Tag Archives | Medical

An Unhealthy Interest in Medical Paraphenalia

Collecting things is so brilliant. Not only is there the joy of tracking things down and displaying one’s new toys in order to drool over them on a daily basis, but one learns so much around the items; geography, social history, fashion, the skills of the maker and so on.  I have always encouraged my children to collect stuff for all those reasons.

DIY ECT

I collect Ladybird Books, gollies, books generally and old-fashioned cut glass (particularly perfume bottles).  But, given the money, I could very easily be persuaded to collect powder compacts, trains and train pictures, WW2 stuff in a significantly more serious way than I do now, paintings, beautiful furniture, odd musical instruments and recordings of them being played, and Indian artefacts.

However, I do have a secret thrill which I am rarely in a position to indulge.  Medical Stuff.  I have a craving to collect old medical books, medical instruments and associated items.  I once saw, on the Antiques Roadshow, an apparatus for giving tiny electric shocks by cranking a handle which conducted electrical impulses through little paddles which were held against the body to stimulate circulation and muscle tone in invalids.  It was in a beautiful wooden case and was a thing of beauty.  “I wants it precious, I wants it”, I mumbled to myself.  It was several hundred pounds and out of my reach but if I ever get the chance, a similar apparatus will be mine. Oh yes, it will be mine.

DIY bronchial dilation

I do own several very old medical textbooks including Diseases of the Skin (1937), The Encyclopaedia of Sex Practice (1938), a turn of the century anatomy textbook, Applied Surgery (1894), A large, layered anatomy model from the late 1890s and, my pride and joy, Alimentary Sphincters and their Purposes (1910).

I have very little actual equipment; a Wrights Coal Tar Vaporizer, an old bedpan, a leather doctor’s bag, assorted bottles and some baby stuff.  Then, just as I was leaving the market a couple of Sundays ago, the couple on the next stand showed me this:

It is an old DIY enema kit.  The wall-mounted enamel jug would be filled with the cleansing fluid of your choice and the tube would then be inserted up your bottom while you lay on the floor on a pile of towels, and after a period of time, one would repair to the lavatory and …er … release.  I bought it on the spot and it now resides on the bathroom wall, between the basin and the loo, with the rubber tubing hanging down in a disconcerting and slightly menacing way.

It will never be used, well not by me anyway, mainly because I have a pathological distaste for anything to do with back bottoms.  However, a coffee enema is an extremely efficacious treatment for acute pain and migraine.  Not a skinny, double-shot cappuccino with sugar you understand, but strong black filter coffee.  No really.  I know people.

Comments { 17 }

Giving Blood, Monty Python and Kazuo Ishiguro

Blood cells

This week I attended another blood doning session .  Back in June last year I told you about the importance of giving blood and I also gave you a bit of history about blood and the scientific understanding of it.  I won’t bang on about that again but you can read the article here.

There’s always a bit of banter at the centre and this evening I suggested to the group how funny it would be if, when lying on the couch, one of the nurses said, casually “I wonder if you’d consider giving us one of your kidneys today?”

This led on to a general conversation about Monty Python’s Live Organ Donations, where a bloke comes to the door and asks for someone’s liver (because they carry a donor card) and gets stroppy when the bloke says he’s still using it.  We also had a laugh with a blind woman who was there with her dog.  I thought it would be so funny if the dog jumped up onto the next couch to his mistress determined to give a pint of O Pawsitive and then lay there, gently pulsing his leg and chatting amiably with the nurses about how his day had gone.

Of course, this is all very topical.  This weekend the film of Kazuo Ishiguro’s creepy and compelling novel ‘Never Let Me Go’ is being released in the cinemas.  This is the story of three children who spend their lives at a seemingly utopian English boarding school and the convoluted relationships they develop with themselves and other children as they grow to adulthood.  As the book progresses you start to get the sense that there’s something nasty in the woodshed but you can’t quite figure out what.  The truth is so shocking and distasteful that it’s hard to take in.

The book haunted me for some time and I shall be very interested to see what they do with the film.  Ishiguro is such an accomplished storyteller with an enviable mastery of language, that the film maker’s task of interpretation must have been a tough one.

Comments { 12 }

Testicles and What To Do With Them

In which the Wartime Housewife explains What Testicles Are, How to Examine Testicles, Why you should Examine Your Testicles, Unusual Symptoms, What To Do if you find Something Unusual, Brief Information on Testicular Cancer and Treatment

Firstly, stop sniggering and pay attention.  I know what you’re all saying, “The difficulty is stopping me handling my testicles!!” or “Would you like to do it for me (name)?”.  This is important.  Also I regret resorting to gender stereotypes to get your attention.

Testicular cancer represents only 1% of all cancers in men, but it is the single biggest cause of cancer-related deaths in men aged 15-35 years in the UK. Currently, about 1,500 men a year (around 1 in 400) develop the disease in the UK. Unfortunately, the number of UK cases has trebled in the past 25 years and is still rising.  Now do I have your attention?  And Ladies, that includes you.  You should know what you’re dealing with.  Print it off and give it to your sons to read.

THE TESTICLES The testicles are sometimes called the testes. They’re two small, oval-shaped organs, contained in a sac of skin called the scrotum, which hangs below the penis.  From puberty, the collecting tubules inside the testicles (see diagram below) produce sperm, which can fertilize a female egg. The testicles are the main organs of the male reproductive system.

The tubules form a coiled tube called the epididymis. This feels like a soft swelling at the back of the testicle. The epididymis carries on to the outside of the testicle and widens to become the spermatic cord (or the vas deferens). This joins to the ejaculatory duct where sperm is mixed with a fluid called semen (made by the prostate gland) before it is ejaculated out of the penis.

