their age.

It promotes self-care in order to maximize seniors' chances for

good health.
The book is divided into eight
chapters. The introductory chapter
deals with some of the determinants
of good health, and the next covers
physicians, drugs, coping skills and
personal safety (including falls). Subsequent chapters deal with 1 9 common complaints, common problems
(all diseases except for incontinence), specific advice for older
women and men, cognitive and affective concerns, interpersonal issues, in-home assistance, institutionalization, advance directives and
terminal care.
These areas are generally well
covered, with some minor exceptions. In the section on nutrition,
there is inadequate discussion of
communal meals (e.g., meals on
wheels). The book should have provided advice or guidelines on potential problems with nutrition. The
section on dealing with physicians
may lead to unrealistic expectations.
The author advocates that histories
be taken and physical examinations
performed annually. The description
of what to expect at an appointment
with a physician has little connection with the "real-life" experience of
15-minute office visits. Surprisingly,
little is said about the dangers of
over-the-counter drugs. There are
some factual errors (e.g., that the
prevalence of dementia is less than
5% among people 65 years of age
and older), but they are rare. The
advice given is generally practical,
but how many seniors will drink 8 to
10 glasses of water per day, as the
authors suggest? The discussion of
hypertension is buried in the section
on stroke.
A few things are missing: a good,
concise discussion of legal and financial issues (e.g., wills, power of attorney and guardianship or trusteeship),
a listing of resources for readers (e.g.,

424

CAN MED ASSOC J * 15 AOOT 1996; 155 (4)

nongovernmental agencies such as

the Osteoporosis Society of
Canada), and, for a Canadian audience, differences among the
provinces in what is available and in
laws that affect elderly people.
Despite some shortcomings, this
book is a good buy for aging Canadians with an interest in their
health and health care.
David B. Hogan, MD, FRCPC
Associate professor
Faculty of Medicine
University of Calgary
Calgary, Alta.

TAKING CHARGE OF YOUR

FERTILITY: THE DEFINITIVE
GUIDE TO NATURAL BIRTH
CONTROL AND PREGNANCY
ACHIEVEMENT
Toni Weschler. 382 pp. lIlust. HarperCollins Publishers,
Inc., New York; HarperCollins Canada Ltd., Toronto.
1995. $28. ISBN 0-06-095053-6

Overall rating: Good

Strengths: Extremely detailed analysis of signs
of fertility; appendices deal with unusual situations
Weaknesses: Inconsistent descriptions of some
medical procedures
Audience:
Patients wishing detailed guidance to
achieve or avoid pregnancy and
health care workers wishing to supplement their knowledge of fertility

A uthor Toni Weschler set out to

produce a manual for achieving
pregnancy or avoiding it through
the use of the Fertility Awareness
Method (FAM). This technique appears easy to understand, but it is
difficult for patients to maintain
faithfully, unless they are methodical
and highly motivated. There is a
good index and excellent appendices
(constituting one third of the book)
that discuss special situations (e.g.,
the use of the FAM during breastfeeding).

I suspect that infertile couples

will benefit most from the comprehension this book provides and
from its practical pointers. For patients simply confused about when
their fertile times occur or patients
concerned about short luteal phases,
this book helps to demystify the fertility cycle. It also helps to explain
conventional tests and treatments
(not all of which are routinely available in Canada).
There are subtle anti-establishment biases in most of the anecdotes. Medical procedures are almost invariably described as
"painful." The book has few inconsistencies, but they are annoying
when they occur; for example, the
side effects of a hysterosalpingogram
and diagnostic laparoscopy are confused in an early chapter. Some information, such as the change in the
position of the cervix during menstruation, is controversial. However,
this particular information is part of
an optional exercise and certainly
does not appreciably alter the rest of
the instructions. These inconsistencies may, however, deter medical
readers, and the author may therefore miss the opportunity to supplement the basic knowledge of health
care workers.
The chapters on premenstrual
syndrome and menopause are useful
but unexpected in a volume on fertility awareness.
Overall, I would be comfortable
recommending this book to infertile
couples and to highly motivated
couples who wish to avoid pregnancy without using medical devices
or drugs.
Charmaine Roye, MD, FRCSC
Department of Obstetrics
and Gynecology
Brantford General Hospital
Brantford, Ont.
Committee on Public Education
Society of Obstetricians
and Gynecologists of Canada