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Archive for the ‘General health’ Category.

RESIDENTIAL AND PRIVATE NURSING HOMES: COMMON PROBLEMS

Some problems are common to both private residential and private nursing homes so a lot of thought and guidance is needed before any decisions are made. The first problem is funding. For most elderly people the cost is now borne by their local social services department. Their care manager will obviously be looking for value for money and is only allowed to use a certain number of known and registered homes, which keep their prices reasonable.
If the client has assets, they will be expected to pay the full rate themselves until their capital falls to such a level that the social services will step in. Some carers are so desperate to find a home that they will meet the difference themselves, only to find that as the rates go up, as they invariably do, they can no longer meet the difference, and their relative has to leave. All these financial considerations have to be sorted out before the person moves in, especially if help is needed from the local authority. Many homes require a month’s money in advance and some do not refund any should the client leave or die in this time.
The location of the home can be another problem. Many carers choose the private sector partly for the convenience of having a family member nearer to make visiting easier. Many old people still live in inner cities whilst their children have moved out to the suburbs or the country. For most old people the move out of their home is traumatic enough, but for many they have to move considerable distances either to be nearer relatives or simply to an area where the weekly costs are affordable. Circumstances change and sometimes carers have to move because of business commitments, leaving the person stranded in a totally new environment.
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ABOUT GENERAL SURGEONS

As the march of medical science advanced into the realms of high technology, pills, potions and prevention – general surgeons got left behind. The appearance of the operating endoscope is just the golden technological opportunity that this hard pressed group of medical specialists was waiting for. Once more in the spotlight each day, they redefine the role of all the traditional intra abdominal procedures. Each passing week sees an old technique succumb to the advancing tide of endoscopic innovation. Gall bladders, hernias, appendixes and even the resection of cancerous lengths of large bowel are all attempted by the general surgeon’s latest technological toy.
Whilst it is fair to say that these general surgical techniques are indeed an advance on the abdominal search and destroy operations of old, there is still a fly in the surgeons’ philosophical ointment. The removal of a gall bladder may be beneficial for the patient; but it does nothing for the gall bladder. The same can be said about appendixes and uteruses which Australian surgeons remove at rates almost unmatched by any other corresponding group of health professionals any where in the world. If today, surgery is still a necessary evil, let us not forget that in terms of treatment resorting to the knife means that health promotion still has a long way to go.
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COMMON INFECTIONS OF CHILDHOOD: COLDS (UPPER RESPIRATORY TRACT INFECTIONS)

Upper respiratory tract infections are the commonest cause of illness in children as well as in adults. A number of terms are used (sometimes inaccurately) to describe these ailments. They include ‘colds’, ‘flu’, ‘tonsillitis’, or ‘pharyngitis’. The average preschool child has at least six colds a year. Sometimes, especially in winter, it seems that the child is unwell for weeks at a time, barely getting over one cold before becoming sick again. Young children are particularly susceptible because they have not had a chance to build up immunity to the many viruses that are responsible for colds. As the child grows older, the frequency of upper respiratory tract infections decreases because he gradually builds up his immunity.

Cause

Most colds are caused by a virus. In fact there are over two hundred types of virus that can cause the common cold. This is the reason it is not possible to be immunised against a cold.

Colds are more common in the winter months. Cold weather by itself does not increase the chance of getting a cold, but people are in closer contact with each other because they stay indoors and are more likely to infect each other. The viruses which cause colds are spread by sneezing, coughing and hand contact.

Clinical features

These are well known to all parents and are essentially the same as in adults. There will be various combinations of a stuffy or runny nose, sneezing, sore throat, cough, headache, red eyes, swelling of lymph glands, and occasionally fever. Often there will be a loss of appetite, and sometimes nausea and some vomiting. Children may be miserable or irritable.

The actual symptoms will vary from child to child, and from illness to illness. Usually the symptoms will last anywhere from a few days to a week or more, and the child recovers fully without any problems.

Very occasionally there are complications such as ear infection, laryngitis, croup, or a lower respiratory tract infection such as bronchiolitis or pneumonia. These are relatively uncommon illnesses compared to the uncomplicated cold, which is widespread.

Investigations

Very occasionally the doctor will order a blood test, throat swab or, rarely, a chest X-ray, but for the majority of children with upper respiratory tract infections no investigations are necessary.

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PREGNANCY/EVERYDAY LIFE: BLOOD TESTS AND ULTRASOUND SCAN

Blood tests

Some abnormalities can be detected through specific blood tests. This involves taking blood from a vein in the mother’s arm. Blood tests are done routinely and regularly throughout pregnancy. Tests are done to check for rubella, anaemia, and bleeding tendencies. At around 16-18 weeks a test is done to check the level of alphafetoprotein in the mother’s blood, which can help to determine whether the foetus has any serious neurological defects such as spina bifida. The timing of this test is crucial and if dates are inaccurate, the results may be interpreted incorrectly. If the test result is abnormal, and you are sure of your dates, it will probably be repeated, and an amniocentesis will be recommended so that a more certain diagnosis can be made.

