Medsarticles. Medical Weblog

There is no cure for the common cold. There is no specific treatment that will make the cold go away more quickly. You can help to relieve the child’s symptoms in a number of ways. Paracetamol in appropriate doses can be given if fever is present. (Do not give children aspirin — it can have potentially serious side effects. Lozenges (the cheapest one from the milk bar is just as good as the very expensive ones from the chemist) or warm drinks will ease a sore throat and dry mouth. Nasal drops or spray will ease a blocked nose. Decongestants are sometimes useful, but you must be aware of side effects such as rapid heart rate, jitteriness and insomnia. You should always consult your doctor before using them.

It is a good idea for the child to take things easy, though he does not need to stay in bed. Let your child decide how much activity he wishes to engage in. Although it is likely that he will not be hungry, make sure that he drinks lots of fluids. His appetite will return as he starts to feel better.

There are a number of treatments that are not necessary. Because colds are caused by viruses, antibiotics will not help, even though they are often prescribed. Not only are antibiotics (such as penicillin) unnecessary, but they can be harmful by causing stomach upsets and diarrhoea. Parents should always ask the doctor if a prescription is really necessary — all colds will get better without antibiotics, and just as quickly. Cough medicines are of no benefit — the cough is due to irritation of the trachea or to excess mucus, and cough medicine does not affect either. Similarly, there is no evidence that vitamin C is of any benefit.

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The liquid which surrounds the foetus inside the womb is called amniotic fluid and because the baby drinks it and passes it out again, it is rich with foetal cells. This fluid can be used to test for certain genetic or inherited disorders in the foetus, including Down syndrome. It can also be tested in later stages of pregnancy to determine the maturity of foetal lungs, if there is a risk of premature birth.

Amniocentesis is usually done under ultrasound control. A small area on the skin of the lower abdomen is anaesthetised, and a fine needle is passed into the sac containing the amniotic fluid. A small amount of fluid is withdrawn for examination.

This test is usually performed on the understanding that if a serious abnormality is detected in the foetus, the pregnancy will be terminated. In early pregnancy, the risk of miscarriage after amniocentesis approaches 1%, but there is no risk to the mother herself, who may just feel some minimal physical discomfort. If performed later in pregnancy to assess maturity of the foetus, the risks of miscarriage is negligible. Because the incidence of congenital abnormalities increases with the age of the mother, this test is usually offered to any woman who becomes pregnant after the age of 37, whether she has had previous pregnancies or not. Check with your doctor for further details.

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In an attempt to relieve some of the anxiety and misunderstandings about solving sexual problems, and to illustrate the fourth perspective that underlies super marital sex, I present the twenty most frequent questions asked by spouses in my study. The questions express the innate wisdom and courage of-all of the patients, their vulnerability, and their infinite struggle to continue the development of their love maps and grapple with the complexities of marriage.

After reading and discussing the information and tests in the first nine chapters, practice being a sex-therapy team. Answer these together as if the person asking each question had consulted you in the sex clinic you built for yourselves in Chapter Eight.

Just before you get to the list, guess what is the number-one asked question, the single most often raised concern. It’s number one on this list of twenty. The other questions are not presented in any particular order, because they were raised at about equal frequency.

1. Why does he/she want more sex than I do?

The “frequency and interest” issue tops the list. The question may be asked in a variety of ways, such as “Why does he avoid me sexually?” or “Why am I so much more interested in sex than she is?” or “Why am I always the one who has to start it off or think of it?”

2. Why won’t he/she do oral love (fellatio/cunnilingus)?

3. Why does he/she have a “fetish” (for an object or activity)?

4. Why does or doesn’t he/she get turned on to pornography?

5. Why can’t I (he) slow down my (his) ejaculation?

6. Why can’t I (she) come quicker? (And why can’t I get and stay erect or wet?)

The “sexual reflex failure” questions were asked in many forms, but all contained the same concern for the breakdown or change in a natural sexual reflex, including pain in intercourse.

