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Most children will not need any special investigation. The diagnosis of asthma is usually made on the basis of history and physical examination. Children who have more severe asthma, or who have frequent attacks, may require a chest X-ray. Some children may have special breathing tests, often arranged by a paediatrician or respiratory specialist. This usually applies to those who have ongoing, persistently severe asthma.

Once children with asthma reach 6-7 years of age or thereabouts, their management may involve regular measurement of lung function two or three times each day using a peak flow meter. This is a small device which measures how well the lungs are functioning, and may give early indications that the asthma is worsening.

If your child needs to use a peak flow meter, your child’s doctor will explain how to use it properly and record the results.

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Since diabetes can result in more frequent infections of all types, vaginitis is a particular problem for sexual functioning. Both partners may experience pain in intercourse related to this and other tissue infection. About one third of women with diabetes have problems with orgasmic contractions, probably related to the same neurological and vascular damage as in the male. Erection of the clitoris would also be expected to be affected. Diabetic women should check for recurrent mild urethral infections, cystitis, and vaginal abscesses, these are all treatable, so there is no reason to continue to have pain in intercourse. If you notice a decrease in natural lubrication (maybe due to microcirculation problems), check with your doctor. Again, do not assume that sexual problems are always related to your disease. If there is a lubrication problem, lubricants can be prescribed or recommended.

As with men, all areas of the sexual-response system remain intact for diabetic women. Interest, arousal, psychasms, and other dimensions do not have to be impaired if open communication and degenitalized approaches are considered and practiced.

Diabetes is like any other disease in that it is helped by positive emotions and intimacy, and hindered by fear and helplessness. Even if your diabetes gets worse, remember, you do not cause it to get worse. Even with your best efforts, diseases run different courses. None of these courses preclude intimacy. Every couple I treated in which one or both partners were diagnosed as diabetic were able at five-year follow-up to experience a mutually pleasing sexual life, even when the diabetes itself might have worsened. There were eighty-seven diabetic men in the sample and forty-seven diabetic women. While initially thirty of the men were considering implants, none of them went ahead with that procedure following counseling.

If severe genital problems have resulted from diabetes, there are still several things that ean be done to enjoy sex. You read about some of these in Chapter Eight. One of the oldest medical jokes relates to a man whose arm hurts every time he tries to raise it. He tells the doctors about his problem and the medical advise is, “If it hurts when you do that, then don’t do that.” I would add, “If it hurts, check out why, if it can’t be helped, try something else.”

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READINESS: Readiness is the one phase of the ten-phase super sex model that was focused upon by the first three perspectives. Readiness refers to the body’s response to interest and arousal. It is the physiological reaction that accompanies interest and arousal, the tumescence stage, when blood rushes to erotic areas of the body, including the genitals, preparing for body-to-body interaction. Readiness is an entire body response, not just a genital response. Remember, lack of readiness does not mean lack of interest or arousal. Research does not support such a relationship. Readiness is a reflex, and can take place with little arousal and be absent even when there is a great deal of both interest and arousal.

Your own experience teaches you that you have been aroused, but not ready. Sometimes you have awakened ready, but not aroused. You have been interested and ready, but not aroused. You have been ready, but not interested, and your desire, your frequency might or might not have reflected any of these changes in the sexual system, because sex is really not an automatic cycle, it is a system of interactions of different mind and body states. The cycle orientation of the first three perspectives mislead us. Use your own experience as the couples did and you will see that sexuality is not some type of automatic slide, but a complex mind/body interaction. This fourth perspective emphasizes the subjective experiences of the couples rather than the observational orientation of earlier perspectives.

“I know you think I’m ready,” reported the husband. “You think I’m always ready. Well, I’m not. My penis does not speak for me.”

“If I can’t tell by your penis, how am I supposed to know if you are ready?” asked the wife.

The orientation of the first perspectives is clear in this exchange. Both partners have confused what the body does with how the person feels.

