OTITIS MEDIA, OR МIDDLЕ EAR INFECTIONInfection of the interior of the ear after a sore throat is not nearly so frequent as such infections used to be. The specific action against staphylococci, pneumococci, streptococci, and other germs that infect noses and throats wrought by the antibiotic drugs and sulfonamides has enormously reduced such complications. However, neglect of a sore throat or a virulent infection may occasionally be followed by spread of the germs to the middle ear. One or both ears may be infected. The condition usually begins with a pain in the ear and a high fever. The pain is continuous, but may be irregular, and is usually worse at night. When the doctor looks at the eardrum it is seen to be bulging. If the drum is not opened the pressure may cause it to burst. Then a thin watery discharge will come out, often changing to thick creamy pus. When the eardrum is cut or bursts the pain stops immediately and usually the temperature falls. The discharge may persist for a long time.*24/318/5*

COGNITIVE-BEHAVIORAL THERAPY FOR BDD: OTHER POTENTIALLY HELPFUL CBT TECHNIQUES – ACTIVITY SCHEDULING AND SCHEDULING PLEASANT ACTIVITIESActivity Scheduling: This approach is often used in the treatment of depression. It consists of scheduling activities throughout the day by writing them down in an appointment book and then doing them. This approach doesn’t directly target BDD symptoms, but it minimizes idle time, leaving less time for BDD obsessions and rituals. It can also improve your mood. Activity scheduling may be especially useful for people with severe BDD and depression who find it hard, for example, to even get out of bed.Scheduling Pleasant Activities: This approach is similar to activity scheduling. It consists of scheduling and then doing pleasant and enjoyable activities—ideally every day. This technique, too, can minimize idle time, so there’s less time available for BDD obsessions and rituals. It can also improve your mood.Some people find that additional techniques may also be helpful for them, such as relaxation techniques (like deep breathing, progressive muscle relaxation, or meditation). Other people find it helpful to learn assertiveness training or how to accept compliments.*327\204\8*

