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Providing health care services in supportive environment and dedicating our experience and resources to maintain quality of care emphasize patient satisfaction.

Taking Steps to Better Heart Health.

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defining our path to continued growth and enhanced connectivity with the people we serve, embracing the spirit of change prevalent in society, technology and health care.

Sunday, April 30, 2017

Feeling Itchy With Allergy Testing

Doctors sometimes use skin prick testing to find out what may be causing certain allergies. Potential allergens (substances that may be the cause of an allergy) are put on your skin in drops. The skin is then pricked and you wait for a reaction about 20–30 minutes later. If your skin becomes red and itchy or swells up, you’ve had a positive reaction, and doctors then discover more about what you may be allergic to. A different form of allergy testing called patch testing can also help to pinpoint the cause of an allergic skin reaction. In patch testing, certain substances are placed directly on your skin to identify skin allergies. Allergy testing is useful only when you don’t really know what you’re allergic to, and so that you can identify potential causes.

Testing Your Blood

Blood tests can be useful for diagnosing and monitoring many medical con-ditions and can tell you whether some organs are functioning properly or if they’re struggling because of some kind of damage. The thought of needles may put you off, but blood tests don’t hurt much. You feel only a little sting, like pinching your skin gently between your fingernails. Here’s a brief glance at a few types of blood test:

Blood sugar (or glucose): Doctors use this test in diagnosing diabetes.

Full blood count (or FBC): This test looks at various cells and plateletsin your blood and is helpful in investigating anaemia, infection or bleed-ing problems (see Chapter 1 for more info on blood cells).
Kidney function (U&Es or C&Es): This test looks at the salts in yourblood and overall kidney function. Doctors commonly send you for this test to monitor diabetes and when you’re prescribed certain medications.

Liver function (or LFTs): Although called liver function, this series oftests is more about assessing liver damage.

Tests for inflammation or infection: Plasma viscosity (or PV) or eryth-rocyte sedimentation rate (or ESR) tests rise in infection or inflammation such as arthritis.

Thyroid function (or TSH): This test is useful when diagnosing andmonitoring an underactive or overactive thyroid gland, which can cause symptoms such as tiredness and constantly feeling cold

Saturday, April 29, 2017

Knowing What Not to Do When Giving First Aid

Knowing what not to do is just as important as knowing what to do in an
emergency situation. Take care and try to avoid these common mistakes
when dealing with an emergency:

. Don't put butter, ice or anything else apart from a clean dressing
onto a large or deep burn: Anything you put on a deep burn, other
than a clean dressing, is of no use and would need to be removed in
hospital . ouch! Using ice can even cause additional damage. Instead,
put your burn under running water for at least 10 minutes and wrap it
loosely in clean cling film or a clean non-fluffy cloth. Go to an Accident
& Emergency (A&E) department if you suffer any burn thatfs larger than
the cap of a milk bottle, because even small burns can be deep.

. Don't take large objects out of wounds: You may cause even more
damage and set off a major bleed, ending up in a right old mess. Instead,
build a ebridgef over the object by applying pads to the skin surrounding
it. Build up padding around it until this bridge is higher than the object.
Finally, cover everything with a clean bandage and call e999f.

. Don't put your finger in the mouth of a choking child: You may induce
vomiting or damage the childfs throat.

. Don't hang a choking child upside down by the feet: Doing so can be
very stressful for the child and you run the risk of accidentally causing
a head injury if you drop the child or bang the head against another

. Don't move if you suspect an injury to the spine: Doing so may make
things worse. In the worst-case scenario, you may even cause serious
permanent damage.

Providing Simple First Aid for Bleeding

Bleeding can range in severity from a simple scratch to life-threatening loss
of blood. Here’s a quick low-down on dealing with some forms of bleeding:
✓ Bleeding from minor cuts and grazes: Wash and dry your hands, put
on disposable gloves and then clean any of your dirty cuts or minor
wounds under running water. Raise the affected area above the level
of the heart if at all possible. Use a sterile dressing to cover the wound
temporarily and clean the surrounding skin with water and soap. Instead
of then patting the area dry, always take one swipe with a clean pad and
then use a new one if possible. Finally, cover the wound completely with
a sterile dressing or plaster.
✓ Nosebleed: A common reaction to nosebleeds is to tilt your head back,
but avoid the temptation to do so – you may swallow blood and vomit
as a result – and also placing a cold object on the base of your neck is
unlikely to make any difference. Instead, sit down, lean forward and
pinch the soft fleshy tip of your nose rather than the hard bit. Avoid
coughing, sneezing and speaking, because doing so may set off the bleed
again. If you feel weak, lie down on the floor and take up the recovery
position (as I describe in the preceding section) until the bleeding stops
and you feel better. Go to hospital if the bleeding doesn’t stop or is very

