Avoiding exposure to the sun is the best way to prevent sunburn and skin cancer. This is almost impossible with children. Taking the following precautions will lessen the risks of sunburn:
1. Always put a hat and a long-sleeved shirt on your child if he is going into the sun. It does not have to be a sunny day for sunburn to occur. UV radiation can also penetrate cloud cover, so be especially careful on overcast days.
2. Use sunscreen which is a blockout (minimum protection factor of 15 + ). During the summer, apply this even if you are only going out shopping with your child. Always apply sunscreen before exposure to the sun. Reapply it every few hours.
3. Do not use oils, even if they claim to aid tanning. They increase the chance of sunburn because they effectively absorb more of the sun’s rays.
4. Limit the time spent in the sun to early morning or late afternoon. Avoid the few hours around midday, when the sun is at its strongest.
5. If your child is outdoors playing in a pool, reapply water-resistant sunscreen every hour.
6. Start sun exposure gradually, for 10 minutes a day, over 2-3 weeks, and build it up by 5 minutes a day.
7. Make sure there is always shade available for your child, for example, a beach umbrella.
8. Remember that reflected rays from snow and from water can also cause severe sunburn.
9. Remember to cover sensitive areas such as lips and nose, which are more prone to sunburn. There are special preparations available, or plain old zinc cream is very effective. (This now comes in many bright colours as well as white.)
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BREASTFEEDING A PREMATURE OR UNWELL BABY
If your baby is born prematurely, or is unwell, he may be difficult to breastfeed. If you strongly wish to breastfeed, let the nurses and doctors taking care of your baby know this. They will be able to advise you on expressing your milk in order to keep up your supply until your baby is strong enough to suck at the breast. If your baby is unable to take breastmilk, it is possible to freeze it for later use (see below). Success depends upon the condition of your baby as well as your own determination.
Breastmilk can be expressed either by hand, or using a breast pump. If you are in a hurry, it may be difficult for you to express; you need to be relaxed and calm to ensure that your milk flow is adequate. If you are having difficulty, try having a hot bath or shower, and then massage your breasts. If you wish to hand express, use a sterile plastic container with a wide mouth to collect the milk, and rhythmically squeeze your areola between your thumb and fingers to empty the milk ducts. Try to apply a pressure similar to the pressure of your baby sucking. A breast pump can be less bothersome and quicker than hand expressing, but many women prefer the latter. If you do decide to use a breast pump, make sure that it is properly sterilised to give your baby some feeds. Not only will this provide your partner with enjoyment, but it will also give you a little extra time for yourself.
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There is no spelling error in the title of step nine. I suggest that couples “manage” a threesome. This is not a sex threesome, but dinner or some activity with another man or another woman with the spouse present. It is a chance to involve spouses in business relationships and other friendships that they would not otherwise be a part of.
We live in a time when the complexity and anonymity of life provides temptations for sex outside of marriage. We are exposed to attractive, available potential sexual partners almost every day. We typically relate to these people when we are well dressed, impressive, demonstrating our social or occupational competency, energetic, and without our spouse. In our marital ijfe we may feel spent, de-energized, dressed for comfort. The managed-a-trois is an opportunity to see our partner at his or her best, being reacted to and reacting to other attractive, interested, and interesting persons. With both husband and wife present the temptation or competition of outside relationships is reduced, while the positive effects of newness and energizing input from others is available.
If there is someone important to you whom your spouse does not know, super marriage depends upon using this managed-a-trois opportunity to acquaint your spouse with that person. A good marriage does not require this all-inclusiveness of the partner, but super marriage does.
“We went to a play with my friend. He loved it. He walked in with a woman on each arm. We had dinner and talked. It was really fun,” reported the wife. “People weren’t used to seeing that, and he was proud and smug as hell.”
“We went a step further. I went out with a married couple we both know and she did the same last month. It really breaks the pattern and gives us a bunch of new stuff to talk about,” said one husband. “It’s probably not surprising that the stronger our marriage gets, the more independent we feel. This ‘managed-a-trois’ assignment is just good fun.”
