HELPING YOUR CHILD COPE WITH EPILEPSY: WHAT DO YOU TELL THE SCHOOL AND HIS CLASSMATES?

Teachers are an important part of your child’s environment and can be enormously helpful to the child with epilepsy. If they are informed and properly educated, the teacher will know what to do and what to say to classmates should a seizure occur in school. They need to be prepared should a tonic-clonic seizure occur. They can be very helpful in alerting the parent and physician to changes in performance or personality that might be related to drug toxicity.One of the prevailing myths is that children with epilepsy are stupid or have learning problems. According to many studies, children wi th epilepsy do tend to have more difficulties in school, but this may be a consequence of fear or anxiety, his own and others’. Nor does this mean that all children with epilepsy have learning problems. Most children with epilepsy do not. Some teachers may see learning problems that aren’t there. They may be responding to the myths. But often, the teacher is sensitive to your child’s needs. If she points out problems, your physician can evaluate whether they are related to medication. The school may be able to devise an individual educational program to meet your child’s needs, if one is required.Learning problems may not be the result of epilepsy at all. Many children who never had epilepsy don’t learn easily. Or, as noted, problems may be a side effect of medication. A change in your child’s personality or in his abilities when medication is started may signal such a cause. Early identification of this possibility may allow the physician either to reduce the dose of the drug or to change the medication.To be sure that teachers, school nurses, and principals have accurate information, you may provide some of the excellent pamphlets available either directly from the Epilepsy Foundation of America or from a local affiliate. Many pamphlets are written so that a young child can understand them and are available either free or for only a nominal charge. Pamphlets such as Because You Are My Friend explain epilepsy in simple terms to a young child’s siblings and friends and, when appropriate, can be used in the child’s classroom. Your local epilepsy association can probably provide speakers or perhaps the wonderful puppet show “Kids on the Block,” and will try to help educate the school. A brief classroom session may help your child’s classmates be more understanding, helpful, and friendly should they see your child have a seizure.*181\208\8*

HOUSE MITES – A CAUSE OF PERENNIAL ALLERGIC RHINITIS

Although they are just one of many forms of insects with whom we share our living quarters, mites are the most important from an allergy perspective. A subclass of arachnids, two species of these microscopic creatures account for the majority of “house mite” allergies: Dermatophagoides pteronyssinus and Dermatophagoides farinae. One or both may be present in a home at any time. Cleanliness of the home or its occupants has nothing to do with their presence.
Mites need three things to survive: food, proper conditions of humidity, and safety. All three are found in homes. Their primary food source is shed skin cells from the human inhabitants and pets or feather-stuffed bedding and furniture. Skin shedding occurs in areas where humans spend the most time when at home, so there is good reason why the highest concentration of mites is found in stuffed furniture, carpeting, mattresses, and bedding. They also accumulate in clothing and stuffed toys.
The old saying “safe as a bug in a rug” should be the house mite motto. These microscopic creatures burrow deep into upholstered furniture, stuffed toys, bedding, and loose, long-pile carpet. Here, moisture conditions are optimal for survival and the mites are sufficiently protected so as to be impervious to vacuuming and other human efforts to eradicate them. Or, at least they were.
Modern living – central heating, better sealed homes, and wall-to-wall carpeting – has benefited both man and mite. Mites require very specific conditions of humidity in relation to temperature for survival. Ideal conditions encompass a relative humidity of 55 to 75 percent over a temperature range of 59 to 95 degrees F. What better place than a home at 70 degrees F and a relative humidity of greater than 60 percent? Still, because temperature and humidity conditions vary greatly throughout the United States, the concentration of mites is greater in some areas than in others.
Mites have no lungs. They take air and water into their bodies primarily by diffusion through their shells. Thus, the greater the relative humidity, the greater their ability to acquire water. Their humidity needs are generally satisfied indoors, particularly in the winter months when the central heating system is functioning. In general, a combination of relative humidity of 40 to 50 percent and a temperature of 82 to 83 degrees F (28 to 34 degrees C) prohibits mite survival. So, whereas mites are found in most homes in the states bordering the east and gulf coasts, they occur in only a minority of homes in the states along the Rocky Mountains.
People are allergic to the mite fecal pellet. A single mite will produce some 200 times its weight in these potent, highly allergenic fecal pellets during its short lifetime (about 4 weeks). Once expelled, the pellets break down, incorporate into the dust of the house and become airborne when the carpet, bedding, furniture, and so on are disturbed. Microscopic in size, these particles are easily inhaled into the nose and lungs, where they trigger allergy symptoms. The density of the live mite population in your home determines the degree of problem you will have with mite fecal particles. Although dead mites and their body parts do become airborne, they do not contribute significantly to mite allergy.
*17/322/5*

