CHILD’S HEALTH: NOSEBLEEDS (EPISTAXIS) AND OBJECT IN EAR

Nosebleeds are a relatively common occurrence at any age, and are rarely cause for concern.

Cause

In small children the commonest cause of nosebleed is picking crusts from the inside of the nose, and in so doing scratching the delicate lining and damaging a small blood vessel. Blowing the nose vigorously, or any form of trauma can cause a nosebleed. Frequent nosebleeds may be a sign of a blood disorder but this is rare. The amount of blood lost due to a nosebleed will usually not harm your child.

Treatment

The most effective treatment for a nosebleed is to apply firm pressure with your fingers on the sides of the nostrils. Continue for 5 minutes, keeping the head still. If bleeding does not stop completely, continue for another 10 minutes. If after 15 minutes you still cannot control the bleeding, see your doctor, or go to a hospital casualty department. If your child suffers from recurrent nosebleeds, your doctor may recommend cautery, a simple procedure in which the vein which has been bleeding is sealed off.

When to see your doctor

• if bleeding has not stopped after 15 minutes despite the application of firm pressure on the nose;

• if your child has recurrent nosebleeds;

• if in addition to having nosebleeds, your child is generally unwell, looks pale or has unexplained bruises on his body.

Object in the ear

Cause

Young children in particular like to explore their own bodies, and may insert small objects into their ear.

Clinical features

This can cause itching, swelling and pain, or the child may complain of a blocked ear. An offensive discharge may be present sometimes if the object has been there for several or more.

Treatment

If you suspect that your child has an object lodged in his ear it is safest to let your doctor see him. Your doctor will probably syringe the ear with warm water to remove the object, or use a special ear probe. Trying to remove the object at home with a cotton bud may only push the object in further and this can cause damage to the delicate ear drum or canal. If the ear is infected your doctor may prescribe antibiotic ear drops or medicine.

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NEWBORN’S BEHAVIOUR AND COMMUNICATION

Babies call up considerable emotion in us — that is their survival skill. The earliest communication between baby and parent takes place through emotional cues which may even start before birth. It is through the sharing and understanding of that emotion that a parent is able to identify what is going on with a baby, and respond instinctively. Parent and child become emotionally attuned.

A baby has the ability, through his behaviour, to elicit the care of others. Parents are soon able to distinguish the nuances between a ‘pooey nappy cry’ and a ‘feed me’ cry. Facial expressions and gurgling often make parents melt with coos or giggles of love. Your baby may be small, but he is a powerful communicator and knows how to make his needs known.

Many parents feel ambivalent about having a child. This is a normal part of all parenting. If the parents are unable to acknowledge their true feelings, they run the risk of not being able to tune into the child appropriately. We all want to produce a beautiful child as a product of love. If, for example, a couple have a deformed baby, it may be very difficult for them to verbalise that their child is not physically beautiful. Yet this is often exactly what needs to be done.

The parent-infant relationship is important in the continuing development of the child. Parents provide emotional nourishment for the child, and studies have shown that without consistent parenting children may become withdrawn and may not develop normally.

A child’s sense of self is thought to develop at around 7-9 months. He begins to recognise that there is a shared world and also begins to learn to abstract, realising that pointing leads to something beyond the finger. From early infancy, an enormous amount of learning takes place in the relationship with the parents, through the ‘mirroring’ of facial expressions and voice. This is more than just mimicking; it is a tuning-in to each other’s emotional experience. Emotion is how we all began to communicate. It can provide a special intimacy beyond the limitations of words. In many ways emotion is still the most powerful language that we have.

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SUPER MARITAL SEX: A SEXUAL HEALTH EXAM

I’ve worried about this for almost ten years, and now you tell me it is absolutely normal that my left testicle is a little larger and hangs lower than the right? I always thought it meant that I was a little less fertile or that maybe I hurt it that one time I fell off the seat on my bike and cracked my nuts on the crossbar. I always sort of hide it whenever I shower at the club. I really don’t think my wife even knows.

HUSBAND

He has always acted funny about his genitals. He never lets me really see them or touch them. I touched his testicles one time and he pulled away like I had killed him. Why didn’t he ask the doctor?

WIFE

I did. He just laughed and said maybe I had pulled on one for too long. I never mentioned it again.

HUSBAND

Several of the husbands and wives reported similar instances of worries and misunderstandings that were never clarified, even made worse, by the lack of comfort and sexual knowledge of the medical field. As with all of the tests in this book, taking the sexual health’ exam together is the best way to learn about each other and yourself Dr. June Reinisch, director of the Institute for Research in Sex Gender, and Reproduction, reports that questions to her nationally syndicated column often contain misinformation and a refusal by physicians and other health professionals to respond openly, comfortably, and directly to sexual questions from their patients. Any doctors who don’t hear such questions in their practice can be sure that they have stopped them through their own discomfort with the topic.