The testicles also produce the hormone testosterone. Hormones are chemical messengers that help to control different activities in our bodies. Testosterone is responsible for:

  • your sex drive (libido)
  • getting an erection
  • having a low voice
  • facial and body hair
  • muscle development.

EXAMINING YOUR TESTICLES

From puberty onwards, it’s important that men check their testicles| regularly for anything unusual like a lump or swelling. When you get used to this you’ll soon get to know what feels normal for you.  Cancers found early are the easiest to treat.  The best way to check for testicular cancer is to examine yourself once a month after a warm bath or shower, when the scrotal skin is relaxed.  

How to examine your testicles
Hold your scrotum cupped in your hands, leaving your fingers and thumbs free on both hands to examine your testicles.

Take notice of the size and weight of them. It’s usual to have one testicle slightly larger than the other, or for one to hang lower down, but if you notice any increase in size or weight, this could be an indicator that there’s a problem..

Carefully feel each testicle one at a time. You should be able to feel a soft tube at the top and back of the testicle. This is called the epididymis which carries and stores sperm. It may feel a little bit tender, but this should not be mistaken for  an abnormal lump. You should be able to feel the firm, smooth tube of the spermatic cord which runs up from the epididymis.

Feel the testicle itself. It should be smooth with no lumps or swellings. Men rarely develop cancer in both testicles at once, so if you’re not sure whether your testicle is feeling ok or not, this is why it’s important to feel both of them for comparison.

Remember – if you do find a swelling in your testicle, make an appointment and have it checked by your doctor as soon as possible. 

Also remember that most lumps are NOT cancerous, but it is still important to get checked out.

SYMPTOMS OF TESTICULAR CANCERThe most common symptom is a lump in a testicle. But there may also be other symptoms depending on whether the cancer has spread outside the testicle.

Signs to watch out for include:

  • a lump in one testicle.
  • pain and tenderness in either testicle.
  • discharge or pus from the penis.
  • blood in the sperm at ejaculation.
  • a build-up of fluid inside the scrotum.
  • a heavy or dragging feeling in the groin or scrotum.
  • an increase in size of a testicle (one testicle is normally larger than the other but the size and shape should remain more or less the same).
  • an enlargement of the breasts with or without tenderness.

WHAT IS CANCER?

Cancer is a disease that occurs when the cells of the body multiply in an uncontrolled manner creating a lump called a tumour.  Testicular cancers are also called germ cell tumours (GCT). In men, germ cells produce sperm and as a result these tumours usually develop in the testicles. 

There are two main types:

Seminomas These usually occur in men between 25 and 55 years of age.

Non-seminomatous germ cell tumours (NSGCTs)  This group of tumours is called teratomas. Although this isn’t strictly accurate, it’s a term that was previously used and is still often used. It’s also easier to say.  This group of tumours usually affects younger men – from about 15 to 35 years old. It includes different types of tumours such as teratomas and embryonal tumours.  Many are a mixture of these types.

WHAT CAUSES TESTICULAR CANCER?

We don’t know what causes testicular cancer, but research into this is ongoing.   There are factors which can increase the chance of getting testicular cancer. These are:

  • Undescended testicle (known as cryptorchidism) Usually the testicles develop inside the abdomen of the unborn child and come down (descend) into the scrotum at birth or by the time the child is one year old. Men who’ve needed an operation to bring the testicle down into the scrotum have a higher chance of getting testicular cancer.
  • Family history Men with a brother or father who have had testicular cancer are slightly more at risk of getting it (although the risk is still small). Research shows that a particular gene is the cause of testicular cancer in some men. It’s possible that this gene is inherited and may be why testicular cancer sometimes happens in brothers or sons of men who’ve had it.
  • Carcinoma in situ (CIS) This is abnormal cells in the testicle which (if left) can develop into testicular cancer. CIS tends to be discovered when men have a biopsy of the testicle to investigate infertility (inability to have children). The testicle with the CIS is usually removed.
  • Cancer of the other testicle A small percentage (3–4%) of men who’ve previously been treated for testicular cancer will go on to develop a cancer in the other testicle.
  • Ethnicity and social status Testicular cancer is more common in white men than African-Caribbean or Asian men. It’s also more common in wealthier social groups. We don’t know the reasons for this.
  • Body size Men who are taller appear to have a higher risk of testicular cancer, but it’s not clear why.Sometimes an injury to a testicle or the groin may bring a testicular cancer to your doctor’s attention. But there’s no evidence to suggest that injury to a testicle increases your risk of getting cancer. Having a vasectomy doesn’t increase the risk of getting testicular cancer either.TREATMENT FOR TESTICULAR CANCER

    The three main treatments for testicular cancer are surgery|, chemotherapy| and radiotherapy|. Your treatment will depend on the stage| of the cancer and whether it’s a teratoma or seminoma.

    Your treatment will be planned by a team of specialists who work together (known as a multidisciplinary team or MDT) to decide which treatment is best for you. It usually includes:

  • a surgeon who specialises in testicular surgery
  • oncologists – doctors who have experience in testicular cancer treatment using chemotherapy and radiotherapy
  • a specialist nurse who gives information and support
  • a radiologist who analyses scans and x-rays
  • a pathologist who examines cells under the microscope and advises on the type and extent of the cancer.

The MDT may also include other healthcare professionals, such as a physiotherapist, psychologist or counsellor.

Your doctors will talk with you about the best treatment for your particular situation. If you have any questions, don’t be afraid to ask your doctor or specialist nurse. It often helps to make a list of the questions you want to ask and to take a relative or close friend with you to help you remember what is discussed. 

