Blog About Health & Medicine

The frequency of bowel movements varies greatly from individual to individual, and also depends on age, so it is difficult to give a precise definition for the word ‘constipation’. Babies may have as many as four or more bowel movements each day, especially if they are breastfed. On the other hand, some may have a single movement daily, or even less often. Constipation is best considered as a reduction in a child’s usual frequency of passing stools, often associated with pain and difficulty in passing a bowel movement.

Investigations

Sometimes the doctor will order an X-ray of the child’s abdomen to document the extent of the child’s constipation. If the doctor suspects that there may be neurological or other reasons for the constipation, he may order other special investigations, but this will be very uncommon.

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Many parents choose to bottle-feed their baby using humanised formula. Modern formulas are derived from cow’s milk, and are modified to resemble breastmilk nutritionally although they do not carry the same protection against infection.

Strict attention must be paid to sterilisation of equipment and only freshly prepared formula should be used, following the manufacturer’s instructions closely. Be accurate with amounts, as deviations from those recommended may give your baby diarrhoea or constipation. Always wash your hands thoroughly before starting, and make sure that the water has been boiled for at least 5 minutes then cooled before mixing. Prepared formula should be stored in the refrigerator for no more than 24 hours; after this time it should be discarded due to the risk of contamination. Never reheat formula after it has been used. When transporting milk, it is best to keep it chilled to prevent the formation of bacteria.

The amount and frequency of feeds will vary from baby to baby, and is best determined according to demand. Most babies will initially require feeds every 3-4 hours. Feeding time is usually around 20-30 minutes duration and your baby may need to stop halfway through a feed to be burped. You can prevent your baby from developing excessive wind by ensuring that you hold the bottle at an angle so that no air can pass into the teat. If your baby does not wish to finish the whole bottle, do not try to force him.

The same intimacy can be achieved between you and your baby while bottle-feeding, as with breastfeeding. The biggest advantage of bottle-feeds is that the father can share equally in the experience. Feeding is a time for closeness and pleasure for both parent and child, no matter which method you decide to use.

A small proportion of babies may be allergic to cow’s milk protein, and soya milk formulas may be a preferable alternative. If you feel that your baby cannot tolerate cow’s milk formulas, speak to your maternal and child health nurse, or your doctor.

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LOVE REACTION: Loss can emphasize the value of the presence of others, and the bereaved spouse may turn to the partner for a renewal of intimacy and love. If the partner is puzzled by such a need, by a request for romance at this time of sadness, or if the partner overtly or covertly rejects such a longing for love and its manifestation through sex, hostility and anger can result, worsening the grief reaction and even jeopardizing general health.

Sometimes the grieving partner “tests” his or her own relationship for love at the time of loss, making sure his or her most important source of social and intimate support is still intact. An unsuspecting partner may “flunk” this love test, never knowing that he or she has been tested, and the grieving partner sinks further into depression at what he or she sees as yet another loss.

SEXUAL WITHDRAWAL: Bereavement Brings with it a range of physical and emotional reactions. Nausea, disequilibrium, muscle and joint pain, chronic headache, sweating and chills, bowel and urinary disruption, and other symptoms of bereavement are not uncommon and may delay return to sexual intimacy.

Emotionally, guilt or self-blame regarding the loss may result in a self-imposed compensatory celibacy, a paying of penance for imaginary or real responsibility for the loss. The partner’s attempts to break through such withdrawal may be perceived as insensitivity, and the partner may become a target for projection of the blame and self-recrimination felt by the bereaved.

Sometimes a compulsive searching is part of the grieving process; searching for the lost person and the feelings lost because of the bereavement. This cognitive and emotional wandering results in a distractability that represents yet another form of sexual withdrawal. It may show in listlessness, lack of attention, fading in and out of attention, failure to listen, and long periods of passivity and for the marital partner.

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Love is an emotional experience, a deep feeling. It just happens. You don’t have to do anything about it, it sort of does everything to you. You have to let it happen.

HUSBAND

I referred earlier to the “smitten” aspect of the mythology of love. We expect love to happen to us, that we are somehow full of pre-planted love seeds that sprout spontaneously in response to a person who stimulates them. We feel that we ourselves have little to do with love, because it overwhelms us. Cartoon characters develop a silly grin, their eyes gloss over, and their heart may grow inside their chest, throbbing to the breaking point. We assume that we are stationary targets for love arrows, targets more than archers.

“I know he was probably the worst thing that could ever have happened to me, but I just could not help myself. Love is blind, and so was I. He turned me inside out.” This report from one of the wives illustrates the assumption of love as an involuntary reflex.

Psychiatrist Scott Peck states, “Of all the misconceptions about love, the most powerful and pervasive is the belief that ‘falling in love’ is love.” We do fall in “limerence,” but love itself, loving, is not a reflex, it is a volitional act. We decide to love. All love is a conscious decision, not a helpless mammalian legacy.

