Fears and phobias seem to peak at about 3 years of age. Children of this age may exhibit fears about a whole range of things. The most common are fear of the dark, of insects, of monsters, animals and so on. As a child’s cognitive ability and imagination expand, so do his fears, so older children may be afraid of ghosts, or of going to sleep in case they do not wake up.

Sometimes fears and phobias may be grounded in an actual situation. For example, the child may have been frightened by a dog, or a friend or relative may have been sick or died, or a television program or movie may cause ongoing anxieties in the child who is unable to differentiate reality from fantasy.

Occasionally a child’s fears may be evidence of deeper underlying fears and anxieties, or of emotional problems that need specific attention, especially where the fears are significantly interfering with the child’s everyday life. These children represent a small minority, and it is important for parents not to overreact.

In most children, these fears and phobias are transient, disappearing as the child gets older or else becoming relatively trivial so as not to interfere with the child’s activities. For example, many adults have phobias such as a morbid fear of spiders or snakes.

You can reduce the impact of these fears by recognising that they are a normal part of development, by not overreacting, and by handling them in a sensitive and reassuring manner. A night light is often helpful for children who are afraid of the dark. Allowing the child to play with a young puppy or with a friendly and gentle older dog may reduce his fear of dogs. Reassurance about the child’s safety is always important. Avoid ridiculing or dismissing the child’s fears, which are very real. In reassuring him, be careful that you do not unwittingly reinforce the child’s fears: for example, by agreeing that the dog is aggressive and scary. There is a fine line between making the child feel better and making the fears even more real in his mind.

It is rarely necessary to seek medical advice for the normal fears and phobias of childhood, unless they are having a negative impact on other aspects of the child’s aay to uay lire, or unless it is reit mat tney are manitestations ot deeper psychological problems.

*175\90\8*

During situations of stress the sufferer may have recurrent migraine interspersed with tension headache. In treating this common disorder it is important to try to teach the patient to relax.

A variety of eastern and western relaxation methods can be learned. Physical activity can provide an outlet for inner aggression and help relaxation and reduce the frequency of headaches.

The pain of a tension headache will usually respond to simple analgesics. Stronger pain-relieving drugs may be necessary.

Diazepam, a commonly used tranquilliser, has the advantage of not only relieving nervous tension but also muscle spasm. This may be used to treat an acute attack, or for prevention.

Some patients are depressed and their headaches improve if they are given anti-depressant drugs. Manipulation of the neck can relieve the spasm and pain of an acute headache and may reduce their frequency.

The drug pizotifen which is used in the prevention of migraine and cluster headaches may also reduce the frequency of tension headache.

*402/71/1*

This is the period, or menstrual flow.

And then the cycle begins over again.

The usual pattern is for a cycle of about 28 days. Ovulation happens about 14 days before the period starts.

This is fairly constant, and may vary only from 13 to IS days.

If the cycle is longer — say, between five and six weeks between periods — ovulation still occurs about 14 days before the period begins.

While this time of ovulation to period is constant, what does vary is the time from period to ovulation.

Sometimes a period may be missed altogether, and many women are concerned that “bad\blood is being retained and can cause all sorts of problems.

This is not so.

When the periods are “heavy”, it means that an excess amount of endometrium is built up and then got rid of.

Conversely, when the period is light, it means that only a small amount of tissue has been built up.

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The common symptoms are an itch of the eyes, nose, throat and ear lobes. There may be coughing, sneezing, probably wheezing. This may be accompanied by heat of the affected parts. Attacks may come on suddenly, in certain seasons, or at certain times of the day. Headaches, nosebleed, recurrent sore ears may occur. Often there is a nasal discharge, and frequently the eyes smart and water.

Treatment

It is another form of allergic reaction, and avoiding as much as possible the known troublemakers is the best idea. Keep away from house dust (if known to cause symptoms); avoid venturing outdoors as much as possible on dusty windy days, particularly when pollens to which the child is sensitive are in the air. Spring and summer, and maybe autumn, are often trouble times—it depends largely when the offending pollens are in the atmosphere in the greatest quantities. Frequently pollens may come from grassing areas many hundreds of kilometres away; these may be carried to city areas by prevailing winds and upper air currents in an amazing manner.

