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When to see your doctor

It is usually a good idea to see the doctor when this habit first becomes apparent, to rule out any scalp condition such as ringworm or other cause of inflammation which can be treated. The doctor may also be able to throw some light on other psychological factors which may be contributing to the problem. Occasionally the child may need to be referred to a specialist, either a dermatologist (skin specialist) or a paediatrician.

It is not known why some children pull their hair out, and there is nothing specific that can be done in terms of prevention. When it does occur, attention to possible sources of stress in the child may improve or cure the condition.

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“I sort of feel okay about me. Not good, not bad. Just okay,” said one husband.

“Well, then,” answered the wife. “What does that make me? Why did I marry just okay? I think I deserve A-plus.”

My interviews of sex offenders and persons debilitated by paraphilias, when sex is separated from love, indicate that one common thread unites all of these persons: They all have extremely low self-esteem. Sex becomes more important than people. They seem to treat others sexually as they feel about themselves. They become driven by a sexual compulsion for “it” rather than him or her. How you feel about yourself will predict to a great extent how you feel about your marriage and how your partner will feel about himself or herself.

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These may be used in different strengths, depending on whether you want complete protection or want some rays to pass through and allow you to build up a tan. Ask your chemist — he has a list prepared by the National Health and Medical Research Council and the Anti-Cancer Council.

The sun can burn the skin and this causes the same trouble as any other burn. A first degree burn is where there is reddening without blister formation. This can be painful and incapacitating. Toxic products can form in the damaged skin, be absorbed and lead to malaise, fever and the inability to work.

The delicate skins of children and older people are more likely to suffer damage. Plenty of fluids, rest and the application of cold compresses will help to relieve this sunburn.

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Repeated labors, particularly difficult ones, are believed to stretch and weaken all those structures which support the uterus. Tears through the lower vagina and perineum (the area between vagina and rectum) can weaken the pelvic floor and later lead to prolapse.

This is why most doctors who deliver babies often carry out an episiotomy by making a cut in this area to enlarge the opening as the baby is born, rather than allow a large head to tear it in an uncontrolled manner.

After menopause, the tissues may be weakened by the lack of circulating oestrogen, the female hormone. When the uterus falls down, it causes a feeling of pressure and discomfort, which may be worse when the woman strains by coughing or carrying heavy loads.

If the cervix protrudes, it may become inflamed and ulcerated by rubbing against the underclothes.

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The doctor or even a careful and watchful parent may not detect symptoms early, for they are often vague and ill defined. They include mental sluggishness, a pale grey cool skin, often constipation, a large tongue, and flabby muscles; the latter may cause the abdomen to protrude and there may be a swelling over the navel (called an umbilical hernia). The child’s cry or voice may be hoarse.

The baby may develop at a slower rate than normal, the eyes may seem to be widely spaced, and mental development is noticeably slow. Mental reaction is below normal. As the infant becomes older, the symptoms become more apparent, the skin tends to be dry and coarse, the hair dry, brittle and coarse.

Treatment

Today, in most Australian cities, new-born babies are ‘screened’ for thyroid deficiency, and in time this will become universal in hospitals before mother and baby leave. At present, hypothyroidism affects about one baby in 4000.

Treatment is invariably successful. The thyroid hormone (usually in the form of the artificially produced product thyroxine) is given. This must be supervised carefully and perhaps continued for a long time. But it will avoid the serious consequences of untreated thyroid deficiency.

Babies who have missed the screening system, and who develop any of the symptoms described, should have prompt medical investigation by the doctor. The earlier treatment is commenced, the more successful will be the results and the less likely is the risk that the baby will develop serious mental handicaps.

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The rash is typical. It usually commences on the face, and mucous linings, including the lips, oral cavity and even the tongue, and this can be very uncomfortable and make eating and drinking difficult. The rash then spreads to the body, and the blisters may be extremely numerous over the chest, back and shoulders. They are less common on the arms and legs, and fairly rare on the hands and soles of the feet.

The lesions tend to come in waves, two to four crops, usually in two to six days. They commence as small red blotches. These become raised, and the typical blisters form. They look much like droplets of water with a thin skin over them. These are easy to break. Gradually, the blisters dry out, and scabs form; and these finally fall off, usually by the ninth to thirteenth day. Scabs are said to be highly contagious; and for this reason, pupils are often not readmitted to school until the last scab has vanished.

As the illness progresses, the skin may become itchy. This is usually mild at first, but intensifies as the days pass, and the blisters worsen. As the blister stage advances, a fever often develops.

