Symptoms: pain; swollen neck glands; difficulty in swallowing

Home care:

Have the child gargle with salt water and drink extra fluids.

Give aspirin or paracetamol to relieve pain.

Keep the child isolated until the cause of the sore throat is diagnosed.

Precautions

-    A child with a sore throat accompanied by any of the following symptoms should be seen by a doctor:

    swollen or tender neck glands

    persistent difficulty swallowing

    pus-like discharge from eyes or nose

    earache

    sinus pain

    breathing difficulty

    chest pain

    rash

    stiff neck

    weakness or exhaustion

    confusion

    prolonged vomiting

-    Any child with a sore throat and fever that are still getting worse after 24 to 36 hours should be seen by a doctor.

-    A child with a sore throat should be kept away from other children, particularly infants, until a diagnosis has been made.

In theory, and in the medical school classroom, a sore throat is one of the simplest childhood problems to diagnose and to treat. Medical textbooks state that a sore throat is usually caused by a virus and, therefore, does not require treatment with antibiotics because viruses do not respond to medication. A sore throat that is not caused by a virus is generally due to streptococcus bacteria. These organisms can be identified by culturing throat secretions, and a strep throat can be treated with penicillin or, if the child is allergic to penicillin, with erythromycin.

In practice, however, the diagnosis and treatment of a sore throat is not so straightforward. Viral infections sometimes are complicated by streptococcal infections. A throat culture may isolate streptococci organisms even though the illness is not being caused by these organisms, and about 5 percent of throat cultures will not show streptococci even when they are present and are, in fact, the cause of the sore throat. Some bacterial illnesses that cause a sore throat will respond to antibiotics, but the infecting bacteria cannot be identified through an ordinary throat culture.

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What are they?

At one end of the spectrum there is complete blindness-a condition affecting some 16 million people around the world. There are several causes, including detachment of the retina, amblyopia, glaucoma, congenital blindness, trauma to the eye, diabetic retinopathy and various infections. The common conditions affecting the eyes (and sometimes leading to blindness) in western countries are considered under the headings glaucoma, diabetes and cataract.

Short sight, long sight and presbyopia (old sight) affect most of us to some degree, with more than half of all North Americans and British between the ages of 6 and 74 wearing glasses or contact lenses all or some of the time. Unfortunately, the problem seems to get worse with age. Fewer than 12 per cent of 6-11-year-olds need correction yet about 95 per cent of those aged 65-74 do. Whether or not such deterioration in vision is inevitable is open to debate. Research over recent years suggests that much could be prevented.

What causes them?

• Poor nutrition.

• Poor lighting.

• Mental strain.

• Wearing spectacles.

• Too little exercise of the eyes.

Prevention

The eye is an extremely sensitive barometer of diet. When the eye’s diameter changes by even as little as a millimeter it makes a big difference to vision. At one end of the poor-nutrition scale, a quarter of a million Asian children go blind each year from malnutrition. Xerophthalmia, the main cause of such blindness, is a result of generally poor nutrition and in particular of a lack of vitamin A. Few westerners, however, are at risk of losing their sight due to a faulty diet. Many, though, have far worse sight than they should have.

An early sign of vitamin A deficiency is poor vision in dim light. One study of 100 people taken at random found that twenty-six of them had at least some degree of night blindness. The prevention for this is to eat foods rich in vitamin A. Liver is the best source but fruits and green leafy vegetables are good sources. Zinc too has been found to be vital for night vision. Studies of people with the condition who did not respond to vitamin A supplements have found that adding zinc made the difference. Zinc is now known to play a vital role in the conversion of vitamin A to its active form, retinol-dehyde, in the retina. Vitamin  and folate in particular are now being studied in the context of healthy vision.

It appears that green and yellow vegetables are vital if one is to maintain healthy vision. Some food additives, particularly monosodium glutamate (MSG), have a particularly bad effect on the eyes, according to one US researcher. When added to commercial foods in large amounts it damages the nerves. He feels that MSG should not be given to children, though he is less cautious about adults as they have a natural barrier to the toxic effects of the substance.

Although short-sightedness is not mainly caused by diet certain research seems to show that a poor diet worsens it. One study found that myopic people, who ate too much sugar and protein, were deficient in chromium and didn’t metabolize calcium properly. There are now numerous studies linking poor nutrition to eye problems and vitamin E is an exciting area of research. Highly vitamin E-deficient animals go blind in time. The human retina, it appears, is susceptible to oxidation-unless protected by an anti-oxidant such as vitamin E. Research in rats has found that a diet poor in vitamins E and A results in permanent damage to nearly half the animal’s visual cells in eight months. There is little doubt that a whole food, unrefined diet is the best starting point to improving poor sight.

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Shed, garage and workshop

• Use the right tool – don’t make do.

• Use ramps for cars, not piles of bricks.

• Keep garden tools hanging safely on walls.

• Keep weed killer and other chemicals high up and out of reach. Never use domestic

containers (e.g. lemonade bottles) for weed killer etc.

• Check children’s bikes for safety at least twice a year.

• Wear safety goggles or glasses when sanding or grinding.

• Wear a mask when spraying and ventilate the area.

