she was the dictator's mistress. only an insignificant concert at his side. or pursuing her own visions. but certainly has no other woman got some close to. life and death with a few. starts july twenty first on d. w. . welcome to in good shape here's what's coming up. veggies from the ocean what makes algae so healthy. fun on the water high stand up paddle boarding strengthens your whole body. relief for it she skinned that's our main

topic today with your host dr costin like you taught. people step away if they're new somebody who's constantly scratching himself because he might have fleeced of lice or something infectious or just some mental thing going on so it's in his makes you live and it makes his suffering because it's nice is always on during lunch or breakfast during dinner and if you want to get rid of it you have to come to this place of the berlin charity to dr martin mids welcome to the church . finding the cause and chronic paratus is sometimes like shot of holmes trying to solve the. case. thanks for having me so what's

a main challenge in your field of work which is the main challenge is that there's not just one cause for each process so the patients are all different sorts of problems that are coming to us and we have to identify the one main reason for the protests and that can be quite a challenge when one can patients visit you well it's a broad range of patients that risk so we see every age group basically we see patients with skin diseases we see patients with other diseases so there's really not this one patient involved in the main problems the patients suffer from well many of the patients do indeed have skin problems like a victim or titers or duty carrier that caused the problem but there are also other reasons like internal diseases or or other problems that these patients come up with so we really don't have this one one typical kind of patient so the main thing

many patients just think if my skin is easy it's all about the skin but yours it's not it's also about the intruding audience. itchy skin can be excruciating and constant or severe itching is a symptom that should be taken seriously as come till i feel a kind of stabbing pain that makes me jump and then i start scratching myself that's. oh it's really awful it feels like the itching is coming straight from my bone sometimes from deep inside not just on the surface of my skin also. there are many possible causes for itching also called pro writers i'm a source isn't always in the skin itself. often it takes a long time to figure out the cause. that happened to. it started ten years ago very suddenly she was out taking a walk on the soles of her feet started it ching. hai my feet feel like they're

burning to get a burning it ching sensation across the soles of my feet. it feels like i've just stood on a burning hot stove there's no other way to describe it. it spreads from her feet to her hands and then her entire body sometimes it's such torture that she uses a fork to scratch the soles of her feet. i just don't know what else to do. it helps my fingers aren't strong enough to get the itching under control. like many people who suffer from etching she's had trouble sleeping for years those who is studies of the patients who suffer from it xing and those with severe chronic pain syndrome show a similar impact on quality of life and single here absolute for. some patients experience depressive episodes were developed clinical depression or anxiety that's

what can happen if you suffer from terrible itching for years on end. after two years on your home can host was referred to specialists they discovered the reason behind a change and also immune liver disease research is still don't know exactly why liver disease can cause a chink. also suffers from constant chronic itching. in her case it's just her back and her arms but it's. sometimes it's so bad that she also grabs an object to help her scratch. that's one weekend and not once in the middle of the night i didn't want to wake anyone up so i went damn stead's and i took a knife and scratched myself with it. one day she saw a report about a specialist outpatient clinic for pro writers after a few tests a doctor found

a new dish which has considerably fewer nerve fibers in her skin than a healthy person would she was diagnosed with neuropathic pro writers. neuropathic prices can be caused by nerve damage into a new dish we tell us case the source of the problem was in her cervical spine something probably a slipped disc in japan. that eventually triggered a chill in the region of the body served by the. there are many different treatments for etchings. in the new hometown hosts case she was prescribed a medication that blocks specific receptors responsible for the itching she gets regular intravenous treatments. tell it was prescribed an oral psychoactive medication and an anti-histamine. was i think is tonight

in taking the medication for two weeks and i'm already feeling a lot better i don't have to scratch myself as much needed mansel cats and before here it's like it's a relief i can sleep at night my medication dosage has been adjusted and now the itching is manageable. both women say the itching isn't entirely gone but there's been of lot of improvement. now we've got a patient with bright with this is the best thanks for joining us today at that we before we turn to the talk about your kind of disease i want to know we just saw that the diseases can cause brightest but what other internet users can cause it many internal diseases can cause practiced or be a factor into the existing for a just and apart from a little disease it's typically diabetes for example or kidney failure so patients with chronic kidney problems they very often also have to sometimes do severe

practice mysteriously do it for i go how digital start you had to begin. to go through a period it started many years ago on my arms i put band-aids on them sometimes and that helped but and twenty fifteen i was hospitalized after i lost some kidney function you can come home from a commercial notes with your chin got really bad. turned off in slow motion first it was just in my later. it spread to my back retrieve i think you know with. the more i scratched of the more it kept spreading of course because i also have diabetes so when i scratched myself hard enough that i hurt myself the wound would take a long time to heal. and when i scratched the wing would open up again that was a problem and so sick that i seen people move away from you so you have interesting because you're the opposite i was young this woman you'd be it's unpleasant with

