If your child’s tongue has a patchy appearance which resembles a map, he has what is known as a geographic tongue. This is a condition of unknown cause, in which the tongue has an uneven pattern of blotchy red areas interspersed with smooth patches. It is not painful and does not interfere with taste sensation.

It is not associated with any diseases, nor does it require any treatment. The tongue usually returns to normal, but it may take years.

EARACHE

Earache can be caused by either an ear infection (external or middle ear) or an object placed in the ear.

Clinical features

Earache is usually one-sided and may be accompanied by a runny nose, fever or vomiting. The pain can be quite severe.

Treatment

Treatment depends on the cause of the earache.

When to see your doctor

All children with an earache should be examined by their doctor.

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More severe jaundice, in which bilirubin levels are very high, may require treatment with an exchange transfusion in which your baby’s own blood is replaced by compatible fresh blood but this is not common.

If your born baby has breastmilk jaundice, it does not mean that you should stop breastfeeding. Rather, discuss with your nurse or doctor the possibility of alternating between breast and infant formula feeds.

When to see your doctor

• if your child is unwell, feeding poorly and not gaining adequate weight;

• if your baby develops jaundice in the first 48 hours after birth;

• if the jaundice becomes more noticeable after a week;

• if the jaundice has not disappeared after two weeks.

Prevention

The only form of jaundice which is preventable is that due to Rh incompatibility. The mother is given an anti-D injection immediately after delivery and this prevents complications in subsequent pregnancies.

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isn’t it? I mean, I’m his wife, for God’s sake.”

ANSWER: Fantasies are the most intimate and personal of sexual issues in couples, even more so than actual behaviors. What we think we might like to do or dream about doing seems to threaten spouses more than what actually takes place. No fantasy is sick; only hurtful behaviors are sick. The fantasy you describe is very common. Even though some couples find this hard to do, you may want to buy a few issues of one of the more explicit sex magazines and read the letters to the editor or other sex letters. As strange and artificial as these letters may seem, you will see that some of them are similar to some of your most forbidden thoughts. Rest assured that someone has already had your fantasy. Blocking fantasy by a spouse only raises anxiety and causes withholding of feelings and private thoughts, both of which block super marital sex. Fantasies are related more to how we learned about sex than they are to our feelings about our partner.

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Animals consume large amounts of food, before they become killed for meat. For example, a cow eats about 30 kg of food each day. By the time it is 3 years old it has consumed at least 30 tonnes of food. A cow’s body makes every attempt to excrete toxins. As with us humans, not all toxins become excreted. Those which are deposited around the body are of the worst kind: everything easy to metabolise would have already been excreted. As a result, a 100 kg of meat contains the worst combination of toxins, concentrated from about 30 tonnes of food. Summarising, meat contains hundreds of times higher concentration of toxins, than contained in the initial food the animal has eaten.

Drugs like anabolic steroids, antibiotics, growth hormones, and other chemicals are added to animal food to “enhance” the production of meat. Most of such drugs and chemicals are illegal for human use. I would bet, that you would not want to try such food. And yet, resulting animal meat contains hundreds of times greater concentration of worst toxins than the initial animal food.

Animals get sick. You do not know what sicknesses an animal had developed before it was killed for meat. The combination of bacteria and parasite activity in a sick animal produces toxic cocktails you do not want to hear about. The meat from such animal contains a full cocktail, because the animal stopped living before it had a chance to metabolise and excrete any part of it.

Animals have parasites, living in various stages in various parts of their bodies. All parasites have a very complex life cycle comprising many stages. This simply speaking ensures their survival. Meat of course contains parasites in various stages, some of which are very difficult to detect and eliminate, even in the cooking process. You do not want to hear just what animal parasites are capable of doing to your body.

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Because influenza may be a serious illness for an individual and an epidemic can cause many deaths and considerable illness with loss of time from work, some form of prevention may be necessary.

Amantadine is a drug which can prevent infection by the influenza virus if taken regularly. It can also protect against other viral infections.