HOUSE MITES – A CAUSE OF PERENNIAL ALLERGIC RHINITISAlthough they are just one of many forms of insects with whom we share our living quarters, mites are the most important from an allergy perspective. A subclass of arachnids, two species of these microscopic creatures account for the majority of “house mite” allergies: Dermatophagoides pteronyssinus and Dermatophagoides farinae. One or both may be present in a home at any time. Cleanliness of the home or its occupants has nothing to do with their presence.Mites need three things to survive: food, proper conditions of humidity, and safety. All three are found in homes. Their primary food source is shed skin cells from the human inhabitants and pets or feather-stuffed bedding and furniture. Skin shedding occurs in areas where humans spend the most time when at home, so there is good reason why the highest concentration of mites is found in stuffed furniture, carpeting, mattresses, and bedding. They also accumulate in clothing and stuffed toys.The old saying “safe as a bug in a rug” should be the house mite motto. These microscopic creatures burrow deep into upholstered furniture, stuffed toys, bedding, and loose, long-pile carpet. Here, moisture conditions are optimal for survival and the mites are sufficiently protected so as to be impervious to vacuuming and other human efforts to eradicate them. Or, at least they were.Modern living – central heating, better sealed homes, and wall-to-wall carpeting – has benefited both man and mite. Mites require very specific conditions of humidity in relation to temperature for survival. Ideal conditions encompass a relative humidity of 55 to 75 percent over a temperature range of 59 to 95 degrees F. What better place than a home at 70 degrees F and a relative humidity of greater than 60 percent? Still, because temperature and humidity conditions vary greatly throughout the United States, the concentration of mites is greater in some areas than in others.Mites have no lungs. They take air and water into their bodies primarily by diffusion through their shells. Thus, the greater the relative humidity, the greater their ability to acquire water. Their humidity needs are generally satisfied indoors, particularly in the winter months when the central heating system is functioning. In general, a combination of relative humidity of 40 to 50 percent and a temperature of 82 to 83 degrees F (28 to 34 degrees C) prohibits mite survival. So, whereas mites are found in most homes in the states bordering the east and gulf coasts, they occur in only a minority of homes in the states along the Rocky Mountains.People are allergic to the mite fecal pellet. A single mite will produce some 200 times its weight in these potent, highly allergenic fecal pellets during its short lifetime (about 4 weeks). Once expelled, the pellets break down, incorporate into the dust of the house and become airborne when the carpet, bedding, furniture, and so on are disturbed. Microscopic in size, these particles are easily inhaled into the nose and lungs, where they trigger allergy symptoms. The density of the live mite population in your home determines the degree of problem you will have with mite fecal particles. Although dead mites and their body parts do become airborne, they do not contribute significantly to mite allergy.*17/322/5*

GLOSSARY: RETINOL AND ACID

Retinol
Years after retinoids (in the form of Retin-A] hit the market, the mad scientists at many beauty companies started tinkering with a version for ‘over-the-counter’ usage. The result was retinol, a close relation to tretinoin that must first be converted to retinaldehyde and then to all-trans retinoic acid in the skin. Like its distant relatives, retinol is said to simulate collagen, unclog pores, promote a rosy glow and help with acne and rosacea. Even more so than with tretinoin, retinol
can sometimes be highly irritating to the skin.
Acid
The word “acid- might alarm some people, but be assured that these naturally occurring acids are unbeatable at accelerating the cell renewal process. Meet the family:
Alpha Hydroxy Acid (AHA) – glycolic (sugarcane); malic (apples); tartaric (grapes); lactic (sour milk); citric (citrus fruits). Ideal tor removing surface dead skin cells.
Beta Hydroxy Acid (BHA) – salicylic acid, the lone BHA. is found naturally in willow bark, sweet birch bark and wintergreen leaves. It is a fat-soluble acid, allowing it to penetrate into the pores. Poly Hydroxy Acid (PHA) – a newer, less irritating acid, that is easily tolerated by most complexions.
*41\82\8*

