May 21, 2009

Roseola is a common infection amongst babies and young children. Cause

Roseola is caused by a type of herpes virus. Clinical features

The onset of roseola is sudden and dramatic. The young child develops a high fever which lasts for 3-4 days, and then disappears quite suddenly with the appearance of a characteristic rash. The rash of pink, slightly raised spots occurs mainly on the trunk, but may spread to the arms and neck. The rash rarely lasts more than 24 hours.

Treatment

There is no specific treatment for roseola. Management of the high fever is important in order to prevent febrile convulsions, which are more likely to occur in this age group.

When to see your doctor

• if your child has an unexplained high fever;

• if your child develops a rash;

• if your child is generally unwell for no apparent reason or in addition to the above symptoms.

*281\90\8*

May 19, 2009

1. “Do girls have balls, too?”

Yes. In boys the balls, where the sperm is made, are called testicles, and they are on the outside of the body’s body in a sac called the scrotum. In girls, the balls, where her eggs are made, are inside, in the lower part of her body. They are called ovaries. “Balls” is just a slang word some people use for testicles, but boys and girls both have similar sexual organs. As usual, slang or bad words for sex and sex parts can confuse things.

2.    ”Why do women bleed between their legs?”

They don’t really bleed, as they would from a cut. Every month a nesting place for a baby is made in a part of the woman’s body called the uterus. If a sperm and egg get together, a baby grows there. If the nest is not needed, it comes out the way a bird’s nest can fall from a tree. What comes out is the nesting material, with some blood and other things that make the nest. This is what is called menstruation. Women catch this unneeded nesting material with various types of pads. This is all part of a very natural process.

3.    ”How do the boys get their sperm?”

Sperm is made in the testicles and the eggs are made in the ovaries. Boys make millions of sperm every day, but girls are bom with several hundred eggs, and only some of them ripen and become eggs that can join with sperm.

*317\97\8*

May 18, 2009

I feel like I am just too much work, so I try to hurry. If I try to hurry, I just can’t come. Then I end up faking it. Sometimes I try so hard that my muscles hurt.

WIFE

I have discussed the fact that the first perspectives of sexuality saw women as sexually sluggish, capable of intense response only after intense, prolonged stimulation. It was an accepted fact that women take longer than men. This view was not upheld in the wives in my group.

In cases where the wife was seen as “slow” to respond, it was clear that there is no such thing as a slow sexual response. Just as we would not speak of a slow sneeze, we cannot view sexual response as anything but natural and reactive to the specific situation, partner, and type of stimulation.

“I rub right on her clitoris for what seems like hours,” reported one a long time. She will usually finally come, but by then I can have a sore forearm and I am not excited. She’s just real slow to respond.”

This report illustrates the blaming of female response for couple ignorance about sexuality. Later in my work with this couple, it turned out that C-area stimulation for this wife was not effective. G-area stimulation combined with simultaneous talking about fantasy led to intense and what the couple reported as “really quick coming.” They eventually became less interested in the quick part and learned to enjoy the journey more than the destination.

Sexual response cannot be wrong, too fast, too slow, “too” anything, because it is a natural human response, unique to all of us and each of us. Once we learn this, we are free to become sexual together, for there can be no right or wrong in what is natural and beautiful.

*144\97\8*

The reasons for extramarital sex are as varied as the people who engage in it. No research has ever told us why people do it. I suggest, however, that one reason is that extramarital sex has enjoyed a sexual monopoly. It gets most of the attention and offers a cafeteria of descriptions guaranteed to meet some appetite. It is seen as so much fun that it is resisted only by control, awareness and religious punishment, self-denial, and acceptance of the myth of the more moral but less intense sexuality of marriage. Seldom do you read that sex in marriage is not only better than sex outside of marriage, but that extramarital sex falls far short of the intimacy and sexual fulfillment available within marriage. You will learn throughout this book that no form of extramarital sex can compete with super marital sex, and once this lesson is learned, spouses having affairs may begin cheating on their “lovers,” and having “intramarital” sex with their husband or wife.

