Archive for May, 2009

CHILD’S HEALTH/BOWEL DISORDERS: CONSTIPATION TREATMENT

Thursday, May 21st, 2009

Treatment

Treatment depends on the specific cause of the pain. Do not give any medications for pain until you have discussed this with your doctor. Painkillers may serve only to mask the real problem, and make diagnosis more difficult.

When to see your doctor

• if your child complains of severe pain in the abdomen;

• if your child has recurrent bouts of abdominal pain;

• if your child is unwell or has a fever in addition to the pain;

• if your child has diarrhoea or vomiting;

• if any blood is present in the stools;

• if you suspect that your child has swallowed something poisonous.

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COMMON PROBLEMS WITH BREASTFEEDING: INADEQUATE MILK SUPPLY

Tuesday, May 19th, 2009

It is difficult to tell just how much milk your baby is actually getting when you breastfeed. An indication that the amount may not be sufficient is a baby’s poor weight gain during the first few weeks or crying immediately after feeds. Of course, there may be other reasons for a baby’s failure to gain weight or not settling after feeds, but if he is otherwise well it is worth checking with a doctor, who will assess feeding technique, as well as the mother’s and the baby’s general health. Inadequate rest, poor diet or insufficient fluid intake, as well as anxiety, can all contribute to a decrease in your milk supply. Expressing between feeds can help boost your milk supply. Try to avoid giving complementary feeds unless absolutely necessary, and then only give a maximum of 60 ml of formula after each feed. If your baby is unwell and feeding poorly, this may also compound the problem. Seeking the advice of a breastfeeding counsellor or your maternal and child health nurse can also be invaluable if you are concerned about your milk supply.

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YOUR MARITAL HEALTH/SEX AND PROBLEMS OF DAILY LIVING: SEXUALITY’S DIRTY DOZEN

Monday, May 18th, 2009

1. Loss

2. Parenting

3. Parenting parents

4. Work or career problems

5. Financial problems

6. Balancing outside relationships with marriage

7. Problems fitting recreation into relationship

8. Relocating, moving to a new home

9. Problems with transitional life phases

10. Insufficient time or poor time management

11. Counterproductiveness and ineffectiveness of institutions

12. Difficulties in living and loving according to morals, values, attitudes, and beliefs

The husbands’ and wives’ quotes were reported in the same order as the problems list above. This list represents some of the major obstacles to super marital sex. Go through the list one more time and assign points for your marriage on each item on a 0-to-10 scale, with 0 representing no such problems now and 10 representing severe problems in that category. Talk it over with your spouses and decide on a number value for each item.

The average score for the thousand couples on this test was 68 points of a maximum 120 “sexual stress points.” The average for four thousand other couples who took this brief test during some of my lectures was 53. The couples found it helpful to convert this score to a percentage by dividing their score by the total possible 120 points, resulting in about 44 percent of possible sexual stress points for the lecture groups who were not coming for specific sexual help and 57 percent for the clinic group. At five-year follow-up, the clinic couples averaged a score of 24, or 20 percent. Their stress points were significantly reduced because of time, treatment, improved sexual life, or change in life circumstances. I have never seen a couple accomplish super marital sex without significantly reducing their percentage on this test. This chapter is about ways in which you may reduce this percentage together as another step to super marital sexuality.

I tell my patients to remember three “grabbing” techniques when facing life’s transitional problems. These techniques include sup-tins each other, holding on to your sense of humor, even at the worst of times, and clinging to your belief system and the faith that your super marriage will be able to cope.

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MARITAL HEALTH/LOVE LIE : “LOVE IS SEPARATE FROM SEX. “

Monday, May 18th, 2009

She is just not able to separate love from sex. She thinks they’re exactly the same thing. If she’s turned on, she says she wants to “make love.” She really means that she wants to make sex, but she just has to make them the same in her mind.