Give the child plenty of fluids to drink. They tend to dilute or wash away histamine from the system, the chemical that is liberated by the allergens and the basic cause of the adverse reactions.

Cold packs to affected areas can often give relief. Icy cold packs to the eyes, ears, skin and itchy irritating areas may assist. Applying anti-itch creams and lotions can also bring relief—for example, Eurax cream, Calistaflex, or Liniment calamine containing benzocaine 3 per cent (be sure to keep it away from eyes).

Antihistamine tablets or liquids for younger children often neutralize the histamine and reduce symptoms. But this often makes the child drowsy, so care in avoiding accidents is essential afterwards. Often a good long sleep will follow, which in itself may be beneficial.

In recent years, excellent preventive measures have become available. As with asthma, sodium cromoglycate capsules placed in an insufflator (a rubber bulb) enable the powder to be inhaled into the nose. Long-term use (at the critical times when symptoms most commonly appear) may often reduce their frequency and severity.

More recently, beclomethasone dipropionate (Beconase inhaler) may similarly reduce the severity when inhaled. It takes up to 14 days for these preventive measures to exert their full benefit. They will not give immediate relief from an attack, and they are not designed to. They are to be used as a preventive measure.

Ephedrine was often used in the past, and may still be used by some doctors for mild cases. Various synthetic derivatives are now often used instead of ephedrine itself.

Some doctors find that discovering the allergen by performing allergy tests and then desensitizing the patient is a successful way in which to increase the body’s inbuilt immunity to future attacks. In the main, however, this system is not popular, for it involves regular weekly or bi-weekly visits to the doctor for injections—not a popular pastime for children of any age, as most parents would agree.

*77\87\2*

The most frequent cause of serious delay and difficulty in learning is mental subnormality. But another important cause is a slowness in maturation. Some children learn to acquire some skills much quicker than other skills, and much more rapidly than other children. Children with a late puberty are often slower at learning.

Sometimes learning difficulty may be associated with a condition called minimal cerebral dysfunction, claimed to be a consequence of inadequate oxygen reaching the brain at birth. This may result in the so-called hyperkinetic syndrome (commonly known as hyperactivity). The child is often restless, on the move all the time, has a short attention span, is impulsive and clumsy and emotionally unstable. He or she rejects discipline and finds ordinary duties irksome. Often it is very difficult to cope with these fellows at school. (See below under Hyperactivity)

Some children have difficulty with words. Many normal persons have been through a stage of stammering (but have ultimately done all right), simply because for them piecing words together was difficult—just as other children were perhaps slow in learning to walk or to control their urine or to ride a bike. Sometimes the stuttering persists, and in certain cases it may represent a mild degree of brain damage.

Dyslexia means difficulty in reading; dysphasia is difficulty in learning how to speak; dysgraphia is difficulty in writing. There are all manner of variations to these disorders.

Treatment

It is essential that any speech difficulty be carefully checked by a doctor to establish whether there is any neurological disability. Then an assessment by an educational psychologist who can manage the child is essential. There are many problems and difficulties, but a reasonable outcome is often possible.

*28\87\2*

You are most at risk if you are white, slim and small-boned; if your menopause is early; or if your mother or grandmother suffered from the disease. Rheumatoid arthritis, diabetes, thyroid problems and certain asthma drugs are other risk factors, and caffeine, nicotine and alcohol all accelerate loss of bone mass.

Because it replaces the oestrogen in the body after menopause, hormone replacement therapy can protect you against osteoporosis.

But prevention is better than cure. It is important to make sure you include plenty of calcium in your diet throughout life, not just at menopause, along with vitamin D to aid absorption. 700-1000mg of calcium daily is recommended before menopause and 1000-1500mg after.

