Measles is a highly contagious and potentially serious disease, most common in the 3-5 years age group. It sometimes affects older children and adults. It is spread from person to person by ‘droplet’ infection, usually by coughing or sneezing. If your child gets measles, he is infectious from a week before until a week after the rash appears.

Cause

Measles is caused by a type of virus called a paramyxovirus.

Clinical features

The incubation phase occurs 10-12 days prior to the onset of illness, and usually there are no signs of ill health. The earliest symptoms are rather like those of a heavy cold — a runny nose, sneezing, fever, conjunctivitis and a dry, often severe, cough. You may notice Koplik’s spots, tiny white marks on the inside of the cheek and at the back of the mouth, which are characteristic of measles.

A typical rash appears on the third or fourth day of the illness. It starts behind the ears and along the hairline, and consists of numerous small, red, irregular patches, which spread over the face and neck in the first 24 hours. These later extend to the body and limbs. The patches merge to give a blotchy, red appearance to the skin. At this stage of illness the fever may become very high. After 3-5 days, the rash starts to fade and the fever drops, which makes the child feel better. There may be some peeling of the skin. Occasionally there are complications of measles. These include secondary infections such as otitis media (ear infection), laryngitis, and pneumonia. These are usually bacterial, and respond well to antibiotics. A rare complication of measles is encephalitis.

Treatment

See your doctor if you suspect that your child has measles. There is no cure for measles, but keeping the fever under control and making sure that your child drinks plenty of fluids and gets lots of bed rest can lessen the severity of the symptoms. Keeps lights dim, if your child complains of sore eyes. Keep your child at home, to prevent spread of the disease to other children.

Prevention

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

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Dropping out: Some young people withdraw not only from school or life, but from sex. They feel unaccepted or undesirable, or their parents overtly or covertly convey a message of sex as unimportant or unacceptable. The young person then seeks all fulfillment outside of sexuality. As dangerous as focusing exclusively on sexuality, this type of adjustment is tolerated by schools and society. The person may look for meaning through cultism. He or she may become overinvolved in isolated activities such as working at the computer, watching television, playing video games or the recendy popular so-called adventure games that seem to become a substitute reality. Young people may look to a pseudoreligiosity, reborn before they have had their full chance to have been born at all. We often are on the alert for “hypersexuality” and promiscuousness, but we should be equally vigilant as parents for our tendency to keep our children delightfully benign Peter Pans, desexualized, alone, and afraid to reach out to others for pleasure and intimacy.

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I get this warm, full feeling. And then, when I come, I almost wet the bed. I used to think it was urine, but it isn’t. I feel it come out differently, sort of squeezing out in little spurts.

WIFE

Some women lose urine during sexual response. When you suspect this is the case, a complete urological examination is in order. Be sure to tell the doctor the exact circumstances under which you experience this loss of urine. If you cannot talk candidly with your doctor, you have the wrong doctor. Ask for a referral from your local medical school. If you masturbate, notice if urine seems to escape under that circumstance. If there is a medical reason for this loss of urine, a specific physiological cause, it is possible to correct it. Sometimes surgery will be required.

Remember, feelings of urinary urgency are related to emotional states as often as they are related to anything physical. Excitement, fear, anticipation, and anxiety can all cause upnary loss. Some loss of urine with orgasmic contraction is not unusual in women, for their orgasmic physiological contractions do not prevent loss of urine as happens in men.

In some cases, women do experience an emission of fluid through the urinary meatus, the opening to the urethra which transports the urine outside of the body. Data indicates that a very small number of women report this fluid during orgasm. The fluid is not ejaculate, urine, or vaginal lubrication, but seems to come from the Skene’s glands along the urethra.

Of the 1,000 women in the 1,000 marriages, 106 reported that they felt and saw some fluid released with orgasmic contractions. So, while women do not really ejaculate in the sense of forcefully emitting a fluid, some women do report what they feel to be an ejaculatory type feeling at orgasm. This seems particularly true in what I call Type II orgasms, the concern of myth number two.

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“Hurry!” screamed the wife. “My God, can’t you hurry?” They could not hear her screams, but the medical team could see her frantic gestures as they pushed the life-saving cart toward her husband’s hospital room.

The husband and wife had lived together for years. They had raised children, cats, assorted rodents, developed their careers, and now did daily battle in the wars of their children’s adolescence. They had faced many struggles and pressures, even tried to rekindle the failing sexual energy in their marriage, but they had never considered the possibility of a premature end to their life together.

“Oh God! Please hurry!” she yelled one more time before turning to scan the monitor at her husband’s bedside for any sign of life. She was praying for their marriage, just one more chance to be with him, to love and hold him. Perhaps too late, she had been startled into the realization that her marriage was the only thing that meant anything. The cards and flowers from friends and colleagues that filled the room seemed now to be reminders of the distractions that always seemed to dominate, to rob the time this husband and wife had for one another. And now, there would be no time left.

