Body-rocking is always a transient phenomenon, representing that particular phase of the child’s life. It is best ignored and no intervention is necessary.

*184\90\8*

“It’s a nightmare,” the wife reported. “I can’t really remember much of it. He would just touch me. Every night, my rather would touch me.” The wife continued in more detail to describe her experience. Her therapist was able to help her free herself from feelings of guilt, even responsibility for her own abuse.

“They all grabbed me,” reported the husband. “They pulled my pants down and took turns hitting my penis. I cried, and they said that until I stopped crying, they would not stop hitting. I couldn’t stop. The coach came in, and I told him I just fell. I never told anyone this.”

Men and women in the couples sample all reported some instance of sexual abuse. This becomes the dark part of our love map, a part that leads us away from love, leads us to seek out compensation or sanctuary from the threat of a corrupted intimacy.

*84\97\8*

Many men have anxiety and some sexual dysfunction following a heart attack. Most of the problem is fear.

The physical exertion of having sex may cause angina and this may so inhibit a man that he develops impotence.

Others lose their libido or interest in sex as a secondary result of the depression which often follows a heart attack. This depression is usually due to a loss of one’s previous health.

Many women also have problems with sex after their husbands’ heart attacks.

This may be related to fear that the effort of sex will cause a further heart attack or even guilt that he experiences pain or has to have sex to satisfy her.

The doctor should have a full and frank discussion with the man about his sexual life following a heart attack. His wife should be present and her sexual obligations and needs considered and discussed, as well as her husband’s.

Few doctors have the insight and lack of embarrassment to be able to do this regularly and competently. Some specialists think it is the duty of the patient’s local doctor, and the family doctor may think it the specialist’s job.

Often the doctor is just too embarrassed to raise the subject directly with the patient and if the patient asks he may be fobbed off with a non-commital answer.

*411/71/1*

The young, non-smoking woman who uses the Pill to “space” her family has no reason to be alarmed. Older women, those over 30 and particularly smokers may consider a different method of contraception.

Many women, to avoid the risks associated with taking the Pill, are having their tubes tied. But this may lead to heavy and more frequent periods after a number of years and require a hysterectomy or removal of the womb.

The older methods of contraception, such as the diaphragm and the condom, both used in combination with a spermicidal cream, are becoming more popular. Vasectomy, or male sterilisation, may be more commonly sought by couples where there are so many complications when the woman assumes the responsibility.

Reversal of tubal ligation and vasectomy is possible but fertility may not return, particularly when the reversal is attempted a number of years after the original sterilisation.

*157/71/1*

We all know the body has a heart. Often it’s equated with emotions. ‘Heart-throb’ and ‘heart-break’ are common words which relate feelings to this important part of the body. Although the ancients believed the heart had something to do with life, they also related it to psychological sensations. Of course, it has nothing to do with emotional feelings, although if there are moments of tension or anxiety, the heart will often begin to bang away. This is because the brain sends out impulses to the adrenal glands via the nervous system. In turn, a chemical called adrenaline is pumped into the system. One of its many functions is

to accelerate the heart rate. So, the banging heart and the wildly thumping chest in moment of fright or distress.

The heart is simply one massive muscle which acts as a pump. Its job is to keep the body’s blood circulation active for 24 hours a day. It does this with perfect agility, often for 70 or 80 years or more, beginning a few months after conception. The heart is formed during the first three months following conception, and the baby’s prenatal circulation is soon established.

The heart consists of four chambers, which are referred to as atria and ventricles. There is one of each on each side of the heart, commonly referred to as the right side and the left side.

Blood comes from all parts of the body via a system of collecting lubes called veins. These finally empty into one large tube which enters the right atrium through a valve. The chamber is filled, and at the next heart beat, as the muscle squeezes tightly, the blood is forced through another valve into the right ventricle, a fairly large chamber which accommodates the blood. When the beat stops, the valve snaps shut. At the next beat, this blood is pumped through another valve into a large short tube called the pulmonary artery. This conveys the blood to the lung system.

Here carbon dioxide is released from the blood, and a fresh supply of oxygen taken aboard; the bluish-coloured blood suddenly turns a bright fiery red. At the next pump, the blood flows back via another short tube, called the pulmonary vein, to the left side of the heart.

