СИНДРОМ ХРОНИЧЕСКОЙ БОЛИ-CHRONIC PAIN SYNDROME

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Parents regard head-banging in young children as one of the more distressing behaviours in childhood. The sight of their toddler repeatedly banging his head against the cot or on the floor, often with a force so violent that it seems inevitable that a serious injury will be sustained, causes intense concern in most parents. Yet this is a behaviour that is relatively common, occurring in 10%-15% of young children, with boys outnumbering girls by a ratio of 3 to 1, and there are virtually never any serious consequences. The peak age for head-banging is from about 6 months to 3 years, and the vast majority of children outgrow it, in the same way that they outgrow other rhythmic, repetitive, self-stimulatory behaviours (body-rocking, thumb-sucking).

Cause

It is not known why some children engage in head-banging. Nor is it clear why it is more common in boys than girls. Like other rhythmic, self-stimulatory behaviours, it seems to soothe and comfort young children at a particular developmental age and then becomes unnecessary as the child matures and his repertoire of coping behaviours expands. It seems to be a response to stress or discomfort, although usually no distress is discernible to the parents. It may increase in frequency and duration during periods of insecurity or stress such as separation or illness.

Head-banging, along with other repetitive behaviours such as body-rocking, is seen more frequently in certain groups of children, such as those with mental retardation, autism, those who are blind, and often in institutionalised youngsters. Again, the reason for this increased frequency is not clear. The persistence of head-banging may be associated with underlying psychological or emotional problems.

Clinical features

The usual picture is of a baby, or particularly a toddler, repeatedly hitting his forehead against the headboard of the cot or bed, or against the mattress, the floor, or even against the wall. Often it occurs at bedtime, but it may happen at any time of the day. The duration varies from a few minutes to up to an hour or even more. Although it appears that considerable force is being used and it seems to the parents that the child must surely sustain an injury, it does not seem to bother the child at all. In fact the opposite is true — the child appears to enjoy it.

Frequently there will be a bruise, welt, callus or even an abrasion on the child’s forehead. Very rarely will the child’s actions result in any bleeding, and he never suffers any serious injury from the head-banging.

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Here were some of the recommendations in this area.

1. Your spouse should be introduced to all of your friends at least once. Each of us needs distance and our own chance to be free and be a “non-spouse” once in a while, but super marital sex depends on total disclosure. Make sure your spouse knows everybody you know.

2. Never, but never, criticize your spouse to someone else or in front of someone else. Marriage is for intimacy, and that includes the dignity of both sexual and problem-solving privacy. One angry wife stated, “Unless you want to have sex with me in public, don’t try to screw me in front of our friends.” Take your spouse with you when out with your friends sometimes. There is no rule that all groups must match up gender for gender, couple for couple. Maybe your spouse could become a different type of friend to you by seeing your friends and relating to them in different settings. This was the idea behind the “managed-a-trois” assignment discussed earlier.

3 If you are putting more effort into your friendships and into your interactions outside of marriage, stop and ask why. Your primary energy, including your emotional and physical presentation of yourself, should be for the marriage.

4. When your spouse is available, take advantage of it. Time is always a problem, so talking on the phone or spending time with friends while your spouse “waits” can cause subtle and sometimes not so subtle messages of lack of concern or feelings for your partner. Try to schedule most of your calling and visiting when your spouse is not available or when you have mutually planned some time for other friends.

5. You do not have to be inseparable. Go to some couples’ parties without your spouse when this seems convenient. One reason for friends is that they provide variety, different points of view and feelings. If one or the other of you feels that you are going to a dinner or party reluctantly or as a favor, discuss the possibility of going alone. Your host or hostess will probably be shocked at first, and rumors of your impending divorce will start immediately. You know better, and that is what really matters. Show off. Show them that your super marriage is strong enough to allow for independence.

I have described six of the “dirty dozen” problems that can affect super marital sex. You and your partner have reviewed each issue together and come up with some of your own plans for dealing with these problem areas. Dealing with loss, parenting, parenting your parents, working and loving, finances, and working others in and out of your marriage are strong challenges in themselves, so take a break here before going over the last six problems. Stand up and hug. If you have some time, have some super sex. You’ve earned it.

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Ordinary tap water with a teaspoon of salt added to each half litre (1 pint) and stored in the refrigerator can be applied on gauze to the burned areas. Local applications of soothing creams can also help. These often contain small amounts of local anaesthetic.

