Hives are generally caused by an allergic reaction to various substances, which may include certain types of foods, food colourings, preservatives, plants, drugs (for example, penicillin), insect bites, and many others.

Clinical features

Hives are intensely itchy, raised, pinkish spots which together form a rash, usually on the trunk. Spots may become quite large (up to 5 cm in diameter each) and may form giant urticaria which are very large patches on the skin. Hives usually last for several hours and then slowly resolve.

Treatment

There is very little you can do except to try to ease the itching with calamine lotion. A spoonful of bicarbonate of soda added to a tepid bath may also help to ease the symptoms. Your doctor may suggest using an antihistamine until the hives resolve. Hives are not contagious.

When to see your doctor

• if your child has marked swelling of his mouth or tongue, or has difficulty breathing (angioneurotic oedema);

• if your child is generally unwell or has a fever in addition to having hives;

• hives appeared immediately after the child took any sort of medicine;

• the rash has not disappeared after 2-3 days.

Prevention

Try to identify the cause of the allergy and have your child avoid the offending substance. In many cases the substance cannot be identified. You may wish to discuss with your doctor the option of skin tests for allergies.

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Psychologist The psychologist assesses development and intelligence, behaviour and emotional status of the child. Some also offer parental counselling and family therapy. Works in a community or institutional setting, often as a member of a multi-disciplinary team. May work privately.

Psychiatrist A doctor who has undertaken further training in the assessment and management of behavioural and emotional problems. A child psychiatrist receives additional training in paediatric aspects of emotional and behavioural development. While a child psychiatrist and child psychologist may both be involved in managing children with emotional problems, they have different sorts of expertise because of their different training.

Speech Pathologist Evaluates and treats children with problems of speech and language. Speech pathologists also work with young children who have difficulties with eating and drinking due to co-ordination problems of their mouth and tongue, such as in cerebral palsy. Works in hospitals and the community. Occupational Therapist Trained in assessing motor and visual-motor function. An occupational therapist will be involved in helping some children with learning difficulties, as well as many children with developmental delay and difficulties of motor function.

Physiotherapist Is concerned with the evaluation and treatment of children with motor problems, especially cerebral palsy, as well as those with neuromuscular and joint disorders. He also plays an important role in the treatment of other conditions, such as chest infections.

Play Therapist Uses play as a means of encouraging children’s self expression. This includes assisting children to work through fears and anxieties and preparing them for potentially frightening experiences such as hospitalisation or surgery. Most children’s hospitals have an active play therapy department.

Social Worker Provides support and counselling for parents and families who are experiencing financial, emotional or other stresses. Can put parents in touch with agencies and community-based resources. Many social workers undertake counselling of parents and sometimes family therapy.

Dietician An expert on nutrition for children, including normal children with the need for particular nutritional advice, as well as children with medical problems or other special needs.

Audiologist Is trained to assess hearing in infants and children (as well as adults). Has access to special methods of testing hearing even in young infants and children with multiple handicaps.

Special Education Teacher Performs educational assessment and remediation in children with academic difficulties, including those with learning difficulties and private.

Ophthalmologist A medically trained specialist with expertise in the assessment and treatment of eye disorders, including problems of vision. Optometrist Checks a child’s vision, and fits glasses.

Genetic Counsellor Provides advice to parents about genetic conditions. Usually (but not always) a doctor who has undertaken additional training in genetics.

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PROLONGED CONTEMPLATION: I think I start to think things over before it’s over. That is, I start to feel empty even when he’s in me. I think, Oh well, at least I’m getting held. That’s more than I usually get.. I even start to cry, but 1 cover it up by faking arousal.

WIFE

When we are lying there after, I just think to myself. I think about life, work, us, the kids. I don’t know why, but after sex, I get very reflective, very philosophical, kind of funky.

HUSBAND

Seventy-five women and 109 men reported this prolonged contemplation. Cold-running times are often accompanied by long periods of introspection, often negative introspection of missed opportunities and goals. Fewer women than men reported problems, with prolonged contemplation, perhaps because they were more comfortable with or more acclimated to such reflection and thoughtfulness about sexual intimacy. Of course, the men and women were all in therapy, so introspection was to be expected. As I pointed out in the introduction, I am including numbers here for illustration, not documentation. The numbers cannot tell us how often these problems occur in the general population, but they can help us understand about the gender overlap, generality, and life-systems orientation of sexual difficulties.

I noticed that the women reflected on the marriage, the relationship, the loving. Men tended to reflect on life in general, as if forgetting the sex and moving on to unresolved daily problems. This finding, as with all of the findings in this subjective report, is certainly not true of all men or women, not gender-caused. However, some of the difference may be related to expectations and views of sexual experiences and the effect of our love maps. The colder we are running in our life, the more we may freeze up a little after sex.

