It is important to differentiate breath-holding episodes from actual seizures. Normally this can be done on the basis of a careful history, but the doctor may want to order an EEG (electroencephalogram) in order to be certain.

Treatment

There is no specific treatment for breath-holding episodes. Parents should try to stay calm during the episode. Make sure the child is in a safe position where he cannot roll off the bed or fall off a chair. Do not slap the child or splash water onto his face. Breath-holding episodes never cause any lasting harm to the child, and always disappear as he grows older. The main intervention is to reassure the parents, for whom these episodes are as frightening as a convulsion.

When to see your doctor

Some parents will be confident enough to take these episodes in their stride; others will want a medical check-up to ensure that there is no underlying medical condition. You should not hesitate to see your doctor if you are concerned, even though there is no treatment that can be recommended.

Prevention

Little can be done to prevent breath-holding attacks. While in theory it might be possible to minimise frustration for the child, in practice, of course, this is impossible. Do not change your parenting style radically in the hope of preventing these attacks from occurring.

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‘ ‘He opened the door right on his own face,” she said, laughing. “He came around the car in tuxedo and all, opened the car door, and almost knocked himself out.”

“I can beat that,” added the husband. “I got up after the movie, and my leg was asleep. I mean, really out, like it had been amputated. I dragged it up the aisle with me. She never looked back. I tried to stomp it back to life, and she looked away. I was dying of embarrassment.”

*86\97\8*

Although this aspect is not related only to anxiety disorders, it can be the single most important issue in the disorders. Despite our ongoing attacks and anxiety, it can be the one issue we are most concerned about. It is as if we intuitively know the root cause of our suffering.

The lack of identification goes beyond our cry of ‘this is not me’. When we say ‘this is not me’ we are referring to the image we had before the disorder. Despite the image we had of ourselves, we have always known that we never felt any sense of who we are. We never had a real sense of self. This essential element was always lacking in our lives, and it is from this that our feelings of inadequacy, lack of confidence and lack of self-esteem arose.

We counteracted these by our need to be perfect. Over the years we adapted and modified our behaviour to what we perceived were other people’s expectations of us. We became who we thought we should be, and in doing so suppressed much of who we could be. Our identity became dependent on other people’s perceptions of us. The more dependent we became, the more we had to suppress our real self, even if we didn’t realise we were doing it. The more we suppressed our self, the more inadequate we felt. The more inadequate we felt, the more we felt the need to be perfect.

*100\94\8*

Let’s start with an example. Say a person agreed to removal of part of the lower bowel, on the understanding that this would give him a good chance of being cured of bowel cancer altogether. At the operation, his surgeon finds something that was not known before the operation—the cancer has grown through the bowel wall and into the wall of the bladder. The cancer cannot be completely removed without removing part of the bladder as well. Even if this is done, the chance of cure is much smaller than was advised beforehand. This surgeon has two choices. He or she can take the decision away from the patient by going ahead immediately with whatever operation seems best. This is what most surgeons do. Or the surgeon could simply sew the patient up again and discuss the new situation with him when he wakes up. Clearly this wouldn’t be good for the sick person, who would then have to consider having another operation within a very short time. It also wouldn’t be good for the surgeon. The average surgeon is much too concerned with maintaining his or her power and authority over the patient to even consider such a course of action. Doing this would mean admitting lack of care in planning the operation. More importantly, it would also mean acknowledging that the person having the operation was indeed the best person to make the decision.

*225/40/1*

And don’t forget that your dog may have even more trouble coping.

We sweat or perspire (whatever your preference) most of the time but this is invisible. It becomes obvious only when excessive.

Some people sweat more than others and this can be embarrassing and unpleasant.

Although hot weather increases the amount of perspiration, it allows you to wear lighter clothes and footwear.

In humid weather, evaporation of sweat is impaired and so the body may be bathed in this fluid. Tight clothing can irritate the skin and lead to the condition known as prickly heat or Miliaria rubra.

Some skins are more sensitive than others. Wearing loose, light clothing and bathing frequently in cool or cold water, without soap, may be all that is necessary to prevent or treat this condition. Drying the skin thoroughly will prevent chafing and applying talcum powder will also help.

*413/71/1*

In these times, when a woman may have several different doctors treating her for illness of different parts of the body, each may not be aware of what the others are prescribing.

Doctors should always ask patients what drugs they are taking but some people are so used to taking some preparations, such as the Pill, that they no longer consider it a drug and may neglect to mention it, even when directly asked.

Being aware of the dangers of interaction of drugs should make patients more aware of their responsibilities.

