The Health Blog

What about the neighbours?

Parents are always concerned about the reaction of neighbours when planning to implement these strategies for helping their children with their sleep problems. We recommend that parents tell their neighbours of the problem and of the planned intervention. The vast majority of people will be sympathetic and supportive once they are told, especially if the eventual outcome will be peace and quiet for everyone.

Use of medications

Drugs have a limited place in the treatment of sleep disorders. They are not the cure or the answer to these problems, and are probably used too frequently and for too long. The management of sleep problems in childhood revolves around the behavioural techniques described above. Most children will respond readily to these suggestions, and drugs are not needed.

In a small number of cases, medications are useful over a short term to break the cycle and give the behavioural techniques a better chance of working. They are given in full doses for 2-4 nights, then the dose is gradually reduced over the next week while the other strategies are being put into place.

Drugs should never be used as the only form of treatment of sleep problems, and should never be used for longer than two weeks.

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Avoiding constipation and subsequent straining at stool is an important part of reducing the frequency and severity of symptoms. Having a diet high in fibre is a good way of ensuring normal bowel function.

Sometimes, it may be necessary to use laxatives to ensure that the bowel works without undue strain. Bulk-forming or softening agents are better than harsh purgatives, as these latter may become habit-forming and the bowel gets lazy and requires larger doses.

Proper examination of the bowel is always necessary to exclude a primary cause for the bleeding, such as a cancer. It may be that some other condition such as a cancer of the rectum may be present as well.

Injection of haemorrhoids is a satisfactory method of dealing with first and early second degree piles. A solution, usually of phenol in almond oil, is injected into the mucosa around the dilated veins and causes clotting in the veins and eventual fibrosis, which occludes the dilated veins.

Another technique for second degree piles is to insert a proctostope to see the projecting pile and slip a small rubber band over it. This cuts off the blood supply at the base and, after a week or so, the obstructed pile sloughs off. This procedure is sometimes associated with secondary bleeding.

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If it hasn’t, this spongy lining is no longer needed and is shed. This is the period, or monthly bleeding.

When a woman’s reproductive life first starts, many of the cycles are anovulatory. This means that no ovum is released. At the menopause, the same thing happens.

The menarche, or onset of the periods, is occurring at a younger age. This is believed to be due to better nutrition as girls seem to be growing taller, quicker and to be reaching sexual maturity earlier.

Recent research seems to indicate that women are going through menopause at a later age and these factors are extending the menstruating years. Studies in Australia and Britain show that the average age for menopause is just over 50.

The assumption that those who started their periods early finish late, and vice-versa, appears not to be true. It also appears that the age at which the first child is born and the number of children the woman has does not influence menopause.

As the average age of the start of the periods is just over 13, most women can expect a menstruating life of nearly 37 years.

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This is a fairly rare disorder, occurring in perhaps one in 2000. It is an inherited disorder, and symptoms often start soon after birth. The main attributes are a diseased pancreas gland (which sits in the abdomen), chronic chest infections and a high level of solium in the sweat. A persistent early cough is often the first sign. A failure to thrive despite adequate food, diarrhoea and a distended abdomen generally follow.

Treatment

Treatment is usually difficult. Special antibiotics are needed, and the requirements may be ongoing. Specialist care centred in a major hospital which has full facilities is usually necessary. The final outlook is grave, and most patients perish before reaching adult life. Parents are cautioned that, being an inherited disorder, there is a one chance in four that with any subsequent pregnancy another child with the same disease could be born. It is a sad fact of life, but one worth knowing about.

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‘Danny is still wetting the bed at night,’ Sandra said. ‘By now he should have dry nights. I’m worried he may have something wrong with his bladder or kidneys.’

‘There are many variations to what we believe is normal,’ I replied. ‘Most children—in fact, about 90 per cent—manage to learn bladder control between the ages of eighteen months and five years. Very few manage it before they can walk properly, which is usually around the 18-month mark. The rest tend to wet the bed intermittently for a short while, but a few continue for quite a few years. It seems more probable in boys.’

‘That’s my problem,’ Sandra continued. ‘Danny may have several good nights in a row. Then, wow! several really bad ones in quick succession. He simply floods the place.’