✓ Severe bleeding: Wearing disposable gloves, press onto the wound
with a dressing pad, or with your fingers (to interrupt the bleeding and
prevent further blood loss) until you have a sterile dressing to hand. If
you can, raise and support the injured area, but be particularly gentle if
you think you may have broken a bone. Lay down to aid circulation if a
danger of shock exists (a dangerous loss of body fluid –

. Bandage the dressing pad firmly until you control the
bleeding, but make sure that you don’t make it so tight that you stop the
blood circulating to your fingers or toes. If the bleeding continues and
seeps through the bandage, apply a second layer of bandage. If this process
still doesn’t work, remove everything, start again and call ‘999’ for
an ambulance.

Suspecting autism and Asperger syndrome - Autism Treatment Solutions

We previously talked about about Analyzing Autism Spectrum Disorders

Now: what is autism in details ?
Autism is a form of developmental disability that interferes with the way
people communicate with, and relate to, other people and the world around
them. Asperger syndrome is a particular form of autism.

People with autism and Asperger syndrome have difficulties in the following
three areas:

✓ Social communication.
✓ Social interaction.
✓ Social imagination.

Autism Treatment Solutions

Although all people with autism have difficulties in similar areas, their condition
impacts on their lives in different ways. Experts think that both environmental
and genetic factors may lead to changes in the way the brain develops
in people with these conditions, but no-one knows for sure.
Experts are fairly certain that autism hasn’t got anything to do with the way
you’re brought up or your particular social circumstances – and be reassured,
the condition is certainly not your fault or that of your family! You’re born
with the condition – and you can’t catch it from other people or from childhood
immunisations such as the MMR vaccine.

Autism is a condition in which you have problems with social interaction,
and find communicating or interacting with other people difficult. If you have
autism, you find that making sense of the world around you is difficult, which
in turn can create a feeling of anxiety.

Autism stays with people for life but can affect them in a variety of different
ways, which is why professionals tend to refer to it by the term autism
spectrum disorder. Many people with autism can lead an almost normal life,
whereas others may struggle and need a lot of help and support because of
their learning difficulties.

If you suffer from autism you’re likely to experience the following problems in
the areas of social communication, interaction and imagination:

✓ You find communicating with other people difficult.

✓ You struggle to interact with other people socially. Doing so just doesn’t
come naturally. You may find social rules – such as how close to stand
to people or what are acceptable topics to talk about in certain situations
– hard to understand.

✓ You may find that you’re misunderstood a lot of the time and struggle to
get jokes or understand sarcasm.

✓ You don’t easily understand other people’s body language and have
problems appreciating the significance of tone of voice or facial

✓ You have a hard time expressing your emotions or feelings.

. You struggle to imagine what other people may be thinking or to understand
abstract ideas.
. You may find predicting ewhat will happen nextf difficult.
If you have autism, you may also display these other characteristics:
. You may like routine and have a fixed daily schedule or way of doing
. You may be very creative . lots of people with autism are talented and
skilled writers, musicians or artists.
. You may show increased or reduced sensitivity to certain senses . taste,
smell, sound, touch or sight.
. You may develop a very strong interest in a certain subject or hobby .
reaching a level of eobsessionf which other people find unusual.

Asperger syndrome
Asperger syndrome is a form of autism. People with Asperger syndrome have
fewer problems engaging in conversation, are often of average . or above
average . intelligence and are without the learning difficulties that many
people with autism suffer from (look at the previous section on eAutismf for
info on typical symptoms). However, people with Asperger syndrome may
have specific but often less disabling learning difficulties such as dyspraxia
(difficulties with thinking out, planning out and executing planned movements
or tasks) or dyslexia (which may include problems with reading,
spelling, writing, speaking or listening), as well as other conditions such as
attention deficit hyperactivity disorder (ADHD) and epilepsy.