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You will learn in a later chapter about strategies to help marriages, not individuals, cope with problems of daily living and the fact that none of us really has a “sex” life but rather a full life in relationship to everything and everyone. Strong marital systems grow within their life system.

Too much adaptability and marriages can become only problem-solving units at the expense of joy and the pleasure of daily living. Again, a flow, a wide “stretchability,” a marital elasticity makes for the healthiest, most enduring intimacy system.

The example husband added, “When my Uncle Ned died, I cried until I was dry. I cried in the corner of the basement by the workbench. I don’t think anybody ever really saw me cry.”

The wife reported, “When I [notice not "we"] had to put my mother in that nursing home, it was one of the worst things I have ever had to do. I cried for hours in the tub at night. All I heard was ‘Are you going to be in there all night?’ I felt so alone.”

The couple I am using continues to show one major characteristic: a lack of any system for mutual growth, learning, and change. Any system, and particularly marital systems, that fails to learn and change will develop dis-ease and eventually die.

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Even if consciousness is not lost, the peculiar feelings and apprehension may cause panic and anxiety and the over-breathing may continue. If looked for, this over-breathing is usually obvious.

One method of treatment is to get the person to slow the rate of breathing. Another is to get the person to breathe into a paper bag.

In this way, he re-breathes his own expired air, which is high in carbon dioxide, raising the blood level and stopping the symptoms.

Modern technology means new opportunities for some and no opportunities for many. Those who can cope with these stresses can survive.

Unfortunately, for many others, the very rapidity of the changes have produced intolerable stresses and they fail to cope. We are therefore likely to see more psychosomatic illness.

Learn how to relax and come to terms with life now, so you can be one of the “winners” of our new society.

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Depression is common at the menopause. It may be improved when oestrogen, the female hormone, is given to treat the physical symptoms of oestrogen lack. Some drugs, particularly those used to treat high blood pressure or hypertension, may induce depression.

The illness of depression is associated with many symptoms — some physical, some mental or emotional.

There is usually a sleep disorder. There may be difficulty in getting to sleep but, more commonly, there is awakening during the night. Sometimes the person may sleep from 10 to 12 hours and wake unrefreshed.

Physical tiredness is common. Irritability is also common.

There are often a number of minor physical disorders as well — headaches, constipation or various aches and pains. Everything becomes an effort. There is no joy in life, in routine or special events. There is usually a loss of interest in sex.

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The diagnosis can be established by a special test, which estimates the salt content in the child’s sweat. It is a .difficult test to do, but can be done in the major pediatric centres.

These are located in the capital cities, but the Commonwealth Government is giving financial aid to the child and a parent for travel to a children’s hospital for testing, if they live more than 200 km outside the metropolitan area.

Unfortunately, there is no specific drug to counteract the effects of this disease.

Treatment involves antibiotics for each chest infection and regular physiotherapy to keep the lung free of secretion.

The child needs to be encouraged to take part in plenty of physical activity.

A modified intake of fat in the diet is necessary, and pancreatic enzymes, given as tablets or powders, are necessary for the digestion of food.

In summer, and during hot weather, extra salt must be taken to replace that lost in sweat.

The Australian Cystic Fibrosis Associations Federation is an active body of concerned parents, doctors, nurses and physiotherapists.

It is involved in raising funds for research and publicity in running camps for CF children, and for counselling parents of children who are duly diagnosed as having this disease.

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Nowadays, most of the drugs used for arthritis and other types of moderate pain are non-steroidal anti-inflammatory drugs (NSAIDs), a group of agents that includes aspirin as well. While effective in relieving pain, NSAIDs are “two-edged swords” that cause a lot of side effects including even gastric ulcers in possibly up to 20 percent of patients who take them regularly for a long time.

Fortunately, the American Family Physician (32#4:275) reports, there is a new NSAID that is much less likely than all the others to injure the stomach. Named Salsalate, it is chemically very similar to aspirin, but lacks that acetic acid part of the molecule which makes aspirin so irritating to the stomach. Nonetheless, Salsalate is probably just as effective.

People who fail to respond to it will have to use one of the other NSAIDs. If in doing so they are likely to have a gastric problem, the stomach can be protected with an additional drug, such as Ranitidine, taken simultaneously to prevent acid secretion.

Coca-Cola and Stomach Acid

By drinking Coca-Cola, we significantly increase the amount of acid in the stomach and duodenum, the parts of the gastrointestinal tract that are most prone to ulceration, the journal Gut (25:386) reports. This could seriously interfere with the healing of peptic ulcers, could be responsible for their relapses and, the report suggests, may even predispose us to the development of ulcers.

In view of these findings, ulcer patients should avoid Coca-Cola. It may also be wise for people who have a peptic ulcer to avoid the many similar soft drinks, which could possibly have the same effect.

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