CHILD’S HEALTH/SKIN DISORDERS: BRUISING AND CALLUSES

BRUISING

When your child falls over or knocks himself against something, the skin may become bruised. Bruising is very common in children, especially over the area of their shins, due to the rough and tumble nature of their play. Bruising is due to bleeding into the skin from blood vessels which have been damaged. Any bruising which cannot be explained by the normal activities of children, should be looked at by your doctor. Certain patterns of bruising may be found in children with a bleeding tendency, although it must be emphasised that this is rare.

Treatment

Ice packs applied to the bruise immediately for 10 minutes can help to ease the bruising and the pain. Bruises take 7-10 days to disappear, changing colour as they heal.

CALLUSES

Calluses are areas of hard skin, caused by thickening of the layers due to prolonged pressure or rubbing. They commonly appear on the hands or the feet and are not painful. They actually provide a protective layer, and occur commonly in children who run around barefoot. No treatment is necessary. If you wish to soften the callus, wet it and pare it down with a pumice stone which you can buy from the chemist. Occasionally cracks or splits appear over callused areas. These should be softened by rubbing with sorbolene with 10% glycerol cream which is available from any chemist. Exposure to the air can aid rapid healing. If cracks persist or are painful, consult your doctor.

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YOUR TODDLERS’ CARE

Toddlers are the group most at risk of injury. They are mobile, curious, impulsive, and full of energy. They do not yet have any sense of danger, and this is immediately apparent to all parents as they try to cope with their toddlers’ running and climbing and exploring. Toddlers need to be supervised at all times. They are at an age when they continually explore the environment. Parents have a responsibility to encourage and guide this exploration while at the same time making sure that the risks of injury are minimised.

Water safety

This is the peak age for drownings. Children must be constantly supervised around water. If you have a swimming pool, make sure there is a Standards-approved between your house and the neighbours’ house are secure. Never leave your child alone in the bath, even for a moment. Do not rely on older children to supervise a toddler. Check the environment to make sure there are no pools of water; young children can drown in water only a few centimetres deep. Nappy buckets pose particular dangers when children are learning to walk.

Scalds

Toddlers are very much at risk for scalds, especially from cups of tea or coffee, but also in the bath or by pulling at tablecloths, the cords of electrical appliances, or knocking over saucepans or buckets containing hot liquids. Do not nurse or cuddle your toddler if you are holding a hot drink.

Burns

Make sure that there is effective sun protection when the child goes outside to play. Hats, long sleeves and blockout creams are the order of the day. A young child’s skin is very sensitive, and severe sunburn can occur even on an overcast day. Be careful of open fires, radiators and barbecues, and keep matches and cigarette lighters out of reach.

Falls

Toddlers love to climb, and may use chairs or tables to explore wardrobes or high shelves. Secure furniture such as bookshelves and dressers which can be toppled over. Put safety catches on windows.

Cuts and lacerations

Keep knives and scissors out of reach, and pad sharp edges of tables and bookshelves.

Choking

Make sure the child sits while eating. Do not give him peanuts, as they are easily inhaled, and keep beads and small parts of toys out of reach.

Poisoning

Keep medicines under lock and key (tablets can look like lollies to a young child), and store detergents, dishwasher powder and liquid and other household chemicals out of reach and preferably in a locked cupboard. Do not store household poisons in soft drink or fruit juice containers. Your toddler should travel in a Standards-approved toddler restraint in the back seat of the car. If your child can open the car door even while restrained, keep the door locked.

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OUR MARITAL HEALTH/OWNING AND OPERATING YOUR OWN SEX CLINIC: FINDING OUT WHO’S THE MATTER WITH US

One of the most important steps in the super marital sex treatment program was to help the couples understand their marital system in measurable, behavioral terms. This is difficult, because we tend to speak in the terminology of pseudopsychology, using such words as “defensive,” “aggressive,” “regressive,” “passive-aggressive,” “neurotic,” “masochistic,” and “infantile.” We have become what Martin Gross calls “psychologically directed,” seeing normal reactions to daily life as “sick.” Anger, despair, and frustration are viewed as “problems.”

Our sexual diagnostic terms reflect this same psychology orientation. A NIMH study reported that virtually no family in the nation is free of mental disorders, and that up to sixty million Americans exhibit deviant mental behavior related to schizophrenia. The same thing that has happened to our sexual health has happened to our mental health. We have been declared statistically sexually ill. Masters and Johnson indicate that over half the couples in the United States have sexual problems, and they provided the terms that, with slight modifications by the American Psychiatric Association, are the new sexual-babble of our time.

