Health News and Information

There are many different causes of constipation. By far the most common is a lack of fibre or bulk in the child’s diet. Some children hold back, often because they are too busy playing or it is otherwise inconvenient, so that stool accumulates and having a bowel movement causes discomfort and pain. Sometimes, especially in babies and toddlers, passing a hard bowel motion may cause a tear in the lining of the anus (anal fissure), causing painful defaecation and leading the child to hold back because of the pain. In this way, a vicious cycle is created, with holding back because of pain causing further constipation, which then means more pain. Toddlers may hold back during attempts at toilet training, so beginning this cycle. In rare cases, there are neurological reasons for constipation.

The child will have less frequent bowel movements than usual, and may complain of difficulty in passing a movement. Often there will be associated discomfort and sometimes pain on defaecation. In some children there is abdominal pain, usually in the centre of the abdomen around the umbilicus, and often spasmodic like colic. Parents will comment that the child is listless and has lost his appetite.

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WIND

Most young babies swallow small amounts of air while feeding, especially if they suck vigorously. If large amounts of wind build up in the gut, they can cause discomfort and crying, and increase the likelihood of regurgitation of feeds. When positioning your baby for burping after a feed, make sure that you support him in an upright position such as up against your shoulder or seated on your lap, or lie him prone over your lap and gently rub or pat his back. If he does not burp after 2 or 3 minutes he probably doesn’t have excessive wind.

WEANING

Weaning your baby from the breast is often a difficult decision to make. Timing may depend on various factors, and is usually best guided by the baby himself. As he is introduced to solids his appetite for the breast may decrease. Some mothers choose to wean their babies after 3-6 months, or upon returning to work themselves. Try not to rush into weaning; it is often a gradual process, and with a little juggling you can continue some breastfeeds even though you are working. You may need to express breastmilk once or twice a day and have someone else feed your baby while you are at work. If you do decide that it is time to wean your baby, talk to your maternal and child health nurse or doctor about how to approach it. A gradual change-over period is usually recommended so that both you and your baby have time to get used to the transition.

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SPECIFIC SEXUAL PROBLEMS: With the complexities of metabolic and neurochemical reactions that accompany grief, it is ot surprising that specific transitory sexual problems can result. Fatigue, failure to eat and exercise, and disruption of sleep and other life schedules can impair sexual reflexes. If both partners are aware that time will usually take care of the problem, sexual function will return to normal as the grieving response diminishes. If, on the other hand, the sexual problem is viewed as “just another crisis related to the loss,” it may become more established in the sexual interaction pattern, a permanent side effect of the misunderstood grief response.

LOSS OF SEXUAL SELF-ESTEEM: Grieving is a de-energizing process that must take place whenever a relationship ends. When life energy decreases and the bereaved partner feels weak, drawn, and listless, she or he may also feel that personal sexual attractiveness has been lost. During grieving, there may be a period during which self-care and attention to hygiene, dressing, posture, and general self-presentation are ignored or neglected. The bereaved partner may present this “grieving mask” to avoid intimacy, to hide from what he or she perceives as premature, even insensitive sexual overtures. When others seem unattractive to the grieving person at this time of loss, it is easy to neglect one’s own physical appearance.

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Love is the most basic, natural of all feelings. If the world would only give love a chance, return to its natural love state, we could save the world from this mad dash into global disaster.

HUSBAND

During the major blackout in New York City some years ago, people shined flashlights down from their apartments to help those below find their way. At the same time, looters and muggers were on the loose to an extent never before imagined, even in New York. Which is the “natural state,” the aggressive capitalizing on human misfortune or the caring, helping motivation of the apartment dwellers? The answer is that both states are natural.

Nobel laureate Konrad Lorenz suggested that aggression is basic to human nature. Anthropologist Ashley Montagu speculated that human cooperation and caring have an evolutionary base. Dr. Reuben Fine describes what he calls “love cultures”: harmonious, sexually open, contented, and happy places where aggression, if present at all, is directed to outside forces and spirits. Freud felt that love and aggression were both characteristic of human nature.

Theorists and researchers have been unable to support the conclusion that any one human characteristic or experience is more natural than any other. To assume that “love will out” is to be unrealistic. The effort must be to maximize our efforts to teach, encourage, and nurture love, not trust in its evolutionary advantage.

“So help me, I could just kiss you,” said the wife. “So kiss me. I’ll help you,” said the husband. Love needs all the help it can get. It will never make it on its own.

“If he doesn’t love me anymore, there’s nothing I can do or he can do about it,” the wife reported. “You either love someone or you don’t. It’s a basically natural feeling, like hunger or sex.”

