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THE SIXTH MONTH

Activity

Baby tends to turn his head readily; he can lift his lower limbs high and stretch them out. He can now turn and twist in any direction and roll around when lying flat on his tummy. He becomes more and more mobile, getting up on his hands and knees, making forward movements. Or he may creep along, using his limbs to assist in his movements. He can now stand erect, but support is still usually necessary.

He is learning how to balance more readily, and may still need a little support. He can bend his trunk, bounce and dangle objects. He can sit alone for short periods only, and may be able to stay in the one spot for half an hour but may slump forwards on to his hands in an effort to balance himself.

His movements are improving and increasing. He can hold his bottle by now, and can manipulate many objects. He tends to reach for items with one arm rather than both at the same time.

Talk

This is gradually becoming more adult-like, with more consonants interspersed with the vowel sounds he has been making for some time. The vocal pitch and volume tends to vary and normalize. He shows more control over the noises he is making.

His baby babblings continue, and often these increase when he is excited. He tends to respond to female noises by more babblings.

If happy or unhappy, he gives vent to this vocally. He tends to growl, complain, grunt, coo and gurgle, depending on the mood of the moment.

Mind

His range of movements increases. He will often coo or cease crying when he hears music or certain voices. He will likewise react to different volumes of noise.

He is now alert most of the hours of daylight, and he is also aware of what is happening for up to two hours at a time.

If he sees an object he wants, he reaches for it directly and more concisely, without so much of the inaccurate jerking movements of previous months. Movements are becoming more definite. He keeps looking at the object he reaches for but may even close his eyes whilst reaching. He can now pick up toys expertly and without the tentative inaccuracies of the past.

He often looks at things upside down, and purposely alters the viewing angle.

He shows increasing interest in certain objects—he will tend to pick up a cup by the handle, lifts inverted objects, etc. If he drops a toy, he will often deliberately reach out to grasp for it and retrieve it.

He will look at writing or scribbling done by somebody else.

He realizes that his hands and the things they move are related.

He is gaining greater control over his hand movements. For example, he may hold one block, reach for another, and then look at a third block, being capable of this increased range of mental and physical activity.

Relationships

He still smiles at his reflection in the mirror, and he can tell his real self from the reflected image. He now recognizes his name and will turn in answer to it. He often tries to mimic the facial expressions of others. If holding an object in his mouth, he will tend to touch it with each hand alternately.

Strangers tend to disturb his mental equanimity. He can tell adults from children, and he tends to react favourably to children, whether he knows them or not. He will call his parents if he needs help

He likes playing with people, especially games in which he and another are mutually involved, such as ‘peek-a-boo’. He enjoys the interpersonal relationships of others.

He likes to feed himself with his fingers. His appreciation for taste develops and he soon develops strong preferences. He likes to manipulate his bottle without outside interference and may commence to use a cup.

At long last, he may sleep through the night, and he tends to sleep about half of the normal 24-hour day/night period. In short, baby is really starting to ‘grow up’.

AN IMPORTANT NOTE

Enormous normal variations occur in individual babies. The above scheduling is only a guide; and do not be too worried if your baby does not conform exactly to it. Each baby is a human personality in the making and will differ. However, if there are obvious marked variations, or an exceptional slowness, it is important to have the baby checked by your paediatrician or family doctor.

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Posted in General health.

MENOPAUSE

Also known as ‘change of life’, menopause is the ending of the menstrual or reproductive cycle in women. It most commonly takes place in women between the ages of 45 and 55. Some stop menstruating suddenly, others experience irregular periods for several years before menstruation ceases altogether.

While menopause is a natural stage of life, there are many problems commonly associated with it, mostly the result of diminishing levels of the female hormone, oestrogen. Some women are troubled by hot flushes, excessive bleeding, vaginal dryness, nervous disorders and depression during the transitional period.

Because the adrenal glands take over some of the functions of the ovaries at this time and produce oestrogen, the proper function of these glands is important for keeping the uncomfortable symptoms to a mimimum. Vitamins B5, C and E, as well as zinc, all boost adrenal activity. The group of compounds known as bioflavonoids may also help during this time to ease both physical and emotional discomfort. Related to Vitamin C, they assist with its absorption and proper functioning in the body. One good source is the pith of citrus fruits but they are also found in vegetables, particularly onions, and in ordinary tea.