The blisters often become infected, but apart from this complications are rare, and the disease usually clears up rapidly and leaves little aftermath. Sometimes depressions are left and if on the face they may be lifelong, much to one’s annoyance in later life! On rare occasions a viral encephalitis may take place. In some children who may be on special medication, such as steroids for asthma, and in whom, the body’s normal immune response to infections is reduced, the disease may run a severe course and present a high risk.

Treatment

Treatment is usually simple. Many cases are very mild, some children having only a dozen blisters or fewer. But others are covered with hundreds of them. Most cases may be treated at home with simple measures.

Bed rest for a few days is suggested, especially if there is a fever and the child is obviously off-colour. Most children are sensible and know when it is time to hit the cot. They are excellent barometers of their own illnesses, as most parents know.

Plenty of fluids are advisable. This replaces fluids lost from sweating when feverish. It also helps to rid the system of dead germs and debris that inevitably collect in the system during any acute infective illness. Water, fruit juice, lemonade and similar drinks are suitable. Adding glucose D to fluid equals food; and if the appetite is reduced, this is a good idea.

There are no food restrictions. But in the acute stages, lack of appetite is common. Also, if the mouth, tongue and lips are severely blistered, eating may be difficult. In fact, the oral cavity often looks a mess, and soggy, yellowish sores look extremely uncomfortable. Jellies, junkets, custards, ice-cream, mashed vegetables, soft stewed fruit, clear broth (but nothing too hot, for it may burn) are best. Eggs, done in a variety of ways, are high in protein, easy to eat and digest and highly palatable.

A daily bath is advisable. Luke-warm water is best. Some advocate adding condy’s crystal to the water to make it a very faint pink. This may help check infections if they are present in the blisters. But a note of caution: Condy’s is notorious for staining white baths a dirty brown; so very faint pink is adequate—and get rid of the water and clean the bath promptly when finished. The child should be dabbed dry with a soft towel, and put back to bed. Do not rub the body vigorously, for this may break the blisters and encourage added infection, which may prolong convalescence.

If the itch is maddening, relief may be given in the form of the many antipruritic (anti-itch) lotions and creams readily available from the pharmacist. Apply if and when the itch becomes particularly trying. The warmth of the bed or of heaters may aggravate itching.

If there are obvious skin infections, antibiotics in the form of ointments for local use, and occasionally capsules by mouth, may be prescribed by the doctor. Call the doctor if there are any aspects that worry you, or if the disorder is not responding fairly well to simple home remedies.

Occasionally, mixtures (for infants) or tablets (for older children) may be required to reduce elevated temperatures and relieve pain and discomfort. Paracetamol elixir is effective. It is readily available at pharmacists, and dosage is usually written on the label (it varies with age). Paracetamol or aspirin tablets are suitable for children aged 6 years or older. The dosage is usually on the label for these too, and varies with age.

Complications are unusual, except skin scarring from large blisters, especially if they become infected. On very rare occasions, viral encephalitis (a viral brain infection) may occur, which is extremely serious. A return to normal with most cases of chicken pox is the usual rule.

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Rebirthing can be undertaken while lying on a mat or table. Sometimes a therapist may get patients to float face down in warm water, using a snorkel to breathe, so that the experience will more closely resemble that of the foetus in the womb.

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Signs and symptoms

Encephalitis may start with the symptoms of a common cold. The child may have no fever or a high fever (40.6°C). The child usually has a headache, vomits, and is disoriented (confused) and sleepy. Occasionally, convulsions and unconsciousness may occur.

A child with encephalitis will usually be unable to flex his or her neck forward to touch the chin to the chest while the mouth is closed. Sometimes the child cannot sit up without supporting the trunk with both hands braced behind (in a tripod fashion). This is a life-threatening situation.

Home care

None. See your doctor immediately if your child shows any symptoms of encephalitis.

Precaution

• If your child has had a severe reaction to any of the vaccines listed, be sure to tell your doctor before a booster of the vaccine is given.

Medical treatment

Since encephalitis may be a complication of another disease (such as measles, mumps, whooping cough), a child with such a disease and encephalitis symptoms will probably be examined for encephalitis. Knowing that the child has been exposed to poisons may also lead the doctor to suspect encephalitis.

A definite diagnosis is based on the child’s medical history; a blood count; a spinal tap; identification of the infecting organism in the spinal fluid, nose, throat, or stools; and the presence of antibodies (protective substances made by the body to fight the infecting organism) in the patient’s blood.

If encephalitis is diagnosed, hospitalization may be required. There is specific treatment for only a few types of encephalitis, since most viral infections are hard to treat. There is no medication that can kill the invading virus after it has caused the infection. Usually, however, treatment to ease the symptoms and to help the patient withstand the disease until it runs its course leads to recovery.

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