As if to shout down the hopeless, whistling drone of the monitor, she screamed at her unconscious husband. “Carl! Carl! They’re coming, darling. Hold on, damn you, hold on!”

The medical team resembled a group of urgently serious clowns trying to control their wagon of magic tricks. But now the wagon began to control them, just as this wife’s life had controlled her. The wife, doctors, nurses, other patients, and visitors all stopped to watch as the cart first wobbled, then smashed on its side on the tile floor, scattering its cargo.

After the crash, the hospital was silent. The wife felt more alone than ever before, too late in her prayers for a second chance to love, really love, her husband and to love, really love, her marriage.

The stillness of despair and hopelessness was broken by a faint beeping sound. The wife’s eyes caught those of one of the nurses. In an unspoken language, these two strangers shared the hope that this crisis was transforming itself into a miracle.

The wife turned slowly toward the monitor, afraid that any sudden movement might frighten away the uncertain sign of life. She watched as the monitor first showed sharp, large curves followed by the steady peaks and valleys. Even her untrained eyes knew those blips indicated that life had returned to her husband. She stood motionless, chilled, as the screen of the monitor blurred through the tears in her eyes.

The wife was startled to awareness by the medical team now crowding toward her husband. The frantic work on the doctors and nurses seemed more cultural right than necessary intervention, a formal celebration of the fact that her husband’s heart and their marriage had been scared back to life by the crash of the cart. Her husband would survive in spite of, perhaps because of, this strange turn of events.

Stop. Before you read further about this couple’s second chance at marriage, claim your own second chance for your marriage. Don’t wait until it’s too late. Go and get your spouse, call her or him at work, summon him or her from the lawn work, from cleaning the basement or repairing the faucet that will always leak anyway, and take his or her hand. Hold on now while you can, and ask each other these questions. “Why are we married? What are ‘we’ for anyway?” You got married, now how about really being married? Reread this little story about the couple in the hospital and talk about your own marital priority. Don’t wait. Start now. Plan to read and share this book together. I have seen hundreds of couples who have waited too long, who have missed their chance for a super marriage. Please don’t miss yours.

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Would you like to lose weight? It really is quite simple. All you do is eat properly — and that usually means eating less.

Obesity has reached epidemic proportions in the developed world while in the poorer countries many still die of starvation.

Obesity only occurs when the food eaten has a high joule value compared to the amount of fibre it contains.

Kilojoules do count. They are the measure of energy which the food contains.

With highly processed food, the bulk of fibre is removed. This applies mostly to the carbohydrates or starches and these foods become concentrated.

You are obese when your weight is 20 per cent or more greater than the ideal weight. This ideal weight for sex, height and age has been worked out by studying life insurance statistics. Those who are at an ideal weight for their height and age live longer than those who are above the ideal. And the greater the weight, the shorter the life span.

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The first sign that anything is wrong may be a pain in the calf when you hurry to catch the train.

The pain gets worse until you stop to rest. It tends to come back with the same amount of exertion. Slowly, you find the pain comes more easily with shorter distances.

This is intermittent claudication, the name derived from the limp of the Roman Emperor Claudius.

Atheroma is the common type of arteriosclerosis or hardening of the arteries. Plaques of fatty material build up on the inner lining of the artery, much the same as rust builds up and blocks a water pipe.

This is the same process which occurs in the coronary arteries of the heart and can lead to angina or a heart attack.

When atheroma blocks the cerebral or brain arteries, a stroke can result.

In peripheral vascular disease, the arteries to the limbs, usually the legs, are affected. The narrowing or eventual blockage may involve the whole length of the artery but, more commonly, it is patchy and only segments are affected.

Atheroma becomes more common with increasing age but has been noted in the arteries of young men who have died as a result of accident and who were regarded as being in good health.

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If all the practitioners you see are medical doctors, they are ethically obliged to pass on all the information they have about you to the doctor of your choice. You would not need to undergo the same tests again if you changed doctors.

Don’t be shy about asking for other opinions. It is very important for you to find a practitioner with whom you feel confident and comfortable. Unfortunately, in this far from ideal world, it is not always possible. If you can’t find such a person, or if the treatment you want is only administered by a practitioner who is a poor communicator, you may have to use a third party to help. In this situation it would be especially important to take a medically knowledgeable friend or family member with you when you see the practitioner. Or you might have a general practitioner who communicates well with you who could serve as an ‘interpreter’. He or she can get all the information from your practitioner and pass it on to you in a way you can understand.