GLOSSARY: RETINOL AND ACIDRetinolYears after retinoids (in the form of Retin-A] hit the market, the mad scientists at many beauty companies started tinkering with a version for ‘over-the-counter’ usage. The result was retinol, a close relation to tretinoin that must first be converted to retinaldehyde and then to all-trans retinoic acid in the skin. Like its distant relatives, retinol is said to simulate collagen, unclog pores, promote a rosy glow and help with acne and rosacea. Even more so than with tretinoin, retinolcan sometimes be highly irritating to the skin.AcidThe word “acid- might alarm some people, but be assured that these naturally occurring acids are unbeatable at accelerating the cell renewal process. Meet the family:Alpha Hydroxy Acid (AHA) – glycolic (sugarcane); malic (apples); tartaric (grapes); lactic (sour milk); citric (citrus fruits). Ideal tor removing surface dead skin cells.Beta Hydroxy Acid (BHA) – salicylic acid, the lone BHA. is found naturally in willow bark, sweet birch bark and wintergreen leaves. It is a fat-soluble acid, allowing it to penetrate into the pores. Poly Hydroxy Acid (PHA) – a newer, less irritating acid, that is easily tolerated by most complexions.*41\82\8*

THE SELF-POISONER: PATTERNS OF SELF-INDUCED TOXICITY – GRIEVANCE COLLECTORS

Many people seem to have lives in which nourishing experiences are totally missing. Their emotional lives are largely limited to habitual complaints about their misfortunes. During the infrequent periods when they are not focusing on their grievances, they go into trancelike depressions. For them, aliveness is associated with toxic emotional attitudes. It is as if this poisonous behavior had some sweetness—for without it they are lifeless.
An example is the person who reacts with rage when he encounters injustice. As his anger rises, his aliveness returns. The more he feels justified in his anger, the more he glows in self-righteousness. If he is an employer, he may dump his grievances on the mistakes of his employees, but rarely on a customer t)r someone who has power over him. In other instances, his rage is directed against abstractions such as society, politics, or world problems. He distorts these activities into a pattern of scapegoating and impotent anger so he can feel alive.
The grievance collector feeds on the unpleasant in numerous ways. It becomes his way of life. These are people who become uncomfortable and awkward in joyful, happy situations. They are embarrassed and flustered when confronted with pleasantness.
The pay-off for those who collect grievances is that in so doing they avoid the risk of initiating any spontaneous behavior of their own.
*64\350\8*

THE SELF-POISONER: PATTERNS OF SELF-INDUCED TOXICITY – GRIEVANCE COLLECTORSMany people seem to have lives in which nourishing experiences are totally missing. Their emotional lives are largely limited to habitual complaints about their misfortunes. During the infrequent periods when they are not focusing on their grievances, they go into trancelike depressions. For them, aliveness is associated with toxic emotional attitudes. It is as if this poisonous behavior had some sweetness—for without it they are lifeless.An example is the person who reacts with rage when he encounters injustice. As his anger rises, his aliveness returns. The more he feels justified in his anger, the more he glows in self-righteousness. If he is an employer, he may dump his grievances on the mistakes of his employees, but rarely on a customer t)r someone who has power over him. In other instances, his rage is directed against abstractions such as society, politics, or world problems. He distorts these activities into a pattern of scapegoating and impotent anger so he can feel alive.The grievance collector feeds on the unpleasant in numerous ways. It becomes his way of life. These are people who become uncomfortable and awkward in joyful, happy situations. They are embarrassed and flustered when confronted with pleasantness.The pay-off for those who collect grievances is that in so doing they avoid the risk of initiating any spontaneous behavior of their own.*64\350\8*

