Poliomyelitis is a serious viral infection, which is rarely seen now in Australia, thanks to a widely successful immunisation program.

Cause

The poliomyelitis virus is spread via coughing or sneezing, or by handling infected stools.

Clinical features

The incubation period for polio can be from 3 days to 3 weeks. Initially the child may have symptoms similar to those of a heavy cold or flu, with fever, headache and generalised aches and pains. In severe cases this progresses and the nerves are affected, causing paralysis of certain muscles, which is usually permanent. Muscles commonly affected are those of the limbs, or those used for breathing.

When to see your doctor

See your doctor if your child has any of the symptoms described above.

Treatment

Any child suspected of having polio should be seen by a doctor and admitted to hospital if there are any signs of paralysis. If your child has not been immunised against polio for any reason, make sure you let your doctor know.

Prevention

All children should be immunised against polio. Because the condition is now so rare (due to successful immunisation program), many parents have become complacent about immunisation. Make sure that your child is fully immunised.

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Deference: A young person who seems to defer not only to parents,: but peers and everyone else, is showing the danger sign of low sexual self-esteem. Make no mistake about it. Self-esteem is sexual esteem, and to ignore that dimension of development while trying! to provide more education, more experiences, more special train’ ing or therapy, will never completely overcome a self-esteem prob-| lem. There is no escaping the fact that sex and love education is al fundamental part of self-development, the development of the! child’s reputation with himself or herself.

Developmental Retardation: Much has been written about learning disabilities and other developmental problems. Unfortunately, little is written about the sexual dimension of such problems. And impact as well as a cause of some developmental problems is deprivation of sex and love education, on the part of the child and/ or the parents. When we begin to “work” on our children, to correct them, therapize them, drug them to slow down or drug them to speed up, to tutor them, test them, and place them, we sometimes forget their needs for sexual education. I have spoken for years throughout North America on the topic of sex and the impaired child. I have learned one important rule: the more the impairment, the more the need for touching, holding, and closeness and for information about sex.

Marriages who raise impaired children have their own unique stresses and joys. It is an extra challenge to remember and find time to provide good sex education when providing life experiences and education itself can demand so much energy. Parents of impaired children sometimes struggle to find enough time, even any time, for their own sexual lives, let alone find time for sex education. It is important to find this time, even at the expense of other opportunities for the child, for his or her sexual life is at the apex of overcoming and/or coping with these special disadvantages.

I have found that the questions asked of me by some of these child òåï are the best, most basic sex-education questions of all. I have included their questions here, with my brief answers, so you may see how important sex is to them, and how important those “ÂÀßÓÅ” facts really are, and how the most basic of questions can teach us all about sexuality. The questions from teenagers and their parens ts were different from the following questions only in complexity of expression, not intensity of the need to know. Try to answer each question as a marriage before reading my answer. Try to relate each question to your own life, even if the questions come from children with developmental problems. There is a wisdom and a lesson in the simplicity and honesty of these children’s won-deringgs about sexuality.

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Researcher Helen Singer Kaplan writes that lack of orgasm during intercourse “may represent a normal variant of female sexuality. ” If focus is exclusively on orgasm rather than psychasm, one would be hard pressed to understand why intercourse is so popular I with women other than for closeness and intimacy. Of the 1,000 women, 823 reported psychasms in intercourse at five-year follow-up. “Once I learned the difference and stopped working for just something in my genitals, I started to really have orgasms, I mean psychasms.” This wife’s report was typical of those women who learned, as did their husbands, that orgasm and psychasm are dif- I ferent. Brain-wave patterns change during psychasm, and even I Masters and Johnson, the third-perspective researchers, state that “the mind turns inward to enjoy the personal experience.”

