Itchy skin may be due to a variety of causes. The commonest reason for excessive itching is dry skin. Other causes include eczema, insect bites, allergic reactions or hives, scabies, or psoriasis. Treatment always depends on the cause of the itching, and if you are in any doubt whatsoever it is advisable to check with your doctor before trying any creams or lotions.

JAUNDICE IN CHILDREN

If your child has jaundice, you will notice a yellowish hue on his skin, and the whites of his eyes (the sclera) will also be yellow.

Cause

The commonest cause of jaundice in older children is an infection of the liver called hepatitis. Other causes are very rare.

Clinical features

As well as the obvious yellow hue of the skin and the whites of the eyes, a child with jaundice may have dark yellow urine and pale-coloured stools. His skin may also be itchy.

Treatment

The treatment of jaundice in children also depends on the cause and severity of the illness. We encourage you to discuss all aspects of treatment with your doctor.

When to see your doctor

A child with jaundice should always be seen by a doctor, especially if he is unwell, or drowsy.

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Immunisation is a technique in which a killed or weakened strain of a bacterium or virus is given to a child or adult, in order to build up the body’s defence against a particular infectious disease. After immunisation the person develops antibodies. These are special proteins that recognise and fight these same diseases when they try to invade the body.

WHY IMMUNISE YOUR CHILD?

Immunisation protects your child against certain diseases which can be life-threatening. World-wide programs attempt to eradicate these diseases. A good example of this is smallpox, which used to kill many thousands of children and adults all over the world. In the 1970’s smallpox was wiped out entirely by a very successful immunisation campaign. Other serious infectious diseases have been brought under control by immunisation programs. These include:

• diphtheria

• measles

• mumps

• pertussis (whooping cough)

• poliomyelitis

• rubella

• tetanus

• haemophilus B (HIB).

These are the diseases against which you should have your child vaccinated. It may save your child’s life one day. Due to the success of immunisation programs, many of these diseases are rarely seen today. This does not mean your child no longer needs to be immunized against them. Parents often forget that only a short time ago many children became very ill and even died because of diseases such as polio, which used to occur in epidemic proportions.

It is vital from the point of view of the community that all children are immunised. Non-immunised children are certainly at far greater risk of being infected with these diseases and, because they lack immunity, they risk serious complications and even death. Non-immunised children also help to spread infection in the community, and make eventual eradication of the disease virtually impossible. It is vital to inform your doctor or maternal and child health nurse if your child is not immunised, so that special care may be taken during outbreaks of certain infections.

The benefits of immunisation far outweigh any risks. Give serious thought to the consequences — for the child and the community — of not immunising your child. We strongly urge you to have your children fully immunised.

Many misconceptions surround the issue of immunisation, and some parents refuse to have their children immunised. If you are still unsure, talk to your doctor before making any final decisions and discuss any doubts you may have.

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HUSBAND

It almost seems like having sex decreases our sex life. When I have it, I just don’t want to have it again. I feel like all the energy is gone then.

WIFE

One hundred and nine men and 59 women reported that their refractory periods seemed longer than other times in their life. When we run cold, there may be a tendency to overdo it when we finally find the time and energy for sex. When we become contemplative, we also lengthen the refractory period by avoiding behaviors that may lead to re-arousal. Since the cold reactor is in a perpetual emotional refractory period, it seems logical that such a life orientation would enter into the sexual system.

What about your own sexual system? In terms of this new diagnostic system, what types of problems is your sexual system experiencing at this time? Don’t deliver a verdict. Think about your sexual functioning to determine who is the matter with the sexual system. You are not assigning blame or responsibility for the problem, for each partner is responsible for self. It means understanding that it is “who,” not “what,” that matters in achieving super marital sex, the who of the combination of you both. It is how we are and who we are as people who relate that really matters.

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Next, count up the number of items you circled to the left of the

5 (0, 1, 2, 3 or 4). Again, both spouses in oar example scored identically, and they each circled three numbers to the left of the 5. Subtract the number of times you scored to the left of 5 from the number to the right of 5, and you have your sexual-system score. It is possible to have a negative score not in meaning but in the interpretation of your scores. To understand the meaning of your score in this new systems context, place it on the following line:

ACCOMMODATING MARRIAGE SYMMETRICAL MARRIAGE»» ««COMPLEMENTARY MARRIAGE -10 9876543210+123456789 10

If your score fell in the minus range, your sexual system is functioning in the symmetrical mode at this time. You tend toward an egalitarian, romaticized, nonsexist, balanced relationship. If your score fell toward the plus side of 0, you tend toward a more separated, sexist marriage that has less balance than the symmetrical marriage.

