Anaemia occurs when there is too little hemoglobin in the blood. Hemoglobin is the substance that carries oxygen in the blood and gives the blood its red color. Normally, hemoglobin is contained within the red blood cells (RBCs). A child can be anemic because there are too few RBCs, because each RBC contains too little hemoglobin, or as a result of both conditions.

There are more than 30 types of anaemia, each with its own cause and treatment. The most common is iron deficiency anaemia. Anaemia can occur at any age. Some forms run in families; others are acquired.

Among the most common causes of anaemia are a poor diet that does not include enough of the nutrients needed to manufacture hemoglobin (iron, protein, folic acid, vitamin Bi2, and copper); the loss of blood by internal or external bleeding; a failure to absorb nutrients, even though they are eaten; the formation of abnormal (short-lived) RBCs; an inability of the bone marrow to produce RBCs fast enough; and the too-rapid destruction of normal RBCs within the body. In addition to the many diseases that are forms of anaemia, many other illnesses can produce anaemia.

Signs and symptoms

Most cases of anaemia produce no symptoms. However, tiredness, shortness of breath, rapid pulse, and jaundice (yellowing of the skin and the whites of the eyes) may be clues. If a child looks pale, check the nail beds, the inside of the eyelids, and the membranes inside the mouth for additional colorlessness. Also watch for these possible causes of anaemia: vomiting of blood; blood in the stools (red or tarry-black bowel movements); excessive menstruation; a grossly inadequate diet; chronic diarrhea; and exposure to poisonous substances.

If you think your child might have anaemia, see your doctor. The presence and type of anaemia can only be determined by laboratory tests. Periodic examinations and a medical history taken by a doctor can help detect anaemia early, an important factor in treatment. If one family member has anaemia, watch for symptoms in other family members.

Home care

Never attempt to treat anaemia yourself. The wrong treatment can be harmful and will make a proper medical diagnosis difficult. All children should receive a balanced diet to prevent anaemia caused by lack of proper nutrition.

Precaution

Iron overdosing is the second most common poisoning among children in this country. If iron supplements are prescribed by your doctor, keep them out of the reach of children. Some iron medicines are sweet, and children might mistake them for candy.

Medical treatment

To evaluate your child for anaemia, the doctor will give your child a physical examination, take a medical history, and test for simple total blood count. Your doctor may also need to take a reticulocyte (young RBC) count, platelet (a blood element that aids in clotting) count, and measurements of iron and of the iron-binding capacity in the blood. More extensive testing, if necessary, will include hemoglobin electrophoresis, sickle cell test, urinalysis, test of stools for hidden blood, examination of bone marrow, test for poisons, examination of the child’s parents’ blood, X ray of the intestinal tract, and blood chemistries. These tests will determine the type of anaemia.

The treatment prescribed may include adding supplementary iron and vitamins to the diet, a change in diet, and-though rarely-a blood transfusion. Iron or vitamin injections also are rarely called for and, if given, are administered for the first one or two doses only.

As treatment proceeds, be sure additional tests are scheduled to check on the effectiveness of the treatment. The proof of proper treatment is in the cure.

*11/84/5*

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Posted by admin on April 28th, 2009 :: Filed under General health

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Sometimes friends ask me to stay on for a meal at night after school, but I can’t because of my evening insulin dose. It is too far to go home just for an insulin injection.

Don’t let your diabetes routine spoil things for you. What are the options?

1.     Miss out on your evening dose that night. If it is a small dose and you are careful with what you eat and pretty accurate this might be all right. Check your blood glucose when you get home, and if it is high give a small dose of quick acting insulin before supper.

2.     Refuse the invitation and go home for insulin. Not a good idea. Even if you didn’t want to stay you shouldn’t use diabetes as an excuse.

3.     Ring up your parents and ask them to drive over with your insulin and syringe. This would answer your problem but would it be fair to ask? Only you (and they) could answer this.

