YOUR CHILD’S HEALTH/ TEMPER TANTRUMS: TREATMENT

The theory of management of temper tantrums in young children is straightforward and, when put into practice, always works; it is putting it into practice that is difficult. The principles of management are no different from the management of most other developmental problem behaviours in childhood — reinforce wanted behaviours and ignore unwanted behaviours.

However, most parents, for reasons that are perfectly natural and understandable, have difficulty in applying these principles in a consistent way. The reasons for this are many. Often there is disagreement between the parents as to the best way to manage problematic behaviours. It is usually the father who takes a softer line, generally because he does not perceive the problem to be as severe as the mother. In most families it is the mother who is the primary care-giver, so that the father tends to assume less responsibility for day to day care. He sees that the child seems better behaved for him, having fewer tantrums. When the mother suggests a behaviour modification plan, often the father thinks that she is overreacting. It is vitally important that a management plan for children with frequent temper tantrums, or any other behaviour problems for that matter, be agreed on (and adhered to) by both parents, otherwise it is bound to fail.

Temper tantrums are best ignored. As soon as the child begins to have a tantrum, you should immediately leave the room, or turn your back. It is important that the child be paid no attention whatsoever. That is more easily said than done, of course, yet that is the mainstay of successful management. The details of behaviour modification, which is used in the management of most behaviour problems in childhood, are described elsewhere.

The frequency and duration of temper tantrums are inversely related to how much attention the parents give to the child during the tantrums. If you can accept that they are a normal part of the child’s functioning at a particular developmental phase, and not turn them into a power struggle (which, by the way, the child will always win, one way or the other) then they will simply disappear over time. Unfortunately, many parents, despite their best intentions, get drawn in, virtually guaranteeing that tantrums and often other associated problem behaviours will continue and intensify.

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HEART ATTACK – MYOCARDIAL INFARCT

The drug trinitrin is widely used to treat angina and it may even help in the diagnosis.

These tablets are placed in the mouth and sucked or chewed but not swallowed. The drug is absorbed through the mucous membrane of the mouth directly into the blood stream and works immediately. Should a clot form on an atheromatous plaque in one of the coronary arteries, it will block the artery. This is a coronary occlusion.

If the heart muscle supplied by that artery is deprived totally of its blood supply, death of the muscle will occur — a myocardial infarct.

Ischaema is the term given to impaired blood supply of any tissue. Myocardial ischaema may be temporary, as in angina, or prolonged, as in coronary occlusion.

The pain from an occlusion is of the same type as angina but is not produced by exertion and is unrelieved by rest. The pain may persist for hours and only be relieved by giving strong pain-relieving drugs like morphine and its derivatives.

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PREGNANCY RISKS – INTRODUCTION

Pregnant women and their doctors often read about the hazards to the foetus of taking any drug during pregnancy.

The anti-morning sickness tablet, marketed in Australia as Debendox, came under notice because of a court case in America. It must be stressed that this drug had been used widely in Australia for more than 20 years and there is no evidence that it increases the risk of foetal abnormalities.

Just because a woman who has taken a drug during early pregnancy has a child with an abnormality does not prove cause and effect.

Congenital abnormalities occur in one in 40 births and, so, are common.

Because of the costs involved in defending this drug in the courts, the makers have withdrawn it from the market.

Of even more importance is: what should epileptic women do when they become pregnant? Most are taking at least one, sometimes two, drugs to control their epilepsy.

Some recent reports have indicated that there is an increased incidence of foetal abnormalities in the children of these women, particularly the risk of hare lip or cleft palate.

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BABY AND CHILDHOOD URINARY TRACT DISORDERS: VAGINAL REGION INFECTIONS

In girls occasionally an irritation occurs in the vaginal region. Called vulvovaginitis, it may affect the vulva at the vaginal opening. There are many causes, ranging from a lack of hygiene, to infections from germs, to threadworms (which may have journeyed from the back passage and become lost in the vagina), to hormonal deficiencies. It sometimes indicates early diabetes.

There may be no symptoms at all. Or there may be a discharge from the vagina, or itch or irritation. The discharge may be whitish, or clear or stringy and slimey. Sometimes it is pussy if there is an infection present. A bloodstained discharge may indicate a foreign object has been pushed into the vaginal canal— this is not uncommon with youngsters.

Treatment

Any symptoms in this region should receive medical attention. With a few simple tests, the doctor can often diagnose the cause and order the correct treatment. Frequently, adequate cleanliness and hygiene will prevent these problems from taking place.

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BABY AND CHILDHOOD ILLNESSES: AUTISM

Childhood autism was first recognized in 1943 by Dr. L. Kanner, and since then has become a fairly well recognised problem. Only in the past few years has an increasing amount of interest been taken in the problem which affects about 5 children in every 10 000 under the age of 15 years.

