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Nightmares are related to real or imagined things in the child’s daily life, such as stress or anxiety about school or friends or families, or may be the aftermath of a frightening movie or news item. No matter how bizarre the nightmare, the fears are very real to the child. In reassuring the child, do not simply dismiss the episode as just a bad dream, but address the issues that the child raises and respond to the fear.

After reassurance the child is usually able to go back to sleep readily. Nightmares are common and normal, and in most instances no special intervention is required. As children grow older, they are better able to cope with bad dreams.

Night terrors, while part of the spectrum of arousal disorders, are quite different from nightmares. The child wakes in the middle of the night literally in terror. He will be sweaty, breathing rapidly, with his heart racing and eyes bulging — in a state of panic. There may have been a scream which alerted the parents in the first place. The child is usually inconsolable, and may not even be aware of the parents’ presence. After a few minutes the child goes back to sleep, and will generally have no recollection of the episode the next morning.

Night terrors are frightening for parents as well as for the children. They last only a few minutes, have no long-term consequences, and they usually resolve spontaneously over time. If they are very frequent and cause major family disruption, they can usually be successfully treated with small doses of medications but this is rarely necessary. In older children meditation or relaxation exercises have been suggested, but there is little evidence about their effectiveness although they can do no harm.

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It is postulated that there is a tight band of tissue, just inside the anal margin, forming part of the sphincter muscle which keeps the bowel opening closed.

Under a deep but short-acting general anaesthetic, the surgeon distends the sphincter, disrupting this tight band. At the same time any projecting piles or skin tags are snipped off.

The person undergoing this procedure can leave hospital the same day and usually is absent from work only for a few days.

But formal operation with excision or cutting out of the dilated veins and the overlying skin and mucous membrane which forms the pile remains the most suitable treatment for permanent control of third-degree piles.

Unfortunately, this operation has a bad reputation. Many people believe it is associated with a lot of post-operative pain.

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Sometimes the reverse happens and the periods become heavier and more frequent, due to some associated disorder.

Most women worry about the possibility of becoming pregnant at this time and are concerned about when they should discontinue contraception.

Those woman who have shown their fertility by still having children into the forties are more likely to conceive than those who may not have had a child for 10 or 15 years and yet have not been too careful in avoiding conception.

Because ovulation may still occur, most doctors would advise their menopausal patients to practise contraception until a full year from the last period.

Most women go through the menopause, or climacteric, with a minimum of discomfort and few symptoms. Unfortunately, for others this time of their lives may become a nightmare and they suffer severe physical and mental symptoms.

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‘Most of the young children whose mothers say they have loose, frequent or bulky stools do not suffer from malabsorption. Their physical growth is normal and the abdomen is not distended,’ paediatrician Dr John Apley says in his book Paediatrics. ‘The symptoms are not primarily in the child’s intestine, but in the mother’s cerebrum (mind).’

Dr Apley is not being unkind, nor is he being funny. He is stating the truth. However, if any parent is worried about his or her child’s bowel actions, it is best to have the patient properly checked out, to make doubly certain there is no underlying basis. Most cases are not serious. Some are. Sometimes if emotional stresses and family tensions are solved, then the diarrhoea may also be cured.

Some infants and children have an intolerance to sugar in the diet. It may occur in young babies. This intolerance is built up, and may apply to certain sugars only. It may follow from a surgical operation or from gastro-enteritis. If the sugar is identified and withdrawn from the diet, a magical cure may follow

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‘Could it be because of some underlying disease of his bladder system?’ Sandry asked, hopefully.

‘It is possible, but not probable. Bring Danny in to see me, and we’ll have all this checked. We’ll have a few simple tests done to eliminate organic disorders as possible causes.’

‘Supposing he is physically perfect. What is the routine then?’ Sandra asked. She really wanted Danny fixed up, and I hardly blamed her. Washing sheets every day of one’s life can be a bore and even a physical hardship, in spite of modern washing machines and all that.

‘Examining all possible emotional causes is the best starting point. Then trying to correct these as far as possible. Trying to explain why certain situations occur at least offers the child some reason, and hopefully Danny is old enough to comprehend this.

‘Next, the best method is the pad-and-bell alarm system. This is simple, but requires a bit of fiddling around. When the device is set up, an alarm rings each time Danny wets the bed. He quickly wakes up. The bed is changed, he is taken to the toilet, and an explanation given as to what it is all about.

‘You can make a game out of it. Explain that the less he wets the bed at night, the fewer times he will be disturbed. Aim for 100 per cent, and make a big success event when he goes through the night without the alarm sounding.’