It gains access to the left atrium, once more via a special valve which conveniently opens for a short time to allow the blood entry. At the next pump, the blood flows from the left atrium to the large left ventricle via another connecting valve. Finally, as the heart pumps again, this refreshed, vigorous, oxygen-rich blood pours forth via another valve into the aorta, a huge artery much the size and shape of a piece of hose pipe.

*86\87\2*

‘I’m glad you came,’ I said. ‘Take a seat, and let’s talk medi-talk.’

‘Good,’ she replied, settling into one of the comfy seats. I like having comfortable seats for my patients and their relations. It makes them feel more at ease. Gone are those horrid, hard, squeaky old-fashioned things some doctors still harbour in their rooms. They should all be relegated to the rubbish heap, in my opinion. But back to the story…

‘Some weeks ago you mentioned protection from disease, but I’ve been talking around, and everybody seems to have all manner of ideas about it.’

‘You’re partly right, Jane,’ I said. ‘Over the past few years, what was a normal, clear-cut procedure has become a bit blurred. This is unfortunate, but there are several reasons.’

‘What, then, should I believe?’ Jane queried. ‘I am anxious to do the very best for Sarah, but I don’t want to take any unnecessary risks or be foolish about it in any way.’

‘That’s perfectly reasonable too,’ I went on. ‘Let me give you the picture, and try to put everything into perspective.

‘The facts of the situation are that today we have several very effective ways of preventing, almost entirely, several serious diseases which in years gone by have been major killers in our country. The ones I refer to are whooping cough, diphtheria, tetanus and poliomyelitis—polio, for short.

‘But in addition, we can also offer good protection against ordinary measles, mumps, German measles (commonly known as rubella), and a few others that may be indicated in special circumstances.’

‘It seems quite a major undertaking, and certainly an amazing list of good tidings,’ Jane said. ‘But what about these sinister comments I hear? I’ve been told that there are certain risks. Some doctors apparently claim that the risks of certain forms of immunization may be more dangerous than the benefits to be gained.’

Whooping cough

‘I know about the comments you’ve heard, Jane,’ I said. ‘And I’m sorry you’ve had your head filled with these stories. To start with, the most controversial concerns the whooping cough vaccine. In Australia, there has never been much doubt about it and nearly all doctors administer it to babies. It gives extremely good protection against whooping cough, which, until mass immunization started some years ago, was a major killer of babies in the first six months of their life. It’s a terrible disease, and small babies, often at the age of two or three months, simply died from it.

‘Immunization altered all of this, and today we seldom see a case. However, a few years ago in Britain there were several cases of brain damage in babies, supposedly linked to whooping cough vaccines. An awful furore broke out, and lots of people turned against the vaccine, foolishly. This included many mothers with babies who should have been vaccinated, but were not.

‘In the meantime, in Britain the vaccination levels for this disorder have greatly reduced. Now the aftermath is starting to be experienced. There is a growing number of cases of whooping cough in Britain and the death rates will inevitably escalate in the next few years unless there is a prompt revision of this trend— which seems doubtful.’

‘I see what you mean. So you advise that Sarah should have whooping cough vaccine then?’

‘Most definitely,’ I replied. ‘In fact, this matter has been very carefully studied by all the health commissions in Australia, and they are unanimous in their recommendation. I base my opinions and judgement on their opinions, plus the mass of material in the medical journals attesting to its continued safety and value.’

‘That sounds reasonable,’ Jane replied. ‘It’s amazing how a few people with loud voices can dominate the scene with ill-founded ideas.’

‘But that’s the same the world over,’ I answered. Diphtheria

‘What about the other diseases?’ Jane then queried.

‘Diphtheria, for a start. There’s not much doubt about that. It was a terrible killer until recent times, but mass immunization has again knocked it for a loop. I haven’t seen one case of diphtheria in thirty years of doctoring.’

‘That’s not a bad record,’ Jane said.

‘Not bad. And it’s a real tribute to the value of mass immunization. That’s the only reason,’ I added.

Tetanus

‘Tetanus, what about that?’ Jane queried.

‘Tetanus is rarely seen in Australia. In fact, there are probably less than twenty deaths annually from this fellow. But it’s bad, bad news if you happen to get it. Awfully painful, and a slow, horribly unattractive way to die. It is a totally preventable disease and should never happen in an advanced country. Protection is readily available to everyone, protection for both children and adults. Tetanus spores are everywhere, especially in soil; that’s why even a thorn prick in the garden is a potential danger. Most cases of tetanus in our country came from small puncture wounds.’

