Eczema is worsened when the skin is dry, so oils and lubricating creams applied to the skin are helpful, as are the use of bath oils. All these help to prevent the skin from becoming dry. If your child is scratching at the rash, try putting cotton mittens on his hands at night. Always make sure that nails are cut short and kept clean. If the scratching becomes vigorous, discuss with your doctor the possibility of using an antihistamine medication for a few days, which may provide both you and your child with some well needed rest, and give the rash a chance to heal. If the rash becomes infected, your doctor will probably recommend a short course of antibiotics.

Avoid giving your child prolonged baths. Bathe him only once a day, and add a moisturising bath oil. These can be bought without a prescription. Do not use soap on young children; it is unnecessary and may worsen the eczema. Older children may use a mild soap under the armpits and around the anal and genital region. Always apply a lubricating cream after washing as this helps prevent moisture loss.

If, despite all these measures, your child’s eczema does not improve, you may wish to discuss with your doctor the possibility of referral to a skin specialist.

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Are they courteous and warm? Are the waiting facilities adequate? Do they cater for children, with a bright atmosphere, toys and children’s books, and carpet so that toddlers and young children can play on the floor? Is there space to park a pram or pusher?

• Has the doctor had particular training in paediatrics? Some doctors have had special training in paediatrics after they have graduated, but many have not. Some will have had several months of working with children, others a year, and some will have had a number of years. Do not be afraid to ask the doctor how much training and experience he has had with children. While it is not essential to find a doctor for your child who has been specifically trained in children’s health, naturally those who have will generally have a better understanding of children and their illnesses than those who have not.

• Is the doctor friendly? Do you and your child feel welcome? Look for a doctor who is easy to communicate with, who always pays attention to your concerns and doesn’t appear to rush you. Just as important, make sure that the doctor treats your child with respect and sensitivity and takes the time and trouble to talk or play with him, to explain things to him if he is old enough, and is generally aware of the special needs of children, especially if they are unwell or feeling anxious.

• Are the office hours convenient? Does the doctor offer an after hours service? If not, what arrangements are made for emergencies at nights and weekends? Does the doctor do house calls? Is there a locum working out of the practice who will have access to your child’s records? Or does the doctor rely on a locum service?

• How easy is it to make an appointment to see the doctor? What about emergencies? Is he generally on time, or does seeing the doctor usually involve a long wait? What are the busiest and quietest times of day?

• What are the charges for a consultation? Does the practice ‘bulk bill’, charge the ‘recommended’ fees, or are the fees higher? How much are the out of pocket expenses following a consultation?

You may wish to write down some of the other things that you think are important in choosing a doctor for your child, or use this space to write down any comments that will help you choose.

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HUSBAND

Virtually all of the men reported some hypersensitivity of the F and/or R area sometimes during their sexual experiences. Two hundred twenty-one of the men reported it as frequently problematic. Some of them (62) reported “strange” sensations in the penis or scrotum during sex that they felt interfered with their enjoyment.

HYPERSENSITIVITY OF G AND/OR Ñ AREA: It’s like it’s hot or gets hot. It actually stings. It burns right up to the inside.

WIFE

Seventy-three women reported this problem. As I have reported, it is a mistake to indicate that there is a G “spot.” However, all of the women in the thousand were able to discover, according to their subjective report, a region of sensitivity in the anterior vaginal wall. For some women, this region extended throughout the entire anterior and posterior parts of the vagina.

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DISCORD:

WHEN ONE PARTNER IS EMOTIONALLY HOT, THE OTHER GETS HOTTER, COLD MEANS COLDER FOR OTHER

WIFE

RHYTHM:

A FEEDBACK LOOP IS INTACT. PARTNERS HELP TO STABILIZE ONE ANOTHER, AND ADJUST TO AND FOR EACH OTHER

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TENDING TOWARD    -TENDING TOWARD

RHYTHM    NO RHYTHM

Does your marriage have a “marital-stat,” a type of emotional thermostat in which one partner can help the other to back off of an argument, to cool down, and one partner can help to bring up the other partner when emotional support is needed? The presence of a good marital-stat is like a good sense of rhythm, a fine-tuned thermostat in your home. When things get cooler, the thermostat calls for more heat. When it is getting hotter, the thermostat calls for a little cool air. Is there a lack of rhythm, with emotional heat in one partner causing the maladjusted marital-stat to call for even more heat from the other partner?

Scientists refer to this idea of rhythm as cybernetics, the study of feedback, of ecological and systems maintenance through some mechanism of automatic adjustment, heating up and cooling down, going faster and slower in corrective responsives cycles. In a sense, this chapter on the marital system is about sexual cybernetics. Intimacy and sexual interaction serve as the feedback instrument. Super Marital Sex Opportunity Number Two, presented at the end of this chapter, will show you more about how sexual cybernetics works.