All women should exercise regularly and eat a high proportion of raw foods. For hot flushing, take the herb dong quai which possesses the ability to balance hormone levels. This herb is being used by Western women as an alternative to hormone replacement therapy.

Recent research indicates that dong quai, a rich source of both Vitamins E and B12 may also be helpful in the treatment of anaemia and in controlling cholesterol buildup in blood vessels. A naturopath can advise you on the correct dose for your needs.

Avoid the common trap of resorting to tranquillisers to combat depression. Instead try lifestyle changes to lift your mood or learn relaxation techniques to ease anxiety. Active women appear to suffer much less from depression around this time of life. The inclusion of oats in the diet can also help alleviate mild depression.

One of the greatest risks associated with menopause is the gradual loss of bone mass. This condition is known as osteoporosis and can result in fragile bones which fracture easily. Throughout adult life, women should take care to keep their calcium intake high and calcium supplements taken during and after menopause may help.

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Posted in General health.

ANXIETY IN THE MIND: NERVOUS TENSION

There is a difference between true apprehension and the more common nervous tension. They may occur either separately or in combination. Nervous tension is a less complicated sensation and lacks the feeling of impending disaster. We feel tense in the mind, the brain, or the whole self. Relaxation seems impossible. We feel wound-up like a spring and cannot let go. There is an absence of normal mental ease, and in its place there is the feeling of being overwrought.

This nervous tension of anxiety is often accompanied by physical muscle tension. When we are anxious, our muscles are tensed, ready for the call to action which in fact never comes. The tensed muscles may become sore and tender. If this is generalized we are said to suffer from nervous rheumatism, but more often the stiffness is confined to certain muscle groups, particularly those around the neck and shoulders.

Minor degrees of nervous tension show themselves in the way we function in our everyday life. There is a lack of ease about our reactions. Even in such a simple thing as walking, the natural ease of movement is lost, our arms do not swing in the accustomed fashion and our gait has the appearance of being strained and awkward. Sometimes these symptoms of anxiety very closely resemble those of organic illness.

A woman in her early fifties had been thoroughly investigated by a competent physician, and had had psychiatric treatment with drugs and discussion of various domestic problems. She complained to me that she was tired and lethargic. She was dizzy when she stood up and would become breathless when walking up a slight hill. She said that she was wobbly on her legs so that she had difficulty in standing to do the cooking.

I thought that an organic cause for her symptoms may have been overlooked, and I referred her back for further investigation, but nothing could be found. So I started her with relaxing mental exercises, and she has made a dramatic improvement, which shows that her symptoms were in fact due to anxiety. I later discovered that her unsteadiness on standing was due to the increased nervous tension in the muscles of her legs.

Nervous tension may be seen in our manner of speech. There is a tendency to talk abruptly and too quickly. The flow of words is interrupted and the observer is aware of a loss of natural ease of communication. In simple things such as writing, our tension makes us hold the pen too tightly. Our hand starts to shake, our writing becomes jerky, and the letters lose their normal rounded outline.

There is another aspect of nervous tension which further disturbs us. We do not like other people to know that we suffer in this way. It is considered socially desirable to be relaxed and at ease. To be tense and uncomfortable is to be socially inept, and as a result we do all we can to disguise our inner tension from those around us. We try to behave in a relaxed manner, and when we are seated we assume a posture of ease in the hope that others will not guess what is going on in our mind. In this attempt to keep from the others the truth as to how we feel, we concentrate on what we are saying and on the tone of voice as we say it. We try to present a facade to them so that they will not guess our true state of mind. To keep up this facade requires more and more effort. We have to concentrate on it so much that we can only give half our attention to the matter in hand. We become aware that we are not functioning to our full ability; we become more apprehensive, and our anxiety is still further increased.

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Posted in Anti Depressants-Sleeping Aid.

KIND OF PAIN: THE CRAMPS (SPASMODIC DYSMENORRHOEA)

Before you can sort out which treatments will suit you best, you must first discover which kind of period pain you suffer from: spasmodic or congestive dysmenorrhoea. Like so many medical terms, they are rather a mouthful. I prefer to call them ‘the cramps’ and ‘the aching miseries’. They’re horrible whatever you call them.