A key feature of Asperger syndrome, however, is that you tend to be preoccupied
with complex issues. For example, people with Asperger typically hold
jobs in engineering, computing, mathematics or academia because their concrete
thinking is often much better developed than their abstract thinking.
You may also find that other people think of you as eccentric, because youfre
more likely to take up activities such as trainspotting or collecting.

With Asperger syndrome you may have quite complex emotional or relationship
needs, and so if you show symptoms, consult your GP who may offer to
refer you to a specialist for further assessment and arrange help and support
for you.
With the right support and encouragement, you’re likely to lead a full and
independent life. You can improve your quality of life in many ways, and various
therapies and interventions are available such as behavioural therapy and
dietary changes.

Experiencing obsessions and compulsive behaviour

Images, urges or thoughts that keep coming into your mind (for example, a
fear of being locked in, or having to check something over and over again)
are called obsessions. Obsessions are more than just your normal worries in
day-to-day life – they tend to be unpleasant for you and may make you feel
anxious. Even if you try to ignore your thoughts or suppress them, you may
not be able to get rid of them, with the end result that your obsessions can
start to rule your life. Some people develop strategies to work around their
obsessions, but life can become difficult when these attempts fail.

Here are some examples of common obsessions:
✓ An exaggerated or unpleasant fear of making a mistake.
✓ A fear of getting contaminated with germs.

An extreme need for exactness or symmetry.
✓ An excessive worry that you’ll come to harm.
✓ A powerful fear of behaving unacceptably.
✓ A strong sexual or religious urge that you feel is unpleasant.

Obsessions such as these ones can lead to actions that you feel you need
to repeat constantly – a condition called compulsive behaviour. Compulsive
behaviour is usually directly linked to obsessions – you’re trying to respond
to the anxiety or distress that your obsessions cause.

Obsessions may lead to compulsive behaviour such as the following:
✓ Having to carry out certain rituals on most days.
✓ Needing to perform certain acts or having to behave in fixed repetitive
ways most of the time.
✓ Cleaning things or washing your hands very frequently, perhaps every
few minutes.

✓ Having to order and arrange things in a certain way.
✓ Checking again and again that you’ve switched off the lights or your
oven (you may regularly get up again to do so after you’ve gone to bed),
or when you calculate sums you go over your results over and over
again . . . just to make sure.

✓ Hoarding items to what other people would consider to be an excessive
extent, although you yourself may not perceive this behaviour as a
✓ Carrying out mental acts such as repeating words silently, counting or

When obsessions and compulsions impact on your life, they become jointly
known as obsessive compulsive disorder, or OCD. OCD can be very mild (in
fact, many people sometimes show OCD-like behaviour some of the time, and
this can be entirely normal) or so severe that you’re quite disabled and

OCD can start at any age, but most people develop this condition in childhood
or adolescence. The exact causes of OCD aren’t known, but experts believe
that genetic factors, adverse life events, abnormalities within a group of
nerves in the brain (called the basal ganglia) and changes of some chemicals
in the brain play a role.

Coping With Boundless Energy and Depression: Mania and Bipolar Disorder

Being elated and full of grandiose ideas and energy can be a great feeling, but
may also be a sign of mania or the less severe form, hypomania – which is
mania without any delusions or hallucinations. The main problem with suffering
from mania or hypomania is that you can lose touch with reality. You
may not realise that you’re doing so, but to other people you may be behaving
oddly or even bizarrely. No-one knows exactly what causes mania, but
experts think that a combination of physical, environmental and social factors
may play a role.