Here is a system for formulating your own “diagnostic system” from the fourth perspective. “Talking it over” is much more important than “labeling it.”

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THE DESEXUALIZATION OF THE AMERICAN MARRIAGE/WAY TO LEAVE YOUR LOVING: MARITAL INVASION: IN-LAWS, OUTLAWS, AND OTHERS

Super Marital Sex Rule: The marriage is the most important element of each partner’s life. All other persons’ concerns always come after the marriage, never before or instead of it. No one is more important or of equal importance to your spouse in the super marriage.

He should have married his mother. She ran his life, runs his life, and will always try to run our marriage if he lets her. If he would have married her, it would have saved time on gas and phone bills. ,

WIFE

American marriage is under constant bombardment by extraneous influences, as is clear from the MIM factor. Work, schools, hospitals, governmental agencies, family, and neighbors continually impinge on marriages, stretching them to provide for others what the marriage can not provide for the couple itself.

When daily living was not so anonymous, so computerized, mechanical, and fast-paced, marital and family life was free to respond more to the natural cycles of life, the changes within and among people. Now the American marriage is a socially reactive unit more than it is an intimate active relationship that governs itself.

A call from school, a computer-generated message, car phones that can even let you know if you were called while you left your car, all place us under the potential continued surveillance of others. We have become a “beeperized” culture, never really out of touch as long as a little tone reminds us that a person out there needs us more urgently than the person here with us now.

Parents live longer, so responsibilities in parenting parents as well as children have emerged. In those couples who had parents living, “parenting parents resulted in obligations, distractions,” and sometimes guilt that encroached on marriage. In-laws miles away affect the marriage, with recurring themes of conflict regarding who said or did not say what to whom or who did not attend what family function or did not call enough.

It is certainly not just obligation and distraction that invades the marriage, but difficulties finding a new relationship with parents and others once we are married. Extended families require a psychological maturity that few of us attain. Sometimes it takes all of our energy to be, as one husband put it ‘just civil’. We may unconsciously resent the fact that our time which our spouse takes away from the expiring time available for relating to our parents. How much of what is done for whom relates to guilt, fear of loss, and split between loving now and loving for the past.

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PNEUMONIA – DESCRIPTION

Pneumonia is an inflammation of the lung with consolidation.

This means that the air sacs are filled with fluid or thick secretions and cannot fulfil their function of exchanging gases between the blood and air.

There are pneumonias due to viruses of many types and there are the bacterial infections.

Lobar pneumonia, where one whole lobe or large segment of the lung is involved, was a more common illness than we now see. It often attacked the otherwise healthy person.

The patient was ill for many days and the high fever either settled suddenly (crisis) or the person died.

Complications were many and frequent and those who survived often were unable to work for many months.

This pneumonia is due to the pneumococcus, a germ which is sensitive to most antibiotics. Lobar pneumonia, if recognised and treated early, is no longer a serious threat.

It appears to be less common and this might be because of the wide use of antibiotics in minor respiratory infections.

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CONSTIPATION – MOST IMPORTANT POINTS IN AVOIDING CONSTIPATION

Examination of the patient including the bowel is also usually necessary. Sometimes barium enema X-ray is required. Direct visual examination of the inside of the bowel by sigmoidoscopy is another investigation.

Once the correct diagnosis has been made, correct treatment can be used.

If chronic purgative abuse is the cause, it can be difficult to correct.

One of the most important points in avoiding constipation is getting into the habit of emptying the bowel at the same time each day (or less frequently if this is normal for you). Following a meal, the gastro-colic reflex stimulates the bowel to act after some 10 to 15 minutes. This should not be ignored. Set a regular time each day and then try to keep to it. Increasing the bulk of one’s diet seems to regulate the bowel.

Laxatives are all right for acute constipation and may make life more comfortable when the condition is due to some temporary upset but it is not necessary to have “a good clean out every now and then.”

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CIRCUMCISION – GENERAL INFORMATION

The function of the prepuce is to protect the delicate and sensitive glans which, in circumcised infants, may become inflamed and irritated by ammonia in the urine and rubbed by the nappy.

