naps. You were the beginning. dear middle child: I've always loved you best because you drew a tough spot in the family and it made you stronger for it. You cried less, had more patience, wore faded hand-me-downs and never in your life did anything first. But it only made you more special. You were the one we relaxed with and realized a dog could kiss you and you wouldn't get sick. You could cross a street by yourself long before you were old enough to get married. And you helped us understand the world wouldn't collapse if you went to bed with dirty feet You were the child of our busy, ambitious years. Without you we never could have survived the job changes and the tedium and routine that is mar-riage. to the baby: I've always loved you best because while endings are gener-ally sad, you are such a joy. You readily accepted the milk-stained bibs, the lower bunk, the cracked baseball bat, the baby book that had nothing written in it except a recipe for graham-cracker piecrust that someone had jammed between the pages. You are the one we held onto so tightly. You are the link with our past, a reason for tomorrow. You quicken our steps, square our shoulders, restore our vision and give us a sense of humor that security, maturity and durability can't provide. When your hairline takes on the shape of Lake Erie and your own children tower over you, you will still be our baby, a mother Multiple Sclerosis What is MS? Multiple sclerosis is a neurological disease-a disease of the central nervous system, the brain and the spinal cord. It is not a mental dis-ease, nor is it contagious. Approximately 500,000 Americans now suffer from MS and related diseases. The brain and spinal cord are directly related to such functions as walking, talking, seeing, eating, tying a shoelace, opening a door. These activities are controlled by impulses from the brain and spinal cord. The impulses travel along nerves in the brain and spinal cord, then to other parts of the body. The nerves are coated by a substance called myelin. When MS hits, patches of myelin disintegrate and are replaced by scar tissue. Why this happens, or how, is a mystery, but when it does happen, impulses have trouble getting by the scarred spots. There is interference. With interference come malfunctions -the danger signals of MS. MS danger signals are varied and unpredictable. They are often mistaken for signs of other disorders. Each symptom, by itself, could be a sign of other ailments. But, warns the MS Society's Medical Advisory Board, a combination of three or more symptoms such as those listed below, when they appear at once, or in succession, could be symptoms of MS. These symptoms should never be ignored. They are signals to see your doctor at once. It may very well not be MS. But let your doctor tell you-don't guess. Here are signals that could mean MS: Partial or complete paralysis of parts of the body. Numbness in parts of the body. Double or otherwise defective vision, such as involuntary movements of eyeballs. Noticeable dragging of one or both feet. Severe bladder or bowel trouble (loss of control). Speech difficulties, such as slurring. Staggering or loss of balance (MS patients erroneously are thought to be intoxicated). Extreme weakness or fatigue. Pricking sensation in parts of the body. Loss of co-ordination. Tremors of hands. Hypersensation to sound. Multiple sclerosis is usually progressive, proceeding in a series of unpredic-table attacks, each attack usually causing further disability. However, this is not always the case. A number of patients may suffer mild and fleeting symp-toms and enjoy long periods in which there is an absence or improvement of symptoms. There is no known cure. The cause is yet to be found. MS usually attacks people in their prime years, twenty to forty. Onset before eighteen or after forty-five is known but uncommon. Unfortunately, no medication has been found to be successful as a treat-ment for MS. Virtually hundreds of drugs have been tried in an effort to influence the natural course of the disease-including antibiotics, vitamins, hormones and cortisone-but as yet no specific drugs or forms of treatment have proven consistently beneficial. While no specific cure exists, the patient can and should be treated. Good general medical care designed to prevent upper respiratory and other infec-tions is recommended. Braces may be prescribed for stabilizing usable limbs. The physician may recommend massage, passive or active exercise, and other measures suitable for promoting the greatest effort on the part of the patient to keep active. Emotional support of MS victims by family and friends is extremely impor-tant. Keeping MS patients involved in day-to-day activity is vital. They must not be written off as invalids and permitted to withdraw or become reclusive. A positive, hopeful mental attitude can be immensely helpful. When MS strikes, families can turn to their local chapter of the National Multiple Sclerosis Society for information, sympathetic help and guidance. Chapters can make available many specific services including aids to daily living, social, recreational and friendly visiting opportunities, professional counseling to alleviate social and psychological pressures, and medical guid-ance through the chapter's medical advisory committee. The progress made in the Society's programs of basic and clinical research and professional education brings hope and help through the dissemination of accurate, valid, authentic information. credit: National Multiple Sclerosis Society, 257 Park Avenue South, New York, New York 10010. How to Live with Multiple Sclerosis and Enjoy Life In 1947, when my wife and I had just turned thirty, she began to notice a persistent numbness in her right foot. After trying to ignore it for a while, we went to a doctor to see what might be causing this minor problem. We were thunderstruck when he diagnosed it as the onset of MS. In what presumably was meant to be kindly reassurance, he hastened to add that there was no reason to panic because "She might live another twenty years." Tests of spinal fluid and other examinations confirmed his diagnosis of MS. The confirmation was devastating. Imagine what it is like to be told in the prime of your life that you have a nerve disease with an unknown cause, one for which no cure has been discovered; a disease which may kill you quickly or incapacitate you in any or every way over a period of years. After the ini-tial shock, our first resolution was to meet this crisis as a team-together all the way. I had recently returned from military service in World War II. We were eager to resume civilian life, get back to an interrupted career, buy a home and start a family. On the final point, medical opinion was unanimous: For-get it. We also were faced with other major adjustments. We could not foresee how badly or how soon my wife might be incapacitated. We didn't know how much of our savings might have to go for her treatment. We decided to defer buying a home so that we would be able to afford effective treatment if it should become available. In the next five years we accumulated a medical fund and enougih beyond that to enable us to make a down payment on a home in the suburbs. By the time we moved into it, my wife walked with slight difficulty and was losing the use of her right hand and arm. With quiet determination so typical of her, she trained herself to eat, write and perform other tasks with her left hand. (If it sounds easy, try tying your shoes that way.) She has done everything possible to maintain the regular schedule of any homemaker. What she can-not handle physically, I do. She has refused to be relegated to a wheelchair. From the first intimation of her illness, my wife has shown indomitable courage, along with a beauty of character, grace and self-control that abso-lutely win me. Whatever her fears, she keeps them to herself. Whatever her pain-and there has been plenty of it-she refuses to