Cause

Otitis externa, also known as swimmer’s ear, is caused by an inflammation of the skin lining the ear canal. It is more common in children who swim a lot, because water remaining in the ear afterwards can be an irritant. Commonly, a secondary bacterial or fungal infection develops.

Clinical features

If your child has otitis externa, he may complain of a painful or itchy ear. Sometimes a discharge will be present. The ear usually feels blocked and your child may have difficulty in hearing.

Treatment

If your child has a mild case of otitis externa, your doctor may simply prescribe ear drops which usually have a combination of steroids and antibiotic in them. These should be used for a week and then the ear should be examined again. If your child has a more severe otitis externa, your doctor may insert a small length of gauze, called a wick, which is soaked in a solution of antibiotic and steroid. Do not touch the ear and make sure it is kept dry at all times. Do not allow your child to go swimming until the ear is completely healed.

• if your child complains of an earache;

• if there is discharge from the ear;

• if your child is generally unwell, has a fever or is vomiting;

• if otitis externa becomes a recurrent problem.

Prevention

If your child suffers from recurrent otitis externa, it may be helpful to put drops in the ear after swimming and bathing. Your doctor will be able to advise you about these.

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Cause

Jaundice is caused by the breakdown of red blood cells. This process releases a chemical called bilirubin which gives the skin its yellow colour. In babies the process of breakdown of red blood cells is very rapid, and the system in the liver of disposing of bilirubin is relatively immature. This overload causes what is termed physiological jaundice.

Another cause of jaundice in the newborn is breastmilk jaundice, in which a chemical secreted in the mother’s milk interferes with the breakdown of bilirubin. This usually resolves itself after several weeks and does not require treatment.

A rare cause of jaundice in the newborn is due to incompatibility of the mother’s and the baby’s blood groups. This is not usually a problem during a first pregnancy because the mother’s and the baby’s bloodstream do not mix. The problem arises after the delivery during which some of the baby’s blood may have mixed with the mother’s blood. The mother then develops antibodies which become active during the next pregnancy and cross the placenta to attack that baby’s red blood cells. If this has happened, it usually becomes apparent in the first 24 hours after birth. In this situation the mother develops antibodies (immunity), which recognise the baby’s red blood cells as foreign and attack them. Their destruction leads to the release of bilirubin into the baby’s bloodstream, and the subsequent appearance of jaundice.

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am turned on sexually, but other times I just hate it. It could

be PMS, couldn’t it?”

ANSWER: Premenstrual syndrome continues to be researched, and there is much left to learn. There is no doubt that some women, indeed some men, have strong and marked periods of emotional, physical, and intellectual changes related to neurohormonal patterns. There is also no doubt that sexual response is related to all life cycles. The best thing to do is to graph not just menstrual cycles, but any cycles you feel are taking place. At the same time, make a graph of your couple cycle, how the two of you are relating. See if there is any pattern or relationship. If there is, consider a medical checkup. There are dietary, exercise, and other tactics that can be tried that may help. Most often, though, there is a strong interaction between life stress and life cycles. There are usually good reasons why we feel sexual or do not feel sexual, and usually these relate more to how we are living than any innate predetermined pattern. Graphing the couple and spouse patterns, talking this over, and reducing general life stress are important steps. When sex problems are attributed to PMS, or to any one factor or partner, we fail to understand the systems nature of sexual intimacy, the MMS, meaningful marital system.

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Now, we know what is best to eat. The question we can ask is: what ft5ods are dangerous to eat and why ?

I have already demonstrated the devastating effects of solvents and other poisons entering our body. No one who understands the consequences of poisoning should ignore such warnings.

It is quite clear, that we should avoid foods containing colours, flavours and other food extracts. Not because of the extracts themselves, but because of dangerous solvents used to extract them. These solvents (benzene, various alcohols etc..) are directly responsible for most of the “incurable” diseases of 20-th century including cancer, AIDS and Alzheimer disease, just to mention a few.

Your body has a limited capacity to process solvents and alcohols. We seem to recover quite well from alcohol (ethanol) poisoning for example. Note, however, that such recovery takes time, during which you have the solvent (alcohol) present in your body, effectively assisting your parasite friends in their activities.

We should not limit our attention to food. Note, that our skin can also absorb poisons from the environment. For that reason, we should also examine all products which come in contact with our skin like soap, shampoo, toothpaste, cosmetics, perfumes, deodorants, hand creams, make-up, cleaning agents etc..