If blisters form, this indicates the burn is deeper and it is classed as second degree. If the blisters are small they can be left but, if large, they are better broken and the fluid drained.

Do not just prick the blisters with a needle — this lets the fluid out but infection in. Clean a pair of scissors by soaking in a disinfectant (boiling blunts them), then cut away the skin overlying the blister so there is no overhang left. This isn’t painful. The raw surface can be dried by gentle pressure with sterile gauze and a drying lotion like mercur-ochrome applied.

If the blisters are large and extensive, it is better to seek medical advice.

The chronic effects of the sun are more dangerous. Repeated exposure to UV light, over many years, leads to premature ageing of the skin.

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Complete prolapse of the uterus outside the vagina is called procidentia. This may make it difficult for the woman to move about and the uterus is subject to irritation and inflammation.

When the bladder falls back into the vagina, it distorts the normal anatomy where the urethra, or tube which carries the urine to the outside, leaves the bladder.

This leads to problems with passing urine. It may be difficult to completely empty the bladder and so small quantities are passed frequently.

The commonest symptom, however, is stress incontinence. When the woman strains by coughing, laughing, sneezing or lifting, the urine may involuntarily come away.

A watchspring pessary, which is a flexible rubber ring, can be inserted into the vagina to hold the uterus in place. This sits firmly in the vault or upper part of the vagina and is kept there by pressing on the pubic bone at the front of the pelvis.

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Unlike hypothyroidism, hyperthyroidism is usually a condition of older children and is more probable in girls in the 12-14 age group, but it may affect any age.

Symptoms may develop rapidly. Entire body functions are speeded up, and the child tends to be nervous and irritable, fidgets and cannot sit still for long. The skin tends to be warm and clammy, the skin flushed, and in some cases the eyes appear prominent. Often the heart seems to race. The child may often feel weak and look thin, despite a good appetite. There may be a substantial rate of growth, probably above average. In adolescent girls, menstrual periods may start late or may be absent. Any symptoms of this nature need medical attention. The doctor will arrange suitable tests to help diagnosis.

Treatment

Treatment will depend on the extent of the disorder and the age of the child. In some cases, medical treatment with the use of tablets aimed at reducing thyroid activity will be adequate. In other instances, surgery may be necessary. It is a case of a special form of treatment being worked out for each patient. With proper care, the outcome is usually good.

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The other name for mumps is epidemic parotitis. (Don’t you enjoy these gobbledegook names that doctors use? It makes even the simplest problem seem difficult. That’s probably why they use them!)

Mumps is a common infectious disease, rarely seen in persons under the age of three, but rife after that. It can occur at virtually any age, from young to old, but children are the usual victims. It is caused by a virus, and usually attacks the parotid gland. This is a large organ that sits in front of and below the ears. It produces saliva, and for some unknown reason the virus simply loves having an affair with it. Also, various other glands under the jaw (the submaxilliary salivary gland) may also become involved.

It is not as highly infectious as some of the other childhood disorders, such as measles and chicken pox, and is usually spread via contamination of toys and articles shared with others. A person may infect another from two days before the appearance of the glandular swelling, until it has subsided completely. The glands are not always affected. It takes 12-24 days for the germ to incubate and produce symptoms.

During the prodromal period (the days immediately before the glands are noticeably involved), there is usually a fever, a feeling of being unwell, and probably pains about the ear when eating and swallowing. The skin may feel sensitive and tingly.

Suddenly the salivary glands become affected. They swell, become tender to touch, and this is aggravated by any movement of the jaw, such as eating, talking, swallowing food or fluid. The fever may reach 40°C (104°F) or it may be only mild. There may be headaches, aches and pains and a general feeling of misery and being off-colour.

The most serious complication is the onset of a severe headache, stiffness of the neck or back muscles, vomiting, lethargy, and a further increase in temperature which may reach 41.1°C (106°F).

This may indicate meningeal irritation—meaning the virus has attacked the lining of the brain.

Another important and fairly serious complication is when the virus moves to the testes in males or the ovaries in females. This may cause swelling and pain in the scrotum or lower pelvic regions. In fact, it may prolong the illness and cause a great deal of discomfort. The main hazard is that this may reduce fertility in later life; and cases of subsequent sterility, whilst not common, have often been reported. Occasionally the pancreas (a gland in the abdomen which produces insulin), the kidneys and the ears may be attacked and can produce serious symptoms. But these complications, in the total picture, are not common.

