May 21st, 2009
Epiglottitis is less common than croup but more serious. It occurs most commonly in the toddler and preschool age group.
Cause
Epiglottitis is caused by a germ (Haemophilus influenzae) which causes inflammation and swelling of the epiglottis. The epiglottis normally sits at the top of the windpipe and prevents food and liquid entering the windpipe during swallowing. When it is inflamed and swollen, the epiglottis blocks air flow, causing breathing difficulty and marked distress.
Clinical features
The onset of epiglottitis is very rapid. Unlike croup, where the child has symptoms of a cold before he develops a barking cough and stridor, epiglottitis develops rapidly in a child who has previously been perfectly well. Within a few hours the child is often desperately sick. He looks toxic and unwell, pale, with saliva drooling from his open mouth. He will often have a soft snoring noise when he breathes, and will sit well forward, refusing to lie down because it causes him further respiratory distress. He is irritable and restless, feels hot, and it is difficult to console him.
No investigations are indicated. The diagnosis of epiglottitis is made on the basis of a very rapid onset of symptoms in a previously well child, and characteristic clinical signs. In fact, no investigations or procedures (such as taking blood, measuring temperature) etc. should be performed if epiglottitis is suspected because they may distress the child and precipitate obstruction of the windpipe.
Treatment
If epiglottitis is suspected, the child must be transferred immediately to a hospital which has an intensive care unit. There a breathing tube is usually inserted to help the child breathe, and antibiotics given intravenously.
When to see your doctor
Epiglottitis is a medical emergency, and if it is suspected then medical assessment must be obtained immediately. Do not delay — it is literally a matter of life and death.
Prevention
Epiglottitis is preventable by having your child vaccinated against Haemophilus influenzae. This is commonly called the Hib vaccine, and is now available in Australia. Make sure your child is fully immunised. This will prevent him from contracting this and other potentially fatal diseases.
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May 19th, 2009
Losing a baby, at any stage of pregnancy, can be a devastating experience for parents. No matter how much we try to rationalise this experience or to be philosophical about it, we cannot negate the fact that emotionally we have experienced a loss. The conspiracy of silence that has surrounded miscarriage for so long only serves to reinforce the sense of isolation that parents may feel regarding their loss.
Miscarriage is common. One in five pregnancies ends in miscarriage, and 75% of these occur within the first 10 weeks. Most miscarriages that occur in the early stages of pregnancy are a result of an abnormality in the foetus. Sometimes the miscarriage is due to a blighted ovum, that is, an egg that was not fertilised but caused a ‘phantom pregnancy’. Some fertilised eggs simply do not develop properly, and are rejected by the mother’s body.
Miscarriages during the later stages of pregnancy can be due to numerous factors, cental insufficiency (a placenta which stops functioning properly).
Having a miscarriage is not an experience that you need to go through alone, and talking over your feelings with others who have had similar experiences may help to ease the burden of guilt (unfounded) that you may be carrying. It may also give you the opportunity to air the sadness that you are bound to feel. This will help to rebuild your confidence, and make you feel more positive about trying again. Talk to your partner, who will also be feeling down. Share your concerns, feelings of guilt, fantasies with each other. Couples who have gone through repeated miscarriages, or who have had difficulty conceiving, may experience a sense of grief with the onset of each period, as if they have lost another ‘potential child’. This is a perfectly normal reaction, and you both need to mourn for this too, in order to achieve acceptance of the loss and to heal the ‘wounds’. Not discussing these feelings openly with each other can lead to a sense of resentment and anger which may interfere with sexuality too. This can lead to a vicious cycle of anxiety about sex, which is exactly what you don’t need if you are trying to conceive again.
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May 18th, 2009
“He wants to put it up my butt. I hate it. It hurts. Why would anybody want to do that?”
ANSWER: Even though the rectum has connotations in our culture that make it seem dirty and corrupt, it is actually a very sensitive area. You know that, because you know how much it hurts you when he tries to enter you there. There is nothing unnatural about anal penetration. It is purely a matter of two things, preference and knowledge. The issue of preference can be addressed only by open communication. The issue of knowledge may help in this situation, because the facts may help you both to come up with a solution to your differences. The tissue in that area of the body is not only sensitive but can be damaged easily. Lubrication is important, so if you ever decide to do it, use a well-lubricated condom. Infection can be a problem, too, so make sure there is no cross-stimulation from the rectum to other areas of the body. Finally, it takes practice and cooperation to accomplish penetration of the anus. Practicing with slight insertion of the little finger and moving on to more and more penetration can help, and learning to relax the muscles in that area facilitates entry. Super marital sex rules indicate that the small-step approach can help here, with approximations of penetration aided by verbal fantasy of penetration. Surrendering or forcing only causes you both to relate such activity to the cultural orientation of “a pain in the ass.” An important super marital sex rule is that there should never be intentional mental or physical pain or coercion during any sexual interaction.
