Archive for June 3rd, 2010

MEDICAL PHILOSOPHY: MEN’S CHANGES WITH AGING

Thursday, June 3rd, 2010
The age of full maturity has been, except in a few states, set by the Registry of Voters at twenty-one, and I see no reason for questioning their judgment as we consider it from a physiological point of view.   For the next quarter century there are not necessarily any striking changes. The most evident, naturally, are the external appearances. The skin and its appendages most certainly do give a good many indices of age. That presumably is the reason why middle-aged women use so much paint, powder, and lipstick. Why the teenagers with damask cheeks and soft fresh lips do not take advantage of their superior youthful charms is their secret. It is perfectly natural for the skin slowly to lose its elasticity with advancing years and to develop small, rough growths. Most of these are harmless and unimportant. The breasts, which are appendages of the skin, have a good deal of weight in relation to their size, and the constant pull of gravity usually starts them sagging early in life. The disinclination of modern young mothers to nurse their children is founded largely on a belief that nursing causes a loss of fullness in the breasts. As a matter of fact, those who have not nursed also find a decrease in fullness which can be measured.
Rare is the woman who does not acquire a middle-aged spread and rare the dashing young soldier who on the twentieth reunion of his organization can get into his old uniform. Few advance through the years without eating enthusiastically and exercising in a more restrained manner. Then the change of texture of the bodily tissues results in a rearrangement of fat accumulations. As middle age advances you will probably have to squeeze into your old clothes or have them hang on you in folds.
One thing you may be sure of. Between twenty and forty, or fifty, you are going to slow up a lot. Your muscular reactions will change their speed so that even you will notice the difference. Fast athletes become second raters, though to the uninitiated they look as good as ever. That fraction-of-a-second lag is the difference between the good man, which the player still is, and the marvel which he was and which the man who takes his place is now.
Times have changed. I do not know why today a man in his fifties or sixties is not necessarily as much an oldster as one of his age was two generations ago. I fondly hope that a good part of this change may be due to the knowledge – and perhaps a little to the wisdom – that my profession has developed and has insidiously instilled into the general population.
*102/276/5*
GENERAL HEALTH

THERAPY FOR CHILDREN: UNDERSTANDING BABY’S BEHAVIOR

Thursday, June 3rd, 2010
As a parent you should find out what behavior can be expected of your child at different ages. Dr. Greenspan gives the following timetable:
•   0-2 months: responds to sights and sounds; can calm self down
•   3-7 months: shows signs of pleasure and joy
•   4-9 months: communicates wishes by showing various feelings with gestures, facial expressions, and sounds
•   10-18 months: expresses complex feelings and demands with gestures, words
•   24-36 months: uses language and pretend-play to work out fears and emotional needs (e.g., may hug a doll when Mom is away)
•   30-48 months: employs logical thinking and demonstrates knowledge of the difference between reality and fantasy
Parents should seek help if a child does not show these coping skills roughly on this time schedule. Parents also should seek help if the child is constantly irritable, inattentive, withdrawn, won’t eat, can’t sleep, bites or hits other children, or doesn’t talk by 18 months.
With help, parents can overcome some of these problems by learning to understand the baby’s behavior and to respond to it by adjusting their own behavior accordingly. The first step, says Dr. Greenspan, is to establish a connection. You do this by playing on the floor with the baby. You learn to read the child’s signals. With a passive infant – one who doesn’t do or say much – you exaggerate: “Oh, what is this? Do you want to see that?” Then you follow up by engaging the baby’s interest by pointing out details. With an active child, you try slowing and focusing techniques. If he or she stops at a toy, for example, engage the baby in talk about the object.
“One child we had in treatment,” Dr. Greenspan relates, “would stop at a toy for only 2 seconds. We extended the stop to 6 seconds, eventually to 30 seconds.”
He cites the following as problems likely to begin in infancy:
•   Autism – The child doesn’t communicate with any other human being.
•   Depression – The child is sad, weepy, cannot sleep, cannot eat.
•   Attention disorder – The child seems unable to focus on anything – toys or humans – for more than a few seconds.
Dr. Phillip Strain, an associate professor of psychiatry at the University of Pittsburgh, has a new way to deal with autistic children. In LEAP (Learning Experiences, An Alternative Program for Preschoolers and Parents), at the Mifflin School in Pittsburgh, he places normal children with the autistic children to serve as role models for behavior and communication.
“We get many to go on to kindergarten,” Dr. Strain says. “And if we get the autistic child by 2.5 years, we usually can prevent the self-injury so common in these children.” (Some of their self-destructive acts are head banging, eye gouging, hair pulling, and hand biting.)
Autism remains a mystery. Doctors theorize that some autistic children have a chromosome deficiency that may have caused the illness, while others may have got it from a virus. Under the best programs, some autistic children develop to their maximum potential.
Patty Caito placed her two normal children in Dr. Phillip Strain’s autism program when they reached age 3. The experience of helping other children, says Mrs. Caito, enriched her children, too.
“There was an autistic child named David who never said a word,” she relates. “He just screamed. After a few months, he was saying words. My kids would come home and say, ‘Dave said this and Dave said that.’ They loved seeing his progress.”
Infant psychiatry itself is still in its infancy, but Dr. Stanley Greenspan asserts, “If we can provide them with the right emotional environment early enough, most of these troubled babies can be won.”
*102/266/5*
GENERAL HEALTH