buckle. There is never a hint of self-pity. It is a pleasure to be with her. She has great zest for life, a keen sense of humor, a fast mind and a presence that is comfortable and comforting. From the first we have worked together to maintain as much of her strength and mobility as possible. For most of the time we have done it on our own. Our doctor has seemed to be content with maintaining her general health, providing low dosages of muscle relaxants and vitamins, and review-ing her condition annually. I have been concerned, in addition, with preserv-ing joints and muscles so that a working structure will still exist when a way is discovered-as we pray it will be-to restore nerve function. For over twenty-five years we did the best we could at home with a series of exercise devices. Three years ago we discovered a dedicated physical therapist. We visit him weekly. In addition, we work together each morning and evening on an exercise program he has devised. The improvement has been slow but substantial-and thrilling. After ten years of using a walker for support she is learning to walk again without one. Occasionally other couples who face MS ask us for suggestions on how to cope with it. The disease is so varied in its effects, and the temperament, needs and attitudes of individuals vary so widely, that generalizations may not apply. With those cautions, here are suggestions that have worked for us: Consider MS as something to bring you together rather than to break you apart. The partner with MS needs reassurance, support, love, companionship, understanding and tenderness. The other partner has a real opportunity for personal fulfillment through being needed and responding to need. Rework your lives to yield the greatest satisfaction within limitations im-posed by MS. Outside of working hours I am at home with my wife. I have developed many kinds of recreation-music, writing, working in wood and metal, to name a few. They substitute for golf, bowling and other away-from- home kinds of recreation. Make the MS partner part of the act. Over the years I have been invited to speak at many job-related conferences and seminars from Maine to Mexico, and from Florida to Alaska. I have always asked my wife to accompany me -and she has always accepted. She has won the admiration and friendship of all who have met her-and she has had more to think about and enjoy than if she had taken the easier option of staying at home. These trips give us something exciting to share and remember. Forget what you're missing. Don't keep reminding yourself of what you must give up because of your MS or your partner's. Being physically sound is no guarantee of happiness. Many great physical specimens are also great at making themselves miserable. If you have MS don't compare your case with others. Every individual is different. Don't borrow false hope from someone who has had a remission. Don't borrow terror from someone who hasn't Live one day at a time. Hope for the best. Exercise to your maximum ca-pacity so you will still have joint mobility and muscle if the miracle of remis-sion or nerve restoration should come to pass. Hang tough. I'll never forget a young Marine who suffered battle wounds that resulted in the loss of a leg. "Okay, I'm a cripple," he said. "But I'm not disabled. Don't ever call me that!" That's the spirit that makes a winner, no matter what the scoreboard shows. As Ann Landers says, "It's not what hap-pens to us, but how we take it that counts." credit: Anonymous. Care and Treatment Throughout history, long, carefully manicured nails have been a symbol of wealth and social status. In Asia, the well-to-do women let their nails grow so long it was obvious that they were incapable of performing simple household tasks. Even today, long manicured nails are status symbols of a sort. The as-sumption is that such hands couldn't possibly wash dishes, scrub floors or type. The rate of nail growth varies according to the individual and can be influenced by many factors. Several diseases and infections slow up nail growth. Pregnancy, typing, piano playing and nail-biting make nails grow faster. Nail growth is greatest in youth and decreases slowly with age, drop-ping almost 50 percent between the ages of twenty-five and seventy-five. For some mysterious reason the middle fingernail grows the fastest, and the nails on the right hand of right-handed people grow more rapidly than those on the left hand. COMMON NAIL PROBLEMS Nails can be damaged by too much manicuring or improper manicuring. The most common error is cutting the cuticles. The cuticle protects the nail fold from infection. A cuticle should not be cut unless it is tom and ragged. Trimming will prevent further tearing. First the nails should be soaked in warm, soapy water to soften the cuti-cles. Then the cuticles should be pushed back gently with the fingertip or a towel-don't use another nail or a pointed file. Hangnails are the most common cuticle problem. A hangnail is a ragged, often triangular, flap of dead skin. The best remedy is to remove it at the base with sharp clean scissors. If the area is inflamed, the attention of a doc-tor is advised. Nail infections can be painful and serious. Nails that break and split are a common problem. The notion that eating large quantities of gelatin will make nails stronger is a myth. The best way to cope with fragile or splitting nails (when not caused by disease) is to protect them with several coats of nail polish. Nail hardeners should be used with great care. Although such products do harden the nail, they can cause severe allergic reactions. Such preparations have been known to cause dryness of the nail, discoloration, discomfort, bleeding under the nail and eventually the nail may drop off. CARING FOR YOUR NAILS Nails respond best to kind, gentle treatment. Wear rubber gloves when scouring pans. Use a pencil when dialing. When gardening, put soap under your nails and wear gloves. Use the pads of your fingers for picking up things, never your nails. In general, if you pretend you are trying not to smudge wet nail polish, you will use your hands in such a way as to almost never break a nail. TOENAILS Any of the conditions that affect fingernails may also affect toenails. Sev-eral other conditions are peculiar to toenails. An ingrown toenail forms when the soft tissue of the side of the toe is pene-trated by the edge of the nail. The first symptoms are pain and redness, fol-lowed by swelling and pus. Without proper care, severe infection may follow. Mild cases of ingrown toenails are best treated by applying wet dressings and lifting and paring off the excess nail. More severe cases may require re-moval of all or part of the nail by a physician. (Don't try to do this your-self.) The main cause of ingrown toenails is shoes that are too narrow. Cutting the toenails too short and too far back at the comers is also a contributing factor. Flat feet, excessive curvature of the nail and an unusually large big toe are other possible causes. In any case, the first rule of treatment and pre-vention is that shoes must be wide enough and long enough so they will not put pressure on the toes. The nail must be allowed to grow until the edge is clear of the end of the toe before it is cut Then it should be cut straight across with the sharp comers only slightly rounded. credit: Committee on Cutaneous Health and Cosmetics, American Medical As-sociation. Rochester, minn.