Now you  know.  Bath Time….

Sources
MacMillan Cancer Support http://www.macmillan.org.uk
NHS UK  http://www.nhs.uk.org
Cancer Research UK   http://www.cancerhelp.org.uk/type/testicular-cancer
The Net Doctor http://www.netdoctor.co.uk/diseases/facts/testicularcancer.htm

Comments { 17 }

Basic First Aid Kit

My First Aid Kit - oversized but worth it. I always have a small kit in the car and always have one in a back pack when walking

It is important to have a well-stocked first aid kit in your home to deal with minor accidents and injuries. Everyone in the house should know where it is and I would strongly encourage you to teach your children some basic first aid skills or at least what to do in an emergency.  You could be the injured person. 

Personally I would suggest schools teach a little less ‘Citizenship’ and a bit more cookery, needlework and first aid.  But what do I know.

Remember:

Your first aid kit should be locked and kept in a cool, dry place, out of reach of children.

Medicines should be checked regularly to make sure that they are reasonably within their use-by dates.

You should also keep a small first aid kit in the car for emergencies.

YOUR BASIC FIRST AID KIT

A basic first aid kit should contain:

  • Small, medium and large sterile gauze dressings
  • At least two sterile eye dressings
  • Triangular bandages
  • Crêpe rolled bandages
  • Plasters in different shaps and sizes
  • Safety pins
  • Disposable sterile gloves
  • Scissors
  • Tweezers
  • Alcohol-free cleansing wipes
  • Micropore tape.
  • Thermometer
  • Cream or spray to relieve insect bites and stings.
  • Antiseptic cream
  • Painkillers such as paracetamol (or infant paracetamol for children) or ibuprofen
  • Cough medicine
  • Antihistamine tablets
  • Eye bath
  • Steri strips or skin closures
  • A First Aid instruction leaflet
  • The name and telephone number of your doctor
  • The name and telephone number of some neighbours or relatives who may be able to offer assistance

Over time I will give you information about how to conduct some basic first aid techniques.

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Natural Home Remedies: Part 4 – Bee Propolis

 

This jar cost £5 and should last at least 3 years

In which I discuss the origin and medicinal usefulness of Bee Propolis, it being anti-fungal, anti-bacterial, anti-inflammatory, emollient and cicatrizant.

 Back in September, I reported on our trip to Audley End in Essex for Boy the Elder’s 13th birthday.  One of the groups of people we encountered was The Essex Beekeeping Association.  I think Beekeeping is a practically magical pastime that has so many positive association; nature, honey, waggle-dances*, the inexplicable ability to fly and their vital role in the ecological balance of Earth.

For humans the medicinal effects of propolis are most efficacious and it is available directly from beekeepers and from health food shops in various preparations including raw propolis, creams, lozenges and tinctures.

Propolis is routinely used for the relief of various conditions, including inflammation, viral diseases, ulcers and superficial burns or scalds. It is also believed to promote heart health, strengthen the immune system and reduce the chances of cataracts. 

Old beekeepers recommend a piece of propolis kept in the mouth as a remedy for a sore throat and I can attest to the value of this.  Put a small lump of propolis into your mouth and press it firmly into one of your back teeth.  Allow the propolis to dissolve slowly throughout the day or overnight and the soreness or phlegm is significantly reduced or gone completely.

Claims have been made for its use in treating allergies but propolis may cause severe allergic reactions if the user is sensitive to bees or bee products.  As always, I would never recommend treatment for this kind of condition without consulting an accredited Naturopathic practitioner.

Propolis has also been the subject of recent dentistry research, since there is some evidence that it may actively protect against caries and other forms of oral disease, due to its antimicrobial properties. 

There are also clinical investigations being undertaken in Japan for the use of propolis as an anti-tumour agent as it would appear that propolis may induce cell cycle arrest and have an anti-proliferation effect on C6 glioma cells.

But what exactly is Propolis?

Propolis is a mixture of various amounts of beeswax and resins collected by the honeybee from plants, especially from flowers and leaf buds. Bees have been observed scraping the protective resins of flower and leaf buds with their mandibles and then carrying them to the hive like pollen pellets on their hind legs. It is assumed that at some point during the collection and transport of these resins, they are mixed with saliva and other secretions of the bees as well as with wax.

The resins are then used by worker bees to reinforce the structural stability of the hive.  It lines the inside of nest cavities and breeding combs, and is also used to repair combs, seal small cracks in the hive, reduce the size of hive entrance and to mix small quantities of propolis with wax to seal brood cells.  These functions also have the associated advantage that the antibacterial and antifungal effects of propolis seem to protect the colony against diseases.  It also reduces vibration and can be used to seal off any waste matter that is too big to remove from the hive and might otherwise putrefy and cause disease.

Further reading:

http://www.environmentalgraffiti.com/news-healthiest-insect-produce-you-could-wish/    

* Five Boys by Mick Jackson – essential reading if you want to know about Waggle Dancing.  No, not the beer.

 
 
 

 

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Phobias: I don't like spiders and snakes but that ain't what it takes…

This picture genuinely makes me feel queasy

This is a bit of a long article but phobia is a complicated subject.
I am frightened of spiders.  Not just a bit scared but REALLY frightened.  I have had several incidents where my arachnophobia has been clearly demonstrated.

