The Health Blog

DIAGNOSING ASTHMA IN CHILDREN – HISTORYWHEN A CHILD shows frequent symptoms of coughing and wheezing, parental anxiety is natural and understandable. These symptoms must be brought to the doctor’s attention. Almost every child with asthma needs medical attention at some time or the other, and in most cases the first correct diagnosis is made by the family doctor. Many a time, a child is brought to the doctor with the anxious parents announcing that the child has asthma. All doctors, however, examine the child before coming to any conclusion, or advising any treatment. It is possible that cough and wheeze may not be due to asthma. The doctor would also want to establish beyond any doubt that the child has asthma, and to find out its cause.HistoryThe doctor will probably start by reassuring the parents and making them feel relaxed. He will ask them to describe the symptoms they may have observed. It is important for the parents to understand that their discussion is at the heart of all investigation by the doctor.It is also important for the doctor to obtain a clear and a detailed history of the child’s illness. This is a little complicated. The history has to be obtained second hand from the parents, usually the mother, rather than from the child. The way the parents recount is, more often than not, biased by what they believe to be the problem, or what they have heard, or been told.Parents often feel that all they have to do is recount details of the child’s symptoms, but are surprised, and sometimes confused and frightened, when asked a whole lot of questions by the doctor. It is essential for the doctor to know as much about the child as is possible, including when the symptoms began, early development, and what makes the symptoms better or worse. Questions may also be asked about the child’s general health and previous illnesses, if any, and the emotional state. It is important for the doctor to find out about the frequency and severity of the symptoms the parents have observed, and whether these attacks interfere with the child’s everyday life. The doctor will want to know about the conditions and environment at home and at the school.It is also necessary to ask if the parents have noticed any other signs of allergic reaction in the child — sneezing, sinus infections, allergic rhinitis, hay fever or eczema or any allergic reaction to foods or medicines.The doctor would also like to know of factors such as weather, exercise or infection which seem to influence the child’s condition.All these questions are designed to help the doctor gain a better understanding of the problem. The parents must appreciate that these are necessary, even if they are uncomfortable, or cause some embarrassment. Family History. It is now accepted that asthma which begins in infancy or childhood is more likely to be inherited than asthma that begins late in life. Knowledge and history about the health of other family members is therefore an important aid in diagnosis. More often than not, some member of the child’s family—father, mother, brother, sister, or a grandparent or a maternal uncle or aunt, may have an allergic illness like asthma, rhinitis, eczema etc.If one of or both the parents, or someone else in the immediate family and at home, is a smoker, the parents would need to be informed that cigarette smoke is harmful for the child, and likely to aggravate his condition.*46\260\8*

WOMEN AND AIDS: SOME SERIOUS FACTSNow there is increasing realization that HIV is not an infection that certain groups get because of inherent group characteristics but rather an equal-opportunity pathogen that can attack anyone who engages in certain high-risk behaviors. If you engage in these high-risk behaviors, it doesn’t matter who you are, what your race or socioeconomic status group may be, or what your sexual orientation is.With this realization, the focus has finally turned to the 51 percent of the population that was long ignored: women. These are a few of the facts that have emerged:- From 1985 through 1997, the proportion of AIDS cases among American women increased from 7 percent to 22 percent. In 2000, over 43 percent of all AIDS cases in the United States were among women.- In rural America, HIV/AIDS due to heterosexual sexual transmission is increasing faster than in any other part of the country. Women most at risk are ethnic minorities and the economically disadvantaged. Among sexually active heterosexual teenagers, college students, and health care workers, nearly 60 percent of HIV cases are women.- Women in the age group of 13- to 24-year-olds accounted for 44 percent of new HIV cases in 1997.- Most women with AIDS were infected through heterosexual exposure to HIV, followed by injection drug use (sharing needles).- Women of color are disproportionately affected by HIV; African American and Hispanic women together account for 76 percent of AIDS cases among women in the United States, though comprising less than 25 percent of all U.S. women.- Of all AIDS cases among women, 61 percent were reported from five states: New York (26 percent), Florida (13 percent), New Jersey (10 percent), California (7 percent), and Texas (5 percent).- AIDS is the leading cause of death among African American women ages 25 to 44, and it is the fourth leading cause of death among all American women in this age group.Compounding the problems of women with HIV are serious deficiencies in our health and social service systems, including inadequate treatment for women addicts and lack of access to child care, health care, and social services for families headed by single women. Women with HIV/AIDS are of special interest because they are the major source of infection in infants. Virtually all new HIV infections among children in the United States are attributable to perinatal transmission of HIV.*44/277/5*

