Herbal Health

Treatment

There is no effective treatment for nail-biting in children. The use of gloves or mittens, threats or punishment, or bitter nail polishes or solutions to paint onto the fingers have not been shown to work, and may cause considerable embarrassment and distress to child and parents alike.

Some advocate the use of chewing gum, arguing that it is difficult to bite one’s nails when one has a mouthful of gum. However, leaving aside concerns about teeth, it is clearly not practical to have gum in the mouth for 24 hours every day. In older children, especially girls, teaching them to take pride in the appearance of their nails is often effective. This can be reinforced by the purchase of a nail file or manicure set.

Where children are visibly anxious or stressed, you should look for contributing factors, and try to deal with them. Sometimes relaxation techniques and similar strategies may be helpful, as may referral to a counsellor if you are deeply concerned about the possibility of underlying psychological problems, but this applies only to a small minority of these children. In older children who are embarrassed by the habit and are clearly motivated to give it up, behaviour modification techniques may be helpful. This should be organised with the help of a psychologist or other professional with experience in the area.

There is usually little reason to seek medical advice for nail-biting in children. If the nailbed or surrounding skin becomes infected, the doctor will treat it appropriately, although it may recur as long as the child continues to be a nail-biter. Sometimes the family doctor may uncover underlying stresses or emotional issues, especially in adolescents, that may contribute to the nail-biting. Issues of confidentiality then need to be taken into account, and this needs to be carefully negotiated between the doctor and family members.

Prevention

No strategies to prevent nail-biting are known. Theoretically, it might be considered that minimisation or reduction in stress levels may lessen the chances of nail-biting beginning or continuing, but this has not been demonstrated to be the case. It goes without saying that good and open communication with children is desirable and can serve to minimise stress.

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This is a highly specialised form of imaging, using sophisticated computer techniques, to build up a detailed picture of the structures being examined. It is mainly used to examine the head and brain, spinal cord, chest and abdomen. ‘Slices’ or scans taken at many levels build up a complete image of various organs and internal structures when viewed together. Occasionally some dye is injected into the body through a vein on the back of the hand to highlight certain structures. The procedure itself is painless.

As with ordinary X-rays, CT scanning does expose your child to small amounts of radiation, but this is well within all safety limits.

The machinery itself can look quite frightening to children, as they have to lie still within a large cylindrical tube. It always helps if you stay close to your child during the procedure, and remain calm and reassuring. It may be necessary to give a younger child a light general anaesthetic to ensure that he lies perfectly still for the test.

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Peter was exhilarated. It was early morning and he had reached halfway in a 10 km bike ride along the coast road. He wished he had brought his camera. Peter had loved photography ever since he was a child. He had always wanted to be a photographer, and now he was one. He thought of his parents. They had both worked long and hard to pay for his university fees, and they were proud of him when he received his PhD and entered the world of academia. Panic disorder/ agoraphobia had changed all that. As Peter progressed towards recovery he realised that academic life was not for him. He struggled silently with the realisation for three years because he didn’t want to let his parents down. He even studied for another degree, hoping to combat his disquiet. It didn’t work, and he made the break to follow his dream of being a photographer. He knew he was taking a risk, but he also knew it was worth it. He was free.

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If diagnosis and treatment are combined in the one operation, you cannot be in control of the treatment decision. You must agree to the surgeon carrying out whatever operation seems best once the diagnosis is made. You are put to sleep not knowing what operation will be done. Whether or not your surgeon attempts to discuss all the various possibilities with you beforehand, this is not a good option for you. It means you are likely to be unnecessarily disturbed and confused by having to consider a whole lot of different possibilities before your operation-Why do surgeons recommend the frozen section type of procedure then? They recommend it because it is easier for them and because they take it for granted that they should decide what operation is best. Do all you can to ensure that the diagnosis is made before you agree to a treatment-type operation.