‘Does tetanus cause much trouble in other lands?’ Jane asked.

‘Does it ever!’ I replied. ‘The total number of tragedies isn’t known, but we do know that well over a million die from it each year. The overwhelming majority are in the developing lands of the Third World. At least half—perhaps more—occur in infants under the age of six months, the statistics show.’

‘Phew! That’s terrible,’ Jane said, with a grimace. ‘Now tell me a bit about poliomyelitis. I understand it’s also rife in certain countries.’

‘It is indeed, alive and thriving, and killing off huge numbers of children. Once more, it’s mainly in the Third World countries, where vaccination has barely touched the scene. But since dramatic mass immunization campaigns in this country were started in the mid-1950s, the death rate, and the number of persons left crippled and deformed, has zeroed out. Seeing a new case of polio today is a unique experience. They simply do not happen, and as far as I know there hasn’t been a polio death recorded here for some years.

‘But once again, it will remain this way only as long as the majority of parents have their infants immunized. It’s as simple as that. And simple it is: taking a small amount of syrup from a spoon is easy for a baby. The stuff even tastes pleasant. As well, the government supplies the vaccine free of charge—another plus.’

‘It’s nice to get a free deal occasionally,’ Jane said. ‘It’s even better when it benefits one’s child. That’s good value.’

‘I agree. We often criticize governments, but with immunization campaigns and products, they do an excellent job. Of that, there is no doubt.’

Measles

‘Now what’s the bit about measles? Is it really necessary?’

‘It isn’t essential, but there are a significant number of children who do get measles—the ordinary kind—and suffer serious complications, so it’s believed to be worthwhile. Viral encephalitis kills a substantial number of Australian children annually, and for this reason alone it is believed to be worthwhile immunizing all children. In fact, in America they have set themselves a target date, 1982, when they hope to have all their children mass-vaccinated against measles.’

‘What an enormous task,’ Jane said. ‘Will they achieve it?’

‘Who knows,’ I said. ‘They’ve fallen apart with mass campaigns in the past. Remember their swine flu debacle? Nevertheless, when children are involved, public support is often enormous. I hope they succeed—and I hope Australia decides to follow suit. Besides brain damage, the measles virus can cause havoc in the eyes, ears, throat and chest. It’s bad news for many, many children.

‘A single shot is usually administered at the age of 12 months. Before this, the child receives a lot of immunity from the mother, and if given earlier the vaccine may not do its job properly. One needle may be adequate, although in America they talk of booster shots later in the child’s life. Time will ultimately give us the final answer of what is the best long-term course to follow.’

‘Supposing a child is not vaccinated against measles at this time. Can it be done later on?’ Jane asked.

‘It is okay, but most children have acquired immunity to measles by the age of ten. I might add that an enormous number of children have also had an attack well before that age.’

Mumps

‘Is mumps vaccine given routinely these days?’ was Jane’s next query.

‘No, it’s not. The vaccine has been available for some time—in fact, a few years. But it’s not widely used. However, this changed in 1981 when the National Health and Medical Research Council recommended it be routinely included in immunization programmes for infants. Mumps’ chief complication is its ability to cause an infection in the testes in males or the ovaries in females; in time, this can lead to infertility or sterility in later life. This would be the main reason for administering it. Also many doctors think its chief use may be in places where children are in close community, such as in boarding schools—there has also been talk of using it in army camps, and similar institutions.

‘A single shot is given, in the case of infants at the age of twelve months along with the measles vaccine. In fact, it is possible that a combined measles-mumps vaccine may become available.’

*37\87\2*

Well in advance of conceiving, a woman is advised to give up smoking and drinking, eat well and exercise regularly. A course of the Chinese herb dong quai [Angelica sinensis) will help to tone the female reproductive system. However, the intake of dong quai should cease before conception takes place and the herb should not be taken at any stage during the pregnancy itself. The inclusion of nutritious red clover, nettle or ginseng tea in the diet is safe and beneficial for the woman waiting to conceive. If conception proves difficult, consult a health professional. A supplement of folic acid can help as can an increased intake of Vitamin B2, also known as Riboflavin.