I will stress again— never allow yourself to be pressured into making a decision before you understand what is involved. You can always go away, think about it, discuss it with others and then come back with your decision. It is extremely rare for a situation to be so urgent that immediate decisions are necessary.

*10/40/1*

1. Electrodessication and curettage.

This method of treatment involves the application of an electric current of low voltage and high amperage. The heat produces cell death, and a spoon-shaped curette is then used to remove the dead tissue. This cauterization and curettage is performed sequentially until only normal tissue remains.

2. Cryotherapy.

This involves the application of an extremely cold material, such as liquid nitrogen ( — 196°C) or solid carbon dioxide (-79°C). Freezing of the tissue also produces cell death. Experience is required to assess the time needed to obtain sufficient depth of freezing to eradicate the tumour. Only superficial B.C.C.s, not nodular ones, are suitable for this form of treatment.

3. Surgery.

Sometimes excision and suturing, with or without skin grafting, may be necessary or preferable. However if the lesion is small, accessible and in certain specific regions, this is not normally required. It is the most suitable treatment, though, for recurrent tumours.

Other methods of treatment include Mobs Chemosurgery for difficult tumours, and radiotherapy for elderly people with tumours not overlying bone or cartilage and not exposed to wear and tear’.

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These are symptoms that do not appear until some time after the menopause, but which tend to get more noticeable and troublesome as the years go by:

• bladder problems, such as stress incontinence, and needing to empty the bladder frequently and without warning

• recurrent bacterial infections of the vagina and urethra (the passage through which urine is discharged)

• vaginal dryness

• pain during sexual intercourse

• generalised muscle aches and pains

• thinning skin and hair

• Bleeding and shrinking gums sometimes improve with HRT.

• Many women experience ill-defined muscle and joint pains around the time of the menopause, especially in their hands, wrists, elbows, knees, shoulders and lower back. These are often misdiagnosed as arthritis, and this particular type of joint pain usually improves with HRT. Women whose arthritis gets worse around the time of the menopause may find HRT brings some improvement.

• The causes of hair loss and brittle nails are not very well understood; these problems may be linked more to increasing age than to a fall in hormone levels.

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Interest in herbal and other alternative therapies (also called complementary therapies) has escalated in many industrialised countries since the 1970s. The reasons are complex but probably include an increasing scepticism about science, and a public that is less willing to accept the truth of statements by ‘experts’ including medical practitioners. Periodic national health surveys in Australia from 1977 to 1990 show progressive increases in the number of consultations with alternative therapists. At the same time numerous doctors and others involved in health care have highlighted problems with medical knowledge, for example the limited perspective which drives certain treatment approaches. Recognition that other perspectives may have something valuable to offer is evident among practitioners and trainees of mainstream Western medicine.

A recent survey in Britain showed that 80% of doctors want to include some form of alternative medicine in their practices; and a recent study of Australian fourth year medical students found that an overwhelming majority of 92% were keen to study alternative medicine as part of their degree. The students were most interested in meditation, nutritional medicine, acupuncture, naturopathy, Chinese herbal medicine, homeopathy, hypnosis and the ancient Indian treatment, ayurvedic.

A criticism commonly made about alternative therapies is the lack of solid scientific evidence about their effectiveness and safety, a problem compounded by the lack of quality control in the manufacture of some substances. These therapies have, for the most part, not been submitted to the sort of evaluation of efficacy (double-blind trial) required in recent decades for drugs used in orthodox medicine. While some alternative therapies have stood the test of time, having been used for centuries in some countries, careful long-term studies of risks and benefits tend to be lacking or only recently initiated. Ironically, while orthodox medicine is becoming more open to alternative approaches, alternative medicine is now being submitted to increased scientific scrutiny. As evidence of this, the manufacture of herbal medicines in Australia has been governed by an act of federal parliament since 1993 and the Australian government recently established a Traditional Medicine Evaluation Committee within the federal Department of Health.

Many of the alternative therapies share a common philosophy that life-giving energies and substances help maintain the human body in good health and balance. Ill-health is regarded as the result of a loss of balance caused by a sub-optimal lifestyle or an accumulation of toxic substances, including the products of infectious disease. To correct disturbances to the body’s balance, or to maintain the existing equilibrium, the alternative therapies adopt a holistic treatment approach that emphasises the patient rather than a problem organism or toxin. The focus is on an individual’s ability to overcome disease with the help of substances that clean and strengthen the body, rather than on the disease-destroying abilities of particular pharmaceuticals.

It is sometimes assumed that because herbal products and nutritional supplements are of natural origins they are therefore free from serious ill-effects. Unfortunately this is not always so. All herbal and nutritional supplements should be used cautiously and monitored regularly by a skilled practitioner, because adverse effects can occur—just as they can with orthodox medicines.

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