Treatment

There is no specific antibiotic—as with most other viral infections—that will cut short the attack. Ideally, the treatment is bed for a few days, until the temperature has fallen and the child feels improved. Once again, most children are good barometers and will want to get up and start moving about as soon as they feel a little better. Isolation is often suggested until swelling of the salivary glands has subsided, for the virus is transmissible to others.

Plenty of fluids are advised, for they require little effort apart from swallowing and do not unduly exercise the jaws. Water, water-based drinks and fruit juices are all good. Any food may be served, but those requiring little chewing are best. Softly boiled and poached eggs, mashed vegetables, stewed fruit, broth and soup, custards, ice-cream, jellies and soft toast are all suitable. There is no restriction on food to be served to the patient.

Pain and fever may be reduced by giving analgesics and antipyretics. Paracetamol elixir for children aged under six is suitable; and for those over six years, paracetamol or aspirin tablets may be given. Dosage is usually written on the label.

Warm applications such as compresses may give relief if the swollen areas of the face are sore. Warm, salty-water mouth rinses may give a feeling of freshness, and improve the outlook.

Most patients recover with few, if any, problems. Even those with gonadal involvement usually recover. If there are any symptoms that appear odd, or that are not responding to simple home remedies fairly promptly, call the doctor for further advice on management. This is especially important if any of the symptoms indicating complications develop, particularly high fevers, headaches, neck stiffness, lower abdominal pain or testicular pain. These are the main problem areas.

A vaccine is available for children to prevent mumps. This may be given at the age of 12 months, and consists of one single injection. In time, it may be available as a combined mumps-measles vaccine. Its use is not widespread at present, for some doctors do not think mumps is serious enough to warrant routine immunization, but this attitude is now rapidly altering. In 1981 the National Health and Medical Research Council recommended routine immunization of children against mumps.

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Wilhelm Reich was a Viennese psychiatrist who was a follower of Sigmund Freud but later broke away to establish his own therapy. Like Freud, Reich believed that frightening and painful experiences and feelings could be repressed by the conscious mind. Reich based his therapy on his belief that repressed feelings could cause physical as well as psychological problems and that these could be released by certain movements. He divided the body into seven zones in which tightening of certain groups of muscles created ‘body armour’. Rigid patterns of behaviour he termed ‘character armour’. He believed that the blockages created by these armours impeded energy flow in the body and could lead to deteriorating health.

Reichian therapy is a form of bodywork in which the therapist helps the patient to become aware of the ways in which posture, muscular tension and breathing patterns reflect emotion. Physical manipulation of the body aims to relax the body armouring.

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Eye allergies are allergic reactions of the eyes. They may affect the conjunctiva (the transparent covering over the whites of the eyes and the insides of the eyelids). They may also affect the skin on the eyelids and around the eyes.

Eye allergies are caused by a wide variety of substances carried to the eyes by the air or by the hands. Seasonal, airborne materials are pollens from trees, grass, weeds and other plants. Non-seasonal airborne materials include house dust, feathers, molds, and animal dander (tiny scales from the skin of an animal). Many irritants may be carried to the eyes by the hands, including nail polish, household cleaning products, materials from stuffed toys, and finger paints.

Signs and symptoms

The whites of the eyes become red and itchy. The eyes water, but no pus is formed. Occasionally, the whites become visibly swollen with clear jelly-like material. The eyelids become swollen and red. The skin of the eyelids may be smooth or rough and scaly. Pouches beneath the eyes may become swollen and bluish and resemble “shiners”.

Certain clues can distinguish eye allergies from several other conditions that also cause reddened eyes (conditions such as conjunctivitis, viruses, foreign bodies in the eyes, sties, glaucoma). Eye allergies cause itching and tearing but never cause pain or pus. Swelling of the whites of the eyes is a key sign of an eye allergy.

Home care

Oral antihistamines usually help. With your doctor’s permission, use of eye drops containing phenylephrine or ephedrine brings temporary relief. Applying cold compresses to the eyes may also ease the discomfort. Whenever possible, identifying and avoiding the irritating substance is clearly the best solution.

Precautions

• If there is pus or pain in the eyes, the condition is probably not an allergy.

• If the pupils of the eyes are dilated (enlarged) and slow to respond to light, see your doctor.

• If home treatment is not effective in 24 hours, see your doctor.

• If vision is affected, see your doctor.