  • When I worked in the Invertebrate House at London Zoo, one of the keepers invited me to watch Geraldine, a red kneed bird eating spider, moult.  She was behind six feet of bullet proof glass so I knew I was safe and I do think they are fascinating and beautiful creatures.  However, later that day, she brought the moult down to show me.  She had it on her hand and put it about 12 inches from my face.  I don’t remember moving but I found myself curled up in a corner of my tiny office, cold, clammy, my chest tight and with shooting pains going down my left arm and hearing my disembodied voice screaming “Get it away from me, get it away from me!”
  • A few weeks ago, I was driving my children to school when a crab spider the size of my thumbnail let itself down on a thread from the sun visor in front of my face.  I slammed the brakes on, stalling the car, and leapt into the road, narrowly avoiding a passing Landrover.  The driver stopped to see if I was ok and I had to ask him to remove the spider before I could get back into the car.
  • Yesterday, I was removing the plastic pane from a skylight and a dead house-spider dropped on me. Sobbing, I dropped the pane, which broke and, having hysterically brushed the dead spider off,
    I had to sit down with a cup of tea to calm down.  That little incident has cost me £28 in repairs.

So what is the difference between being fearful and having a phobia?  The main difference is in the intensity of the emotional reaction: a strong dislike of flying is a fear, whereas a pathological fear (an intense, uncontrollable, yet intangible fear) is considered to be a phobia.  It is different from anxiety in that the nearer you get to the situation or thing, the more anxious you get and so you tend to avoid it.  Take yourself away from the situation or thing and you feel fine.

No trouble

The next question is where do phobias come from?  Sometimes fears can stem from an incident which happened in the past; Sister the Second dates her fear of things with no legs from childhood when a boy put two halves of a worm down her neck and another boy threw a box of maggots at her.  Some fears are evolutionary i.e., they stem from a genuine instinct that something might kill you.

The Psychologist, Kendra Cherry, cites that many Phobias are not directly related to the cause of the emotion, they are symbolic of it. The most obvious example is the fear of snakes,: how many people do you know who have been harmed by a snake? None? It is an interesting fact that per capita there are just as many snake phobics in Ireland as in any country in the world. However there are no snakes native to Ireland – so in effect apart from zoos there are no snakes in Ireland! So Question: Where did all those people go to get frightened of snakes? Answer : They didn’t go anywhere! their fear doesn’t have anything to do with snakes, they have a fear/strong emotional reaction to  being out of control – which their mind symbolizes and then projects onto snakes and associations to snakes.

I agree with this entirely.  One of things that I most loathe about spiders is the way they move – that horrid hesitant fumbling – and yet you know that if they want to, they can cover huge distances incredibly quickly and almost certainly straight up my arm and into my hair.  It’s sneaky and covert and I dislike people who behave like that too.

Cherry adds that  phobias are a symbolic representation of an internal anxiety. Although some Phobias appear  to serve an obvious purpose (fear of fire, drowning etc.) others seem  to make no sense at all but as strange as some phobias seem they are all serving a particular purpose.

The symptoms of phobic anxiety vary from person to person,  but often include:-

Nausea - A feeling of sickness often accompanies a phobic reaction
Increased heart rate – As the body starts to become anxious the heart rate increases
Tremors/shaking – Adrenalin is pumped into the body causing shaking and tremors
Increase in perspiration – The body tries to cool itself down by sweating
Numbness or tingling – As blood is pumped towards the vital organs the extremities become numb
Feelings of unreality – as the mind searches for a way out we become dissociated from what is happening around us
Feeling short of breath - in order to gain more oxygen during panic the chest begins to contract
Chest pain or discomfort – anxiety as adrenaline over works the chest and discomfort is felt
Emotional – fear, panic, wanting to cry, anger (wanting to kill or remove the object) wanting to run but often stuck not being able to move

The biggest problem is what to do about it.  The purpose of therapy is to find the originating cause (the unconscious conflict) of the phobia and release it – and when the emotions are released, the phobia disappears.  In theory. If a phobia is causing difficulties in your life it is important to get help as soon as possible and there is plenty out there.

Cognitive Behavioural Therapy (CBT):  This is a talking treatment which helps us to understand how we get into negative patterns of thinking that can actually make the phobia or anxiety worse.  CBT can help you to change your ‘extreme’ thoughts or to learn to see unhelpful worries as ‘just thoughts’.  It is an incredibly powerful therapy for all sorts of psychological problems.  There are now computer programmes which you can you use to access CBT and your GP should be able to point you in the right direction.  There is a programme called ‘Fearfighter’ which can be available on the NHS.

Graded Exposure:  This is a way of facing our fears one step at a time.  It can be effective because spending time in a feared situation can decrease and even obviate your anxiety.  You start by tackling your fear in a tiny way, for example by having a picture of a spider on your wall, and once you feel comfortable with that, you can move onto the next step.

Medication:  Medication can play a part in the treatment of phobias an anxiety but they must be used with great care.  The most popular drugs are benzodiazepenes (such as Valium) but they are highly addictive and should only be used in a crisis or for a specific, short-term situation.  Anti-depressants have  use in some situations to control underlying anxiety or to control background depression which can lead to loss of confidence and ability to cope.  Also beta-blockers can be extremely useful to control the symptoms of anxiety associated with phobias such as public speaking, social activities or experiential problems.  However, one still needs to tackle the underlying reason for the phobia or treatment is simply a sticking plaster which will eventually ooze and fester.

I have never done anything about my fear of spiders because it doesn’t affect me on a daily basis.  I can pick up a crane fly or a harvestman without blinking because I know it’s not a spider. I also realized something quite profound today, which is that I actually quite like having an area of justified weakness.  I spend my life being strong and capable, being obliged to deal with absolutely anything that life throws at me.  Being scared of spiders and being able to articulate a completely acceptable fear is something of a relief.  I can be weak and vulnerable and no-one minds, no-one even laughs at me.
I’m just glad that I don’t live in a country full of big hairy things that bite and sting.  I’d have to do something then.