Marriages tend to stick with marriages, to go to the theater, to parties, to dinner as couples. This opportunity provides the chance for a different pattern, for relating outside of the “two with two” pattern. Couples report a different view of their spouse when they see her or him in this context. Couples develop friendships with one person instead of just couples, developing a wider friendship circle outside the confinement of “couples only.”
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Once we remove the manipulation from courtship, and from marriages attempting to re-court, we are free to develop a wide range of relationships. ‘ T don’t think men and women can ever really just be friends. Once they see you as a friend, you either become their mother or their therapist, or they just vanish, to come back once in a while when someone breaks up with them.” This report from one of the wives illustrates the cliche about men and women relating, that it is always sex or nothing at all between women and men.
We can develop into new relationships and modify others; we do not have to dump people. Think of the friends of both genders we would have if we did not allow our sexual immaturity to dictate that male/female relationships are either hot or cold, if our courting added to our list of friends instead of to our list of failures.
We are so genitally oriented in our society that we define infidelity by juxtaposition of the male and female genitalia. If the genitals get near one another, and particularly if an unauthorized penis enters an unauthorized vagina, cheating has occurred. If we become workaholics, ignore our families, neglect our health and the health of those who love us, if we spend most of our time outside of the family and the home, that is not infidelity. I suggest we have this backward. There is probably much more unfaithfulness to marriage because of work and play than because of extramarital sex.
Work at keeping and making friends, even if you used to have a more romantic involvement with them that changed for some reason. Men and women can play tennis without having sex. Super marital sex depends on maintaining attractiveness to others, experiences with others that enrich the marriage. The same goes for courtship. Don’t dump people, save them. Keep their name and number. Keep them as friends. It may sound impossible, but it works. If you view courtship as collecting a wide range of friends, one of whom will become that one special lover for life, then courtship will lose its defensive orientation, its manipulation and pain. It will become a process of personal and social growth.
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Tetanus is a preventable disease and fortunately it is now rare. The reason it occurs so infrequently is because most of us have been immunised against it.
However, it remains an extremely severe disease and despite intensive modern treatment over a third of cases still die.
Tetanus is caused by a rod-like germ, Clostridium tetani, which grows best in low concentrations of oxygen.
This is why it is particularly likely to develop in damaged tissue, such as following a crushing injury or a burn.
The germ is widespread in nature.
It lives commonly in the gut of many animals especially the grass eating ones.
It does no harm to the animal but it passes out with the animal droppings and contaminates the soil.
The tetanus germ gains entry into our body usually when the skin is broken by a wound and is contaminated by soil.
The disease has an incubation period of around 15 days.
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Like a sauna, they may cause a marked loss of fluid which is reflected in the scales. But this weight loss is temporary and, as the fluid is replaced by drinking, so the weight returns to its previous level.
It may be satisfactory for a jockey to spend the morning in a sweat box so he can ride at a certain weight that afternoon, but it is of little value to the obese man or woman to sweat off a kilo or two and then believe they are losing weight.
Unfortunately, the diuretic usually not only washes sodium from the body but potassium as well.
In most cases, little is lost and there is no bodily disturbance. In a few cases, so much potassium is lost that it causes symptoms of tiredness, lack of interest and some cramps that may herald that all is not well. Very low blood levels may lead to problems with the heart rhythm, particularly if the drug digitalis is also being taken.
Potassium is widely found in a number of foods, particularly citrus fruits, tomatoes and bananas, which are often recommended for those on diuretics.
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Kawasaki may be the name of a motor-cycle but it is also the name of a less well-known disease.
Dr Tomisaku Kawasaki, of the Tokyo Red Cross Medical Centre, reported the first cases in 1967; more than 20,000 cases have been reported in Japan and many more in other countries, including Australia.
The cause is unknown but it results in a feverish illness with enlargement of the lymph glands and a rash, ulcers or blisters in the mouth or on the tongue.
