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Nowadays tonsillectomy is performed far less frequently. In fact, only a minority of children have their tonsils removed. There is little medical evidence that the removal of tonsils makes very much difference to the general health of the vast majority of children. In particular, it does not reduce the frequency of colds or sore throats that are a normal part of childhood.

These are the commonly accepted reasons for performing a tonsillectomy on a child:

1. Repeated attacks of tonsillitis — three to five attacks per year over at least 2 years. The doctor will also take into account the severity of the attacks, the response to treatment, the effect it has on the child’s general health and lifestyle, including his absences from school.

2. Obstruction of the child’s airway or breathing passages. The child may have apnoea (forgets to breathe), may snore at night, may have difficulty swallowing, may not gain weight satisfactorily, or may fall asleep during the day. Airway obstruction is relatively rare in children.

3. Other causes such as an abscess in the tonsils (quinsy), or chronic tonsillitis (persistent infection which does not clear up despite repeated courses of treatment, and which is more common in adolescents and adults than children).

Sometimes the doctor may recommend that the child’s adenoids be removed (adenoidectomy) because they are enlarged. Like the tonsils, the adenoids are a collection of lymphoid tissue at the back of the throat, which are part of the body’s defence against infection. If they become chronically enlarged, they may contribute to a number of problems, including middle ear disease (glue ear), deafness, and obstruction of the breathing passages. The latter may cause the child to snore at night, breathing with his mouth open because his nose is blocked.

An adenoidectomy is most commonly performed in a child who has frequent ear infections and resultant hearing loss. It is often done in conjunction with another procedure, such as the insertion of tubes in the ears (grommets) or tonsillectomy.

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If the birth has been difficult because your pelvis is small and the baby is big, his collarbone (clavicle) may break on one side. This injury is also more common with breech deliveries. Because babies’ bones are malleable, the fracture heals well without treatment, occasionally leaving a small lump. Gentle handling until the break heals will reduce pain and discomfort. More rarely, fractures of the long bones of the arm or leg (humerus and femur) are seen. This kind of break will require splinting until it heals. Skull fractures are also rare, but need to be watched carefully, although they generally heal without complications.

Bruising

Your baby may come out looking like he’s been in a fight! His face or head may be swollen and bruised. If this is a mirror injury, it requires no treatment and will resolve itself. If there is marked swelling due to significant bruising, then a skull X-ray may be performed to rule out a fracture, and the baby’s blood may be checked to make sure there have been no complications from bleeding. In the majority of cases the results of these tests are normal, and the bruising is due to the pressure on the face and head during the baby’s passage through the birth canal. If forceps are used, they may leave visible marks on each side of the face and head. These usually disappear after a few days and are not a cause for concern.

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cottage] than at home? We’re the same people.”

ANSWER: That’s exactly the point. You are the same couple, so the trick is to look at how you relate and what you do up north compared to what you do at home. Most likely you have more time, less pressure, and you make sex a priority away from home. You should know, however, that this is very good news, because vacations are also times when couples fight, draw further apart, and exaggerate their problems. The fact that time away becomes time together reflects a strong relationship just waiting to get some of the same attention and priority at home. One more thing. Different places for sex seem to be invigorating, and you don’t have to go all the way up north for that. Try going downstairs at home, even out to the garage.

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It appears to be as common as headache but it is a symptom which many people find difficult to describe and, when the term is used, different people often mean different things.

For some it may be anorexia or loss of appetite. It may be nausea or even vomiting. Others regard it as abdominal discomfort. There may be regurgitation of food or acid into the mouth.

“Water-brash” is a symptom where bitter acid fluid from the stomach is regurgitated up into the mouth.

Heartburn usually means a pain behind the breastbone.

The indigestion may be associated with flatulence or be used to describe this condition where there is an excess of wind in the stomach which is either brought up or passed onwards and passed as flatus.

Just as there are different conditions which mean indigestion, so there are many causes of this symptom.

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To be scientifically correct, the term “antibiotic” should be reserved for those drugs obtained from a living organism, such as a fungus or mould.

Those other drugs which act in the same way but which are synthesised in the laboratory, are usually spoken of as chemotherapeutic drugs.

These agents kill or inhibit the growth of bacteria, and there are few bacterial diseases which don’t respond to them.

However, those infectious diseases which are due to viruses are not influenced by antibiotics, except for a few caused by the larger viruses and a few organisms which appear to be halfway between viruses and bacteria.

The sulphonamide drugs were the first of these new tools of medicine. Their action was first reported by the Bayer company in Germany in 1935.

Although the sulphonamides are active against a wide range of bacteria, their main use now is in urinary tract infections. A new generation of doctors has grown up with so many other antibiotics available that the sulphonamides are rarely thought of when prescribing treatment.

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Many people with medical conditions such as heart disorders, or diseases of the respiratory system like asthma and bronchitis, will benefit from regular yoga practice as will those with muscular or nervous disorders. Some postures are designed to tone and stimulate internal body organs and glands. There is no high impact aspect to yoga nor any sense of extreme aerobic exertion. Rather, strength is built through muscle control, balance and body awareness. Breathing is very important as the embodiment of the life force or prana. Like T’ai-chi, many of the postures are derived from the movements of animals and birds.

Yoga requires little equipment although a lot of people like to work on a rubber mat. Belts and frames are sometimes employed to maintain postures without straining the body. Your clothing need only be loose and comfortable. As with most physical and mental disciplines, it is recommended that you seek ongoing instruction from a qualified teacher. Select a school with an emphasis on the aspect of yoga which most interests you. Hatha yoga concentrates on physical discipline while Raja yoga places more emphasis on controlling the mind. Bakti is the devotional aspect of yoga.

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Nonetheless, the Western Journal of Medicine (143:357) reports, modern pottery colored with lead-containing pigments may not be safe, even if the covering glaze appears to be intact, since it often becomes scratched off or cracked. Furthermore, even some glazes contain lead. People who color pottery or paint with lead-containing pigments (such as cinnabar) are also at risk and must wash their hands before touching their mouths or handling food.

Symptoms of lead poisoning from such sources include mood changes, headache, aching of the limbs, constipation, and bouts of colicky abdominal pain. Since lead poisoning is quite common, anyone having these symptoms should ask a doctor to check them over with this cause in mind.

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Home care:

Keep the child as cool as possible, preferably in an air-conditioned room.

Cool baths and careful dusting with corn flour or baby powder help relieve discomfort.

If the rash is on the face, rest the child’s lace on an absorbent pad placed in the crib.

Be careful not to overdress the child.

Use prickly heat powders during warm weather.

Precautions:

-    Use powder carefully; if a baby inhales large amounts of powder, lung inflammation can occur.

-    Overdressing a baby is a frequent cause of heat rash; the baby need be dressed no more warmly than you dress yourself.

-    The use of detergents and bleaches on bed linens and clothing may aggravate heat rash.

-    Avoid using bubble baths, water softeners, or oily lotions on a child with heat rash.

Heat rash is a mild skin condition caused by temporary blockage of the sweat gland openings on the skin. Heat rash, also known as prickly heat or miliaria, is the most common of all rashes in children of any age. Almost all babies get heat rash during hot weather. Heat rash can even occur in cold weather if your child is overdressed either during the daytime or nighttime. Fair-skinned children (redheads and blonds) get heat rash more frequently than other children, and they suffer the most from it.

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