The early perspectives of sex research mistook physiology for psychology. Masters and Johnson write, “The subjective experience of orgasm in men starts quite consistently with the sensation of deep warmth or pressure that corresponds to ejaculatory inevitability.” In women, Masters and Johnson report the subjective aspects of “orgasm” as a “pleasurable feeling that usually begins in the clitoris and rapidly spreads throughout the pelvis.” The women in the thousand marriages reported such sensations as “an altered state of consciousness,” “being free from everything,” “sort of merging, actually being my husband,” and being “lost, tripped out, gone but more here than ever.”

Contractions in the pelvic area accompany orgasm in both genders. Both male and female experience the anal sphincter contractions. There is a physiological phase of being “on the brink,” of being about to experience pelvic contractions. Masters and Johnson saw women as not experiencing a sexual “brink.” They write, “Women do not have a consistendy identifiable point of orgasmic inevitability.” The women in my couples group did in fact report the sensation of a “brink,” and inevitability of physical orgasm. Four hundred twenty-two of them reported this phenomenon “always,” and a total of 644 wives reported this brink sometimes.

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If it’s candles and music instead of tuna fish and potato chips on paper plates, it probably means there will be some sex that night. We like to keep up the national average, you know. Do our share for the sex revolution and the age of enlightenment. Two and one half times per week, rain or shine. Well, a little more often when it rains, because we can’t work outside.

HUSBAND

Super Marital Sex Rule: Super marital sex depends on sexualizing the entire marriage, not separating sex into a category of obligatory marital duty, afterthought, or a different “part” of the marriage. The “super” in super marital sex refers to “whole,” to making intimacy a way of living and being together, not something you do sometimes. There are more spouses having affairs within their marriage than outside of them, separating marital sex from marital love, resulting in a form of “extramarital” sex rather than an “intra-marital intimacy.”

Extramarital sex has traditionally been viewed as adultery, marriage partners having sex with a person other than their spouse. It has received good press and is statistically quite popular. More than 70 percent of husbands and 40 percent of women report sex outside their marriage. In my sample of 1,000, the number was 76 percent of the men and 47 percent of the women. Extramarital sex is variously described as forbidden, sinful, destructive, .dishonest, and dangerous by some persons and by others as constructive, evolu-tionarily natural, energizing, fun, and somehow, if done “right,” preventive of divorce and marital problems by providing “outside” stimulation.

In the thousand couples, the 760 men and 470 women who reported sex outside of their marriage were always in a marital relationship in which at least one of the partners was less than satisfied with the intimacy of the marriage. There was no evidence in my sample, and there is no evidence in anyone else’s data, that extramarital sex enhances marital sex. My work with couples indicates that at the very least, extramarital sex is distracting from the effort and time necessary to develop and enjoy super marital sex.

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Mothers feed their children not only for them to live and grow but also as a sign of love. Sometimes they overfeed a child to satisfy some neurotic need of their own, and this may lead the person later on to seek satisfaction in eating for other needs besides hunger.

Being overweight is unhealthy at any age. Obesity can lead to an early death. Coronary artery disease, high blood pressure, diabetes, gallstones and osteoarthritis are all associated with being overweight. How does one go about losing weight? What I said at the beginning is true. Eat and drink less.

Crash diets are of little use. Many people do lose weight at the start, but within weeks or months are right back where they started.

A good reducing diet should contain around 3200 kj to 5000 kj a day. The diet should be balanced and have an adequate intake of vitamins and the essential food factors. It should be low in carbohydrate, high in bulk and moderate in fat and protein.

Carbohydrate is easily converted to fat in the body. Fat on the other hand, while it is high in kilojoules, is more slowly absorbed and cleared from the blood. It is therefore more satisfying than carbohydrate and you may not feel hungry for hours after a high fat meal. Protein is difficult for the body to convert to fat and burns up energy in doing so.

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If the narrowing occurs slowly, it may stimulate the smaller and little-used blood vessels to dilate and carry a larger supply of blood than the narrowed main channel. These are known as collateral blood vessels.

Impairment of blood supply is known as ischaemia. The ischaemic lower limb may develop coldness, numbness or pins and needles. Intermittent claudication is the major sign.