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THE JOY OF PERFECT HEALTH: ACKNOWLEDGMENTS

I make no claim, that I developed anything new. All the techniques listed in this book are known and proven for thousands of years.

Modern scientific evidence, summarised in this book to convince its readers is taken directly from books and articles published by many talented, dedicated, honest medical practitioners and scientists, who are not afraid of telling the TRUTH.

In particular, I would like to express my gratitude to Hulda Regehr Clark, Arthur Baker, Deepak Chopra and Sheldon Saul Hendler for their wonderful books.

I am grateful to Dr Vagif Sultanov, for his inspiring public lecture about fasting.

I am also grateful to Ed McCabe, a reporter, for bringing to the attention of the general public (mine included) oxygen therapies, against considerable opposition of the medical establishment and the media.

It would be impossible for me to collect quickly the scientific evidence I needed without access to the Australian NEXUS magazine, which has published great articles as well as summaries and reviews of many interesting and original books. I salute all those people associated with NEXUS. You are doing a great job.

I would like to express my gratitude to Nick Haritos, who corrected the manuscript.

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IRITIS – TREATMENT

These adhesions may become permanent and bind the iris down so that it can no longer dilate or constrict the pupil.

The most important part of treatment is to prevent these adhesions. So drops of atropine and homatropine are used to dilate the pupil, pulling the iris away from the lens.

Homatropine has the advantage of being short acting, and so the dilation can be quickly reversed once the inflammation has subsided.

But this drug works poorly in children and in some adults, and so atropine is required.

This unfortunately, has a much longer action, and it may take up to a week before the pupil returns to its normal size once the drug is stopped.

If the pupil is dilated, this interferes with clear vision and makes the eye over-sensitive to light.

The other drug of importance is cortisone in the form of drops, instilled into the eye to reduce inflammation.

Iritis may be mild or severe, it may persist for weeks or months, or may rapidly subside within a few days.

Unfortunately, it is prone to recur.

Assessment of any underlying condition is necessary so that this condition can also be treated.

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ASTHMA – DIAGNOSIS OF ASTHMA

Some children are labelled as having wheezy bronchitis or asthmatic bronchitis rather than asthma. This is because the wheeze is usually present only during a respiratory infection. Most experts believe that these are all mild asthma.

It doesn’t really matter what the condition is called, as long as the child gets proper treatment and the parents are not frightened by having their children labelled as asthmatic.

Usually the diagnosis of asthma can be made on clinical grounds, but some tests may be necessary to confirm it, assess its severity or check for associated factors.

Testing lung function by having the patient blow into a special machine is accurate and gives a lot of information. It may be necessary to provoke an attack, do the test and then reverse the breathing difficulty by giving drugs that dilate the bronchial tubes.

In allergic individuals, skin tests to find to what substances the person is allergic are also of use.

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COULD A SPORTING ACCIDENT CAUSE ENDOMETRIOSIS?

An interesting letter arrived from a woman in Colorado, posing a question that had not been asked of me in a long time. In her letter Sherry said that she wanted to settle the nagging suspicion that endometriosis may have been induced through fate’s intervention. She specifically referred to two accident! in her past, in which she had been struck forcefully in the abdomen.

“Maybe I’m grasping at straws,” she wrote, “but I can’t help wondering bow I got endometriosis. There’s nothing like it in my family and I seem to be the only woman I know of out here with the condition. Isn’t there some likelihood that a shock to the system can start some internal chain reaction that brings on this disease?”

Sherry had been an active teenager, although menstrual cramps slowed her down through her high school years. During the last half of her senior year, her cramps worsened. Yet she suffered silently. “I was raised to be tough about things that made us physically and emotionally uncomfortable.” she wrote. “It isn’t unusual out here. This is a ranching community and lire can be hard. No one cares about complainers.” It was during a difficult bout with menstrual cramps that she played in a school volleyball competition and was struck by the ball as she jumped to hit it.

“I doubled over so suddenly, and I was in so much pain,” she wrote, “that I had to be carried off the court. For days after that, I felt like I had to urinate all the time. The pain soon stopped, but my cramps started to get worse from about that time.” Over-the-counter painkillers offered some relief while she waited to “grow out of” the problem. But it was not to be. Five years later. Sherry went on to say in her letter, she was horseback riding with her new husband when she was thrown by the horse, landing belly-down on a rock. This time, she began bleeding. Frightened, she went to a gynecologist.

Sherry was hospitalized and went into surgery for removal of an ovarian “chocolate cyst.” a cyst with blood in it that has become dark brown and thick as tar. When a biopsy of the cyst was performed, it revealed endometriosis. Curious, Sherry asked her doctor if the first accident might have set off some “internal disorder” that fostered growth of the disease. It was the doctors opinion that accidental traumas have no effect on the onset of endometriosis.