One of the key steps in helping couples discover super marital sex was to re-teach them about the voluntary nature of love. If they clung to the assumption of love as a helpless, “willing victim” state, then they were trapped into the conclusion that once the reflex mysteriously “went away,” it was gone for good. At best they had to wait for it to return again, to be rekindled by some mysterious evolutionary biochemical spark. You “do” love, you do not get it, for “it” is not a thing. Love is a dynamic, volitional process that takes place within a system.

“I lost it, and I don’t remember really when. Love just went out of our life,” stated one of the wives.

“Yes,” said the husband, “We sort of became brother and sister one day. It was probably gradual, but the light went out.”

Our “love light” is not automatic.

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The tongue can give the doctor a clue to diagnosis. Coating or furring of the tongue is not really diagnostic of any one condition.

It is often furred in smokers, in mouth breathers and in those with poor oral hygiene. And it becomes coated during the course of any feverish illness or even with a simple digestive upset.

The tongue becomes dry and coated in dehydration and this can be a good indicator of the fluid balance of the body.

Where the tongue is coated in some parts but smooth in others is called the “geographic” tongue as it looks like a map. There are usually no other symptoms.

It is believed that this is due to emotional factors and seen only in anxious individuals. It requires no treatment.

In the past mothers used to worry whether their children were tongue-tied.

The frenulum is a band of tissue under the tongue which anchors it to the floor of the mouth. True tongue-tie is rare. The frenulum is short and this prevents the child from extruding the tongue.

If the child can put the tongue beyond the bottom teeth there is no problem.

Some tongues have deep fissures or cracks and an older generation of doctors looked for this sign as one indication of syphilis. But some people have inherited this condition and with them fissures in the tongue are normal.

An ulcer at the side of the tongue can come from an ill-fitting denture or a broken tooth. It can also be due to cancer.

In some anaemias the tongue loses it papillae (the taste buds) and becomes smooth, shiny and sore.

Leukoplakia is a pre-cancerous condition. The tongue becomes dry with a thick, white deposit like dry, cracked, old paint. This is mostly seen in elderly heavy smokers with poor mouth hygiene.

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Many examinations, even in the non-clinical subjects, are oral rather than written. Why, then, do we become inarticulate with our patients?

Perhaps it’s because of lack of time — too many people to see in too few hours. Perhaps it is because of lack of teaching in this respect in the medical school — an over-concentration on disease rather than on people.

Whatever the reason, this lack of communication does exist.

Most doctors would be unprepared to enter into a debate with a patient as to the merits of one antibiotic over another, based on that patient’s reading of an article in a magazine.

But I do think that every patient has the right to expect a simple explanation of what the doctor thinks is wrong with him and what he intends to do about it. And what side-effects he may expect from the treatment.

It doesn’t take long — perhaps two or three minutes. But I think that these two or three minutes are the most important part of the consultation.

Most consultations with the doctor are for minor illnesses — the patient really wants reassurance. And if he doesn’t get it, he is dissatisfied.

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Mumps (epidemic parotitis) is an infection caused by a virus. This affects the salivary glands, especially the parotid gland which lies in front of and below the ear.

The incubation period is about three weeks. The illness usually appears as fever and enlargement, pain and tenderness of one or both parotid glands. There may be difficulty in opening the mouth and in eating and drinking.

The illness rarely lasts beyond one week, unless one of the complications sets in.

As in other viral infections the brain may become involved, causing an encephalitis.

In young men and boys beyond puberty, the testes may be involved. When orchitis (inflammation of the testes) is present, there is usually a high temperature and considerable pain.

As a rule, only one testis is involved but, occasionally, both may be.

Cortisone may be used in an attempt to reduce the inflammation, as atrophy (shrinking of the testis) may occur and it may lose its function.

Involvement of the testes before puberty is rare.

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Jogging and Overweight

Overweight people trying to shed pounds would be wiser not to do so by jogging. Bones and joints in the legs and feet can be severely stressed by this type of exercise when one is overweight. The combination of running and excess weight can even crack the bones of the pelvis in otherwise fit young people, according to Medical World News (23#25:57). The cracked bone causes aching in the buttock with hip move ments, and requires that, for six weeks, all activities that produce the pain be stopped.

Exercise can certainly help dieters. However, it should be of a kind that does not overly stress weight-bearing structures in the lower limbs. Walking three or four miles a day or working up a sweat on an exercycle or rowing machine is helpful and safe. It is better to lose weight by other means first before taking up running or jogging.

Is Jogging Safe?

Every year, just enough slim young people collapse and die while jogging that many physicians hesitate to recommend this form of exercise. At autopsy, the heart muscle in these cases usually looks as if it has not been getting enough blood supply. Until recently, however, the cause of this has been a mystery, since the young victims’ coronary arteries are rarely found to be narrowed by fat and cholesterol deposits (atherosclerosis).

Now, it seems, the mystery has been solved by the discovery of “bridges” of heart muscle across the coronary arteries. When the muscle contracts, the bridges squeeze the coronary arteries and thus reduce the amount of blood they can deliver to the heart muscle. Since the bridges are part of the heart’s muscular wall, coronary blood flow is reduced most severely during exercise when the heart is beating faster and more forcibly than usual. There could be no worse time for this to happen.