Ultrasound scan

An ultrasound scan is routinely performed at around 20-22 weeks to check the progress of the pregnancy, especially the size and maturity of the foetus. It also shows whether there is more than one foetus present. It is your baby’s ‘first photo’ and can be quite an exciting event for the parents. Occasionally the sex of the baby can be detected if the genitalia are clearly seen. You may both decide that you do not wish to know the sex of your baby until it is born. If so, make sure you let the doctor who is performing the ultrasound know, so he can respect your wishes. The test converts sound waves into images on a television screen and is not dangerous. Interpreting ultrasound images requires a lot of experience. Make sure with your GP that the doctor performing the ultrasound is an expert in the field.

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YOUR MARITAL HEALTH/SEX AND PROBLEMS OF DAILY LIVING: BELIEVE IT OR NOT

Our daily living style makes little room for beliefs, and clinging to morals that many view as old-fashioned has become difficult. The fear of AIDS has resulted in some people attempting to modify their sexual behavior to prevent illness or death. While behavioral change is necessary during the crisis of AIDS, we should also be busy asking ourselves about the meaning of sexual intimacy. We should be busy not only trying to prevent the spread of a deadly disease, but busy spreading a value system that teaches the emotional and physical immunity provided by mutually pleasing, exclusive sexual intimacy. If we fail to learn from AIDS and other sexually transmitted diseases, another disease will simply replace AIDS after it is conquered medically.

The couples were asked early in the program to make at least one time a week “worship time.” It didn’t matter what they did during that time, but they were asked to go somewhere and worship living, love, and life together. One wife reported, “You know what we did? We did every church and temple we could find. We took the kids every Saturday or Sunday morning and went to any place of worship. Just sitting there together was relaxing. It was really the only time other than watching television, or going to funerals, or weddings that we have ever sat together quietly, respectfully, spiritually and just were together.”

Sex and Problems of Daily Living: Why Nobody Has a Sex Life 271 Super marital sex is the most highly advanced, exclusive, high-level form of human relationship possible. It requires attention to all of the dirty dozen. It requires an effort, commitment, and willingness to change first and think about it later. Unlike the first three perspectives of sexuality, the fourth perspective upon which super marital sex is based emphasized a totality of life involvement, a cleaning up of the dirty dozen.

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HYPERTENSION – SELF-MONITORING

Some doctors ask their patients, under treatment for hypertension, to buy and use such machines for self-monitoring, so the doctor can have a more accurate assessment of the daily fluctuations of the levels.

It is my belief that monitoring one’s own blood pressure without instruction and interpretation may cause anxiety and serve no useful purpose.

High blood pressure causes no symptoms and therefore is usually detected only at routine checking. Symptoms, when they do develop, are most often late and due to damage to various organs.

Headaches may be common in well-established and severe hypertension, but the symptom is so common it may be unrelated to the level of pressure.

Persistent high blood pressure places a strain on the left ventricle of the heart. This is the chamber which pumps blood through the aorta to all the body. Persistent strain causes this side of the heart to enlarge.

This pattern of left ventricular strain or hypertrophy (enlargement) may show on the electrocardiogram, or ECG.

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ALLERGIES TO FOOD – CAUSES

Allergic conditions are a little like rheumatic disorders — they’re common in our community but tend to be forgotten when there’s money for research.

Figures show that between 10 and 20 per cent of the population suffer from one or more allergies and over 80 per cent of families have a sufferer.

It’s not only pollens and dust which may offend — but food. Allergy to food may cause a variety of symptoms, including hives or urticaria, asthma, rhinitis or nasal problems, eczema, gastro-intestinal troubles and even migraine.

Allergy to foodstuffs has been incriminated in hyperactivity in children and may be a factor in Meniere’s syndrome (which causes giddiness) and in the bowel disorder of ulcerative colitis.

Animal foods such as cow’s milk and hen’s eggs are the most common but shell fish, some vegetables and fruit are also recognised as potent allergens.

A great deal of attention has been focused on cow’s milk because of its widespread use in infant feeding. The gut of infants appears to be able to absorb the proteins of this food without digesting them so they enter the bloodstream and can provoke the onset of allergy.

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VACCINATION

The technique of vaccination was discovered in England in the late 18th century by Sir Edward Jenner, who noticed that the dangerous disease, smallpox, did riot affect milkmaids, who were exposed to a similar disease in cows, known as cowpox. Jenner used material from cow-pox sores to immunise patients against smallpox.

