Antidepressants Blog

Cause

Hand, foot and mouth disease is caused by a virus called Coxsackie A. It is not acquired from animals and has nothing to do with hoof and mouth disease. It is very contagious amongst groups of children, but it is a relatively mild and harmless infection.

Clinical features

Outbreaks of hand, foot and mouth disease typically occur in summer and autumn, and mainly affect preschool children. The incubation period is 4-6 days and your child may have a mild fever for a day or two before the typical rash appears. Small mouth ulcers usually appear first, soon after the fever starts, and your child may complain of a sore mouth, or simply go off his food and refuse fluids. Small blisters appear on the hands and feet, usually on the palms and soles. Tiny red spots may appear on the buttocks, but these usually do not form blisters. The rash usually clears up after 7-10 days.

Treatment

Treatment is symptomatic, and the intake of fluids should be encouraged to avoid dehydration. This may be difficult, as your child’s mouth may be sore. Try ice blocks made from cordial and water, icy poles, or jelly. It is best to stick to soft foods for several days and avoid tangy foods such as tomatoes, lemons, grapefruits and oranges. Paracetamol should be given to ease discomfort and lower the fever. Hand, foot and mouth disease is not a serious illness, and most children recover quickly without any complications.

When to see your doctor

• if your child is refusing fluids as well as solids;

• if your child is showing signs of dehydration;

• if your child has a high fever in addition to a rash, or is generally unwell;

• if you suspect that your child has hand, foot and mouth disease, or you are unsure of the cause of the fever and rash.

Prevention

Hand, foot and mouth disease cannot be prevented.

*311\90\8*

General practice

This is the mainstay of good medical care for your child and family. There may be one doctor working alone (solo practitioner) or several doctors may have combined to form a group practice. The general practice will have complete medical records for your child (as well as yourself), and the practitioner will be likely to have built a trusting relationship with your family over the years. He will be aware of the local networks of other health care providers, such as maternal and child health nurses and specialists.

Locums

These are doctors who work after hours or during periods when your usual doctor is unavailable. If they are working out of the practice, they will have access to the medical records. If they work for one of the locum services, it is most unlikely that they will have available any previous medical records. Sometimes they will provide a record of the home visit to your regular doctor the next day. Ask your doctor what kind of locum support he uses.

24 hours clinics

While these clinics are often convenient, they are usually staffed by doctors on a casual or short-term basis, so do not provide the continuity of care that a general practice can offer.

Community health centre

These almost always offer a range of health professionals, although not all of them employ doctors. They claim to have a more preventive and ‘whole family’ approach to health care, although a good GP will also take this approach.

Telephone consultations

Often parents call their doctor or the local hospital to obtain information or advice. You need to be aware that it is often difficult for a doctor or nurse to provide appropriate advice over the phone. He or she can only give general advice and information — there is no substitute for actually seeing the child. If you have real concerns, then you should consider taking the child to be seen rather than relying on telephone advice.

Chemist

The pharmacist is a professional who can provide advice for reasonably simple and straightforward complaints. You should remember that they do not have any specific medical training. It is unfair to put the pharmacist in the position of having to diagnose and suggest treatment for a medical condition — you are better off seeing your doctor.

Hospitals

Hospitals vary greatly in the facilities and expertise they offer, according to their size and location. Children’s hospitals naturally offer the whole range of paediatric care; small community hospitals, on the other hand, may have no specific paediatric facilities or equipment, or staff with paediatric training. It is often a good idea to find out exactly what facilities your local hospital offers, rather than wait until you have an emergency.

*15\90\8*

ABBREVIATED ORGASMIC CONTRACTIONS: It’s like it doesn’t really completely fire; you know what I mean. It doesn’t throb like it used to. They’re there, but not the same.

I can’t get that feeling. I just don’t feel it thump or pulse like it did. I mean, it does throb, but not fully.

Can you guess which is the man and which is the woman? The first report was from a wife, the second from a husband. Aging can diminish the intensity of the pelvic contractions that accompany orgasm (though does not diminish psychasmj, but premature diminishing of this reflex is related to emotional state; an emotional looseness is translated to a genital response. When your emotional energy is drained, the pelvic contractions decrease, too. Four hundred forty-three men and 388 women reported this problem.

You can already see the numerical overlap in this problem report. The more I talked with the couples about this model of sexual response and understanding sexual problems, the more they shared a range of feelings about sexual experience. They were no longer limited by the genital focus.

*174\97\8*

It’s really embarrassing. My stomach seems to gurgle every time we try to make love. I mean, it’s loud. He never says anything about it, but you never hear that in the movies.

WIFE

At first I thought it was coming from her vagina, this strange rumbling sound. I think it’s her stomach, though. She is just in lousy shape, and she eats about four Ding Dongs or King Kongs or some junk food before bed every night. What does she expect?

HUSBAND

HETEROSTASIS:

LACK OF INTEGRATION OF

HEALTH RULES INTO

MARITAL LIFE. SEPARATE

HEALTH FOCUS AND HEALTH

BEHAVIORS

0123456789 10

TENDING TOWARD    TENDING TOWARD

HOMEOSTASIS    HETEROSTASIS

In terms of overall health, the rules are simple. Be moderate in caloric intake and exercise, reduce fats, minimize red meats, avoid smoking and alcohol, and learn to cope better with stress. In spite of all the research on health, these rules have long been known and many of us do our best to practice them. In your marriage, do both of you work together to integrate good health practices (homeostasis)? Or do you work separately if at all on the physical health of your marriage (heterostasis)?