Since few of us know whether or not we have this abnormality (only 1 percent of us do), it is recommended that we avoid exercising our hearts past the point where bridges, if present, would tighten excessively around our vessels.

According to a report in Medical World News, this means not letting your pulse rate exceed 150 per minute. If your pulse beats faster than this during exercise, rest until it slows down and thereafter exercise more slowly. By training, you will more easily be able to keep your pulse below 150.

Leg and lower body exercise, as in jogging, has become a national compulsion which, as the body ages, may do more harm than good, the editorial writer in Modern Medicine suspects. The trauma of repeatedly pounding one’s feet on pavement while jogging, he points out, damages the ankles, knees, hips, and spine because the human body (unlike the bodies of four-legged animals) is just not well designed for endurance running.

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Signs and symptoms

The condition exists if one or both testes do not rest in the scrotum at birth. However, an undescended testis must be distinguished from a migratory or retractile testis. A migrating or retractile testis has completed its descent into the scrotum, but has risen temporarily into the groin. A migratory or retractile testis returns to its normal position as a boy matures, and it needs no correction. If the size of the scrotum is normal, the testis is migrating; if it is small, the testis is undescended. An undescended testis sometimes can be felt in the groin, but it may be mistaken for a hernia or a swollen lymph gland.

Home care

If a testis appears to be missing from the scrotum after birth, check periodically to see if it has descended of its own accord. To check for an undescended testis, place the child in a tub of warm water and pull his knees up toward his chest. If the testis is migratory it will often descend into the scrotum. If the testis is undescended, it will not.

Precautions

• Don’t worry the child by discussing the condition. An undescended testis can usually be corrected.

• Do not postpone correction of an undescended testis. It should be corrected when the boy is between four and seven years old.

• A boy with an undescended testis has an increased chance of an inguinal hernia.

Medical treatment

Your doctor will examine the child’s scrotum and groin carefully and check for the presence of a hernia, which often accompanies an undescended testis. Some doctors give hormone injections to encourage the testis to descend, but most prefer to perform surgery when the child is between the ages of four and seven, and not to use hormones at all.

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•    Breastfeed your children totally for at least the first six months. Wean them on to sugar-free, unrefined whole-foods right from the start of solids.

•     Discourage a taste for sweet foods. Read labels carefully and avoid foods and drinks with added sugar. If you can’t ban sweets altogether, give them in batches after meals rather than letting children eat them between meals; or have a ’sweet day’ once a week when the children can eat sweets to their heart’s content and then prohibit them during the rest of the week.

•     Give them fruit or savory foods for school snacks and discourage them from buying sweets at the tuck-shop.

•     As a family eat healthy, unrefined foods rich in dietary fibre.

•     Ensure that you have a toothbrush for every member of the family. A good brush should have a small head, with soft nylon bristles and a flat brushing surface, so that you can reach all parts of the mouth. As soon as the bristles begin to splay out, replace the brush.

•     Teach your children to clean their teeth from a very early age. A toddler can play with a toothbrush to get used to it but until they are about 8 or 9 children need to have their teeth cleaned for them by an adult if it is to be done well. Get the child to do them first; then follow up with a proper clean.

•     Teaching children to clean their teeth properly is greatly helped by using disclosing tablets or solutions. These are harmless food dyes that stain the plaque and show how ineffective the brushing has been at getting rid of it. Once the plaque has been disclosed (stained) get the child to try to brush it away-both of you will be surprised at just how sticky plaque is. Disclosing tablets can be obtained from chemists and dentists.

•     Always use fluoride toothpaste, but discourage little children from swallowing it. Never scrub the teeth across, always brush from gum to tooth, and remember to clean the inside surfaces of the teeth and the crinkly biting surfaces of the big back teeth.

•     When your children are older (about 12 or 13) they can be shown how to use dental floss. Pull out about 10 in from the container and wrap it around the middle fingers of both hands and make a ‘bridge’ of floss across your two thumbs. Gently ease the floss between the two teeth (in front of a mirror is easiest) being very careful not to snap it down and cut the gum. Gently scrape it up and down the sides of the neighboring teeth to remove plaque and food residues. Once you have done one gap go on to the next and work systematically from gap to gap. The whole thing takes about two minutes when you get good at it.

•     Take your children to the dentist regularly every six months from the age of 3. This will enable him or her to pick up disease early, to prevent the unnecessary loss of valuable first teeth, and to use surface applications of fluoride which are valuable preventives against decay. Discuss with your dentist whether fluoride tablets would be beneficial to your child.

•     If in doubt about anything ask your dentist, and encourage him or her to be interested in prevention. Show him that you think it is important for you and your children.

•     Adults should follow the advice given above but don’t need to go for regular check-ups nearly so often as children. Fluoride toothpaste is still advisable and valuable.

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