Most of us know at least one person who has had kidney stones. With few exceptions, he will describe the process of passing the stone as one of the most painful things he has ever experienced. Those of us who haven’t had kidney stones wonder how a tiny grain of crystal can create so much intense pain for such a long period of time.

The truth is, kidney stones are a common condition. Kidney stones fall into several categories, depending on their composition. More than three quarters of all stones are calcium stones, and these are the most likely to recur. One out of every 10 people has a uric acid stone, which is commonly caused by the disease gout. Other stones that occur more rarely are cystine stones and struvite stones, which arise due to a urinary tract infection.

Kidney stones are a common condition, and for the majority of people they pass through the urinary tract unnoticed. When one or more of the tiny crystals that form in the kidney cluster together, the stone becomes larger than the ureter tube it must pass through, and that’s when trouble starts.

As the stone starts to move down the ureter, you may feel the pain first on your side just above your hip and down to your bladder directly above your genitalia. Then both the stone and the pain slowly make their way further south through the ureter. The entire process may take up to three weeks. Along with the acute pain, you might also suffer from a fever and bloody urine, signs that the stone has blocked the ureter, which can prevent urine from escaping. In some cases, these symptoms may be a sign of a severe kidney infection, which is much more common in women than in men.

Once the stone reaches the bladder, the pain stops and the stone is quickly eliminated from the body. Some people may pass several significant stones a year with no more than a backward glance. Others, for whom the pain is too fresh a memory, may embark on a plan of prevention while they’re still passing the first stone.

*327\167\8*

Calamine lotion and hydrocortisone creams are the most commonly used over-the-counter preparations for contact dermatitis. If blisters start to form, you might want to cover them with gauze to prevent infection. And certainly you should stay away from whatever caused the red patches in the first place.

If the contact dermatitis does not clear up after two weeks or if the rash becomes sevete, see your doctor, who may advise the use of corticosteroids or other prescription medication to treat the condition.

If you think your rash is caused by anxiety and flare-ups start to become regular events, your physician might suggest biofeedback or another relaxation technique to help you learn how to control your stress. In my practice, I see many adults whose necks turn beet red when I examine them. All they have to do, I tell them, is relax.

Tips and Precautions

For some people, their sensitivity is so acute that even calamine lotion causes an allergic reaction. If this describes you, try applying a mixture of baking soda or Epsom salts and water to the rash. Mix the two together to make a paste, and then spread it over the affected area. If the contact dermatitis doesn’t improve after a week or two, see your doctor.

*272\167\8*

Appendicitis is a very serious disease. When the appendix becomes inflamed and infected, the process can spread so fast that gangrene and rupture may set in within a matter of hours. Rupture of the appendix leads to peritonitis, one of the most serious of all diseases.

As the inflammation of the appendix develops, there are usually three main symptoms: nausea; abdominal pain that starts to localize in the lower right part over the appendix area; and mild fever in adults, sometimes high fever in young children. There may also be vomiting, constipation, and diarrhoea. Chills and convulsions, which are fairly characteristic of pneumonia, meningitis, and other severe infections, rarely occur at the onset of appendicitis in children.

How you can save a life

Statistics show that when a person with appendicitis takes a laxative, his chance of dying is three times as great as it would be if no laxative had been taken. With more than one dose of a laxative, the possibility of dying is seven times as great. This is due to the fact that laxatives and cathartics increase action in the intestine, and may also increase the pressure within the little sac. The more the pressure, the more likelihood that the sac will burst. The same is true for enemas. It has also been shown that a delay in operating lessens the chance of a cure. So many people have died as a result of taking a ‘good physic’ when they were developing appendicitis that I am inclined to call laxatives the first assistant of this killer.

Here are the rules to follow in order to save a life—your own or another’s—when appendicitis gives its warning signals. First of all, be sure to remember that any abdominal pain lasting for more than three or four hours may be appendicitis.