It does not give lasting protection, only while it is being taken. However, it is too expensive for widespread use for the whole population during influenza outbreaks but may be of value in those particularly at risk and who are not covered by immunisation obtained from the vaccine.

One attack of influenza will produce antibodies which will persist and render the person either fully or partially immune.

However, the A strain of virus has the ability to slightly change its character and so antibodies to a previous virus may not be fully effective against the new virus.

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Appendicitis was a rare condition until the end of the 19th Century. Since then, it has become common and its incidence is increasing following the change in diet in the developed countries.

Appendicitis, like cancer of the bowel, haemorrhoids and diverticulosis, is thought to be due to a modern diet which contains little bulk or vegetable fibre.

Appendicitis was first fully described in 1886 by Reginald Fitz, professor of medicine at Harvard, USA, yet the condition occurred in ancient times and has been found in Egyptian mummies.

Robert Lawson Tait, a surgeon at the Hospital for Diseases of Women in Birmingham, England, carried out the first operation for removal of the appendix six years before Fitz published his work.

The cause of this condition is still uncertain, although diet is believed to play a part.

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Three weeks after doctor have diagnosed her case, a second patient says: “How did I get endometriosis? No one in my family has it but me.” Joan fervently wants to know why she has been “singled out” by this disease, since her sisters and mother are tree of it.

A third woman explains: “My mother was tortured by menstrual cramps and endometriosis until menopause. Through some miracle, I’m okay. She said I still could get it, too, that the real ‘curse’ is inheriting this kind of pain. Is my mother right?” Diana has been fortunate thus far, but she feels it’s just a matter of time before the first symptom of the disease becomes apparent.

Nearly all his patients with endometriosis routinely ask questions like these; in fact, such questions ate fundamental and make good sense. Could there be a strong hereditary component in a family’s gene pool that determines which of its women will or will not develop endometriosis? Pursuing a genetic link to this disease may provide one kind of clue to its cause, and that pursuit begins with the most basic question: Why me?

In continuing efforts to track down the cause of endometriosis, modern scientists have tended to concentrate on the physiology and chemistry of the disease. They have only just begun to examine the role of heredity more intensively. Specifically, they are looking for evidence of tendencies toward the disease among female relatives on both the maternal and paternal sides of a family. So far, the key to determining whether a woman will develop the disease lies in her inherited predisposition.

Not all genes establish absolutes, such as curly hair, brown eyes, or the shape of fingernails. Some genes set a range of possibility or susceptibility, not an absolute number or condition. You may be genetically predisposed to weight gain, but your actual weight can be environmentally determined by caloric intake, general health, and a combination of personal and regional attitudes about being overweight. A similar type of range applies to predispositions to diseases such as diabetes, cancer, and endometriosis; important genetic dues have recently been found to common mental disorders, too, including Alzheimer’s disease and manic-depressive illness.

Geneticists expect a simple test to be available in the future that will predict above average susceptibility to illnesses, both fatal and disabling, which no doubt could include genetic testing for endometriosis.

Imagine this: by the time such a genetic marker is found, not only could there be a cure for sufferers, but a preventive treatment might be available for those who would contract id For now, a conjunction of heredity and environmental factors for millions of women has resulted in endometriosis—but each woman, still has some control over the management and cure of the disease, despite her family history.

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The initial type I infection occurs mainly in infancy and childhood, when it is usually minimal and often unnoticed. The incubation period is between four to five days and is followed by raised antibody levels in the blood and other body fluids such as saliva. These antibodies, however* do not prevent recurrences. Recurrences vary in frequency from weeks to months to years, and appear to be due to reactivation of the virus rather than reinfection. This is thought to be perhaps due to chronic infection of the salivary or tear glands. Alternatively, the virus may persist in the nerve cells of the peripheral nerves, supplying the infected area. Although most type I infections are on the lips, no part of the skin is immune to infection. Fingers, shoulders, buttocks and legs are frequently affected. Commonly, itching or burning precedes the small, grouped blisters by an hour or two. These blisters then rupture and ulcerate, and occasionally become secondarily infected. They normally heal in seven to ten days, sometimes with scarring.

