11 Sep 09 YOUR CHILD’S HEALTH CARE/ GENITAL, GROIN AND URINARY TRACT PROBLEMS: VAGINA, OBJECTS PLACED IN THE
A normal part of children’s development is to explore their own bodies. As part of this process, girls may place all manner of objects inside their vaginas, ranging from crayons to marbles. These objects are usually promptly forgotten about until parents notice a foul smelling vaginal odour or discharge several days later.
When to see your doctor
Always seek medical advice in these situations. See your doctor immediately if you suspect that your daughter has put a sharp object in her vagina, or if there is any pain or bleeding.
Young girls occasionally have a whitish discharge from their vagina, which does not irritate them and does not smell. However, if your daughter complains of itching, and her vulva is reddish in colour, she may have a thrush infection, or dermatitis. Any offensive vaginal discharge, or bleeding in a pre-menstrual girl should arouse suspicion of a foreign object having been pushed into the vagina by the child. Newborn baby girls may have a slight vaginal discharge due to the lingering hormonal influences from the mother.
VAGINAL TEARS
Vaginal tears in children result from some form of trauma, such as landing with legs astride on something sharp, or straddling a fence. This can cause pain and bleeding, and you should see your doctor for advice on treatment of the injury.
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11 Sep 09 YOUR CHILD’S HEALTH/BONE AND JOINT DISORDERS: GENERAL PROBLEMS
Apart from congenital dislocation of the hip, most orthopaedic problems in childhood are not serious. They generally occur as part of the normal growth pattern of the child and eventually correct themselves without any active intervention. Parents often become concerned because their child walks or runs awkwardly, wears out shoes, or appears pigeon-toed or knock-kneed. While it is often wise to have the ‘problem’ checked by your doctor or a paediatric orthopaedic surgeon, special shoes and supports are used too much.
Most orthopaedic surgeons advise parents to save their money — inexpensive shoes are just as satisfactory as the most expensive. Children’s feet will develop and grow normally whatever shoes they wear, as long as they fit reasonably well. It certainly is not necessary to purchase children’s shoes at specialised and expensive shops — those bought at discount stores are just as good.
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11 Sep 09 YOUR CHILD’S HEALTH/BONE AND JOINT DISORDERS: ARTHRITIS, SEPTIC
Cause
Septic arthritis is caused by infection of a joint, most often with a Staphylococcus or Haemophilus germ which has spread from a preceding skin or upper respiratory tract infection.
Clinical features
Septic arthritis occurs most commonly during the first year of life. The onset of illness may be quite sudden and the baby usually has a fever and is generally unwell. Swelling over the affected joint is marked and the baby may not move the affected limb due to pain. A toddler may begin to limp.
X-rays and blood tests can help in confirming the diagnosis. In addition, a special bone scan is usually performed to highlight the areas of infection. Sometimes fluid is aspirated from the joint under local anaesthetic using a needle, and sent to the laboratory for analysis.
• if your child has an unexplained fever, or is generally unwell;
• if your child has any swelling or pain over a joint, or is reluctant to use one limb or part of a limb.
Treatment
If your child is suspected of having septic arthritis, it is usual to admit him to hospital for thorough investigation and immediate treatment with the appropriate intravenous antibiotics. The stay in hospital is usually from 10 days to 2 weeks. Only in the most severe cases is surgical drainage necessary.
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11 Sep 09 YOUR CHILD’S HEALTH/BONE AND JOINT DISORDERS: BONE INFECTIONS (OSTEOMYELITIS)
Osteomyelitis is an infection within the bone. It is more common in children between the ages of 3 and 12 years and occurs more frequently in boys.
Cause
The infection is commonly caused by the Staphylococcus germ, which may enter through an open fracture or infected sore.
Clinical features
The onset of the illness is usually sudden and is often, although not necessarily, characterised by fever and general lassitude. The child may avoid moving the affected limb, and an older child may complain of pain. The commonest bones affected are those of the upper arm and leg. Swelling, redness and tenderness occur over the site of the infection.
Investigations
X-rays, blood tests and special bone scans are performed to confirm the diagnosis. These are usually performed in hospital. X-rays themselves are not always conclusive in the early stages of the infection.
• if your child has an unexplained fever or is generally unwell;
• if your child complains of pain in part of a limb, or does not move a limb;
• if there is any swelling, redness or tenderness over a bone.
Treatment
It is critical that treatment be started as soon as possible, as this leads to the best long-term results and minimal complications.
given orally for several weeks upon discharge from hospital. While in hospital, bed rest is important. Sometimes surgical drainage of the infection under anaesthetic is necessary.
After the acute phase of the illness has passed, physiotherapy helps to maintain the mobility of the limb.
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21 May 09 YOUR CHILD’S CARE/TEETH: DEVELOPMENT AND TEETH
Children usually cut their first tooth between 6 and 9 months of age; from then on, teeth erupt rapidly. A good rule of thumb is to calculate 7 months plus one month for each tooth. For example a child of 10 months would be expected to have three teeth (7 plus 3 months = 3 teeth). By the age of 3 years, the average child will have twenty primary or ‘milk’ teeth.
As the teeth push through the gums, children can become irritable, drool a lot and sleep poorly. The gums may become sore, reddened and tender. A blister will sometimes appear over the gum to herald the arrival of a new tooth. Contrary to popular opinion, teething in infants and young children is not responsible for fever, ear infections, diarrhoea, or other ailments.
