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Archive for March 11th, 2009

I shall discuss a number of the so-called minor illnesses. Only rarely do they actually disable people. Only very exceptionally do they lead to death. But in my experience as a doctor, I have found that a tremendous amount of pain and emotional upset is caused by these conditions—most of it unnecessary. Almost all of them are either completely curable or can be greatly improved by medical or surgical help. But all too often people with headaches, sore feet, varicose veins, haemorrhoids (piles), constipation, and so on, suffer stoically for years because they feel that their doctors or the hospital clinics do not want to bother about such little things.

Believe me when I say that any doctor worthy of his medical degree is extremely interested in correcting or relieving these nuisance ailments. Doctors want individuals to seek expert advice about anything they consider unsightly—and not to try to hide it when it can be cured, or to experiment with unscientific, often dangerous, ‘cures’ or ‘aids.’ Doctors know that the nuisance ailments almost never limit themselves to marring the appearance. They may interfere with sleep, spoil appetites, and pave the way for local or general infections.

I know that many persons suffering from the nuisance ailments have forgotten what it is like to feel really well.

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In caring for a child with a contagious disease, you must protect others from catching it, including yourself, unless you know you are immune. Precautions vary in different diseases, and health department regulations also vary. In general, the following minimum precautions should be observed.

Precautions

Read Chapter 6 for further information about communicable diseases.

Keep the patient away from others for as long as your doctor says it is necessary. If you have other children, be particularly careful not to let them go into the sick child’s room. Because they were probably exposed to the disease while he was coming down with it, ask your doctor about protective shots.

Many diseases are spread by the saliva, so be sure to do the following: (1) Leave a smock or long apron in the patient’s room and slip it on over your clothes while you are with him. (2) Turn your face away when he coughs or sneezes. (3) Keep your hands away from your mouth. (4) Wash your hands thoroughly with soap and very hot water when you have finished attending to him.

Masks over mouth and nose should be worn only at the doctor’s request, since they may frighten sick children.

If the child is too sick to do so himself, place all used cleansing tissues in a paper bag that can be pinned to the side of his mattress, and then either burn the bag or shake the contents into the toilet. In most children’s diseases, the patient’s linens can be washed with those of the family in plenty of very hot water, and so can his dishes.

Special precautions are required for diphtheria, poliomyelitis, smallpox, typhoid fever, and dysentery, if you must care for someone with one of these diseases at home. Ask your doctor about them.

After the child is well, clean the room thoroughly and put the blankets, mattress, books, and other objects in the sun for a few hours. All badly soiled objects should be cleaned or destroyed.

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The most important thing for parents to remember is that jealousy is very painful, and that pain can have bad effects. Of course, you cannot prevent it entirely, and you certainly should not make children conceal it. But you can help your children to overcome it.

The first child is going to have to adjust to sharing the limelight. Make it as easy for him as you can, while respecting the rights of the second child. For example, it will not hurt the new baby if you refrain from talking about him constantly in front of his older brother or sister, and it certainly will not hurt him to show you love them both.

Let your children know that they are not alike and that you would not want them to be, because you love them just as they are. (This, incidentally, holds true for twins, too! I always advise parents of twins not to dress them alike.)

Love locked up in parents cannot do the child much good. Both fathers and mothers should show their love. As a doctor, I prescribe plenty of praise, encouragement, and affection. Also, set aside a few minutes or more every day that belong entirely to your child, not to duties and discipline.

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Many hospitals prefer to place their newly operated patients for a few hours (or less) in a room near the operating room, called the recovery room. Here a specially trained staff keeps close watch on the blood pressure, breathing, and general condition of the patients who are recovering from anaesthesia. Do not be alarmed if you find yourself in an oxygen tent or receiving fluid by means of a tube inserted into a blood vessel. Such techniques are widely used.

You and the doctors and nurses now have work to do to prevent complications. Modern surgery has made phenomenal advances in this area in the past few decades. Moving the legs helps prevent the formation of blood clots in the veins of the lower part of the body. These clots are dangerous because parts of them may break off and travel to the lungs where they can block a major blood vessel. Early ambulation, the practice of getting patients out of bed and having them walk even the first or second day after a major operation, helps prevent this and other complications. After most types of operations, it is necessary to breathe deeply and to cough. This helps expand collapsed portions of the lungs and wards off pneumonia.

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The term ‘gland’ is given to any part of the body that develops a secretion. There are two types of glands: the exocrine and the endocrine.

Exocrine glands are usually called glands of external secretion. Among them are the salivary glands that pour saliva into the mouth and the mammary glands that produce breast milk. Glands of this type secrete the digestive juices of the stomach and the bile of the liver.

While the glands of external secretion send their products through a duct, or tube, the secretions that endocrine glands produce go directly into the bloodstream. That is why they are also known as ductless glands. The substances these glands secrete are called hormones.

The islands of Langerhans in the pancreas

Many years ago, a scientist named Paul Langerhans studied small clusters of cells that formed what he called islands scattered throughout the pancreas, the flat organ situated below and behind the stomach. The main part of the pancreas produces juices that play a major part in the digestion of proteins and fats, while the islands control the body’s use of sugar by secreting the hormone called insulin. This hormone enables the body to use, or burn, sugar and starch after they have been converted into glucose by the digestive juices. The body has to utilize this glucose in order to provide heat and energy, and to help in the utilization of other foods. Any sugar the normal body does not immediately need is stored in the liver.

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