Call your doctor immediately. Or you can obtain a thorough examination for appendicitis in the emergency room of any reliable general hospital. You should be taken there by car, if possible.

Lie down and remain as quiet as possible. Do not massage the abdomen.

Take nothing by mouth—no food, water, or medicines. Especially avoid taking any cathartic or laxative.

Do not take an enema.

Do not use a hot-water bag. If the pain becomes very severe, an ice-pack may be applied.

*275\68\2*

Breasts

Some adolescent girls feel shy, or even ashamed, because of their breast development. Mothers should encourage them to be proud of their developing womanhood.

Mothers should not only emphasize the fact that breast development is a normal part of puberty, but also explain that shortly before or during menstruation, some tenderness and swelling are apt to occur and should cause no concern.

I describe the breasts and problems connected with their size in more detail in Chapter 18.

Body hair

The adolescent girl may develop an excess of hair over the thighs and legs or under the arms. Facial hair sometimes becomes disfiguring. Parents should take this seriously, because it can be very important to a sensitive young girl. If neither bleaching nor shaving seems a satisfactory solution, your daughter may want to have the hair permanently removed. This can be dangerous if it is attempted by anyone but an expert.

Menstruation

Usually menstruation begins at 12 to 14 years of age, but it may start as early as 10 or as late as 18. Maturing early or late often runs in a family. However, if a girl’s menstrual periods begin at 10 or earlier, or if they have not started by the time she is 17, a doctor should be consulted. A doctor should also be consulted if the characteristic changes of puberty—the development of the breasts, pubic hair, and so on—occur unusually early or late.

All girls, and boys as well, should be told about menstruation— preferably by their mothers—before they and their friends reach the age of puberty. It is not easy to say exactly how they should be told. Parents should not give children information which they cannot understand, or in which they are not interested. The opportunities for privacy, the possibility of the child’s learning about menstruation from other sources, and similar factors must all help to determine the age at which each child should be told about it. The important thing is the attitude of the person giving the information.

Menstruation is not a sickness, and it is not something to be ashamed of. It should not be called the curse. Mothers should explain to their teenage daughters that many females experience some discomfort or cramps in the lower abdomen, usually at the onset of a period, and that menstruation may be a nuisance for the first day or days, especially if the flow is profuse. However, it should cause no real difficulty.

Pad Versus Tampon. Either is safe from a health standpoint. If the flow is profuse, pads may be required to absorb it. Most virgins can use the small-size tampons, and mothers should not imply that a girl who uses a tampon is not ‘nice.’

Feminine hygiene

Aside from ordinary washing and bathing, no feminine hygiene measures are necessary. Baths or showers may be taken during menstruation, although extremely hot or cold ones should be avoided. Women and girls who prefer not to bathe during their periods should wash the outer genital parts with warm water and soap at least once or twice a day.

If strong odours persist or if there is a discharge from the vaginal passage between periods, be sure to see a doctor. These discharges and odours usually result from an infection that should be attended to.

*219\68\2*

In the first few weeks of pregnancy, there may be a slight loss of weight, especially if there is any morning sickness. Then the increase begins, and it usually becomes a problem to keep the weight down.

If you are of normal weight, an ideal increase during the course of your pregnancy would be 20 pounds. If you are underweight, the doctor may decide that this is a good time for you to pick up a few permanent extra pounds. But if you are already too heavy, he may actually put you on a reducing diet.

You should watch the quality and the amount of food that you eat. You should consume about 2000 calories a day. These should come mainly from meats and other proteins, green vegetables, and fruit. Starches, fats, and sugars—bread, rice, potatoes, spaghetti, butter, and desserts—should usually be restricted. Most nutrition experts believe that the pregnant woman needs one and a half times as much protein as the non-pregnant one.