4.     Stay for the meal and plan to have a modified dose of insulin when you get home. About two thirds of the usual dose at supper time would probably cover you satisfactorily, but check your blood glucose. You could need a little more of the quick acting insulin if it is high. I favour the fourth option but discuss it with your parents when the occasion arises.

I am going on a school camp. What should I do about blood tests and insulin?

The best way to enjoy your camp is to make sure you don’t have a hypo, or let your diabetes get out of control. Be prepared for activity, perhaps delayed meals and unusually late nights.

Take a good supply of syringes, an extra bottle of each insulin (in case of accidents) blood testing strips, urine-ketone strips and a good supply of carbohydrate exchanges, such as dried food, barley-sugar, other lollies and biscuits. It may be best to take the blood testing strips that don’t need a meter (BM Test Glycemie 20-800 or Glucostix).

Make sure a responsible adult knows about your diabetes and what to do if you have a hypo.

Make sure that your friends know that you will need insulin injections and may need extra food or sugar.

Divide your supplies of insulin and syringes into two packs. You carry one and a responsible friend or adult carries the other. A lost pack could otherwise spoil the camp.

Discuss what to do about blood tests and insulin in advance with your doctor. Here is my suggestion: Do a blood test when you get up. If it is low have some sugar at once while waiting for breakfast. If it is high and you don’t feel well check for urine-ketones. You could need extra quick acting insulin if ketones are positive but check in advance with your doctor how much you would give.

Otherwise have a slightly reduced dose of insulin because you will probably be pretty active at camp and need less insulin because it works more efficiently this way. Have extra carbohydrate during the day if you are very active, especially hikes or swimming.

If a meal is delayed have one or two exchanges at the usual time while you wait for the meal. Have your evening dose of insulin just before the evening meal, but reduce the dose to prevent a night time hypo.

Do a blood test before you go to bed. If it is low have an extra starch exchange to make sure that you don’t become hypoglycemic during the night.

With these precautions you should have no trouble – and your parents won’t need to worry about you either.

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Posted by admin on April 28th, 2009 :: Filed under Diabetes

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Home Free after 30

The United States may have a smaller proportion of J men joining the club of octogenarians than Japan, where w life expectancy is much longer than it is for most other folks on the globe. But studies show that if we can make it to the big eight-oh, we end up outliving 80-year-olds in Japan and many European countries.

If you want to increase your chances of making it into your seventies and beyond, the doctors from the esteemed Framingham Heart Study-a Massachusetts community-based health study of more than 10,000 men and women that has been in progress for more than 30 years-have a very simple prescription for men to follow-. Smoke less, keep your blood pressure in check, and exercise to strengthen your lungs and lower your heart rate.

Among 747 healthy 50-year-old men whom researchers began studying more than two decades ago, those who had lower blood pressure, smoked fewer cigarettes, and had lower heart rates and better lung function-both associated with cardiovascular fitness-were significantly more likely to see their 75th birthday than those who did not.

The Outer Limits

So what’s the longest you can expect to live once you’ve successfully navigated past childhood diseases, car crashes, and chronic diseases? Experts agree that you probably won’t live as long as the oldest people on record- about 120.

The only authenticated case of a man who’s ever reached this remarkable milestone was Shigechiyo Izumi, a Japanese man who made it to The Guinness Book of World Records for living 120 years and 237 days. More remarkably, Izumi continued to work until he was 105.

“Thousands of individuals will be able to make it past 100,” says Dr. Olshansky. “But our inherited program for growth and development leads inadvertently to a biological limit on life.” Evidently, that’s the price we pay for being a sexually reproducing species.

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Posted by admin on April 23rd, 2009 :: Filed under General health

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This is a kind of protein that both promotes and reflects inflammation levels in our body. It is elevated in the bloodstream in a number of varied diseases. New research has shown that elevated blood levels of C-reactive protein (CRP) are a major risk factor for heart disease, possibly being more significant than cholesterol levels. CRP is an independent marker for future cardiovascular disease, meaning even if you have a low or normal cholesterol level, you are at great risk of heart disease if you have high CRP levels. Your doctor can easily order a blood test to check you CRP level.