As an example, instead of a toothpaste, containing poisonous fluoride and many plant extracts of unknown quality, you could use salty water (1/2 glass of water + a teaspoon of salt). When your body is pure, salty water does an excellent job.

It may be not possible to avoid poisoning altogether, but with the knowledge we have acquired, we could greatly reduce the extent of poisoning, with minimal effort on our part. Note, that once you have selected a brand of shampoo for example, you need not to do it again. If you have the knowledge of how to make safe products, share this knowledge with others, in the way I am sharing what I know with you.

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If complications do not develop, the symptoms subside after four or more days but the person feels weak and listless for a week or two or even longer.

There is no mistaking an attack of influenza for a mild respiratory infection we all call the flu.

With influenza, the person is so sick he is confined to bed and unable to visit the doctor, who must come to him.

The treatment, as in any viral infection, is symptomatic. There are no antibiotics to kill the virus. However, in influenza, secondary bacterial infection is so common that most doctors will prescribe antibiotics to prevent or treat these secondary infections. Bedrest, fluids, aspirin or paracetamol to ease the aches and reduce the fever and a cough suppressant are all used.

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The allegation is worrying many doctors, politicians and the public, and peer review has been suggested as the answer.

This means that an individual doctor’s work would be reviewed by his fellow practitioners and compared with what is generally accepted as right and proper.

Operation figures reflect not only what the doctor considers necessary but also what the patient demands.

In this modern age, many people are not prepared to tolerate chronic symptoms which, perhaps, their parents were prepared to put up with because of a fear of operation or anaesthetic.

For example, appendicitis is common and the standard English textbook recommends that early diagnosis and prompt removal of the appendix is the ideal. If this be done, it may be that a number of “normal” appendices are removed.

The appendix comes off the caecum or first part of the large bowel. It is present only in humans, some anthropoid apes and the wombat.

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“How could a man develop endometriosis?” she asked. “How did nature go so wrong in George’s case?” Since neither she nor her stricken husband could justify the problem rationally—men, after all, do not menstruate—Mrs. Petersen wondered if perhaps like might have been somehow responsible for his plight. Of course, she was not to blame, since endometriosis is net transmitted sexually, nor is it a contagious disease in any way. Endometriosis is a rarity in men, and how it occurs among them may enlighten us in treating women.

George Petersen’s bout with endometriosis unfolded in this astonishing letter. He was only forty years old when the first symptoms appeared. George was in generally good health, except for frequent and severe headaches, brought on, they thought, by stress; be had also succumbed to chronic bladder problems. ‘Our doctor said George had an enlarged prostate,’ Mrs. Petersen wrote, ‘and be never really felt at his best for nearly two years. It seemed like a terribly long time for us. Finally, he was told he had cancer of the prostate. It scared us, but at least we knew what was going on, terrible as it was.’

George was assured that the recovery rate was high, she said, especially if the cancer was caught early. He agreed to the treatments that were advised, including a form of estrogen, which was supposed to shrink the tumor. About a year after George discontinued estrogen treatments, sharp abdominal pains began to plague him. George feared the cancer had returned, or worse, that perhaps it had spread from his prostate to other organs. He avoided medical care for a few months, until he collapsed one night in extreme pain.

“He managed to use the bathroom and urinated blood.” Mrs. Petersen wrote. “This was a mournful night for us, since we feared the worst. Dr Obama got George to a hospital and his doctor operated on him the following day.” In surgery the doctor saw that the cancer was under control, but that there were many spots of endometriosis around his bladder! This is what caused him such crippling pain, along with other irritating symptoms.

George was probably born with dormant cells that, under the right conditions, developed and behaved as if they were endometrial tissue. He experienced the identical symptoms that women have with the disease, we know that estrogen is a factor in the growth of endomctriotic tissue in women. If George stays off estrogen treatments, the endometriotic cells should shrink and the disease not recur.

To many scientists, this man’s unique reaction and sensitivity to the hormone validates the embryonic theory of why endometriosis could develop in some individuals but not in others.

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Warts are caused by infection of abraded skin by the human wart virus (Papova virus). They spread most rapidly under warm, moist conditions, at sites of trauma. It is estimated that about one quarter of all warts spontaneously disappear within six months. The mechanism of spontaneous resolution is not fully understood, but is certainty related to the resistance or immune response of the person. The development of immunity is related to the person’s make-up, and to the amount of virus present, which varies in warts of different kinds. Plane and plantar warts, which contain little virus, are the most persistent and difficult to cure.

