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Most doctors would define a fever as a temperature greater than 38.5° Celsius, which is present for 24 hours or more. A child may have a slightly raised temperature for a brief period of time for many reasons, including increased physical activity.

It is often inaccurate to try to determine the child’s temperature without a thermometer. Feeling a child’s skin temperature (for example, by putting lips to the forehead) is not a reliable way of diagnosing a fever. Sometimes a child may appear flushed, and his skin may feel warm, but the child’s core temperature will in fact be quite normal. This is seen especially when he has a cold or has engaged in vigorous physical exercise. It can also occur on a very hot day.

All parents should have a reliable thermometer and be able to take their child’s temperature. If you are not sure how to do this, ask your local doctor or maternal and child health or community nurse to show you. A child’s temperature can be taken orally (putting a thermometer in the mouth under the tongue), rectally (putting the thermometer a little way into the baby’s rectum), or under the armpit. Under the armpit is usually the safest way, especially in young children.

Often taking the temperature of a baby or young child is more difficult than it seems. Generally, temperatures can only be taken orally in children over the age of 6 years. Below this age they are usually unable to co-operate and may bite the thermometer which contains mercury which is dangerous if swallowed. Children who have a blocked nose due to a cold may find it hard to breathe keeping their mouth closed, so that a reading obtained from the armpit is often easier. Rectal temperatures are best reserved for babies and young children under the age of 12 months. Taking a rectal temperature is often difficult, especially when the baby is very active — there is a risk of the thermometer sliding out of the rectum, or of the tip of the thermometer damaging the lining of the rectum.

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This test is used for babies and children who are not yet toilet trained. It is less reliable than an MSU (see opposite), but is useful to exclude the presence of a urinary tract infection.

Procedure

If you are at a clinic, the staff will help you with this procedure. Clean your child’s genital area with warm water and pat dry with a clean towel. Apply the adhesive plastic bag provided by your doctor or nurse. You should ideally try to give the child a lot to drink before applying the bag, because if it is left on for more than 15-20 minutes, contamination can occur. Be very careful when removing the bag and transferring the urine to a sterile jar, because contamination with non-sterile surfaces can easily occur. If you are at a clinic, the staff will do this for you.

‘Dipstick’ test

This test can be performed on ordinary specimens of urine. It is a general test which indicates whether the urine contains protein, blood, sugar or other substances which should not be present in normal circumstances. The sticks are a commercially available kit and are simple to use. Your doctor will always have some dipsticks in the surgery to do on-the-spot tests if needed.

Micturating cystourethrogram (MCU)

This is a special X-ray, in which dye is injected into the bladder via a catheter, and shows the bladder and urinary system both before and during the process of your child emptying his bladder. It can be used to detect cases of vesico-ureteric reflux.

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1. Review all of the positives of where you live now. What characteristics of “how” you live where you are would you like to take along with you?

2. Discuss the positives of the move emotionally as well as pragmatically for both partners and the entire family.

3 Discuss the negatives, the fears. Even if your fears seem unreasonable or immature, they are still your fears. By raising them now, you will be better prepared for conflicts that arise later.

You will forget something when you move. No matter how careful you are, all moves get messed up somehow. Don’t blame yourself or your partner. Don’t mix the move with an attempt to purge all of your “stuff.” Moving is difficult enough, so don’t make the move a complete reappraisal of your marital collection of “things.” If you do that now, when you are rushed, you may throw out something you wished you hadn’t, and that will make the adjustment to moving just that much more difficult.

6 Try to see the move as a change and not a dumping of a prior life. Homes are emotional feelings, not wood and brick buildings. Talk about the feelings.

7 Don’t try to have sex as soon as you move in. “We tried to christen the new bedroom after a day of stacking, moving, and cleaning. It didn’t work. We should have just held each other and slept.” This report from one of the husbands is good advice and in keeping with the warning never to force or test marital sex. If you are thinking of having sex as a test or for any reason other than joy and intimacy and closeness, don’t do it.

8. Assess together what the move does to your support systems. Moves can come to mean new beginnings or cause rehashing of unresolved issues. Attend beforehand to the emotional dimensions of moving and there will be fewer, but still many, problems. As bad as it may seem, this move most likely is only practice. You will probably move again in a few years.

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The eggs may be eaten by sheep and other animals as they eat grass which has been contaminated by dogs’ droppings. It can spread to man by handling dogs or by dogs’ droppings contaminating areas where man can come in contact with the eggs and transfer them to his mouth.

Children are often affected because they are more likely to fondle dogs and be unaware of proper hygiene.

When eggs are eaten, they pass to the intestine where they hatch. The embryos burrow through the wall of the intestine and enter the small blood vessels.

From here they go to the liver where they may settle and develop into a cyst. Some move through the liver and pass along to the lung and can set up cysts there. Others can escape through the lung and pass to the heart, then be transported to other areas of the body, such as the brain.

The cysts which form may grow slowly and not cause symptoms for many years. The liver is affected in about 70 per cent of cases, the lungs in about 30 to 40 per cent, and some cases have cysts in two or more areas.

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The number of reported cases has now dropped dramatically.

Almost all American cases were associated with one brand of tampon, Rely, which was not available in Australia. This was unique in that it was made of polyester foam and carbonmethyl cellulose, substances not found in other tampons.

What should women now do?

Those who regularly use tampons and find them far more convenient than pads may, in the present

light of our knowledge, continue to do so but they should observe these rules:

Personal hygiene should be scrupulous with proper washing of the hands prior to insertion of the tampon.

Avoid touching the vaginal lips with the tampon and take care not to injure the vaginal wall in inserting it.

Tampons should be changed regularly perhaps four times a day and not be left in overnight.

