June 2011
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June 26, 2011

To decide who should look after the children, parents need to consider a number of questions. Who wants the child? Who does the child like? Who is fit enough? Who is trustworthy? Who is emotionally capable of caring for a child? Who will think of the child first, will protect the child? Whose house is suitable? Who has enough room for a child? Who feeds their own children well? Who will pay attention to education, to developing the child’s talents? Who values what you do? Who has the money to take on a child? Who has the physical energy? Who has a stable home life, is in a stable long-term relationship, has stable relationships with other relatives? Who holds a job? Who is not drinking or using drugs?     Needless to say, no one is saint enough to meet all these qualifications. For many parents, deciding who should look after their children comes down to two questions: Who among my friends and relatives do I love the most? Who loves me the most?     Some parents have several children and need to consider whether to try to keep them together or to place them in separate surrogate families. Social workers generally advise keeping brothers and sisters under one roof: they say siblings do best together.     But keeping the children together is not always possible. If not, perhaps their surrogate families will take on the responsibility of keeping brothers and sisters in touch with each other. Perhaps, if everyone agrees, this can be made part of a legal agreement.     Some parents have raised children alone. They need to consider a further question of whether they want the child’s other parent to have custody of the child. In all states, at the death of one parent, custody of the child will normally be assigned to the remaining parent. If you do not want the child’s other parent to have custody, see a lawyer. Sometimes the other parent will legally sign off his or her parental rights. Sometimes another person—an especially close relative or friend—can be given legal custody instead. In any case, your state’s Department of Social Services or Friend of the Court can advise you on this decision, and help you find the attorney to make the necessary arrangements.     Once parents have made these decisions, they discuss the decisions with everyone concerned. When talking to their children, they often do not discuss their decisions outright. Instead, they tell the children gradually. They say, “What do you think it would be like living with your aunt?” Or they say, “If anything ever happened to me, your grandmother will look after you.” Or, “If I should get sick, your cousin will care for you for a while.” Whether people discuss this decision with their children gradually or outright, one way or another, they do let the children know who will take care of them. Children need this reassurance.     When talking to their relatives, they must be more forthright. This is not always easy: sometimes the people not chosen, especially relatives, are upset at the decision. Helen, though her sons are nearly grown, asked her father and stepmother to watch out for the boys and take them in when necessary. They all agreed. Helen also has a sister she did not choose, in truth because she trusted her father and stepmother more. But she did not want to hurt her sister, and so she gave her sister what she thought was a palatable reason for the decision: that the father and stepmother had more money, and that taking on two young men would thus be less of an imposition on them than on her.     In general, people find reasons for explaining their decisions that are not personal but are external to the person. In other words, they did not choose a certain person because he or she is more trustworthy, or has a better marriage, or a better temper, but because she or he has a better income, or better benefits, or a bigger house, or no other children, or children the same age.     When deciding what sort of legal arrangements to make between your children and their surrogate parents, get advice. The three options are custody, guardianship, or adoption. Custody means the person you choose has temporary responsibility for the child. A guardian has certain but not all parental rights. And adoption is the legal equivalent of biological parenthood.     You can choose an option and make the necessary arrangements at any time. Helen has a friend who has her second opportunistic illness and who arranged for her mother to legally adopt her young child; the mother is now that child’s legal parent. Many agencies offer advice on this subject: the state Department of Social Services, social workers, and such private social services as Catholic Charities, Jewish Family and Children’s Services, and Lutheran Social Services can help. In any case, to guard your rights as a parent, make any such arrangements only with the advice of your own lawyer.
*94\191\2*

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June 11, 2011

Osteoarthritis is an insidious villain that develops gradually, often exhibiting no symptoms for decades. It creeps up on us during our 30s and 40s, usually becoming noticeable in our 50s and 60s.Also known as degenerative arthritis or degenerative joint disease, osteoarthritis occurs when cartilage begins to break down and no longer acts as a cushioning pad in the hands, hips, knees, back, and other joints. Without this protective padding, bone will rub against bone. Pain, tenderness, swelling, stiffness, and sometimes deformity can result.If you suffer from osteoarthritis, you are not alone. The Arthritis Foundation estimates that there are about 15.8 million Americans with osteoarthritis, the majority of them women. In fact, knee arthritis is the most common cause of disability in the developed world.The condition doesn’t affect how long you will live, but it can make everyday activities and life in general, very uncomfortable for those unlucky enough to have the more serious forms of the disease. But there is some good news: Although osteoarthritis has widely been regarded as an inevitable part of aging, like wrinkles or gray hair, some evidence suggests that it may be preventable.*6/306/5*

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June 9, 2011

One of the most important single procedures used by the physician is the use of his hands in order to palpate or feel changes that have occurred underneath the surface of the body. As medicine is practiced in some parts of the world, patients seldom get time even to remove the necessary clothing to permit the doctor to look at the skin or to put his hands on various portions of the body in order to feel changes that have taken place.When there is a suspicion of a new growth the doctor will look to see if there is any visible sign of a change on the surface of the body. He will then press with his fingers to determine whether or not lumps may be felt underneath the skin, or whether the outlines of various organs in the abdomen have been changed from what is usually felt.New instruments have been developed that enable the doctor to project his powers of observation in a way that was not possible fifty years ago. There is now an electrically-lighted instrument for every entrance and exit of the human body. The cystoscope, the bronchoscope, the esophagoscope, and the gastroscope are types of instruments which enable the doctor to look into the urinary bladder, the bronchial tubes, the stomach, and many other portions of the body.With the X-ray the doctor can detect changes in the outlines of organs inside the body, and by combinations of the use of the X-ray with the use of certain drugs that can be taken internally he can get pictures of changes in outline and in functioning of various tissues of the body. He can even see tumors which project into the cavities inside the brain. In addition, there are devices such as the electroencephalograph which enable the doctor to determine changes in the function of the brain. There are also functional tests for the kidney, the stomach, the liver, the heart, and other vital organs.Transillumination means that light is thrown through the tissues of the body; this is one of the tests that is used particularly in studying the breast for the presence of new growths.New also in the study of cancer is the use of radioactive isotopes. We know today that certain chemical substances taken into the body will be carried by the blood to certain organs or tissues, where they are deposited. Thus, more than 90 per cent of iodine taken into the body goes directly to the thyroid gland. Calcium is deposited in bones and teeth. Some substances go directly to the liver. Radioactivity attached to these chemical substances goes with them, and they can then be detected in various portions of the body by use of the device called the Geiger counter, which shows the presence of the radioactive substances by a clicking sound. All over the country research is now being made to determine how valuable radioactive isotopes can be in aiding not only in diagnosis but also in treatment of cancer.New also in the study of cancerous changes are the studies that are now being made on the blood. Certain conditions such as excessively rapid growth of the red blood cells, called polycythemia, or excessively rapid growth of white blood cells, as in leukemia, can only be detected by examining specimens of the blood under the microscope. Since these conditions come on insidiously, a proper examination will always include the taking of a specimen of blood and an observation of this blood under the microscope. It will include also counting of the cells in the blood, because there are several different types of cells and the relative percentages of various types of cells in the blood may be of the greatest significance in relation to determining the existence of these conditions that are called cancer of the blood.*3/318/5*

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