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Previous chapters in this book provided quite some criticism of the practices of conventional medicine.

The indisputable progress in many areas of medical and other related sciences was yet to be mentioned. This would include among others: the life saving emergency treatments, technology and instrumentation for chemical and biological analysis and the breathtaking progress on the frontiers of “mind-body” medicine.

Deepak Chopra, MD, a pioneer of modern mind-body medicine, is the author of numerous inspiring and mind-bending books, which are listed in the References. In his books,* he illustrates the process of mind and body interaction drawing up on many clinical examples as well as research results from medical science and modern quantum physics. He has met and continues to meet with the considerable opposition from his colleagues – conservative medical scientists, who insist that they should see everything under their microscopes to believe it. Deepak Chopra points out, that medical sciences simply ignore monumental advances made in other sciences, mainly in the Quantum Physics.

Not only do microscopes have limited resolution, and the visible bandwidth of light is extremely narrow (0.4-0.7 micrometers), but even if we could separately look at each molecule, atom or an elementary particle – there is exactly nothing to look at ! Physicists have found quite a long time ago, that any elementary particle or atom is just a form of energy, oscillating in some state of equilibrium, and therefore it is essentially 99.999 % empty space. We can see, detect or sense the matter composed from such atoms, only because their energy interacts with us as observers, ie. for example reflects light that is visible to us. On that level of understanding, even physicists agree, that there is essentially no difference between thought and matter. Thought can become matter and matter can become a thought. Deepak Chopra gives some stunning examples of such transformations not from the mysterious ancient past, but from within contemporary India.

If you need more explanation from the modern Quantum Physics point of view, and do not feel an expert in physics, please read an excellent book “Superforce”, by Paul Davies, listed in the References. Paul Davies is a respected professor of physics, and he does a wonderful job of explaining achievements of modern physics to non-experts. It is really worth the effort to read his book.

*7\96\8*

Vertigo (giddiness or loss of balance) may occur with the disorder known as Labyrinthitis. This is thought to be a viral infection. Crops of cases tend to occur at the same time. The attacks are short-lived from a few days to one or two weeks and they pass off completely with no permanent ill effects.

These attacks may be mild, and giddiness only occurs with movement of the head. Nausea and vomiting may be associated with the giddiness and these attacks may come spontaneously even at rest.

The doctor needs to examine the patient to exclude some more serious cause of these symptoms such as vascular accident (stroke) or a tumor.

No treatment in mild cases of labyrinthitis is required, but drugs will reduce the giddiness and the nausea and are used if the symptoms are severe.

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Operation has a bad reputation among the public and, at times, the profession. There is no doubt that the right operation by the right surgeon on the right patient for the right condition, brings a satisfactory result to all concerned. Perhaps the bad results are due to one of those four conditions being wrong.

Acupuncture is currently being hailed as the treatment for everything from dandruff to corns.

I think there is valid evidence to show it may be of benefit in reducing chronic pain and, therefore, help those who remain in pain despite many different treatments. Its place in the management of the acute stages of back condition has yet to be shown.

The best advice I can give you if you have, or in the future get, a bad back, is to go to a doctor you know and trust and be guided by his advice.

It is this pressure on nerves where they originate and leave the spinal canal which causes the severe pain called sciatica running down the back of the thigh and the outer leg.

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Home care

Until the hyperactive child has been professionally evaluated and diagnosed, home treatment cannot be undertaken. Once the diagnosis is confirmed, the family of the hyperactive child is given specific recommendations tailored to the child’s needs. Removing from the child’s diet foods that contain artificial colorings, flavorings, or preservatives is believed by some specialists to lessen the incidence of hyperactive behavior. However, others feel that the special attention given to a child whose diet is being controlled, not the diet itself, probably accounts for any improvement in behavior. Ask your doctor before you initiate any changes at home.

Precautions

• True hyperactivity is present from infancy. If your normally active child is over two years old and suddenly becomes overactive, look for clues in the child’s environment.