ASTHMA CASE HISTORIES: ‘CHILDHOOD ASTHMA’, NEVER OUTGROWNKate is a journalist who, until recently, carried her asthma medication everywhere. Now her only regret about asthma is that she misses chocolate.In 1971 I got a pink fairy suit with a wand and an asthma attack fot Christmas. I was five, and I couldn’t work out how to stop the feeling that I was drowning on dry land, and the red panic that followed it. I must have looked bizarre — a gasping, pale, little figure with gossamer wings. Afterwards, of course, all the countless specialists, chiropractors and physiotherapists my mother took me to told me, never fight the asthma, just flow with it. Easy to say in educated tones, but impossible to do. You can’t tell a child who is sure she is about to die not to fight for her life. And 20 years and thousands of empty puffers later, the instinct is the same. Practice doesn’t prepare you at any time for a bad attack.I have always been one of those sufferers whose condition is a giant roller coaster, swooping in and out of health at amazing speed, taking 20 puffs of Berotec one day and two the next. I guess this is mostly because I kept waiting for asthma to just go away one day. I looked upon definite controls as giving in to the fact it was with me to stay. But early in 1991, the Volumatic, a plastic device which looks more like a drink container than something I will love forever, led to my lung capacity being normal. Normal, a word I had mentally stored away as something which would never apply to me.It wasn’t for lack of trying that I didn’t find my stabilizer until I was 25. My first asthma medication was Intal in a spinhaler. The grains tasted like chalk. Then it was Ventolin and Becotide sprays. Usually I went to primary school two days a week and couldn’t break into a gentle trot to the tuckshop without feeling the tell-tale tightening in my lungs. I hated the undignified wheeze that came from my body, the embarrassed faces of the other kids and the scramble through my schoolbag for my Ventolin. It always agitated me as much as the attack itself.The days I wasn’t at school, mum and I criss-crossed the suburbs in search of something other than being told I would grow out of it and should learn to swim. Chlorine and fear of water triggered attacks anyway. I endured 40-minute injections of Bricanyl, having my mum pound my back daily (to clear my lungs, supposedly) and a psychiatrist who said it was all in my head, and that my parents should buy me a dog to take my mind off myself. Mum used to buy me a Beatrix Potter or Enid Blyton book for every blood test or nasty consultation, and I could read newspapers by the time I was six.My parents bought a nebulizer and a seaside hotel in Tasmania to escape the dreaded Melbourne eastern suburbs asthma belt. The doctors said I would die; I flourished and reached the three-stone weight mark. I still had asthma, but nothing like it had been. I got sick of waiting to grow out of it. At ten I was able to tell a doctor that an intravenous Bricanyl injection would do the trick, or that half an hour on a nebulizer was all that I needed, and yes, I am allergic to Nuelin in any form. Doctors rarely credited me with any knowledge of my own condition, and still largely don’t.In Hawaii in 1979 I got pneumonia and was taken to hospital. I was separated from my family for two hours at the height of an attack and given the wrong dose of adrenalin. Later we were told it should have killed me, and I still remember the way the patterned wall tiles came to life and tried to creep up my legs. In New York in 1988 a casualty doctor flatly refused to believe my attack was bad, left me untreated for over an hour and then had to administer three different drugs in quick succession to keep me breathing. He managed to make me anaemic in the process. My friend sat in a wheelchair in the cubicle, and in between reading her Harold Robbins novel, took photos of me in various stages of treatment in case anything went wrong. Unbelievable as it may sound, some good did come out of this experience: at age 211 was told, for the first time by any doctor, that aspirin can trigger asthma attacks.Once I had a severe attack and we were out of Ventolin for the nebulizer, so dad went to the chemist. He came back two hours later, having stopped in at a friend’s house to watch the golf on TV. I was in hospital after that for five days. My dad was mortified. You should never be blase about asthma.The medication itself can be terrifying, even though you know it’s saving your life. After a heavy dose I lie in bed and my whole body feels like a huge heart, really pumping and speedy.When I first started thinking about planning for a pregnancy, the asthma prickled me — I used to be sure the Berotec and regular steroid doses were somehow getting together in my body somewhere and plotting against me. Plus there was the added concern that Berotec was being phased out in Australia and I had come to really depend on it. If I went to the milkbar without it, the panic would bring on an attack. I went to a specialist. My lungs were then functioning at about 40 percent. He told me to cut out dairy foods and prescribed a change from Berotec back to Ventolin, which had stopped being effective for me about ten years ago, and Becloforte. But the secret ingredient was the Volumatic, a large volume inhaler attachment — in unscientific terms, a round plastic tube with a slot for a puffer at one end and a mouthpiece to inhale from at the other. Because the Volumatic’s mist penetrates deeper into my lungs, the medication works quicker and far more effectively.This all sounds improbably easy, but within a week of the two-puffs-each, three-times-a-day routine, I was sleeping through the night, something that hadn’t happened for literally years. I could have a glass of wine and laugh and exercise without wheezing. Two months later I went back to the specialist — my lung function had doubled and was normal. The specialist told me to come back for a check-up in 12 months. I feel like the fat lady who has swapped her size 26 tent dress for a size 10 bikini.*59\148\2*

How an entire centre can be put out of order is seen in the case of a stroke. The attack usually occurs in the inner capsule and not! the outer part of the brain or the cerebral cortex. If a blood vessel on the right side of the inner capsule ruptures, the blood supply to the outer parts of the brain is disrupted and the consequence* appear on the left side of the body. This inversion is due to the fact that the cerebral hemisphere controls the opposite side of the; body. Whatever we sense on the right side is registered on the left side and vice versa. If the body is able to repair the damage, the paralysis will pass and the ability to speak, which was lost, will return. If the speech centre remains disturbed, while the centre governing the connecting ideas continues to function, then the person will find himself in the embarrassing situation of thinking! correctly but expressing himself in a muddled way. However, tfl will not happen if he writes down his thoughts instead of trying! to express them verbally.
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The functions of the brain, as far as they have been discovered, are amazing. Picture, if you will, the control room of a large power plant or a modern ocean liner, or the instrument panels of a jet plane. All the numerous instruments and switches elicit our amazement and admiration. These control centres are, in a manner of speaking, the brain of, for example, the ship or plane. Everything that takes place, every change in direction, every response to the changeable elements, every command, comes from that control centre, the brain. The energy needed to make everything function is supplied by generators which produce energy, or power. When the power supply is insufficient or fails completely, it can be put down to problems in the central control because it is either mal­functioning or is out of action. This can happen even though engines and equipment have been designed and built in spectacular ways.