THE CRAMPS (SPASMODIC DYSMENORRHOEA)-These are very severe, griping, cramping pains in the lower part of your abdomen which start either just before your period or immediately it begins. They can last anything from half a day to five days and they often seem to be one long continuous pain. Many women just have to lie down because they’re in too much pain to do anything else. Some faint; some feel very sick; some actually vomit; some crawl through the day, just enduring. The majority of sufferers are young girls, although I’ve met older sufferers too. The pain can be cured, or at least diminished, by the birth of a first baby although, as many women have already found, this isn’t always so.

Women who’ve had the cramps and then later had a baby will tell you that the cramps and labour pains are very similar. I have met several who said that, of the two, the labour pains were much the easier to bear, especially in the first stages of the birth. At least there’s some point to that pain. You can ride it, and use it, and there’s a baby at the end. One of the real miseries of period pain is that you know you’re going to have to endure it every month —month after month after month. It’s the relentless regularity that wears you down. Fortunately this is the kind of period pain that can be most easily helped by deliberate relaxation.

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Posted in Pain Relief-Muscle Relaxers.

THE UPS AND DOWNS OF ADDICTED LIFE

The addict is basically unstable, in that he tends to require an ever-increasing dose of his addicting substance in order to keep well. By keeping “well” is meant the maintenance of immediate stimulatory effects (“highs”) and avoidance of delayed withdrawal effects (“hangovers,” or “lows”). This is true of the drug addict, food addict, or alcohol addict. The main difference between these types of addictions is that the drug addict usually knows the identity of his addicting substance, whereas the food addict is ordinarily hooked on one or more unrecognized foods. The drink addict, or alcoholic, is usually hooked not on alcohol per se but on one or more foods from which alcoholic beverages are derived. More will be said about addiction to these food-drug combinations later.

An addiction response is quite properly referred to as a “trip.” Such a journey, consisting of many ups and downs, may stretch over many years. At first, the “highs” of addiction may be pleasant and rewarding. But as the “trip” continues, such “highs” tend to become less desirable, though still far preferable to the more disastrous “lows”. The addict’s prospects are bleak, whether he is hooked on foods, drink, or drugs. Generally speaking, he tends to climb to a certain stimulatory level before falling into a pit. The pit consists of increasingly common and prolonged withdrawals which can no longer be avoided or postponed by recourse to the formerly effective substances. Allergies of all sorts, including fatigue, aches and pains, and depression come to dominate the addict’s life. When he is no longer able to cope with these withdrawals as he formerly could, he finally seeks medical care.

Table 1 presents the various levels of addiction and the manner in which they affect the addict’s physical and mental state. It can be seen from this chart that many of the most common chronic illnesses can actually be way stations of the addiction trip. These include some problems usually dismissed as “psychosomatic” by physicians and psychotherapists.

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Posted in Allergies.

CHILDREN’S HEALTH: CAT SCRATCH FEVER

Cat scratch fever is caused by a minor scratch or bite from a kitten or young cat. It is caused by a germ – probably a virus – although the cat is not ill. The puncture wound or scratch does not heal in the time expected. One to two weeks later, the wound is still red, sometimes with a small amount of pus. One to six weeks after the incident, the lymph nodes near the wound become swollen, tender, and red. The child has a low-grade fever (37.8°C, oral; 38.3°C, rectal). Eventually the lymph glands may break down and discharge pus through the skin.

Signs and symptoms

The signs of cat scratch fever are a minor cat scratch or bite that hasn’t healed; large, tender lymph nodes; and a low-grade fever. There may be pus in the wound. If you don’t know that your child has been scratched by a cat, it may be difficult to tell cat scratch fever from a wound infected with staph or tuberculosis germs.

Home care

Scrub all cat scratches and bites immediately with soap and water for ten minutes. Then apply an antiseptic. If the wound becomes infected, see your doctor.

Precautions

• Unsupervised play between cats and young children is dangerous to both the child and the cat.

• Do not allow children to tease or torment cats or any other animals.

Medical treatment

Your doctor will rule out other illnesses by blood tests and cultures. Treatment with broad-spectrum antibiotics is occasionally helpful. Cat scratch fever may require surgical incision and drainage or the complete removal of a lymph gland.

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Posted in General health.