The New England Journal of Medicine published an article stating that inflammation is a better indicator of who will have a heart attack than high cholesterol. In this study almost 28 000 healthy postmenopausal women had blood tests and were monitored for eight years. The women with high levels of CRP were twice as likely to have a heart attack or stroke as the women with high levels of LDL “bad” cholesterol! A study done on men published in the same journal showed that men with the highest CRP levels had three times the number of heart attacks and two times the amount of ischemic strokes as men with normal levels. The really interesting fact is that the incidence was independent of other risk factors including blood fat levels and smoking!

The theory is that having high CRP levels means you have chronic inflammation in the walls of your coronary arteries. This inflammation makes it more likely that fatty particles and immune cells will be attracted to the artery wall in an effort to repair the damage. This sets the stage for the development of a fatty plaque and full blown atherosclerosis. High blood levels of CRP indicate that you are more likely to have a heart attack, and the higher your level, the less likely you are to survive that heart attack. Recent studies have also shown that high CRP levels increase the chance of an artery re-closing after it has been opened by balloon angioplasty.

What causes elevated C-reactive protein?

The following conditions are most likely responsible for high CRP:

• Chronic or acute infections.

• Autoimmune disease.

• Allergies.

• Obesity.

• Diabetes mellitus.

• Consuming trans fatty acids (hydrogenated vegetable oil) and oils high in omega 6 fats, such as soybean, corn, safflower, cottonseed and sunflower oils.

• Diets high in sugar, refined carbohydrates and high glycaemic foods, such as white bread, potatoes, biscuits and breakfast cereals.

• Cigarette smoking.

• Lack of antioxidant nutrients in the diet.

*4/53/5*

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Posted by admin on April 23rd, 2009 :: Filed under Uncategorized

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Many of the features of OSA are not a direct result of snoring per se but are a consequence of obstructive events during sleep which cause blood oxygen levels to drop to dangerously low levels. The absolute priority given to the body’s need for oxygen can be put into perspective when we consider that a healthy human can survive without food for several weeks, survive without water for days, but will die within minutes of oxygen deprivation. Not surprisingly, snoring is the most prevalent symptom of OSA, occurring in about 95% of patients with the syndrome. A cluster of other symptoms is also very common and will be found to a greater or lesser extent depending on the number of apnoeas experienced in a night and the severity of oxygen deprivation.

Sleepiness

The patient with OSA is classically prone to daytime sleepiness, often found slumped in front of a television or at the table during a dinner party. Most alarming are those patients who seek help after falling asleep behind the wheel of a car or while operating dangerous machinery. The tendency to fall asleep during the day is attributed to poor quality sleep at night caused by arousals associated with each obstructive event. Anyone who has observed a patient with OSA will be aware of the repetitive nature of airway obstruction and the resulting sleep fragmentation. Airway collapse is followed by increasing respiratory efforts to overcome the obstruction and to relieve intolerably low blood oxygen levels (hypoxaemia). The degree of sleep disturbance probably relates to the severity of the apnoeic period; some patients experiencing a mild arousal from REM to NREM states, while others will be fully awakened by such an episode. Sufferers of advanced OSA are caught in a cruel cycle. The relentless process of obstruction and arousal many times a night leaves the sufferer sleep deprived, lethargic and irritable. He cannot help trying to make up for lost sleep at every opportunity yet it is sleep which sets in motion events such as loss of upper airway tone which in turn result in obstruction and arousal.

Personality changes and memory loss

Memory deterioration and an inability to concentrate are symptomatic of sleep apnoea. The reasons for this are not completely understood but it is suggested that they result from the cumulative damage of perhaps many years of hypoxaemia during sleep. The disturbed sleep patterns of OSA are also likely to result in such impairment, and there is little doubt that both hypoxaemia and sleep fragmentation contribute to the problem of impaired memory and learning ability. As a consequence of the social readjustments that have to be made and the behavioral and personality changes which may arise, these people may be seen in the first instance by Psychiatrists for treatment of depressive illness.