There are many ways of treating warts. This multiplicity indicates that there is no one effective treatment for all warts. The aim of treatment must always be to remove the wart without hazard to the patient, with minimal discomfort and absence of scarring. Effective treatment not only destroys the wart but activates the immune system winch hopefully will prevent further infection.

Common warts are probably best treated, at least initially, with local applications of either formalin, salicylic acid, cantharadin, or combinations of these. This treatment has the advantage of being painless and can be done at home. If they prove resistant, then cryotherapy is the next choice. This entails freezing the wart, either with carbon dioxide snow at — 79°C or liquid nitrogen at — 196°C. It is frequently necessary to repeat this treatment three or four times with, ideally, no longer than a three-week interval between treatments. Occasionally, warts may be resistant to cryotherapy, or too large for freezing to be effective. Patients then have the option of undergoing diathermy with curettage under local anaesthesia. This is sometimes known as ‘burning the warts out’. The disadvantage of this form of treatment is that it is rather painful and occasionally leaves scars. Curettage or ’spooning out’ of the wart, without diathermy, is frequently more effective.

Plane warts are usually responsive to local applications. Since they commonly occur on the face, this is also a more appropriate mode of treatment. Various preparations may be used.

including topical 5-Fluorouracil, a preparation used for some skin cancers and solar keratoses. If they persist, then cryotherapy is the logical and only other mode of treatment.

Plantar warts are frequently most difficult to treat. Once again local preparations containing salicylic acid and/or formalin, either in a paint or in a paste, are the most beneficial. If progress is slow, cryotherapy is the best alternative. Both diathermy and curettage, and superficial X-ray therapy, may be effective. However, there is a high incidence of recurrence and scarring. The scar may be more painful than the preceding wart, and more persistent!

Genital warts usually respond well to podophyllin paint. This type of preparation is really only useful in moist areas, and therefore rarely effective on other types of wart. The applications may have to be multiple, and should ideally be carried out at weekly intervals if necessary. Occasionally cryotherapy may be required. Diathermy and curettage requires a general anaesthetic, and is therefore a last resort.

Unusual and controversial forms of treatment include immunotherapy, where a persons own wart extract is injected into the warts. Also, D.N.C.B. (dinitrochlorbenzenel has been used to stimulate a person’s immunity, so as to enhance the natural rejection process. Similarly, smallpox vaccination has been tried. Treatment based on psychotherapy and on hypnosis both have their proponents. More recently the anti-cancer drug, bleomycin, has been injected into warts.

These are but a few of the many forms of treatment available for this very common infection.

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- Use wholegrain bread and cereals such as brown rice, wholemeal spaghetti and other pasta, wholegrain breakfast cereal, wholegrain crispbread, oatmeal or wheatmeal biscuits, wholemeal flour and other wholegrain cereal foods.

- Eat at least three pieces of fruit and four serves of vegetables each day.

- Eat the skins on fruits and vegetables e.g. potatoes in their jackets and the skins peaches, etc.

- Add one tablespoon of bran or wheatgerm to prepared breakfast cereals.

- Add dried beans, dried peas, brown rice or lentils to soups and casseroles.

- Thicken soups and casseroles with bran or wholemeal flour.

Implications.

1. Dietary fibre intake (from both soluble and insoluble sources) should be increased to a level greater than 30 grams per day.

2. Increased consumption of fluids may be necessary with extra fibre.

3. Inform clients that they may experience greater flatulence from extra fibre.

4. Select foods with resistant starch as they provide similar benefits to fibre.

5. People with diabetes should choose foods with a low GI to reduce fluctuations in blood glucose.

6. The use of foods high in sugars may need to be limited by some clients.

7. Encourage the consumption of a wide variety of unprocessed plant foods, including fruits, vegetables, wholegrain cereals, legumes, pasta and rice.

8. Clients should be encouraged to eat more wholemeal or wholegrain bread (with low-fat spreads and toppings) per day.

9. Read food labels for starches and fibre.

10. Choose foods labelled to indicate a higher fibre content.

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When told I had moderate endometriosis, I was amazed as I didn’t think I had anything wrong.

Over the next two years I had three laparoscopics and two laparotomies as well as courses of Danazol, Duphaston and Provera. The drugs proved ineffective as my endometriosis is apparently very tenacious.

In July 1986, my specialist asked if we had considered going on the IVF programme, as he felt the endometriosis was preventing the eggs transferring from the ovaries into the fallopian tubes.

I said ‘No’, as I thought that was for people who were desperate for a child. It dawned on us that we were desperate! The waiting list was 22 months long, so we put our names down.

