Archive for the 'General health' Category

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

CHILD’S HEALTH/SKIN DISORDERS: FINGERNAIL INFECTIONS (PARONYCHIA)

Thursday, May 21st, 2009

Cause

These infections of the cuticle or nailbed are due to infection with bacteria or a fungus, which enter the skin through a crack in the cuticle of the nail. This is more likely to occur if your child bites or chews his fingernails.

Clinical features

The finger is swollen and red, and sometimes pus oozes from the nailbed or cuticle. The lymph glands in the armpit may also be swollen in reaction to the infection.

Treatment

If the infection is only mild, and no pus is present, soak the finger in an antiseptic solution and then apply iodine. If there is pus in the sore, your child will probably need antibiotics. If the infection is fungal, then your doctor will prescribe an antifungal cream which should be used for 2-3 weeks.

When to see your doctor

See your doctor if your child has any of the symptoms described above or you are worried.

*308\90\8*

THE NUTS AND BOLTS OF HEALTH CARE FOR YOUR CHILD: CHOOSING A DOCTOR

Tuesday, May 19th, 2009

All children at some time have illnesses that require medical attention. Most will be relatively minor, such as the coughs and colds that are a normal part of growing up. Sometimes an illness may be more serious, so that prompt and expert medical attention becomes a matter of life and death. Access to good medical care for your child is very important, and parents need to choose a doctor carefully.

In some communities there is only one doctor, so there may be no choice. Most parents will have a choice of health care providers for themselves and their children. Some families will have gone to the same doctor or clinic for many years, and it seems natural that the children should also attend that doctor. While there are obvious advantages in the one doctor or clinic seeing all members of the family, many parents choose a different doctor for their children, for reasons outlined below.

If your family moves into a new community, you can obtain a list of local doctors from the Australian Medical Association or sometimes from the local hospital, or else ask friends, neighbours or the local maternal and child health or community nurses. Parents should not hesitate to ‘interview’ doctors to see whether they seem appropriate to provide medical care for their child. If you don’t have a good instinctive feeling about the doctor after talking to him, it may be wise to seek somebody else.

Here is a checklist of some of the things that you may want to consider in choosing a doctor for your child. The list is not intended to be complete and is not in order of importance. You may wish to add points you think are important.

*12\90\8*

YOUR MARITAL HEALTH/FINDING OUT WHO’S THE MATTER WITH US: HOT SEXUALPROBLEMS – DIMINISHED AFTERGLOW AND DIMINISHED CONTEMPLATION

Monday, May 18th, 2009

DIMINISHED AFTERGLOW: I don’t glow after sex, I just sort of smolder. I think it’s the origin of the word “burnout.” I feel spent.

HUSBAND

Absence of afterglow was reported in 907 of the husbands. They could not understand the idea of feeling invigorated after sex, instead feeling that sex had exhausted their energy supply, at least temporarily.

I feel a sense of relief, or completion, but I sure wouldn’t say a “glow.” It’s like a job well done. It’s getting off.

WIFE

Five hundred fifty-one women reported the lack of or diminished afterglow. More often than the men, they knew about afterglow, might have felt it following some of their sexual experiences, including masturbation, but reported a connection between partner and the afterglow phenomenon. It is difficult to glow alone after being sexual with someone.

DIMINISHED CONTEMPLATION: I just tune out after it’s over. I don’t feel like moving, thinking, talking, or doing anything but sleeping. I drift away.

HUSBAND

Four hundred fifty-three men reported the absence of or no understanding of reflection or contemplation following the sexual experience. The “energy release” model of early sexual research probably conditions many men to feel that an athletic event has ended when sex is over. It was new for most of the men to ask themselves about satisfaction, to reflect on the sexual experience rather than to forget it.

I’ve learned to tune out after sex. I used to laugh sometimes, cry other times, or sometimes get real philosophical. It was like I was on a drug after sex, like it was with some good pot. Now I don’t have the time or the interest. I just turn over and go to sleep.