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At operation, the protruding sac is cut off and the stump pushed back inside the abdominal cavity. This sac is formed from the peritoneum, which lines the inside of the abdomen.

The muscle layers of the abdominal wall are then repaired and tightened so as to prevent recurrence. The muscles are pulled tightly together with stitches. Sometimes a layer of stitches or wire is placed between the muscle layers so as to add strength.

The usual stay in hospital is about five days. Most workers are given six weeks off work to recover but the self-employed and those who can be found suitable alternative work involving minimal lifting of restricted weights can return to work within four weeks.

Unfortunately, despite the skill of the surgeon, the hernia may recur and require another operation. This second attempt is always more difficult than the first repair because of the scarring and the difficulty in separating the various muscle layers.

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If mother and foetus are ABO incompatible, her anti-A and or anti-B antibodies would rapidly destroy the foetus’ red cells before they could induce antibody formation.

An Rh negative woman can be sensitised and develop antibodies if she receives a blood transfusion of Rh positive blood.

In the past, Rhesus iso-immunisation was a great worry to every doctor who delivered babies. With modern treatment, it should no longer be seen. Unfortunately, that is not yet the case.

Where an Rh negative woman becomes pregnant to an Rh positive man, in most, but not all, cases the child will be Rhesus positive.

It is rare for the woman to be sensitised in her first pregnancy but one in 10 are sensitised by the second and the percentage becomes higher with each pregnancy. Previously, in six out of every 1000 deliveries, the child would be affected by Rhesus iso-immunisation.

Once the mother has formed these antibodies, they readily cross the placenta to enter the baby’s circulation and can destroy the baby’s red cells.

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Hair conditioner is usually a cream to be used as a rinse after the hair has been washed, its basic ingredient being an antistatic compound that forms a residual film on the hair. Shampooing decreases the hair’s normal oily film, resulting in a dry and dull appearance. This may lead to static electricity, making the hair unmanageable; in this state the hair is more prone to tangling, and combing may result in breakages. Conditioners help to control these problems by making the hair more manageable, and leave it feeling soft and glossy. Egg or beer conditioners simply leave a layer of sugar or protein on the hair which may appear to provide more ‘body and manageability’. Protein conditioners, like other protein-containing products for the hair or akin, are not absorbed. They therefore do not change hair structure, affect hair growth, or in any way permanently after the hair. Although hair consists of a protein known as keratin, the hair above the skin is dead tissue that cannot be fed or revitalized. Furthermore the protein derivatives used are derived from animal tissue, not human hair, and are hence incompatible. Protein conditioners have the same effect as any other conditioner, namely to coat the hair shaft with a film that tends to temporarily make the hair appear thicker and improve its appearance and manageability. It does nothing to strengthen the hair or restore its structure, and its affect is only temporary.

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The fine art of grazing! Hands up all those who thought that sensible eating meant keeping to three meals a day? Traditionally, there has been a belief that sensible eating meant sticking to three square meals a day. Perhaps this stems from images of an erratic eater. You know the one, the person who skips breakfast making up for it with snacks during the day and then feasting before sleeping at night—certainly not the ideal pattern! New evidence suggests that the people who graze properly, eating small amounts of food throughout the day at frequent intervals, may actually be doing themselves a favour.

A recent study which compared people eating a diet of three meals a day with those who had three meals and three snacks showed that snacking stimulated the body to use up more energy for metabolism compared to concentrating the same amount of food into three meals. It’s as if the more fuel you give your body the more it will burn. Frequent small meals stimulate the metabolic rate.

The problem with grazing is that most snacks turn out to be high fat foods like cakes, chocolate, snack bars, crisps or pastries. Another criticism of grazing has been that for people who eat too much, increasing the number of times that they face food is tempting disaster. Overeating is less likely to occur if the foods eaten are carbohydrate rich and have a low G.I. factor. Using these foods, you will feel satisfied before you have overconsumed!

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