When the affected leg is raised, it becomes paler as the blood drains out of it, yet, when hung down, it flushes with blood, looks red and may feel temporarily hot.

If the circulation to the skin is affected, it is more serious and may show itself with ulcers on the feet and legs or with rest pain that typically, comes on in bed when the legs are warm. It is a severe, burning type and may be relieved by hanging the foot down out of the side of the bed.

Total blockage of the blood supply to the leg or a portion of it may result in gangrene where there is death of tissue.

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The moment a practitioner gives information to a third person without your permission he or she is no longer treating you as a responsible adult person. This is wrong. If you allow a practitioner to do this, you are putting yourself into a helpless, dependent position and giving up responsibility for yourself. It might seem the easiest way out but, believe me, it’s not in the long run. ,”,ù

You may know that your practitioner has already had discussions with friends or relatives in your absence. They are probably doing this in a well-meaning but misguided attempt to ‘protect’ you. Unfortunately the reality remains regardless of whether or not you know about it. Hiding the truth from you won’t make it go away—it will just make the whole situation harder for you to grapple with.

fe$ guarantee that if you are in this situation your imagination is running wild: ‘It must be really terrible if they can’t tell me.’ I say again—your imagination will usually come up with something much worse than the truth. If you insist on being told, you are likely to get a new lease of life. You will be able to direct your energies positively into battling with a real, rather than an imaginary, situation. You will be able to share your fears and concerns freely with your loved ones. Your friends or relatives who have been given the information will feel great relief when the heavy burden is lifted from their shoulders. They also will then be able to direct their energy much more positively.

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The S.C.C Is a tumour arising from the prickle cells of the epidermis which lie above the basal layer. This form of cancer easily Invades the dermis, and may on occasions spread to local lymph glands or more widely through the blood stream.

Causes. S.C.C.s are much more prevalent on sun-damaged skin. They may however arise following prolonged exposure to chemical carcinogens such as tar, lubricating oils, creosote and soot. Occasionally they arise at the site of an old Injury, such as a burn or leg ulcer. The taking of arsenic for medical purposes, many years previously, will predispose one to developing a S.C.C. The majority of these cancers are due to the cumulative effect of solar damage in genetically predisposed people, and occur on sun-exposed areas. The incidence is high amongst outdoor workers—especially those with fair or freckled complexions—living in countries like Australia, South Africa, or in the American State of California. (The incidence is 15 times less in blacks than in whites of the same area.

Features. A S.C.C. rarely arises in healthy-looking skin. They usually appear against a background of blotchy pigmentation, alternate thickening and thinning of the skin, and wrinkling. Frequently, they occur within a longstanding solar keratosis. The most common sites are the backs of the hands, the arms and the facial area.

The earliest sign of a S.C.C. is often a firm thickening of the skin, usually at the base of a solar keratosis. More frequently, however, the earliest sign is a warty growth, or a small ulcer, with a rolled solid border. Initially the ulcer is not obvious because of a firmly adhering crust, which bleeds when it is knocked off. The lower lip is a favourite site for these S.C.C.s. Here a S.C.C. may be preceded by a white flat patch, known as leukoplakia, or dry, scaly, cracked lips. It may begin as a persistent fissure or crack, which becomes hard and ulcerated, or as a warty or fleshy, red growth.

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Disease of the arteries is the Number One cause of death in women over 50. Whether the cause is heart attack or stroke, arterial disease kills one woman in every four.

The arteries carry blood from the heart all round the body, and so it is important for our health that they remain in good condition. If they become narrowed, or clogged up, then the blood can’t flow so freely, and there is a much increased chance that the flow will suddenly become completely restricted, causing a heart attack or a stroke.

Some of the factors that contribute to heart disease are outside our control, such as the natural ageing process, and the hereditary aspect of heart disease; other risk factors we can do something about, by giving up smoking, not drinking too much alcohol, taking enough exercise, eating the right diet and learning how to handle stress.