• Never accept a diagnosis of hyperkinesis from anyone but a trained, skilled, and experienced professional.

• Remember that an accurate diagnosis usually requires a team approach involving all those who care for the child – parents, teachers, doctors, and other professionals.

• Don’t mistake ordinary misbehavior for hyperactivity; if a child is overactive with one family member but not with the others, the child is not hyperactive.

Medical treatment

A child suspected of hyperkinesis must have a complete medical examination, including vision and hearing tests. The doctor will take a detailed account of the child’s medical background, evaluate school reports, and usually recommend a series of tests that are carried out by a psychologist. The doctor may also try various medications. Among the medications that may be given are drugs such as dextroamphetamine, methylphenidate, or permoline. Both you and the child’s teachers will be asked to keep the doctor informed of changes in the child’s behavior once a program of treatment is established. The hyperkinetic child may need special educational placement; also, because hyperkinetic children often have emotional problems resulting from poor social relationships at home and at school, counseling may be indicated.

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•    Serious physical disease is a common cause of depression. In the acute phase of a serious disease at least a quarter of patients become depressed, according to one US study of 150 people in hospital for physical ailments. Several studies have found a high correlation between suicide and physical illness. Rheumatoid arthritis, peptic ulcer, and high blood pressure, were found to have the greatest ‘suicide’ potential in one study.

Chronic illness and disability can, undoubtedly, make people depressed. For some such people depression becomes a way of life.

Talking of chronic disease, several surveys have found that people who are depressed stand a much greater chance of dying prematurely of cancer than do others of the same age.

•    ’Glandular’ problems can sometimes cause depression. Thyroid disease is a fairly common cause.

Food allergies and intolerances are an increasingly recognized cause of depression. Foods especially likely to be at fault are cows’ milk, eggs, nuts, and wheat and its products. Elimination diets can be useful in detecting the culprit but results can take several weeks (as opposed to days with other food-allergy manifestations) so one has to be very careful in the early stages to be sure that the diet is not so poor that this adds to the clinical problem. Taking plenty of water, minerals and vitamin supplements will definitely help.

•     Babies and children are a major source of depression. One of the most depressed groups of people in the West is the group of young children’s mothers. Post-natal depression is extremely common, with eight out of ten women complaining of at least some ‘baby blues’. Women who deliver at home have much lower levels of depression post-natally, as do those whose babies are exclusively breast-fed.

•     Success. We have been conditioned into thinking of depression as caused by failure and negative life events but a small minority of people become depressed when they achieve goals and are successful. Some see their success as undeserved or a hollow sham and yet others fear it will be taken away from them. Some fear what success will bring and back away from it just as they are about to achieve it. Many people unconsciously (and sometimes even consciously) fear the effect that their success has on others and fear the rivalry it produces. Rather than provoke such rivalry (which may remind them of childhood rivalry) they fight shy of success even when it stares them in the face.

•     Mental or physical fatigue is a little-discussed cause of depression but most of us can easily slide into true depression if either or both strike. This could be at the heart of much of the depression seen in young women with small children.

The menstrual cycle causes depression regularly in a proportion of women. About half of all women have at least some premenstrual symptoms, and depression can be a real problem for a few. Admission to mental hospitals, suicide attempts, child battering, and depressive episodes are all more common pre-menstrually than at any other time of the month in the female population generally. Clearly there is a hormonal effect but recent thinking suggests that dietary imbalances too play a vital role.

•    Retirement, divorce, separation and loneliness are powerful sources of depression in our culture today. Divorce and separation are especially likely to make people depressed, particularly if children are involved. Admission to mental hospital and all kinds of physical illness (including cancers) are much more common in the divorced and separated than in the married. Marital problems themselves are potent and common causes of depression. One large study compared various different forms of therapy for depression and found that of all those tested (including drugs) marital therapy was the most successful.

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