HIV: ON LIVING-TAKING CONTROL: DIVIDE AND CONQUER

Cut overwhelming and insoluble problems into manageable, solvable ones. People have various ways of doing this.
Divide problems into those that have solutions and those that do not, and focus on the problems that have solutions. Helen had been thinking about dying and worrying about how her family would deal with her death. She could not annul the fact that her death would create problems for her family, so she decided to solve a smaller problem. “I am a real junk collector,” she said. “I thought, if I died tomorrow, would my family want this twelve-year-old perfume? I’ve pitched out so much I didn’t need. I went through them and laughed and laughed—at the prices, at the styles. I threw out two of my three corkscrews. I threw everything out. My
surroundings are so much more comfortable, and now my family won’t have to sort through all that junk.”
Focus on short-term problems. Alan had been angry and depressed because he was just becoming established in his career when he began getting sick. After talking to his counselor and his partner, he decided not to focus on his long-term career goals—”I gave up on rich and famous,” he says. Instead, he makes only short-term goals he knows he can accomplish. He has a kit for a grandfather clock he wants to build. He’d like to learn some Italian. When he accomplishes those goals, he says, he will make some more. He tries not to “get upset if the goals don’t get accomplished.”
What this tactic comes down to is this: avoid looking at the whole picture and trying to solve everything at once. Steven says he lives from one day to the next, and does only what is necessary to get through each day. He says he solves only small problems, one at a time, and trusts they will add up. June says that a caregiver needs to do exactly the same: “I concentrate only on making a particular day better,” she said. “I just don’t bother with the big picture.”
Like Steven, Dean says he has learned to stop worrying about overwhelming problems. He tries to change only what he can: “I always tried so hard to change things I couldn’t. Realistically I can’t change my problems—the only way not to have problems is to be dead. And I can realistically change myself. I forgot I could make myself happy. I am as happy or unhappy as I decide to be. I’m surprised at how happy I am, and it’s not in spite of the problems. There are happy people with problems.” In short, take it a little at a time. Expect of yourself only what is reasonable. Try not to borrow trouble or worry about what might happen or cross bridges before you come to them. Be easy on yourself.
*237\191\2*

HIV: ON LIVING-TAKING CONTROL: DIVIDE AND CONQUERCut overwhelming and insoluble problems into manageable, solvable ones. People have various ways of doing this.     Divide problems into those that have solutions and those that do not, and focus on the problems that have solutions. Helen had been thinking about dying and worrying about how her family would deal with her death. She could not annul the fact that her death would create problems for her family, so she decided to solve a smaller problem. “I am a real junk collector,” she said. “I thought, if I died tomorrow, would my family want this twelve-year-old perfume? I’ve pitched out so much I didn’t need. I went through them and laughed and laughed—at the prices, at the styles. I threw out two of my three corkscrews. I threw everything out. My surroundings are so much more comfortable, and now my family won’t have to sort through all that junk.”     Focus on short-term problems. Alan had been angry and depressed because he was just becoming established in his career when he began getting sick. After talking to his counselor and his partner, he decided not to focus on his long-term career goals—”I gave up on rich and famous,” he says. Instead, he makes only short-term goals he knows he can accomplish. He has a kit for a grandfather clock he wants to build. He’d like to learn some Italian. When he accomplishes those goals, he says, he will make some more. He tries not to “get upset if the goals don’t get accomplished.”     What this tactic comes down to is this: avoid looking at the whole picture and trying to solve everything at once. Steven says he lives from one day to the next, and does only what is necessary to get through each day. He says he solves only small problems, one at a time, and trusts they will add up. June says that a caregiver needs to do exactly the same: “I concentrate only on making a particular day better,” she said. “I just don’t bother with the big picture.”     Like Steven, Dean says he has learned to stop worrying about overwhelming problems. He tries to change only what he can: “I always tried so hard to change things I couldn’t. Realistically I can’t change my problems—the only way not to have problems is to be dead. And I can realistically change myself. I forgot I could make myself happy. I am as happy or unhappy as I decide to be. I’m surprised at how happy I am, and it’s not in spite of the problems. There are happy people with problems.” In short, take it a little at a time. Expect of yourself only what is reasonable. Try not to borrow trouble or worry about what might happen or cross bridges before you come to them. Be easy on yourself.*237\191\2*