The accommodating marriage is a super sex marriage. It adapts over time. The score of this type of marriage would be near zero. This type of marriage has a high AC, or alternating capacity, going back and forth between symmetrical and complementary in response to external and internal needs in the overall marital sexual system. Like all systems, ease and balance seem healthier than disease and extremes, so a score around zero is the healthier score and a place for our focus throughout this book.

You now understand more about the systems approach and what is meant by super marital sex, a sex that goes beyond the limits of day-to-day patterns, holistically growing and changing with, for, and because of the partners’ interaction. How you find someone to form such a relationship with and how you discover such a relationship for your marriage requires integrating our marital “IQ”, Intimacy Quotient, from Chapter One and your sexual-system score from this chapter. I will show you in Chapter Three how the courtship ritual works in our society and how you can re-court your marital partner by a new set of super sex rules, how intimate systems are formed.

The couple we have been following managed to break their solidified pattern of male-dominated, female-compliant, distant, and misperceived patterns of sexuality and daily marital living. They did so through the steps you will learn in the following chapters. They learned about their own love experiences. They learned the loving. Most important of all, they learned that mutual responsibility within and for an ever-changing system of intimacy was vital to their own personal as well as their marital health. They continue to struggle together with this learning, loving, within a system that gives more room to grow.

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It is tiny, just visible as a small dot and spreads from person to person, usually by close contact.

It is common in families and among young people

who may share a bed with a friend. It may spread to nurses from infected patients and then be further spread, particularly in nursing homes.

The female mite burrows into the skin and lays her eggs, which hatch and the immature larvae move out on to the skin, mature, mate and so the cycle continues.

There are often no symptoms for one or two months. It takes this time for the body to become sensitised to the mite.

This sensitivity produces a rash and an itch, which is usually worse in bed. It involves the trunk and the arms and legs but does not occur on the head and neck.

The typical burrows are not easy to see and are more common on the hands and wrists. The rash usually consists of red and raised papules or bumps and there are many scratch marks.

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These are the mono-amine oxidase inhibitors (MAOI).

Mono-amines are chemicals which occur naturally in the body. Adrenalin, the main hormone which stimulates the body in the “fight or flight” mechanism, is a mono-amine. Certain other mono-amines are concerned with the transmission of nervous impulses in the brain.

There is an enzyme in the body, mono-amine oxidase, which breaks down these mono-amines. The MAOI group of drugs inhibits the action of the enzyme and allows the chemicals to act unrestrained.

This, apparently, is of benefit in treating emotional disorders. However, some side-effects may develop if certain mono-amines are in the diet.

The amino-acid tyramine occurs in many foods. It has a tendency to cause a rise in blood pressure, but normally the action is counteracted by the enzyme. When the MAOI drugs are taken the action may be blocked and, if these foods are taken, a dangerous rise in blood pressure, associated with severe headache, may occur.

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Each cell of the human body contains 23 paired chromosomes on which are carried the genes, those chemical markers which determine who and what we are.

The germ cells, which are the ovum from the female and the sperm from the male, are different.

These cells contain only 23 single chromosomes. When they fuse at conception, the new individual then has 23 pairs, half from the mother, half from the father.

One chromosome, normally termed the X chromosome, determines the sex. A female has two X chromosomes whereas the male has only one X chromosome and a smaller and rather insignificant Y chromosome.

All ova contain X chromosomes but the sperm may have an X or Y and whichever one of these fertilises the ovum determines the sex. In Down’s syndrome there is an extra chromosome usually at number 21.

This is called 21 trisomy.

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As the cancer enlarges it also puts pressure on, and may partly or completely block, nearby structures. If these are the bowel or bladder, a change in bowel or bladder habit will result. This can take the form of going either more or less often, change in consistency of the motion, an unusual amount of wind, looseness of the bowel, a feeling of needing to hurry to get to the toilet and sometimes pain on opening the bowels or passing urine.