An ulcer may form on the meatus or opening of the urethra at the tip of the penis. This forms a scab which is broken away each time the boy passes urine and is associated with screaming and blood on the nappy.

Meatal ulcers are rare in the uncircumcised.

These ulcers may heal and form a contracting scar which can obstruct the flow of urine — a urethral stricture.

Circumcision is normally done around the eighth day from birth. There are several operative techniques — which one will depend on the surgeon’s preference.

Some doctors carry out a proper dissection with stitches to bring the cut ends of skin together, which is the usual method of adult circumcision. Other ways involve placing bell-like instruments over the glans and cutting around the edge. A popular method is to use bone forceps to crush the skin edges and reduce bleeding. These operations are conducted without anaesthetic, but if done on infants over four weeks of age an anaesthetic is usually given.

There are a number of risks faced by the infant, no matter what the operation: too little skin may be removed but this only affects the appearance. If too much skin is removed and the shaft of the penis denuded, it can lead to a tender scar.

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YOUR CANCER YOUR LIFE – BENIGN TUMOURS (DIFFERENT TYPES OF BENIGN GROWTH)

There are many different types of benign growth. They can develop internally as well as on the skin— most of them can grow considerably bigger than warts! However, benign growths are usually easy to treat—in many cases it is best and easiest just to leave them alone. Removal may be recommended if they are causing cosmetic problems, discomfort or interfering with normal body functions, for example, by causing a blockage of the intestine. Also, if there is any doubt as to whether growths are benign or malignant, they should be removed or at least sampled so that they can be examined under the microscope. The cells of a benign growth are always well differentiated, that is, they look very similar to the normal cells of the organ in which they occur. Once completely removed, benign growths are very unlikely to grow back.

These then are benign growths. Malignant growths (cancer) develop when there is a much more serious disturbance of the normal relationship between our cells and the control over growth and differentiation.

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SEX AND SEXUALITY AT THE MENOPAUSE:LOSS OF LIBIDO

Anxiety is a big passion-killer, and the middle years can produce a whole range of anxieties – problems with your children, worries about your ageing parents, suspicions that your husband might be interested in another woman, or even that he might have a heart attack during love-making. Any one of these would be enough to make you feel like saying, ‘Not tonight, dear, I’ve got a headache’.

Depression can reduce both men’s and women’s levels of desire to absolute zero. If your depression is directly related to the fall in your level of oestrogen, then there is a good chance that HRT can make you feel your old self again. It’s therefore very important, if you see your GP about feeling depressed, that you also tell him about your other menopausal symptoms, so that he can link the depression to the menopause. If you don’t, he may simply prescribe antidepressants, and if your problem is caused by a drop in oestrogen, then anti-depressants will do nothing at all to tackle the underlying problem, and may just make you feel very much worse.

Stress and tension are common during the middle years, and can be made worse if you and your husband find it hard to communicate with each other. Women have conflicting roles at this time. Perhaps you are trying to reconcile the problems of being, simultaneously, a wife, a mother, a grandmother, a daughter and perhaps even a mistress. Each role makes quite different demands on you. Your mother may have perfected the art of ‘putting you down’, and making you feel still a child. Your grandchildren, on the other hand, probably think you are very, very old!

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RECUPERATION AFTER HYSTERECTOMY: BLADDER FUNCTION

Bladder function may also be affected following hysterectomy due to bruising of the bladder or damage to the nerves and blood vessels that connect it to other organs. The resulting difficulty in emptying the bladder may be overcome by inserting a catheter (tube) into the bladder. In some women the bladder is rested for several days and the catheter drains urine continuously into a closed bag beside the bed. When the catheter is removed the bladder sometimes goes ‘on strike’ and is difficult to empty. A physiotherapist can help ease any discomfort by encouraging full relaxation of the pelvic floor muscles and applying gentle diaphragm pressure from above. Because of bruising, damage to nerves or changes in anatomy following hysterectomy, bladder function may not return to normal until one or two months after surgery. It is extremely important to practise pelvic floor and abdominal exercises once healing is complete. Not only do they help with bladder control, they also enhance muscular support for the newly positioned organs.

A bladder infection may complicate matters, causing a feeling of scalding when urine is passed, a feeling of wanting to pass urine frequently or pain. The doctor will send a specimen of urine for laboratory examination and will prescribe an appropriate antibiotic to clear the bladder of any infection that is found.

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