Recently, it is been proposed that Vitamin K may play a role in preventing osteoporosis, and it may be a good idea to include foods rich in this vitamin in your diet — turnips, greens, broccoli, cabbage, liver and cereals. The trace element boron may also help the body avoid loss of bone mass; it is found in apples, pears, grapes, leafy vegetables, pulses and nuts.

A high intake of protein, particularly animal protein, may make the problem worse, so cutting down on meat after menopause at the same time as eating more vegetables and cereals is probably wise.

Gentle weight-bearing exercise will help strengthen and thicken your bones; you don’t have to run or jog — just walking will do, and T’ai chi is another possibility. Exercising throughout your life is the most effective strategy, but it’s never too late to start. One study of women aged 65 to 69 found that those who exercised for half an hour a day three times a week over three years increased the bone mass of their arms by 4.3%, compared with a 2.5% loss in a control group. Before you start a new exercise regimen, it’s a good idea to consult a health practitioner, especially if you already suffer from osteoporosis or heart problems.

*27\69\2*

The elbow contains two separate joints. The larger is a hinge joint that allows the forearm to bend and to straighten in relation to the upper arm. The smaller, less obvious joint of the elbow is between the upper ends of the two bones of the forearm (radius and ulna). This smaller joint allows the forearm to rotate, to turn the palm up and down. It is this smaller joint (radioulnar joint) that is partially dislocated when there is a sudden yank on the child’s hand or wrist. It may occur when a parent tries to save the child from a stumble or fall. It may also occur when a child is swung around by the wrists in a game or when the child tries to grab a handhold to prevent falling.

Signs and symptoms

When an accident causes a dislocated elbow, there is immediate pain. The pain may be felt anywhere from the elbow to the wrist. The child refuses to use the affected arm, clutching it against the side with the good arm. The child holds the affected arm with the palm of the hand facing back. Attempts to turn the palm forward cause pain. Swelling of the wrist and hand develops several hours later. If you know that the arm has been yanked and the child holds the arm with palm facing back, a dislocated elbow is a likely cause. However, if you do not know that the arm has been pulled, you may not realize the cause of the problem. A dislocated elbow is commonly mistaken to be an injured wrist.

Home care

The first time you suspect your child has a dislocated elbow, have a doctor treat it.

A dislocated elbow tends to occur again, however. There is a simple procedure for correcting a dislocated elbow, which parents can frequently do themselves. Your doctor may teach you the procedure if the elbow becomes dislocated often. If this manoeuvre is done within a few hours of the accident, a sharp snap or click is heard and actually felt near the elbow. The child is immediately relieved of pain and can use the arm freely.

Caution: Do not attempt to correct a dislocated elbow unless you have been taught the correct procedure by a doctor.

Precautions

• Do not use the procedure for correcting a dislocated elbow unless the symptoms exactly fit the description and you are sure the arm has been yanked. A fracture (break) of a forearm bone can produce similar symptoms. • A dislocated elbow should be treated as soon as possible. If the elbow is dislocated for more than a few hours, correcting it may be more difficult because of the swelling; then for one to two days after correction, the arm may still be sore and not fully usable. • After an elbow is dislocated, the joint remains susceptible to another dislocation for three to four weeks. Be careful.

• Make a habit of lifting your child by the upper arms or under the armpits. Do not lift a child by pulling on hands, wrists, or forearms.

Medical treatment

Your doctor will determine if the elbow is dislocated and may request an X ray to be sure there are no broken bones. (Sometimes, positioning the arm for the X ray returns the dislocated bone to its proper place.) After the diagnosis is certain, your doctor will correct the dislocation using the standard procedure mentioned.

*51/84/5*

To test their hypothesis, Dr. Haude and his colleagues asked 33 older adults with a mean age of 72.3 to rate themselves and a deceased sibling (mean age at death was 64.6) on a scale that evaluates one’s sense of humor. The results showed that the surviving siblings had a better sense of humor than their dead relatives. Though he admits the data are limited, Dr. Haude says the study shows that “if you appreciate humor to a greater extent than somebody else, you’re likely to live a little longer.”