7. Why can’t she (I) come in intercourse?

8. Why can’t we come together?

9. Why does he/she talk (or not talk) during sex?

10. Why won’t she let me (why does he want to) have anal sex?

11. Are you sure he/she isn’t homosexual?

12. Why is sex so much better on vacation or when we are away from home?

13. How can I have sexual enjoyment when it goes against my religious principles or upbringing?

14. Is he/she having an affair (and that is why there is a sex problem)?

15. Can I ever get over the sexual abuse I experienced?

16. Does PMS (or other menstrual issues) affect sex?

17. Isn’t that sex fantasy sick?

18. Isn’t masturbation very bad (or very good) for you?

19. Why am I not sexually attractive to my spouse (or how could I ever be as sexually attractive as she/he would like)?

20. Is this normal? (Whatever “this” is.)

Even though it will take some time, sit down and try to answer each question out loud as a couple. Discuss it first before you give your answer. Keep your answer brief, related to the fourth perspective of super marital sex if you can, and be as direct as possible, if the question is too vague (and they all really are), restate it to a form you can answer.

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Untreated, it can lead to heart failure, where the heart fails in its action as a pump and the blood is no longer pushed efficiently through the lungs and kidneys. The person becomes short of breath and fluid may be retained in the tissues, leading to oedema (swelling).

High blood pressure may damage the kidneys and lead to their failure and cause secondary effects which push up the pressure even further.

Damage to the arteries from the raised pressure is widespread throughout the body and, in the eye, may lead to impaired vision from small haemorrhages or a clot or thrombosis in the retinal vessels.

Damage to the arteries supplying the brain can cause strokes. Transient ischaemic attacks (TIA) occur when there is spasm or actual blockage of small cerebral arteries. These are like minor strokes but the symptoms do not persist.

A clot in a major brain artery causes a stroke or cerebro-vascular accident (CVA). Partial recovery from the paralysis, which is the main symptom, is usual.

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Cow’s milk contains about 14 different proteins, all capable of becoming allergens. Each may be broken down or digested into around 12 different substances and all of these can induce an allergy. This means there are over 100 different combinations in cow’s milk which may induce allergy in susceptible individuals.

The testing of food allergies may be difficult, as the original food may not be the problem but products from it.

Children with allergies to cow’s milk may have recurrent episodes of diarrhoea, sometimes with blood in the motions, or the allergy may result in eczema or even asthma.

If both parents have a history of allergy, there is a strong likelihood their children will be similarly affected. If the infant is to be artifically fed, a substitute for cow’s milk should be considered, at least for the first six months.

Goat’s milk is also capable of causing allergy and, unfortunately, so is soya bean. Plants contain protein, carbohydrate and oils, all of which are capable of being allergens. It is the oil of soya bean which is the main cause of allergy to this food.

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This is the passage leading from the neck of the uterus, or cervix, to the exterior of the female body, the vulva. It is the passage in which sexual intercourse takes place and through which the menstrual fluid passes each month. During childbirth it forms a part of what is called the ‘birth canal’.

Vaginal health and hygiene are important. Some clear, odourless discharge from the vagina is perfectly normal and is required to keep the vaginal walls moist, clean and slightly acidic. However, when the discharge becomes discoloured and is accompanied by an unpleasant odour and/or itching, it is likely that an infection is present or that the acidity of the vagina has been altered, leading to a proliferation of a yeast fungus known as Candida albicans. This latter condition is quite common and known simply as Candida or thrush. It has a number of causes, including a diet too high in refined sugars and the taking of antibiotics. It is generally treated by increasing the acidity of the vagina to discourage the proliferation of the yeast bug. For natural remedies for Candida, see the separate entries in this book. Other more serious causes of vaginal discharge, itching or pain are venereal diseases such as gonorrhoea.