One of the most uncomfortable side effects of early pregnancy is morning sickness, the nausea resulting from the destablisation of the gastric juices. While mild and lasting only a few weeks in most women, the vomiting and resulting loss of nutrients can be debilitating. Ginger is highly effective in reducing nausea in all cases and the tablets, powder or fresh root can be taken safely at this time. A widely prescribed remedy for mild morning sickness is raspberry leaf, taken as a tea or a tablet, and both peppermint and chamomile teas have helped many a pregnant woman face the day. It is recommended that you drink no more than 3 cups daily.

The nutritional demands on the pregnant woman soon increase and care should be taken with the diet to include the consumption of plenty of protein and carbohydrates. The most common nutrients found to be deficient in pregnant women are zinc (from brewers yeast, wheatgerm, green leaf vegetables, eggs and legumes), folic acid (from yeast, green leaf vegetables, nuts, milk, and mushrooms) and calcium (from dairy foods, nuts, green vegetables and fish.) Zinc deficiency is thought to result in increased birth defects and increased stretch marks on the mother. Folic acid, a B Group vitamin, assists with the production of red blood cells. Calcium gives strength to teeth, bones and cartilege. Being rich in a citrate of iron, raspberry leaf tea taken throughout pregnancy helps to prevent miscarriage and strengthen the uterine and pelvic muscles for the birth. It can help control the pain when administered during labour itself, while feverfew will regulate contractions and help to hasten the expulsion of the afterbirth.

During pregnancy, normally healthy women are prone to ailments like indigestion, constipation, fluid retention and backache. Most of these can be safely treated with natural remedies. Take slippery elm for indigestion, psyllium seeds for constipation and seek advice on gentle exercises you can do to relieve backache. Consider a gentle spinal manipulation by a qualified chiropractor if backache is severe.

After the birth, the mother’s milk flow can be increased safely with the help of herbal preparations such as raspberry leaf tea, dill or fennel oil or milk thistle seeds. Raspberry tea is soothing when dabbed on sore nipples.

Some herbs which are uterine stimulants, and others which contain chemicals that will cross the placental barrier, should be avoided in pregnancy. Do not use any of the following unless prescribed by a qualified practitioner. (Some of these are culinary herbs which are safe to use in small amounts in teas and cooking, but should not be taken in therapeutic doses.)

*36\69\2*

Any ear pain can be temporarily relieved by aspirin or paracetamol. Gentle heat applied to the ear may relieve pain but occasionally worsens it. Anesthetic ear drops must penetrate to the eardrum, and some ear, nose, and throat doctors prefer that these drops not be used. Nose drops and oral decongestants may unblock the Eustachian tube to relieve an earache accompanied by nasal congestion or allergy.

Precautions

• Severe earaches and earaches that last more than a few hours should be seen by your doctor.

• Children with congested noses should not go swimming.

• Babies and children under two years old should not submerge their heads underwater.

• When flying in an airplane, give your child something to drink as the plane ascends and descends.

• Early treatment of head colds and nasal allergies with nose drops and oral decongestants may prevent some ear problems.

• Children who tend to get swimmer’s ear (infection of the ear canal) should have their ear canals cleaned by a doctor at the start of each swimming season. Then preventive ear drops should be used at the end of each swimming day.

• Never put any object (not even cotton swabs) in your child’s ear canal for any reason.

Medical treatment

To determine the cause of pain, the doctor will carefully inspect your child’s ears, nose, throat, and neck. For otitis media, your doctor will prescribe antibiotics by mouth for five to ten days or until the ear is normal. Nose drops, oral decongestants, and anti-allergy medications also may be prescribed.

*60/84/5*

Get steady. Your “circadian rhythm” is simply the pattern of biological functions (such as the release of certain hormones or changes in body temperature and metabolic rate) that vary with how and when you feel sleepy or alert. The first commandment of circadian rhythm obedience is to keep regular sleeping hours, say sleep researchers. You sleep best when you go to bed at about the same time every night and wake up about the same time every morning.

Haphazard sleeping schedules, on the other hand, can sabotage your circadian rhythm. “Your body temperature does not go up and down as much if you keep a random sleep schedule,” Dr. Bonnet says. “So you get into this zombie state where you never feel very alert or very sleepy either.”

Stay steady. Why do we sleep late on weekends? Because we can.