• Work in a good light.

• Petrol must be kept in metal cans only (plastic degenerates and leaks). No more than 4

gallons may be stored at home.

• Keep children away when you are doing something dangerous-in one third of DIY accidents

it is the watching child who is hurt.

• Never run an engine in a closed garage.

Gardens

• Make sure ladders have a firm footing.

• Don’t be overprotective to older children.

• Supervise small children all the time on swings.

• Keep ponds fenced or covered if you have young children.

• Make water butts safe.

• Make sure paths and steps are even, especially for the elderly.

• Teach children to recognize poisonous trees and shrubs.

• Teach everybody to respect swimming pools.

• Put out fires before going to bed.

• Never throw inflammable liquids or aerosol cans on to fires.

• Wear stout shoes or boots when mowing.

• Clear lawns of stones and toys before mowing.

• Never leave a mower unattended when the engine is running or, in the case of an electric

mower, still plugged in.

• When using power hedge clippers, keep the flex over your shoulder out of your way.

• Don’t leave garden tools lying around-they are a danger to everyone.

• Keep septic tanks properly covered.

• Check deckchairs and garden furniture for safety after the winter.

• Never adjust your mower or hedge trimmer while it is running.

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Some men may appear to be going through what has been called a male menopause when their testosterone levels drop below their normal range; this can result in impotence. In some cases, testosterone supplements have been used; however, they are rarely effective.

Some men who have had prostate surgery are permanently unable to achieve an erection on their own. However, there is a surgical technique in which an implant is placed in the penis to make it erect—all the time.

A man who wants more choice in the matter can use a pump device along with a surgically implanted sac in the penis. Whenever he wants to have an erection, a few squeezes of the hand pump, and bingo! instant erection: the sacs fill with fluid. Afterwards, he pumps again, and the fluid returns to a reservoir in the testicles. A man can also have an orgasm with this technique.

Does this sound too technical or make you squeamish? Another option is to inject the hormone prostaglandin directly into the urethra; this will provide an instant erection. The injection is easy to do and is not at all painful. Some of my patients have found it to be extremely satisfactory.

There is also a medication called yohimbine, which, when taken daily, seems to have the same effects as testosterone and will allow a man to achieve and then maintain an erection so that he can have an orgasm.

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If you have bloody diarrhea, the doctor will do a physical exam, a blood test, and a digital rectal exam to help determine the cause. He may also need to use a sigmoidoscope in order to examine the intestine visually.

Sometimes, however, bloody diarrhea can be caused by bacteria, a virus, or a parasite, frequently resulting from foreign travel and strange food and water. If your doctor suspects that this is the case, he will probably run a series of blood tests as well as a stool test. If the bloody diarrhea is caused by a viral infection, your doctor will advise you to drink plenty of fluids; I advise soup, with additional salt to replace the potassium lost in diarrhea, or Gatorade. For a bacterial infection, he will prescribe antibiotics.

Special Mention for the Elderly

In elderly people, if the blood supply to the bowel is suddenly reduced or even cut off completely, a condition known as ischemic colitis can develop. In this case, the stool will be foul, smelly, and maroon in color. An elderly person with ischemic colitis will also have a fever, and she may quickly go into a state of shock. However, diarrhea can also be caused by a course of antibiotic therapy that has lasted for several weeks, usually after a period of hospitalization, since it can be spread quite easily in hospital wards and nursing homes. This type of diarrhea is caused by the C difficile bacterium, and requires another course of specialized antibiotic therapy.

For this reason, if the bowel habits of an elderly person suddenly change, it’s essential that she see her doctor immediately.

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Description and Possible Medical Problems

There may have been some occasions where you’ve suddenly been short of breath—it probably caught you off guard, but chances are you were able to trace it back to a specific cause. Maybe you haven’t had a chance to exercise for a few days—that’s just how long it takes for your body to begin to lose up to 10% of its conditioning—or maybe you’d been feeling under the weather.

If you don’t fit into either of these categories and you are also coughing and have a fever, it could be something else entirely.

When these symptoms appear in a person over 50 who also has emphysema, acute shortness of breath accompanied by cough and fever can be the sign of an acute flare-up of the disease; frequently, this can be sparked by the flu ot pneumonia or even a virus. However, these collective symptoms may also be a sign of bronchitis, heart failure, or lung cancer. People who have emphysema can live symptom free for long periods of time, even years, without problems except for a chronic cough and shortness of breath upon exertion.

When people over 70 complain of shortness of breath with a cough and fever, they may also be confused and disoriented. In rare cases, an elderly person might also experience heart failure.

Treatment

If you have acute pneumonia, your doctor will probably treat you with a combination of oxygen, respiratory therapy, and antibiotics. If you’re under 50, the treatment can be done at home. If you’re over 50, home-based treatment is still possible, although your doctor will first evaluate you closely to see if this is the best thing. If your doctor decides hospitalization would be best, you’ll be given antibiotics intravenously.

If you have emphysema and get pneumonia, your doctor will conduct a complete examination, including a chest X ray, a CAT scan of the chest if needed, and a bronchoscopy or biopsy if a lesion is found. If your doctor determines that you do have lung cancer, a combination of radiation and chemotherapy will be used to treat your condition.