SKIN IN DISEASE
Whenever there is disease in the body the skin is affected in some ways. As it is an important elimination organ this is only to be expected, but the fact is often overlooked, especially in relation to effective treatment. More attention should be paid to the skin in this respect because it can be used as a useful diagnostic aid and also as an indication of the progress that is being made in the body’s return to health. Apart from the actual local changes that may take place when there is a particular skin complaint, such as, for example, psoriasis, the unhealthy skin shows definite changes in its general texture. It may be too dry or too moist, and it will most certainly lack the normal elasticity. When it is picked up under the fingers and thumb it will feel lifeless and lack that responsiveness so characteristic of the healthy skin. There are many people whose skin may be in this condition, and although they may not suffer from any so far diagnosed disease, their general health will be very poor. If the skin were used to estimate the general condition it would be possible to institute effective treatment much earlier than is usually the case.In some cases the sebaceous glands are either inactive or too active. In the latter case, the skin takes on an oily condition which is far from pleasant and which spoils the appearance of the skin. The same is true of the sweat glands, and here the perspiration may be offensive, especially in certain parts of the body. The feet may often be affected in this way, and too many people think that such a condition can be rectified by the application of some deodorant. This is not so, because the excessive perspiration and its offensiveness are related to some inward disturbance of the system. The nerve endings in the skin may be irritated by the localized condition and set up itching of varying degree. Here again, one should not think that the suppression of the irritation is the proper way out of the difficulty. Whilst local relief may be given, the cause of the irritation must be found and removed if the case is to be satisfactorily handled. So many of these local troubles are the outcome of some disorder within the system that it is usually very dangerous to use suppressive treatment and thus merely put off the day of reckoning.When the skin is sallow, and showing other forms of discoloration, there is no point in trying to hide the condition by the use of various cosmetic aids, because it is only the outward and visible sign of a toxic system. Nature is trying to store in the least dangerous places the effete matter the disease is developing within the body. The person who suffers from chronic dyspepsia often shows it in the colour of the skin, which is sallow and dry, and the sufferer from sluggishness of the bowels is never without signs of it within the various tissues of the skin.
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Animals — other than man, monkeys and guinea pigs — meet the demands of stress, any kind of stress, by producing extra ascorbic acid in their livers. Man cannot do this. His adrenal glands work overtime, and so great a quantity of the ascorbic acid present in the body is used up that a deficiency is likely to occur.

Supplements of Vitamin C improve the person’s ability to withstand the effects of stress. This has been shown in hundreds of experiments with animals, especially guinea pigs — which suffer the same disability as humans.

Many experiments have shown that animals given doses of ascorbic acid survive the stress of cold, heat, im­mersion, poisons and injury far better than those receiving no or very little supplement — their ability to withstand the stress depending on the ascorbic acid levels in their body tissues.’

Those few tests carried out with humans have shown exactly the same principles.

High doses of Vitamin C have improved the ability of such groups as soldiers, industrial workers, students and patients to withstand such stresses as cold, burns, injuries, any kind of surgery, many poisons from minerals, pollu­tion, drugs and bites and stings of snakes and insects, and allergies.

Moreover, the exhaustion that follows a stressful situa­tion is far less when the blood levels of Vitamin C are normal or above normal.
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Although not high on the list of killing diseases, rheumatism of one kind or another causes more pain and disability, more loss of work and efficiency than any other complaint.

It is estimated that in U.S.A. 13 million people suffer from arthritis — while in Australia the N.S.W. Council for Rheumatism estimates that 33 in every 1000 of the popula­tion suffer some disability from arthritis, but 66 per 1000 from all rheumatic disorders. A survey made several years ago showed that half the invalid pensioners and about half those permanently unable to work had rheumatic com­plaints.

I believe ‘rheumatism’ is even more prevalent. Looking round among patients — myself included — I can find scarcely one adult who has not suffered from ‘rheumatic’ pains and twinges in the joints at some time in their lives.

Most of these are seasonal and transient. It is the chronic sufferer — the crippled elderly and those crippled even in youth with progressive rheumatic arthritis who need help.

Reading of all the many ‘cures’ claimed for arthritis and rheumatism would lead to utter confusion if one did not bear in mind certain definite principles that are essen­tial to success.

