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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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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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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.

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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.

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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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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.

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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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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.

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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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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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Whether you’re 30 or 70, you want your muscles to be well exercised and toned. Without good muscle tone we feel tired and weak and have difficulty at work, home and play. I use a dynamometer to measure the muscle strength in the hands of my patients. I find that people who can squeeze only 30 or 40 pounds of pressure can double or triple that figure after a simple exercise program. I’m not suggesting that you need to develop a bodybuilder’s physique. Muscles do not need to be bulky, but they should be toned. Depending on the exercise, you can tone and stengthen various muscles in your body to give yourself a feeling of health and put a spring in your step.

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If you carefully read the labels, you’ll find that many packaged, canned and frozen items have very little real food left in them, and even less real food value. Many of their nutrients have been heated, frozen, processed or leached out. What you get is the food “shell,” along with large dollops of added fat, salt, sugar and chemicals. Occasionally, you also receive just enough spray-on vitamins to satisfy government regulations.

Nature fills her foods with nutrients. Man fills his foods with fat, sugar, salt, fillers, modifiers, texturizers, flavorers, preservatives and coloring agents. I am awed by the creativity of food chemists, but I am appalled by their lack of concern for our health.

Compare a real potato, for example, to a typical brand of artificially flavored mashed potatoes. A potato contains potato. Artificially flavored mashed potatoes contain potato flakes, monoglycerides, natural and artificial flavors, sodium bisulfite, calcium stearoyllactylate, BHA and BHT, sodium acid pyrophosphate and citric acid. Now, I’m not saying that everything in artificial potatoes is harmful. But why take a chance when the alternative is a tasty, 100 percent safe and nutritious potato? It comes back to the general rule: Did Nature make the food or did man? Nature makes potatoes. Man makes artificial potatoes.

Fast foods are also a health problem, for the same reason that processed foods are. The people who make fast foods and processed foods load their products with fat, sugar, refined carbohydrates, salt and chemical additives.

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Your “doctor within” is an interlocking system, so some problems may affect more than one part of your “doctor within.” Depression, which is linked to a biochemical imbalance in the brain, can also trigger the release of high-voltage chemicals that can weaken the immune system. Anger and hatred spur the production of supercharged chemicals, which may hasten a heart attack.

Think of your “doctor within” as your shield. If you drop that shield, even a little, you’re exposing yourself to disease. What kind of disease? Anything from a heart attack to herpes. But remember, the heart attacks, herpes and other disorders are really symptoms. The real problem is a breakdown of your “doctor within.” The weak link may be in the immune system, it may be in the mind, it may be improper regulation of blood pressure or blood sugar. But the immune system, the mind and the mechanisms that oversee blood pressure and blood sugar are all part of your “doctor within.”

That’s why I say that most of the diseases we get are really failures of our “doctor within.” You can call them heart disease or infections or herpes or depression or stroke or high blood pressure or cancer, but the truth is that they are all due to a breakdown of your natural defenses. If your “doctor within” is strong, you can shrug off most diseases. That’s what this book is all about: keeping your “doctor within” in tip-top shape.

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Stiff joints also seem to be a fact of life for many people, beginning at about age 40. The health of joints depends on the strength of the muscles supporting them. Regular exercise—walking or running, weightlifting—is essential if you are to hold your own in the battle with aging muscles and joints.

Lower-back pain is also more common among people in their 40s and 50s. Researchers say that a slow, natural degeneration of the disks that cushion the vertebrae and stress can both contribute to back problems in middle-age people. But most people can overcome the pain and prevent further problems by strengthening the lower body and abdominal muscles through exercise.

2) Bone deterioration— strong bones are essential in order to prevent osteoporosis, a health problem which often afflicts older women. Osteoporosis causes bones*to become thin and porous enough to fracture or break easily. The condition accelerates at menopause and affects about 25 percent of women older than 65.

Studies have shown that the stronger a women’s bones are before menopause, the better her chances of avoiding osteoporosis. Adequate calcium intake and regular weight-bearing exercise—walking or running—are recommended to all women to ensure dense bones.

3) Sex— for most women, the hormonal shifts of menopause have little or no effect on desire or responsiveness. Many women at menopause, however, find sexual intercourse painful because of a drying and thinning of vaginal tissues. Many experts agree that the best treatment is to remain sexually active. Studies reveal that postmenopausal women who keep sexually active— with sexual intercourse at least once or twice a week—have considerably less vaginal atrophy than sexually inactive women.

As for men, evidence indicates that older men who keep in good physical condition can apparently maintain their output of sex hormones at the levels of young men. In fact, studies show that both men and women can enjoy sex into their eighties and beyond.

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Homes with unvented kerosene or gas heaters, leaking chimneys and furnaces, and gas stoves are all at risk of carbon monoxide exposure. Low concentration of carbon monoxide can cause fatigue in healthy people and chest pain in those with heart disease. Higher exposures can cause impaired vision and coordination, dizziness, nausea, and death.

