Health related information and news from around the world.

Mumps is most common in children between the ages of 5-15 years.

Cause

Mumps is caused by a virus. The incubation period is 2-3 weeks and the child remains infectious for a week after the onset of symptoms. The infection is spread by close contact or by droplet spread (coughing and sneezing).

Clinical features

Mumps is usually more severe in adults than in children. At the onset of the illness your child may have a fever and feel generally unwell. Swelling of the gland in front of the ear (parotid gland) and under the chin (salivary gland), usually on one side of the face, may cause pain on chewing or swallowing. Complications are rare with mumps, but include inflammation of the testes in boys. This rarely causes problems with sterility. Meningitis and encephalitis can also occur as a result of infection with mumps.

Treatment

There is no specific treatment for mumps. Treatment is aimed at reducing the severity of symptoms, such as lowering the fever with paracetamol. Try to avoid giving your child sour foods, as this will stimulate the salivary glands and cause further pain. Your child may feel better on a liquid diet, as chewing may cause discomfort.

When to see your doctor

• if you suspect that your child has mumps;

• if your child has mumps and develops a swollen, tender testicle;

• if your child has mumps and complains of a severe headache, becomes drowsy, starts vomiting and is sensitive to light.

Prevention

Routine immunisation is now given to all children against mumps, in combination with measles and rubella (see Chapter 4). It is important to make sure that your child is fully immunised.

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When your children seem to be lying more than you might expect (and remember, lying is a natural part of growing up in our society, whether we like it or not), when they avoid open conversations about sex or other topics, even more discussion is necessary. Accusing them of deception will only lead to more deception. Viewing that deception as pain and fear and a need for knowledge about sexuality and living is much more productive. Deception usually means that children are trying in their own way I not only to protect themselves, but you as well. They are trying to protect you from discovering a “them” they feel you could not accept.

If your children have not talked to you at all about sex issues, no matter what their age, they are deceiving you. You can be sure the concern is there. There is only one perfect age for sex and love education, and that is the age of your child right now. There is no “when” problem for this type of education. Children are always ready and they always need it. Educational experts agree with child! researcher and educational therorist Urie Bronfenbrenner that any child can learn anything at any time. What matters is the teacher! and the type of teaching.

Developmental psychologist Jean Piaget called this problem of the right teaching at the right time in the right way the “problem of match.” As a flower needs not too much or too little water and sun, but just the right amount, so it is with education, and sex! education particularly. Our society is providing plenty of fertilizer, but that will only burn and kill the flower if we don’t counterbalance it with the light of knowledge and the nurturance of love.

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We tried for the first seven years. I just could not come when he was in me. I loved our sex, I loved him holding me, but I could not come in intercourse. I came every other way, but the feeling to get to orgasm wasn’t there.

WIFE

I have already mentioned the difference between orgasm and psychasm. Orgasms are organ-based, physiological reflexes characterized by rhythmic muscular contractions in the pelvic region that are associated with the release of accumulated physiological tension. In women, the uterus, the outer third of the vagina, and the anal sphincter contract. There may be three or four contractions in some of these orgasms to as many as fifteen with other orgasms. This is the Type I orgasm brought on primarily by the stimulation of the Ñ area.

Type II orgasm includes an opening or gaping of the outer third of the vagina. The uterus pulls down, and some researchers say that an “A-frame” shape of the vagina results (unlike the “tenting” of the Type I orgasm, in which there is contraction instead of opening of the outer third of the vagina). Stimulation of the G area seems involved in the Type II orgasm.

Both Type I and Type II or a blend of the two can take place in intercourse or in masturbation. Some researchers call these vulval, uterine, and blended respectively. The women in the couples group seldom experienced orgasm of either type in intercourse. Of the 1,000 wives, 86 reported Type I (56), Type II (20), or blended (3) orgasms in intercourse. Seven wives reported orgasms, but could not differentiate as to type. Their reports are purely subjective, i without observational verification. The husbands substantiated the reports either by repeating what their wives had told them or de- ‘ scribing sensations they detected in their wives. The remainder of the women (914), at five-year follow-up, reported no orgasm in intercourse.

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You know, if we could have raised our first child as if he were our second, things would have been much better, for him and for us. Maybe we should pretend this is our second marriage. Why don’t we save the hassle and money of a divorce and just start our second marriage now? We’ve already met anyway, and we have a head start on our problems. Why start new ones with someone else? Okay. 1 declare us divorced and remarried. This is our last chance. We have to stop acting like this is some sort of stupid rehearsal that doesn’t really matter. We have to stop acting like we are kids in a fire drill. Attention. Attention. This is not a test. I repeat, this is not just a test.

WIPE

Super Marital Sex Rule: Super marital sex depends on remembering that there will never be a better time than now to enhance the sexuality, the intimacy, of your marriage. We behave as if we can fix things later, get to them later, do much better later when there is more time. No excuse can change the fact that now is the best time, the only time to join together for a more intimate marriage.

We watched together as the cleanup of the crash site continued. I had been called by the medical team to talk with the wife. “I’m more worried about her than I am about her husband,” reported the doctor. “She’s just sitting there looking off into space.”

