DOCTORS AND HEALTH CARE FOR OLDER PEOPLE: SOME INFORMATION PROVIDED BY GERIATRICS COURSES
YOUR CHILD’S HEALTH CARE: MINIMIZING THE EFFECTS OF DIVORCE ON CHILDREN
Parents must remember that even though their relationship has ended, they are still the joint parents of their children, and always will be. As bitter and tense as many marriage breakups seem to be, it is possible to act in a way which will minimise the damaging effects on the children. Here are some things that are worth remembering:
• Always try to be open and honest with your children.
• Try to diminish the involvement of children in disputes. In particular, it is important not to use the children as a way of getting back at one’s former partner. Avoid having children caught in the middle.
• There will inevitably be disagreements about aspects of parenting, such as choice of schools, health care, discipline, and so on. If there are differences that need to be resolved, consider discussions by phone, or in person when the children are not around.
• Avoid ‘bribing’ children during custodial visits. Parents often compete with each other to gain favour with their children.
• Negotiate access visits that are reliable yet flexible. Nothing is worse for a young child than the disappointment of a suddenly cancelled visit to a parent, or a planned phone call that doesn’t eventuate.
• Consider counselling for yourselves as a couple, after the separation as well as before it. Post-separation counselling is often extremely helpful in resolving issues between the parents, and thus making things easier for the children.
• Consider counselling and therapy for your child if there continue to be concerns about him after the separation. Family therapy is often very helpful. Your doctor or nurse will be able to recommend an appropriate professional.
• There are a number of good books that have been written about divorce and blended families. Check with your local library or bookstore.
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OBSTACLES TO PAIN RELIEF – CONCLUSION
Your doctor may respond by saying that what has been prescribed ’should’ be enough. Such a reply implies that the poor pain relief is somehow your fault. Don’t let your doctor make you feel guilty because you are still in pain. If you are still in pain, it is because you are not getting enough of a strong enough painkiller often enough—simple as that. It is your doctor’s responsibility and duty to correct that situation and if he or she does not do so you have every right to complain and ask for immediate referral to another doctor. The fault does not lie with you.
Some doctors will refuse to increase, or will even reduce your dose of painkiller if they decide it is making you too drowsy. They may do this even though your pain is not controlled. I believe that you have the right to have enough painkiller to control your pain, especially if your cancer cannot be cured and the cause of your pain cannot be corrected. You should decide whether you would prefer to be more alert and in more pain or drowsier and in less pain, even though the decision to be drowsier could mean that you don’t live quite as long as you would have otherwise. Your wishes in this regard are more likely to be respected if you talk to trusted family members or friends and your doctors about them before the situation ever arises. You could even put them in writing if you want to be as sure as possible that your last days will be as you want.
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BITES AND STINGS – GENERAL INFORMATION
Hamilton Laboratories have released a product, Stingose, which is claimed to be of value in treating the bites and stings of insects, spiders, bees, marine creatures and plants.
It contains aluminium sulphate and this chemical denatures or destroys the protein venom of animals and the complex starches of plant venoms.
The quicker it is applied, the quicker it goes to work, neutralising the poison and relieving the pain and discomfort. It also relieves the inflammation and so there are fewer long-term effects.
For those who are allergic to bee stings, the immediate application of Stingose may be life-saving.
In northern waters at certain times of the year, the bluebottle (physalia) and the box jellyfish (chironex) may cause painful and, sometimes, fatal stings. The trouble is, these jellyfish have long trailing tentacles which wrap themselves around the body and with myriad of tiny stinging cells on the tentacles, may keep firing off and discharging venom. Attempting to brush off or wipe away the tentacles may cause further discharge of venom.
Alcohol has been recommended to kill the poison cells, dry the tentacles and make removal easier. There is some recent evidence that methylated spirits and other alcohols may fire off more venom cells. Vinegar has been shown to inactivate them but does not stop the pain or inactivate venom already in the skin. Stingose does.
The Surf Lifesaving Association in Queensland now recommends application of vinegar to inactivate the stinging cells of jellyfish tentacles and then to apply Stingose or a cooling lotion.
Vinegar is not a total treatment. Once the stinging cells have been inactivated by vinegar they should be removed with the finger tips.
Any sign of distress symptoms requires immediate medical assistance.
So, if you want a good weekend, you should not only pack the insect repellent but the best first aid treatment for bites and stings from both insects and plants.
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GALLSTONES – DESCRIPTION
Gallstones affect both sexes and all ages but seem to be more common in the overweight and in women who have had repeated pregnancies.
The condition tends to run in familes but whether because of heredity or common environment factors, such as diet, is not yet certain.
What are these stones which are so common and cause so much concern?