The husband in our couple was a jogger and a softball player, and “demanded” that his wife buy and prepare health food. The wife had little time or made little time to attend to her own health, and was left making beds and cleaning up after dinner while her husband ran miles listening to his portable tape player.

The husband was trim, tan, firm, and energetic. My clerical staff was taken with his robust appearance, describing him as “a real hunk.” The wife looked drawn and tired, and often brought sewing or other family-related work to the clinic waiting room. When I asked about her schoolwork, she said, “I get up at about five A.M. on weekends when it’s quiet. I try to get it done then.”

The wife complained of her own lack of sexual stamina. “I get tired easily. I’m fat, too, and I hate it, but I just cannot lose it for long. During intercourse, it almost scares me how hard he does it to me.”

The husband reported, “She is so fat, so soft, so flabby. She’s like a soft doll. If I am a sexual athlete, then she is Howard Cosell.”

This couple, as many of the others in this report, failed to practice a system of wellness. Few wellness programs attend sufficiently to the system side of things. Doctors see individuals, not couples, for physical exams, and our wellness models are individuals, not marriages.

Super wellness depends upon a system wellness, a view that two people and their children are one, not parts. Too much homeostasis in the system, too much “oneness” can result in neglect of the individual health needs of each spouse, but a lack of homeostasis, of unit wellness, results in disease for both spouses, and no amount of solo jogging will chase down total wellness.

*34\97\8*

Most of these reactions are due to sympathetic stimulation. Some, such as the desire to use the bladder or bowels and the sweating are due to parasympathetic overstimulation.

All are normal reactions to real or implied danger. If we could not respond quickly, almost without thinking, we would not survive.

But this normal response to stress can become abnormal.

If we are tense and anxious, the autonomic nervous system may be overstimulated and produce many or all the symptoms associated with the normal response to a fright.

We can develop nervous palpitations or diarrhoea. We can even pour out so much acid from our stomachs, that it eats a hole into the wall of the stomach or duodenum and forms an ulcer.

Most people believe that “nerves” mean imagination, yet they know their symptoms are real. So they believe they have a real organic illness, such as heart disease or cancer.

This causes further worry and anxiety. This secondary anxiety further stimulates the autonomic nervous system and, in turn, results in more symptoms and so we have established a vicious circle.

This malfunction in the autonomic nervous system is called autonomic dyspraxia or dystonia.

*543/71/1*

Depression is one of the most common disorders of modern life and is believed to be increasing.

In the past, depression was classified into two groups: endogenous, or coming from within, and exogenous, or coming from without. This latter form was also called reactive depression and was usually associated with loss.

Most doctors now think of depression as one illness.

The classification of psychiatric illnesses is always difficult. We are all individuals with our own unique personality, habits and attitudes, so when we suffer emotional disorders they are likely to be as individual as the people who suffer them. Depression is not merely a lowering of mood.

Many refuse to accept they are depressed because they do not feel sad. Sadness, unhappiness and a feeling of depression are normal emotions. Like anxiety they may affect us all at different times.

They become abnormal only when they are inappropriate to the precipitating factors or if they become so severe as to interfere with our normal life.

*286/71/1*

The cause of the sudden infant death syndrome is not known. Well over 100 theories have been suggested and despite considerable research there is no proven one cause. It may well be that there are several factors which can lead to cot death. It is common in all races and cultures and in all socio-economic classes. It affects infants who are breast fed as well as those on the bottle. It is not due to suffocation by a pillow, blankets or sheepskin rugs. It is not due to any vitamin or mineral deficiency nor to any other nutritional factor. It is not due to allergy to the house dust mite or to cow’s milk and it is not due to a reaction to a recent immunisation to triple antigen or other vaccine.

And it is definitely not due to neglect by the parents.

If a cause for the child’s death can be found, then it is not classified as SIDS. The death is totally unexpected. The child may even have been checked as recently as that day by a doctor and found to be in good heath.

It is not easy for the parents, other children, grandparents, other relatives and friends to accept the death. The parents have to cope with both grief and guilt.

Guilt is a normal feeling at this time, but is unfounded. The cause is not something the parents did or did not do.

*35/71/1*

Of course, this is not to say that we can’t identify some of these factors. The immune system can be weakened by other illnesses, poor nutrition, some drugs, some infections, stress, old age, cancer itself and some rare inherited disorders. Very active cancer cells can just develop by chance, but the more mutations that are occurring, the greater chance that one will lead to a cancer. The number of mutations is increased by exposure to radiation, some drugs, sunlight (skin cells only), many chemicals, and some types of infection. Exposure to any one of these factors does not necessarily lead to cancer. Thus, although we know that there are cancer-producing chemicals in cigarette smoke, not everyone who smokes gets cancer. Some smokers are lucky enough either to miss out on any mutations which lead to cancer or to have an effective immune system which prevents any cancers from developing. It usually takes more than one factor to produce cancer—unfortunately we have by no means identified them all yet.

Let me reassure you on two particular factors which worry many people with cancer.

*43/40/1*