We live in a society in which it is much easier to look “out” than “in,” to seek variety when we fail to find intensity. Super marital sex is developed not by variety, adventure, mystery, and the “affairizing” of marriage, but by learning an entirely new orientation to sexuality and its relationship to lasting love. There are many old lessons that will have to be unlearned, and a new perspective on sexuality will have to be developed. This is the purpose of this book. Follow along with each chapter and you will see that extramarital sex doesn’t stand a chance against super marital sex.

*4\97\8*

May 15, 2009

Diets which stress no carbohydrates or high protein or fat can be dangerous unless followed under strict medical and dietetic control.

Motivation is all-important in losing weight. Overweight people who have had a heart attack usually lose weight rapidly and maintain their ideal weight.

Some people even resort to surgery to lose weight. There is an operation called an apronectomy where the surgeon can remove the apron of fat from the abdomen. It certainly is a quick, if expensive, way to shed 10 kilos.

Another operation is a short circuit on the bowel. The upper small bowel is temporarily joined to the lower bowel thus preventing a lot of the food from being absorbed. This must be done with care and only for extreme reasons. It is prone to a lot of complications; deficiencies of vitamins and other essential food factors can happen.

Another operation with less adverse effects is stapling of the stomach. This reduces the size of the stomach and so limits the amount of food which can be eaten.

To lose weight you need to eat less than required and so burn up some of your reserve. When you have reached your ideal weight, you can increase intake to match output and your weight will stay the same.

*512/71/1*

We doctors seem to know a great deal about sickness and not so much about health. Certainly we seem to do well with treatment but have difficulty in convincing people to alter their lifestyles so as to lessen the risk of well-known diseases. Yet the key to success in the degenerative diseases and some cancers, where we know the causative factors, is to avoid them if we can.

Changing our diet and avoiding smoking would reduce the incidence of atheroma.

The diagnosis of intermittent claudication can be made on the history alone. When the doctor examines the legs, he may be unable to feel the pulses in the feet. This indicates obstruction to blood flow.

In the past, various drugs were used in an effort to dilate the narrowed arteries and improve the blood flow. Unfortunately, these have proved disappointing.

Because of the development of operations designed to bypass the obstructed vessel, accurate diagnosis of where the blockage lies is important to decide if operation is feasible.

*256/71/1*

May 12, 2009

So, if you are in this situation, take your courage in both hands and make it quite clear to both your practitioner and your friend or relative that you insist on being included in all discussions like the brave, sensible adult person that you still are. Remember— secrecy divides and weakens, sharing unites and strengthens. Nothing is harder than fighting unknown terrors alone in the dark.

While caring for people with cancer, I must have heard this phrase thousands of times: ‘I suppose I’ll do it if I have to.’ I would always answer: ‘You never have to do anything— there are .ilways choices.’

*13/40/1*

May 8, 2009

The S.C.C Is a tumour arising from the prickle cells of the epidermis which lie above the basal layer. This form of cancer easily Invades the dermis, and may on occasions spread to local lymph glands or more widely through the blood stream.

Because the growth is visible, patients with a S.C.C. usually attend for treatment early, and a cure rate of over 95 per cent should now be the rule. The method of treatment will depend on where the lesion is and on whether it is focalized or has spread. The size and tissue type, as well as the experience of the physician, is also relevant. A good biopsy is usually essential before treatment is planned. The aim of treatment is always the complete eradication of the cancer, along with a good cosmetic and functional result.

1. Diathermy or electrodessication and curettage

This is a well-accepted method in experienced hands, particularly when the S.C.C. is less than 1 centimetre in diameter and on the hands or arm. The cosmetic results are frequently superior to those obtained by surgery or radiotherapy, and the five-year cure rate is better than 95 per cent.