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Initially, sprains should be treated much the same way as bruises. Much of the pain of sprains arises from the swelling and the bleeding in the tissues. Immediately apply ice to the area and elevate the affected limb. Rest as much as possible. Apply arnica as a cream or tincture, or a compress of either arnica or comfrey root, directly on the swelling. Under medical supervision only, arnica can be taken in tablet form to help limit the bruising and Vitamin C and the herb horsetail aid the healing of muscle tissue. Initially, the joint may be strapped firmly to provide support, limit swelling and ease the pain. Soon, however, gentle massage and movement is required to prevent the ligament tissues shortening and tightening as they heal. To begin with, a physiotherapist will only stroke the affected area firmly, progressing to deeper tissue massage with fingers and thumbs only when the injury is healing. Hydrotherapy can also help the patient maintain movement and build up strength in the joint. Note that sprains take longer to heal than fractures do, up to six or eight weeks, and that a joint which has been sprained may be permanently weakened and more prone to dislocation, requiring special care and strapping with elastic bandage when exercising.

Rather than arising from one single over extension of the joints, strains result from the overuse of muscles, through careless exercise or even because of poor work practices. Strained muscles can result in temporary discomfort or the development of more serious nerve and muscle conditions.

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A true funnel chest exists if the breastbone is depressed when the child breathes out, even while the child is at rest and is having no difficulty breathing. If mild or moderate, a funnel chest will cause no harm and will gradually correct itself over the years as the child’s ribs grow heavier and stronger. If funnel chest is severe, it may not correct itself and may interfere with breathing. Rarely is it severe enough to affect the position or functioning of the heart.

Signs and symptoms

A funnel chest can be seen by observing the chest of a well child. The breastbone appears to be sunken in, forming a hollow in the center of the chest. If this hollow appears whenever the child breathes out, this may be a sign of true funnel chest.

If a child has not previously shown signs of a funnel chest, retractions of the lower breastbone are an important sign of breathing difficulty.

Home care

A fixed deformity (true funnel chest) cannot be treated at home. Bring it to the attention of your doctor.

If retractions of the breastbone begin in a child with no earlier signs of funnel chest, look for other signs of breathing difficulty. Then treat the disease that is causing the breathing problems.

Precautions

• Don’t be alarmed by persistent mild to moderate depression of the breastbone in an infant or young child.

• Do not restrict your child’s activities.

Medical treatment

The doctor will determine if the child has a true funnel chest or if the child is having temporary difficulty breathing. In marked cases of funnel chest, the severity and effect on heart and lungs is judged by X ray and other test results.

If funnel chest is severe and persists without gradual improvement, the condition may require surgery. Surgery may be performed if there are signs of limited heart or lung function or for cosmetic reasons. Your doctor may order X rays, an electrocardiogram, and measurements of the lung capacity.

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“Let’s put it this way: You’ll never be able to cut open a vitamin E capsule, sprinkle it over a hot-fudge sundae, and not have to worry about the sundae,” says Dr. Lichtenstein. To beat heart disease, “you may have to make major fundamental adjustments that become habitual. Accept that taking care of your heart is going to be a lifelong project.” But it’s really not as difficult as you might think it is. Here’s how it’s done.

Know your risk. It’s true. Some guys have all the luck (thanks for the reminder, Rod Stewart). And some guys have higher risk factors than others. For example, you’re at risk for heart disease if a first-degree male relative (like a brother or your dad) under age 55 or a first-degree female relative (like a sister or your mother) under age 65 has suffered a heart attack. If you have both, naturally you’re at a higher risk. Got diabetes? High blood pressure? High cholesterol? Low high-density lipoprotein (HDL) cholesterol? Do you smoke? All six? Your risk is higher still. “Those are your major risk factors, and once you have your cholesterol measured, some kind of decision can be made about just how much risk you have. But you really can’t tell until you’ve had your cholesterol checked,” Dr. Lichtenstein says.

Cut your total cholesterol. You’ve heard it so many times, you’re starting to think LDL stands for “lower, dummy, lower.” But bear with us. Reducing the “bad” LDL (low-density lipoprotein) cholesterol generated by your diet and raising your “good” HDL cholesterol with exercise can dramatically cut your risk for heart disease. As you probably know, LDL is called the bad cholesterol because it can penetrate artery walls, narrowing vessels and choking off blood. What you may not know is that research has shown that vascular disease patients who cut their total cholesterol by about 20 percent reduced their heart attack risk by two-thirds, says Dr. DiBianco.

“This helped convert soft, vulnerable plaques into more stabilized plaques that are less likely to break off and clog arteries,” Dr. DiBianco says. According to the American Heart Association, your goal should be to try to keep your total cholesterol under 200 milligrams per deciliter. Borderline high cholesterol is 200 to 239 milligrams per deciliter, while high cholesterol is over 240 milligrams per deciliter. One of the best ways to lower your cholesterol is to eat less saturated fat, the kind found in meat and dairy products, says Dr. DiBianco.

Bring down your blood pressure. Here are some more numbers that can help add up to a healthy heart and a longer, more active life. When checking your blood pressure-once or twice a year should do-look for a reading of 120/80 millimeters of mercury (pronounce it “120 over 80″ just like they do on your favorite hospital drama). That’s considered normal. A reading above 140/90 should be of concern. And when your blood pressure is over 160/100, it’s definitely too high, says Dr. Pickering.

Stop smoking. If you don’t want to give up cigarettes for your own heart’s sake, do it for your sweetheart’s sake. A seven-year study of 353,180 women and 126,500 men who had never smoked found that those who lived with smokers had a roughly 20 percent greater risk of death from heart disease.

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