Physiological changes

The behavioral changes which become increasingly apparent to spouse and friends are accompanied by potentially serious physiological changes, particularly to the heart and circulatory system. Some of the changes occur rapidly in response to each of the many obstructive events during sleep. Blood pressure, for example, is normally slightly lower at night than during the day, but in OSA blood pressure rises during apnoeic periods. There can also be quite startling changes in heart rate when the hypoxaemia associated with obstruction induces a slower heart rate (bradycardia) followed by an increase (tachycardia) when normal breathing is resumed. Apnoea may also be associated with irregular heart beats or arrhythmias, which are potentially life threatening.

Superimposed over the transient yet dramatic changes which occur during sleep are several long term and persistent abnormalities. Blood pressure often remains high and may be the first measurable symptom observed at an initial consultation. Increased blood pressure and other changes to the blood circulatory system also affect the heart which may become enlarged in an effort to overcome the harmful effects of hypoxaemia on the cardiovascular system.

*11/51/5*

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Posted by admin on April 23rd, 2009 :: Filed under General health

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‘Illness behaviour’ is the term used to describe the way we respond to abnormal body signs and symptoms. Obviously this involves concepts such as how a particular person monitors his or her body and its functions, defines or interprets his or her symptoms, takes action and uses the health-care system.

‘Health behaviour’, in contrast, refers to patterns of response to health, when the person has no specific symptoms. This is an especially useful concept when thinking about prevention because a lot of prevention is done by an individual who is well at the time. Examples of such activities are regular medical and dental check-ups, screening and soon. A lot of research has been done on people’s views and beliefs in this area but the best is the Health Belief Model, which looks at the way an individual assesses the likelihood of a problem having serious consequences. It is really a sort of psychological cost-benefit analysis in which people do things according to how important they consider the consequences of not doing them. So it is that we weigh up the advantages and disadvantages of factors as different as wearing a seat-belt, exercise, nutrition, medical check-ups, clinical examinations, careful driving, sanitation and personal hygiene. According to the effect we perceive each factor as having on our lives (for good or bad) we make decisions about how to maintain our health.

Unfortunately, doctors and their patients tend to see health and illness rather differently Doctors are trained to identify illnesses and to treat them as individual entities, whereas their patients see health as a more global matter which governs their overall sense of well-being. Symptoms and other frank signs of illness are seen by patients in the context of how they interfere with the business of living. In other words, illness to most people has a lot to do with feelings.

Many studies show how people’s feelings influence their sense of physical well-being. People who complain of poor physical health are often depressed, feel neglected, have a low morale, feel alienated and are less satisfied with life than those not reporting poor physical health. Also, it is clear from many studies that psychological ill health and distress lead to a very much greater use of all kinds of health services. So psychological factors influence not only people’s views of their health but also how much they actually use health services.

The way we react to illness varies considerably with our personality type and from culture to culture. Some people are stoical in the face of illness, others matter-of-fact, and yet others hypochondriacal. Some people go straight to the doctor with the most minor of symptoms and others are reluctant to trouble him or her with even quite severe problems. The same person over quite a short time-span can react and behave in very different ways. Most studies of illness show that women go to doctors more readily and more frequently than do men. Just why this should be is not known. Perhaps there are real sex differences in many diseases (i.e. they are in fact more common in women); or women may have a lower threshold of tolerance to symptoms; they may be more likely to accept a symptom and seek help for it; they may be more interested in health; they may be more concerned that they keep well because of the considerable pressures on them to run and maintain family and home life; or they may be culturally conditioned to running (in a little-girl-like way) to an authority figure to sort out problems quickly. Whatever the reason-and it might be that none of these is correct-the difference is apparent very early. Studies have found that young “girls use child-driven school health-care systems more than do young boys. Wherever the truth lies, repeated research has shown that much of the disability associated with physical and mental illness is not the result of illness itself but rather the way the person responds to the condition and the way it is managed. For example, a lot of the aggressive behaviour previously seen with schizophrenia has been shown to be a result of the way that schizophrenics were dealt with by the authorities rather than as a part of the disease itself.

