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Broad chest, weak lungs - Are men more prone to respiratory diseases?The long-standing, chronic afflictionof the respiratory disease is called as COPD, i.e., Chronic Obstructive Pulmonary Disease. COPD is the obstruction within the lung tissue, causing improper circulation and entrapment of air. This limits the space for air to move in and out, directly affecting the quality of inhalation. A small reminder here may be necessary - breathing is synonymous with life, why? Because that's how we get oxygen, which is vital for the functioning of each and every cell within the body. With COPD, the ability to take in oxygen gets compromised increasingly. Continued cough, sputum, and shortness of breath are the main symptoms. COPD is more common in men. Does it have to do anything with being a male? Not necessarily. No specific link has been established to say that COPD risk is higher for you solely because you are a man. Then, what could it be? A study conducted in 2011 in USA showed that the number of men who smoke is 5% more than the women who do. To understand the reason behind this, let us see the primary causes of this disease. Air pollution, some genetic predispositions, frequent acute infections, exposure to harmful chemicals for a long time (usually occupational) - are some of the main causes, and the number one cause is smoking, owing to almost 80-90% of the cases. Park this thought. Next piece of information is simply revisiting some facts you may already know: #The gender classification ofsmokers - Men are known to smoke more than women all over the world, not only in numbers, but also in quantity. Whether it is a developing country or a developed one, 2011 studies say there are more male smokers everywhere than female smokers. Not only there are more men who smoke, they smoke for longer periods and more number of cigarettes than female smokers. This may vary from country to country, like India has much less women smokers than USA does, but the difference between the two genders holds true everywhere, only the ratios differ. #Occupational exposure to harmful chemicals and gases - These are industries of mining, textile, chemical engineering, welding, etc. The number of men working in such industries is way higher than women. #Air pollution - Men are more exposed to air pollution since they are outdoors more than women. This may not apply to all countries and societies, but is generally true. Now, we can put the pieces together and understand why COPD is more common in men? Yes, they are at a higher risk because of higher exposure to smoking, pollutants and irritants. Cigarette smoking is the leading cause of lung diseases and male smokers outnumber women across the world. You can figure out the math here!
Even women can kick up a storm - Martial arts and the modern womanMartial arts! Yup you have seen enough of Bruce Lee, Jackie Chan and Jet-Li films on the telly to know there is a lot of hard work involved. All that glass breaking, torso-twisting, nun chucks, whirling to kicking ten opponents at once. Is that all for real? Can a dainty woman go about hurling armed robbers off their shoulders? Or does that happen only in Kung Fu films with real weird names like 'Shaolin Temple Monks down ....' or something equally corny. That apart! Won't you need to learn a bit of Chinese or Japanese to even imitate those shrieks that women in those films emit? Worse still! Imagine they will need sub-titles to even know that you mean business! Jokes apart and no offense to the masters of Muay Thai, Akido and Tae Kwon Do! Martial arts is way beyond just fighting and is in fact a great way of disciplining the body, mind and soul. As a woman too martial arts can have a tremendous impact on your self confidence and awareness about dynamics of the mind. True what they show in martial arts film is all about smashing bones and tables but martial arts goes way beyond that. Through different movements, kicks and punches and holds one may learn to overpower an opponent using his own weight, but martial arts is ALL ABOUT CONQUERING THE SELF AND DESTROYING THE ENEMY WITHIN! So if you are intent on learning martial arts be ready for some action-packed exercise routines that Promote flexibility Increase strength, stamina and endurance Help you gain better control over yourself Help you deal with any problem that life may throw your way Help you be competitive and assertive There are different types of martial arts which have evolved over several centuries. The main forms are Kung-Fu, Karate, Akaido, Judo, Tae Kwon Do, Kalayraipatu amongst others. There is also centuries of philosophies behind the exercises recommended by these disciplines. Some martial arts concentrate only on unarmed combat while there are others which blend both armed combat with weapons like swords, sticks and nun chucks. Martial arts can indeed go a long way today in equipping women with the art of warfare so that they can defend themselves against any assailant armed or unarmed. It will go a long way in shaping societies and culture if the womenfolk are empowered both physically and mentally too. These days it is not uncommon to see martial arts blended with aerobics dance steps. It may not exactly be pure martial arts but that too isn't a bad idea at all. It will only go a long way in developing interest in these ancient art forms and help in their promotion. Just as much as any martial arts movie can. Or maybe even more!