Whatever the immediate causes of arthritis and rheumatism, there is always a basis of stress, with the con­sequent depletion and exhaustion of the adrenal and pituitary glands which renders the tissues of the joints sus­ceptible to the destructive processes which take place in them. ^

Dr Hans Selye, the great Canadian expert on stress, has found that any strain on the body will use up its essential stores from its own tissues — especially proteins, minerals and vitamins far in excess of its normal needs. These must be replenished, if these glands are to continue their work of rebuilding, maintaining normal function and resisting in­fection.

This is why cortisone, a product of the cortex or outer layer of the adrenal gland and A.C.T.H. from the pituitary gland are so effective in temporarily combatting arthritis. But cortisone does not effect a cure. Rather it acts as such a crutch to the failing adrenals that they tend to give up the job of producing cortisone for themselves. Synthetic cor­tisone, however, produces its own side effects and although it must be continued in increasing doses to obtain relief, it should not be used indefinitely as the main treatment.

The first aim of treatment then should be to rebuild depleted tissues and the efficiency of these glands. This can only be done by replenishing the body’s fighting equipment in a completely adequate diet, plus supplements of minerals and vitamins to meet the demands of stress.

Many vitamin supplements are needed to reinforce a well balanced diet. Vitamin E, Vitamin A, the B Complex, especially pantothenic acid and Vitamin C all help to re­habilitate the adrenal and pituitary glands.

Adelle Davis and Irwin Stone who have thoroughly researched all the studies made on the effect of Vitamin C on the adrenal glands believe in its value.

Miss Davis writes in her book Lets Get Well — ‘Although adrenal hormones can be produced without Vitamin C, the need for this nutrient is tremendously increased by stress; and if under-supplied the glands quickly haemorrhage and the output of hormones is markedly decreased. This Vita­min accelerates the rate of cortisone production, appears to improve its utilization and delays it breakdown, and al­leviates many of the limitations resulting from a pantothenic-acid deficiency. Apparently because large amounts of Vitamin C are used to detoxify harmful sub­stances formed in the body during stress, greater than normal quantities are lost in the urine at this time.

‘Huge amounts of Vitamin C appear to protect animals from every form of stress — guinea pigs exposed to very low temperatures remained healthy when given 75 times their normal requirements of Vitamin C; if only allowed smaller amounts, their adrenals haemorrhaged and many animals died.

‘Translated into human terms, 75 times our normal daily requirement of Vitamin C would be approximately 5,625 milligrams. Such a quantity seems startling’, she writes, ‘yet during stress it may not be excessive.’

In actual practice a group of patients whose adrenals were exhausted and unresponsive to other stimuli im­proved greatly when large doses of Vitamin C were given.

The second principle is that early treatment of arthritis in any of its forms offers the best hope of success — before destructive processes have taken place in the cartilage of the joints.

In 1968 the Kennedy Institute of Rheumatology in London found that damage to the synoval membrane lining the joints released destructive enzymes that pitted the un­derlying cartilage and finally eroded the bone beneath. It is at this stage, they wrote, before bone and cartilage can be damaged that treatment must be aimed if permanent dis­ease is to be prevented.

‘If a substance can be found that repairs the leak in the cell wall and prevents the enzymes from eating away the cartilage, a major step may have been taken in preventing the inroads of crippling arthritis’.

I believe that such a substance exists in Vitamin C — which is essential with proteins in building and keeping in repair the coloid substance that cements all cells together and prevents leakage between them.

Dr W. J. McCormick M.D. of Toronto writing in the Archives of Pediatrics states that ‘the most definitely estab­lished function -of Vitamin C is that of assisting in the formation of collagen for the maintenance of integrity and stability of the connective tissues generally and this would include the bones, cartilages, muscles and vascular tissues. A deficiency of this vitamin causes a breakdown and easy rupture of any of the connective tissues including the discs of the backbone, the ligaments and linings in the interior of the joints (synovial membrane) and^ the cartilage which helps in their movement’.

He believes that this may be a common cause and a significant factor in arthritic and rheumatic diseases.

Early tests of Vitamin C in alleviating arthritis or rheumatism were hampered by using it as a vitamin in small doses to correct a nutritional deficiency instead of treating a serious disease already present. In all reports since the 1940s, those workers using large doses of 4 grams (1 gram four times a day) to 8 to 12 grams a day have shown excel­lent results.

