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Cause

The immediate cause of biting is often the child being angry or frustrated, usually at not getting his own way. The reason some children bite in reaction to these feelings is unknown.

Clinical features

Episodes of biting may occur in the home, at daycare or preschool, or anywhere the child comes into contact with others of his own age. It is usually associated with anger or frustration, though occasionally no immediate precipitating event is noted. In many instances parents are first made aware of the problem by daycare or preschool staff.

Treatment

It should be made very clear to the child that such behaviour will not be tolerated. If it occurs again, the child should immediately be removed from the situation, the adult saying to him in a loud, stern voice: ‘No! You are not to bite other children!’ The child should then be removed to a remote section of the home or childcare facility for ‘time-out’.

After an appropriate period of time-out, during which the child is essentially ignored, he can be returned to the group with a comment that biting is naughty and will not be tolerated. If it occurs again, the same consequences must immediately occur.

Prevention

Sometimes gentle biting occurs during play between the young child and parents, and this may give rise to more serious biting later on. Biting at any age should be discouraged.

When to see your doctor

The doctor may help with reinforcing strategies for parents when biting occurs, and may provide information about referral to a paediatrician or psychologist if the behaviour continues.

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It may be difficult to recall, but try to think of that one girl or boy of the opposite gender who seemed to clash with you. This most likely would have taken place around later elementary school, when the genders are trying to mix in a society that blocks that mixture with a set of double messages. It is strange that boys who “hang around with” or “play too much” with little girls in elementary school are seen as “queers,” as being strange, and that later, too much playing with the boys is labeled the same way, unless of course there is aggressiveness involved. Girls who play too much with boys are tomboys, somehow not appropriately feminine. Too much contact with boys later, and they may be seen as “loose.” Not enough, and they may be seen as “gay.” Listen to children playing at a very young age, and you will hear what they consider to be the ultimate insult: “You’re gay!”

Do you remember that one opposite-sex child with whom every boy/girl, male/female issue in the world seemed to be acted out? One wife reported, “he just would not leave me alone. He’d take my hat, knock my books from my hand, wash my face with snow, just was on me all the time.” One husband reported, “She was a little snitch. She would tell on me anytime, making up things as if I didn’t do enough bad things already.” This aggressive male/female interaction, most likely following some “you always hurt the one you love” pattern, also became a part of how you love later.

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Should ventricular fibrillation occur, it can be reversed by using a defibrillator machine to give an electric shock directly over the heart.

Mobile intensive care units (MICA) are ambulances with specially-trained officers who can take cardiographs, interpret them and set up intravenous infusions.

They can give drugs, defibrillate the heart and carry out heart massage. As well, they transport the victim to the nearest coronary care centre. In this way, the victim gets expert help as soon as possible and so reduces the risk of sudden death.

If you develop chest pain which you think may be due to a heart attack, seek medical help at once.

If your doctor is unavailable, phone for an ambulance or get someone to take you to the nearest public hospital.

If it isn’t a heart attack, proper examination will show this and no harm has been done.

If there is a doubt, you may be admitted and investigated then discharged.

If it is a heart attack, early treatment will give you the best chance of survival.

But, please, have another look at those risk factors I referred to earlier in this article. How many do you have?

Now, what are you going to do about them?

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Although some women cannot use the Pill without undue side effects, most can take it, especially the newer low-dose ones with minimum side effects and almost 100 per cent success in preventing conception.

Unfortunately, reports about the long-term dangers associated with the use of the Pill increase and the risks in using it now appear to be greater than at first thought.

The risks seem to be an increased incidence of artery and vein problems, which can lead to thrombosis or clots and blocking of the coronary arteries, with the development of a heart attack.

The International Planned Parenthood Federation in 1977 spelled out the dangers: “The risks are concentrated in women over 35 and in those who smoke and who have used the Pill over five years.

“Women under 35 who use the Pill have, overall, an added risk of one in 20,000 of dying; between 35 and 44, the hazard rises to one in 3000 and, over 45, to one in 700.

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There may be few, if any, symptoms at all in the early stages, until suddenly the kidneys fail. Tell-tale symptoms that all is not well include weakness, early tiredness, vomiting, headaches and restlessness, muscle cramps and probably twitching movements, drowsiness, mental disorientation and confusion. There may be swelling in the lower limbs (called oedema) and elevated blood pressure.

Tests carried out by the doctor will show that blood and protein are present in the urine, often in large amounts, which indicate the kidney system is severely impaired. Various tests that check the kidneys also indicate that they are diseased.

Treatment

Once the condition has been diagnosed, the patient may be admitted to hospital where full facilities for treatment are available. The course is a variable one, and close medical supervision for a long time may be necessary.

Parents must be alert for symptoms that indicate kidney infections and disease, for the sooner a diagnosis is made and treatment started the better.

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•    For children under the age of six:

Paracetamol elixir: Dose varies from 2.5 to 5.0 mL. This may be repeated every four hours whilst symptoms persist. (Check the label for dosage, for the younger the child the less medication required.) Always shake mixtures before use, and give them with water. Do not give aspirin to children under the age of six years. Aspirin is a potent stomach irritant and may cause haemorrhage from the stomach lining.

For children six years of age and up to 12 years: Paracetamol elixir: 5 to 10 mL depending on age. Or 500-mg paracetamol tablets: one tablet every four hours. Or 300-mg aspirin tablets: one tablet every four hours (given after food).