What to eat when you breastfeedAlmost everyone around you will advise you to eat a calorie-rich food that will aid in milk production from your body. But did you know that your body is quite capable of producing enough milk from whatever you eat? Your body has stocked up on all the fats during your pregnancy days itself. You don't really need the extra calorie rich food just to produce milk for your baby. However, how much calories you need cannot be predetermined. Let your body determine your needs. Eat as often as you want, as often as you feel hungry, but remember to eat foods that will give your body the nutrients and not just satiate the hunger. Opt for whole grains, pulses, fresh fruits, legumes, fresh vegetables and nuts. Choose natural drinks like buttermilk, coconut water, and fresh juices. Remember that the foods that you choose must nourish your body with proteins, calcium, and iron other than carbohydrates. Dried fruits and nuts like cashews and almonds and walnuts are the traditional foods given to new moms to enhance breast milk confinement. They are a very rich source of calories and definitely improve the quality and quantity of milk. However, keep a bottle of water or some juice nearby when you breastfeed. The body releases oxytocin when you breastfeed and it makes you thirsty. So, have some refreshing drink before you breastfeed. Most new moms are advised to drink lots of water as it aids in breast milk production. However, breast milk production doesn't really need extra water. It is best to avoid alcohol when you are breastfeeding. The amount of alcohol in blood and breast milk reaches its highest level about 30 minutes after you have a drink and it lowers down only after about four hours. Drinking alcohol is not advised when you breastfeed, however, if you feel like having alcohol, do so after you feed your child. Also, wait for a minimum of four hours before you feed next. Ghee is another item that new moms are encouraged to consume for milk production. However, if you are eating a balanced diet there is no real necessity to eat too much of ghee. Avoid aerated drinks, tea, and coffee while you are breastfeeding. Similarly, junk food and foods that are not cooked at home are best avoided. These types of foods fill you up, but provide no real nourishment. Herbal teas are considered safe drinks during breast feeding. However, consult your doctor before you consume any herbal medicines. Do not forget to take your prescribed supplements of iron, folic acid, and calcium regularly during breastfeeding. Your body also needs more amounts of vitamin C, vitamin B12, zinc, and vitamin A. These, you may obtain by eating foods that are rich in them or your doctor might prescribe supplements. Weight gained during pregnancy may be a concern now and you may want to lose it to regain your pre-pregnancy shape. Remember to lose weight gradually with the help of a balanced diet and moderate exercise. Do not starve yourself. Also heavy exercising may release toxins into the bloodstream and breast milk. Keep in mind that you will gain your original weight back only after your baby has completely weaned off breast milk and has started eating solid foods. Breastfeeding is the best option for your baby. It gives your baby everything that it needs and keeps it free of all diseases. Do not shy away from breast milk, do it the right way! Your body is quite capable of producing breast milk from the well-balanced diet that you eat and there is no real need for a calorie-rich food that new moms are fed.