What can we learn from the above illustration? Energy is sup­plied to the brain via the bloodstream. If the blood carries all the necessary nutrients, nutritive salts and vitamins so that every brain cell receives the food it needs, then everything will function prop­erly. Not every one of the many millions of cells has its own function. The brain is divided into work groups, called centres and more than twenty of these centres have so far been recognised.
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Ringworm is a very itchy fungal infection which is caught from animals and occasionally humans. It is quite common and does not necessarily indicate poor hygiene. It usually responds well to treatment.

Cause

Ringworm is caused by the fungus Tinea corporis, which is commonly caught from young animals, mainly household pets, or strays.

Clinical features

The rash initially appears as a very itchy, red ring on the skin, with a lumpy or raised edge. If you look closely you will see that there are scales present. The centre of the ring is usually clear. The rash grows gradually in size over several weeks, and may spread to involve other areas. If the scalp is involved you may notice a small bald patch with stubbles of hair present. The doctor may use a special light to help in making the diagnosis, or may examine some skin scrapings under the microscope.

Treatment

Ringworm usually responds well to treatment with special antifungal cream, but you need to be persistent and apply the cream twice a day for several weeks. Be sure to keep applying the cream for a week after the rash has disappeared, to prevent recurrence. Discourage your child from scratching the area. Treat all affected family members, and consult your vet for appropriate treatment if your pet is the guilty party. Ringworm is not highly contagious between humans, so you do not need to keep your child away from kindergarten or school. Your doctor may prescribe special antifungal tablets. These need to be taken under medical supervision.

When to see your doctor

• if there are several lesions present;

• if the sores are painful;

• if the rash does not start to improve after a week’s treatment;

• if the rash is spreading despite treatment;

• if there are bald patches in the hair.

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Breastfeeding places additional physical demands upon you as a mother and you should pay attention to your own needs as well as those of your baby. Keeping your sense of humour and taking time out to rest and relax will go a long way towards keeping up your morale, as well as your milk supply.

A well-balanced diet is very important for mothers who choose to breastfeed, and you should follow similar guidelines to those given to women during pregnancy. Make sure that you keep up your fluid intake, especially during warmer weather, and avoid alcohol, caffeine and nicotine, as all these substances are passed on to the baby via breastmilk. Various medications and drugs can also pass freely into breastmilk, so always consult your doctor before taking anything while you are breastfeeding. Moderate exercise is beneficial to your general well-being.

Finally, accept any offers of help from others, whether it be with the cooking, the housework or babysitting. You also need some time for yourself to enable you to cope with the constant demands of a young baby.

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I ask couples to get books, videotapes, audiotapes, and other materials they find interesting regarding sexuality. Some couples find carefully selected and mutually acceptable X-rated videotapes arousing and educational. Some find them degrading and dumb. It is a matter of personal and marital choice, but now is the time to experiment and learn. Try some old romantic films or comedies, whatever seems interesting to both of you.

Most of the couples invested in a video-cassette player and often watched comedy tapes together. Laughing can be one of the most powerful of aphrodisiacs. There would be much less suffering in marriage if we made more time for laughter and fun. Have you ever noticed the happy looks and laughter from people who are helping others? Have you seen the laughter and joy in the entertainers who gather for a charity event? Giving and sharing seem to be very healthy emotions, and they almost always result in hugging and holding. Again, we do tend to feel as we behave, so learn to laugh. Whatever type of tape you watch, discuss it and learn together.

‘ ‘We watch those tapes, and I think they stink. But we talk about them. I saw a few things to try, too,” said one wife.

“I used to sneak to watch the X tapes. I love to share them with her. We have learned to be real selective. They mostly stink. When we get a good one, one with something we both like, then we get turned on.” This husband was the initiator of the tape-viewing, but his wife added, “As long as you want to read those romantic novels with me and watch the old film classics, watch the romances, then I’ll watch the junk with you. We can learn from anything, I guess.”

Interest in sex is maintained only by thinking, reading, and talking about sex. If you speak only of work, school, problems, and bills, then sex will gradually leave the marital agenda.

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