TEN COMMON PHOBIAS:

Arachnophobia – spiders
Ophidiophobia – snakes
Acrophobia – heights
Agoraphobia – a fear of situations from which it is hard to escape which may include, open spaces, crowded areas or difficult situations: many people stop leaving their home altogether
Cynophobia – fear of dogs
Atraphobia – fear of thunder or lightening
Trypanophobia – fear of injections
Pteromerhanophobia – fear of flying
Mysophobia – fear of dirt or germs

Sources:

The British Association for Cognitive Bahavioural Therapy
The Royal College of Psychiatry
www.psychology.about.com

Anxiety UK
MIND
NICE

Comments { 17 }

A Jolly Good Wheeze

Last night I was taken into hospital because I had an asthma attack.  I started to get really wheezy at about 3pm and, no matter how much I used my inhaler, it didn’t really make much difference.  I rang out local cottage hospital at 8pm and asked if I could use their nebuliser but they said that their last appointment was at 8.45 and if I needed any further treatment they wouldn’t be in a position to give it to me, so it was better if I didn’t. 

At 9pm I called the out of hours doctor who sent a paramedic round immediately and I was put on an nebuliser and given an ECG.  My breathing eased quite a bit, but he was worried that my heart was not behaving itself, so he called an ambulance and I was carted off to hospital, while The Father of My Children came and took the boys to his house.  At the hospital they put me on another nebuliser, an ECG, blood pressure monitor and bloods were taken.  I was also given a large dose of steroids. I was discharged at 2am and left to find my own way home, which meant TFoMC was had to drag the children out of bed and come and get me.    

Asthma is an incredibly frightening and exhausting thing. Basically it’s a chronic respiratory condition characterized by difficulty in breathing, frequent coughing and a feeling of suffocation.  An attack of asthma is often precipitated by physical or emotional stress/anxiety, respiratory infections, air pollution and changes in temperature or humidity.  It can also be related to low blood sugar, allergies or disorders of the adrenal glands.

It usually starts with a tightness in the chest which develops before the wheezing.  Breathing and wheezing are often more difficult while trying to breathe out, but this depends very much on the individual and the causes of the attack.  There is usually a rapid pulse (mine was 118 which is considered severe) and a change in blood pressure.

During an attack, the bronchial tubes become narrowed, either because of a build up of mucous or a reaction to an allergen which caused the tubes to go into spasm.  An inflammatory process takes place causing the tubes to swell.  As the symptoms subside, the tubes relax and return to their normal diameter and breathing becomes easier again.  At this point the mucous may start to be coughed up in the form of mucous ‘plugs’ which soon subsides.

The following statistics have been provided by Asthma UK

  • 5.4 million people in the UK are currently receiving treatment for asthma.  Interestingly, although asthma is severe and can result in death, it was rarely fatal in this country before 1900.
  • 1 in 11 children has asthma and it is the most common long term medical condition
  • The NHS spends £1 billion a year treating and caring for people with asthma
  • Over a quarter of a million have missed days of work in the past year due to asthma
  • The UK has the highest prevalence of childhood asthma symptoms in the world

I had my first asthma attack on my 16th birthday and my boarding school didn’t take it very seriously.  I was not given any tests, but was handed a prescription for an inhaler and left to my own devices.  They didn’t even inform my mother.  I have probably only had half a dozen severe attacks since then, mostly in the last 15 years, and on only two of those occasions did I actually think I was going to die. 

The problem for me is that, because my asthma is so well controlled most of the time, I forget that I have it and do stupid things.  For me the triggers are excessive dust, over-tiredness and stress.  Interestingly today, when I saw my doctor, she suggested that I have a personal asthma action plan in place for if I’m getting excessively wheezy.  This is the first time this has even been suggested to me and seems really sensible. 

She has given me my own peak flow metre which measure lung capacity and we will meet again in two weeks to write the plan.  If I had had this metre yesterday, I would have known to ‘phone the paramedics hours earlier and would probably not have needed hospital admission.  According to Asthma UK, people who have a plan are four times less likely to require hospital admission.  Sounds good to me.

There are also practical and dietary pathways that can be followed to help strengthen the lungs, respiratory and immune system. 

  • Good posture and correct breathing techniques can have a most beneficial effect; asthmatics often have poor posture and I am one of those.  Yoga and Alexander Technique are excellent regimes for asthmatics. 
  • Psychological attitudes can contribute greatly, either through stress or feeling emotionally suffocated and unable to express oneself.  Psychotherapy and Cognitive Behavioural Therapy have made significant strides in this area. 
  • Vitamins A, Beta-carotene, Vitamins B complex, B6 and B12, Vitamin C and bioflavinoids are all very helpful and can be obtained in the first instance by including more foods containing these in your diet. Eg liver, eggs, yellow fruits and vegetables, milk, fish liver oil, cheese, marmite, avocados, brown rice, lentils, bananas, citrus fruits and juice, dark green vegetables, cauliflower, peas, green peppers, strawberries, kiwi fruit, whole grains and seeds, honey.  There are no surprises here. 
  • Juicing can be a great way of getting additional nutrients.  I love carrot, apple, parsley and ginger.  Spinach and carrot is great as well.

But please note, I would never, ever advise anyone to use complementary remedies in place of conventional medicine without consulting a qualified and registered naturopath.  People die from asthma and one should never take stupid risks.

I am now feeling fine, rather tired – I spent most of the day asleep – but by tomorrow morning I shall be ready to go again.  I just need to look after myself better and practice what I preach. 