A child experiencing the discomfort of teething may be helped by teething rings or rusks. The pressure of these against the gum may be soothing. The same effect may be achieved by the parent gently rubbing the affected gum with a finger. Sometimes paracetamol given according to directions may ease the pain, and very occasionally a local anaesthetic cream will be of help, though it will tend to wear off quickly.
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18 May 09 DEFINITIONS OF SOME EXPRESSIONS YOUR DOCTOR MAY USE – SOME FACTS ABOUT PAINKILLERS (PART 1)
Here is a table telling you some facts you will need to know about painkillers.
In the first column I have listed their chemical names. If the name of your painkiller is not on this list, it is most likely because you have been given the proprietary (drug company) name and/or because it is a mixture. Ask for the chemical name(s) of your painkiller(s).
In the second column is the dose which, if taken by mouth, is likely to relieve the pain of a person who is just starting on painkillers. These doses are all of about equal strength, so you can work out what dose of another painkiller will have about the same effect if you switch from one to another. Injections are two to four times stronger than tablets or syrup of the same drug.
The third column shows how long each dose usually lasts. Remember, everybody is different. These figures are average, just to give you the general idea.
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18 May 09 VITAMINS – GENERAL INFORMATION
However, it is worth noting that certain foods such as potatoes, which are rich in Vitamin C, also contain an enzyme, ascorbic acid oxidase.
When vegetables are heated slowly, the enzyme becomes active and destroys the ascorbic acid. But if the vegetables are rapidly blanched by immersing in boiling water, then the enzyme does not render the Vitamin Ñ inactive.
The  group vitamins have been claimed to be of use in nervous disorders and as a good pick-me-up for debility, nervous exhaustion and that run-down feeling.
Vitamin Bl, or thiamine, is found in cereals, meat and eggs. A lack of thiamine produces the disease known as beri-beri, a condition seen in World War 2 in prisoners of war fed on a diet of white rice and little else.
Some people can develop an allergy to the synthetic Vitamin Bl tablets or injections.
Vitamin B2, or riboflavin, is found in dairy products and green vegetables, but is widely distributed throughout most natural foodstuffs.
A lack of riboflavin affects the skin and mucous membranes.
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15 May 09 EXERCISE RISK
The idea that participation is better than watching seems to have taken hold in Australia as well as other developed countries and the Western world is on a fitness kick.
Not only the young, but the middle-aged and even the elderly are walking, jogging, swimming and playing tennis and squash.
We have been told that it is all good for our health and likely to reduce the risk of having a heart attack.
When a jogger drops dead, this receives great publicity and can make those of us who are pushing our ageing bodies harder than we have for many years, just a little anxious about whether we are doing the right thing.
People still have heart attacks and some die while sleeping or making love. That shouldn’t keep us awake or make us choose celibacy.
Regular sustained physical exercise, tailored to the needs of age, present fitness and state of health is good for one and may protect from the development of a heart attack. Nothing is absolute in medicine.
The trend back to active exercise for many can only be good for the majority even if, for a few, their exertions are foolhardy or even dangerous.
While exercise may not increase the quantity of life it does seem to increase its quality. Those who take up exercise usually take other steps to improve health such as stopping smoking and improving their diet.
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15 May 09 CANCER OF THE WOMB – GENERAL INFORMATION
Cervical cancer may occur in young women, but its peak incidence is in the late Forties. It is more common in women who have had many pregnancies, in those who have had regular sexual intercourse from an early age and in those who have had many sexual partners. It is also more common in those with a lower socio-economic status.
The herpes virus and the human papilloma virus which causes genital warts are thought to be causes of cancer of the cervix.
Most people still associate cancer with pain but this is usually a late symptom. The earliest symptoms of cancer of the cervix are bleeding and discharge. The bleeding may occur between the periods and may follow intercourse. The discharge is initially clear but later becomes blood-stained and offensive.
In 1933, Dr George Papanicolaou showed that a simple test of placing a scraping from the cervix on a slide and examining it under the microscope could detect cancer in its earliest stage.
This test has been widely used since the late Fifties but, unfortunately, many women fail to take advantage of it.
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15 May 09 WHY YOU ARE THE BEST PERSON TO MAKE DECISIONS ABOUT YOUR OWN TREATMENT – IMPORTANCE OF THINGS
However good and caring your practitioner is, he or she can only consider the medical side of things when recommending treatment. You are the only person who can combine the facts about possible treatments with your own ‘inside’ knowledge in order to arrive at the best decision for you. You know whether it is important for you to live as long as possible whatever the cost. You know how important the changes in lifestyle likely to result from your disease or treatment are to you. You know how important your body image is to you and what things about it are most important for you. Provided you can get the necessary ‘outside’ information, this all makes you, without question, the best person to make the decisions.
I’ll just mention one thing that makes these decisions difficult for anyone, not just for you. Nobody can look into the future and predict definitely what will happen to you, as an individual, if you take a particular course of action. Your practitioner should be able to tell you what is average or likely, what is possible but unlikely and what is so unlikely as to be a miracle if it happens. To start with you should base your decision on what is likely. All patients hope they’ll be the exception—the one who makes a miraculous recovery. By all means keep hoping for this, but base your decisions realistically on what is likely or average. Say your practitioner tells you that one in ten patients get a remission on a particular treatment— that means that nine in ten patients do not. If you have this treatment, you are not likely to get a remission.
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