IMPOTENCE: SOME PREVENTABLE CAUSES

•     Keep up a healthy diet in old age, ensuring especially that you take vitamin and mineral supplements. As we age our intestines absorb nutrients less efficiently, and because of poor appetites and low exercise levels many old people eat poorly anyway.

•     If you have tried all the ‘treatable’ causes of impotence and still have no result, perhaps the problem is ‘in the mind’. The ideal starting point is to discuss the whole subject with your partner, being careful not to apportion blame.

Stop having intercourse. Once the threat of having to perform is removed, many impotent men can erect perfectly well and, with the help of their partner, can get used once more to having full and spontaneous orgasms, by masturbation. By alternately stimulating and not stimulating the penis the partner of such a man can often train him, over a few weeks, to have long-lasting, good-quality erections.

During all this the couple should go back to courtship behaviour with the emphasis on closeness, loving, kissing, mutual pleasuring, massage and so on. When the genitals are brought into play the emphasis can be more on looking and admiration (like children) than on performance. The woman can be of great help by sharing her fantasies and intimate sexuality with the man. This helps him see her as a real woman with earthy needs and appetites and not as an untouchable virgin who is too ‘nice’ to want sex. This works wonders in many such cases. The woman can also help by making a conscious effort not to behave in a ‘motherly’ way that reminds the man of his mother. Few men can function well in this situation because sex with one’s mother (and by extension anyone who behaves in a ‘motherly’ way) is forbidden. On the other hand, quickly switching to sexy underwear and becoming a sex siren can also be intimidating and could appear to the impotent man to be a demand for performance which can set back his progress.

Along with all this the man should re-establish self-masturbation so that he eventually learns that the ‘uncontrollable’ is in fact not so. Sex aids can be useful at this stage. Progress towards intercourse should be slow and controlled, or good gains made over several weeks can be lost in one love-making episode.

•     Lastly, give yourself a chance to have an erection. Too many men bring their worries and overactive mind with them into the marriage bed. Give yourself a chance to unwind before sex. At work a man is generally non-sexual and few men can change instantly from this mode into the lover role. Get changed into comfortable clothes, relax, have a small drink. Spend time together just talking or reading something erotic. Get the lead-up to sex right, spending time showering or bathing alone or together, then cuddle and kiss before even trying to have intercourse or produce an erection.

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Posted in Men's Health-Erectile Dysfunction.

AGE EXTENDERS ARSENAL: COMPANIONSHIP

Medical science has proved that “Only the Lonely” is a more accurate selection than “Only the Good Die Young” if we’re trying to pick the true hits on the Grim Reaper’s jukebox.

The lonely, the disenfranchised, the disconnected, those who feel their lives have no purpose-studies show that these are the folks at greatest risk for coming down with a bad case of premature death or life-threatening disease, says Dean Ornish, M.D., president and director of the Preventive Medicine Research Institute in Sausalito, California, and author of Dr. Dean Ornish ’s Program for Reversing Heart Disease.

Amazingly, in a study directed by psychologist Sheldon Cohen, Ph.D., professor of psychology at Carnegie Mellon University in Pittsburgh, people with the most diverse types of social contacts and networks were the least likely to be susceptible to a cold virus intentionally squirted up their noses.

Why does social interaction seem to have a life-lengthening and health-promoting effect?

“Bottom line: Nobody knows,” Dr. Ornish says. What is known, he says, is that “it is the quality, not the quantity of relationships” that matters.

So no one knows for sure why mingling and sharing thoughts and feelings with others is healing. Theories abound. Dr. Cohen and his research cohorts at Carnegie Mellon believe that having a wide range of social environments is distracting-and that’s good. “For example,” Dr. Cohen says, “someone whose only social role is worker will find problems at work more distressing than someone who works, has a family, and belongs to social groups.”

Whether we call it distress or just stress, it truly is a killer, Dr. Ornish says. Much of his program for heart attack patients is devoted to helping them learn to reduce stressful responses. “We know that when people are under stress, their immune systems are impaired and their cardiovascular system is more prone to heart attacks or sudden cardiac death,” he says.

