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When children are sick they tend to vomit more readily than adults. It is often a single event and the child is back to normal again soon afterwards.
Cause
There are numerous causes of vomiting, but the most common is that associated with any infection, either viral or bacterial, even the common cold. Motion sickness is another cause of vomiting. Vomiting can sometimes occur in association with more serious illnesses such as appendicitis or meningitis.
Projectile vomiting, which is a forceful throwing up of the contents of the stomach, is characteristic of pyloric stenosis.
Young babies tend to vomit up small amounts of milk after feeds. This is called posseting, and is normal. It can usually be reduced if you burp your baby a little more during feeds.
Clinical features
Vomiting is often accompanied by abdominal pain and diarrhoea. Dehydration is one of the serious risks of vomiting, especially in young babies .
Treatment
Medications against vomiting should not be used in children due to the risk of serious side effects. The most important part of the treatment of vomiting is adequate fluid replacement to prevent dehydration.
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NAUSEA
Nausea is the feeling that you want to vomit. It is also known as being bilious or nauseated. Young children will not be able to tell you that they feel nauseated, but they may look pale and sweaty, and complain of a stomach ache. Older children will be able to describe additional symptoms such as dizziness.
Cause
There are many causes of nausea in children, but by far the most common are gastroenteritis, ear infections and motion sickness.
Treatment
Medications against nausea should not be given to children, due to the risk of serious side effects. If your child has nausea it is advisable to see your doctor.
SWALLOWED FOREIGN OBJECT
Babies and toddlers tend to explore things by placing them in their mouths and so they may swallow something which is not food. Many objects will be passed in the stools. If your child does not vomit, cough or complain of abdominal pain, simply sift the stools through a fine wire mesh for the next few days until the object appears. The commonest objects swallowed are coins and beads. Sometimes an X-ray may be taken to locate the object inside the gastrointestinal system.
If your child swallows a sharp, or poisonous object such as a battery or nails or pins, you should seek immediate medical attention. These objects can be life threatening. See also Essential first aid in Chapter 1 for Choking and poisoning.
When to see your doctor
Take your child to hospital immediately if he is choking, coughing, vomiting or having difficulty breathing, or if you are not sure what he has swallowed.
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Pyloric stenosis is a condition which can affect young babies during their first few weeks of life. It occurs more commonly in boys than in girls. The outlet of the stomach into the intestine (the pylorus) is normally surrounded by a sphincter of muscle which prevents food from moving backwards. In babies with pyloric stenosis there is a thickening of this muscle and this causes a blockage.
Cause
The exact cause of pyloric stenosis is not known but it is thought to be influenced by genetic factors.
Clinical features
The classic sign of pyloric stenosis is projectile vomiting, which is a very forceful throwing up of the contents of the stomach, and results from a build up of stomach contents which cannot pass on to the intestine. The baby may also fail to gain weight and may be constipated. The baby is usually restless and cries a lot. He may wish to feed immediately after vomiting because he is hungry. If not diagnosed early, the baby is at risk of becoming dehydrated. Occasionally a lump can be felt in the upper abdomen during feeding.
Investigations
A barium meal is usually administered to confirm the diagnosis, although this may be unnecessary if the doctor can feel the lump.
Treatment
If there is a strong suspicion that your baby has pyloric stenosis, he will be admitted to hospital immediately for surgery. An operation will be performed to release the blockage by splitting the overgrown muscle fibres of the pylorus. This operation usually has no complications and the baby can be taken home after a few days.
When to see your doctor
See your doctor immediately if your baby has the symptoms described.
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If the child passes a bowel movement into the potty, praise him profusely. However, it is then important not to give him the idea that he is expected to do this every time. Revert back to the low key suggestion that he sit on the potty, and don’t be distressed if, after initially delivering the goods, he then resists or doesn’t do it again for a long time. This is a crucial stage, for if the child suddenly becomes aware of just how much this miserable bowel action means to his parents, then he just may realise at the same time the sort of power he wields.
Once this process has taken place, at some stage the child will begin to use the potty regularly, initially for faeces and then soon after for urine, at which point the child is essentially toilet trained. However, parents must expect that it may not go so smoothly — there may well be stops and starts, as well as frequent accidents. Again, it is important to be relaxed and low key about these as well.
There are several other points that are worth emphasising:
1. Never punish your child for any ‘mistakes’ in toilet training, or to subsequent accidents, no matter how frustrating they are to you. This will only make matters worse, and will most likely delay the completion of successful toilet training. Praise and encouragement are always a much better strategy, not only for toilet training but in all interactions with children.
2. Let the completion of toilet training be the child’s accomplishment rather than yours. You can share his pride, but it is important to allow your child to determine the timing and the pace of his toilet training.
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This is the symptom that you probably worry about the most, even if you don’t have it! Here are some facts that may surprise you. Cancer is not always painful, not even at the end. Cancer pain reacts to painkillers just like any other pain. When people with cancer do get pain, it is always possible to greatly relieve it, and sometimes even to get rid of it completely.
I know why you are anxious and frightened about the possibility of pain. You have read about, heard of, or known people who did have pain with cancer and whose pain was not controlled. You, yourself, may even have pain which is not being controlled right now. It doesn’t have to be that way for you.