It is believed that many of these children have brain damage, and more than half are severely mentally retarded. Autistic children have difficulty in relating and communicating with others, and their imaginative capacity is severely retarded. As a result the child tends to perform the same activities over and over, and will often repeat the same set of words frequently. Some children show reasonable levels of intelligence, and originally Dr. Kanner claimed that many were potentially of superior intelligence. Many seemed to have parents following professional occupations, even though they were cold rigid personalities. But this has since been cast into doubt by subsequent research.

Treatment

‘There is no medical treatment, but appropriate management and education can diminish behaviour problems and help bring out any latent abilities,’ the British Medical Journal stated recently in a leading article. The child’s future is closely linked with his ability to develop language, social awareness and useful skills.

‘Most autistic children need care all their lives,’ the Journal says, ‘but a few become independent, though eccentric adults. Very few develop a high level of skill in some special field, such as music, mathematics or art.’

There are now national societies which take a special interest in autistic children, and parents often gain much assistance in this manner. The Autistic Children’s Association of New South Wales is located at 545 Pacific Highway, Artarmon, Sydney, 2064.

DIRT EATING (PICA)

Some children seem to enjoy eating abnormal material that is not food. The range can be remarkable. It may include dirt, clay, snails, peeling paint, starch, and even ice! Some infants love playing with their bowel actions and may even eat this! A weird list of items have been recorded in the books of medical history. A craving for certain foods is more common, and it may include almost anything, from vegetables, to biscuits, sweets or fruits, to an abnormal extent. A few years ago an individual had a compulsive desire to eat ice, and devoured 9000 g a day, according to the Journal of the American Medical Association. Others have been known to eat newspapers and the pages from glossy magazines. One individual sustained a bowel blockage from the amount of newsprint in her intestinal system. If your child shows a propensity for eating odd objects please seek medical help. The child may be referred for assessment by a child psychiatrist.

Treatment

The case will be fully investigated. However, a large number are found to have an iron-deficiency anaemia. The simple use of preparations containing iron may completely reverse the strange compulsion, and the patient readily gets back to normal eating habits again.

‘Pica is quickly cured by therapy with iron, but this valuable information has been generally ignored,’ JAMA magazine recently reported. Do not scold your child—rather seek medical attention. The cure may be far more simple than you ever imagined.

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POISONING

Poisoning occurs when substances harmful to the normal functioning of the body are swallowed, inhaled, absorbed into the skin or injected. Signs that poisoning has occurred include abdominal pain, nausea, vomiting, drowsiness, burning pains from the mouth to the stomach, difficulty in breathing, congestion in the chest, headaches, ringing in the ears, blurred vision and sudden collapse. If possible the type of substance which has been ingested should be determined before giving first aid. Vomiting should not be induced if corrosive or petroleum based substances have been swallowed, nor in cases where the source of poisoning is unknown.

Food poisoning or gastroenteritis is usually caused by bacteria which inflame the lining of the stomach and intestines. The bacteria salmonella and staphylococcus are among the most common culprits and their growth is encouraged by reheating or half cooking food. It is important to practise good personal hygiene, especially washing hands, when handling food and to keep utensils and food preparation areas clean. Frozen food should be defrosted properly before cooking and not refrozen after it has thawed out. Previously reheated food should be cooked at a high temperature. Hot, cooked food should not be left in a cooling oven or other warm place. Bacterial growth develops. Food poisoning also occurs with contaminated seafood.

Symptoms of food poisoning are vomiting, diarrhoea and abdominal cramping, sometimes accompanied by sweating and fever. Diarrhoea and vomiting can lead to fluid loss, so dehydration may follow.

To treat food poisoning, fluid should be replaced by drinking small amounts of water, flat lemonade or diluted fruit juice frequently. Often the stomach will not tolerate solid foods. Taking garlic capsules can help fight infection. Peppermint tea is helpful in cases of nausea.

Poisoning can also occur as a result of absorption of various toxic metals in the environment. Lead, cadmium, mercury and aluminium are widely used by industry and our environment is now permanently polluted by them. These metals cannot be biodegraded into the environment. Lead poisoning can be caused when sanding off old lead based paint during renovations. The bioflavonoid, quercitrin, contained in the juice of citrus fruits, is a good chelating agent for lead, and gradually removes it from the body.

Cadmium is found in tobacco and cigarette paper and in superphosphate fertilisers. Usually found in conjunction with zinc, the ratio of cadmium to zinc is much higher in refined flour and white bread than in the same wholewheat products. Eating wholewheat products and not smoking reduce exposure to cadmium. Vitamin C, glutathione and the trace element selenium all help to alleviate cadmium toxicity.