BACH FLOWER REMEDIES: DR. BACH’S PHILOSOPHY – BACH REMEDIES—THEIR FORM, STORAGE & USE

Bach Flower Remedies are available in dilution form, and can be used in liquid form. One drop of the dilution in a glass of water which can be taken 3 or 4 times in a day. A better and a more practical way is to use the remedy in the form of globules. A drachm phial of No.20 or No.30 globules is saturated with 6-8 drops of the dilution and thoroughly shaken, so that the liquid percolates all the globules.
If this remedy in globule form is kept in a cool & dry place, its effect remains intact for any length of time. 4 to 6 globules placed dry on tongue is one dose. Normally 3 doses at 3 hour interval per day are prescribed. In very acute conditions medicine can be repeated even at 10-15 minutes interval.
If it is desired to give 2 or 3 medicines simultaneously, then 2-3 globules of each medicine can be given together. Alternatively an equal quantity of globules of each remedy is put in a phial and violently shaken so that they are thoroughly mixed together, then 4-6 globules of this mixture forms the combination dose.
A better way is to put 2-3 drops of each medicine in a phial and use this liquid for impregnating the globules to prepare the desired combination remedy.
Not more than 3 remedies should be prescribed as a combination remedy.
*31\308\8*

BACH FLOWER REMEDIES: DR. BACH’S PHILOSOPHY – BACH REMEDIES—THEIR FORM, STORAGE & USEBach Flower Remedies are available in dilution form, and can be used in liquid form. One drop of the dilution in a glass of water which can be taken 3 or 4 times in a day. A better and a more practical way is to use the remedy in the form of globules. A drachm phial of No.20 or No.30 globules is saturated with 6-8 drops of the dilution and thoroughly shaken, so that the liquid percolates all the globules.If this remedy in globule form is kept in a cool & dry place, its effect remains intact for any length of time. 4 to 6 globules placed dry on tongue is one dose. Normally 3 doses at 3 hour interval per day are prescribed. In very acute conditions medicine can be repeated even at 10-15 minutes interval.If it is desired to give 2 or 3 medicines simultaneously, then 2-3 globules of each medicine can be given together. Alternatively an equal quantity of globules of each remedy is put in a phial and violently shaken so that they are thoroughly mixed together, then 4-6 globules of this mixture forms the combination dose.A better way is to put 2-3 drops of each medicine in a phial and use this liquid for impregnating the globules to prepare the desired combination remedy.Not more than 3 remedies should be prescribed as a combination remedy.*31\308\8*

TREATMENT PROGRAM FOR ARTHRITIS

The traditional medical view of rheumatoid arthritis is that it is a chronic illness characterized by spontaneous remissions in most patients who will, with varying degrees of restriction, be able to lead active lives with the use of medications that may (especially the cortisone/steroid drugs) cause more problems than the arthritis itself.
Patient and physician alike are educated not to expect a rapid resolution of the illness, and the outlook is “reasonably optimistic” that conservative treatment can relieve symptoms and keep disability to a minimum. No specific dietary measures or vitamin supplements are suggested, but weight reduction has a high priority in overweight arthritic patients. Associated depression may require psychological support from the attending physician, as well as sedatives or tranquilizers.
The basic program includes rest, medications to suppress inflammation and relieve pain, and physical therapy to preserve joint functions and maintain muscles. Some patients may require surgery.
This drug-oriented program of management may cover a long period of time and be associated with undesirable side effects. It is directed toward the suppression of symptoms, because there is no attention given to the detection and control of the specific identifiable cause(s) of most cases of the disease.
The drug of choice, part of basic conventional management, is aspirin or chemically related drugs known as salicylates. The chemical name for aspirin is acetylsalicylic acid. Salicylates may cause intestinal tract bleeding, dizziness, ringing in the ears (tinnitis), and other symptoms. It must be given with care to patients with stomach ulcers, bleeding tendencies, and asthma.
If the response to salicylates is not satisfactory after two months of treatment with rest and physical therapy, other anti-inflammatory drugs are employed. These are referred to as the non-aspirin NSAIDs – non-steroidal (cortisone-like) anti-inflammatory drugs. They have the same anti-inflammatory activity as aspirin, but it is not possible to predict which drug will be effective in an individual patient. Each drug may have to be tried in a systematic sequence to determine which one will bring about the desired response. These drugs may be taken with aspirin or in place of aspirin.
There are two chemical groups of NSAIDs. The first group is derived from propionic acid and consists of Naprosyn (naproxen), Motrin (ibuprofen) and Nalfon (fenoprofen). The other family comes from indole: Indocin (indomethacin), Tolectin (tolmetin sodium), and Clinoril (sulindac). Many patients taking these NSAIDs will exhibit nervous-system toxicity, including headache and dizziness. Indocin has the greatest potential for gastrointestinal reactions.
*5/295/5*