We have found no reference in any scientific journal that implicates any sort of trauma—such as being hit by a ball, falling off a horse, or being injured in an automobile accident—in the onset of endometriosis. In Sherry’s case, the second accident only helped identify the disease. The fall ruptured an endometriotic cyst, which, upon rapturing, leaked blood over the pelvic organs, causing extreme pain.

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SKIN CARE: HIVES

Hives, known medically as urticaria, are a very common problem They are sometimes known as ‘heat lumps’, appearing as raised’ red lumps which tend to come and go over any part of the body and which are extremely itchy. They are the result of increased capillary permeability, or ‘leaky bloodvessels’. The condition has been closely studied by allergists, dermatologists, pharmacologists, and immunologists. As a result the mechanism of action is reasonably well understood. It is thought that various processes, both allergic and non-allergic, lead to the release of certain chemicals, the most important of which is histamine. These chemicals influence the small blood vessels and capillaries of the skin, leading to skin changes which are characteristic of hives.

There are various known causes of hives (and probably as many unknown).

Infections. Parasitic infection, in particular various fungi, intestinal worms and hydatids, has frequently been associated with hives. So, also, have viral hepatitis and glandular fever in the presymptomatic stages. Similarly, upper respiratory tract infections may be accompanied by hives. Occasionally bacterial infections such as streptococcal or unsuspected focal dental or sinus infection may cause hives.

Physical causes. Several rarer physical causes of hives exist. For instance the pressure of belts or shoes may cause localized hives (in this case called pressure urticaria), as may cold air, water or other cold substances. Heat may also cause localized hives if the heat source is local, or generalized urticaria if the condition is provoked by exercise. A still rarer form of hives, solar urticaria, is an allergy to different wave-lengths of ultraviolet light.

Internal disease. Very occasionally conditions such as lupus erythemaetosus, leukaemia, or cancer of some organ may cause hives. These can usually be excluded as possible causes by appropriate physical and blood examinations.

Psychological pressure. Emotional stress may either cause or aggravate hives. Whether emotional factors alone can produce these changes is uncertain. Before blaming ‘nerves’, the various other possible causes must be adequately excluded. Furthermore, treatment should be instituted to relieve the distressing appearance and itch, which only aggravate the stress. Adequate explanation and reassurance that the condition is self-limiting, must also be given to the patient.

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NUTRITIONAL ASPECTS OF APPETITE CONTROL: CARBOHYDRATE

The satiety value of carbohydrate is clearly greater than fat, however this varies according to the type of carbohydrate. Including a low glycaemic index and a high resistant starch or fibre content can all act to boost the satiety value of specific carbohydrate-rich foods.

The relationship between appetite and the commonly reported ‘carbohydrate addiction’ is less clear. This dietary phenomenon supposedly occurs because of a central imbalance in the metabolism of the neurotransmitter seratonin. The consumption of carbohydrate-rich foods is believed to boost seratonin levels, promote satiety and induce a mood calming effect.

Based on this hypothesis, all carbohydrates should be able to satisfy uncontrollable cravings (a baked potato should do the job just as well as a doughnut). However, this is not the case according to Professor Adam Drewnowski from the University of Michigan. He suggests that it is the ‘powerful hedonic synergy’ of fat and sugar that forms the basis of food cravings. In an interesting study, he discovered marked differences in food preferences between men and women. When males were asked to list 10 of their favourite foods, they expressed preferences for meat, fish and eggs. Obese women rated ice cream, chocolate, cookies, dough-nuts and pies high on their list. He concluded that whilst men prefer protein-rich foods, women’s desires tend toward mixtures of sugar and fat. This finding indicates that the term ‘carbohydrate addict’ may be a misnomer and the term ’sugar-fat addict’ may be more appropriate.

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FEELINGS AND EMOTIONS IN CASE OF ENDOMETRIOSIS: OVERWHELMED AND ISOLATION

You may feel overwhelmed by the various options of treatment that are presented to you. These options may include having no treatment at all — adopting a wait and see approach. This may be the case especially if your endometriosis is mild with few symptoms and you are planning to get pregnant.

Perhaps you were trying to get pregnant before your endometriosis was discovered and the prospect of a six to nine month course of drugs which will prevent you from getting pregnant during that time will be exasperating.

You may have to consider going on a course of fertility drugs if you want to get pregnant — something you may never have considered before.

Having to make a decision about which hormonal or surgical treatment is best for you will almost certainly be overwhelming.

Isolation

‘I feel so alone. I have never heard of this disease and most of my family and friends don’t even know how to pronounce it let alone understand what it means. How can I explain it to them in simple terms when I don’t understand it myself?’.

This is a common cry for help. Many women find it difficult to discuss their gynaecological problems with family or friends because they are embarrassed or simply do not want to burden people with their problems.

Some may find that they feel isolated because partners or family and friends have heard about the symptoms for so long that they no longer want to discuss it now that a diagnosis has been made.

Others believe that once the woman has had surgery such as a laparoscopy or laparotomy she is cured and should have no more problems. Little do they realise that this may be just the beginning.

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