Mercury is another highly poisonous metal. Apart from pollution of the environment, the consumption of seafoods and fish is a major source of mercury. Mercury is concentrated in algae in the ocean and becomes progressively more concentrated as it progresses up the food chain. Selenium is a natural defence against mercury. It is found in wheat which is grown in selenium rich soils.

During the 1970s evidence emerged that aluminium could be harmful to humans when people in Scotland using home dialysis for kidney failure suffered a type of dementia which was traced to the town water supply which was being used in the dialysis and which had been clarified with alum. There has been some evidence to link aluminium with Alzheimer’s disease, but this is still controversial. The consumption of aluminium is increased when food is prepared in aluminium utensils.

Some herbs can cause poisoning when taken in large amounts. It is therefore important to consult a qualified herbal practitioner when taking herbal remedies.

Water contamination by algal blooms, becoming more common with the pollution of our freshwater lakes and rivers, is another source of poisoning. Microcystis, a type of blue-green algae, produces hepatotoxins which cause bleeding and breakdown of the liver, sometimes inducing tumours. In 1981 several people in Armidale, New South Wales, showed signs of liver problems after drinking water from a reservoir contaminated by microcystis blooms.

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DYSLEXIA IN CHILDREN

Dyslexia, also known as “developmental dyslexia” or “specific developmental dyslexia,” is a type of learning disability that affects a child’s ability to learn to read. It is more common in boys than in girls. It’s not known exactly what causes the problem. Dyslexia often runs in families, but no specific genetic defect has been found to account for it. Some children with dyslexia may have had an accident that caused an undetected brain injury, but others have no such history. It is known, however, that dyslexia is not a form of mental retardation. And dyslexia is not related to low intelligence, physical handicaps, cultural disadvantages, low social or economic status, or brain damage.

A child with dyslexia often has no difficulties until entering school. Then the child finds that he or she cannot do things that other children can do easily. This experience can be embarrassing and painful. The child often finds it impossible to explain the problem and may become so frustrated that he or she either disrupts classes or becomes overly quiet and withdrawn. Other children may brand the dyslexic child as “stupid”; teachers and parents may consider the child lazy or unmotivated. The dyslexic child may, in fact, be very intelligent and may be trying extremely hard to learn to read. Pressure from teachers and parents to “work harder” can be confusing and frustrating and can lead to anger and rebellion. Some children with dyslexia find other activities that they can do well, such as sports or music. This may help them to adjust and feel more comfortable.

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SEX AS AN AGE EXTENDER: BOP TILL YOU DROP

There are two ways of looking at the picture. First, robust sexuality keeps you in a better position to stay disease-free. Second, avoiding disease-especially cardiovascular disease and diabetes-is the best thing you can do for your long-term sex life. So not only is sex healthy but also health is sexy.

And while abundant sex won’t guarantee that you live to be 96, consider this advice from our experts. As you’re preparing to live into your nineties as a result of other information you’ve gleaned from these pages, schedule in enough sex time.

You’re going to want it for the same reasons you want it now. It’s a way of having special intimacy with your partner, it’s an excellent form of relaxation, and it’s the best outlet for your horny desires.

“There’s no specific decline in libido with age,” says Alan Brauer, M.D., founder of the Brauer Total Care Medical Center in Palo Alto, California, and co-author of ESO: The New Promise of Pleasure for Couples in Love. “Sexual interest doesn’t change, even in men in their eighties and nineties.” And even at that age, you’ll probably be not only willing but also able. “Erection capacity in healthy men should remain-in fact, does remain- into their nineties,” Dr. Brauer says.

The key word there is healthy. Age per se doesn’t wilt your weapon, no matter what you’ve heard to the contrary. But disease does.

“The graph that shows progressive increases of erectile dysfunction with advancing age is from data taken from hospital populations, people with vascular disease, heart disease, diabetes, alcoholism, and so forth,” Dr. Vinik points out. “You take a population of healthy aging people, and that’s not going to occur.”

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PREVENTIVE MEDECINE: OBESITY

It is impossible to be sure what proportion of the western world is obese but current estimates suggest that about 30 per cent are ‘clinically’ overweight. That obesity increases one’s chances of suffering from diabetes, heart attacks, gall-stones, hiatus hernia, cancers of all kinds, painful feet, arthritis of the hips and knees and several other conditions is now beyond dispute. It shortens life and reduces the quality of life for countless millions of people. Obviously obesity is a terrible health and social problem.

In the 1920s obesity was rare in African rural peoples and a 1960 study suggested that low body weights were lifelong in rural Zulu men. There is now overwhelming evidence that in certain ways the control mechanism of body weight somehow breaks down in an affluent society. Individuals in primitive societies have a kind of automatic regulator which controls the amount of effort they spend searching for food and the amount of food they consume. According to one world expert, ‘Supermarket Man has no such automatic facility.’