Bad idea, Dr. Stevenson says. “The part of your brain that generates sleep doesn’t know the difference between Wednesday and Saturday,” he points out. “When you sleep in on Saturday and Sunday, you push your sleep cycle forward. It’s better to sleep consistently seven days a week.”

Catch up on the front end. It’ll happen. An important deadline-or a more important party-is going to cut into your sleep time. You can make up for some of that lost sleep (but never all of it) the next night. But do it by going to bed earlier, rather than waking up much later than usual, says Dr. Stevenson. Otherwise, you’re sleeping right through your circadian rhythm’s wake-up call. And then all you’re catching up on is lousy, unrestorative sleep. Besides, Dr. Stevenson says, “what matters is how you sleep over the long haul. What you do in a single night is less important.”

Ease your way down. You don’t bounce your two-year-old on your knee all evening, then throw him straight into the crib and expect him to sleep. He needs to relax first. So do you, if you want healthy sleep. “Give yourself a half-hour or 60 minutes to fade out,” Dr. Stevenson says. “You’re entering another part of your life, and you can’t do it in an instant. You need to withdraw slowly.”

You know best what you find relaxing. By definition, it can’t be something potentially upsetting. No checkbook-balancing. No doing your income taxes. Television works for some but upsets others. Remember that a lot of tried-and-true sleep-inducers-such as a warm bath or a glass of milk – probably work because you find them relaxing.

Count sheep. We’re serious. Dr. Stevenson suggests a sleep-baiting technique you can do once your head hits the pillow. “Keep your eyes open, focus on deep breathing, and try to stay awake rather than try to go to sleep,” he says. “Then visualize something you find calming-like fishing on a lake.” Or counting sheep? You bet. “That old cliche is actually distracting, relaxing, and kind of hypnotic,” Dr. Stevenson says.

Wait until you’re sleepy. So you’re not sleepy, you say? That’s fine, but stay out of the bedroom until you are. That’s especially true when you want to sleep but can’t. “You start to see your bedroom as this place of torture where you can’t sleep,” Dr. Stevenson says. “If you’re not sleepy, you should get out of there.”

In fact, sleep experts urge you to use your bedroom for nothing but sleeping-no television, no writing desk, no rowing machine. Of course, they make an exception for sexual relations, but only if the sexual relationship is going well. Hmmm…

Keep naps short. There’s actually a downward blip in your alertness level around mid-afternoon, a fine time for a restorative power nap. But keep it limited to a half-hour to an hour, says Timothy Roehrs, Ph.D., director of research at the Henry Ford Hospital Sleep Disorders and Research Center in Detroit. Longer naps can actually work against your circadian rhythm.

And any time spent napping is time you won’t sleep at night. “A nap is a perfectly good thing if you can deal with that trade-off,” Dr. Vitiello says.

*68/36/5*

It is hard to tell how common piles are in any community because the term is a relative one and most people with the condition do not seek medical help. A study of seventy-seven rural hospitals in Africa found that fewer than 3 people a year were diagnosed as having severe piles. This is dramatically less than in the West where the condition is said to affect half of the entire population over the age of 50!

Piles used to be thought to be a kind of varicose vein of the back passage, but recent research shows that this is not so. They should now be thought of as a prolapse of special anal cushions which, when of normal size and in their normal position, help maintain faecal continence. These cushions are now known to prolapse when hard, sticky stools pass over them and shear them away from their underlying tethering. This can be entirely put down to a diet too low in dietary fibre. Many early cases of piles can be cured by putting the affected person on to a high-fibre diet.

Varicose veins

It is much easier to estimate how common these are than is the case with piles. In North America 19 per cent of men and 44 per cent of women over the age of 30, and 42 per cent of men and 65 per cent of women over the age of 50 have varicose veins. In Third World countries the figure is nearer 10 per cent of people over the age of 30.

The erect posture of humans, constrictive clothing, repeated pregnancies and heredity are no longer acceptable causes in view of the differences in worldwide distribution of the disease. It is now thought that the main problem is the increased pressure in the leg veins that is produced while straining at stool. We in the West strain to pass our hard stools and do so in a sitting position. Peoples who don’t get varicose veins squat to open their bowels (so shutting off the leg veins at the groin) and pass their motions easily because these are very soft (like toothpaste) as a result of their high-fibre diet.

*61/72/5*