Natural contraception, which makes use of modern scientific methods to determine when ovulation takes place, may become more popular. These methods are widely used, especially among Catholics who have a moral objection to artificial methods of contraception.

Of course, this means a certain amount of self-denial for the couple but, for those worried about the dangers of other methods, it is a small price to pay.

*159/71/1*

The use of cosmetics is universal and prodigious, and the number used increases every year. Increasingly men too are being attracted by subtle advertisements suggesting means of improving their appearance—lured perhaps by the implied promises of sexual and material rewards.

People have been looking for the fountain of youth since time immemorial, and the emphasis on youth has never been greater than in today’s leisure and youth oriented society. Because ageing causes such visible changes in the skin, many men and women would like to delay or reverse these changes. Although many products on the market claim to do just this, unfortunately none has ever lived up to its claims. Some of these so-called rejuvenating creams contain Allantoin, Plankton and embryo or placental extracts. The particles of these extracts are too large to penetrate the skin, and so can have no effect on the skin. Others contain unibiogen’ from the butterfly cocoon. This is advertised as a ’skin food or fertilizer which jolts tired cells back into their plump youthful state’. Aloe Vera, the juice of the aloe plant leaf which contains 99-5 per cent water and 0,5 per cent of various amino acids and carbohydrate, is also touted as a rejuvenating cream. As already mentioned, none of these appear to have the kind of effect that would iend any support to their therapeutic claims. Mink and turtle oil, marketed as superior to other oils in cosmetic preparations, owe their dubious reputations respectively to the expense and beauty of mink pelts and the longevity of the turtle.

*9\44\4*

Why do people get heart disease? Atherosclerotic heart disease develops early in life when the many factors that cause it have a strong influence. Over many decades doctors and scientists have identified the processes in fine detail and now most of the factors which cause heart disease are well known. Theoretically this type of heart disease might be largely prevented if everyone’s risks were assessed in youth and if all the right things were done throughout the rest of their lives. In practice there has been only a limited development of the ways to screen people for risk early in life, and the resources needed to achieve prevention are just not available. However a great deal is already being done to identify risk factors in healthy people and those with established heart disease. Those who take the necessary action reduce their risk.

*139\33\4*

Skinfold measures. Skinfold calipers, discussed above, can be used as a measure of fat distribution as well as a total fat measure with specific body sites (such as subscapular) being used for relative measures of fat loss.

*64\186\4*

It is much less common than in times past and is more likely where housing difficulties occur; poverty, overcrowding and domestic difficulties seem to predispose to it.

It seems to attack children in the 5-15 year age group. It is rare before this and rare afterwards.

In acute cases, the child runs a fever and feels ill. Pain starts commonly in a large joint, such as the knee, ankle, elbow or wrist. It may become hot and swollen. After a few days the pain and swelling may leave that joint and spread to another one. Sometimes there is a rash. Occasionally, small swollen lumps appear over the elbows or wrists or at the base of the skull.

The heart is frequently involved. As the fever continues, the heart starts beating at a much faster rate than normally. Prompt medical attention is essential.

Some children, especially girls, may develop odd, irregular, muscular movements along with the joint pains. This is called chorea, or St Vitus’s dance. Often the child becomes emotionally upset and unstable, fidgets and is clumsy in movements. Strange movements of the limbs and weird facial twitchings and face pulling occur. These are entirely out of the child’s control. In mild cases, they may seem to be a bit like habit spasms, but in severe forms they can be marked and widespread.

Most cases of acute rheumatic fever are preceded by a simple throat infection by the germ called the beta-haemolytic streptococcus, and the strange joint symptoms may commence from one to three weeks later. The odd movements of chorea may start at any time from three to 15 weeks after the initial infection.

Sometimes acute attacks of rheumatic fever will continue in a silent manner, leading on to a condition called chronic rheumatic fever. This means the heart is definitely involved, and scarring of the heart muscle or the valves has taken place. The doctor usually finds special tell-tale signs that indicate this has occurred.

Treatment

Many doctors believe that prevention is better than cure, for many infected throats can herald this disorder. Prompt medical treatment by the doctor for sore throats in children may prevent onset of the disease, and parents should always be alert to complaints from their children. They should also make certain that medication prescribed is taken for the full course, and not merely for a few days until the throat seems a bit better.

Common sense in making certain the child has a good nutritious diet is essential. Making every effort to keep a reasonable standard of living will at least reduce the chances of contracting infections in the first place.

The doctor will work out a programme of treatment and it is essential it be followed. For acute cases, bed-rest, the salicylates, antibiotics and sometimes the steroid drugs are prescribed. A good diet is essential, and emotional back-up for the child always useful.

*88\87\2*