your love gone swimming have sometimes been asked if it's contagious so you came to the clinic and took them it's what did she find we did not find new things but we just knew that we had to treat her right just to reduce the burden. and if you would treat the debuts at the kidney disease wouldn't brightest. just go away well this is one important aspect of what we're doing is that we try to control he's underlying problems however as you know we cannot cure diabetes or we cannot cure chronic kidney so it's important to deal with this disease this with this specialist a respected specialist in these areas but the main aim there is to not let it get worse but it's really not that we can we can hear of these problems right now that

you treating that right it's just internet came back this is the most important thing that we can do for the patients to symptomatically treat the practice so that the severity of the itching goes down considerably. in the end this means also a causative treatment or at least it can cause that treatment because we know that there is something. like a chronic pain you know when we know that there's a pain memory there's also something like an. each memory so to to break this the itch memory this intuitive treatment can be also called. so the mystery isn't what important the symptoms right now and they're better right not to be getting it oh dear newport news eased somewhat they ask here to write the itching between zero and ten with ten being the worst but when i came here the

ching was somewhere between a six and seven now it's a three to four so i'm fairly happy with my progress and the. things to be there for sharing your story with us thank you and so we just talked about all the interim courses for writers but the scheme can be of course by itself like in the room to the tightness of. the neck. in elbows and the legs of the main problem areas from manford kinds of. he has a chronic condition called neurogenic titus also known as a topic eczema his skin has difficulty retaining moisture so it becomes dry red cracked and very itchy. like most people with the condition manfred has suffered from your dumb otitis since childhood. is flawed so you know when i was more physically active or did more sport the itching would get worse but the weather also had a big effect i'd have to scratch the red patches so hard it scratched them open and

they'd start to bleed and. near damage tends to have non-acute phases and times when symptoms flare up manford latest flare up came three years ago he changed his diet and the types of fabric he wore he had to stop working for more than a year and couldn't lead a normal life and in all. three have another. while others were out playing football or going on bike rides and i was lying at home in the dark i used loser. to try to calm it down right lying really still so i didn't aggravators it through . this new quotes country for. people who suffer from hay fever an ass much greater risk of having your german scientists and because there's a genetic predisposition so that children. manfred also suffers from hay fever in summer he's the only one in his family with nerve

damage titus though so he's not sure where it came from the exact cause of the condition is still unclear but alongside genetic predisposition stress is also known trigger and that could be the reason why his new york flared up again. with three years ago i was working as a roofer. a very physically strenuous job. i'd work from seven am to five pm sometimes on saturdays as well all the pending on the job and. then i'd go home shower eat and then go straight to my other job as a d.j. . i'd work at weddings and they go on until two or three in the morning next the walked down the. he's been treated by a number of damaged hala jests and has tried all manner of ornaments and creams but when the itching gets really severe creams on enough that's not my. cup side was

there were periods when it was really dramatic and i spent time in hospital and when i was off work i was on courses it helped but it was very intense then i went back to work in the pain was just as bad as it was before maybe it was. has seen many patients with similar experiences. called. acute cases cortisone is a very good effective and low side effect treatment but if you use it repeatedly you're at risk of skin atrophy thinning of the skin and that can actually exacerbate the condition for. just over a year ago manfred started taking part in a trial for a new medication the active ingredient is supposed to suppress the skin's inflammatory response. this medication is given by injection so the patient gets the injections at regular intervals. something seems to

be working. for nearly a year now manfred has been symptom free. they're relatively new medications against atopic dermatitis on the market. yes indeed so there's one drug that has just been licensed and of last year which really makes a difference for patients with atopic dermatitis this is a drug called up which is the mono clonal enter body which means it takes away a certain aspects in the body and that really helps the patients quite good so what results can you achieve with them so the study results showed really an excellent improvement in these patients which excellent means that in many patients we really achieve clearance off of the skin symptoms importantly however this is not a healing of the disease but it's a symptomatic treatment so getting this can get a good condition ok back to each in his and paradis syrian general approach you

have with the patients no actually there is not one general approach because the causes the underlying diseases are so different so for example the patients. must cells are the main players of the of the itch and this is like you to carry a for example and there is to me is the cause of the crisis and there we can use antihistamines and they work quite well however in many other situations history does not play a role at all in there and then we have to predict for other drugs to treat these patients thank you symptomatic treatments them in symptomatic treatments exactly and so what kind of medications to offer the patients just symptomatically so these are drugs that we know for example from chronic pain treatment or also from under the presence one example the standard drug that we actually use in treating chronic itch is cover penton you mentioned earlier that there's something next. each

memories like pain memory where patients suffer from chronic pain and the cause of the pain is gone but the pain is still there so it's the same in legions yes it's really the same so this is actually one of the biggest problems that we're facing in a in treating our patients with chronic providers that there was a cause at some point and we cannot identify this cause anymore but the. memory is still there so so these are exactly those patients where we need to cheat with systemic drugs because we can't get rid of the problem by treating the skin can you delete that memory well we really do not know at the moment how good we can delete the memory or how long we have to be able to treat the patients to delete the memory but but it is indeed the idea that we want to achieve an effective treatment of the itch for a certain amount of time and by that hoping that the brain sort of forgets