-A housewife wrote a letter to the Mayo Clinic request-ing an appointment. Her complaint: "I fall asleep driving. I find myself on the wrong side of the road, off the shoulder, narrowly dodging parked cars or slamming on the brakes to avoid hitting the car in front of me. "I have tried naps ahead of time, napping along the side of the road, sing-ing, slapping myself, everything-to no avail. My children have been accus-tomed to saying, 'We'll wake you when the light turns green, Mom.' "I've always welcomed red lights and trains at a crossing. Even a two- minute nap is a relief. "I've slept washing dishes, washing clothes, fixing meals, eating meals. I've slept in restaurants, at dances, stage plays, concerts and in church. I've fallen asleep while taking dictation." Dr. Robert Yoss, a Mayo Clinic neurologist, has been hearing such horror stories from truckers who've driven big semitrailers of! into the ditch, execu-tives who have lost jobs because they fell asleep in a business conference and people whose marriages have broken up because they fell asleep making love. They are victims of the strange disorder known as narcolepsy, an uncon-trollable desire to sleep. They can fall asleep anytime and any place. Some doze off ten or fifteen times a day. A quick nap will revive them, but only temporarily. The drowsy state soon returns. "The best way to understand how a victim feels is to stay up two nights in a row, without sleep, then try to work as usual for the third day," says Dr. Yoss. "For you, it will be a temporary thing. For the narcoleptic, it is con-stant." Dr. Yoss believes there is a little narcolepsy in all of us. "It's a matter of degree," he explains. "Most of us can be reading a book after a heavy meal, when it is quiet, and begin to realize we are not getting much out of it. Then the head gets jerky and we find ourselves dozing off. The individual with a narcolepsy diagnosis does the same thing, only more often. It is a misconception that he is feeling fine at one moment and then at the next moment, whammo, he's unconscious." For every sleepy person there is probably a philagrypneac (lover of wakefulness). These people seem to be able to get by on four or five hours of sleep, are always alert and enjoy an eighteen-hour production day. "A philagrypneac wouldn't complain to a doctor because his wakefulness would not be considered a disease," commented Dr. Yoss. "Neither is narco-lepsy a disease. It is just one end of the spectrum. Narcoleptics are just nor-mal people who are not average in their ability to keep awake and alert." The neurologist classified wakefulness in five levels-alert and sharp, alert but losing sharpness, tired but not drowsy, drowsy and very sleepy. Whether one is at one extreme of the spectrum or the other is a matter of heredity, not a cultivated behavior pattern, Dr. Yoss believes. Fortunately, there is a good treatment for narcolepsy, he adds. Stimulant drugs are taken at prescribed intervals. The patient also is encouraged to get a good night's sleep. "The key word is 'good,' " he emphasizes. "Eight hours of sleep with many interruptions is not good. Our goal is to have well-rested people during the day." credit: Arthur J. Snider, Science and Medicine, Chicago Sun-Times. Nervous Habits and Compulsive Behavior Nervous habit is a term used by laymen to describe repetitive movements which people make from time to time. The movements seem to have no ap-parent purpose or usefulness, and the person making them is partly or totally unaware of his actions. These repetitive movements are more likely to appear when the person is worried or anxious. In the nineteenth century, anxiety and worry were thought to be caused by some kind of physical affliction of the nerves, the brain or spinal cord. We now know that in only rare instances are the nerves themselves actually affected when people are worried or anxious. Most of the time the nerves themselves are quite healthy and the worry or anxiety comes not from a physical disorder of the nerves but from disturbances in thought and emo-tion. Nose picking and nail biting are probably the most common "nervous habits" of adults. They fall into a category of repetitive movements which might technically be called autoerotic; that is, they give bodily pleasure and you can do them yourself. They are partial pleasures which stem from in-fancy-islands of childhood in the personalities of people who otherwise may be quite mature. They represent unconsciously the kind of reassurance and pleasurable gratification that a kindly mother may once have given to an agi-tated infant. We have no good idea why they persist in some people. They are not usually nor ought they to be the reason for seeking professional psy-chiatric help, though they often spontaneously diminish or disappear in the course of psychotherapy which may be given for other reasons. Nail biting often follows an earlier childhood experience of extensive thumb sucking. The thumb sucking may disappear and be replaced by nail biting; or in some instances the thumb sucking persists into adult life. When children suck their thumbs, they not infrequently pull or rub their ear lobes, their noses or their hair. Sometimes the hair pulling produces baldness; it goes so far that patches of the scalp are denuded. Any one of these as-sociated movements (ear lobe pulling, nose touching or hair pulling) may be-come separated from the original thumb sucking and persist as a nervous habit by itself. The hair pulling may proceed from the hair of the head to the eyebrows, the eyelashes and even rarely to the pubic hair. People who have this habit feel no pain in removing their hair, and indeed are likely to say that it feels good. Rhythmic rocking is another common nervous habit in infants. It may be-come severe enough to involve banging the head against the crib or wall. It also falls into the autoerotic category of giving bodily pleasure to the child, strange as this may seem to an adult observer because the head banging may be so intense as to produce bruises. Vestiges of this habit can be seen in adults who unconsciously rock themselves when they are disturbed, although head banging is likely to be seen only in extremely disturbed adults. Nervous habits by themselves do not indicate severe psychopathology, but any of them may be associated with other disturbances, some severe. There is usually embarrassment about the activity itself or its effects. This embar-rassment or shame usually leads the person to make some effort to stop the habit, but the efforts are likely to be unsuccessful because (1) the activity is pleasurable, (2) it allays anxiety and (3) it is often carried on more or less unconsciously. Efforts by parents and others to bring a stop to the activity are likely to make matters worse. In children, particularly where the approval of parents is so important a source of well-being, the parental criticism which is experienced by the child as disapproval simply makes him more anxious and unhappy, and is likely therefore to lead to intensification of the habit. For nail biting and thumb sucking all kinds of devices have been used as deterrents-bad-tasting substances on the thumb or fingers, restraints of vari-ous kinds on the hands or arms, devices inserted in the mouth. Most often these fail, and in the instances where they succeed, the symptoms are likely to be replaced by others, such as nightmares. In older children or adults, these devices may be helpful in preventing nail biting or thumb sucking. The older child or adult may be willing to co-operate because he himself very much wants to stop, and he appreciates the fact that his habit is likely to go on out-side of his awareness. He is willing, therefore, to use mechanical devices as a reminder, an aid to making him aware. In contrast to the young child, he may be able to make use of and may even solicit the assistance of other peo-ple to remind him without loss of self-esteem and intensification of anxiety. Some habits are more worrisome to professionals than others. Hair pulling, for instance, is likely to be a manifestation of a somewhat more intense state of anxiety and inner loneliness than nail biting, especially when it involves the eyelashes or the pubic hair. Professional consultation should be sought Although they are not usually considered "nervous habits," two other types of repetitious actions should be noted: compulsions and tics. Both of these have a somewhat different significance than the autoerotic