Treatment
Because this behaviour is always transitory and self-limited, and there are never any consequences, no intervention is necessary. Parents should be reassured that it is harmless, despite the vigour with wich the activity the activity is pursued, and the best course of action is to ignore it. There is no effective intervention that will reduce the frequency or duration of the head-banging, or will result in making it disappear any more quickly than it otherwise would have.
Some parents, concerned about the consequences of head-banging, try to stop it by smacking the child, or otherwise punishing him. This will often have the opposite result to the desired effect. By drawing further attention to the activity, there is a very good chance that it will continue longer than it otherwise would have, because the behaviour is being reinforced by the parents paying attention to it.
There is nothing effective that can be done to prevent head-banging, because it is not known why some children exhibit this behaviour. It is important to simply ignore the behaviour so as to ensure that paying attention to it does not prolong it.
When to see your doctor
You may want to see your doctor for reassurance that the child is not hurting himself, especially if there is evidence of bruising or swelling. There is generally no need to seek medical advice.
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REACTIONS TO IMMUNISATION
Vaccines are extremely safe and effective compounds which have been thoroughly tested. They are in use worldwide. As with all medicines, some people do have unwanted reactions. These are virtually never serious, and pass quickly. We stress again that the benefits of immunisation far outweigh any risks.
Some children have mild reactions to immunisation, such as local redness and swelling at the site of injection, or mild fever and irritability. To reduce fever and reactions, paracetamol should be given according to recommended doses prior to the immunisation and afterwards if necessary.
PERTUSSIS (WHOOPING COUGH) VACCINE
A lot of controversy surrounds this vaccine, which is usually given in combination with diphtheria and tetanus vaccines. Pertussis is a serious and sometimes fatal infection of the respiratory system. Although it mostly passes without complications, young children have been known to become extremely ill and even die from whooping cough. Babies do not acquire natural immunity from their mothers after birth, and are most vulnerable. Antibiotics do not provide effective treatment for the disease. The pertussis vaccine is extremely effective in preventing the disease and reducing its severity. The major controversy surrounding immunisation is related to concern that it may cause neurological damage.
Recent figures show a slightly higher incidence of short-lived, unpleasant side effects such as fever, crying and swelling and redness at the injection site but more serious reactions are extremely rare.
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It is unknown and unfamiliar. The dawning sense of self is like living with a person we don’t know, living with a person whose values and needs are different. Having to welcome such a stranger into our life on such an intimate level is naturally frightening, even though the stranger is ourself.
This is one of the most confusing aspects of the working-through process. As we learn to face the attacks, the anxiety and the fear we may also have to learn to face the fear of change and the fear of the new emerging self. The carefully constructed defences of a lifetime have been torn down. Rebuilding on more solid foundations means we have to push past the new fears.
When the new fears emerge we will have already broken through many barriers and overcome many of the fears associated with the disorder. We will be able to push past these new fears also, but it must be done gently and intuitively.
The essence of who we are, the essence of our self, is intact. It has always been there and will always be there. Now we have a chance to get to know our self. Now we have the chance to develop and integrate it into our life.
The process is hard, but each step we take means we learn more about the process. In the beginning it is difficult; there is fear, there is anger, there is frustration. ‘Why do I have to go through this, why can’t I just be normal like everyone else?’ What is ‘normal’ anyway? Use the anger, the fear and frustration to push past these new fears. With each step we gain new awareness, new knowledge and increased strength.”The process becomes easier and more tolerable. This is life, this is growth, a continual evolution. Now we can work with it by letting go and flowing with it, not by trying to control it.
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So far, we have discussed putting limits on what your surgeon can do in an unexpected situation. The same considerations apply if your surgeon recommends, as the treatment of choice, a procedure that you are not prepared to undergo. You, as a responsible adult, have the right to refuse any form of treatment that you don’t want, even if such refusal could mean that your life is likely to be shortened. No one has the right to override your refusal to any procedure, even when it could temporarily extend your life.
Of course, this, like so many things, is easier said than done! Your surgeon may be hurried, impatient and irritable with you. Your surgeon may tell you that he or she simply can’t understand how anyone could make such a stupid decision. Your surgeon may appear to be insulted, disappointed or hurt because you are rejecting his or her advice. Don’t be deterred by such reactions. You do know that there are limits to what you are prepared to sacrifice in order to live a bit longer. You probably know that even dying could be a better alternative for you than some types of drastic treatment. Trust what you know about yourself. You do know what’s best for you.
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Small dilated blood vessels (telangiectasia) lead to a blotchy appearance and there may be areas of patchy pigmentation or depigmentation.
The elastic tissue degenerates and the skin becomes thin and more prone to injury. Solar keratoses are reddened patches covered by white scale and are common on the face and backs of the hand.