which and how big are the chances that you'll get sufficient results for the patients well i would say that we can improve the situation in basically every patient the question is how good are we in improving the situation so there are few patients with these chronic problems where we achieve a complete control of the symptoms but if we get to sixty seventy percent improvement and this is quite a success and that can be achieved in quite some patients thank you for answering all my questions so what do you do right ok you're watching the show and i hope that you will continue watching after the show just go to your computer and sent me all your questions to our experts i e-mail. coming show we'll be talking about it being diagnosed with a serious disease getting bad news from your doctor can be quite a shock how best to cope with this. send your questions about that too in good

shape as. d.w. dot com just put diagnosis in the subject line we hope to hear from you. so you want to stay in good shape but running is too exhausting. and cycling is simply too dangerous. and yoga is too complicated. so here's something new try you pay. in the summertime people like to be out and about. one pleasant pass times paddling while standing. champions of stand up paddle boarding or s.u.p.p. say you don't have to be young and sporty to do it. we're about to test that claim . there are a few basic requirements you can't be wobbly on your feet you need a little stamina and you can't be totally out of shape plus you have to be able to

swim. it's best to start with a big wide board absolute beginners start on land after legs far apart that helps with balance. in this group after just a few minutes everybody managed to stand out on the water. it's not impossible not even that difficult. it's fun it takes some getting used to it is rather wobbly. countering the wobble is one reason the sport is also good exercise it trains core muscles the intense effort to maintain stability on a wobbly or vibrating surface strengthens muscles that are otherwise hard to target orthopedist kristoff bomber thinks a superior is super. muscle groups you can't feel from without are extremely important for maintaining a healthy posture and ensuring stability from. brought

a vertebra around joints and. there are special exercise devices that wobble or vibrate dr varmus says they help patients with osteoporosis osteoarthritis of the knee and back pain with s u p the wobble is unpredictable so dealing with it can activate further muscle groups instructor mario insists on good technique you haven't keep your arm stretched that's very important so you work all the trunk muscles and boy and it's something that to a human and i'm the one in the paddle in the water and pull it back the force goes through the arms to the shoulders by the pectorals and abdominals to the pelvis and from there to the legs from the legs to the feet to the board and that's what moves it forward in the form. the whole body is hard at work that's good for strength coordination and endurance but there's more. when we cycle we sit same with driving

and working at a desk at school children sit stand up paddle boarding forces you to stand actively . stand up paddle boarding is sport fun and healthy exercise for just about anybody for that extra throw the next stage could be yoga or pilates as out on the water on a fine summer's day. of course you know that veggies are put for your health. but you think hell it's up to crunch and you already have cucumber it's not long ago. and you find bell peppers to uninspired. so here's something new tries see wheat veggies of the same. seaweed or allegheny added habit of the oceans for hundreds of millions of years and they can be good for you thanks to minerals from the seawater and other essential nutrients they contain. the food industry has discovered alkie they. can

be grown in huge tanks and processed as a healthy alternative to fish. edible forms of red green and brown alkie and then variously as dolls nori welcome a combo and see spaghetti. they can be used in salads soups and as a company months to fish and meat. fresh seen wheat is popular in parts of asia but in much of the world mainly come in dr form. instructions on how to prepare them can be found on the packet or on the internet where all kinds of recipes are available. seaweed is also a growing trend in organic stores. really the healthy food of the future we are asked to nutrition experts when i see we contains lots of vitamins such as beta carotene just like vegetables they grow on land doesn't cause they have about as much of that is carrots and cabbage seaweed also has relatively large amounts of

minerals mainly zinc and magnesium but in that too they're similar to the mineral content of lettuce and cabbage. algae have a pretty high water content and not many calories. so they're much like our standard vegetables with around twenty five to forty calories per one hundred grams . who. have a lot of dietary fiber so they help digestion but caution is advised especially when you come in dried form mentioned you should lose not about people with thyroid problems have to be careful with high add in intake dried products in particular have relatively high amounts of by the in so they should be avoided. profit margins are too fresh seaweed has less but even there you have to take care not to eat too much. fats he. has ordered several varieties on the internet

she's on a diet and she wants to try out the sea vegetables they arrive in dried form. first she soaks the scene wait for five minutes in salt water it's absorbs the water quickly and looks quite fresh dried for two years but fresh all rehydrated seaweed has to be consumed within a few days. since spaghetti and walker made a cooked in a soup for three minutes. nori and dulce can be used to make a salad seasoned with have been a gret. hundreds who were right or wrong it was super easy to her back and terms of taste the salad was a bit fishy but delicious but in a soup it didn't taste at all official perfect as the hawk no fish or i would definitely recommend it and i think i'll try out some more see it in for you and. be into. whether red to green or brown or green algae are easy to protet given your

criminal boost to the menu the best so far today and don't miss your appointment next week with your t.v. g.p. see you then and i'm so then let's all try to stay in good shape the future. the e.u. . the be. the best.

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race. fifteen minutes.

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from the forest starts. w. . is a v.w. news live from berlin after twenty years if there's again france has lifted the world cup trophy for a second time to be a good chunk of team beat croatia in the final in moscow setting up wild celebrations back home which both undoubtedly lasted well into the night. late they crushed croatian hopes with a can.