habits. The compulsive acts have a ritual quality to them, and may seem excessive to the person involved or may seem natural and remain unquestioned. Hand washing is a good example. It may be necessary for a dentist or a nurse to wash their hands twenty or thirty times a day, but for the ordinary person four or five times a day is enough. If he washes his hands much more often than that, twenty or thirty times a day for instance, he may attempt to explain it in some way that seems plausible, but this explanation would likely seem to be farfetched, a rationalization to others. Indeed, the person himself may be aware that his hand washing derives not from reason but from anxiety. There are ritual compulsions to touch or not to touch. There are proce-dures which seem almost ceremonial that have to be repeated in a certain se-quence at certain times of the day, for instance before going to bed. Failure to perform any of these acts may produce great anxiety in the person, which is relieved only when the act is performed. These compulsive acts may have a simple repetitive character like the autoerotic habits noted above, or they may be a repeated series of separate acts. The person who displays this kind of behavior is less likely than the nail biter or hair puller to be aware of or disturbed by his "habit." For one thing, the compulsive habit is less likely to be offensive to others or embarrassing to the perform of the action. And secondly, it is more likely to go on outside the person's awareness. If he is aware of it at all, it seems natural and appropriate to him. These compulsive ritual acts are not in themselves pleasurable like the first group of nervous habits that we considered. They are not remedial in the sense that they supply missing pleasure or reassurance. They are rather in the nature of guards against some kind of danger. The nature of the protection, its magical or symbolic significance are not usually known to the person; nor does he know what the danger is against which his ritual act protects him. The meaning of both the danger and the protective act lie in the unconscious mind and cannot usually be discovered except by special techniques of psy-chotherapy. In most instances, they do not need to be discovered because the compulsive behavior by itself is not necessarily a sign of pervasive psycho-pathology. Most people have some compulsions just as most people have some auto-erotic habits. For instance, most people feel compelled to knock on wood after commenting on some fortunate aspect of their lives, or they must say "God forbid" when they verbalize some gloomy possibility. These are magic ritual "protective" measures. They might indeed feel anxious if something prevented their doing them, but it is highly unlikely that these compulsions by themselves would move someone to seek professional assistance. Yet another kind of "nervous habit" is the tic. The tic is a quick, jerky, usually purposeless movement, often of the face or head. The extremities or trunk may sometimes be involved. It has a spasmodic quality usually like a wink of the eye, or a flashing grimace of the face or part of the mouth, or a jerk of the head. It happens more often when one is upset or anxious. The person doing it is completely unaware and when it is called to his attention he is nonplused. In contrast with compulsions where the person can make up some kind of plausible excuse, the possessor of tics is at a total loss to ex-plain the behavior. Nor does he have any control over it, in contrast with the two types of habits discussed above. Tics, like compulsive acts, are signs of unconscious worry and conflict. They usually represent both the forbidden wish and the protection against it. We do not understand why or how the mind chooses one kind of symptom rather than another; and in this sense, we do not understand why tics occur in some people. By themselves they are not usually sufficiently troublesome enough to interfere with the person's effective social functioning, and it is rare that someone seeks professional treatment simply because of the presence of a tic. Short of psychotherapy, there is no specific treatment, but anything which tends to lower the general level of anx-iety in a person is also likely to ameliorate the tics. There is a fourth category of "nervous habits" which do indeed warrant the designation "nervous"; that is, they stem from physical diseases of the nervous system, the brain and the spinal cord. Such diseases may give rise to repetitive acts or movements which can easily be confused with tics. Tremors and tic-like movements which come from physical disorders of the nervous system may also be intensified by emotional upsets and anxieties, although they are less likely to be affected than psychologically caused tics. In any case, the sudden onset of tic-like movements warrants a medical con-sultation to determine whether they are of emotional or neurological origin. credit: Gene Gordon, M.D., Senior Attending Psychiatrist, Children's National Medical Center, Washington, D.C.; Faculty, George Washington University Medi-cal School, Washington, D.C.; Supervising Training Analyst, Baltimore-District of Columbia Psychoanalytical Institute. (Inverted) There are two problems associated with inverted (turned in) nipples. The most obvious problem is a cosmetic one, particularly if the opposite nipple is not inverted. The second problem is the functional inability to breastfeed a child. This problem can be corrected surgically. The surgery is uncomplicated and does not require an overnight stay in the hospital. It is usually performed under local anesthesia and takes about an hour. The scar is usually well hidden in the areola (dark area around the nip-ple). Each physician will place his/her own postoperative restrictions on the patient, but generally they are few. There is little postoperative discomfort. Depending on the cause of the inversion, it is possible for the nipple to re-tain sensation and the ability to breastfeed after surgery. Since there is a definite functional need for this operation, most insurance companies will reimburse the patient. The various causes of inverted nipples are: Congenital: (You were bom that way and when the breast developed, the problem became apparent.) Scar tissue from previous surgery of the breast. Cancer. In some cases a woman with cancer of the breast will experi-ence a pulling in, which results in an inversion of the nipple. Since cancer is a possibility, any woman who has a new or sudden inversion of the nipple should see a physician immediately. A woman seeking correction of this problem should make sure that her doctor is well qualified to correct inverted nipples. A qualified Plastic and Reconstructive Surgeon may be researched by contacting your family physi-cian, local medical society or the American Society of Plastic and Recon-structive Surgeons, Inc., 29 East Madison Street, Suite 807, Chicago, Illinois 60602. Many major cities have local chapters. credit: David Ross, M.D., Plastic and Reconstructive Surgery, Chicago, Illinois. Nursing as a Career Nursing plays a major role in health care. As important members of the med-ical care team, registered nurses perform a wide variety of functions. They observe, evaluate and record symptoms, reactions and progress of patients; administer medications; assist in the rehabilitation of patients; instruct pa-tients and family members in proper health maintenance care; and help main-tain a physical and emotional environment that promotes recovery. Some registered nurses provide hospital care. Others perform research ac-tivities or instruct patients. The setting usually determines the scope of the nurse's responsibilities. Hospital nurses constitute the largest group. Most are staff nurses who pro-vide skilled bedside nursing care and carry out the medical treatment plans prescribed by physicians. They may also supervise practical nurses, aides and orderlies. Hospital nurses