Herbal Health

Cause

The cause of pain on urination is most commonly a urinary tract infection. Irritation of the vulva and urethral opening by soaps or shampoos can also occasionally cause stinging and burning on urination.

Clinical features

Urination stings, burns or is painful. The child will have a frequent urge to urinate, but will find starting difficult, or will only pass small amounts even though he feels he has a full bladder.

Treatment

Encourage your child to drink a lot of fluids to help dilute the urine and ‘flush out’ the kidneys and bladder. Urinary tract infections should be treated appropriately by your doctor and followed up carefully.

When to see your doctor

Always consult your doctor if your child complains of pain on urination.

Prevention

As for urinary tract infections.

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Vesico-ureteric reflux is one of the commonest causes of urinary tract infections in children, and if not detected early can lead to scarring of the kidneys.

Cause

Vesico-ureteric reflux is due to a defect in the valve mechanism where the tube from the kidney (the ureter) joins the bladder. Normally urine flows in one direction away from the kidneys, down the ureters, into the bladder and then down the urethra to the outside. If your child suffers from reflux, whenever he passes urine, a small amount escapes backwards from the bladder and flows towards the kidneys. The stagnant urine can also lead to infection. The degree of reflux can vary from minor to severe.

Clinical features

There are no specific signs of vesico-ureteric reflux. It is usually discovered when a child is being investigated for urinary tract infections.

Investigations

A micturating cystourethrogram and a renal ultrasound are usually performed to determine the degree of reflux, and whether there has been any kidney damage.

Treatment

In mild cases, any urinary tract infections resulting from the reflux are promptly treated, and your doctor may advise a long-term course of antibiotics in small doses to prevent recurrence of infections. The kidneys and urinary tract are monitored regularly via urine tests, follow-up X-rays and ultrasound, to make sure that the situation is not worsening. Most mild cases of vesico-ureteric reflux will resolve spontaneously with age. In more severe cases surgery may be indicated. Your doctor will explain to you the preferred treatment and follow-up plan for your child.

Prevention

There is no way to prevent vesico-ureteric reflux.

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Growth occurs in predetermined phases, although there is a great deal of individual variation. For example, a baby on average will double his birthweight at about 5 months, and treble it at about 12 months of age.

The rate of growth in children (weight, length or height, and head circumference) is measured in percentiles. When you visit your doctor or nurse, your child may be measured and these measurements plotted on percentile charts. This is to check that growth is proceeding appropriately.

Percentile charts are comparative graphs of children’s growth rates. If your child’s weight is on the 50th percentile, he is the same weignt as 50% of children of his age. If he is on the 97th percentile he is heavier than 97% of children of his age; being on the 3rd percentile means he is in the bottom 3% for his age. There are different percentile charts for boys and girls.

Checking percentile charts may give the first indication that a child is ‘failing to thrive’, is overweight, too tall, or too short. Growth is most rapid in the first couple of years of life, and then again in adolescence. The latter is known as the adolescent growth spurt.

A child’s head grows in a similarly predictable manner. At birth, the baby’s skull is very soft, with two open spaces or holes at the top of the head. These are called fontanelles, and allow the bones of the skull to grow as the child grows. The one at the front, called the anterior fontanelle is the larger of the two, measuring 3-5 centimetres at birth, although again this varies considerably. Both fontanelles are closed by about one year of age.

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Surgery is a good way of tackling a few particular types of pain due to cancer. For example, pain due to a blockage of the bowel or kidney can sometimes be relieved by removing the responsible growth or bypassing the blockage. Pain due to a fracture through cancer in a bone, can often be most quickly relieved by putting a metal pin or plate in the bone. The bone is most likely to remain pain free if this surgery is followed up by radiation treatment.

Even chemotherapy is sometimes recommended for people who have painful cancer growths. The pain will be relieved only if the growth is shrunk, so consider this method of pain relief only if you have a type of cancer which is very likely to be sensitive to the chemotherapy.

If you do decide to seek pain relief by tackling the responsible cancer itself, you will still need painkillers in the meantime. The fact that your pain may be relieved by radiotherapy or surgery later doesn’t mean that you shouldn’t be getting relief with painkillers right now. The following section is important for all of you with cancer pain — those who are having anti-cancer treatment as well as those who are not.

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Vitamin C, or ascorbic acid, has occupied a lot of interest recently, not only for its effect in preventing the common cold but because of its actions generally in human nutrition.

Vitamin Ñ is widely distributed through many foodstuffs. The green vegetables, citrus fruits and potatoes contain considerable quantities.

This vitamin is necessary for the proper development of connective tissue in the body, especially the coverings of blood vessels.

Lack of ascorbic acid produces scurvy, with bleeding in the gums and other soft tissues, failure of wound-healing, and poor resistance to infection.

Infantile scurvy is seen in children artificially fed without a Vitamin Ñ supplement.

There are groups who believe that large doses of Vitamin Ñ are beneficial to health and indeed can treat or prevent a large number of illnesses.

Orthodox medical and nutritional experts do not accept this.

If you eat a proper diet, it is not likely that you’ll suffer from a Vitamin Ñ deficiency.

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For proper physical fitness, a balanced diet is essential. The body should be at the correct weight for height and age. All the essential food factors should be included in the diet.

Protein is necessary to build up body tissue and to replace wear and tear. Fat is necessary to provide essential factors. Carbohydrate provides a ready energy source but excess tends to accumulate as stored fat.

Minerals and vitamins are necessary in small doses. Bulk in the form of vegetable fibre is necessary for the proper functioning of the bowel.

Exercising three times a week is the bare minimum. Four or five times a week is better. People who are fit look better, feel better, work better, are sick less often and have less chance of developing a heart attack.