‘It’s not unusual,’ I said. ‘And here’s the background to it…

‘It seems that children who continue to bed-wet often have bladders of smaller capacity than those who manage to have dry nights quicker. In fact, besides passing urine in bed during the night, they tend to pass it more frequently during the day. Not that they pass more during a 24-hour period but simply because their bladder is able to accommodate only a smaller volume.

‘The best time to start to teach bladder control is in the 15-24 month age. Training should be gradual and non-coercive, I feel, with tolerance to accidents, which hopefully will gradually lessen. Of course, some parents try to outdo their neighbours and have their child learning “good habits” much too early. They are coercive, and this may often have the reverse effect on the young child, who becomes confused about it all, or builds up resentment, and finally does the exact opposite to what the parents want.’

‘I’ve tried to be very subtle about it all,’ Sandra said. ‘We’ve never made an issue about it. We accept it all and endeavour to encourage Danny all the way. We do make a big thing out of successes and try to play down failures. But, it still goes on…’

‘Very often hidden underlying factors may play a part. Frequently there are emotional situations which may not be apparent to the parent but which are playing a major part in Danny’s outlook and reactions.’

‘I’ve often wondered about this,’ Sandra said. ‘My husband Jim lives a very busy life and has never-ending business commitments. He is frequently called interstate on business matters, and fairly regularly simply vanishes from the home scene, for several days at a time.

‘I wonder if Danny worries about this, whether he feels neglected or harbours resentment. When Jim returns he always makes a big fuss with Danny. Then, bingo! A week later he’s off again on another trip. I’ve sometimes noted—although I haven’t kept accurate records—that the bed-wetting bit is often worse when Jim is away. I have wondered, and so has Jim.’

‘It is quite probable that Danny feels neglect or resentment at being suddenly deprived of his dad, especially as he is made such a fuss of when Dad’s around. It may be his way of telling you he wants more tender, loving care without the sudden breaks.

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Finger and toenails are made from a specialised kind of skin cell. The stratum lucidum, the cell layer which separates the dermis and epidermis layers of the skin, hardens as the fingers and toes of the foetus develop in the womb. Nail cells are living when they have not yet emerged from under the skin but are dead from the ‘moon’ of the nail outwards. Nevertheless, this dead cell material can vary in texture, strength and flexibility depending on the condition of the original living cells, the nail bed, a person’s general health and environmental factors.

While strong and healthy nails in themselves are desirable, weak, splitting, discoloured or ridged nails can tell us much about our nutrition and overall health. For example, white spots can indicate zinc or Vitamin A deficiency. Ridging and brittleness can point to a sluggishness of the thyroid or poor circulation. White pits or grooves can result from anaemia or calcium imbalance, and spooning can indicate low iron levels. These deficiencies can be overcome with dietary adjustment and vitamin or mineral supplements. Some tests have shown that taking gelatin or silicon helps increase the flexibility of the nail.

However, external factors such as detergents, solvents, and, ironically, manicure preparations themselves, are the most common causes of nail defects. Damage to the cuticle when manicuring can lead to a variety of infections. Nail polish removers contain solvents which can seriously dehydrate the nail. Avoid acetone removers or look for a brand which contains moisturising oil. Even polishes can cause acute allergic reactions resulting in inflammation and marking of the nail surface. Fungal infections under the nail occur when the hands are wet too often. To avoid this and limit the damage caused by detergents and high alkaline soaps, protect the hands with gloves when cleaning, washing and gardening. Nail brittleness increases with age.

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Coughing is a valuable defense mechanism of the body. It is the body’s way of removing any foreign material that enters the respiratory tree (the organs used for breathing). The respiratory tree includes the throat, larynx, trachea, bronchial tubes, and lungs. Coughing is not a disease itself. It is an automatic reflex that is set off by any foreign matter that enters the respiratory tree or by any irritation of the lining of the tree.

In most cases, coughing helps remove unwanted materials from the body, although sometimes coughing does not succeed. The only harm in a cough is that it may keep a person from sleeping, or it may cause sore muscles and exhaustion if the cough is hard and frequent. Coughing may also lead to vomiting.

A cough is only as serious as the disease or condition that causes it. As with a fever, a child with a cough is no less ill if you lessen or stop the cough. A child with a mild illness and a cough is still only mildly ill. To correct the cough, cure the disease.