usually work with groups of patients that require similar nursing care. For instance, some nurses work with patients who have had surgery; others care for children, the elderly or the mentally ill. Some are administrators of nursing services. Private duty nurses are self-employed and give individual care to patients who need constant attention in homes, hospitals or other convalescent insti-tutions. Office nurses assist physicians, dental surgeons and occasionally dentists in private practice or clinics. Community health nurses care for patients in clinics, homes, schools and other community settings. They may also work with community leaders, teachers, parents and physicians in community health education. Nurse educators teach students the principles and skills of nursing both in the classroom and in direct patient care. Occupational health or industrial nurses provide nursing care to employees in industry and government and along with physicians promote employee health. According to the most recent data from the Interagency Conference on Nursing Statistics, there were 961,000 employed registered nurses on January 1, 1976. It is estimated that about 1.5 percent of the total employed regis-tered nurses are male. A license is required to practice professional nursing in all states and in the District of Columbia. To get a license, a nurse must be a graduate of a school of musing approved by the state board of nursing and pass a written state board competency examination. Nurses may be licensed in more than one state, either by examination or endorsement of a license issued by another state. Three types of educational programs-diploma, baccalaureate and associ-ate degree-prepare candidates for licensure. However the baccalaureate program is preferred for those who aspire to administrative or management positions, and for those planning to work in research, consultation, teaching or clinical specialization, which require education at the master's level. In public health agencies, advancement is generally difficult for nurses who do not have baccalaureate degrees in community health nursing. It is important to consider future career goals as a nurse and to be aware of the career op-tions available from each of the three different types of nursing education programs, because moving from one type of program to another is time-con-suming and costly. Graduation from high school is required for admission to all schools of nursing. Diploma programs are conducted by hospital and independent schools and usually require three years of training. Bachelor's degree programs usually require four years of study in a college or university, although a few require five years. Associate degree programs in junior and community colleges require approximately two years of nursing education. Varying amounts of general education are combined with nursing education in all three types of programs. Students who need financial aid may qualify for federally sponsored nurs-ing scholarships or low-interest loans. Those who want to pursue a nursing career should have a sincere desire to serve humanity and be sympathetic to the needs of others. Nurses must be able to accept responsibility and direct or supervise the activity of others; they also should be able to follow orders precisely and to use good judgment in emergencies. Good mental health is needed in order to cope with human suffering and frequent emergency situations. Staff nurses need physical stam-ina because of the amount of time spent walking and standing. A growing movement in nursing, generally referred to as the "nurse practi-tioner program," is opening new career possibilities. Several post- baccalaureate programs prepare nurses for highly independent roles in the clinical care and teaching of patients in such areas as pediatrics, geriatrics, community health, mental health and medical-surgical nursing. Employment opportunities for registered nurses are expected to be favora-ble through the mid-1980s. Some competition for more desirable, higher pay-ing jobs is expected in areas where training programs abound, but opportu-nities for full- or part-time work in present shortage areas, such as some southern states and many inner-city locations, are expected to be very good through 1985. For nurses who have had graduate education, the outlook is excellent for obtaining positions as administrators, teachers, clinical special-ists and community health nurses. Registered nurses who worked in hospitals in 1976 received average start-ing salaries of $11,820 a year, according to a national survey conducted by the University of Texas Medical Branch. Registered nurses in nursing homes can expect to earn slightly less than those in hospitals. Nurses employed in all federal government agencies earned an average of $15,500 a year in 1977. Most hospital and nursing home nurses receive extra pay for work on eve-ning and night shifts. Nearly all receive from five to thirteen holidays a year, at least two weeks of paid vacation after one year of service, and also some type of health and retirement benefits. For information on approved schools of nursing, nursing careers and scholarships, contact: Coordinator, Undergraduate Programs, Department of Nursing Education American Nurses' Association 2420 Pershing Road Kansas City, Missouri 64108 and Career Information Services National League for Nursing 10 Columbus Circle New York, New York 10019 credit: Julie McGuire, Coordinator, Career Information Services, National League for Nursing, New York, New York. Based on a piece by Jean MacVicar, Director of Division of Hospital and Long-Term Care Facility Nursing Service, 1978-79. Edition of the Department of Labor's Occupational Outlook Handbook. The Licensed Practical Nurse Practical (vocational) nursing is an occupation that provides many job satis-factions for those who have a genuine interest in helping others. Practical nursing programs prepare men and women to give nursing care under the su-pervision of a registered nurse or a physician, to patients in simple nursing situations. In more complex situations, the licensed practical nurse functions as an assistant to the registered nurse. The licensed practical nurse is em-ployed in hospitals, extended care facilities, nursing homes, clinics and other health care facilities. Practical nursing programs are approximately one year in length. In some states they are longer, and a few programs are shorter. Each program es-tablishes its own admission requirements. The majority of programs accept both men and women who have good health and are interested in a service career. Academic requirements vary from state to state so it is important to contact the board of nursing in the state in which you wish to study in order to learn whether or not you need a high school diploma. Scholarships are sometimes available for deserving students. Information about these may be obtained from the secondary school counselor. Most practical nursing programs require full-time attendance. This will in-clude classes, practice of nursing procedures and supervised learning experi-ences with real patients in a hospital, extended care facility or nursing home. Satisfactory completion of a state-approved program in practical nursing is required before you are permitted to take the examination for licensure. The examination is given by the particular state board of nursing. Licensure as a practical or vocational nurse gives the person the legal right to practice as a licensed practical or vocational nurse in the state in which the license was is-sued. Each state sets its own minimum licensing requirements. A practical nurse licensed in one state and wishing to practice in another must apply to the state board of nursing in the second state for licensure. Requirements vary slightly from state to state, however licensure in another state is not difficult to obtain and does not require the writing of an examination. credit: Jean MacVicar, Director