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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Symptoms: low-grade fever; loss of appetite; headache; swelling of the salivary glands.

Home care:

The child with mumps needs rest. Give aspirin or paracetamol for pain and fever.

Do not give the child spicy foods.

Isolate the child from other family members.

Precautions

-    Make sure that your child is vaccinated against mumps.

-    One attack of mumps provides lifelong immunity. If the child has had mumps, but develops symptoms similar to those of mumps, the problem is some other disease of the salivary glands. Report the problem to the doctor.

-    If mumps involves the ovaries or pancreas, the child will have abdominal pain. If the testes are involved, the testes will be swollen and tender.

-    If a child who has not been vaccinated is exposed to mumps, he or she can receive the vaccine shortly after exposure to the disease to prevent becoming ill with mumps.

Mumps is a moderately contagious infection caused by a specific virus which involves the salivary glands. It is contracted by contact with the saliva of an infected person. The incubation period – the time it takes for symptoms to develop once the child has been exposed to the virus – for mumps is 14 to 21 days, and the disease can be passed on any time from two or more days before symptoms appear until all symptoms have gone. One attack provides lifelong immunity; if a child has had mumps and subsequently develops similar symptoms, the problem is not mumps but some other disease of the salivary gland.

Complications of mumps include meningitis, encephalitis, permanent deafness, and orchitis (inflammation of the male sex glands called the testes). The disease may also involve the ovaries, the female sex glands, or cause an infection of the pancreas.

A vaccine is available to prevent mumps. It is usually given in combination with measles and rubella (German measles) vaccines during the child’s second year at around 15 months of age. This vaccine is 95 percent effective in preventing mumps.

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•    Simply slowing down the pace of one’s life can help prevent hypertension. According to one US expert, people who talk fast tend to have high blood pressure. ‘Such people don’t put commas into their sentences’ he claims. As a result they breathe poorly and this also contributes to their high blood pressure. This researcher uses a piece of equipment that can measure blood pressure very accurately during talking and other routine social interactions. He found that virtually everyone’s blood pressure goes up (by about 10-15 per cent) when speaking. Hypertensives, however, are more reactive-the higher a person’s blood pressure when quiet, the more it goes up when speaking. This statement is based on a study of 2,000 people from the cradle to old age. The researcher teaches people to speak more slowly and to put commas back into their sentences. Just using this method alone he has had formidable success in curing hypertension without drugs.

•    Take your blood pressure every day. It used to be thought that people taking their own blood pressure would be made anxious or neurotic about it but twenty years of clinical experience shows that this is not the case. Rather, research has found that people get reassurance from measuring their own blood pressure. This may account, at least in part, for the positive results achieved by people monitoring their own levels.

A study in Seattle asked sixty hypertensive people to measure their own blood pressure at home twice a day for a month. At the end of the month there were significant reductions in blood pressure (10 points or more) in 43 per cent of the sixty. Clearly the actual taking of the blood pressure had acted as a sort of simple biofeedback mechanism.

•    Getting a pet appears also to help with high blood pressure-even a tank full of fish can be beneficial! A researcher at the University of Pennsylvania thinks that ‘companion animals in particular provide an access to intimacy’. You talk to your pet more slowly, you smile a great deal, your voice becomes gentle and the cadence of the speech changes. It is a much more relaxed dialogue, characterized by a combination of touching and talking! Pets exert a calming effect through the day. He found that the presence of pets reduced their owner’s blood pressure by 10-15 per cent. Anything that turns your attention outwards to the natural environment around you is a powerful way of controlling tension.

•    Eat onions and garlic. The Bulgarian Academy of Sciences in Sofia tested extracts of garlic on forty-six hypertensives. Most showed a drop in blood pressure of about 20 points as well as a decrease in physical symptoms. Onions are now known to contain prostaglandins, natural hormone-like substances that lower blood pressure.

•    A recent study at the Oregon Health Sciences University has found that there is a link between calcium and high blood pressure. A study of computerized records of 10,000 people in the US aged between 18 and 74 found that there was a direct link between the amount of calcium they ate and their likelihood of suffering from hypertension. People suffering from the disease were on average eating between 18 and 22 per cent less calcium than those with normal blood pressures. Conversely, those who had a high calcium intake had low blood pressure. Clearly much more research needs to be done on this. In any event, the finding does not mean that we should all go out and drink large amounts of milk (which contains calcium), as milk (whole milk at least-skimmed milk is better) contains unwelcome levels of fat.

The role of calcium in blood pressure is complicated and not yet totally worked out, but there is now considerable interest in calcium-antagonist drugs. Epidemiological evidence suggests that there is a link between low dietary calcium and high blood pressure as we have seen, but large trials have yet to be carried out. Some studies giving one gram of calcium to people with normal blood pressure have shown a substantial lowering of blood pressure. There is epidemiological evidence linking high blood pressure in pregnancy with calcium deficiency.

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