For children twelve years of age and over: Double these doses (that is, an adult dose).

Medication (tablets) should be kept in air-tight bottles, or preferably in sealed blister packs or sealed tin-foil to preserve their potency. Always keep medication locked away from children, for an excessive intake of these medications may be fatal. (If an overdose is accidentally taken, refer to section on poisoning and act promptly. See Chapter 16.)

In most cases of infections, bed-rest for a few days and plenty of fluids are advisable. Fluids swish dead germs, unwanted debris and toxins from the system. Chilled water, cold lemonade and fruit juices are ideal; milk drinks are usually less attractive. Often the drinks are more palatable and useful if the stomach-settling powdered food, glucose D, is added: here the usual amount to add is 1 teaspoon (about 4 g) per glass of fluid.

Cool sponging and gentle drying of the skin with a soft towel is also refreshing, tends to reduce temperatures, and makes the patient, of whatever age, feel much better. Simple measures are often very effective.

At all times, give the minimum medication for the minimum amount of time. And refrain from self-medicating—always be guided by the doctor’s instructions, and always check with the doctor if you ever have any doubt. Remember, doctors are on your side, and will do their best to help effect a prompt cure. Most family doctors are happy to give as much advice as need be whenever illness strikes, especially when children are involved. After all, most doctors are parents too!

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Cut down on salt, sugars and saturated fats. Reduce your intake of tea and coffee which affect the body’s ability to absorb nutrients. Increase your intake of Vitamin B6 by eating more fish, soya beans, yeast, nuts, bran, brown rice, avocado, citrus fruit and egg yolk, or take a 200 mg supplement of this B-complex vitamin which will help prevent fluid retention and reduce irritability. Many women find that a course of evening primrose oil helps, taken in the days just before the onset of the period. Dong quai, a Chinese herb which helps balance oestrogen levels, is increasingly prescribed in cases where the mood swings are severe.

If these simple remedies don’t work, you may have a more serious hormone imbalance, the reasons for which are best diagnosed by a qualified medical practitioner.

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Sleep experts, on the other hand, see it as a restorative daily health tonic, an ally of the alert, the ambitious, and the long-lived.

In fact, researchers suspect and are investigating a direct link between sleep deprivation and disease. There’s already at least one study supporting the widespread suspicion among sleep specialists that people who don’t sleep very long don’t live very long. Several researchers have connected insufficient sleep with less-efficient immune system functioning, possibly via a reduction in the activity of NK cells-the “natural killers” that go after invading viruses.

Disorders and disdains

A serious sleep disorder such as sleep apnea can quadruple the risk of heart attacks and triple the risk of stroke, even in otherwise healthy men.

But the troublemaking tendencies of inadequate sleep more often come down to basic military strategy. In your war on disease, like any other war, rested troops fight best.

Take stress, for example. While it’s still not proved that inadequate sleep causes stress, it certainly sabotages your ability to handle your daily dose of it. “If you’re poorly rested, you’re likely to find stressful situations to be even more so. And the relationship between stress and health is fairly clear,” says sleep researcher Michael Vitiello, Ph.D., professor in the department of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle.

Stress isn’t the only one of life’s little challenges your sleep-swindled brain has a problem with. Your reaction skills also take a hit when you cheat your sleep.

“Relatively small amounts of sleep deprivation will quickly affect your alertness and psychomotor performance,” says Michael Bonnet, Ph.D., professor of neurology at Wright State University School of Medicine in Dayton, Ohio, and director of the Sleep Laboratory at the Dayton Veterans Affairs Medical Center. “You become less responsive, especially in a sedentary situation, such as driving.”

Small wonder, then, that sleepiness is second only to drunkenness as a cause of fatal single-car accidents. All things considered, getting yourself killed in a car crash is not a recommended strategy for avoiding disease.

So why do so many guys shirk their sleep duties? Some suffer from one of the more than 80 disorders dogging our sleep. The most well-known is insomnia-difficulty in getting to sleep or staying there-which haunts women more than men. The most serious, though, is sleep apnea. And it can be a killer. Its top targets are men between ages 30 and 60, especially if they’re overweight. One study found that 24 percent of healthy middle-age men had sleep apnea.

With sleep apnea, you literally (and repeatedly) stop breathing when you are asleep. It’s actually your body’s rescue plan to keep arousing you so that you can breathe again. But the constant waking, even though it’s so brief that you won’t even remember, deprives you of the sleep you need. Your sleeping hours are virtually worthless; hence, your waking life is virtually nonfunctional. “And that’s life-threatening,” says Michael Stevenson, Ph.D., a psychologist and sleep specialist at the North Valley Sleep Disorders Center in Mission Hills, California. “It can get bad enough to increase your blood pressure and your risk for stroke and heart attack, not to mention automobile accidents and injuries on the job.”

So if you snore (harmless in itself, but also a possible clue to apnea) and you find yourself constantly waking up sleepy and staying that way all day, pay attention. See a sleep specialist, says Dr. Stevenson. Sleep apnea is treatable.

Serious as apnea can be, the most common reason that men don’t sleep enough is … well that they just don’t sleep enough. Ask almost any man and he’ll tell you that he functions just fine on limited Zzzs, thank you. But there’s a difference between functioning well and just functioning, according to Dr. Vitiello. “I’d never argue with someone who says he can get by on four or five hours sleep,” he says. “But his very choice of words condemns him. He’s getting by.”

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