WIFE

One hundred twenty women reported this problem, and the majority of the wives in the sample reported that the reflective phase of the sexual system diminished with length of marriage. Our culture’s linear view of time, the start/stop orientation we bring to sex, does not help us reflect. We tend to be prospective in our sexuality; foreplay is much more popular than after- or replay. Hot-running life-styles allow little time for looking back or prolonging experiences through reflection. We barely have time to enjoy the moment once, and seldom twice or thrice.

*171\97\8*

THE DESEXUALIZATION OF THE AMERICAN MARRIAGE/A SEXUAL-SYSTEM EXAM: PAYING “ATTENTION” TO SEX

Monday, May 18th, 2009

We have never really talked. When I ask her for more attention, more feeling, she takes it as a criticism orputdown. We just can’t talk it over, work it out. She has no idea how I really feel inside.

Husband

Do you feel clearly understood in your marriage, sometimes even well beyond what you say or do? Do you feel “well sensed ” and listened to beyond words (attention)? Or do you seem to have to expend a great deal of energy just to get your feelings stated, and even then feel misunderstood (disattention)? This atten-tion/disattention issue is another example where it seems that attention must be much “better” than disattention. The purpose of taking this test is to learn a new view of the marital system that allows for constructive disattention, some relief from the vigilant state required for constant attention. It’s the strong relationship that can tolerate misreadings and occasional low empathy because it is counterbalanced with corrective reading and sensing of one another’s feelings. If you score this test by placing each item on a circle instead of a line, you see how systems theory works. Too much attention, for example, throws the circle off balance; it turns awkwardly and may steer off course. The same is true for too much disattention.

One of the husbands managed to learn this new scoring system by equating it to breathing. You need to inhale good fresh air, but you have to make time to exhale also. This “flowing” concept is at the heart of a systems view of intimacy.

Attention in this case does not just refer to talking and listening. Psychotherapy, marital therapy, and so-called sexual therapy focuses primarily on words, on talking, thinking, listening, and physically touching and being touched. Super marital sex adds “supersensory” communication. I am not referring to “extrasensory” perception, because sensing is not an “extra.” We all have

it, but we must learn to develop it. Supersensory marital communication can be practiced, enhanced, and strengthened. We can go beyond talk-and-touch therapy, and work toward our own forms of “marital telepathy.”

Physicists know that communication takes place on levels beyond the see and touch world. Physicist Fritjof Capra writes, “Throughout history, it has been recognized that the human mind is capable of two kinds of knowledge … the rational and the intuitive.” This part of the marital sexual system test refers to the intuitive dimension of marital interaction, a dimension too long ignored by professional therapists and health-care workers. All healing depends as much or more on intuitive communication and awareness than it does on the rules of rational, verbal communication.

Our example couple scored high toward the disattention end of the axis. Not only was the husband unaware of his wife’s pain, but she, too, failed to sense his difficulties. The husband stated, “I leave the table because I just don’t know what to do. If I try to help, I think she thinks I don’t think she is doing a good job, sort of letting us all down.” The wife responded, “He just does not give a damn. He’s just lazy and self-involved. He never gives one thought to how I might feel.”

When I presented a part of this report at a recent professional meeting for therapists, one of my colleagues stood up and said, “I tell my couples that the only way anyone is ever going to know how you feel is if you tell them. You must share your feelings and listen for the feelings of your spouse. Now you come along and tell us that there is some sort of ‘supersensory communication’ in marriage. There just is no such thing. We have to talk, listen, and do. This is a ridiculous idea . . . sensing. That’s when couples get in trouble, trying to sense instead of trying to communicate.”

I responded by saying, “You are making an important point, but if you will let me continue, I think I can document my ideas with case examples.”

The therapist answered, “Never mind. I can just tell what you are going to be saying, and I don’t want to hear it.”

The audience laughed at the obvious contradiction, referring to his “sense” of what I was going to do as a means of denying that sensing goes on all the time.

Again, some “rest” from constant attention is necessary in any system. Watching and listening or being watched and listened to all of the time can be as disruptive to the marital system as no attention at all.