The incidence is thought to be greater than what is reported as many mild cases may be missed.
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In recent years computers have been linked up to very sophisticated X-ray machines to produce a more detailed and quite different type of picture than those I have described above. The pictures which this system produces look like a cross-section of the part of the body under study. This means that they represent what you would see if you sliced the body right through at a particular level and looked at the cut surface. The usual type of X-ray is produced by a broad beam of X-rays passing through the entire part of the body to be checked. With the CT scanner, a very narrow beam of
X-rays passes backwards and forwards across the body in a thin strip. Instead of an X-ray plate on the other side there are special crystals which react very quickly to X-rays falling on them. Messages are constantly being fed into a computer telling it how many X-rays went in one side (from the X-ray source) and how many came out the other side (as indicated by the reaction of the crystals). By analysing these messages sent from every angle around the body, the computer builds up the cross-sectional picture. The process can be repeated at other levels in the body as neccessary. CT scan pictures give us much more detail than an ordinary X-ray. Contrast methods are often used in combination with the CT scanner to give the maximum possible information. The problem with CT scanners is that they are extremely expensive and need expert staff to ‘read’ the pictures. They also Involve the use of considerably more radiation than normal rays.
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Chronic stress. There is good anecdotal evidence of a link between stress and body fat levels, although the association is a complex one. Under cases of acute, life threatening stress, animals (including humans) stop eating and go into a protection mode. They also tend to burn more energy, both through increased physical activity and increased ‘nervous energy’. However, most modern day stress is usually less life threatening and more chronic, or long term in nature. Under these circumstances many humans—particularly fat ones—tend to eat more, drink more alcohol, and generally become less active, all factors predisposing to increases in body fatness. Long term, ‘chronic’ stress can increase obesity by:
• encouraging over-eating (especially of high-fat snack foods)
• immobilising efforts to improve lifestyle
• decreasing feelings of ‘self control’
• consuming available energy and efforts while in survival mode
• increasing alcohol consumption.
‘Restrained eaters’ (those who restrict their food intake because of consciousness of being too fat) tend to be most likely to gain fat under periods of chronic stress.” Caution about eating, and all other concerns about food intake usually go by the wayside with long term increases in stress levels and food may serve a ‘comfort’ role to the stressed individual. In one research study, women were shown to be more prone to over-eating during stressful periods, whereas only men regarded as ‘emotional eaters’ respond in this way. In any case, anyone prone to fat gain during stressful situations should perhaps deal with the stress as a means of body fat regulation. Stress alleviation initiatives, therefore, may be an integral part of a body fat management program for some individuals.
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Will I need help when I come home? What about driving?
Many women find they need help with cooking and showering during the first week home. If there is no one to whom you can turn for such assistance, home help can usually be arranged through local councils with the aid of a doctor’s certificate. Driving is best avoided until you are fit enough to walk up stairs and move your body freely, which usually takes two to four weeks from the time of surgery.
I had a hysterectomy three weeks ago and still find I need to
take painkillers. Is this usual?
No, this sounds like there may be a problem whose diagnosis requires a medical check-up. Most healing takes place during the first two weeks after surgery so pain should have disappeared by this stage. Prolonged pain suggests there may be something amiss with the wound such as an infection, or an internal problem such as bleeding, blood clot formation, infection or adhesion formation.
When I come home after a myomectomy or hysterectomy what will I be able to do?
Most women find that they need to rest during the first week at home, gradually increasing their activities after this. Most doctors can provide examples of abdominal exercises which can help strengthen the abdomen and improve the flexibility of the scar once the wound heals (seven to ten days). Walking or light gardening is usually possible three to six weeks after surgery. Lifting will do no harm at this stage and a gradual increase in the weight and the amount of stretching involved is beneficial. Make sure that you bend your knees and keep your back upright when lifting objects. The common worry that activities such as lifting or stretching (for example to hang washing on a clothes-line) may weaken wounds or undo stitches is groundless.
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