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First, try to determine the cause of the redness and swelling by asking yourself the following questions:

1. Have I recently eaten a new food?

2. Have I changed the brand of a cosmetic I normally use?

3. Have I recently been out in the woods and in contact with a variety of plants?

4. Did I recently scratch or injure the skin on my face in some way and neglect to clean and disinfect it properly?

You can treat the symptoms above yourself by (1) eliminating any suspect food from your diet; (2) not using any new cosmetic on your face; (3) treating the inflammation with calamine lotion and aspirin; and (4) cleaning the red, swollen area. You may also want to try an over-the-counter steroid cream such as Cortaid or an antihistamine such as Benadryl to relieve the itch. Never use alcohol, as it can dry out the skin and make the itch worse. Some people also find a cool bath to be helpful.

If you’ve taken these steps and your skin is still red and swollen, or the condition gets worse, see your doctor. You may have an underlying infection that will respond only to professional treatment and prescription medication.

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The muscle tone of the neck and throat can gradually become lax over the years, but these changes don’t happen to everyone. For those who do experience a weakening of the muscles inside the throat, the voice may change in timbre as the space between the muscles responsible for the vibration of the vocal cords and the resonance of your voice narrows. This really isn’t terrible; you may finally get that deep, husky voice you’ve always wanted. While most people experience no discomfort, sometimes the weakening of these muscles can bring on a scratchy throat that is difficult to alleviate. The lining of the throat may also become drier, especially when speaking, so it may be necessary to drink more water throughout the day, which is never a bad thing. The good news is that the swallowing mechanism was designed to last a lifetime and rarely causes any problems.

The most common concern about the way the neck muscles age is primarily a cosmetic one, since the skin and outside muscles of the neck gradually weaken and lose their tone. This typical aging of the neck is one of the telltale signs of growing older and is the reason why the field of cosmetic surgery has grown by leaps and bounds. Cosmetic surgery of the neck can help to reestablish the sharp angles of youth.

Unfortunately, the effects aging has on the throat and neck are largely irreversible; although they’re frequently touted as effective, neck exercises do little to tone the muscles of the neck. And if your throat muscles are weakening, talking moRe won’t help tone them up. A lifelong regimen of regular cardiovascular exercise and good eating habits is still the best cosmetic defense to help keep every part of your body looking and feeling young.

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A normal part of the aging process is that certain parts of the body begin to dry out. In some cases, such as oily skin, this is cause for celebration. The eye also begins to dry out somewhat with age, and, though it may not be a reason to celebrate, having dry eyes isn’t a serious health problem. It’s also relatively simple to treat.

It’s common for problems with the tear ducts, which are also called the lacrimal glands, to flare up in midlife adults, though overproduction of tears is as common as underproduction.

When the tear ducts produce fewer tears, the eye can become red and irritated and may feel gritty at times. If you have a tendency toward dry eyes, you’ll find that the condition will often occur in both eyes, not just one at a time. Men and women who have rheumatoid arthritis are also prone to dry eye syndrome. More women than men are affected, and chronic dry eye syndrome—also called keratoconjunctivitis sicca— usually makes its first appearance in midlife, usually about the age of 50, when the tear glands begin to produce fewer tears.

Sometimes people with dry eye syndrome find that their eyelid does not completely close during sleep. Again, this is nothing to worry about.

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From the moment we hit adulthood—which, as children, we wanted desperately to reach—most people begin to look for signs that they’re aging. And the first place they usually look is their face. The second is their hair.

Because the hair and face spend so much time exposed to the elements, whether it’s sunlight, the cold, or pollution, it’s inevitable that they show the first signs of aging. And because they are so visible, in essence broadcasting our age to a society that still largely prefers the bloom of youth, thousands of people are employed and hundreds of substances have been invented to help hide what many people perceive as the ravages of age.

Facial wrinkles, of course, are the first thing that come to mind when we speak of the way the face ages. But they are just one way in which the face grows older, and you can learn more about wrinkles in Chapter 9, “Skin.”

The bones in the face also begin to atrophy slowly with age, resulting in a loss of bone mass in the jaw and skull. The cartilage of the nose may also lose some of its definition, and the nasal passages may become smaller. The loss of muscle mass in the face eventually leads to the sunken, drooping look that’s common in elderly people.

The hair on our heads and elsewhere on our bodies unfortunately don’t escape the aging process, either. Though the hair on your head may become thin and turn grey, excess hair may grow in other parts of the body where it didn’t appear before. Men may notice that the hair in their nose and on the outside of their ears has increased in volume, while women may find that the decreased level of estrogen that accompanies menopause causes hair to grow in unexpected places, especially on the face.

The skin of the scalp begins to thicken with age, and the scalp also secretes less oil. As a result, the hair may become more brittle.

The signs of aging on the hair and face are irreversible, though advertisers would have you believe that cosmetic and surgical procedures exist that can turn back the clock. The use of cosmetics and surgery is up to an individual preference or desire. The aging process itself is dictated by the biological clock and one’s own genetics. Some people just age faster than others.

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