TREATMENT PROGRAM FOR ARTHRITISThe traditional medical view of rheumatoid arthritis is that it is a chronic illness characterized by spontaneous remissions in most patients who will, with varying degrees of restriction, be able to lead active lives with the use of medications that may (especially the cortisone/steroid drugs) cause more problems than the arthritis itself.Patient and physician alike are educated not to expect a rapid resolution of the illness, and the outlook is “reasonably optimistic” that conservative treatment can relieve symptoms and keep disability to a minimum. No specific dietary measures or vitamin supplements are suggested, but weight reduction has a high priority in overweight arthritic patients. Associated depression may require psychological support from the attending physician, as well as sedatives or tranquilizers.The basic program includes rest, medications to suppress inflammation and relieve pain, and physical therapy to preserve joint functions and maintain muscles. Some patients may require surgery.This drug-oriented program of management may cover a long period of time and be associated with undesirable side effects. It is directed toward the suppression of symptoms, because there is no attention given to the detection and control of the specific identifiable cause(s) of most cases of the disease.The drug of choice, part of basic conventional management, is aspirin or chemically related drugs known as salicylates. The chemical name for aspirin is acetylsalicylic acid. Salicylates may cause intestinal tract bleeding, dizziness, ringing in the ears (tinnitis), and other symptoms. It must be given with care to patients with stomach ulcers, bleeding tendencies, and asthma.If the response to salicylates is not satisfactory after two months of treatment with rest and physical therapy, other anti-inflammatory drugs are employed. These are referred to as the non-aspirin NSAIDs – non-steroidal (cortisone-like) anti-inflammatory drugs. They have the same anti-inflammatory activity as aspirin, but it is not possible to predict which drug will be effective in an individual patient. Each drug may have to be tried in a systematic sequence to determine which one will bring about the desired response. These drugs may be taken with aspirin or in place of aspirin.There are two chemical groups of NSAIDs. The first group is derived from propionic acid and consists of Naprosyn (naproxen), Motrin (ibuprofen) and Nalfon (fenoprofen). The other family comes from indole: Indocin (indomethacin), Tolectin (tolmetin sodium), and Clinoril (sulindac). Many patients taking these NSAIDs will exhibit nervous-system toxicity, including headache and dizziness. Indocin has the greatest potential for gastrointestinal reactions.*5/295/5*

CLASSIFYING THE IRRITABLE BOWEL SYNDROME: TRYING THE COMMON-SENSE APPROACH – MASSAGE EXTERNAL & WIND – MOUNTING PRESSURE

Massage External
Massage with oil (olive is good) from the right groin up and above the navel then down the left side; continue for ten minutes. This also helps to break down and eliminate toxins. Another way is to rub the abdomen with the lightest possible touch in a clockwise circle; there is no need to undress. It is surprising how much gas is released from the stomach with this simple exercise.
Internal
Laughing is a good internal massage, but if you are full of wind your sense of humour will probably have deserted you. Controlled abdominal breathing is also helpful.
Wind – Mounting Pressure
It is not only trying to pass a hard motion that causes pain; a colicky pain can be experienced when the bowel is trying to move the hard faeces through the colon, or when wind which cannot escape causes the bowel to stretch to a point where it contracts in protest and causes a sharp pain.
In a Yorkshire churchyard apparently there is a headstone which offers words of wisdom on this subject:
Wherever ye be let the wind go free For stoppage of it was the death of me
Sound advice, but not always possible when you are constipated.
*14\326\8*