These small lesions are unsightly and may go on to develop into skin cancers. Cancer of the skin has reached epidemic proportions in Australia and will eventually develop in a third of us.
For this reason, we should all learn to cover up when the sun shines and to avoid the middle of the day when the sun is at its zenith and the rays are most potent.
Some chemicals applied to the skin can sensitise the skin to UV light and lead to a rash. Some drugs taken internally can do the same.
During the long summer, millions of us swim each weekend. We seem to have an abnormal fear of sharks but give little thought to the risk of drowning. Unfortunately, drownings are like road accidents — most victims have been drinking alcohol.
Be careful about swimming in rivers, pools or at the beach after drinking.
And if you are going near water, learn how to carry out artificial respiration, by the mouth-to-mouth method.
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These were used in the past in frail old women for whom operation might have been too dangerous. Now, with modern anaesthetics and resuscitative measures having improved so much, there are few patients who are considered too sick to risk operation.
Sometimes, they were used in younger women who still wanted to have more children and may be still used for that purpose.
For those with severe symptoms, operation is usually indicated. This repair operation is usually called the Manchester or Forthergill Repair, after Dr Fothergill, a gynaecologist of Manchester in the UK, who devised it.
As well, the lax tissue from the front and back walls of the vagina is cut out, like taking a tuck in a piece of material. The underlying tissues are pulled together with stitches. In elderly women who are no longer leading active sex lives, the opening of the vagina may be considerably tightened so as to lessen the chance of recurrence. This would make intercourse impossible.
In sexually active women, vaginal repair tightens the opening to what it was before childbirth.
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Man is a hairy animal. An adult has about five million hair follicles of which 100000 are on the scalp. Virtually the only areas spared are the palms of the hands, soles of the feet, and lips. Most of the skin surface is covered with short, fair, fine, and poorly developed hair known as vellus hair or ‘fuzz’. Certain specific areas such as the scalp, genital area and armpits grow coarser, thicker, coloured hair known as terminal hair. There is a marked difference between the hair in different areas of the body, making simple generalizations about hair growth impossible. Originally, hair had four important functions to fulfil. These included improved sensory awareness; heat regulation; sexual attraction and protection. Of these only the latter two are relevant today: hair still contributes to sexual attraction, and still protects the nose and eyes.
Hair grows from follicles, which are finger-like indentations of the superficial epidermis and dermis, each of which encloses at its base a small bud of dermis. The hair filament may be regarded almost as a secretion arising from the division of cells surrounding this bud. It is composed of the same type of keratin protein as the skin itself. However, it does not contain nerves, blood vessels or any vital ’sap’. There is therefore no truth to the supposition that dull, lank hair with split ends is due to escaping ’sap’, and that singeing the ends will prevent this.
Hair does not grow continuously, but in cycles. All hairs on all parts of the body grow, rest, and fall out according to a cycle which is repeated without interruption throughout life. The duration of various stages in the cycle varies from one part of the body to another, with the scalp being the longest of all — from three to six years. There are three distinct phases of the hair cycle: a prolonged hair growth phase (anagen); a short transitional phase (catagen); and a longer resting phase (telogen). With the growth of the new hair the old hair is pushed out of the follicle and is shed. At any time of the scalps cycle there will be anything up to 100 hairs shed per day. However, as different parts of the scalp will be at different stages in the cycle at any one time, no nett loss is usually detected. Hair grows faster during the summer, and women’s hair grows faster than men’s, averaging about 10 millimetres a month. However, with ageing, the rate of growth slows down.
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More and more people these days realise the benefits of having breakfast. Scientifically, having breakfast has been proven to help you lose weight and to lower your cholesterol levels. We also know that eating breakfast can help to stabilise your blood sugar levels. It kick starts your metabolism and gives your body food when it really needs it. Missing breakfast can cause symptoms of fatigue, dehydration and loss of energy.
One of the things we notice when non-breakfast eaters start having breakfast is that all of a sudden they develop a morning appetite that they haven’t had since childhood. Eating breakfast becomes easier. In fact it becomes a necessity (which is what it should be). Our bodies require fuel to run on and yet too many of us expect to go about our work without topping up our fuel tank first.
If your breakfast leaves you starving by mid morning, have a closer look at what you ate for breakfast. Many breakfast cereals and breads have a high G.I. factor which means while they pick you up initially, they won’t last long. When the energy runs out and your blood sugar starts to drop, you feel hungry again. Eating a low G.I. breakfast ensures your breakfast is going to take you through to lunch time.
In the breakfast section you’ll find simple recipes from a quick milkshake to delicious mueslis and more adventurous dishes for a weekend breakfast—all guaranteed to sustain you through the day.
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