*31\97\8*

PSORIASIS – CONCLUSION

Friday, May 15th, 2009

The nails are often affected, usually with evidence of psoriasis elsewhere but, occasionally, they alone are involved. In this case, the diagnosis may be missed and the problem thought to be due to fungal infection or some other cause.

The nail may show small pin-head size pits or the nail may separate from the underlying nail bed or it may be thickened and discolored.

Unfortunately, treatment produces little benefit. Psoriasis on the skin responds well, in most cases, to local applications but the nail seem particulary resistant.

Patients undergoing treatment with methotrexate often show an improvement in their nails.

It is worth repeating that most cases of psoriasis are mild and can be controlled by simple means. Self-medication should be avoided, as it may irritate the skin.

Sometimes a previously satisfactory treatment loses its effect. When this happens the sufferer will need to change to something else. Later, the original treatment may again be effective.

*540/71/1*

CROHN’S DISEASE – GENERAL INFORMATION

Friday, May 15th, 2009

The most common symptoms are abdominal pain and diarrhoea and the diagnosis may be missed and thought to be either an episode of mild appendicitis or the irritable-bowel syndrome.

Sometime ulcerative colitis may be suspected, if Crohn’s disease affects the large bowel. At times there is a fever and weight loss.

When the rectum and anus are affected there may be localised pain, bleeding and sometimes a fistula or track leading from the bowel and opening out on to the skin around the anus.

Involvement of large areas of the small bowel may lead to poor absorption of food, anaemia, vitamin deficiencies and malnutrition.

Treatment is not altogether satisfactory, as this is often so in diseases where the exact cause is not always known. Cortisone or its derivatives are often used as in any chronic inflammatory disorder.

One of the antibacterial sulpha drugs can be of value in acute flare-ups, but is of little use in long term maintenance.

It may be necessary to operate and remove the affected segment of the bowel when medical treatment fails.

Most patients can be kept in reasonable health and can live full and active lives.

*283/71/1*

COLIC IN BABIES

Tuesday, May 12th, 2009

Almost one in three babies have episodes in which they cry vigorously, sometimes for several hours, draw up their legs and go red in the face.

It is usually assumed they have abdominal pain. This “three-month colic” usually starts in the first six weeks of life, nearly half having stopped by three months and 90 per cent by six months.

The cause is unknown, but is often said to be due to intolerance to cows’ milk. However, breast-fed babies seem as prone to get it as those artificially fed.

Cows’ milk proteins are thought to enter the mother’s breast milk and taking the mother off cows’ milk may be of benefit.

Many of these babies seem to settle with a mixture containing antispasmodic drugs with a sedative.

*32/71/1*

CHILDREN’S HEALTH: SHOCK

Tuesday, April 28th, 2009

Emergency symptoms

Apply emergency treatment immediately.

Emergency treatment

1.    Give essential life-saving first aid: take steps to stop bleeding and make sure the child’s airway is open.

2.     Get professional help immediately. Call police or paramedic squad.

3.     Keep the child lying flat with the head lower than the body (unless there is a head injury).

4.     If there is a head injury, have the child lie flat without elevating the feet.

5.     Keep the child warm.

6.     Do not offer food or water.

Symptoms: weakness; feeling faint; rapid, weak pulse; paleness; cold, clammy skin; cold sweat; chills; dry mouth; nausea; rapid, shallow breathing; restlessness; confusion.

Precaution

Shock can be fatal if the victim does not get immediate professional emergency care.

Shock is the term used to describe a sudden drop in blood pressure or a collapse of the circulatory system, which seriously reduces the blood supply to all parts of the body. Shock is an extremely dangerous condition; if it is not treated quickly it is usually fatal.

Generally, shock occurs when a great deal of blood or body fluid has been lost. It can also occur when blood vessels dilate (expand) and cause blood to pool or collect in one part of the body instead of circulating normally. The danger of shock exists in virtually every case of serious accident, injury, burn, or poisoning. Shock can also follow any of the following: severe infections; wounds or broken bones; hemorrhage (severe and uncontrolled bleeding); insect stings (in people who are allergic to the insect’s venom); excessive vomiting or diarrhea; heart attacks; or reaction to certain drugs.

*184/84/5*