Signs and symptoms

Coughing is itself a symptom of a disease or of an irritating substance in the respiratory tree. Most coughs are caused by viruses (common colds, croup and bronchitis). Some are caused by bacteria (sinusitis, epiglottitis, bacterial pneumonia, whooping cough). Other coughs are caused by allergies (asthma) or by inhaling irritating particles from the air.

Home care

Since coughing is only one symptom of an illness, you must treat the whole illness – not just the cough. When the illness is cured, coughing and other symptoms will be relieved. There are, however, steps you can take to help relieve coughing.

Give the child plenty of liquids. Use a vaporizer or humidifier to add moisture to the air. Cough medicines are sometimes useful. There are, however, different types of cough medicines, which are used for different types of coughs or for different types of illness.

Cough suppressants are used to reduce the frequency of the cough by suppressing the cough reflex; they may contain a narcotic (codeine, dihydrocodeinone, or hydromorphine) or a non-narcotic (dextromethorphan or benzonatate). Consult your doctor before using a narcotic cough suppressant.

Cough looseners are used to loosen a tight cough; they contain an expectorant (glyceryl-guaiacolate, guaifenesin, ammonium chloride, or antimony potassium tartate), which may help the person cough mucus out of the lungs.

Cough tighteners are used to dry up a loose cough; they contain a decongestant (ephedrine, pseudoephedrine, phenylpropanolamine, or homatropine).

Anti-allergy drugs are used to fight the allergy causing the cough; they contain ephedrine or an antihistamine. Some cough medicines contain a combination of ingredients and are intended to serve more than one purpose at the same time. Many different combinations of drugs are on the market in liquid form or as tablets or capsules. Before purchasing a cough medicine for home use, consult your doctor about the type of cough medicine (if any) that should be used.

Remember also that sometimes it is better not to try to suppress the cough. In some illnesses (especially asthma and pneumonia), coughing helps the child get rid of excess mucus in the lungs or air passages.

Precautions

• Do not give cough medicine to a child with croup.

• Do not give cough medicine to a child with any breathing difficulty unless you know you are treating asthma, and then give only anti-asthma drugs.

• Do not give cough medicine to a child who may have inhaled a foreign body.

Medical treatment

Your doctor will concentrate on treating the condition causing the cough, not on the cough itself. Narcotic cough medicines and some with antihistamines require a doctor’s prescription.

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Men don’t stretch. And for good reason: They hate it.

“Stretching’s just not fun,” says Janet Sobel, a physical therapist and clinical specialist at National Rehab Hospital/Suburban Regional Rehab in Chevy Chase, Maryland. “The results aren’t visible. No muscles bulge. And you don’t look cool doing it.”

But stretching is a joint-saver, according to Sobel, as well as a circulation-promoter, a performance-enhancer, and an injury-preventer. All of those things are important for disease prevention. “Stretching doesn’t directly decrease the likelihood of disease,” Sobel says. “But by enabling you to exercise without injury, it enables you to do what you need to do to minimize your disease risk.”

Here’s how to ride the stretch limousine to better health.

Stretch daily (or almost). “Stretching should be like brushing your teeth,” says Barbara Sanders, Ph.D., chairman of the physical therapy department at Southwest Texas State University in San Marcos. “It should be part of your daily routine.” Since we’re talking about only a few minutes to do a handful of stretches that require no equipment, you’ll probably find seven days a week doable and even enjoyable. But five is an acceptable minimum, Sobel says. “You’re not going to see results if you do it every other day,” she says. “But if you do it five days a week, it will pay off.”

Hold the stretch, but not your breath. To get the big benefits, you should hold each stretch for 20 to 30 seconds and repeat two or three times, Sobel says. And hold it still – no bouncing. At first you’ll notice a temptation to hold your breath as you hold the stretch. Resist it. “Breathing is very important,” Sobel says. “If you don’t breathe, you’re going to tighten up and it will hurt. That’s counterproductive.”

Stretch for as long as it takes. And that’s not very long. The only requirement is to work all the major body areas. “A basic stretch routine will be six to eight stretches,” Sobel says. Three repetitions of six stretches at 20 seconds each is six minutes. You spend more time than that looking for your bathrobe in the morning.