A correctable disfigurement of face: Cleft lip and palateThe Times of India reports that "With an incidence of 7 per 1000 children, cleft lip and palate deformity is one of the most common deformities among Indian children." The number of infants born every year with cleft lip and cleft palate in India is 28,600. This means 78 affected infants are born every day or 3 infants with clefts are born every hour. Cleft lip and palate develop early in pregnancy where lack of adequate amounts of tissues lead to two parts of the face failing to join adequately at the middle. A cleft lip or hare lip (as it is commonly called) refers to separation of the two sides of the upper lip. There appears a narrow opening or gap over the skin of the upper lip. This separation may sometimes extend beyond the base of the nose and may involve the upper gum and/or the bones of the upper jaw. A cleft palate refers to the gap between the two edges of the roof of the mouth, causing it to remain open at birth. The bony front portion of the roof of the mouth or the hard palate may be involved alone, or along with the soft palate or the soft back portion of the roof of the mouth. Since lip and the palate develop separately, it is possible to have a cleft lip without a cleft palate or vice versa. Causes of developing cleft lip and cleft palate: The exact cause of cleft lip and palate is unknown. Some research, however, suggests that these clefts are caused by a combination of genetic and environmental factors. The risk of such clefts thus can be reduced by adopting a healthy lifestyle during pregnancy. This includes avoidance of smoking, alcohol and having a healthy diet to avoid excessive weight gain during pregnancy. Cleft lip and palate can occur alone with no other problems or defects. This is called non-syndromic clefts. They may also occur as part of other birth defects and then may be called part of a syndrome. Cleft lip and palate may occur on one side (unilateral) or may occur on both sides (bilateral). Unilateral cleft lip and palate is more common than bilateral cleft lip and palate. Left-sided cleft lip and palate is twice as common as right-sided cleft lip and palate. The reason for this is unclear. A cleft lip or combined cleft lip and palate are seen more commonly in male babies. Cleft palate alone is more common in female babies. The face of the baby usually develops around 5th and 9th weeks of pregnancy thus this defect may arise early in pregnancy. Treatment of cleft lip and palate: Cleft lip and palate is usually corrected using cosmetic or plastic surgery. Results are usually very good. After treatment, most children have a normal appearance. To prevent and correct associated speech problems and dental problems, treatment is also sought from speech and language therapists, as well as dental surgeons (orthodontic specialists). Excellent results may be seen if the specialists work in tandem.
Causes and treatment of sleep talkingIt is usually believed that sleep talking is associated with dreaming, but there is no scientific evidence available to support this hypothesis. In few cases, it may be associated with sleep disorders or any other diseases. Sleep terrors and REM sleep behavior disorder (RBD) are two sleep disorders associated with sleep talking. Sleep terrors are associated with frightening scream, kicking, and thrashing. It is commonly seen in children. Awakening becomes difficult during sleep terror. Patients with RBD utter a sudden loud cry, grunt, shout, or act out their dreams, usually violently. Other causative factors of sleep walking are emotional stress, mental health illnesses, substance abuse, fever, and certain medications. Treatment: Evaluation of the patient Patients with sleep talking should be evaluated by a specialist doctor especially if it is seen in adults or associated with violent actions, screaming, or intense fear. If children with sleep talking have disturbed sleep pattern, they should be evaluated by the pediatrician. The doctor asks questions to the parents, roommates, and bed partners about the nature and the extent of sleep talking. There is no definitive treatment available for sleep talking, although the doctor may test to record the sleep pattern of the patient to identify any sleep disorder. This test is known as polysomnogram. Management Sleep talking usually does not require treatment. Avoidance of stress and plenty of sleep at night may help to decrease sleep talking. However if any sleep disorder is identified by polysomnogram, it is treated accordingly by the doctor. If underlying causes like mental illnesses, substance abuse, or medications are identified, they are also managed accordingly. Mental illnesses like depression should be treated with proper counseling and medications. The patients should refrain from alcohol, heavy meals, fatty meals, etc. The patients are advised to follow regular sleep schedule, get adequate amount of sleep, and practice proper sleep hygiene so that severity and frequency of sleep talking is decreased.