Fluid

Drink plenty of fluid, at least eight glasses a day. This may be water, but anything liquid—milk, coffee, tea, fruit juices, and soups —counts, too. Avoid fattening beverages like sweetened sodas and soft drinks. You need a large amount of fluid to flush the kidneys and bladder frequently. This greatly reduces the danger of infection to the urinary tract. You may have heard of women who retain an unusual amount of water and suddenly become large and puffy in appearance. This is not due to the fluid they have been drinking, but it is a sign that something is wrong, and it requires the immediate attention of the obstetrician.

Diet problems

You may experience acute cravings for certain foods, such as pickles, lobster, and sweets. Do not be upset if you have an intense desire for something you may never have been interested in before. Provided it is edible, it will do no harm to eat it. But it will not hurt you or the baby if you do not!

*164\68\2*

The seas around Australia harbour a number of species whose bite or sting has proved fatal to man. Numerous other fish will, if eaten, cause serious illness, even death. The only warning that should be followed is: do not eat any fish which you cannot easily identify.

Three well-known lethal species of marine animals are the stoncfish, the blue-ringed octopus and the sea wasp (or box jellyfish).

The stonefish inhabits the coral reefs and estuaries around the coasts of the northern half of Australia. The fish, lying dormant on the bottom, resembles a piece of weathered rock or coral, but one of its 13 dorsal spines can pierce the foot of an unwary wader.

The immediate effect is unbearable pain, swelling, and paralysis of the muscles near the sting. The victim begins to find difficulty in breathing, and unless an immediate antivenene injection is available, his condition may become critical. Breathing should be encouraged by artificial respiration, and the excruciating pain can be relieved by soaking the affected part in very hot water. Get the victim to the nearest hospital as soon as he can be moved.

The blue-ringed octopus is a tiny creature, three or four inches long, found in rock pools along the coast. When disturbed, the coloured rings turn brilliant blue, and if the creature is picked up or examined, the bite of its tiny beak injects paralysing venom. Within minutes, a feeling of weakness, numbness about the face and difficulty in breathing are followed by respiratory paralysis. The only treatment at this stage is artificial respiration to aid the patient’s breathing and this may need to be applied for several hours. Urgent hospital care is necessary.

The sea wasp, or box jellyfish, found in the warm tropical waters of Australia, has up to 64 long invisible tentacles trailing behind it, each loaded with tiny stinging capsules. On encountering the tentacles, the victim recoils quickly, causing the tentacles to be torn from the animal and to be wrapped around the victim, resulting in more stings and excruciating pain.

The outcome of the stings is dependent on the amount of venom injected as well as the age and state of health of the victim. If a lethal dose of venom has been injected, there is little that can be done to avoid respiratory failure. If the sting is less severe, pour methylated spirits or alcohol over the affected area, taking care to avoid spreading the tentacles to unaffected skin; artificial respiration may become necessary during this procedure. Rush the victim to the nearest hospital.

*109\68\2*

Most diseases and sores of the lips, tongue, and mouth are either very minor or very serious. The slight cracks from dried-out lips heal readily, and the irritating lumpy spots in the mouth called cankers disappear quickly. But other whitish spots, lumps, or sores may indicate early stages of cancer, or they may be signs of syphilis or some other serious disease. You can usually tell the mild from the serious conditions by the rapidity with which they heal. Any canker or fever sore or a lump that does not heal readily should be seen by a doctor—or by a dentist, if it appears to be due to a rough spot on a tooth that is irritating the lining of the mouth.

Trench mouth (Vincent’s angina) is a common infection characterized by sores and ulcers on the lining of the cheeks, the gums, and the back of the throat.

Most lipsticks are harmless unless you happen to be allergic to something in them. They have no value except for their appearance. Cracked, chapped lips, from which you may suffer during cold, or dry and hot weather, will usually get better if you apply a soothing preparation such as boric acid ointment, petroleum jelly, or cold cream.

Your mouth does not need, and may actually be harmed by, so-called medication that claims to cure bad breath.

*54\68\2*