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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Overweight people with big abdomens are in much worse health than are equally obese people whose fat is distributed around the hips and limbs, Medical World News (26#3:74) reports.
In people who are equally overweight, abdominal obesity carries about five times as much risk of heart attack and stroke as does fat deposited elsewhere. Fat in the abdomen, apparently, is much more “active”, so far as the body’s chemistry is concerned, than fat elsewhere. It is associated with elevation of the blood cholesterol levels, sluggishness of fat disposal by the liver, and impairment of insulin secretion in response to sugary meals.
The easiest way to determine a fat person’s degree of risk from this type of obesity, according to the News, is to measure the circumferences both the waist and hips. When the waist-to-hips ratio is above 1.0 in men, or above 0.8 in women, the risk of heart attack and stroke is five to 10 times greater than normal.
Men, it has been found, are more prone than women to abdominal obesity, even though in general, they are less likely to be overweight. Beer drinkers had better beware.
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Emergency symptoms: Choking; inability to breathe or cry
Emergency treatment: Call police or paramedic squad.
Symptoms: Gagging; pain in throat or chest; difficulty swallowing; abdominal pain; vomiting
Home care:
A small, smooth object that the child has swallowed should pass out of the body in the stool without treatment; examine the stools until the object is passed.
In the case of a larger object, examine each stool to see if the object has been passed. If it does not appear within one week, notify the doctor.
- Do not give the child a laxative in an effort to speed passage of a swallowed object.
- No medication or other agent is available to speed up or make safer the passage of a swallowed object through the system.
- An object lodged in the oesophagus must be removed promptly, preferably by a doctor.
- Any object that has not left the body within one week should be reported to the doctor.
Over 95 percent of the cent-size foreign objects that are swallowed by children cause no trouble and pass from the body in the child’s stool. However, objects that are larger may become lodged in the oesophagus (the tube through which food passes on its way to the stomach). Sharp objects (pins, needles, bones, matchsticks, nails, glass splinters) may lodge in the tonsils, throat, or oesophagus. Objects longer than a toothpick may not be able to pass out of the stomach and may have to be removed surgically.
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What is it?
A reddening, blistering and eventual burning of the skin when exposed to sunshine. Sunshine can also predispose to the formation of certain skin cancers.
What causes it?
Most westerners perceive that they look better if their skin is brown rather than pale. This leads many millions purposefully to expose themselves to sunshine, usually when on holiday in warm, sunny climates.
The sun continually bombards the earth with all kinds of radiation. Direct exposure to the whole spectrum would be fatal but the earth has a protective layer called the ozone layer which encircles the globe at high altitude. This layer lets through only the relatively harmless long-wave radiation (UVA) and a little of the short-wave type (UVB) which is more dangerous. It is UVB that is the main culprit in sunburn, skin ageing and skin cancers caused by sunlight. Clouds further cut out a lot of the less harmful UVA waves but let through as much as 80 per cent of the UVBs that have got this far. This makes hazy and overcast days just as dangerous as sunny days.
Certain drugs can sensitize people to the sun. All the following make people burn more easily: antibiotics such as tetracycline; diuretics; oral contraceptives; some anti-histamines and tranquillizers; and certain heart medications. Even some perfumes and aftershaves can do this.
Exposure to the sun triggers a chemical reaction to produce a pigment called melanin in the skin.
Melanin absorbs UVBs, and the more the skin is exposed to sunshine the more melanin is produced and the better the protection from the harmful effects of UVBs. Dark-skinned ‘white’ people and, of course, brown-skinned people, have more melanin in their skin anyway and so tan with less sunburn. No tan offers total protection from the sun though. Recent research has found that sun can weaken the body’s immune systems. A group of fair-skinned people were exposed to artificial sunlight for half an hour daily over a two-week period. Tests showed a weakening of the immune system, including a slight reduction in white-blood-cell numbers. In some people these changes remained for up to two weeks after the exposure to the sunlight.
Prevention
The secret of sunburn is to prevent it. Here’s how:
• It takes several days to get used to the sun, so start slowly. Expose yourself for only two half-hour periods a day over the first few days. Increase this exposure as the days go by. Take it especially gently if you are a blonde or a redhead.
• Drink plenty of fluids (not alcoholic).
• Remember that sea-water makes you burn faster.
• Use an effective sunscreen lotion. Most suntan lotions don’t protect you from the burning rays of the sun at all-they are simply fluids that help you ‘cook’. A protective sunscreen will contain a B-complex vitamin called para-amino-benzoic acid (PABA). Tests have found this to be by far the most effective protection against ultraviolet light. PABA still lets some of the UVBs through so you still get a tan, but you don’t burn. It is vital to keep topping up the sunscreen preparation throughout the day because it washes off in water. Experiments with rats found that feeding them vitamins E and Ñ built up a substantial resistance to the burning effects of ultraviolet light but this has not yet been confirmed in humans.
• Remember that water, concrete and sand reflect sun that can burn you badly and quickly.
• The sun is at its most dangerous between the hours of 11a.m. and 3 p.m. so avoid these times, at least at first.
• Wear a hat when you go sightseeing. The hours pass quickly and you can get a lot of sun without realizing it.
• Wear good-quality sunglasses. US ophthalmologists are concerned because they are seeing increasing numbers of people with a condition called macular degeneration. Some believe that this is directly related to sun exposure. It used to be seen only in the elderly but now is occurring in people in their thirties and forties. Experts think that, to be safe, you should wear sunglasses if you are in the sun for more than thirty minutes, and that sun-bathers should not expose their eyes to strong sun for more than fifteen minutes. Polaroid lenses keep out the glare but do not necessarily contain UV filters, and some experts maintain that wearing dark glasses that do not filter out U V light can actually be more dangerous than wearing none at all.
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