2. Surgery

Excision is often necessary for large tumours or for those in difficult sites. It is of course also necessary when lymph nodes or other areas are involved.

3. Radiotherapy

X-ray treatment is suitable for cancer on the head and neck, particularly in elderly people. The disadvantage of this therapy is that from 8-10 separate treatments are required, and the resultant scars are often cosmetically inferior, and certainly more fragile.

*109\44\4*

The first report on the use of hormones to reduce symptoms of the menopause said, in 1935:

‘In most patients, symptoms are rather mild, so no treatment is necessary except an instructional and reassuring talk from the medical adviser as to the normality of the symptoms, their temporary nature, the importance of avoiding stress and anxiety, and perhaps the administration of a simple nerve sedative.’

The writer of this report was right in that these symptoms are all normal, and many of them are temporary. However, that doesn’t mean we have to live with them if they are reducing our quality of life. Pain during childbirth or tooth extraction is normal, but most people nowadays would choose to use various methods to reduce it.

If you are one of the lucky ones, and you are not bothered by hot flushes, night sweats, distressing states of mind, vaginal and bladder problems, and if you are at little or no risk of developing osteoporosis, then you will probably feel that HRT would be an unnecessary medical intervention for you.

Few elderly people regard old age as a blessing, yet we all want to get there. To do it, all women have to go through the menopause, with its many and varied symptoms, few of which we would wish upon ourselves if we could redesign female biology from scratch. Women born in this century were the first who could confidently expect to live to three-score-years-and-ten, and most of us will five another 10 or more years beyond that. We want them to be rich, fulfilling years. There is nothing any of us can do to stop the ageing process, but at least many of the problems of the menopause can now be relieved by replacing the oestrogen we all inevitably lose.

*19\42\4*

Excisional surgery for endometriosis means cutting and removing or destroying endometriosis tissue wherever it lies in the pelvis. The surgery can be performed in a traditional manner through a large, open abdominal incision about 13 cm wide (open excisional surgery at laparotomy) or during a laparoscope in which the inside of the pelvis is viewed through a laparoscope, a tubular instrument with a light at one end and an eyepiece at the other, which is used to ‘spotlight’ internal organs.

If surgery is to be performed in the latter manner, a woman is anaesthetised for laparoscopy (usually a general anaesthetic) and then several small incisions (up to 1 cm each) are made in her abdominal wall. A needle inserted through one of these incisions is used to introduce carbon dioxide or nitrous oxide gas into the abdomen. The gas separates the organs from each other so that the doctor can gain a clear view. The gas also expands the abdomen, making the woman look about six months pregnant — but only until the end of the procedure when she regains her normal shape. Meanwhile, the laparoscope and any other instruments needed to cut out endometriosis tissue are introduced through the other incisions. For instance, a laser (for laser vaporisation) or an electrocoagulation device (for diathermy) may be inserted. After laparoscopic excision of endometriosis tissue, the laparoscope and other instruments are removed, the gas is allowed to escape and all incisions are closed with a suture or two. The American College of Obstetricians and Gynecologists rates electrocoagulation and laser treatment as equally good options for destroying endometriosis at laparoscope.

Long-term information about the efficacy of surgical approaches in removing endometriosis and reducing its symptoms suggests that they may be about twice as effective as drug therapies. Success rates are around 80% with surgery and about 40% with drug treatments. Whichever technique is under consideration, women should be aware of the risks of these procedures. General anaesthesia can cause nausea, vomiting and impaired concentration for some time after surgery. The potential complications of excisional surgery with or without laparoscopy include bleeding, infection, damage to internal organs and the resultant need for another operation to repair any damage. Following laparoscopy, some discomfort is normal for a few days. Pain in the shoulders, neck or abdomen may occur if the gas used within the abdominal cavity is not removed completely. Very occasionally, a life-threatening air embolism occurs, in which a bubble of air enters the bloodstream and produces an obstruction in the heart or elsewhere.

*37\198\4*

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