Archive for May 18th, 2009

CHILDREN’S SLEEPSLEEPLESS NIGHTS

Children’s sleep, or the lack of it, is a major preoccupation for many of today’s parents. “Does your child sleep through the night yet?” seems to be the first question everyone asks—if your puffy eyes do not speak for themselves. Someone else’s smug response, “My child has slept through the night ever since we brought him home from the hospital,” wakes up every hair on the back of your neck—even though they, like the rest of your body, can barely function.

It is, understandably, an issue charged with an entire range of emotions—anger, guilt, relief, and elation. All parenting issues seem intensely important, but this one seems even more so. Perhaps this is because sleep—or the need for it in both parent and child—can begin to affect one’s decision-making ability and undermine even the most confident parent. It can bring discord to ordinarily happy families and affect parents’ feelings toward their child.

But it is possible to look objectively at the problem, to define it as it appears in your family, and to determine a course of action with which you will feel comfortable. In order to devise a workable plan, you first need some solid information about young children’s sleep.

When a child’s sleep habits cause recurring or continuing problems for the child or his parents, there is a sleep problem.

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CONSTIPATION – GENERAL INFORMATION (SYMPTOMS)

As with all symptoms, it is quite common for more than one factor to play a part in producing constipation. Once the cause(s) have been found, consider tackling them directly. It may be possible to treat a blockage by surgery, radiation or chemotherapy. However, the cost of doing so may outweigh the benefit if, for example, the treatment is unpleasant and has only a small chance of shrinking the growth enough to relieve the symptoms. If you either can’t or don’t want to get rid of the cause of your constipation— for example, because it is due to painkillers which you want to keep taking — you will have to tackle the symptom itself. Prevention is better than cure here. Don’t wait until you are really badly constipated before doing something about it.

I suggest for a start you consider taking some form of laxative regularly. Laxatives work by softening the motion and/or stimulating the bowel muscle—good examples include liquid paraffin, phenolphthalein, dioctyl sodium sulphosuccinate, danthron, lactulose, and senna. If you normally take laxatives anyway, you will need much bigger doses now than someone who is not used to taking them. Other ways of helping the bowels to keep moving are by taking a high-fibre diet (but not if you have a blockage of the bowel), drinking plenty of fluids and exercising as much as is possible and comfortable.

If these measures don’t keep your bowels moving easily, you may also need to use suppositories or enemas, with the help of a nurse. By the way, most nurses know much more about treating constipation than most doctors. I suggest that you ask a nurse for help if you have this symptom. This should be easy if you are in hospital. If you are at home, just ask your doctor to arrange for a nurse to visit you there.

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RESUSCITATION – EXTERNAL CARDIAC MASSAGE

Make sure the heart has stopped before doing this. The pressure you exert on a patient’s chest — adult or child — may do damage. Some doctors think that external cardiac massage should only be done by someone trained in its procedure. However, YOU may have to use it in an emergency.

In a child, the most common causes for a cardiac arrest are drowning, electrocution and suffocation. In an adult, a heart attack is probably the most common. It may also result from poisoning or from gassing.

The signs of cardiac arrest are: loss of consciousness; the patient has gone blue or is pale; there is no pulse; the breathing has stopped or there may be some gasps for a while; the pupils of the eyes dilate and do not respond to light.

The heart is a pump, pumping blood to all the tissues in the body. The aim of treatment is to start this pump again by compressing the heart between the breastbone and the backbone.

Act swiftly, for if the brain is deprived of oxygen for longer than 3-4 minutes, irreversible damage may result.

Lie the patient on a hard, flat surface. Kneel at the side of his chest; tilt the head back to open the airway.

For an adult, place the heel of the hand on the lower part of the breastbone, or sternum, and cover it with the other hand. Rock forward and press down firmly on the breastbone — not on the ribs. The chest wall in an adult should move 2Óã-5 centimetres (1-2 inches).

Do it gently the first few times to assess the resistance of the chest wall. For an adult, keep it up at the rate of 60 a minute. For a child, use only one hand (two fingers for an infant), but increase the rate to 90 a minute. If someone else is present, get them to do mouth-to-mouth resuscitation at the same time as you do cardiac massage. One breath to every five pushes on the chest. If you are alone, you will need to do both actions yourself. Two breaths for every 15 pushes on the chest.

Check to see whether your work has any effect. The pulses will return, the color will improve and the pupils of the eyes will constrict.

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