An adult man, wherever he lives and however he eats, who eats 1 per cent more energy every day than he expends accumulates 1 kg of fat per year. At 30 such a man would weigh 30 kg (66 lb) more than someone who had been in good energy balance for a lifetime. Obesity is a real hazard to hunter-gatherers because it slows them down, affecting their ability to catch prey and to escape animal predators. So in survival terms it pays the hunter-gatherer to keep slim. Such peoples get their food mainly from plants, and individuals spend 2-3 hours a day gathering food, three-quarters of which is supplied by women and children gathering and one quarter by men hunting. Many hunter-gatherers live long enough to become obese but they do not do so. In one study of such a group 7 per cent of the men were over 65 but they were all slim.

The first agricultural revolution, in about 10,000 BC, changed things radically for most of the world’s population as man began to farm cereals and to store food. The diet of today’s peasant agriculturalist has changed little since this time. Although food shortages occur in developing rural peasant communities, resulting mainly from population density and poor soil fertility, competent scientific observers say that even where the population is not dense, the soil is fertile and there are two harvests a year, body weight remains low throughout adult life.

Pastoral peoples plant no crops but raise animals and eat meat, blood and milk. Studies show that their blood cholesterol levels remain low despite the high intakes of animal fat and cholesterol, and that obesity is rare.

The second agricultural revolution started in Europe towards the end of the eighteenth century and crop rotation and fertilizers, together with better machinery and animal husbandry, changed western eating habits totally. The upper classes became wealthy; meat, butter and milk could be consumed throughout the year; and sugar intake went up, as did that of alcoholic drinks. Obesity suddenly became extremely common in the upper social classes, towards the end of the seventeenth century and even more so in the eighteenth century. Portraits of even quite young people of the time show double chins.

With the coming of the Industrial Revolution in the nineteenth century the production of goods and wealth really took off. This enabled radical changes in the production, storage and transport of food. Dietary fibre began to be milled out of bread-the staple diet of the masses. Salt, sugar and fat intakes rose and the consumption of starchy foods fell. Fruit and vegetable intakes rose steadily. People got less exercise, as machines began to do the work. Slowly food became so plentiful, even for the masses, that people began to eat snacks between meals as well as regular meals-themselves a luxury for many until 200 years before.

So why is obesity so common in the West and hardly ever seen in non-westernized peoples? The main answer is that our food has radically changed in character-it is not simply that we eat too much of it, as was previously thought. Over half the energy in the food of a hunter-gatherer or peasant agriculturalist comes from high-starch foods. Such a diet eaten even ‘to excess’ does not cause obesity, partly because it is almost impossible to eat an excess, so bulky and filling is it. At least two-thirds of the energy in a western diet comes from fibre-free fats and sugars and low-fibre cereal products. Undoubtedly, there are other factors in the production of obesity but, looking at populations overall, food is undoubtedly at the heart of the problem. That westernized people can slim by adopting a high-fibre (rich in unrefined carbohydrate) diet is no longer in doubt; and the observation that slim, rural dwellers in non-westernized countries can be made obese very quickly on a western diet is not easy to refute.

It seems that food intake stops when we feel we have had enough and that we feel satisfied sooner on foods rich in dietary fibre – i.e. unrefined carbohydrate foods. It is simply so easy to over-consume refined foods that have no appetite-controlling capacity that we in the West eat ourselves to obesity.

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EYESTRAIN

More and more people are spending more and more time working on personal computers in their homes, and that could mean an increased risk of eyestrain or fatigue. In fact, if you spend several hours a day staring at a video display terminal (VDT), the risk of eyestrain is relatively high, unless you take some basic precautions.

One way to avoid “VDT eyestrain” is to take regular breaks and get away from the monitor screen. This is especially important if you spend a full work day (6 to 8 hours) working on a computer. Experts recommend that you take a 10 to 15 minute break every 2 to 3 hours and refocus your eyes (some doctors recommend that you take periodic breaks every 20 to 30 minutes and focus on distant objects). You may also consider working from a printout of your screen, rather than the screen itself, whenever possible.

Another way to avoid eyestrain is to work from a darker screen. Many times computer users operate their VDTs at such a bright level, eyestrain is a frequent result. Try turning the brightness down to a relatively dim level and then adjust the contrast knob in order to make up the difference. If background lighting is not adequate, an adjustable desk lamp may be of help.

You can also cut down on the amount of monitor-screen glare, which can lead to eyestrain, by making a hood to put over your VDT. You can make such a hood, using heavy black cardboard placed on top of your monitor. Both sides of the cardboard should be folded down over the VDT. Filters are also available to help

reduce the glare on the screen

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