of Division of Hospital and Long-Term Care Facility Nursing Service, 1978-79. From Practical Nursing Career, 1976-1977. Nursing Homes A Checklist of What to Look for After deciding to place a parent, the next problem is finding the proper home. How does one go about checking out nursing homes? Wetzel McCormick, administrator of the Warren N. Barr Pavilion on the Near North Side in Chicago, lists some of the things that should be on your checklist (specifically, this relates to Illinois but can be applied to most states): Check with your state Health Department or your local Health Department to find out if the home has had a record of problems. Is the facility accredited by the Council for Long-Term Care Facilities of the Joint Commission on Accreditation of Hospitals? All nursing homes in Il-linois must have a license. But not all are accredited by the JCAH, which means the facility has been evaluated (at its own expense) by the council, which states that it meets government standards in regard to quality of staff, health and food services, safety requirements, etc. Be aware that in a nonprofit institution any operating surpluses are re-turned to the facility to upgrade patient care and services. For-profit homes may use the return on investment for outside purposes. Does the home have a full-time medical director who is responsible for the staff and is answerable for the care of its residents. Is the professional staff adequate? Are physicians on regular duty or on call at all times? There should be a registered nurse on twenty-four-hour duty on every patient floor. And there should be a nursing supervisor for every shift. Is there a social service staff? Are there plenty of nurses aides and social and rehabilitation aides? Is there regular review of all personnel? Ask these questions and keep your eyes open when you visit. Is the home eligible for Medicare reimbursement? Does it provide ancillary health care such as dental, optometric and podiat- ric services? Does it have physical and occupational therapists? Are the social, recreational and religious programs suited to the prospec-tive resident's needs? Ask to see proof that the building meets safety and fire code standards. Are fire drills held regularly? Visit the home at different times of the day to observe if it is kept dean. Find out if the bed linens are actually changed as regularly as you are told they are. Are the rooms comfortable and orderly, and do they provide enough space? Talk to residents (and those visiting them) to get their impressions. Ob-serve the way residents are treated by the staff. Find out the views of staff members. Does the facility have a selective menu that is posted, and are special diets available? Does the home encourage meetings between the staff, residents and fam-ily members to establish lines of communication, to hear opinions and answer complaints? McCormick maintains it is important for a person looking for a nursing home to communicate with the prospective resident. "It is important to mini-mize that person's fears by assuring him or her that you have found a com-fortable place that provides the best of care," he says. "It should also be pointed out that there is a period of adjustment that varies for each resident in a controlled environment, such as a skilled nursing facility. Even though we try to motivate residents to get involved, every person has to adjust at his own pace." credit: Illinois Masonic Medical Center, Warren N. Barr Pavilion, Wetzel McCormick, Administrator. Written by Barbara Varro, Chicago Sun-Times. Nutrition What the Body Needs to Keep Well and Functioning Nutritionally your body will do its best in growth, functioning and mainte-nance if it is properly nourished from birth until "death do us part" And nu-trition for nine months before birth is also important. Proper nourishment comes from eating a variety of foods and not eating too much in relation to one's weight and physical activity. This variety can include any foods-chocolate, sugar, Harvard beets, even so-called "junk foods"-but should be based on what nutritionists call the Basic Four Food Groups. They are: Protein Group-meat, fowl or fish. Dairy Group-milk (any kind), or anything made from milk, cheese, yogurt, ice cream, etc. Fruits and Vegetables-any kind but always a variety. Cereals-foods made from wheat, com, rice, oats-again always a variety. And don't eat too much of anything. Unfortunately, we are surrounded today by a multitude of self-appointed "health and nutrition experts" whose only qualification is that they eat three times a day. We hear of the glories of so-called "natural organic" foods, the benefits of megavitamin therapy, and the path to "revolutionary quick weight loss" through low carbohydrate diets. Newspapers repeatedly carry stories that are enough to make anyone's stomach chum: "Food Additives Linked with Hyperkinesis," "Sugar is a Deadly Poison," "Chemicals in Bacon Cause Can-cer." Today we need all the help we can get in sifting food facts from food fads. The most serious problem is that rampant rumors and resulting anxiety dis-tract you from the real nutritional guidelines-ones which have taken genera-tions of scientific research to establish, which are very simple, and which you should be following in an effort to eat for good health. Let's take a critical look at some of those food rumors and nutritional non-sense that are now circulating. We also will present some scientific facts to wise you up when your local food faddist comes calling. "those chemicals" in your food Before you get caught up in the current wave of chemical phobia, remember that all foods, indeed all living things, are made of chemicals. A hot, steamy solution which contains, among other things, essential oils, butyl, isoamyl, phenyl, ethyl, hexyl and benzyl alcohols; tannin, geraniol and other chemicals, is not some artificially wicked brew, but a simple "natural" cup of tea. If you have rejected those new artificial egg substitutes because the ingre-dients include "lecithin, mono- and diglycerides, xanthum gums, tri-sodium and triethyl citrate," and a long list of other chemicals you can't pronounce, remember that 100 percent natural eggs, even organic ones laid by happy hens, contain, among other things, ovalbumin, conalbumin, mucin, lecithin, butyric and acetic adds, zeaxanthine and phosphates. Not only will you find strange-sounding chemicals in natural foods, but there is no basis for the widely accepted assumption that natural is better than artifidal. In addition to occasionally being harmful, some perfectly safe natural foods contain deadly toxins. For example, a potato is a complex aggregate of more than 150 different chemicals, including solanine, oxalic acid, arsenic, tannin and nitrates. Solanine is a potent chemical which in high doses can in-terfere with nerve impulses. Each of us, on an average, eats about 119 pounds of potatoes a year containing enough solanine to kill a horse. How-ever, when consumed in the small quantities present in a serving of potatoes, there is no adverse effect on the body. Other examples: lima beans contain cyanide, a deadly poison, but not enough to worry about; nuts, wheat and other cereals may contain toxic sub-stances called afiatoxins produced by contamination with certain types of molds, but not enough to harm us. Additionally, natural foods quickly deteriorate with time, often developing molds and other growths which can cause disease. Thus, some preservative is necessary. Even wheat germ turns rancid if left unrefrigerated for a short time. So raise your eyebrows in healthy skepticism when you next encounter an advocate of the "back to nature" movement. DO ADDITIVES CAUSE CANCER? In the context of the misunderstanding about "chemicals," additives and modem food-processing techniques have been put on trial as the likely vil-lains in the cancer "whodunit" mystery. Cancer has moved from being the eighth leading cause of death in 1900 to