Vaccines are made from viruses and bacteria which have been killed or weakened by heat or chemical treatment but are still able to provoke an immune response which causes the production of antibodies to that disease. Sometimes live organisms which are non-virulent to human beings, such as cowpox, are used as vaccines.

During pregnancy most live vaccines are not permitted, since the live organisms can cross the placenta, causing abnormalities in the foetus. Smallpox, rubella, hepatitis B and yellow fever vaccines all contain live organisms, as does the Sabin vaccine against poliomyelitis. None of these are suitable for pregnant women. However the Salk vaccine against poliomyelitis and vaccines against hepatitis A and B, cholera and typhoid fever are all permissible.

The subject of vaccination is controversial. Some children have serious reactions to vaccines. However a great deal of serious disease has been prevented by vaccination. As a result of world-wide vaccinations against smallpox, the virus has become almost extinct. Among the diseases for which vaccines are available are diphtheria, tetanus, whooping cough, poliomyelitis, measles, rubella, tuberculosis, hepatitis A and B, cholera, typhoid, paratyphoid and yellow fever. Many of these vaccines are available free of charge, especially for children. It is recommended that children be vaccinated against polio at two months and begin a series of three ‘shots’ to immunise them against diphtheria, tetanus and whooping cough. Unfortunately the whooping cough vaccine can cause serious side effects in about one in 100,000 cases. In Britain, where concern about these side effects prompted many people not to have their children vaccinated, major whooping cough epidemics resulted and a number of children died or suffered serious brain damage. It would be wise to consult a doctor if you are worried about the effects of such vaccination. One should also remember that the side effects of vaccination are generally less dangerous than the disease itself.

When travelling to foreign countries where certain diseases are common, doctors often advise patients to be vaccinated a number of days before their departure to allow time for the immune system to produce the necessary antibodies.

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BAD BREATH

While it is true that disease in almost any part of the body can cause bad breath (halitosis), over 90 percent of cases stem from local conditions in the mouths of otherwise normal people, the Finnish medical journal, Suomen Laakarilehti (40:2309) reports. Most of the remainder have an abnormal lung condition, and only very few have a “general” illness that taints both the bloodstream and breath, such as liver or kidney failure, or diabetes.

To determine whether bad breath is coming from the mouth or from elsewhere, exhale deeply through the nostrils with the mouth shut. If another person can detect an odor on the breath under these conditions, it must be coming from the lungs, the U.S. Pharmacist (10#10:24) reports.

Conversely, bad breath detectable when one exhales gently through the mouth with the nostrils closed must be coming from the mouth. Mouth conditions giving rise to halitosis include poor hygiene with putrefying food particles between the teeth, dental caries or plaque, and inflammation of the gums or gum pockets that harbor rotting food. Bad breath from these causes, of course, can usually be dealt with by dentists.

Another mouth condition frequently overlooked as a cause of bad breath is the growth of fungus or yeast over the top of the tongue, making it appear coated or “hairy,” a problem that can usually be eliminated by brushing the tongue when one is cleaning the teeth.

Older people who take good care of their mouths may nevertheless have bad breath, the Journal of the American Medical Association (254:2473) reports, since they do not produce sufficient saliva. The resulting oral dryness allows odor-producing bacteria to flourish between their teeth. The remedy for this problem is to use a mouthwash or an artificial saliva spray between meals.

Lastly, dryness of the air inside a house may be making a contribution to bad breath since it leads to crusting of mucus and excessive bacterial growth in the nose and mouth, especially in elderly people, who already have some nasal and oral dryness. Dryness of the air, however, can easily be eliminated with a humidifier. Consumer Reports (50:679) recommends the ultrasonic type of humidifier since, unlike the others, it spreads very few bacteria.

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CHILDREN’S HEALTH: GUMBOILS

 

Symptoms: Inflammation, swelling, or pain at the base of a decayed tooth, injury or discoloration of associated tooth

Home care

Aspirin or paracetamol will help relieve pain.

Have the child rinse the mouth with warm salt water or apply warm soaks to the affected area.

If the tooth is about to come out naturally, the loss of the tooth will allow the pus to drain and the gumboil to heal without treatment.

If the tooth is not loose, or is a permanent one, consult a dentist.

Precautions

-    Do not confuse a gumboil with a canker sore, which does not protrude in the same way as a gumboil.

-     If the child loses baby molar teeth prematurely, the spacing and positioning of the permanent teeth can be affected.

-    Some dentists believe that a gumboil on a baby tooth can endanger the permanent tooth before it emerges. If your young child has a gumboil, see the dentist.

A gumboil is an abscess (a collection of pus in inflamed tissue) in the gum at the base of a decayed tooth. It is caused by infection reaching the root canal and traveling to the tip of the tooth’s root. Gumboils usually occur only with baby teeth, rarely with permanent teeth. Gumboils are common after a cavity in a tooth has been repaired and filled. They are also common in untreated decayed or injured teeth.

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