Sources
Asthma UK
All about Asthma and it’s Treatment without Drugs by David Potterton, pub. Foulsham 1995
The Nutrition Almanac by G J Kirschmann & J D Kirschmann, pub. McGraw-Hill 1996
The Manual of Conventional Medicine for Alternative Practitioners by Stephen Gascoigne, pub. Jigme Press 1996

Comments { 25 }

Sleeper – Part 3

Babies.  The guidelines for getting babies into good sleep habits are pretty much the same as for children and adults.  Plenty of fresh air, good routines and take away their mobile ‘phones.  Sorted.

But seriously folks babies are clever creatures and they pick up on how things are going to be run pretty quickly.  Now I am almost certainly going to get pilloried by someone at some time for my approach to babies and I must stress that these are MY opinions and ultimately you must go with your own instincts.  Midwives vary, in that some of them give you good advice and some of them feed you the party line.

The most obvious things to make babies cry are being hungry, wet, dirty or windy.   These things make me cry too.  Let’s assume that they have fed well, have a clean dry bottom and have burped like a builder on Special Brew.  Put them in the cot, wrapped appropriately, with the window open, tell them it’s sleep time and leave the room.  If they start to cry, give it a good long time before you go back, and when you do, don’t pick them up, tell them it’s sleep time, make lots of reassuring noises and leave again.  Be firm. This can be quite hard, but in the long run it pays off and they soon learn that you mean it.

If a child is constantly hungry, it may be that they’re not getting enough from you or their bottle.  Boy the Elder was a ridiculously large baby and although he fed well, he was still always hungry.  I started supplementing his feeds with thin baby rice, then pureed swede at 5 weeks and he was as happy as a sandboy.  Ask your midwife or family for advice if you’re not sure. 

Boy the Younger, on the other hand, was small, thin, yellow and had pointy ears.  He didn’t sleep, he was jaundiced, he didn’t feed properly, he didn’t stop crying.  For the first month I wished I’d never had him (and I can’t tell you how bad that feels).  And then I returned to my right mind and took him to see the cranial osteopath.  She diagnosed compression at the base of his skull and very tight membranes across the plates of his head.  It only took a few sessions before there was a massive improvement in his feeding and sleeping.

Cranial osteopathy is a wonderful thing.  During the birth process, babies are stuck upside down in a tight, nasty place for quite a long time and this can cause the plates of the skull and the vertebrae of the spine to compress and tighten.  This compression can lead to poor feeding, poor sleep habits and restlessness.  Boy the Younger had a permanent headache for three months so it was no wonder he cried all the time and was off his trough.

Boy the Elder simply couldn’t be bothered to be born and at ten days over his due date I was carted off to be induced.  After 18 hours of established labour, an emergency C.section was carried out to prevent the pair of us being carried off.  He was born with a very pointy head indeed, so he was whipped off to the osteopath within ten days.  He was the healthiest, most well behaved baby one could hope for and he was sleeping through the night at 8 weeks.  Osteopaths aren’t cheap, but my goodness it’s worth it.

If babies are restless, massage is a wonderful way, not just of relaxing them, but bonding with them as well.  There are lots of great books about baby massage and many health centres run classes.  Otherwise, a good Aromatherapist will show you how to do it.  It also improves circulation, muscle tone, digestion – it soothes the gut if they suffer from wind or colic, and helps to boost the immune system.  It can also form a mutually advantageous part of their routine if you get into the habit of doing five or ten minutes of massage after the bath and just before you put them down to sleep.  You can also add one drop of lavender essential oil to their bath which helps to promote deep sleep.

I always put my children to sleep in the pram in the garden during the day, summer and winter alike.  I remember Sister the First ringing me in November (BTE was born in September) and she remarked on how quiet it was.  I told her BTE was asleep in the garden.  “No wonder he’s quiet!” she said “he’s got hypothermia!”  Oh how we laughed.  The only time I brought them in was if it was really torrenting with rain, foggy or snowing.  The blankets were on, the hood was up, the apron was secured with the flap up and the pram was turned into the wind.  For BTE I had a normal sized pram in which he could lie flat, but for BTY we had renovated my mother’s beautiful 1950’s, coach built, Silver Cross pram which was big enough to hold small parties in.

If you really don’t feel safe putting your baby outside, then put the cot near the window and leave the window wide open to allow the fresh air in.  If it gets chilly, pop a hat on them and an extra blanket.  They don’t die of cold when you walk them to the shops so they won’t die of cold in their bedroom.

If you can manage to establish routines early on, it is easier to continue these when they start crawling and toddling.  I am not a morning person and if I’m woken very early I’m a very bad person indeed.  When BTE started escaping from his cot, we put a stairgate over his bedroom door and left a few toys and books where he could get them.  He soon realised that I would come and get him, but that no amount of yelling would get me there any earlier.  It was rather nice to pad down to his room and see him sitting looking at his books or playing with his toys. 

BTY was not so compliant, as he is a morning person (and still bounces about at a revoltingly early hour).  I used to leave a drink of water and a piece of bread and butter under his cot and this would keep him quiet until I got up; earlier than I would have liked, but still civilized by most people’s standards.

And one more thing.  Don’t put babies in front of the television.  Don’t laugh, I know lots of people who have.  When I was teaching baby massage classes, I had a mother come to me because her 3 month old baby would not sleep at all during the day.  It turned out that she was lying him on a rug in the lounge with the television on all day to keep him amused.  We had a conversation, she switched the telly off, put him to sleep outside and bingo.  Slept like a …. baby.