The gallbladder is pear shaped, about 10 cm long, and lies tucked under the liver. It acts as a reservoir of bile and concentrates it.
Bile is formed in the liver and contains the acids necessary for the digestion of fats and also bile pigments, which are breakdown products of the red blood cells.
Diet may be the most important cause but, again, the mechanism is not proven. Diets high in refined sugar, those lacking in fibre and those high in polyunsaturated fats predispose to the formation of stones.
Although most stones contain cholesterol and some consist only of this substance, a diet high in cholesterol does not seem to lead to stones.
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EXCESSIVE BODY HAIR – INTRODUCTION
Nature isn’t fair. Just when a man is losing the hair on his head, a woman may be gaining a crop of unwanted hair elsewhere.
But the middle years of the menopause are not the only time an excess of hair can worry women — the problem may start in the teens.
The amount and distribution of body hair is often determined by our genes and varies with the race or ethnic group to which we belong.
Hirsutism, or excess of body or facial hair, is usually caused by an increase of the amount of androgen or male hormone in the female.
Women produce male hormones both from the ovaries and the adrenal glands, which lie above the kidneys and produce the “stress” hormones, adrenalin and cortisone. Some chemicals, which have this androgenic activity on the hairs, may be produced in the skin.
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EXPRESSIONS USED TO DESCRIBE EFFECTS OF TREATMENT – REMISSIONS —COMPLETE AND PARTIAL
The word remission means that the cancer growths have got smaller. If your doctor tells you that you are in a complete remission, this is certainly extremely good news. It means that no traces of cancer can be found in your body at that particular time. It does not guarantee that there are no cancer cells still in your body. As you already know, there are no tests that can detect very tiny cancer seedlings. Fair enough, you may say, but surely a complete remission means at least a definite possibility of permanent cure. I’m afraid that even this is not always true. Complete remissions can be produced by palliative cancer treatments. These remissions are never permanent. On the other hand, a complete remission with potentially curative treatment certainly does mean possible permanent cure. You can’t say it is a definite cure until later—after enough years have gone by for any dormant seedlings to activate and make their presence obvious.
The expression partial remission means the cancer deposits have got smaller, but are still detectable. They can still be felt, or seen on X-rays, scans, biopsies etc, or detected through blood tests. A treatment that quickly produces a partial remission may eventually produce a complete remission if continued. People with partial remissions tend to live longer than people whose cancers don’t respond to treatment. However, of course, no one who has only a partial remission is ever cured.
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THE G.I. FACTOR: WHY IS BEING OVERWEIGHT A PROBLEM ANYWAY?
If you are overweight you are at increased risk of a range of health problems. Among these are heart disease, diabetes, high blood pressure, gout, gallstones, sleep apnoea (snoring) and arthritis. Along with this list of physical side effects of being overweight, there are an equal number of emotional and psychological problems.
The proportion of overweight people in our society is increasing, despite the expanding weight-loss industry and an ever increasing range of ‘diet’ or ‘lite’ foods. It is clear that the answer to preventing people from becoming overweight is not a simple one. Nor is losing weight easy to do. The G.I. factor can make it easier, however. It tells you which foods satisfy hunger for longer and are the least likely to make you fat. When you use the G.I. factor as the basis for your food choices:
• there is no need to overly restrict your food intake,
• there is no need to obsessively count kilojoules,
• there is no need to starve yourself.
Learning which foods your body works best on is what using the G.I. factor is all about.
It is worthwhile taking control over aspects of your lifestyle that have an impact on your weight. You may not create a new body from your efforts, but you will feel better about the body you’ve got. Eating and exercising for your best performance is the aim of the game.
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PHYSIOLOGICAL ADAPTATIONS TO SLIMMING
The loss of body fat can lead to a range of physiological outcomes which, in turn, affect the further loss of body fat. Physiological adaptation to weight and fat loss can be divided into predictable changes (such as the decline in RMR in response to the loss of lean mass) and adaptive changes (where the body actively works to reduce the rate of weight loss). Dr Rudy Leibel and his colleagues from Rockefeller University in New York have tried to quantify the adaptive changes in lean and obese people as they lose weight. For a 10 per cent weight loss, they found that total energy expenditure declined by about 450kcal, of which about half could be explained by the changes in body composition and half could be considered adaptive.
Studies at Cambridge University on a particular species of desert mouse for example, have shown that when compared with a ‘dry mouse—or one accustomed to plenty of food—the desert mouse is able to adapt to decreases in body weight caused by lack of sustenance by simply slowing down its metabolic processes. Humans have less facility to actively alter metabolic processes to match changes in food intake, although adaptations do certainly occur.
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