In Dr. Cohen’s study that we mentioned earlier, participants’ blood levels of norepinephrine and epinephrine were measured regularly. These two hormones are released when we are under acute stress. Dr. Cohen’s researchers squirted the common cold virus up the nostrils of all the test participants. Those who became infected were those who had the highest levels of the stress-indicating hormones and were those with the fewest types of social contact. At this point in medical research, however, it is too early to say that we gain the health effects of positive interaction with others because our brains instruct our glands to exude some protective chemicals-or our brains emit specific electrical impulses-that strengthen our immune systems, Dr. Ornish says.

Dr. Ornish and colleagues have implemented and studied the effects of programs “that increase the sense of connection and community, and we have found that the patients initially think that this is the part of the program that will be least helpful. And yet when they have gone through the program, they find that it is the most powerful and meaningful part.” That’s because the peer interaction encourages people to stick with positive helpful behaviors, such as healthy diets, ceasing smoking, and other goals the programs set forth for the patients, Dr. Ornish says.

“People who feel lonely and isolated are more likely to smoke, abuse other drugs or alcohol, eat too much, work too hard, or watch too much television as ways of numbing, distracting, or killing the emotional pain that they feel. I think the real epidemic in our society is this emotional or psychological or spiritual heart disease-this sense of loneliness, isolation, and alienation that’s so common when people feel that sense of disconnection,” says Dr. Ornish. People in the throes of that epidemic are more likely to engage in behaviors that increase their risk of premature death or disease, he says.

So how does one get connected? First, says Dr. Ornish, realize that there is a difference between being alone and being lonely.

“It’s not how many people you call every week or how many people live in your household,” says Dr. Ornish. “It’s not so much the number of social contacts you have but the perception of whether you feel loved and cared for and nurtured by them. Someone could be alone by choice-in a monastery, for example-and they can also feel that sense of interconnection with something spiritual.

“It doesn’t necessarily have to be another person,” adds Dr. Ornish. “Some studies show that even having a plant to take care of, or a pet, prolongs life. Anything that takes us outside of the belief that we are separate and only separate, I think, is healing. The word healing even comes from the root ‘to make whole.’”

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Posted in General health.

BREAST DISORDERS: NIPPLE DISCHARGE

Some women always have a slight discharge from their nipples, and others may develop one during or after pregnancy. Although nipple discharge is not normally the sign of a serious condition, and is rarely associated with cancer, its cause should always be investigated, particularly if the discharge is blood stained.

The long-term use of oral contraceptives may be associated with a watery, milky discharge from the nipple, which can be dealt with by stopping taking the contraceptive. As the pill is the most effective form of contraceptive, it may be worth putting up with a slight discharge if it does not cause you much distress. Always ask your doctor’s advice before stopping any form of contraceptive, and make sure you use another suitable type.

Paradoxically, a discharge may sometimes also result if the contraceptive pill is stopped.

A milky discharge may occur at puberty and, although it is likely to resolve itself without the need for treatment, it should be brought to the attention of your doctor:

Very rarely, a profuse watery, milky discharge may be caused by a pituitary tumour. If a tumour develops in the pituitary gland in the brain, it can cause increased secretion of the hormone prolactin which triggers the ‘let-down’ reflex which normally leads to the release of milk during pregnancy.

The following are some other, more important, causes of discharge from the nipple.

Duct papilloma

This is a benign tumour of any epithelium, which is the layer of cells covering the body’s surface and lining most of its hollow structures. In the breast, a papilloma may form in the ducts near the areola. Although some believe that duct papillomas may be linked to the development of breast cancer in women near the menopause, such an association has yet to be proved.

Symptoms

Papillomas occur mostly in women between the ages of 35 and 45, and may cause a bloodstained discharge from the nipple. A lump may be felt on examination.

Diagnosis and treatment

The nipple discharge may be examined under a microscope, but the results are often unreliable. These tumours may show up well on mammography when a radio-opaque substance is injected into the duct containing the papilloma. This investigation is known as a ductogram and is relatively painless.

Treatment is normally by microdochectomy, which involves expressing the discharge to identify the duct containing the papilloma and then inserting a probe into it. The duct, the inserted probe and the papilloma are then removed.

Duct ectasia and plasma cell mastitis

Duct ectasia is a benign disease in which the ducts just under the nipple become swollen with their own secretions.

Symptoms

The nipple of the affected breast may become inverted, and the ducts may secrete a green or yellowish fluid which can occasionally be bloody. The area around the ducts may become inflamed, giving rise to a type of ‘mastitis’.