CLASSIFYING THE IRRITABLE BOWEL SYNDROME: TRYING THE COMMON-SENSE APPROACH – MASSAGE EXTERNAL & WIND – MOUNTING PRESSUREMassage ExternalMassage with oil (olive is good) from the right groin up and above the navel then down the left side; continue for ten minutes. This also helps to break down and eliminate toxins. Another way is to rub the abdomen with the lightest possible touch in a clockwise circle; there is no need to undress. It is surprising how much gas is released from the stomach with this simple exercise.InternalLaughing is a good internal massage, but if you are full of wind your sense of humour will probably have deserted you. Controlled abdominal breathing is also helpful.Wind – Mounting PressureIt is not only trying to pass a hard motion that causes pain; a colicky pain can be experienced when the bowel is trying to move the hard faeces through the colon, or when wind which cannot escape causes the bowel to stretch to a point where it contracts in protest and causes a sharp pain.In a Yorkshire churchyard apparently there is a headstone which offers words of wisdom on this subject:Wherever ye be let the wind go free For stoppage of it was the death of meSound advice, but not always possible when you are constipated.*14\326\8*

HOW WE DIAGNOSE A SEIZURE AND DECIDE WHAT IT WILL MEAN FOR YOUR CHILD: WAS IT A SEIZURE?

After a careful, detailed history, the physician should be able to say one of three things:
1. “That episode was clearly a seizure.”
OR
2. “That was clearly not a seizure. It sounds to me like a fainting spell (breathholding spell, etc).”
OR
3. “I’m not sure what that episode was. I don’t think it was a seizure, but let’s wait and see if it recurs. If it does recur, I want you to observe him carefully and look for …”
Even if a single episode was a seizure, it may not be important for your child’s future since most single seizures do not recur or require treatment. If episodes are recurring, it should not take long for careful observation to determine their true nature. If infrequent and not interfering with the child’s life, they are less important. Rare episodes will either disappear as mysteriously as they appeared, or they will become sufficiently obvious and frequent to allow proper diagnosis.
Many people have been told they have seizures and, subsequently, have been treated with medication because of incorrect interpretation of single events, such as fainting. When in doubt about an event or about the circumstances of it, it is usually better to wait to see if a similar event recurs. It is better to live with uncertainty than to allow yourself or your physician to be too eager to label the event and begin your treatment. If there is doubt about the nature of the event or events, whether or not your child is on medication, you should explore this further with your doctor. Even when your child clearly has had a seizure, different seizures will have different meanings for the child’s future. The meaning may well depend on the context in which the seizure occurred. He may not need extensive evaluation and medication. Decisions about these may depend on the circumstances in which the seizure or seizures occurred.
*18\208\8*

HOW WE DIAGNOSE A SEIZURE AND DECIDE WHAT IT WILL MEAN FOR YOUR CHILD: WAS IT A SEIZURE?After a careful, detailed history, the physician should be able to say one of three things:1. “That episode was clearly a seizure.”OR2. “That was clearly not a seizure. It sounds to me like a fainting spell (breathholding spell, etc).”OR3. “I’m not sure what that episode was. I don’t think it was a seizure, but let’s wait and see if it recurs. If it does recur, I want you to observe him carefully and look for …”Even if a single episode was a seizure, it may not be important for your child’s future since most single seizures do not recur or require treatment. If episodes are recurring, it should not take long for careful observation to determine their true nature. If infrequent and not interfering with the child’s life, they are less important. Rare episodes will either disappear as mysteriously as they appeared, or they will become sufficiently obvious and frequent to allow proper diagnosis.Many people have been told they have seizures and, subsequently, have been treated with medication because of incorrect interpretation of single events, such as fainting. When in doubt about an event or about the circumstances of it, it is usually better to wait to see if a similar event recurs. It is better to live with uncertainty than to allow yourself or your physician to be too eager to label the event and begin your treatment. If there is doubt about the nature of the event or events, whether or not your child is on medication, you should explore this further with your doctor. Even when your child clearly has had a seizure, different seizures will have different meanings for the child’s future. The meaning may well depend on the context in which the seizure occurred. He may not need extensive evaluation and medication. Decisions about these may depend on the circumstances in which the seizure or seizures occurred.*18\208\8*