We can do something about it. The most common reason for unrelieved cancer pain is simply ignorance— ignorance on the part of many doctors and nurses, as well as on the part of many people with cancer. Many doctors and nurses simply don’t know enough about the individual painkillers and how to use them most effectively. They don’t know how small the risk of addiction is when painkillers are used simply to control pain. Sometimes they don’t even know that it is realistic to aim for good control of cancer pain with painkillers.
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Vitamins and their place in human nutrition are very poorly understood by most people.
Sold and swallowed in large quantities to give instant energy, restore potency or prevent colds, they represent an expensive, but also a probably useless fad.
The vitamins are organic chemicals present in small quantities in food, and are necessary for the normal nutrition of the body.
Vitamins are divided into two groups — the water-soluble vitamins (the  group and Vitamin C) and the fat-soluble vitamins (A, D, E and K).
The body requires a certain minimal amount of these chemicals daily for the proper maintenance of health. If the diet contains less than the required amount for long enough, then signs and symptoms of a deficiency state will occur.
However, taking an excess quantity of vitamins — above that necessary for health — provides no extra benefit. In fact, with some of the vitamins, such as A and D, definite disease states may occur from excessive intake.
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The heart is a pump and regular, sustained exercise makes the heart work harder and so improves its efficiency.
The heart rate slows and the stroke volume — the amount pumped with each beat — increases. The coronary arteries dilate and become permanently wider.
Arteriosclerosis, or hardening of the arteries, is associated with a laying down of the atheroma or fatty tissue along the inner walls of the artery. This — like rust in a pipe — narrows the artery and can obstruct the blood flow. Widened arteries can take a great deal more build-up of atheroma before the narrowing obstructs the blood flow.
The lungs become more efficient and develop a greater capacity. But exercise also has other effects on the body.
Those who exercise regularly appear to become addicted to it. Certainly it gives a good reason for stopping smoking. You can’t really become fit while you continue to smoke.
Some experts have come up with a reason why those who push themselves hard with physical exercise seem to enjoy it despite the pain of aching limbs and a panting chest.
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If the woman is not awake for several hours after the birth, she may be separated from her baby and miss the initial “bonding” or closeness to the baby.
Following a general anaesthetic and a caesarean section, the woman may be nauseated and the bowels may not start working for one or two days. The abdomen is full and bloated. It may be necessary for her to have intravenous feeding. Despite all this, it is still possible for her to breast feed.
If time allows, most surgeons use the “bikini” cut. This incision is transverse across the abdomen and low so that it is hidden in the pubic hair. Despite having had a caesarean section, a woman can still wear brief bathers without a scar showing. Under emergency situations, the doctor may have to work through the older incision from the navel down.
Caesarean births are increasing, and this is not just for the convenience or financial gain of the doctor. Because modern medicine has made this operation so safe, it can be used more frequently in the interests of the baby.
Because of the possibility that what is hoped to be a natural birth may run into complications, all pregnant women should discuss a caesarean with their doctors.
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In case you still believe that experts always make better decisions than you could, here are some actual examples of what can and does happen. Some surgeons do pointless extensive and mutilating operations to remove secondary growths. Doctors often recommend intensive chemotherapy to patients with cancers for which it makes no difference to the average length of life. The only ‘benefit’ is that the growths of a minority of patients get smaller for a short time. Thus, chemotherapy is often recommended when it has only, say, a one in twenty chance of temporarily (for a few weeks or months) shrinking cancer growths and no chance at all of curing the cancer. Doctors sometimes continue patients on chemotherapy while their cancer growths are actually getting bigger and more extensive. Practitioners whose patients’ cancers continue to grow while undergoing treatment with cleansing diets usually still exhort them to persevere with their diets and take no medications at all, not even painkillers.
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Scientists have been studying what makes one food high and another low for more than fifteen years. There is a wealth of information that can easily confuse. We have summarised the results of their research in the following table which looks at the factors which influence the G.I. factor of a food.
The key message is that the physical state of the starch in the food is by far the most important factor influencing the G.I. value. That’s why the advances in food processing over the past two hundred years have had such a profound effect on the overall G.I. factor of the food we eat.
Particle size. Another factor that influences starch gelatinisation is the particle size of the food. Grinding or milling of cereals reduces the particle size and makes it easier for water to be absorbed and enzymes to attack. That is why cereal foods made from fine flours tend to have high G.I. factors. One of the most significant alterations to our food supply came with the introduction of steel roller mills in the mid-nineteenth century. Not only did they make it easier to remove the fibre from cereal grains, the particle size of the starch was smaller than ever before. Prior to the nineteenth century, stone grinding produced quite coarse flours that resulted in lower rates of digestion and absorption.
When starch is consumed in its natural packaging—whole intact grains that have been softened by soaking and cooking—the food will have a low G.I. factor. For example, cooked barley has a G.I. factor of only 25. Most cooked legumes have a G.I. factor between 30 and 40. Cooked whole wheat has a G.I. factor of 41.
The only whole (intact) grain food with a high G.I. factor is rice, specifically low amylose rice, such as Calrose rice at 83. These varieties of rice have starch which is very easily gelatinised during cooking and therefore easily broken down by digestive enzymes. This may help explain why we sometimes feel hungry not long after rice-based meals. However, some varieties of rice (Basmati, a long grain fragrant rice, and Doongara, a new Australian variety of rice) have lower G.I. factors because they have a higher amylose content than normal rice. Their G.I. factors are in the range of 54 to 64.
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