Just do what you can. What’s the most annoying moment in those stretching classes at your health club? How about when the instructor tells you not to worry if you can’t go “all the way” in some stretch that looks like it was invented by one of those contortionists in Chinese circuses? All the way? You can’t even begin it.

Don’t even try, Sobel advises. “Get as close as you can until you feel a comfortable pull, but not pain,” she says. “Be attentive to your body’s signals. Each person has his own genetic design, and you want to achieve your own potential, not someone else’s. Ultimately, you’ll get there.”

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It would be quite wrong to suggest that all illness could be abolished by ‘right living’, but there is no doubt that changing one’s lifestyle and behaviour even a little can result in a greater resistance to illness and quicker recovery from disease.

Most of us have become sloppy about the way we run our lives and often have only ourselves to blame when things go wrong. We flagrantly abuse our minds and bodies and then wonder why they let us down. I put ‘minds’ first because as many as three-quarters of all symptoms are caused by emotional and psychological disease. Don’t forget that the largest group of prescriptions written in most western countries is for mind-altering drugs. We also try to cope with the stresses and strains of modern life by the frequent consumption of cigarettes, alcohol and caffeine- and cola-containing drinks-all of which have provable harmful effects, at least in some people.

It is an old truism that ‘you are what you eat’ and it is certainly a fact that you can only get the nutrients essential for the healthy working of your body by eating them.

We are all brought up to believe in the ‘balanced diet’ but the adequacy of the sort of protein-and-two-veg regime generally designated by this phrase is almost certainly a myth. A 1980 study (and there have been many over the years throughout the western world) found that only 15 per cent of the UK residents interviewed were consuming a diet that could provide even the minimum dietary requirements as laid down by the Department of Health and Social Security and these are themselves reckoned to be too low by many experts. In the USA two workers did a detailed study of 860 dental patients and found that almost half had frank vitamin and mineral deficiency states and that 6 per cent had no vitamin Ñ in their blood at all. Another US study found that 88 per cent of 120 randomly selected people had a significant deficiency of at least one vitamin and that 63 per cent were deficient in more than one. As we learn more about minerals it is becoming apparent that most people are short of these too.

Unfortunately, most people think that if they eat a little of a wide variety of foods their body will somehow balance out the goodies and end up healthy. Modern research has proved otherwise. Evidence now suggests that modern farming practices, which deplete the levels of essential nutrients in the soil by intensive cropping, mean that even the starting point-plants and animals from agricultural sources-are poor in all kinds of essential substances. Intensive farming methods, drugs used to fatten animals and so on, have provable negative effects on our health and nutrition. A further loss of vitamins and minerals occurs between the picking and the eating as modern food processing removes much of what is left. Few people realize the grave deficiencies of their modern diet, yet government departments repeatedly assure us that all is well.

All the above assumes that the consumer is really trying to eat healthily-and I am saying that this is very difficult to do, however well motivated one is. But the vast majority of the population doesn’t try. They consume large amounts of sugar, white-flour products, fat and alcohol, and suffer considerable nutritional deficiencies as a result.

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Travel sickness is a problem that many of us have had to cope with especially if we have children. Children are quite often sick in the car, or in the boat, or in the plane, or any time that they are subject to motion.

When children get travel sickness or motion sickness there are quite a few things you can do and one of the most important is to keep them busy and occupied. Word games are a good idea as they have to keep looking out of the window and so they are not looking at things within the car. Reading while driving is not a good idea as it can upset their balance and cause them to be sick. Encourage them to look at the scenery and point out things as they are going along. Most effective is to put the sick child in the front seat.

Don’t let them eat greasy foods and fill them up with foods that are going to make them nauseous. What you should be looking at is to give the children wholesome foods the night before and a small breakfast before travelling as it is very important that they do have something to eat and drink.

One of the things that I have used successfully is ginger. Ginger is often used in cooking, but to take ginger before you go on the trip and during the trip, can really make a difference in the prevention of motion sickness. It does not have the harsh side effects of some antihistamines and other travel-sickness medications. Ginger is gentle to the stomach, helps with flatulence, and also helps the digestive system.

SUPPLEMENTS

Travel Calm Ginger l tablet 2 hours before travel then 1

tablet every hour during travel.

vitamin B6 50 mg daily

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