Don’t smoke, drink in moderation, eat a balanced diet and take proper exercise. Learn to relax and you may not only live longer but enjoy it more.

The message Life: Be In It applies to you. You should exercise as if your life depended on it.

It does.

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Chemotherapy, or the use of cytotoxic drugs to kill the cancer cells, is now part of the initial treatment.

As in other forms of cancer what is developing is a team approach to treatment, the surgeon, radiotherapist, and chemotherapist making joint decisions about the management of each patient.

The implantation of a silicone prosthesis to give the woman a new “breast” is now a regular procedure for many women unfortunate enough to lose their breast because of cancer. The construction of the new breast may be done at the same time as the initial operation of removal of the breast or may be delayed for some months.

If you find a lump go straight to the doctor. If it isn’t cancer you save months of worry. If it is, the earlier it is found and treated the better the result.

The breast is the commonest site of cancer in women, but the uterus or womb is the second.

Cancer may involve the cervix, or neck of the womb, or the body of the womb; and the age at which the cancers occur, the possible causes and their subsequent behaviors differ.

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Of course, not all doctors and ofher practitioners who treat cancer are as black as I have painted. I hope that your practitioners combine the best of modern scientific medicine with the art of healing. I hope they take as much care in finding out how you are feeling and what life is like for you as they do in arranging and assessing tests. I hope your practitioners place as much, or more, importance on the quality of your life as they do on its length. I hope they treat you as a whole person who happens to have cancer and not just as a cancer with a body wrapped around it!

If you don’t have this kind of practitioner, life is going to be difficult for you. Those practitioners who are least likely to make the best decisions for you are also the most difficult to get enough information from to make your own decisions. Switch to another practitioner, if possible. If not, you may have to seek information from other sources such as other practitioners, nurses, other hospital staff, books, other patients, and friends. If you make a decision that does not follow such a practitioner’s recommendation, be prepared to be told by them that you are foolish, ignorant and incapable of properly assessing the situation. Trust your own judgement and commonsense. Don’t be intimidated or cajoled into giving away control of what happens to your own body. Remember, you are the world’s greatest expert on yourself. Nobody else knows how you feel inside and what is important for you. This personal knowledge is of vital importance when it comes to deciding on treatment that could totally alter your life.

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Table sugar or refined sugar (sucrose) has a G.I. factor of only 60-65. This is because it is a disaccharide (double sugar) composed of one glucose molecule coupled to one fructose molecule. Fructose is absorbed and taken directly to the liver where much of it is slowly converted to glucose. So, the blood sugar response to pure fructose is very small (G.I. factor of 20). Thus when we consume sucrose, in effect we have consumed only half as much glucose. This explains why the blood sugar response to 50 grams of sucrose is approximately half that of 50 grams of pure maltose (where the molecules are all glucose).

Many foods containing large amounts of refined sugar have G.I. factors close to 60. This is the average of glucose (G.I. = 100) and fructose ( G.I. = 20). This is lower than that of ordinary soft bread with a G.I. factor averaging around 70. Kellogg’s Cocopops™ which contains 39 per cent sugar has a G.I. factor of 77, lower than that of Rice Bubbles™ (83) which contains little sugar.

So, contrary to popular opinion, most foods containing simple sugars do not raise blood sugar values any more than that of most complex starchy foods like bread. The same is true of honey (G.I. factor of 58). Some types of honey have a much higher G.I. factor (87) than refined sugar (65), possibly because they are a mixture of honey and glucose syrup.

Sugars that naturally occur in food include lactose, sucrose, glucose and fructose in variable proportions, depending on the food. The overall blood sugar response to a food is very hard to predict on theoretical grounds because gastric emptying is slowed by increasing concentration of the sugars, whatever their structure.

Some fruits for example have a low G.L factor (cherries have a G.I. factor of only 22) while others are relatively high (watermelon has a factor of 72). It seems the higher the acidity and osmotic strength (number of molecules per ml) of the fruit, the lower the G.I. factor. Thus it is not possible to lump all fruits together and say that they will have a low G.I. factor because they are high in fibre. They are not all equal. See the tables in Part HI to compare fruits.

Many foods containing sugars are a mixture of refined and naturally occurring sugars. The overall effect on the blood sugar response is too hard to predict. This is why we need to test the G.I. value of sugary foods in real people before we make generalisations about their G.I. factor.

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One of the problems in designing physical activity for the overfat is the negative connotations of the term ‘exercise’. This is probably to do with the association of exercise with high intensity activity. A greater emphasis on low-moderate level activity, and a shift from the notion of exercise as ‘extra-curricular’ to lifestyle changes in activity patterns suggests that a term such as physical activity might be more appropriate. There are two forms of this that are relevant:

• ‘Planned’ physical activity, such as walking, swimming or some other form of aerobic activity carried out regularly, often as a part of recreation.

• ‘Incidental’ physical activity, such as walking up stairs instead of using an elevator, walking instead of driving, or even not using effort-saving devices such as cordless telephones or remote controls for television sets.

Planned physical activity is necessary to compensate for the decrease in daily energy use resulting from changes in work and daily living conditions in most modem societies. Weight-bearing activities such as walking are likely to be the most effective because of the greater energy use. However, in the first instance non-weight-bearing activities such as swimming, which are thought to be generally less effective in fat loss, may be more able to be carried out and therefore less de-motivational.

Incidental activity is designed to counter reductions in spontaneous physical activity that occur in technically advanced societies. It is this which may be of most importance, and may initially even be the only exercise prescription for obese, in contrast to overfat individuals, because of the discomforting and de-motivational aspects of more vigorous forms of activity. As body mass decreases and planned physical activity becomes more comfortable, different forms of planned activities can be introduced.

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