Her eyes never left the cleanup work as she talked. “Another chance. I can’t believe it. Another chance.” With determination and confidence more than sadness or shock, she continued. “I swear to you that I will never, ever take him, take us, for granted again. I almost lost him, lost everything. I swear to you I’ll never let us forget us again. We will be first, not some afterthought, some social convenience, a pair of people who happen to be together.”

Her gaze rose from the pile of clutter to my eyes. She placed a hand on each of my shoulders, looked directly at me, and seemed to appoint me clergyperson, notary public, and certified witness to her personal vow. “Listen. Do you believe me? Do you? I will devote every cell of my body to us. Do you believe me?”

She did not expect an answer, for her vow was to herself and to her husband and their marriage. Her eyes left mine to focus over my shoulder to the gurney being pushed toward us. She rose to embrace her husband, and they cried silently together. “Another chance, darling, another chance.” They sobbed and held each other tightly.

Until this wonderfully terrible moment in their lives, this husband and wife had forgotten their marriage. They had forgotten to share a loving-together, not just a living-together. They had forgotten to touch one another, to nurture the sexuality and intimacy within their relationship. Don’t let this happen to your marriage. Let this book serve as a starting point for a recommitment to intimacy, a second chance before your first chance expires.

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Eating is not only a necessity, we also eat for other reasons — social, pleasure, habit and sometimes to satisfy a hunger for attention or to cope with our anxieties and depression.

We start off with a particular genetic make-up. This we can’t alter. We are destined to be either fat or thin. But then comes the influence of our environment and the behavior we learn. We can learn to avoid being overweight even if genetically we have that tendency.

Unfortunately, the seeds of obesity are often sown in childhood. A fat “healthy” baby is likely to grow into a fat child and a fat unhealthy adult.

It is now believed that the number of fat or adipose cells in the body are determined in childhood and that later in life the cells may increase in size but not in number. Being overweight in childhood means more adipose cells are formed and later in life they tend to fill up with fat and so we become obese.

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The cause of hardening of the arteries is unknown but it is associated with several factors. Diabetes, in which there is a relative lack of insulin, is a disorder in which there is a widespread metabolic disturbance, apart from an inability to metabolise sugar.

Diabetics are prone to develop atheroma in their arteries, more severely and at a younger age, than the rest of the population.

Atheroma is associated with high levels of fat in the blood. The blood fats consist of cholesterol and triglyceride. Cholesterol is produced in the body and is present in hormones and many tissues, and the blood level may be raised by a diet rich in animal fats.

A few cases with high triglyceride levels are due to an inherited disorder but most are the result of a diet high in carbohydrate which, in Australia, is usually due to beer or sugar.

High blood pressure may cause degenerative changes in the arteries and be associated with atheroma.

The other main factor is cigarette smoking.

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Unfortunately, this basic and obvious right is frequently violated in the case of people with cancer. Practitioners often reveal important facts about these people to close friends or relatives without the patient’s permission and, even worse, without giving the same information to the person with cancer. There can be no justification for this except where that person has completely lost his or her mental faculties. Such a person could not be reading this book, so the following applies to you.

You have the right to determine who is given information about you. Your doctor (and hopefully any other practitioner) is ethically obliged to get your permission before giving information to anyone else. It is usual to take your permission for granted in the case of other health professionals directly involved in your case. For example, other doctors, nurses, social workers, physiotherapists and so on who are personally involved in your care would not usually need formal permission to have medical and other relevant information about you. Each of these health professionals, however, is obliged to treat such information as completely confidential. They are not entitled to tell any of it to anyone else without your specific permission. The only other circumstance in which your doctor could take your permission for granted is when you bring a friend or relative into the consulting room with you. However, the doctor must still obtain your permission to give information even to these people when you ìØ not present.

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This is a common manifestation of excessive sun exposure in people of Celtic background and fair akin. It is extremely common in Australia, particularly on the backs of the hand and on the face; It is a precancerous, or premalignant, change in the epidermis. However progression to malignancy occurs in only a minority of these keratoses.

Features. Solar keratoses appears as small, rough patches on the skin surface. Usually they are skin coloured or red, and sting on exposure to sunlight. The scales may fall or be knocked off, but will invariably recur. Occasionally they spontaneously bleed. Some are very small, whereas others can be quite large and grow horny protuberances. Thickening of the base of the lesion, with increasing redness and tenderness, indicates activity and the possibility of malignant change.

Treatment.

1. Cryotherapy

This is the most popular treatment, using either solid carbon dioxide or liquid nitrogen.

2. Diathermy or curettage

When lesions are thick or if malignant change is suspected, this is the preferred treatment, the advantage being that microscopic examination can be performed on the suspect tissue.

3. Chemotherapy

More recently a cytotoxic chemical, 5 Fluououracil (5 F.U.) has been used in the destruction of solar keratoses. It is applied in the form of ointment or lotion twice dotty for 3-4 weeks. Where keratoses or other solar damage is present, acute inflammation followed by superficial erosion will occur. One or two weeks later, healing without scarring and without the return of the keratoses occurs. Frequently, patients observe that the cure is worse than the disease. As this form of treatment is not adequate for basal cell carcinomas, which could be mistaken for solar keratoses, careful diagnosis before treatment and follow-up afterwards is mandatory.

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