  • Make sure your baby has fresh air every day
  • Try to establish a routine as soon as you can and stick to it
  • Have soft lighting in the bedroom
  • Have some cuddly  ‘wind down’ before going up to bed
  • Keep the bedroom cool
  • Read even tiny babies a story, tuck them up, then leave the room
  • If they won’t stop crying  and you’ve eliminated possible health problems , consider massage and/or cranial osteopathy
  • Trust your instincts and if you’re not sure, ask someone.

That’s enough about kipping now.

Comments { 8 }

Sleeper – Part 2

Now today we’re going to talk about sleep and children.  Before we say anything else, let’s establish one thing.  Children need a lot of sleep.  Babies need around 17 hours, young children between 10 and 12 hours.  Teenagers, it would appear, genuinely need more sleep than adults at around 9.5 hours per night.

So.  How many children are actually getting enough sleep to function properly?  According to The Independent newspaper, up to two thirds of British children are not getting enough sleep and have missed as much as 4,500 hours by their 7th birthday.  Blimey.

An increasing number of children are chronically sleep deprived.  This leads them to be bad-tempered, unable to concentrate at school, have poor memory, reduced creativity, have cognitive impairment, they are more clumsy, have lower immunity, behavioural problems and a wide variety of health problems including obesity, diabetes and depression.

Good sleeping habits have to be taught like everything else.  Babies can be taught from a very early age that there are times for feeding and times for sleeping and this should continue into childhood.  Babies and young children are exhausting, particularly if you have more than one and, as a parent, you owe it to yourself to train your child to go to bed at a sensible time, not only for their sake, but for your own.  Parents need child free time and time to rest and be with their partners, even if it’s only for a short time.  Children must not be allowed to dictate the timetable of an entire household.

Another area where chronic sleep deprivation seems to have an impact is children with ADHD (attention deficit/hyperactivity disorder) and inadequate sleep appears to be a contributing factor.  In a study in  Finland, children between 7 and 8 who got less than 7.7 hours of sleep per night were significantly more likely to be hyperactive or inattentive than the children who had 9.4 hours sleep or more.

Now this would appear to be common sense surely.  Our parents’ generation sent us off to bed early as a matter of course, so what’s happened?   I think it’s a combination of several things:

Too much television and time on computers:  although we think TV is soporific and that we’re veg-ing out, it actually stimulates brainwaves but not in a way that aids brain development.  The fast pace in the editing of many children’s programmes leads to difficulties with attention and hyperstimulation.

Not enough fresh air and exercise: not only will this prevent them from becoming overweight which can cause sleep difficulties in itself, but it helps with respiration and a healthy heart.  They will also be tired for the right reasons, all of which promote healthy sleep.

Poor diet: Sugar and refined carbohydrates create fluctuating blood sugar levels that can disrupt your sleep in the middle of the night. Another side effect of excessive sugar consumption is insulin rebound, in which the body is overwhelmed with an influx of simple sugars and as a result cannot digest food properly. This condition causes a stress reaction in the body that prevents sleep.

Lack of parental control:  As a parent we have a responsibility to make sure our children go to bed at the right time.  It’s our job.  We have to set boundaries; 8 o’clock must mean 8 o’clock and when you say one story, only read one story.  If they’re getting enough sleep, there’s a reasonable chance their behaviour will be better and therefore cause fewer disruptions, making you less stressed and therefore better able to cope with enforcing a routine.

Lack of routine:  Children need routine – it makes them feel safe – and this ties in with the paragraph above.  Do the same things every night; warm milky drink, wash, teeth, bed, story, goodnight.  It’s not always possible to stick to it, but do try.

Many children are sent off to bed with no supervision whatsoever.  Many parents don’t read bedtime stories, don’t supervise washing and teeth cleaning, don’t tuck their children up, and let them fall asleep in front of television of computer games.  There’s no security in this.  To be tucked up in bed with a warm kiss goodnight, is sometimes all a child needs to settle.  In my opinion, young children shouldn’t have computers or televisions in their rooms in the first place.  How can you monitor what and when they’re watching?

As adults, we know that when we are chronically tired we cope less well with stress, so why should our children be any different?  Will a permanently tired child turn into a permanently tired adult who can’t cope with the vicissitudes of modern life.  We can’t risk it.

Children do suffer from stress and even if you have a good bedtime routine, life events can cause children to become anxious and not sleep.  Talk to your child and listen to what they have to say.  If it persists, take them to the doctor in case they need some counselling or treatment for a physical problem.

So to recap:

  • Make sure your child has fresh air and exercise every day
  • Set your routine and stick to it
  • Remove televisions, computers and mobile ‘phones from the bedroom
  • Have soft lighting in the bedroom
  • Don’t have dinner too close to bedtime – a milky drink and a biscuit or a banana should be sufficient
  • Have half an hour’s ‘wind down’ before going up to bed
  • Keep the bedroom cool
  • Supervise bedtime, tuck them in, read them a story, then leave the room
  • Make sure they know you’re pleased when they stay in bed – maybe keep a star chart so they can earn a treat

I understand that this is sometimes difficult.  Boy the Elder needs 23 ½ hours sleep a night and Boy the Younger needs 9 or 10.  When they shared a room it was horrendous as Boy the Elder was getting massive sleep deprivation and in the end he would often have to come in with me.  It is much better now they have separate rooms and, combined with a stricter regime, star charts really do help because they can see immediate evidence of their successes.

I’ve just realised that we haven’t even started on babies, so I shall have to do a Sleeper Part 3, but don’t worry, it won’t be as long as the first two!