Now this is all well and good for a person who is a natural-born comedian, but what about the person who cannot make others laugh? Is there hope for the humor-impaired? Michelle Gayle Newman, Ph.D., assistant professor of psychology at Pennsylvania State University in University Park, thinks so. In a study she conducted, she found that two groups of people-one that tended to use humor to cope with stress and another group that didn’t-both benefited positively from using humor during exposure to a stressful film. In this study, all participants, even those who didn’t have a sense of humor, demonstrated fewer stress reactions to the film when they used humor coping than participants who did not use humor coping. As a result of her study, Dr. Newman now believes that “humor can be learned.”

So keep practicing those punch lines.

You may never make it to the open mike night at your local comedy club, but you could still be standing to hear the next generation of stand-up comedians.

*58/36/5*

• The hypothalamus (a part of the brain) initiates a number of hormonal changes.

• The pituitary gland is activated by the hypothalamus and in turn activates the adrenal glands

to produce more adrenaline and non-adrenaline. These powerful hormones do many things

but the main ones are:

• The heart beats more powerfully and faster

• The pupils of the eyes dilate

• The blood pressure rises

• The muscles tense

• The breathing rate increases

• Blood is directed from the digestive system and the skin to other more vital functions

• Blood flow to the kidneys is reduced so as to reduce urine output

• Saliva dries up

• The liver releases stored glucose for energy

• The immune system (which fights infection) shuts down temporarily

In the average stressful situation these changes are temporary and normality resumes after the stress-inducing situation is past. However, for many of us in the West today many or all of these changes become an almost permanent feature of the way our bodies work, as one stressful event follows another. This produces symptoms such as:

Headaches

Dizziness

Sweating

Coiled legs

Hair twisting

Finger drumming

Clenched fists

Nail biting

High blood pressure

Allergies

Ulcers

Skin rashes

Depression

Unreasonable fears

Breathlessness

Sighing

Little interest in life

Poor appetite

Nervous tics and twitches

A fear of becoming ill

Poor self-esteem

Difficulty in relaxing

Difficulty with concentration

Hunched shoulders

A worried frown

A gripped thumb

Clenched teeth

Insomnia

Blurred vision

Swallowing difficulties

Sex problems

Heartbeat irregularities

Indigestion

Backache

Colitis

Irritability

Disturbed sleep

Fatigue and tiredness much of the time

A tendency to cry

Aching shoulders and neck muscles

Food cravings between meals

Smoking or drinking to calm yourself

Feeling neglected or let down

Feeling a failure towards others

Rarely laughing

Feeling uncomfortable touching or being touched

None of these conditions is a ‘disease’ in itself but a combination of several reduces the quality of life and many of them together can reduce a person almost to the point where he or she is unable to cope with everyday life. Many of these conditions will be dealt with more fully in the body of the book and even though there are other reasons for many, if not most, of them stress is probably the commonest.

*52/72/5*

Dong quai has been used in Asia for thousands of years and its reputation is second only to ginseng. Dong quai is regarded as the “female remedy” and has been used successfully for the treatment of many female disorders including menopause, amenorrhea and dysmenorrhea.

Dong quai contains phytoestrogens (plant oestrogens). These natural plant oestrogens compete with the oestrogen in the body for binding sites. The phytoestrogens in Dong quai produce oestrogenic activity when the body’s oestrogen levels are low as is the case in menopause. The ability of the phytoestrogens to occupy oestrogen receptor sites also helps high oestrogen levels. Dong quai is specifically of use for the treatment of menopausal hot flushes. Evening primrose oil in conjunction with herbs and vitamins for the treatment of many hormonal disorders including menopause has met with good results.

Oats are of value when used for the treatment of menopausal depression and neurasthenia. Avena stimulates both the motor and sensory systems. This stimulation gives a lift and elevation in mood.

SUPPLEMENTS

Dong quai 500 mg 3 times daily

oats 1000 mg 3 times daily

vitamin E 500 IU daily

Executive B Complex

(stress B group

formula) 1 tablet daily

Efamol (evening

primrose oil) 500 mg 1 capsule 3 times daily

*103\26\8*