The couple at the dinner table scored toward discord. The wife needed someone to bring her up, to help her readjust, someone sensitive to her personal crisis. The husband only depressed her further through his own disenchantment and his incomplete solution to their sexual problem (his own quick sexual release). The marital system was not being adjusted, just allowed to freeze up in the absence of emotional warmth and intimacy.

The husband required someone to cool down his hot reacting style, but the wife was incapacitated emotionally, sensing but unable to help with her husband’s overheating.

Too rapid and immediate adjustment, too much rhythm, can result in marital instability, too many adjustments to allow for comfortable patterns to emerge. A thermostat that goes on and off too soon and too often eventually breaks. Marriages need time to adjust too.

In super marital sex, couples have their marital-stat working well. They are able to maintain a comfort zone together. The frequency, type, and intensity of their sexual relationship seems to adjust itself automatically, just as a real thermostat is not noticed when it is doing its job. When sex gets too hot, resulting in conflict, even pain (dyspareunia), readjustment occurs. When sex gets too cold (desire-phase disorders and incompatibility), readjustment takes place, and warmth returns. Things do not have to get too hot or too cold before the readjustment occurs. The thermostat, marital-stat, seems very sensitive. Seldom is anyone left crying at the table or angry as he or she drives to a Softball game.

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Methotrexate is a drug widely used in treating various cancers. It is effective in some cases of psoriasis because it depresses the over-activity of the cells in the skin.

This is no cure but can clear most of the lesions of psoriasis. However, in most cases, the rash comes back once treatment is stopped.

Another treatment routine involves using drugs known as psoralens in combination with ultraviolet light. UV light of long wave length (UV-A) is more effective and so special lamps which give this form of ultraviolet light are used. The combination of the first letters of the drug and the light has led to this treatment being called PUVA.

The long term effects of such treatment on the skin is still a matter of debate. It has been suggested that the incidence of skin cancer may be increased and the treatment should be reserved for severe and resistant cases. Again, like methotrexate therapy, it should only be used by those with extensive experience.

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It is most common at the end of the small bowel just where it joins the large bowel.

The causes are unknown and in many ways, it resembles ulcerative colitis, another chronic inflammatory bowel disorder which most often affects the large bowel.

In about 10 per cent of cases the features may so closely resemble both Crohn’s disease and ulcerative colitis that it is almost impossible to tell the difference between the two.

There is some evidence to suggest that it is more common in some families.

Women are more affected than men, and it can occur at all ages but it is rare in the very young and the very old.

Small ulcers develop in the bowel wall and this is usually followed by thickening and scarring.

It can affect one small portion of the bowel or several different areas with normal bowel in between, but this will depend on which part of the gut is affected.

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It involves the smallest of the airways — the bronchioles — as well as the larger bronchi.

The illness often starts as a rather mild infection with a nasal discharge and slight cough, then suddenly worsens with a harsh dry cough, wheeze and respiratory distress. Fever is slight or absent.

The child is obviously ill and in distress and rib retraction is noticeable on looking at the chest. Most cases need admission to hospital for treatment.

WHEEZY BRONCHITIS: Some children develop a wheeze with each respiratory infection. It may be difficult to distinguish between wheezy bronchitis and asthma triggered off by infection.

ASTHMA: Is a spasm or tightening of the muscles in the bronchial tubes, a swelling of their lining, and an excess of mucus, all of which produce a wheeze.

The three factors which cause asthma may act singly or together. They are allergy, infection and emotion.

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Stage I cancer seems to be confined to the organ it started in. There must be no indication that it is even growing out of this organ directly into neighbouring tissues. There is only the one primary growth and, usually, this must be less than a certain size.

Stage II cancers have spread to the lymph nodes which normally drain the organ in which the cancer started. They have apparently not spread to more distant lymph nodes or through the blood. They must be confined within the nodes, not extending out of them to stick to each other or to neighbouring tissues like skin.

Stage III cancers are those which have not yet apparently spread through the blood, but have extended out of the organ of origin and/or the nearby lymph nodes directly into neighbouring tissues.

Stage IV cancers are those known to have already spread through the bloodstream.

The accuracy of the assessment of your stage of cancer obviously depends on how carefully you have been examined and tested. A cancer which seems to be Stage I when you have only been examined by the doctor may prove to be Stage IV after blood tests and X-rays. A cancer which seems to be only Stage II after extensive tests could still be found to actually be Stage IV when it is operated on and the surgeon can see inside.

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