Since the 1950s very little research has been carried out on Vitamin C in these collagen diseases, but the experience of individual doctors since and that of these earlier inves­tigators seem to indicate the dawn of a new era of discovery in effective treatment of rheumatic diseases.

Further large scale research is now needed to confirm and improve results already achieved.
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Australia’s climate is not kind to anybody’s skin. Babies and young children in particular are prone to dry skin.

Cause

Many babies have dry, peeling skin immediately after birth; this is normal and will soon improve. Too much bathing, and using a lot of soap can cause dry skin, or aggravate skin that is already dry. This is because it removes the skin’s natural oils, and the skin can no longer retain moisture.

Clinical features

Dry skin is often itchy and flaky. Areas most commonly affected are the elbows, knees and face. If the skin is excessively dry, cracks (or fissures) may appear which can be painful and even bleed or become infected.

Treatment

Avoid using all soaps in young children. Older children should be encouraged to use a non-irritant soap. Bath time should be shortened, and water should be warm but not hot. Avoid using any scents, bubble bath or bath salts. Special bath oils or

Baby oil can be added to the bath water. You can buy these across the counter at the chemist. Be careful, because they make the bath slippery. Sorbolene with 10% glycerine is an excellent cream which can also be purchased over the counter, and is inexpensive. It is very effective in the prevention and treatment of dry skin, and is non-allergenic.

When to see your doctor

• if your child has persistent dry skin;

• if your child has patches of dry skin which are red and itchy.

Prevention

The use of a lubricating cream after your child’s bath is often helpful in preventing drying of the skin. Do not overdo bath time — do not let your child sit around in the bath for more than 10-15 minutes.

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First Aid Kit (This can be kept in a separate bag.) Adhesive tape

Alcohol wipes or 70% alcohol in bottle Bandages, sterile (crepe, various sizes) Band-aids (various shapes) Cotton wool balls Disinfectant

Dressings (non-stick, e.g. Melolin) Eye pads, sterile Gauze, sterile

Needle (can be used for removing small splinters)

Scissors

Sling

Steristrips (used for closing small cuts)

Thermometer

Tweezers

Medicine Kit

Antihistamine (if prescribed) (for severe allergic reactions) Antiseptic solution (iodine) Calamine lotion

Ipecac. . Use only on the advice of your doctor or the Poisons Information Centre.)

Measuring cup (for giving medicines) Paracetamol

(You may also wish to keep back-up supplies of insect repellent, nappy rash cream, sunscreen, vaseline and zinc cream in your Medicine Kit, as well as having supplies of these handy for day-to-day use.)

Note that medicines requiring refrigeration should be kept on the top shelf of the fridge at the back, not in the medicine cabinet.

Always check the expiry date on medicines and creams or ointments and replace them when necessary. Take all old medications to the chemist for safe disposal.

Never leave medications within reach of children. It only takes a second for a child to grab and swallow something dangerous.

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HYPERAROUSAL: I get all sweaty. My heart beats, any hands are wet, but I feel kind of cold. I get over-ready, overanxious. I’m so turned on that I can’t even feel anything really. I just seem carried away, like I have to do it now or I’ll explode. My wife keeps saying “Slowdown, slow down, take it easy,” but I just want to take it fast. I really can’t control it.

HUSBAND

I have an “on” switch, I swear. I even start kind of a nervous laugh and get dizzy. I don’t know what’s happening, but it’s like running as fast as I can down a steep hill and not being able to stop. It’s frightening, really.

WIFE

Three hundred forty-nine men and 284 women classified themselves as experiencing this hyperarousal state in what they felt was “most” of their sexual experiences. Remember, we all experience this state sometimes in our sexual lives, and we can all experience more than one sexual problem at a time. In fact, hyperarousal and seminal seepage or early Skene’s glands emissions in the absence of contractions commonly occur together.

Hot times in our lives typically result in this “out of control” orientation, and it extends to our sex life. When we are running hot, when we are hostile, impatient, and competitive, we are in a state of maladaptive hyperarousal. Sex can be so intense, so fast-paced, that we almost miss it entirely. Our sexual intensity, our sexual speed seems to break the intimacy barrier instead of the sound barrier, but little real intimacy results as we go right past it.

This category of problem contains erective difficulties. The failure of the penis or clitoris to erect or a lessening of intensity of erective experience is simply a natural reflex to the accompanying emotional state of anxiety, of running hot. It makes little sense to treat the symptom instead of the cause or to blame the penis or clitoris for failing to erect while we are sending direct neurohormonal orders for them not to do so.

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