Plasma cell mastitis can occur if the secretion of duct ectasia leaks out of the ducts and is recognized by the body’s defence mechanisms as ‘non-self. A ‘chemical’ inflammation results, which is fought by the plasma cells involved in the reaction against foreign bodies. This can also lead to the formation of abscesses around the areola, particularly if organisms are able to invade the ducts through an inverted nipple.

Diagnosis and treatment

Nipple discharge may be the only sign of duct ectasia, but a mammogram is sometimes done to exclude the presence of a cancer and to help confirm the diagnosis.

Both duct ectasia and plasma cell mastitis can be difficult to treat, although surgical excision or division of the affected central ducts just under the nipple usually has a good result.

In less serious cases, once reassured that there is no malignant disease present, many women are prepared to put up with the nipple discharge. Those who find it offensive may be treated by surgical removal of the major duct complex and, if necessary, correction of the inverted nipple. Loss of or reduction in nipple sensation may sometimes occur following surgery.

If an abscess forms as a result of mastitis, it may need to be surgically incised and drained. This operation must be done by an expert surgeon as simple incision may leave a scar which continues to drain, causing further nipple discharge. This condition is known as a mammillary fistula.

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Posted in Cancer.

PREVENTIVE MEDECINE: SCRENING PROGRAMMES

Money spent on screening obviously has to come from somewhere and often it is diverted from curative services. This is all very well for those whose diseases are picked up early and successfully treated but what about those who are not treated for diseases only identified later? This raises all kinds of moral dilemmas for the medical profession and for society as a whole.

Next, it is worth considering the emotional, social and occupational harm done to people who think they are healthy but who are subsequently labelled ‘ill’ as a result of a screening procedure. Labelling someone with a disease has profound effects on his or her life. This would not be so bad if doctors could be sure of their labels but they often cannot because such labels are difficult to apply. Doctors disagree profoundly, for example, over significant levels of raised blood pressure, cholesterol and many other apparently straightforward parameters of body function. This means that one doctor will expend time and his or her patient’s emotions investigating further a laboratory result which another would consider ‘normal’. And none of this takes into account the false positives and false negatives that occur in any screening programme and which cause worry and complacency respectively. So it can be clearly seen from all this that simply detecting disease early is not necessarily enough. A World Health Organisation Report, recognizing this as a real problem, says the following about screening programmes:

1.    They must lead to an improvement in end results in those in whom a diagnosis is made (or in those around them in the community).

2.     The therapy for the condition must have a favourable effect on its normal course-not simply bringing forward the date of the diagnosis but improving survival or function (or both).

3.     There must be sufficient health services to ensure that diagnosis raised at screening can be properly confirmed and to provide meaningful medical care for the person.

4.     People who have been diagnosed as having an abnormality must be prepared to go along with medical advice about what to do about it, or the whole procedure is a waste of time.

5.     The long-term beneficial results must outweigh the long-term disadvantages.

6.      The procedure must be cost-effective.

7.     The problems produced by the disease that is being screened for must be large enough to make it worth while doing all the above. Clearly an extremely effective and cheap screening method for a trivial condition, however common, would be difficult to justify.

Having now injected a note of caution into the subject of health screening, we can ask what is worth doing in a preventive health context. Opinions vary, as you would expect, but there is little doubt that it is worth screening for the following seventeen conditions:

1.    Abnormalities of growth and development in children.

2.    Hearing loss.

3.    Visual problems (acuity, squint, glaucoma).

4.    Scoliosis (curvature of the spine).

5.    Cardiovascular risk factors: hypertension, hyperlipidemia (high blood fats), diabetes, sedentary lifestyles, smoking and obesity.

6.    Cancer (cervical, breast, large bowel, testicular).

7.    Anaemia.

8.    Kidney disease.

9.    Sexually transmitted diseases (syphilis and gonorrhea).

10.    Menopause problems.

11.    Alcohol and drug abuse.

12.    Various diseases of the chest other than lung cancer.

13.    Various conduction and rate abnormalities of the heart.

14.    Sickle cell trait in the black population.

15.    Rubella immunity in females.

16.    Phenylketonuria in newborn babies.

17.    Hypothyroidism in newborn babies.

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Posted in General health.