the second leading cause in 1970, but it still causes only a quarter of the deaths that heart disease does. However, when you look more closely at the figures, you'll see no immedi-ate reason for indicting food additives. Statistics clearly indicate that the rise in cancer deaths in the United States in the past forty years is largely attrib-utable to an increase in lung cancer. The lung cancer death rate is now eight-een times as high for men and six times as high for women as it was forty years ago. There is no way to link food additives with lung cancer. Lung can-cer mortality is directly related to the growth in popularity of cigarette smok-ing between 1900 and 1964. The frequency of other cancer deaths related to other sites-for instance, the stomach, which one might suspect could be affected by food-has declined or stabilized. Ironically, it is the use of certain food additives like the antioxidants BHA and BHT which may be responsible in part for the dramatic decline we have witnessed in stomach cancer deaths. You will continue to read and hear stories about how additives are danger-ous and not tested, put into our foods just so companies can make more money. The reality is, however, that we know more about additives (which make up less tharw 1 percent of our diet) than we do about the chemistry of food itself. Food additives, especially those introduced in the past ten years, have survived rigid testing procedures not applied to the great majority of natural products, and without the intelligent use of food additives, it would be far more difficult to feed all of us, food prices would be much higher, and most women would be back in the kitchen for many long hours! ADDITIVES AND HYPERKINESIS Dr. Benjamin Feingold, formerly the Chief of Allergy Department at the Kaiser Permanente Medical Center in San Francisco, has proposed in a pop-ular book that additives, particularly flavoring and coloring agents, make children hyperactive (hyperkinetic). According to Dr. Feingold, all foods containing additives, dyes of any type, or compounds containing salicylates should be excluded from the diets of hyperactive children. But, to our knowl-edge, there is no basis for the Feingold theory. Recently an advisory commit-tee of distinguished pediatricians, nutritionists, psychologists and many others with professional competence concluded that "no controlled studies have demonstrated that hyperkinesis is related to the ingestion of food additives. The claim that hyperactive children improve significantly on a diet that is free from salicylates and additives has not been confirmed." SUGAR: A DEADLY POISON? If you believed everything you read in recent popular books and maga-zines, you'd conclude that sugar was the "killer on the breakfast table" and the underlying cause of everything from heart disease to hypoglycemia. In fact, however, sugar when used in moderation as part of a normal, bal-anced diet is a perfectly safe food. First, even in excess amounts, sugar is not a cause of diabetes (high levels of sugar consumption, though, may exacer-bate this disease once you have it). Second, though for many people sugar may accelerate dental decay, it is actually the sticky and excessive sugar taken between meals that promotes decay, not sugar with meals. Third, there is no evidence that eating sugar increases your chances of developing heart disease. Fourth, sugar is not the "cause" of obesity. Obesity is caused by con-suming more calories than are used up in physical activity. Too many calo-ries are just too many, despite the source. Fifth, sugar is not the cause of hypoglycemia-"low blood sugar." Very low blood sugar is a once-in-a- million event and sugar is not the cause. So, enjoy that chocolate sundae or piece of candy but make it only a part of your total food intake. THE NITRITE IN BACON Sodium nitrite is used during the curing process and is responsible for the characteristic flavor, color, and texture of bacon, ham and sausage products. Without sodium nitrite, bacon would be salt pork and ham would look and taste like fresh roast pork. Most important, sodium nitrite provides protection against deadly botulism poisoning. The concern over nitrite is based on the observation that under some cir-cumstances it can combine with other components of our diet to form chemi-cal compounds called nitrosamines. Some nitrosamines have been found to cause cancer when fed in large doses to test animals. However, sodium nitrite is a normal component of human saliva and some 80 percent of the nitrite in the body comes from vegetables-celery, radishes, spinach, beets, etc. The potential conversion of nitrites to nitrosamines can happen as easily to the saliva's natural nitrite as it can to nitrite from hot dogs or bacon. So it seems a bit absurd to be panicking over small amounts of additives which prevent serious health threats while being unconcerned about naturally occurring nitrites. Certainly nitrites should be further studied. We don't know everything we should about how they work, about what problems, if any, they may cause. But right now we have no other way of curing meats and preventing botulism in these foods and no evidence that nitrites in our foods are a health threat So you can bring home the bacon (if you can afford it) and be confident that there is no hazard sufficiently great to cause alarm. EAT, DRINK AND SUPPLEMENT? The truth about vitamins is twofold: we do need them, but unless you have a medically diagnosed vitamin deficiency, you will get all the vitamins and other nutrients you need from a well-balanced diet. Indeed, you can cause yourself harm by self-medication with massive amounts of vitamins-par-ticularly vitamins A and D, which are not excreted from the body. But you are inevitably thinking, "What about vitamin C? Doesn't it prevent and cine colds?" Unfortunately, it does not. The Journal of the American Medical Associa-tion recently published a nine-month study conducted at the National Insti-tutes of Health in which volunteers took pills daily. Half of the subjects took three grams of vitamin C daily (three grams of the vitamin is roughly the amount you'd get from eating sixty oranges), while the other took "sugar pills." The dose was doubled whenever the volunteer thought a cold was coming on. The results showed that the effects of the vitamin on the number of colds "seem to be nil" . . . Most physicians today do not recommend vitamin C overdosing. Not only do they feel it is a waste of money, but excessive use of vitamin C can cause serious kidney problems. THE "LOW CARBOHYDRATES DIETS" A severe limitation of carbohydrate intake can lead to a temporary weight loss. First, a diet low in carbohydrates tends to promote a temporary salt loss from the body, thus leading to dehydration, a condition which will tempo-rarily send the scale indicator to the left. Second, an individual avoiding carbohydrates soon finds that his diet be-comes uninteresting. He will inevitably eat less, taking in fewer calories. Thus, it should be no surprise that he is losing weight. Studies have shown that people on low-carbohydrate diets consume 13 to 15 percent fewer calo-ries than they usually would. This would be a good path to weight control ex-cept that the calories taken in are not nutritionally balanced. When thirst makes up for the dehydration and the dieter-tired of a boring menu-returns to his regular overeating, the weight initially "lost" returns. What is the point of such a diet? Essentially, it is planned malnutrition. There are indeed some potential problems here. We need foods with all types of nutrients, including carbohydrates. Each plays a role in developing our body and then keeping it in good operating condition. If we omit one of these important classes of food we sooner or later will be in nutritional trouble. If you want to lose weight safely and permanently there is only one way to do so: follow the if-you-want-to-lose-weight-you've-got-to-eat-less diet and