Dryness of the vagina is a problem which affects most women ocassionally and some women more often. It is a common side effect of menopause, when it results from falling hormone levels in the body. Not only can sex become uncomfortable, but the chances of developing vaginal infections increase during and following menopause. Take Vitamin E internally and apply calendula cream to both soothe and lubricate the vaginal walls. KY jelly is also useful for lubrication. Fortunately, regular sexual intercourse, possibly involving prolonged and gentler foreplay, helps to keep the vagina toned and healthy through the later years of life.

Vaginal prolapse can occur after childbirth but not necessarily immediately afterwards. It occurs when the ligaments supporting the uterus or bladder weaken or lose their tone allowing the uterus to drop down into the vagina. A lump is felt inside the vagina and pressure on the bladder and bowel is often increased. Prolapse the more easily prevented than cured. Women giving birth should do some regular form of exercise to strengthen the muscles of the

pelvic floor and disciplines such as the Alexander Technique are known to improve the posture and prevent muscle conditions such as hernias and prolapse. The widely recognised herb for strengthening the pelvic muscles is raspberry leaf, safely drunk as a tea throughout pregnancy. Poor absorption of mineral salts, particularly calcium fluoride, can cause the tissues to weaken. Take calcium fluoride as a tissue salt and increase your intake of Vitamins E and C.

Women’s vaginas vary in width and length but, generally speaking, any fears a woman has about the size of her vagina adversely affecting the sexual pleasure of either her or her partner are unfounded. Small vaginas swell when properly stimulated to accommodate almost any penis without injury and large vaginas will give as much satisfaction if muscle tone is maintained. Desired sexual positions may vary depending on your anatomy.

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Aging, Sjogren’s Disease (an illness involving dry mouth, dry eyes, and painful joints), certain medications, and radiation treatment over the salivary glands — all result in excessive dryness of the mouth. The mouth-drying effect of certain medicines, understandably, is temporary, but dryness of the mouth due to all of the other causes listed above is permanent. Dryness of the mouth is medically known as xerostomia.

Ordinarily just a nuisance, dryness of the mouth can become dangerous if one has angina pectoris (pain in the chest due to heart disease) and relies upon a tablet of nitroglycerin put under the tongue, where it should quickly dissolve and be absorbed for relief. Also, according to Geriatrics (38#5:16), dryness of the mouth can result in tooth decay if left untreated.

The remedy, of course, is to moisten the mouth by drinking frequently or, better still, by using one of the salivary substitute products, such as Salivart or Xero-Lube, which provide not only water but also certain elements normally present in saliva. Salivary substitute spray products that can be carried in the pocket or in the handbag are now available in most drug stores without prescription.

Now, a correspondent to the New England Journal of Medicine (310:1122) suggests, relief from drug-induced mouth dryness can be even more easily obtained by swallowing tablets of another medication called Bethanechol, which stimulates the salivary flow. A doctor’s prescription is needed for these pills.

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Signs and symptoms

Gumboils can be recognized by their typical appearance. Inflammation or swelling that comes to a point, like a tender pimple, appears where the lip meets the gum at the base of a decayed tooth. The area is sometimes painful. Eventually, the gumboil discharges yellow pus. Usually the associated tooth is obviously injured (fractured or discolored) or has an untreated or recently filled cavity. The tooth may be tender when tapped or may be slightly loose. A gumboil is not usually accompanied by fever.

A gumboil may be confused with a canker sore. However, a canker sore is ulcerated (dug out); it does not protrude like a gumboil.

Home care

Give aspirin or paracetamol for pain. Warm soaks or warm salt water rinses will help the inflammation and promote drainage of the boil. (Use one-half teaspoon of table salt in one-half glass of warm water.) If the associated tooth is about to fall out naturally, a gumboil can be left untreated. The loss of the tooth will allow the pus to drain and the gumboil to heal.

Precautions

• If a young child has a gumboil, consult the dentist.

• Some dentists feel that a gumboil on a baby tooth endangers the permanent tooth that has not yet emerged.

• Premature loss of first-year or second-year molars (or permanent six-year molars) can cause later problems in spacing and positioning of the permanent teeth.