*247\97\8*
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May 15th, 2009
Treatment of hysteria is always difficult. It may take some time to arrive at the correct diagnosis and to exclude underlying organic illness.
Sometimes, hospitalisation may be necessary but this may give the hysteric an opportunity to observe those with organic illness, and so the symptoms may become more definite and closer to real illness and further delay proper evaluation.
The underlying inadequate personality of the hysteric makes complete recovery difficult. The aim of treatment should be to restore the person as a functioning unit of society, rather than seeking to fully unravel all the hidden conflicts which have precipitated the illness or remove all the symptoms which have developed.
Too many medical opinions and examinations are only likely to reinforce the symptoms and to create further invalidism. Those treating hysteria should remain non-judgmental and should not react to attempts to manipulate them.
Those of us with an uncompromising view of life may deplore malingering and even hysteria and show this in our attitudes to those exhibiting such symptoms.
*452/71/1*
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May 15th, 2009
An iron deficiency anaemia is likely to occur if there is blood loss and therefore iron loss as well.
The symptoms that may result from anaemia are tiredness and shortness of breath. With iron deficiency anaemia there are other symptoms such as a sore red tongue and there may be a reduced amount of acid secreted by the stomach leading to digestive problems.
The diagnosis of iron deficiency anaemia is made by simple tests of the blood to determine the amount of haemoglobin and also by looking at the red blood cells under the microscope.
They will be less in number and they are also smaller and paler than normal.
The amount of iron in the blood may be measured and this reflects the amount of iron stored in the tissues.
Treatment is simple — iron tablets are given by mouth, usually in the form of the salt, ferrous sulphate which is cheap and effective.
Sometimes iron tablets may upset the bowel, causing diarrohoea or constipation. The iron will also stain the patient’s motion black and the patient needs to be warned about this.
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April 29th, 2009
Weight loss can be caused by a number of physiological and psychological disorders, and if unexplained weight loss occurs, a medical practitioner should be consulted.
Intended weight loss for health or other reasons involves a number of factors. There are many theories regarding weight loss which encompass genetics, food intake and exercise. There is some evidence of a genetic predisposition to obesity and variations in metabolic function. There is also evidence, however, that while some people weigh considerably more than others but have the same food intake, those who weigh more do less exercise.
Most nutritionists agree that effective weight reduction involves a long-term change in eating patterns and behaviour and a gradual but significant increase in exercise. Fad or crash diets used for a short period actually reduce the amount of muscle and water in the body and weight is rapidly regained once the diet is discontinued.
Approaches to gradual weight loss include lowering fat and kilojoule intake while increasing the amount of fatburning exercise. Fat content is reduced by eliminating junk foods and refined sugar and reducing dairy products and fatty meats. Lowering the amount of fat in the diet should correspond with an increase in the intake of fruit, vegetables, legumes and grains. Drinking around 8 glasses of water a day is also recommended. Exercise involving at least three 20 minute periods per week will increase the metabolic rate and burn fat.
*80\69\2*
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April 28th, 2009
When musicians suddenly increase the duration and intensity of practice or playing they risk getting the overuse syndrome, a disorder that causes pain, weakness, and loss of function in certain muscles, the Lancet (2:728) reports. Playing string instruments causes this problem to occur in the upper limbs, but, with wind instruments, it is the lips, tongue, throat, and chest that are affected. In severe cases, stiffening and deformity may occur, with arthritis in the joints of the hands, arm, or spine.
To avoid the problem, musicians should not play continuously for long periods. Parents and teachers of children learning to play an instrument should not insist upon unbroken hour-long sessions of practice. Sporting activity and exercises that extend the range of motion of the spine and strengthen the muscles are helpful. Any repertoire that brings on pain or discomfort should be abandoned.
Lastly, supporting devices that take the weight of an instrument off the musicians’ arms can make a considerable difference. If partial resting fails to alleviate the pain and tenderness, the musician should give up playing completely for many months, until all of the symptoms have disappeared altogether. Other activities (e.g: writing or turning taps) that also bring on the symptoms must be abandoned, too. Medical care is necessary.
Only after the symptoms have cleared completely can the musician safely resume playing, starting with one minute twice daily and extending the time very gradually. Since the overuse syndrome can be so disabling and difficult to overcome, music performers need to be alert to the danger of playing for too long.