Medical treatment

Your doctor will examine the outsides and insides of your child’s eyes. Medicated eye drops are effective but are safe only after a doctor’s examination. Skin tests may be suggested to help identify the substances causing the allergic reaction. Desensitization shots over an extended period are rarely recommended.

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Of course, there’s a catch. In this case, two manly traits interfere with spiritual development. First, we are raised to ignore and discount intuition—our inner voice. Second, we are taught to suppress our emotions. On both counts we need to do some unlearning, says Dr. Kurth. Here’s how.

Pause and listen. Don’t listen only to your reasoning mind. Listen to your inner urges, nudges, leanings, voices. And give yourself permission to act on them, says Dr. Kurth.

Also, make time to just put the world on “pause,” Dr. Kurth says. “We get very caught up with all the events of our lives. And in order to have an intimate connection with some transcendent reality, we have to take time to stop and listen.”

Get emotional. “Listen to your emotions and let your emotions and passions inform what you do,” Dr. Kurth says. One definition of enthusiasm is “being infused with the spirit of God,” she says. Often when we are impassioned, we are connecting with our spiritual essence, she says.

Meditate. Okay, break out those orange robes. Nahhh, we’re kidding. The simplest, most basic meditation, says Dr. Kurth, is simply to pause for five minutes and focus attention on nothing but your breathing. Breathe comfortably, deeply, naturally. Don’t force it. Just relax and watch your breathing for a few moments.

Meet Mother Nature. Take quiet walks in natural settings outdoors, says Dr. Kurth. The beauty, vastness, complexity, and seeming omnipresence of nature can be both awe-inspiring and relaxing.

Pray tell. Talking over problems in prayer, turning them over to a higher power, taking decisions into prayerful consideration, is obviously an effort to connect with the Divine. Throughout history many people have found this a helpful spiritual practice, says Dr. Kurth. You might, too.

Make beautiful music. Singing, playing, or listening to inspirational music opens doors to greater spiritual realization, says Dr. Kurth.

Be creative. “Working in any of the creative arts can help one discover and develop his spiritual nature. The key here is work that involves inspiration. Spirit, says Dr. Kurth, comes from the Latin word meaning “breath,” as in “the breath of life.” And the word inspire comes from the words “in spirit.”

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IMPLANTS OR SURGERY

A natural, safe way to increase your breast size without resorting to implants or surgery is not an impossibility. Many women have discovered that specific exercises, when performed correctly and regularly, can result in a higher, firmer chest and, in effect, a larger breast size. Here are some exercises designed to develop higher, firmer breasts:

1) Assume a sitting position, with your legs crossed and your back straight. Place your hands on the back of your head, with your fingertips touching. Extend your elbows as wide as possible, and to the side.

Bring your elbows together in front of your face (don’t raise your shoulders). Swing your elbows back to the starting position.

Inhale as your elbows come together and exhale as you swing them out to each side.

For best results, do 10 repetitions of this exercise.

2) Another good exercise designed to create a higher, firmer chest requires that you sit on a couch and bring your arms in back of you, resting them on top of the couch. Hold this position for 30 to 60 seconds. Focus on the stretch in your chest muscles. This exercise can be done while you’re watching TV, during the commercials.

Implants And Mammography And Cancer

Specialists say that implants can make mammography difficult and delay the detection of cancer. This poses a particular risk for those women with a family history of breast cancer. Experts advise women who have had implants to tell the mammogram technician that there is an implant.

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We’ve all heard it before—especially those people who use tobacco regularly— cigarettes and other forms of tobacco are addictive. We even know that nicotine is the drug in tobacco which causes addiction, and that all tobacco products contain substantial amounts of nicotine. The nicotine is absorbed quickly in the lungs from tobacco smoke and in the nose and mouth from smokeless tobacco, such as snuff and chewing tobacco. Even knowing all of this, millions of people continue to use tobacco, many of them, perhaps, because the addiction is so powerful.

How powerful is nicotine? Here are some facts, according to the 1988 Report of the Surgeon General on the Health Consequences of Smoking:

1) Used regularly, levels of nicotine accumulate in the body both day and night. In other words, daily tobacco users are exposed to the effects of nicotine 24 hours a day.

2) The more and longer you smoke, the more your body builds up a tolerance to nicotine, meaning the more nicotine you get, the more you need in order to produce the same feelings. That’s the reason that certain unpleasant symptoms, such as headaches and dizziness, which usually accompany beginning smoking disappear once tobacco is used regularly.