Medical treatment

Your dentist will decide whether to leave the tooth in, pull it, replace it with a space retainer, or save the tooth by performing root-canal work. It’s seldom necessary to give the child antibiotics, or to open and drain the gumboil.

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A young man, they say, will do anything for sex. A middle-age man will do anything for money. An older man will do anything for respect. But all men will do anything for a good bowel movement.

The problem is that a lot can go wrong between digestion and elimination, irritable bowel syndrome being an all-too-common example. IBS, as it’s affectionately called, isn’t life-threatening and doesn’t lead to harder stuff like colorectal cancer. It isn’t inflammatory and doesn’t permanently damage the bowel. In fact, it’s not really a disease but, rather, a “functional disorder.”

The function it disorders is bowel movement. You can have painful constipation with difficult or infrequent bowel movements. Or you can have equally painful diarrhea with a lot of loose stools and urgent desires to reduce the real estate between your irritable bowel and a toilet. Or you can enjoy both versions. Adding to the pleasure are crampy abdominal pain, gassiness, and bloating.

As bad as IBS sounds (and feels), it’s not nearly as serious as inflammatory bowel disease, or IBD. This is a group of disorders that cause inflammation and ulceration in the small and large intestines. Ulcerative colitis and Crohn’s disease, the two major members of the IBD family, cause symptoms similar to IBS. But they also can offer nasty bonuses – like rectal bleeding, weight loss, fever and anemia.

Doctors aren’t sure what causes IBS or IBD. They do know that unlike IBS, IBD has a genetic element to it; 20 percent of people with Crohn’s disease have a blood relative with some form of inflammatory bowel disease. There’s no cure for either one, though treatment under a doctor’s care can ease the discomfort. So can the following recommendations from the National Institutes of Health.

Assess your food. Milk products, large amounts of alcohol, avocados, and excess fat of any kind can contract your bowel in inconvenient ways. But different folks react to different foods, so the National Institutes of Health recommends that you actually keep a journal of the relationship between what goes in and how it comes out. It’s not exactly the kind of diary material that made Samuel Pepys famous, but it could help you avoid undue distress from IBS.

Don’t overeat. Those seven-course extravaganzas can cause cramping and diarrhea in people with IBS. Try smaller meals more often or just eat smaller portions. And keep the fiber high and the fat low. High-fiber diets mildly distend the colon (the largest section of the bowel, or large intestine), and that helps prevent symptom-starting spasms from developing. You may feel some bloating when you first up the fiber, but that should stop as your body adjusts to the better diet.

Lessen your stress. Another trigger for IBS symptoms is emotional stress, which can also aggravate the symptoms of IBD simply by increasing the number of bowel movements.

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Women who are thinking about getting pregnant are constantly advised to give up habits—drinking, smoking, drugs—or alter lifestyles which could put a baby’s health at risk. Recently, researchers have been trying to find out whether the same advice holds true for men as well. Since men contribute half of the genetic material to a baby, researchers have been trying to determine what, if any, effect a man’s health or lifestyle has on pregnancy. As yet, no definite conclusions have been reached. However, new studies are underway and experts may soon have some answers to this very important question.

Recent sperm studies have furnished medical experts with the following information:

1) Babies fathered by men who drink alcohol tend to weigh less and have higher chances of birth defects than do babies of non-drinking fathers.

2) Men who smoke tobacco tend to father babies with higher-than-normal rates of birth defects.

3) In some cases, men with lower than average levels of vitamin C produce genetically damaged sperm which could cause birth defects if they fertilize a woman’s egg.

4) Men who are exposed to radiation—usually in the workplace—tend to father children with higher-than-normal incidences of leukemia.

Researchers acknowledge that no conclusive evidence exists to date which would lead to recommending that potential or expectant fathers change their habits or lifestyles. However, the circumstantial evidence and additional studies on the long-term genetic consequences of lifestyles and other factors on sperm may very well lead to such a recommendation in the near future.

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