GOALS OF MEDICAL NUTRITION THERAPY FOR TYPE II DIABETES

Blood glucose and lipid goals join weight loss to a reasonable weight as the focus of therapy for overweight patients with diabetes. This recognizes the fact that modification for fat intake, spacing and size of meals, exercise, and reasonable weight loss can be effective in achieving blood glucose and lipid goals in patients with type II diabetes.
The primary goal for patients with type II diabetes should be to achieve and maintain near normal blood glucose levels. Making healthy food choices, especially modifying calorie intake, can be beneficial. A moderate caloric modification (250-500 calories less than the average daily intake) and increase in physical activity may lead to improved weight control. In addition, modifying fat intake may be associated with a reduction in energy intake and weight loss. A nutritionally adequate meal plan with a modification in fat, especially saturated fat, should be implemented. Research has shown that even a weight loss of 5% to 10% is sufficient for improving glycemic control. Weight loss appears to increase insulin sensitivity and normalizes hepatic glucose production.
The research on the efficacy of very low-calorie diets (VLCDs) is inconclusive. Both VLCDs and low-calorie meal plans lead to weight loss and weight regain. VLCDs may be slightly beneficial to patients with type II diabetes because caloric restriction has been shown to improve insulin resistance and blood glucose response. It is unclear, however, if this makes a difference over an extended period of time. More studies need to be conducted investigating other creative alternatives to VLCDs, such as intermittent fasting which may achieve improved insulin resistance without the varying effects of weight loss and regain.
Due to the impaired insulin secretion in patients with type II diabetes, smaller meals and snacks spaced more frequently throughout the day may prevent exaggerated post-meal hyperglycemia. Also, regular exercise can promote improved metabolic control and weight management. In addition, learning new behaviors and attitudes can promote long-term lifestyle changes.
Monitoring blood glucose, glycosylated hemoglobin, lipids and blood pressure is essential to evaluate nutrition-related strategies. If metabolic parameters do not improve, oral glucose-lowering medication, insulin, or lipid-lowering or antihypertensive drugs may be required. Other than the quantity of food, we need to change the quality to make it more balanced.
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GOALS OF MEDICAL NUTRITION THERAPY FOR TYPE II DIABETESBlood glucose and lipid goals join weight loss to a reasonable weight as the focus of therapy for overweight patients with diabetes. This recognizes the fact that modification for fat intake, spacing and size of meals, exercise, and reasonable weight loss can be effective in achieving blood glucose and lipid goals in patients with type II diabetes.The primary goal for patients with type II diabetes should be to achieve and maintain near normal blood glucose levels. Making healthy food choices, especially modifying calorie intake, can be beneficial. A moderate caloric modification (250-500 calories less than the average daily intake) and increase in physical activity may lead to improved weight control. In addition, modifying fat intake may be associated with a reduction in energy intake and weight loss. A nutritionally adequate meal plan with a modification in fat, especially saturated fat, should be implemented. Research has shown that even a weight loss of 5% to 10% is sufficient for improving glycemic control. Weight loss appears to increase insulin sensitivity and normalizes hepatic glucose production.The research on the efficacy of very low-calorie diets (VLCDs) is inconclusive. Both VLCDs and low-calorie meal plans lead to weight loss and weight regain. VLCDs may be slightly beneficial to patients with type II diabetes because caloric restriction has been shown to improve insulin resistance and blood glucose response. It is unclear, however, if this makes a difference over an extended period of time. More studies need to be conducted investigating other creative alternatives to VLCDs, such as intermittent fasting which may achieve improved insulin resistance without the varying effects of weight loss and regain.Due to the impaired insulin secretion in patients with type II diabetes, smaller meals and snacks spaced more frequently throughout the day may prevent exaggerated post-meal hyperglycemia. Also, regular exercise can promote improved metabolic control and weight management. In addition, learning new behaviors and attitudes can promote long-term lifestyle changes.Monitoring blood glucose, glycosylated hemoglobin, lipids and blood pressure is essential to evaluate nutrition-related strategies. If metabolic parameters do not improve, oral glucose-lowering medication, insulin, or lipid-lowering or antihypertensive drugs may be required. Other than the quantity of food, we need to change the quality to make it more balanced.*4/356/5*

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