“At least give me a chance to make it happen again,” replied the husband.

“I don’t see how,” she replied. “You have exploded at me for years, and I have seen nothing but anger in your eyes. There’s no room for love there.”

The wife had taken the either/or orientation to love, that it is natural and that the presence of any other emotion means that the natural love either was never really there or is crowded out by less “unnatural” emotions of anger or distrust. All emotions are human, and the systems orientation to loving I have been describing does not exclude or favor any one aspect of our humanness.

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The tonsils are two collections of lymphoid tissue lying either side of the back of the throat. They form part of a ring of similar tissue in this area. They were put there for a purpose and we need a very good reason to remove them.

The tonsils and other lymphoid tissues act as a barrier to infection. They contain white blood cells which devour and destroy bacteria and viruses. They are also an important part of the immune system, helping in the production of antibodies to fight off infection.

Sometimes they become infected. Acute tonsillitis commences with a sore throat and often a high temperature, and the lymph glands in the neck are usually swollen. The tonsils are enlarged, reddened and sometimes covered with spots of pus. The usual cause is infection with the streptococcus germ.

Unfortunately sore throats due to either bacteria or viruses, are common. But this is a pharyngitis, or infection of the throat, rather than a specific infection of the tonsils. It is important to note the difference.

The streptococcus germ remains very sensitive to penicillin, and this is the treatment of choice.

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I’m just as guilty as the rest of my colleagues. So let us all — general practitioner, specialist, salaried doctor — give the patient communication and reassurance, as well as expert advice.

Then we can take any criticism because we and our patients will know that this criticism is no longer justified.

When most people talk of “doctors”, they usually mean “medical practitioners”.

It may come as a surprise to learn that most

“doctors” do not have doctoral degrees from a university. The title “doctor” is a courtesy one.

How does one become a medical practitioner?

To practise medicine in Australia a person must be registered as a medical practitioner by the medical board in the state in which he wishes to practise.

The prerequisite is a medical degree from an approved university.

All the Australian universities are “approved”, as also are those of Britain, and most of the universities of the British Commonwealth. But not all.

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I’m sure you’ve heard of the depth-finders that ships use. These instruments send out a beam of ultrasound waves. By measuring how^otig these waves take to bounce back from the ocean floor, the depth at that point can be worked out. Ultrasound waves are not electromagnetic. They are the same as sound waves but of a frequency and wavelength that the human ear cannot pick up. They bounce back off some surfaces just as sound waves bounce back as echoes from cliffs.

Ultrasound can be used in medical diagnosis, because it bounces off some tissues in the body more readily than others and passes through different body tissues at different speeds. A machine that produces ultrasound waves is placed on the skin overlying the part of the body to be checked. The ‘picture’ formed by the waves echoing back can be ‘read’ by experienced people, but is not as clear as those of X-rays and scans. This method was developed originally for pregnant women because of the great importance of avoiding radiation to the delicate foetus. It is now used for many other purposes. Because it doesn’t involve any radiation it is especially useful when repeated examinations are needed, for example, to check the effects of treatment on a growth. However, it can only be used on certain parts of the body and only shows up certain types of abnormalities clearly. Ask your doctor if you want to know more about its possible use in your particular case—it may or may not be suitable and/or available.

Thermography is a means of getting a ‘picture’ of various parts of the body by measuring the amount of heat coming off. For example, a thermographic picture of the breast might show excessive heat coming from a known lump. This would mean the lump was unlikely to be a fluid-filled cyst and more likely to be cancer or an abscess. This method is not very reliable because many factors can influence the amount of heat coming off different parts of the body.

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Cancers actually starting in lymph nodes are grouped together under the name lymphoma. In turn, lymphomas are subdivided into two groups— Hodgkin’s disease and non-Hodgkin’s lymphomas. Each of these groups contains a number of quite different subtypes. Hodgkin’s disease tends to start in one group of nodes and spread in a fairly orderly and predictable way to other groups. Most non-Hodgkin’s lymphomas tend to develop in many different groups of nodes at the same time, although there are a few particular types which spread like Hodgkin’s disease. All lymphomas can also affect the bone marrow, liver, spleen and other organs.

Lymphomas can be treated by radiotherapy or chemotherapy. Hodgkin’s disease and a few particular types of non-Hodgkin’s lymphoma can be completely cured by radiotherapy, provided every involved node is treated. Here it is extremely important to track down every single deposit of the disease. In contrast, if chemotherapy is to be used, it is not as important to know where the disease is, because the chemotherapy drugs go right around the body anyway.

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