‘That sounds a good idea,’ Sandra said. ‘I suppose I can get these devices simply?’

‘They are often available on hire from a chemist. Or you can buy your own. Most children start to have dry nights after five to ten alarms. It is often as successful as that.’

‘Sounds wonderful,’ Sandra exclaimed.

‘Drug medication is also available. We can prescribe a family of drugs called the tri-cyclic antidepressants. Imipramine is often used, and this can work. But often it doesn’t and sometimes when discontinued the child reverts back to previous bed wetting habits. Anyway, after I’ve examined him, let’s start with the pad-and-bell system … plus the little talks, as we have suggested. I hope the combination will be highly successful.’

‘We all hope so,’ Sandra added, with an encouraging smile.

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Naturopaths believe that the breakdown of the normal balance of the body is the cause of illness. While outside factors such as viruses or bacteria may affect health, it is the lack of resistance in the patient which is the primary problem requiring treatment.

Methods of diagnosis include iridology, analysis of blood and urine, hair diagnosis, and others. The naturopath will also want to know about the diet, sleep patterns, menstrual cycle and bowel activity of the patient. The diagnosis of any problem is more concerned with the reason for disturbances in health than in naming the illness. Like other wholistic practitioners, the naturopath concentrates on the individual patient, rather than on diagnosing a condition which has an associated set of symptoms.

Treatment recommended by a naturopath may include changes to the diet. For example, a patient may be advised not to consume drinks containing caffeine, such as tea and coffee, or to give up alcohol or smoking. Someone who is diagnosed as having an allergy may be told to avoid certain foods such as wheat or dairy products. Sometimes a short fast on water or juice, or a limited range of foods may be prescribed in order to cleanse the system.

Some naturopaths practise therapeutic massage, acupuncture and herbalism.

Many naturopaths in Australia are registered with national organisations such as the Australian Natural Therapists Association, the Australian Traditional Medicine Society and the Complementary Medicine Association. When consulting one of these registered therapists, you may be entitled to rebates if you are covered by a participating health fund.

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Signs and symptoms

The key sign of cradle cap is the yellowish, scaly, crusty appearance of the patches. A greasy scalp film can be scraped off. The patches most often appear on the scalp, but may extend onto the forehead. Patches may also appear in the skin fold behind the ears, on the ears, and in the nappy area. The most typical location in infants is over the soft spot in the scalp (the anterior fontanelle).

Home care

Mild cases of cradle cap on the scalp can be cleared by daily, vigorous shampooing. Use soap on a wet, rough facecloth wrapped around the palm of your hand. If regular soap or shampoos do not clear the condition, special shampoos that contain coal tar or salicylic acid are useful. If necessary, apply ointments containing sulphur, salicylic acid, or coal tar to the scalp daily.

Precautions

• Be sure that medicated shampoos and ointments do not get into your child’s eyes.

• Stop using medicated shampoos or ointments if the scalp or skin becomes irritated or red.

Medical treatment

Your doctor will determine whether the condition is cradle cap or some other skin condition, such as a yeast infection or an allergic skin reaction. The doctor’s treatment will be the same as home care. In addition, a steroid cream or ointment may be prescribed.

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Try the combo special. You can even cut down your days from five to three by doing aerobics and strength training at the same time. “You can actually get an aerobic workout by doing weight training,” Taranta says. “Go from station to station or exercise to exercise without taking long breaks so that you maintain a high heart rate.”

Warm your muscles. There are lots of good reasons to warm up before working out. For one thing, warming up puts your brain in sync with your muscles, making them ready to be called upon to work hard. “And common sense tells us that warmed-up muscles are probably going to be less likely to be injured,” Dr. Baechle says. “Plus we know that warmed-up muscles are able to pick up and use oxygen more efficiently.”

When exercise experts talk about warming up, they mean it. Do something to raise the temperature of the muscles you’re going to be using. In weight training, for example, that could mean duplicating the motion of the exercise at very low weight. “Just pick the exercise you’re going to do and use about half the load,” Dr. Baechle says. “If you’re warming up for an activity, make it specific for that activity. Using one-half of the training load in an exercise is a great way to make it specific.”

Stretch out your workout. “Most of us who are 35-plus grew up thinking that warming up was stretching,” Sobel says. “It’s almost the opposite. You want to warm your body up and then do your stretching. Warming up involves increasing the body’s temperature and heart rate through low-level aerobic, full-body activity.”

In fact, a good time for you to stretch is after you’ve done your aerobic or weight workout. “If you cool down by stretching, you don’t get that after-exercise soreness and you get more of the stretching benefits,” says Sobel.

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