HUSBAND

If the nineteenth century attempted a sexless love, then the twentieth century tried for loveless sex. Both efforts failed. Freud taught that love and sex could not be separated, and this view was incorrectly translated to the idea that love was sex or that sex was love. As the clouds and sky cannot be separated, they also are not the same thing. One would not exist without the other, they are part of a system, and so it is with sex and love.

The couples spent hours on their tapes debating the issue of who wanted sex, who wanted love, who needed more love for better sex or better sex for more love. The division is completely artificial. As psychoanalyst Reuben Fine states, “Both love and sex are essential for a full life.”

Love is the feeling and behavior of bonding. Sex is one of the bonding behaviors, the physical merging part of love. A problem is created when we equate that merging exclusively with a genital merging. Touching a shoulder, exchanging a glance, cuddling a child or parent, all are sexual acts and all are part of bonding.

Bonding is a mature, intentional, behavior as well as a feeling. Attachment, on the other hand, is an immature, childlike relationship pattern. I learned early in my work that the couples who had bonded experienced an easier remediation of any sexual difficulty. The couples who had “attached,” dependently and immaturely “linked to” one another, had considerably more difficulty solving sexual problems. They had not been able to integrate sex and love in their own minds, hearts, and relationships.

Ask yourself about your own relationship. Is it a “bond” or an “attachment”?

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THYROID GLAND – TREATMENT (OPERATION)

Friday, May 15th, 2009

Unfortunately about 40 per cent of cases relapse when the drugs are stopped, and then operation is usually considered.

Operation with removal of most of the thyroid gland is used when medical treatment fails or where the gland is nodular or grossly enlarged.

In people over 40 radioactive iodine is the treatment chosen. Iodine is a major constituent of thyroxin and when the radioactive isotope is given it is taken up by the thyroid gland and the radiation destroys the over-active tissue.

The aim of operation is to remove about three-quarters of the gland and the remaining tissue is usually sufficient to maintain normality.

Occasionally, too much of the gland is removed or the other medical treatments destroy most of the gland and so the reverse condition of myxoedema may develop.

This is easily treated by giving patients thyroxin tablets which they have to take for the rest of their lives.

Occasionally the over-activity of the body and too rapid beating of the heart may lead to abnormalities of rhythm of the heart or even to heart failure.

The heart condition usually needs to be controlled before the thyroid gland can be adequately treated. In some people the onset of thyrotoxicosis seems to be precipitated by severe emotional shock.

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DOCTORS – INTRODUCTION

Friday, May 15th, 2009

No one’s perfect, and that applies to doctors just as much as other people.

Doctors increasingly are under attack in Australia and elsewhere. We are accused of thinking more of our incomes and status than of our patients.

We are accused by the political parties, by the media, and by the public.

Some of these criticisms are justified. But most are not.

But I will admit that we do have one fault. And to me, this is the basis of all the mistrust and lack of understanding which occurs between us and those we serve — our patients.

We don’t know how to communicate.

Most doctors are hard-working, competent, and concerned about their patients’ welfare. But we can’t seem to establish rapport, or a two-way communication, with our patients.

A doctor needs to be a good diagnostician — that is, he needs to find out what is wrong with the patient. And he needs to be a good therapist — he needs to know how to treat the patient’s complaint.

But the best diagnostician and the best therapist still may not satisfy the patient if the doctor is not capable of two further things.

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ANOREXIA NERVOSA – CASES

Tuesday, May 12th, 2009

Many cases seem to follow some sexual difficulty. This may only be the development of sexuality which comes with puberty or it may follow episodes of petting or intercourse which the girl cannot handle psychologically.

When the family is examined it is often found that there is a disturbance in family relationships. The outward appearance may be one of family harmony but beneath this calm lies well controlled hostility.

The mothers are usually domineering and rigid in outlook; both parents are intense and seek affection and approval from the girl to compensate for their hostility to each other.