exer-cise more. To emphasize eating less and exercising more we have come up with the "Half plus Twice Diet." And what is this? It is very simple. Eat half of what you ordinarily eat, assuming you eat a varied diet based around the Basic Four Food Groups and get twice as much exercise. Simple, inexpensive, and it works! We call it the "Half Plus Twice Diet" or the "Stare-Whelan Diet." EATING FOR GOOD HEALTH The concerns about additives and vitamin regimens and fascinations with quick weight loss diets to some extent have blurred the understanding of what is important in good nutrition. Actually, it is not as complicated as you might believe. If you are truly interested in eating for good health, forget the latest fads and focus on the three areas which are important and over which you should exert control. Variety. It should come as no surprise that there is no one perfect food. The human body needs a variety of nutrients-proteins, carbohydrates, vitamins, minerals, fats and water-to function properly. Altogether there are some fifty known nutrients and no single food contains all of them. You get these by eating a balanced diet, choosing from the "basic four" food groups: dairy products (a glass of milk-preferably skim or low fat, some cheese, yogurt or ice cream-anything made of milk will do the job); the meat and other high-protein group (two servings daily, choosing from meat, fish or poultry); cereals-any foods made out of wheat, com, rice or oats such as breads, breakfast cereals, noodles, spaghetti and, yes, even cake. Vegetables and fruit-any kinds but in variety (four servings daily will sup-ply you with vitamins, minerals and sufficient roughage). Be sure to include in your variety of vegetables some dark green or yellow vegetables for caro-tene from which the body makes vitamin A, and some citrus fruits or toma-toes for vitamin C. Calories and salt. Instead of worrying about additives, pesticides and "overprocessing" of food, you should actually be concerned about America's number one nutritional problem, overeating. Obviously overindulgence in high calorie "junk food" (actually a food does not become a "junk food" un-less it is overused and then any food can become a "junk food" because its overuse crowds out of the diet the variety of other foods that are necessary for good nutrition. Eat moderately and remember that the best exercise of all is pushing one's self away from the table. Go easy on the salt shakers. It is an accepted medical fact that too much salt can promote heart trouble, hypertension and certain types of kidney dis-eases. Adding salt before you taste your food is not only an insult to the cook but a poor health habit. All food naturally contains some salt so if you must add salt, keep it to a minimum. Fats. In studying the consumption of fats, researchers have distin-guished between three different types of fats and have shown a relationship between cholesterol and the intake of these fats. Cholesterol is an organic waxy compound which is found only in foods of animal origin, but it is also made naturally by several body tissues, particu-larly the liver. Egg yolks are a highly concentrated form of cholesterol but there is none in egg whites. Meats, whole milk, butter, most cheese also con-tain cholesterol but much less than egg yolk; however, these foods contain saturated fats out of which the body makes cholesterol. Two vegetable oils (coconut and palm) also have generous amounts of saturated fats and, hence, have the tendency to raise blood cholesterol even though they contain no cholesterol. Polyunsaturated fats (those of vegetable origin such as soybean, com, cottonseed, sunflower seed and safflower oils) tend to lower blood cholesterol when they replace some of the saturated fats. Monounsaturated fats (like olive oil) tend to lower blood cholesterol when they replace saturated fats, but less so than the polyunsaturated fats. An excessive amount of cholesterol is linked with atherosclerosis, a disease in which the arteries become narrow and obstructed. Atherosclerosis paves the way for the possibility of a heart attack or cerebral hemorrhage (stroke). It has long been known that cholesterol is one of the ingredients in the mushy deposits, or plaques, that block arteries. Evidence is accumulating to indicate that too much saturated fat and cholesterol also play an important role in your risk of developing certain types of cancer-of the ovary, colon, breast, uterus, and prostate-possibly by overstimulating the endocrine glands and by the development in the intestine of by-products of cholesterol that may have cancer-causing properties. So what can you do? The best advice is to get your weight where it should be and keep it there, emphasize low saturated fat and low cholesterol main courses such as fish, poultry and veal instead of steak and roast beef. Use a polyunsaturated margarine instead of butter and eat fewer egg yolks, prefera-bly no more than two "visible" eggs per week. The "visible" eggs are the ones you see (or they see you). Those used in cooking, that are not visible, we generally ignore because they don't amount to much in the total diet. To summarize, let the kooks follow the kooky diets but not you. There are three basic rules for good nutrition. Watch those calories; Eat a variety of foods; and Cut down on all foods rich in saturated fat, cholesterol and salt By following these simple rules you can eat well-and safely. credit: Frederick J. Stare, M.D., and Elizabeth M. Whelan, Sc.D., Harvard University Department of Nutrition. Humorist Gene Kerr once said, "You know you should do something about your excess pounds when you leave your seat on the subway or bus and two people rush to replace you." It's been estimated that approximately 30 percent of the United States pop-ulation is at least 10 percent overweight, and this includes school children. If you will stand on any street comer for ten minutes and look at the men and women as they pass, you will not doubt these figures for one moment. Some people carry their excess baggage better than others. They dress to camouflage the bulges and are clever about selecting styles that accentuate the positive. Clothing may not completely eliminate the negative but it can cover a multitude of sins. Obesity is often prevalent among middle-aged women of low sodo- economic status. The level of fatness in adult females decreases as education and income rise. Black women tend to be more overweight than white women, but black men are leaner than white men. People of English, Scotch and Irish descent are the least likely to be over-weight. Among the members of various religious denominations, Episcopalians are the thinnest of all Protestants, Baptists the heaviest. Roman Catholics are more overweight in general than Protestants. Jews are usually more over-weight than both Catholics and Protestants. This data (which has been disputed) applies only to white Americans, according to Dr. Albert Stunkard of the University of Pennsylvania. So-how can you tell if you are really overweight? Obtain a Life Insurance weight chart. Remember that these charts give generous proportions and re-port the average, not the ideal. If you are 10 to 15 percent over the weight listed for your age, height and sex, then you are overweight. If you are 20 percent or more above the weight listed on the chart, you are obese. A candid and critical look in the mirror will give you a pretty solid clue as to whether or not you need to do something about your weight. Your per-sonal observation and the comparison between your weight at age twenty-five (that's when most people reach their ideal weight) and what you weigh now will provide the ultimate answer to your question. WHAT CAUSES OBESITY? A favorite defense of fat people is, "I have a glandular problem." Approxi-mately two out of a hundred may, indeed, have a glandular problem, but the other ninety-eight are fat because they eat more than they need. The undeni-abl