There are quite dramatic social and cultural differences in the way individuals and groups define illness and respond to it. Studies carried out in the US have shown that Jewish and Italian patients, for example, have been found to respond to pain in an emotional way-tending to make much of it-whilst the English and ‘Old Americans’ are more stoical and clear-headed about it. Irish patients more frequently deny pain. Whilst Jews and Italians appear to react similarly to pain, their underlying cultures are different. Italian patients seek relief from pain and seem satisfied when the pain is relieved, but Jewish patients seem to be more concerned about the significance of the pain for their future health. So pain relief may be what Italians need most but reassurance about the future may be what is most needed by Jews. Clearly this kind of information is essential if one is to plan any kind of preventive health programme.

*11/72/5*

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Posted by admin on April 23rd, 2009 :: Filed under General health

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Eating more can help you realize your weight-loss goals. But you have to be smart about it. If you coat your wonderful lunch salad with a high-fat dressing, it’s not so wonderful anymore. If you slather your whole-grain roll with butter, it topples out of the healthy category and into the not-so-healthy one.

The easiest and fastest way to teach yourself to eat smart is to keep a food diary. In a small notebook, write down exactly when, what, and how much you eat. Was the fish broiled or fried? Did you have one serving of ice cream, or two … or three? Was your baked potato topped with plain low-fat yogurt and chives or with butter and sour cream?

You may be surprised at how your perception of what and how much you eat differs from what really goes into your mouth. You may never have realized how many handfuls of M&M’s you grab from the office candy dish over the course of a day. Or that the bottle of cola that you drink with your lunch contains two servings rather than one. Or that your usual-size portion of fish is three times larger than it should be. All of those extra calories add up.

Learn to recognize portion sizes. Weigh and measure foods until you know what a serving looks like. And always read labels. You’ll be amazed at where you’ll find loads of calories lurking.

Eating smart isn’t about eating boring, tasteless meals—or not eating at all. It’s about eating only when you’re hungry, making healthful food choices, and controlling your portions. It’s about being aware of why you’re eating. It’s about feeding your body properly and feeling good about yourself.

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Posted by admin on April 23rd, 2009 :: Filed under Weight Loss

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Yams are probably the best potato substitute. They are a large cylindrical white root with a dull brown outer skin. Firmer and more fibrous than potatoes, they are very similar in taste but with an interesting, slightly bitter aftertaste. They are best if prepared like sauteed potatoes – boiled and then fried. You need a sharp knife and a strong hand to peel them and cut them into cubes. Boil for about 20 mins or until they are tender. If you buy a large piece of yam and boil it, you can then pack the cooked pieces in individual portions and freeze them. You can fry them from frozen in oil – fry slowly over a low heat for best results. Yam can be bought in West Indian groceries, but tends to be rather expensive. Pieces of fried yam dipped in taramasalata are quite delicious.

Sweet potatoes are also found in West Indian and Chinese stores, and occasionally in ordinary greengrocers or supermarkets. There are many different sorts, with flesh ranging from white to deep yellow in colour. Those on sale in Britain usually have a distinctive reddish-purple outer skin. Peel and dice them, keeping them under water as much as possible to prevent discolouration. Alternatively, you can bake them and serve them with butter (if allowed) or slice and deep-fry them. They have a very sweet, slightly sticky flesh which goes well in soups, or with meat casseroles, but is rather cloying on its own.

Serving sweet potatoes with sharp fruit is a good idea, as the acidity offsets their stickiness. Try frying them over a low heat for 20 minutes (after boiling), adding slices of apple and walnuts for the last 5 minutes. This makes a good breakfast dish. Like yams, sweet potatoes can be peeled and boiled in a large batch, then stored in individual portions in the freezer, and fried from frozen.