When mania or hypomania alternates with episodes of depression (check out
Chapter 21 for more details), it’s called bipolar disorder. Bipolar disorder is a
serious mental health condition that can severely impact on people’s lives.
The ups and downs of bipolar disorder are quite different from what people
experience in their daily lives, in that the episodes of depression and mania
can each last for a few weeks. During the depressive phases, your thoughts
are more negative, your mood and energy levels are low – particularly in the
morning – and you no longer enjoy your daily activities. You may also start to
feel guilty or develop low self-esteem for no apparent reason.
Check the following list to see if you recognise any of these symptoms in

✓ Activity: You may be very active – both mentally and physically –
and feel out of control or even ‘unstoppable’. You may also have an
increased or (more commonly) erratic appetite and have grandiose or
self-important ideas. Although you may not recognise all these symptoms
in yourself, other people may tell you about them. Your sleep
pattern may be all over the place, and not surprisingly you may feel

✓ Finances: Recklessness with money is common during manic phases,
and may affect you and your family considerably. Debt problems aren’t
✓ Hallucinations: Hearing voices that aren’t really there may also occur in

. Ideas and delusions: During manic phases, you may feel that your ideas
are of great importance or brilliance, or that you have extraordinary
abilities, powers or privileges . without much evidence to support your

. Mood: You may feel extremely happy or be irritable and angry. Each of
these feelings may last for several weeks at a time.

. Physical health: Without treatment, your physical health may also be
affected in that you may eventually lack sleep, feel tired and lose weight.
. Risk taking: You may become less risk-averse and engage in behaviour
that may put your health at risk. For example, you may have an
increased sexual drive and become sexually disinhibited, exposing you
to a higher risk of sexually transmitted infections.

If your symptoms are severe, you may even lose the will to live and stop looking
after yourself. See your GP for further assessment and advice. For more
information, contact The BiPolar Organisation on 0845 6340540 or visit the
website at

Sussing out schizophrenia

Sussing out schizophrenia
Schizophrenia is a fairly common and chronic serious mental health condition.
If you suffer from schizophrenia, you show symptoms of psychosis and
may hold abnormal beliefs (called delusions), see or hear things that aren’t
there (known as hallucinations), have abnormal thoughts of someone persecuting
you or feel that your thoughts don’t belong to yourself. Typical of
schizophrenia is that you’re unable to distinguish between what’s real and
what’s in your imagination, which can be quite frightening.

Nobody knows exactly why some people develop schizophrenia, but experts
believe that a mixture of environmental and genetic factors may be responsible.
Schizophrenia may occur together with other mental health problems
such as depression and anxiety, and drug and alcohol misuse is not uncommon.

A common belief holds that when you have schizophrenia, you must have a
so-called split personality – which isn’t true – and that you’re violent towards
others. Again, this belief is a myth – most people with schizophrenia aren’t
violent towards others and are in fact much more vulnerable to violence from
other people themselves.

Forget the myths about schizophrenia, and use this list to help you recognise
the actual symptoms:
✓ Decision making: You may find that making decisions is difficult, or that
you make decisions that seem impulsive or foolish to others. Your decisions
may have endangered you or other people in some way.

✓ Delusions: You may hold an irrational belief that, for example, an elaborate
conspiracy against you exists. You may fear that someone is out
to harm you and may interpret normal occurrences in an unusual way.
Again, you may not notice this symptom, but other people may do and
bring it to your attention.

✓ Drive: If you suffer from schizophrenia, you may lack drive and ambition,
and find engaging with the world around you to be difficult. Other
people may tell you that you seem apathetic. Your friends and family
may feel that you’ve become emotionally flat and lack motivation. You
may not bother looking after yourself and cease wanting to socialise
with other people.

✓ Hearing voices: A typical symptom of schizophrenia is ‘hearing’ voices,
often as if two people are talking about you. You may feel that the voices
are giving a running commentary of what you’re doing, or that the
voices are arguing with each other. However, the experience may feel
normal to you.

✓ Influence from others: You may feel that other people or organisations
are influencing and controlling your thoughts and behaviour, perhaps
by ‘broadcasting’ messages to you, or have a feeling that other people
can read or hear your thoughts.

✓ Language and speech: Friends or family may tell you that your use of
language seems odd and that you’re using words that no one else understands.
You may also talk much less than you used to.

✓ Self-esteem and the way you feel about yourself: Your self-esteem may
be low, and you may feel that ‘something funny is going on’ in the way
you perceive the world or other people around you. You may not realise
that this feeling is a problem, but other people may worry about you.
Noticing any of these symptoms in yourself doesn’t automatically mean that
you suffer from schizophrenia. Other issues can produce similar symptoms;
for example, medical causes such as infections, hormone disorders, other
physical conditions and dementia can mimic schizophrenia. In addition, intoxication
due to alcohol or drug misuse (cannabis or stimulating drugs called
amphetamines are typical examples) or a drug overdose can produce the
same symptoms.