Type II infections occur on and around the genitals of both sexes. They are the commonest cause of genital ulceration seen in the V.D. clinics of Australia, England and the United States. The virus is spread by sexual intercourse, and can cause very painful and long lasting blisters and ulceration. Infections have been on the increase in recent years in most western countries. This is thought to be because of increased sexual activity, young people’s increased mobility, and the replacement of condoms and sheaths by the oral contraceptive pill. There is also some evidence that cancer of the cervix may be more common amongst women who have been infected with the herpes type II virus. Other complications are infection of the newborn, if an infant is born to a mother suffering from active genital herpes. To avoid this, caesarean section is performed in these cases.

The complications of type I infections are quite different and may also be very serious. Corneal (eye) ulcers may occur, and the infection may occasionally become generalized over the entire body, or may affect internal organs, including the liver, heart or brain. This is rare, but can be fatal. Infants or children with atopic eczema should not, for this reason, be nursed or kissed by people with active herpes infection. Similarly, patients with atopic eczema should not be vaccinated with smallpox I variola) vaccine, for fear of developing a generalized eruption.

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• Hunger is a strong physiological sensation regulated in the hypothalamus.

• Appetite—physiological, psychological and social—influences eating behaviour.

• Distinguishing between biological hunger and emotional hunger is important.

• Nutrients in food vary in their ability to suppress hunger, and dietary fat has the least effect on decreasing total energy consumption.

Hunger is the strong physiological sensation which drives us to find and eat food. It has been called a ‘biologically useful sensation’ because of its obvious survival value. It is part of wider appetite mechanisms which include psychological dimensions.

Our hunger and appetite mechanisms, however, seem to provide little defence against the variety of food and ever-present cues to eat in our modem society. Genetic research is now showing that the feeling of ‘fullness’ or ’satiety’ may be partly genetically determined, such that some people have better switch off mechanisms to tell them that they are full. Recent insights into the complexity of the human feeding machine may help us to resolve some old puzzles and lay the basis for a more thorough understanding of eating and obesity.

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How could he say that I should have a complete hysterectomy?

My doctor’s words sounded so insensitive and heartless. After being through so much with him it now sounded like he just wanted to wash his hands of me. His face normally was pleasant but now it reminded me of a Dr Jekyll and Mr Hyde’s face. His good looks and charm had disappeared and were replaced by callousness.

As the tears blurred my vision, my body started trembling. Anger, resentment and despair overpowered my thoughts. I wanted to shout at him, abuse him, scream that it was unfair.

After all that I had been through. The appointments accounted for hours spent waiting, sitting on uncomfortable chairs, reading magazines, looking at the clock and watching its hands move slowly, or staring at the uninspiring paintings on the walls. Then there were the tests, treatments and operations, all of which had been in vain, both mentally and physically.

I kept waiting for my husband to say something. He had always been a great support to me and now when I needed his support the most he was unable to help me.

The doctor was silent. I realised that this would be the last time that I would see him. There would be no more four hour trips travelling to Melbourne to his clinic. No more hours spent huddled with his other patients in the diminutive waiting room.

I was amazed at how quickly his attitude had changed. He had always been so understanding and hopeful. I guess in retrospect I had intrinsically entrusted him to solve my problem.

Seeing him in a different light I noticed how negative his attitude was. I stared at his masked face and words failed me. It appeared that I had been down all the possible avenues and there would never be any children now.

There was not the usual eye contact or friendly goodbye as we parted. Walking past his receptionists desk I remember thinking how I would not be sorry to see die last of her. She had always been so moody and unhelpful. I paused for one moment as the next couple passed by in the corridor on their way to see the doctor. What future lies in store for them? Would they experience the same traumas and ordeals that we had — only to be left with heartbreak at the end?

The lift took longer than usual to reach the ground floor. I walked with my husband out of the building. We still had not spoken a word to each other. When we reached the footpath he put his arm around me and gave me a gentle hug which told me that he too was hurting inside.

Later, after accepting a life without children, we took a good look at our lives and reassessed our priorities; it was a painful process and required courage. We both needed a lot of support and luckily received it from friends and family — and each other.

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