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April 28th, 2009
Symptom: Extra sounds made by the heart that are known not to indicate an abnormality
Home care: No home care is required for an innocent murmur.
Precautions:
- Believe your doctor’s assurance that innocent murmurs are normal.
- Do not make the mistake of over-protecting a child who has an innocent murmur; it is not necessary.
- Try not to be alarmed by the long medical names given to innocent murmurs.
- Most innocent murmurs disappear by the time the child is a teenager.
A heart murmur is an extra sound made by the heart as it pumps. A heart murmur may indicate abnormalities in the heart, or it may simply be a normal sound caused by turbulence as the blood rushes through the heart. The sounds that do not indicate heart disease or abnormalities are called “innocent murmurs,” “insignificant murmurs”, or “functional murmurs.” They are perfectly normal. Some experts believe that almost every healthy child has at least one innocent murmur, and if the child will stay still long enough in a quiet room a doctor will eventually be able to hear it. Other experts put the figure lower, at half of all normal children. As the child grows, the extra sound or sounds usually become increasingly hard to hear. By the time the child is a teenager, the murmur usually disappears, or becomes so quiet it cannot be detected. Only 15 to 20 percent of innocent murmurs continues into adolescence or adulthood.
*99/84/5*
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April 23rd, 2009
Every day, 17 people go to their death after going to work. Each year, more than 6,000 people are killed on the job-92 percent of whom are men. And you thought your home life was stressful?
As you might expect, those at greatest risk for dying on the job are men who work in the great outdoors, where the whims of Mother Nature often become a factor, says Guy A. Toscano, economist in the Office of Safety, Health, and Working Conditions at the Bureau of Labor Statistics in Washington, D.C. Fishermen and loggers have it the worst by far. While the national average for deaths on the job is 5 out of every 100,000 workers, these out-doormen die at rates 20 to 30 times higher- losing more than 100 workers and, in some years, even rates as high as 150, out of every 100,000 on the job. “Truck drivers, farmers, and construction laborers have occupations that have high fatality rates as well as high numbers of job-related fatal injuries as well,” says Toscano.
But as bad as those figures sound, things are actually better than they used to be. Back in 1912, when we knew (and some would say cared) less about job safety, between 18,000 and 21,000 workers a year lost their lives while earning their daily bread. By 1995, with a work force more than triple in size producing 13 times as many goods and services, occupational deaths had decreased by more than two-thirds. “We have become more aware of safety issues in society at large,” explains Michael Buchet, manager of the construction division and the labor division at the National Safety Council in Itasca, Illinois. “In industry, we’ve been encouraging safer workplace practices and are pushing for training, training, and more training.”
That said, after decades of progress, it seems harder to make gains in workplace safety these days, Toscano says. “We’ve clearly hit a plateau in that the number of fatal occupational injuries has held steady at the 6,000 to 6,500 mark for the past five years,” he says. “That doesn’t mean that we can’t make any more progress. But it does mean that safety professionals have to be willing to work harder to recognize risk and promote safety measures.”
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April 20th, 2009
Stress phobics must learn to like and respect themselves and to appreciate their talents and potentials. Here are a few guidelines for the stress phobic:
1. Begin by admitting to yourself that you have feelings, that you’re not without emotions.
2. At the start of each day, face yourself in the mirror. Acknowledge your problems and your feelings. Tell yourself what positive steps you’re going to take to handle a problem and how good you feel now that you’ve made the decision to change.
3. Look at yourself in the mirror and tell yourself how enthusiastic you feel—that you walk, talk and behave enthusiastically. Keep that spirited feeling with you all day. It will help you generate endorphins and other good biochemicals, and overcome obstacles.
4. Believe and act as if you are someone with worthwhile opinions and attitudes. You are. You are someone who deserves to be heard. Seek and you’ll find the method that will enable you to be heard.
5. Learn to speak up when you feel put upon. Gently but firmly pursue your goal. Your friends will have more respect for you when you assert yourself. Gather up the facts necessary to present your side of a discussion and state them in plain language. You’ll feel better when you express yourself; it’s a healing feeling.
6. Look for the opportunities that are present in your life to make beneficial changes. You aren’t fated to have poor health or to live in poverty. You are destined for optimal health and prosperity, and you must tell yourself so, believe it’s so and act upon that belief.
7. Learn to ferret out the causes of dissatisfaction in your life. Face them. Take the steps necessary to correct them, or learn to accept what you cannot change. In any case, get going with your life.
8. Learn to like yourself. The steps that follow will help you develop a sense of self-respect and worth.
9. If you’re not sure of your purpose in life, don’t worry. It will come to you eventually. In the meantime, get on with your life; life is to be lived.
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