One of the factors that increases the risk of developing diseases of the arteries is being male; until the age of 40-50, far more men than women die of heart disease. In fact, it is unusual for otherwise healthy pre-menopausal women to have heart attacks, whereas, sadly, it is not unusual for men in this age group to do so. The reason is thought to be the protective effect of a woman’s oestrogen. Once a woman is past the menopause (whether natural or surgical) her risk of having a heart attack increases, until by the age of 75-80 she has the same risk as men.

The reason for this is possibly to do with cholesterol. There are two forms of cholesterol flowing through the blood vessels: low density lipoproteins (LDLs) which build up on the walls of the blood vessels and are ‘bad for you’, and high density lipoproteins (HDLs) which are ‘good for you’ because they latch on to the LDLs and absorb them through the artery walls to be disposed of by other organs in the body. Many years of research have shown that oestrogen lowers the level of LDLs and raises the level of HDLs. As high levels of LDLs increase the risk of arterial disease (by blocking the arteries), and high levels of HDLs are good for you (because they remove the LDLs), oestrogen has a very positive protective effect.

Also, at times of increasing age, when the major arteries of the body are narrowing, HRT is thought to widen them and so allow blood to flow more freely. In fact, women on HRT tend to have healthier arteries than those not on it; even women of 70 or more can benefit from this protective effect of HRT.

As you will read in Chapter 8, there is a small but increased risk of developing breast cancer after several years on HRT, a fact that has received a lot of publicity. However, heart disease and stroke are the largest single cause of death among women in this country, completely dwarfing the number of deaths from breast cancer. The average reader of this book over the age of 50 is many times more likely to die from heart disease or stroke than from breast cancer (although under the age of 50 the risk of breast cancer is greater). A great deal of research has been carried out in recent years into HRT’s effect on menopausal symptoms and osteoporosis, but much less into its effect on arterial disease. This balance is beginning to change, and over the next few years more will become known about the effect different hormones have on heart disease and stroke. Although HRT was originally prescribed primarily to treat hot flushes, etc, and more recently also to prevent osteoporosis, it is likely that in future years it will be prescribed mainly for its role in reducing the risk of heart disease and stroke. Even now, it is thought that women who take oestrogen have one-third to one-half the risk of developing these two conditions than women who don’t.

(It is worth noting here that almost all the studies that show the beneficial effect of oestrogen on arterial disease have been carried out on women taking oestrogen alone, and not oestrogen with progestogen, although recent work suggests that progestogen may not detract from oestrogen’s cardiovascular protection; there have not yet, however, been any results based on long-term data.

To gain significant protective effect against arterial disease, you may need to stay on HRT for two years or so, preferably longer, and the effect will diminish once you stop. Even then, the oestrogen only reduces your risk of developing these diseases, it cannot guarantee that you won’t get them. We are not immortal!

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Despite a considerable amount of energy, ingenuity and research in recent years, the cause of endometriosis remains shrouded in mystery. This has undoubtedly slowed progress in developing effective treatments.

Drugs such as danazol, progestogens and GnRH agonists are capable of shrinking endometriosis tissue. They work by blocking the action of oestrogen which seems to be an essential ingredient in endometriosis growth. While these drug therapies are not capable of eliminating severe endometriosis, they are often used in the lead-up to surgical, electrical or laser treatment in the hope of making the removal of endometriosis tissue safer and more effective. Many doctors prefer not to prescribe danazol, progestogens at low dose, or GnRH agonists for longer than six months because of side-effects such as weight gain, breast tenderness, depression, nausea and hot flushes. There is also little information about the effects of long-term usage but what we do know gives cause for concern. For example, danazol has adverse effects on blood fats and GnRH agonists cause loss of calcium from bones. For some women, high daily doses of progestogens cause few problems and this therapy maybe recommended when endometriosis recurs after other attempts to remove it.

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