I continued treatment and went back to work to save up for IVF. The long wait didn’t necessarily worry me as I believed I would conceive naturally and wouldn’t need IVF, so I figured the longer we waited the better our chances.

When the letter came after 18 months saying that it was our turn, I had to face reality. I was angry and scared, firstly because we couldn’t conceive naturally and secondly because this was our last hope and its low success rate meant we were likely to remain childless.

Before starting the programme, there were a number of requirements. I had to record the first day of my menstrual cycle for the previous six months, check rubella (German measles) immunity and have had a Pap smear within the last two years.

We had to attend a counselling session, be screened for Hepatitis B and the AIDS virus and checked for sperm antibodies. My husband also had to have had two semen analyses done in the previous six months.

Having met these conditions, I phoned in at 9.45am on Day 1 of my period in February 1988. The treatment cycle proceeded approximately as follows:

Day 4: I started taking Clomid tablets twice daily for five days. We attended the clinic for an interview and paid $1000 for non-rebatable fees. We were asked to sign consent forms stating what we wanted done with any extra eggs that may be collected (we were allowed a maximum of four to be put back). The choices were to donate them to someone else or to allow their use for research or to be disposed of. We could also direct them to be fertilised and frozen for our future use, or for any resulting embryos to be donated to someone else or to research or to be disposed of. We hadn’t expected to have to decide all of this on the spot and found it confusing and rather traumatic.

My husband was shown how to take my blood and give me injections. We were given the necessary equipment, etc. (anyone can take blood and give the injections). Day 5: My husband gave me my first morning injection, HMG (human menopausal gonadotropin) which is a follicle stimulating hormone. We both survived! Day 6: Attended the clinic between 7am and 7.30am for blood tests for oestrogen, luteinising hormone and progesterone levels. I saw the doctor on duty and he ordered the appropriate quantity of HMG, and I was given the injection. I found having a well-padded behind an advantage for all the injections.

Day 7: Clinic for blood tests, injection and consultation with doctor. The amount of HMG was calculated from the previous day’s blood tests which were graphed. Each day the doctor showed me my graph and discussed how I was progressing and answered my many questions. Day 8 & 9: Clinic as usual. In the evening my husband gave me another HMG injection.

Day 10: Clinic as usual, and also had an ultrasound scan to determine the number and size of my follicles. In the evening my husband took my blood (a nervous experience for both of us).

Day 11: Clinic as usual, plus took in previous night’s blood sample. In the evening, my brother-in-law (a vet!) took my blood as my husband was at night school. He said I was easier than an animal as I didn’t have to be shaved first! At 12.45am my husband took my blood and gave me an injection of HCG (human chorionic gonadotrophin). The timing of this injection was given to me by the clinic and is important because ovulation follows within the next 36 hours and enabled operating theatre scheduling. Day 12: Took previous evening’s blood samples to clinic. At 5pm admitted to hospital.

Day 13: My husband attended the hospital between 10 am and 11am to provide a semen sample in the privacy of Room 8′. As my tubes were open and normal it had previously been agreed that I have a GIFT (gamete intra fallopian transfer) procedure, which had a slightly higher success rate. I went to theatre at 12.30pm where six eggs were collected during a laparoscopy. These were then washed — as was my husband’s semen — and then the four best-looking eggs and a quantity of the semen were placed in my fallopian tubes. I remained at the hospital until 7pm and I was then allowed to go home.

I then had to wait two weeks before having a pregnancy test and it really dragged. Although there were no restrictions on activity (within reason), I just crept around, almost too scared to cough.

As each day passed without my period (despite checking each time I felt the slightest twinge), I couldn’t help becoming a bit optimistic although I tried hard not to be.

I was glad I hadn’t committed myself to doing anything or being anywhere during and immediately after the treatment cycle as I slept a lot. The travelling and the stress of being on time at the clinic, together with all the hormone injections, really exhausted me.

I went to the clinic in the morning for my pregnancy test (by blood test) and had to ring up at 3.45pm for the results.

I couldn’t believe it when I was told that my test was positive. I repeated my name and asked the sister if she was sure she had the correct results. I waited until my husband came home from work to tell him rather than ringing him as I had waited years to see the look on his face. After this wonderful news, we didn’t mind the numerous extra bills.

I had to have weekly blood tests for hormone levels at the clinic until I was eight weeks pregnant. I then had an ultrasound scan to ensure that everything was normal and to check the number of babies — in our case just one.

After an almost uneventful pregnancy, I gave birth to a normal, healthy boy.

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