Faking illnesses - An illness in itself?In 2008, a 28 years old woman in the US shared some shocking news with her friends. She had been detected with cancer. She posted updates on social networking sites and wrote blogs on her illness. Sympathy poured in from all corners. Some even sent in monetary help to cover her expenses. The saddest part of the incident though was not her cancer; it was the fact that she had faked it! Police investigations revealed her little trick when no evidences or records were found at the hospitals! Apparently, this isn't a unique case;  faking illnesses or malingering is a very common occurrence. All of us have done it at some point in our lives. While we may have done it to escape a school punishment or to take undue advantage of the office 'sick leaves' for personal purposes, it is usually done on a harmless level. But faking illness can be a chronic disorder too and  medical professionals even have a name for it-; Munchausen's Syndrome. People suffering from this syndrome fake illnesses that they don't actually have, to gain sympathy or simply to be the center of attention. Usually gaining sympathy is the main reason why people fake illnesses. It gives them a chance to be in the spotlight. Everyone calls and visits, expresses concern and fusses over them. Lots of love is showered upon them. Another common reason for faking illnesses, is money and at times, the monetary benefits are higher than the emotional ones. No one hesitates to fulfill the last wish of a dying person, however expensive it may be. Often there are mixed motivations and the person faking an illness has many reasons to keep up the pretense of being sick, for as long as possible. Some people really do have a disease — a mental illness known as a factitious disorder. People with this disorder pretend to have an illness, which is usually a terminal one and often go to great lengths to maintain their hoax. Munchausen syndrome by proxy, is another form of faking illness. People with this disorder, fake illnesses of people under their care; and they usually do this, for monetary benefits. Children are the most common victims in this disease. When you tell someone that your child has cancer, you will receive a great amount of sympathy and all the money you want, no questions asked! People with these disorders are extremely cunning. They go to great extents to maintain their lies. They will build grand stories, complain of fake pains and aches, get admitted to hospitals and undergo a battery of tests, numerous times. Interestingly, they never allow and frequently discourage medical professionals, from talking to any of their family members. Since they know they are faking the illness, they will refuse to undergo treatment, for obvious reasons. . If you think a loved one may be exaggerating or faking their health issues, attempt a gentle conversation, voicing your concerns. Avoid anger, judgment or confrontation, while offering support and care and if possible, help them in finding a treatment. Treatment includes empathy, helping in identifying feelings and issues that led to the development of the disorder and finding  alternative healthy ways to deal with those feelings and issues.
10 bedtime beauty essentials! Here are the beauty essentials you need to take into consideration, before you hit the bed: Baby-soft soles :Before you sleep, apply Vaseline on the sole of your feet. This will adequately moisturize your soles and you can wake up to the great opportunity of wearing those heels you have been dying to try out! Healing the puffy eyes : If you are worried about waking up with puffy and tired eyes (even after 6 to 8 hours of sleep), then put on a little eye cream. You can also keep an extra pillow and make sure you sleep on your back. This will allow the fluids around your eyes to drain easily and reduce the puffiness. Trying out wavy hairstyle : Bedtime is the best time to work on your hairstyle. Before you sleep, shower and fashion your hair into the style you want. Apply a styling cream on your hair gradually, after having air-dried it. Now, decide if you would like to put them up in buns or braids. Stylize them into the pattern and wake up to wavy hair! Let your skin breathe : Those who are suffering from dry skin can apply moisturizer. A humidifier is also a great accessory for help in these cases. You can switch on the humidifier before you go to sleep. This will help your skin to retain its moisture through appropriate hydration. Keep aging at bay :Did you know that sleeping on cotton pillowcases can increase the chances of creases and wrinkles on your skin? Prevent wrinkles by using silk or satin bed clothing. This will also reduce hair breaking. Wake up, miss white smiles: If you want to take off the yellows from your teeth, then brush some baking soda and let them stay for about 8 minutes. Afterwards, thoroughly rinse your mouth. Do not perform this beauty tip more than once a week, it will negatively affect the structure of your enamel. Work on your complexion :During the day, sunlight might disable some face creams from working effectively on your complexion. Make the most use of night and apply a face cream containing retinal and vitamin C. Lengthen your lashes : Eye lashes depth and grace to your eyes. You might feel that working on your lashes will require way too much effort. But, much to your surprise, everything your lashes need is contained in a natural ingredient - castor oil. Consisting of Omega-3 fatty acids, which are highly hydrating, they will avoid your lashes from breaking and also strengthen them. Apply castor oil on your lashes before you sleep and watch them grow thick and healthy within a few weeks! Taking care of your hair : Skim leave-in conditioner through your hair in the evening and let them stay on till the morning. This will let them become soft and shiny. You can also use coconut oil as an alternate conditioner. Readying your nails for polish : Depending on the skin type, the nails of certain people become dry. If you are one of them, it would be best to apply a cuticle cream or oil on them before you sleep to wake up to polish-ready nails.
