Asthma

No Laughing Matter by Joseph Heller and Speed Vogel. Corgi paperback, 1987 (ISBN 07552 13072 9). 296 pages. €2.95. In December 1981 Joseph Heller, author of Catch 22 and other books char,acterised by black humour and mordant, misanthropic writing, was admitted to Mount Sinai Hospital, New York, with increasing limb weakness, difficulty in swallowing and a metallic taste in his mouth. Guillain-BarrB syndrome (GBS) was immediately diagnosed and he spent three weeks in intensive care. Remarkably, he did not need a tracheostomy; Heller says that he would have lost his mind had he not been able to talk. Conversation, wisecracks, critcisms, interruptions and lengthy replies to all questions were his lifeline - plus noisy visits from friends such as the ‘world class hypochondriac’ Me1 Brooks, Dustin Hoffman and Zero Mostel. Heller and his friend and carer Vogel, who write alternate chapters, graphically describe his increasing paralysis and muscle loss, insomnia, depression and tube feeding, his nursing care, physiotherapy and gradual rehabilitation. Heller writes with real insight of the irrational fear of sleep he developed and of the apparently petty details that loom so large in a patient’s day and make the difference between gloom and comfort. His straightforward and lucid account of his medical condition is interspersed with literary activity, romantic interludes and a hectic social interchange. After his in-patient treatment concluded at Rusk Institute of Rehabilitation, New York, he continued with private physiotherapy sessions at home. GBS patients and their carers and therapists will find this an enjoyable and illuminating read. Heller eventually made a good recovery from his gross defects; it is a sobering thought that the medical costs for the first year of his illness came to about €80.000. PATRICIA ALLCHURCH BA MCSP Asthma by Dr John Rees. BMA Family Doctor Guides. Thorsons, Wellingborough, 1988 (ISBN 1 85336 049 X). Illus. 9 8 pages. €2.99. The aim of this book is to increase the asthmatic’s understanding of the disease and to encourage involvement in its management. The author is a senior lecturer in medicine and consultant physician at Guy‘s and Lewisham Hospitals, and it is one of a series produced by the British Medical Association. An introduction is followed by an explanation of the disease, covering symptoms and triggers, with subsequent methods of treatment. The author cencludes that people who know the basic approach to their treatment are more likely to have their asthma well controlled. The objective of the book has been achieved, resulting in a self-help guide for any asthmatic or interested person. It gives a very positive outlook on the condition.

physiotherapy, May 1989, vol75, no 5

The initial impression is very pleasing with clearly presented, well-illustrated and structured content. Of particular note were the highlighted case histories and bordered chapter summaries which helped to consolidate information. The book explains very simply what asthma is and whatyou can do about it. It is readable and the information is relevant and up to date. There are some very good points emphasising the co-operation between patient and doctor in the control of asthma. The selection of material for treatment is good so far as it goes but it tends towards drug management rather than presenting the use of other techniques in conjunction with medication. There could have been more emphasis on breathing control, positioning, relaxation and exercise (which is briefly covered). A separate chapter on these would be preferable rather than including them in alternative treatments. This is an ideal self-help book for individuals to buy or to borrow from physiotherapy departments, health centres or asthma societies. CHRISTINE COLE MCSP Coping with Stress at Work by Jacqueline M Atkinson PhD. Thorsons, Wellingborough, 1988 (ISBN 0 7225 1485 9). Illus. 144 pages. €4.99. Practical ways of dealing with stress are extremely well presented by psychologist Jacqueline Atkinson in this highly readable book. Although she concentrates on stress at work, the self-help techniques outlined can be used in all areas of life. As the author states in her introduction, ‘this book sets out to teach you how to analyse what is causing the stress in your life and then how to develop the skills needed t o combat such stress’ eliminating it where possible and desirable, on occasion using it positively to stimulate change, and in general coping with stress in the most effective way. The book is well laid out in three main sections: (1) Is stress a problem? (2)What causes stress? (3) Coping with stress strategies and skills. The logical order of topics, good use of headings, cross references to other areas of the text and further reading, make a most useful reference book, which also includes a list of addresses of useful organisations. There are only a few diagrams and graphs, but the checklists are excellent. They are well introduced with clear instructions for completion and the objective to be achieved by each questionnaire. The author shows flashes of a delightful

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sense of humour, which lighten the tone without detracting from the seriousness of her subject. The examples given are relevant and the advice is practical and down to earth, with possible alternatives given when appropriate. As physiotherapists we might prefer a slightly different order in the sequence of instructions for relaxation. Perhaps in a later edition Dr Atkinson may choose to revise her description of the technique. This is an easy-to-read book giving some new insights such as ‘free floating joy‘ and looking at known concepts from different angles. Where the responsibility for stress may lie is discussed and sound advice on self-help techniques given, although sufficient detail was lacking in some areas and further reading on these specific topics was not listed as such (eg questioning the origins and how to overcome irrational beliefs). This book achieves its objectives to increase the self-knowledge of individual readers and their overall perception of stress; how and why it may be caused; the strategies and skills needed to cope with their own stress and how to reduce stressful situations for others. I recommend this book to fulfil the dual role of stress prevention and rehabilitation, for those who are interested. It should certainly be available for all students. EVE O’NEILL MCSP Therapeutic Claims in Multiple Sclerosis by William A Sibley MD. Demos Publications, New York, 2nd edition (ISBN 0 939 957 16 7). 198 pages. $11.95 paperback, $19.95 hard back. This book is written for informational purposes only and is a second edition dealing with new and old developments in the treatments of multiple sclerosis. The opinions on their usefulness or otherwise are provided by the Therapeutic Claims Committee, which comprises ten experts in the field of neurology, from all over the world, who actively treat MS patients on a day-to-day basis. The first chapter, the introduction, is a general look at MS, ie diagnosis and cause, and is very clearly set out. The second chapter discusses the problems associated with evaluating treatments for MS, as the exact cause has not been found. The rest of the book then discusses each treatment in turn, under the following headings: Description, Rationale, Evaluation, RiskslCosts and Conclusion. Treatments discussed, range from mannitol to cannabis, methylprednisolone to baclofen, from acupuncture to hyperbaric oxygen. The content is up to date, well laid out and concise. If the wheat can be separated from the chaff the information is very helpful and the edition is a useful reference book for physiotherapists in a hospital library. RUTH PRATT MCSP

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