Many theories have been advanced for the cause of this disorder, but at the moment there is no proof which is convincing. Freudian theory sees this as a rejection of sexuality or of pregnancy. Other psychiatrists see it as part of the obsessive-compulsive personality disorder or of depression. Whatever the cause, the treatment is difficult.

There does appear to be a disturbance in the body image the girl has of herself. A few start off being overweight, many are of normal weight, a few are underweight.

Despite the fact that the girl is obviously underweight to all other observers, she may insist that she is “just right” or “not too thin.”

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ASSESSMENT OF LYMPHATIC INVOLVEMENT

Tuesday, May 12th, 2009

You remember the lymph node system that I described in Chapter 2? How can we check whether or not the cancer has spread through this system?

Normal lymph channels are like cotton threads. Normal lymph nodes (glands) are soft, smaller than a pea and cannot be felt through the skin. If cancer gets into the lymphatic system it usually grows in the lymph nodes, making them bigger and harder. This is usually painless.

Much less often, lymph spread takes a different form—the cancer can actually grow in the lymph channels. If the affected channels are in the skin, the appearance is usually that of a raised, red ‘rash’. One of the most troublesome sites for this type of spread is in the lungs. The solid cores of cancer cells running through the lymphatic vessels make the lungs very stiff. This causes cough and shortness of breath. Unfortunately this problem can be hard to diagnose, because it is often difficult to see on an X-ray in the early stages.

If the cancer fills the nodes or blocks the lymph channels, it prevents that part of the lymph system from carrying out its usual job. One of these is to drain excess fluid from the tissues. So, for example, if the affected nodes are in the armpit, the arm may swell up.

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MEASLES – THE VACCINE

Tuesday, May 12th, 2009

If all women who are likely to conceive receive the vaccine, the complications from this disease will disappear. But each new group of girls should continue to be immunised. Constant reminders will be necessary as it becomes rarer.

Measles or morbilli, is a serious viral infection. Most children in cities have developed it before the age of 10. The incubation period is around 10 days.

The onset is abrupt, usually with a high temperature, cold-like symptoms, watery eyes and a harsh, dry cough. This cough is a marked feature and may suggest the diagnosis before the appearance of the rash.

The rash does not appear until the fourth day. It starts on the forehead and behind the ears and spreads to the face, trunk and limbs.

It is dusky pink, discrete and flat at the start, then becomes red, raised and blotchy. Koplik’s spots may be seen in the mouth before the rash and lead to a diagnosis. These are red with a bluish-white centre.

Complications are common with measles. Middle ear infection, bronchitis and pneumonia occur frequently. The potentially severe inflammation of the brain, encephalitis, can affect one case in 2000.

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CRITICAL PERIODS FOR FAT GAIN: PHYSIOLOGICAL

Friday, May 8th, 2009

Breaking through plateaus. The first process in dealing with plateaus is an acceptance of the fact that this is a normal and natural process. Provided there is no increase in fat mass, the plateau can be countered by attacking the causes. Dietary and exercise habits should be revisited and physiological adaptations to change can, at least theoretically, be ‘shocked’ into change. In terms of exercise load this will mean making physical activity less efficient by changing:

• intensity—increase the speed a regular movement is carried out

• duration—carry out the exercise for longer periods

• frequency—move more regularly (e.g. by adding ‘incidental’ exercise)

• type—vary walking with cycling, swimming, aerobics etc.

With food intake as the other side of the energy equation, plateaus might be countered by:

• decreasing energy intake—but only where this is still high

• increasing energy intake—by re-feeding where intake is excessively low (i.e. under 1000 kcal/day), and has been so for long periods

• decreasing fat intake further

• reducing alcohol intake

• changing food type—eating foods with which the body may not be familiar.

These changes might help an individual break through a plateau then restart and continue reducing fat. The introduction of resistance training as a form of exercise at this stage of a program may also be useful (if desired by the client), not only because of its ‘shock’ value, but also because of the potential maintenance of lean body tissue which can help counteract the physiological adaptations leading to plateauing.

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