7 Pains you should not ignoreWhen the body cries out in pain, most of the times, you know what is bringing that pain, and you do what will help relieve the pain. For example, a serious workout may cause sore aching muscles, for which you will rest a day or two, or take a painkiller. What does one do to know why a body part is paining? One needs to sit up and take notice! The pain could be anything, from a heart attack, to an aneurysm, and could cost you your life! Pain in the head: Headaches are the most frequent pains that we suffer from. Headache could be due to a migraine, due to staying too long in the sun, due to a cold, or simply due to working too long without a break. However, in case you have a headache, and are not able to pinpoint to an obvious cause, rush to the emergency room. Headaches with no apparent cause may be due to a brain hemorrhage, a tumor in the brain, or an aneurysm in the brain arteries! Get yourself checked as soon as possible, if you keep getting headaches for no apparent reason. Pain in the jaw: This could be due to a caries ridden tooth. But most often it is due to an impending heart attack. The classical left sided chest pain radiating to the left little finger is not always seen in all cases of heart attacks. Pains to the jaw and the back are reported very frequently. Often, people tend to take the pain in the jaw lightly, and brush it off to a tooth problem. This may be potentially life threatening, as you never know the severity of the attack! Tingling, numbness and burning of the feet: Diabetes mellitus is a silent killer. Peripheral neuropathy is often the first complication of diabetes. Tingling numbness, and burning in the feet may be attributed to wearing tight shoes and to keeping your feet suffocated in socks all day long. Dipping your feet in a tub of cold water will give you a good night's sleep. But do not let it go at that. Get your blood sugar levels checked before it is too late! Pain in the calves: Do you get nightly pain in your calves that get better with putting your feet up? This is due to long standing hours at workplace, you may say. True, it is due to that. But, it is not something to be left unattended. Calf pains are due to deep vein thrombosis that occurs when the stagnated blood in the veins starts to form clots. The danger here is that the clot could break off and travel to your lungs causing pulmonary thromboembolism that is fatal! Take a break regularly and put up your feet frequently. Let the blood flow and not stagnate! Pain in the back: Most commonly, back pain is caused due to arthritis, and improper sitting postures. But if you suffer from high blood pressure, and are an alcoholic and smoker too, do not take your back pain lightly. It could be due to a heart attack or an aortic dissection! Pain in the abdomen: You may attribute this pain to gases, over eating or indigestion. While these may be occasional causes, persistent pains need to be checked. It could be anything from a gall stone, to gastric ulcers, to a swollen liver, or maybe even pancreatic cancer! Vague, medically inexplicable pains: When you have a recurrent headache or a stomach ache or a backache and you come out with a 'perfectly healthy' report after visiting all the specialists, it is perhaps time to seek the help of a psychiatrist or a counsellor. Your pains could actually be a symptom of depression. Psychosomatic pains are on the rise. The stresses we face in our lives everyday get pushed to our subconscious, and eventually are pushed up bodily in the form of unexplained aches and pains!