*50/40/1*

Most women nowadays are much better informed on medical matters than their mothers or grandmothers were, and they expect to be given as much information as possible. You do not have to be putty in your doctor’s hands; you don’t have to take (or not take) medicine just because he says so; you have every right to full information and then to make your own mind up. Fortunately, the ‘because-I-say-so, my dear, and-don’t-ask-so-many-questions’ type of doctor is becoming a dying breed, and GPs now expect their patients to want information about their condition and its treatment, including the options available and possible side-effects of different treatments. If you are unsure about anything, go along to your doctor with a list of questions written down on paper and then write his replies down, so you don’t forget anything. You may prefer to take somebody into the consulting and less intimidated, and you have the right to do this, and also to a second opinion.

As a result of the scares abut HRT in the 1970s, many doctors are uncertain how safe it is nowadays, and perhaps do not realise that cancer of the lining of the womb can virtually be ruled out for women starting HRT now as long as they take progestogen as well as oestrogen. They might also link safety concerns about the oral contraceptive with HRT, but as the dose is many times smaller, this is a largely unfounded fear. Although many doctors realise the benefits of long-term HRT for osteoporosis and heart attacks, they are also aware that there is an increased risk of breast cancer in women who take it long-term. It is interesting, though, that doctors involved in research projects with women who are taking HRT do seem to be enthusiastic about it; perhaps they feel it really does work, and, in most cases, has more advantages than disadvantages.

Finally, however well you are getting on with HRT, it is not a panacea for eternal good health, and any of us can develop serious diseases. There are some symptoms you should not ignore, whether or not you think they are connected with either the menopause or HRT:

• very heavy periods

• any bleeding or ’spotting’ between periods

• any bleeding or ’spotting’ after sexual intercourse

• any unexplained bleeding once the menopause has passed

• if you still haven’t reached the menopause by about the age of 54

• pain or swelling in the abdomen

• ‘indigestion’-type pain that persists for more than a day or two

• blood in the urine or stools

If you get any of these, see your doctor as soon as possible.

While a few GPs are still reluctant to take menopausal symptoms seriously (‘No one yet died of the menopause, my dear*), many are both enthusiastic and helpful. An increasedear’), many are both enthusiastic and helpful. An increasing number have set up Menopause Clinics within their practices, employing specialist Menopause Nurses, from whom women can receive advice, information and screening. Newly pregnant women see their GPs, and all women approaching the menopause should be encouraged to do so as well, not necessarily to be given HRT, but to discuss the menopause, their symptoms, and any treatment that may be advisable. Women who are well informed about this time of change will feel better able to cope with it, and will not be a burden to themselves or to their doctors.

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Sexual interest, indicated by sexual arousal, sexual fantasising and masturbation, becomes apparent in females and males during the early teenage years. Then, as sexual interest matures in later adolescence, most individuals develop quite specific erotic fantasies. The ability of humans to create and respond to fantasies seems to play a major role in sexual motivation and in sexual receptivity. Strong and deliberate fantasising through erotic stories, pictures, readings and films may help stimulate this interest. Such strategies may help rekindle sexual interest.

Like most species, humans work up to sexual contact with foreplay that excites both partners. Birds coo, bow and strut. Primates spend hours grooming each other. In most mammals, delicate stimulation of sensitive body parts is an important component of stimulatory activity

preceding sex. Many couples find that taking the time to gently and lovingly play with the clitoris, penis, and the nipples, using the fingers, the tongue or a vibrator, can arouse intensely pleasurable sensations. If arousal takes a long time, accept this and continue the activity only as long as you are both enjoying the experience.

There is some evidence to suggest that techniques of sexual intimacy have changed in recent generations with increases in oral sex in marriage, more variation in foreplay and more experimentation with positions. Some women enjoy deep penile penetration and may achieve this by either the female-astride position, or the man-on-top position with her legs on his shoulders and pillows under her hips. Adequate vaginal lubrication is an important consideration and can be achieved using substances such as K-Y jelly or the new hormone-free Replens which lasts for several days and is not messy. Many women find that post-menopausal hormone therapy helps lubrication.

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