Sources:
Royal College of Psychiatrists
The Sleep Disorders Centre, Sacre-Coeur Hospital, Paris
MIND
British Medical Association Journal August 2000
Paediatrics – April 2009
The Sleep Apnoea Trust
The Independent newspaper – May 2003
The Times newspaper – November 2009
Loughborough University, England
The University of Montreal, Canada
The University of Helsinki, Finland
The Good Night Guide for Children booklet

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Sleeper – Part 1

Aha, you thought this was going to be another post banging on about railways didn’t you? (or earrings or Woody Allan).  But no!  It is a proper article about sleep and the importance thereof.  Today I’m going to talk about adults and tomorrow, children.

Firstly, let’s establish a bit of information about sleep.  Sleep is the regular period in every 24 hours when we are unconscious and unaware of our surroundings. There are two main types of sleep:

Rapid Eye Movement (REM) sleep: This comes and goes throughout the night and makes up about one fifth of our sleep. The brain is very active, our eyes move quickly from side to side and we dream, but our muscles are very relaxed.

Non-REM sleep:  The brain is quiet, but the body may move around. Hormones are released into the bloodstream and the body repairs itself after the wear and tear of the day. There are 4 stages of non-REM sleep:

1.      The muscles relax, the heart beats slower and body temperature falls – ‘pre-sleep’.
2.      Light sleep - you can still be woken easily without feeling confused.
3.      Slow wave sleep – our blood pressure falls, you may talk in your sleep or sleep walk.
4.      Deep slow wave sleep – you are very hard to wake. If somebody does wake you, you feel confused.

We all complain about loss of sleep or feeling tired (I know I do) but I wonder how many of us realise just how much lack of sleep can affect us, not just our cognitive functions but on a physical level as well.   Cutting back on sleep is an understandable response to the stress of modern life.  In 1910 an average night’s sleep was nine hours.  By 1975 it had reduced to seven and a half hours and the trend is continuing downwards with some shift workers rarely getting more than five. 

Most adults need eight hours sleep per night.  Some people get by with much less, but it has been demonstrated that these people often have tiny cat naps during the day or have a massive lie-in once a week to compensate.

Sleep deprivation caused tiredness (yeah), lack of concentration, cognitive impairment and behavioural changes.  More road accidents happen because of tiredness than speeding.

It is now known that continued lack of sleep can cause significant physiological problems as well, including weight gain, diabetes, high blood pressure, alteration of hormone production and … erm … oh yes, memory loss. 

A recent study on eleven healthy young men (no it wasn’t me, it was done by proper scientists) monitored their physical well being over 16 nights where they were allowed varying amounts of sleep. The results were interesting but long and complex, so I will summarise thus:-

During periods of sleep deprivation:

  • Their glucose levels resembled those of people with Type 2 diabetes and their glucose metabolism was reduced by 40%.
  • The production and action of thyroid stimulating hormone was suppressed
  • Blood contained increased levels of cortisol later in the day.  This is typical of much older subjects and thought to be significant in age related problems such as insulin resistance and memory impairment
  • All these abnormalities returned to normal after the subjects had had twelve hours of sleep

The primary function of sleep may well be to give your brain a rest, but this study suggests that chronic sleep loss could have long term adverse health implications.

Snoring and Sleep Apnoea are also a big problem, not just for the sleeper but also for the person who sleeps with them.  Sleep apnoea is caused by the increased narrowing of the throat during sleep. Anything that makes the throat narrower to start with (for example enlarged tonsils or a set-back lower jaw) means that it is easy for the throat to close off a bit more and block the airway. A partially blocked nose generates lower pressures in the throat whilst taking a breath in, which tends to suck the walls of the throat together. 

Sufferers of sleep apnoea not only suffer from the normal symptoms of sleep deprivation. Heart problems can be caused or exacerbated because of the pauses in breathing during the night. If you imagine your body is being starved of its much needed oxygen, the heart is going to have to work even harder to pump blood around your body faster, to keep your oxygen levels at the required level. Equally, your blood will begin to contain higher levels of carbon dioxide, as less oxygen is present, which can make your blood more acidic and consequently cause irregular heart-beats.

Probably the most important factor in snoring and sleep apnoea is being overweight with a big neck. Extra fat in the neck squashes the throat from outside, particularly when the throat muscles become floppier with sleep.  Anyone over a size 17 collar is a prime candidate.  Yes really.  If you are a snorer get it sorted – not just for your own health but for your partner as well.

Many adults suffer from varying degrees of insomnia and the reasons for this are as diverse as the sufferers themselves.  Short term sleep difficulties are often associated with anxiety, emotional problems, physical illness or a life event such as bereavement.  Sometimes it can simply be that the insomniac has got into bad habits and needs to ‘re-train’, in the same way that children need to be trained, to sleep at an appropriate time.  Sleeping pills can be helpful for short-term problems but it is vital that the root cause of poor sleep patterns is found, and treatments such as Cognitive Behavioural Therapy can be very effective for some people.

Some hints for healthy sleep:

  • Keep a window open or turn down the heat in your bedroom
  • Make sure your curtains shut out the light
  • Try to have some winding down time before you go to bed – read or listen to soothing music
  • Have a warm bath with a few drops of lavender or chamomile essential oil
  • Don’t put the TV on in the bedroom – it is a proven stimulant (not in a good way)
  • Have a warm milky drink
  • Get regular fresh air eg. a good walk – but not within 3 hours of bedtime

Good night and sleep well.


Sources
:
Science Daily: October 1999
Royal College of Psychiatrists
The Sleep Disorders Centre, Sacre-Coeur Hospital, Paris
MIND
British Medical Association Journal August 2000
The Sleep Apnoea Trust

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