Here are several ways you can reduce the risk of carbon monoxide exposure in your home:

1) If possible, install a vented gas furnace and space heaters.

2) Have a trained professional inspect and clean your central heating system once a year.

3) If you have a gas stove, install an exhaust fan vented to the outdoors.

4) Don’t use charcoal indoors because it produces deadly amounts of CO (carbon monoxide).

A new device recently approved by Underwriters Laboratories is designed to prevent death from carbon monoxide poisoning. The new device resembles a smoke detector and is supposed to sound an alarm if the carbon monoxide in the air nears a dangerous level.

Records indicate that most of the 230 cases of fatal carbon monoxide poisoning reported each year are due to faulty appliances or damaged chimneys and vents. Others result from automobile exhaust in houses that have attached garages.

The new carbon monoxide detectors can operate on batteries or they can be plugged into a household electric outlet. Their sensors, unlike those in smoke detectors, must be replaced every 3 to 5 years, and cost from $15 to $20. The detectors themselves sell for $50 to $70.

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1) Breathe slowly and deeply. Let your head drop forward, then cup the back of your neck with your hands. Press gently, so you will stretch your neck muscles without straining them.

2) Using thumbs and fingers, massage the back of your neck from the base of your skull down to your upper back.

3) As your muscles begin to relax, massage up from your shoulders to the back of your head, then around both sides of your head to your temples and back down again. Continue until your muscles are completely relaxed.

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2) Running— this exercise offers excellent long-term fat-burning potential. The injury risk with running is considered moderate for less than 35 miles per week and very high for more than 35 miles a week. The only equipment needed to start running is a pair of good running shoes.

3) Cycling— the long-term fat-burning potential from cycling is moderate. The injury risk from the exercise itself is low, but can be high if you cycle in areas of high traffic. Since it uses fewer muscles than running, and because it is not weight-bearing, you have to cycle about 40 minutes to equal 20 minutes of running or jogging.

4) Walking— if the total walking time is 30 minutes or less, or if the walking speed is less than 15 minutes a mile, the long-term fat-burning potential is moderate to low. II the walking time is more than 30 minutes, or the walking speed is more than 15 minutes a mile, the long-term fat-burning potential is moderate. The risk of injury with walking is

low.

In order to get maximum fat-burning benefits from walking you should try to set a brisk pace of at least 100 steps a minute and less than 20 minutes a mile. About 4< minutes of brisk walking is equal to 20 minutes of jogging.

5) Swimming— both the long-term fat-burning potential and injury risk are low Swimming is actually the most injury-free sport and it provides excellent benefits for th< cardiovascular system. It also tones practically all muscles. However, if you are overweight, swimming should not be your only exercise. Of all the people tested fo body fat, swimmers usually carry more fat than either runners or cyclists.

While swimming will help keep you lean and fit, you will not lose fat as fast as you would with land sports. Even with that drawback, swimming is a good starting program for overweight people who aren’t used to exercise.

6) Rowing— the long-term fat burning potential of rowing is high, and the injury risk is low. Either indoors or outdoors, rowing is an excellent fat- consuming exercise. It exercises most of the large muscle groups without placing stress on joints and it also helps develop the muscles of the upper body. It should also be noted that rowing causes back problems in some people.

7) Stair-climbing— while the long-term fat-burning potential with this exercise is high, the risk of injury is moderately low. While you are not really simulating stair-climbing, this exercise does require as much energy as running. But it places only about the same amount of stress on the joints as walking.

Treadmill— depending on the incline and speed, the long-term fat-burning potential is moderate to high. The injury risk is low. Treadmills require a good deal of balance and involvement, which enhances the exerciser’s motivation. The best pace on a treadmill is a fast walk or a slow jog.

9) Stationary Bicycling— like its counterpart outdoor cycling, the long-term fat-burning potential is moderate, and the injury risk is low with stationary bicycling. Stationary bikes are both stable and easy to use. This type of exercising has become popular because you can do two things at one time— exercise, and read a book or watch television.

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To avoid consuming an excessive number of calories in the things you drink, try giving up cola. Most colas are overloaded with calories and have very little nutritional value. Instead of cola, try substituting more healthful drinks such as club soda, decaffeinated tea and coffee, fruit juices, and of course, water

This Tastes Just Like Chocolate… Plus It’s Healthy

You might not want to hear it, but chocolate is not especially good for you. Besides being fattening, it also contains a chemical—tyramine—which can trigger headaches. And since it is nearly all fat and contains caffeine, it should be avoided at all costs if you’re suffering from heartburn.

There is some good news, however. For those people who love the taste of chocolate, many people have found that “chocolate” frozen yogurt actually tastes like real chocolate, and it’s a healthier choice for dessert, or anytime. Try it!

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