3) Nearly every component of the body’s endocrine and nonendocrine system is affected by nicotine and smoking.

4) Most patterns of tobacco use are regular and compulsive, and any attempt to give it up usually results in a withdrawal syndrome.

Whenever someone who uses substances that contain nicotine—cigarettes, cigars, pipes, snuff, chewing tobacco—attempts to quit, he or she usually experiences varying levels of the following withdrawal symptoms:

1) A craving for nicotine.

2) Frustration, irritability, anger.

3) Anxiety and tension.

4) Decreased heartrate.

5) Increased appetite.

6) Lack of concentration.

Most withdrawal symptoms seem to reach their zenith within the first 24 hours after quitting tobacco use and then decline gradually after that over several days or a few weeks.

Scientific research suggests that medicines can help reduce certain withdrawal symptoms as well as the likelihood of starting tobacco use again, but they seem to be more effective when used with behavioral intervention, such as relaxation methods and hypnosis.

Local offices of the American Cancer Society, the American Heart Association, and the American Lung Association can provide pamphlets on how to stop smoking and information on low-cost cessation programs. For those people who find quitting smoking “cold turkey” too difficult, the information supplied by these organizations can be very helpful.

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Recent research suggests that some natural chemical compounds found in fruit may help prevent certain types of cancer . The compounds are known as limonoids and were tested on rats. The results showed that limonoids caused an increase in the secretion of an anti-cancer enzyme in the rats’ stomachs, providing them with added protection against stomach tumors and stomach cancers. Limonoids are the natural compounds that create the slightly bitter taste in some fruits, including oranges, lemons, limes, and grapefruit.

Many Nuts And Berries May Help Prevent Cancer

According to results from a study conducted at the Medical College of Ohio in Toledo, elegic acid—a substance found in many nuts and berries—may help your body tend off cell damage caused by certain Cancer-causing chemicals or carcinogens.

Researchers discovered that elegic acid neutralizes carcinogens which have invaded the bloodstream.

The researchers note that the substance only seems to work if it is introduced into the body’s system immediately before or during the time the body is exposed to the cancer-causing carcinogens.

Because the body has difficulty absorbing elegic acid in a concentrated form, supplements of the substance aren’t very effective. The researchers indicate that elegic acid in its natural form—in nuts and berries, such as Brazil nuts and strawberries—is more easily absorbed by the human body.

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Nutrients are substances YOU need to get every day from what you eat and drink, and by that definition water is an essential nutrient. The recommended amount of water is 8 glasses (64 ounces) per day. That may seem excessive, but under average conditions—a moderate temperature, and only light exercise—the body loses 2 to 3 quarts (2 quarts equals 64 ounces) of fluid a day through sweating, breathing and waste products.

All that fluid must be replaced to maintain an adequate fluid balance in the body. Some of the fluid is replaced when you eat solid foods, such as fruits and vegetables— which contain a lot of water. Other liquids, such as juice, milk, soup, and soft drinks, also help replace lost fluids.

Plain water is best, however, because it is more efficiently absorbed than other fluids, especially those that are high in sugar. Coffee and caffeinated soft drinks are not good replacements either because caffeine acts as a diuretic and causes even more fluid to be lost. Alcohol has the same negative effect.

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Findings from a new study suggest that people who wear disposable contact lenses may be up to 14 times more likely to get sight-threatening eye ulcers than those people who

wear non-disposable soft lenses.

Researchers say, however, that the condition may not be due to the lenses, but rather to improper care by wearers. Apparently, many people fail to heed the limits stated on the recommended wearing times for the lenses.

The study was focused on 42 cases of eye ulcers associated with contact lens wear. The results showed that compared with people who use d daily-wear soft lenses; disposable soft lens users had a 14-times greater risk of developing a potentially dangerous eye ulcer called ulcerative keratitis. The ulcers can be treated effectively by antibiotics, but if left untreated, can cause scars and blindness. Key: Don’t wear your contact lenses longer than you are supposed to.

How To Save Over Seventy Percent On Your Contact Lenses

It isn’t always necessary to consult an eye doctor if you want to replace your contact lenses with the same brand, type and prescription. Several mail-order firms offer over 70% off most brands and types of contact lenses. However, many experts are opposed to this type of lens buying because they feel that mail-order customers will stop seeing their doctor for regular vision checkups.

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