A primer on heart attacksIndians around the world have one of the highest rates of heart diseases. Heart attack, also called as myocardial infarction, is mainly caused by a blockage that prevents oxygen-rich blood supply to your heart muscle. In other words, it is the death of the heart muscle. What causes a heart attack? When cholesterol deposition, plaques of calcium and proteins on the walls of your coronary artery cause blockage of the artery, your heart fails to receive sufficient nutrient-rich blood. This leads to the permanent death of heart muscle, and it is unable to pump the blood to your vital organs. Symptoms that signal a heart attack   Chest pain is a symptom of a heart attack.  This pain can feel like tight ache, pressure on the heart as if an elephant is sitting across the chest. However, you may get confused with the symptom chest pain - whether it is a heart attack or an angina pain. Chest pain lasts for a longer time in heart attack whereas the chest pain in angina lasts for few seconds and goes away after rest. The pain experienced during a heart attack sometimes feels like indigestion or heart burn. Other warning signs of heart attack are: Shortness of breath. Lightheadedness or fainting. Upper body discomfort in arm, the back, neck, and jaw. Nausea, vomiting, dizziness. Sleep problems or fatigue. Not every person will have the same symptoms of the heart attack. But if you have any of these warning signs, you have to act fast and get the right treatment.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
Is sex linked to self esteem?Man is a curious creature, full of quirks and contradictions. Sexual intercourse, something that most people consider an intimate and private experience, is spoken about in hushed tones and often, with some discomfort. We don't reveal or talk about our sexual desires, as readily we discuss our salary packages or food habits. This is quite ironic seeing how sex is an important gauge for a person's self esteem and also an indicator of his/her social desirability. The very thing that we do under covers, we somehow choose to "keep under cover". The Link between Sex and Self Esteem: Self esteem is an important factor that determines the mental & physical well-being of an individual. All of us have a craving to be understood, liked and appreciated; and these form the equivalent of our basic needs on the inverted pyramid- Food, clothing and shelter. For a human being to flourish and prosper, consumable food, without the mental food of appreciation, is not enough; and sexual intercourse or an intimacy with the opposite sex, is one way of validating that need. Sex therefore, ceases to be just a physical need instilled by nature for the perpetuation of the species, but goes into the larger emotional cum psychological dimension of self actualization and realization. Though some of us might be embarrassed to broach the topic of 'whether or not we are getting enough', the truth is that every human seeks to achieve his sexual potential, even while he or she might, not be aware of it. Most of us have the ability to get the foods matching our taste preferences onto our plates, but with sex, this could be a little difficult, since sex, is a complex subject with a lot of social, moral and religious links. The truth is evident in the number of marriages (the very cornerstones of civil society) that fail on the basis of sexual compatibility, either by setting unrealistic sexual expectations or by not owning up to, or even identifying, one's sexual needs. This has repercussions on the psyche and self-esteem of a person, and this is especially true in the case of men in particular, as they may feel completely inferior for not being able to attract a sexual partner matching his desires. In some people, this also leads to a case of self-loathing, for having sexual needs which a partner doesn't understand, or much worse, needs which are considered taboo and sinful (Homosexuality, Anal Sex, Group Sex, Fetishes, etc.) These complex emotions can wreak  havoc on a person's self-esteem, by creating severe internal conflicts and serious self-doubts. Now socially, sex can either liberate a person, or hold him prisoner. At times, the unfulfilled needs may get repressed and banished to the shadows, only to be played out later, in the form of sexual adventurism and crime. Just one look at the sexual crimes in our society today, and we can clearly understand just how healthy our collective self esteem is! The very society that frowns upon prostitution, is actually responsible for creating it, though everybody would like to pretend otherwise. The crux of the matter is that "sex" and "self esteem" are closely related; and one should not shy away from addressing any issues one might face regarding one's sexuality. Physical love is necessary for the survival of a relationship and one needs to make time and efforts to successfully create one's own sexual space. The positive effects of a good sex life can be seen in an increased work productivity, fewer illnesses and an increase in one's overall efficiency. Some people are haunted by sexual guilt and confusion and when they keep it all locked up, they suffer from unexplained physical pains and feel 'down in the dumps' mentally. Another problem with appreciation from the opposite sex, is the addiction to  external validation. Some people feel utterly worthless until they receive positive feedback about their looks or abilities on a regular basis. This can be downright devastating, as in these cases, there is a great dependence on external factors for one to feel good. While no one denies the "feel good factor" of sexual appreciation, it is up to each one of us, to decide just how much of control one must be giving to external factors, to determine our personal self-esteem. The appreciation may be theirs, but the esteem is entirely of the self and only the self can decide how much of appreciation and sex is enough.
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