The Chinese make a soup by boiling sweet potatoes in water or stock until they disintegrate and flavouring the liquid with root ginger. They also make a delicious snack called deep-fried sweet potato balls. To make these, boil some sweet potatoes until soft. Mash them and add rice flour (or wheat flour) to make a stiff dough. Take a small piece of the dough, press it down flat, put a half-teaspoonful of peanut butter (or another nut butter) in the centre and seal the dough around it. Roll in sesame seeds and deep fry in vegetable oil.

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Posted by admin on April 20th, 2009 :: Filed under Allergies

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Proceed to Stage 2. Stay on the healthy-eating diet until you are ready to start.

If you are satisfied with your improvement, and don’t like the idea of giving up foods, you could stop here. Reintroduce tea, coffee, alcohol etc, to see which was the problem, following the instructions given below.

If you feel you would like to be better still, go on to Stage 2 of the diet. When you have completed Stage 2 (or Stage 3) you can test your reactions to tea, coffee, alcohol etc.

Some people who feel partially better at this stage, may be suffering from Candida overgrowth. Cutting out sugar could have improved the situation, but to get any further requires a full Candida treatment. If you think this is likely, having considered the symptoms of Candida, then you should try the full anti-Candida diet. Bear in mind, however, that the symptoms of candidiasis and food intolerance are very difficult to tell apart. You may be better off proceeding to Stage 2, and then trying the anti-Candida therapy if this does not work.

Feeling a lot better

Good – you can now test the various things you cut out to see which ones cause your symptoms – see the next section for instructions. Testing can begin as soon as you have been consistently well for a week. If you felt terrible at the start of the diet, then caffeine is the most likely cause. Try a fairly weak cup of coffee or tea for your first test. Bear in mind that there are dozens of other nasties in tea and coffee, besides caffeine – you may be reacting to one of these, in which case you could be sensitive to tea but not coffee, or vice versa.

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Posted by admin on April 20th, 2009 :: Filed under Allergies

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Carol was an active woman in her fifties, who had a part-time secretarial job and was a voluntary worker at the local hospital. With a large family of children and grandchildren to worry about, she tended to ignore the odd aches and pains that she suffered. But as the years went by these grew worse, and finally began to interfere with her life. She had difficulty getting out of bed in the morning, her joints were so stiff, and it was only by the evening that she really loosened up and could move around normally. As well as joint pain, she began to suffer from diarrhoea and wind, which was worse whenever she drank alcohol. Headaches became more regular until she had them almost every day, and she often had severe pains in her face due to sinusitis. She also suffered repeated thrush infections and an itchy rash between the toes which looked like athlete’s foot. It was these two items that made her doctor suspect a Candida infection. She put Carol on a sugar-free diet and prescribed an antifungal drug, nystatin. This made her feel much worse initially, but after a month her bowels were functioning normally, her joints were less

stiff and her headaches were less frequent. Since she was still not completely well, the doctor asked her to try an elimination diet, avoiding cereal grains, dairy products and eggs. Carol was impressed by the change this brought about – she felt much better in herself, less tired and able to be cheerful without making an effort. She also lost some excess weight that she had accumulated. On testing, it turned out to be eggs and wheat that caused her problems. Having improved so much, she was now able to notice the specific effects of certain other foods. For one thing, she noticed that foods containing a lot of additives made her feel tired and unwell, with vague muscle aches. Decorating the house also produced these sort of symptoms, and she found later that solvents such as white spirit and dry-cleaning fluid regularly had this effect.

As this case shows, there are often several different factors at work in individual patients. It is not unusual for food intolerance to go hand-in-hand with Candida overgrowth and sensitivity to synthetic chemicals. How these three problems might interconnect is still unknown.

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Posted by admin on April 20th, 2009 :: Filed under Allergies

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