Considering Unusual Thoughts, Feelings and Behaviour

Along with everybody else, you have ups and downs in your daily life
and experience a range of emotions over time. Everyone is different,
and some people feel or experience things more intensely than others. Most
people, however, know which feelings and thoughts are normal for them.
A change in your normal self – such as developing obsessive thoughts or
behaviours, feeling that you’re ‘in two minds’ or starting to experience the
world around you in a way that seems strange, threatening or unsettling for
you – can be quite frightening. You may wonder whether having these symptoms
is okay, or whether you need to seek help from a health professional.
This chapter aims to give you some idea of what certain thoughts, feelings
and behaviours may mean, whether they may indicate an illness that can be
regarded as a mental health disorder (for example, psychosis or compulsive
behaviour) and when seeking medical advice is appropriate.

Feeling ashamed or embarrassed when you develop thoughts that are unusual
for you is natural, and it may put you off seeking professional help. If you feel
that any of the problems mentioned in this section apply to you and these
interfere with your life, though, don’t hesitate to contact your GP or the
other sources of support I mention – they’ve heard and seen it all before. And
remember that you’re not the only one, so don’t ‘bottle it up’ for too long if
you’re worried.

Feeling ‘Different’
In this section, I help you decide whether to seek advice if you – or someone
you know – start to worry that any of your feelings, thoughts or behaviours
have become abnormal.

Dealing with unusual feelings and thoughts
Changes to the way humans feel or think are often caused by common mental
health conditions and problems, such as the following:
✓ Alcohol and drugs: Drinking too much alcohol or using drugs are
common causes for problems with thinking, feeling and behaviour.

✓ Anxiety: Anxiety (when worries seem to take over your life) and panicattacks (when you suddenly experience an intense feeling of apprehension
or impending disaster) can cause a whole range of unusual feelings
and thoughts. (Chapter 21 has more on anxiety and panic attacks.)

✓ Depression: If you suffer from depression you may feel low in mood,
worthless or guilty, often with no obvious reason. You may be convinced
that people hate you, or feel that your life isn’t worth living.
Depression is a treatable illness, so see your GP for further assessment.

Other mental health disorders such as schizophrenia, which you can read
about in the following section ‘Sussing out schizophrenia’, can also be the
root of unusual thoughts. Medical causes such as acute infections or conditions
affecting your brain can also be to blame.

Making sense of mental health symptoms can be quite difficult, even for experienced
doctors and other health professionals. Therefore, do consult your GP
if you notice any of the following symptoms, which may suggest that you need
professional help:

✓ Abnormal beliefs/delusions are where you hold onto unshakeable – and
usually wrong – beliefs despite evidence to the contrary, which other
people may find unexpected and unusual for you.
✓ Abnormal perceptions: When you wrongly interpret what’s happening
around you, you experience an illusion. When you see something
that isn’t really there, you experience a hallucination. Or, you may not
feel ‘real’, as if someone else is playing yourself – a bit like an actor.
Similarly, things around you may feel unreal or dreamlike.

✓ Abnormal thoughts: Your ideas may leap around like a yoyo, or your
thoughts may suddenly get completely interrupted, with your mind
going blank. You may also feel that your thoughts don’t belong to yourself,
but have been planted into your mind by someone else, or that
someone is taking your thoughts away.

Delusions and hallucinations are sometimes also called psychotic symptoms
(or symptoms of psychosis), which suggest that you can’t really distinguish
between what’s real and what you imagine.

Countless more examples of unusual feelings and thoughts exist, including disturbed
and confused thoughts as well as lack of self-awareness and insight. Any
such beliefs, perceptions or thoughts should prompt you to see your GP for
further assessment. Likewise, concerns about other thoughts, perhaps around
your sexuality, or becoming unusually aggressive or tense – particularly when
this change is affecting your life or that of those around you – mean that you
need to consult your GP to find out what’s going on.

Handling panic attacks

Panic attacks are when you suddenly experience an intense feeling of apprehension
or impending disaster. You’re likely to become anxious very quickly – often
without warning and for no apparent reason. These attacks affect a lot of people
and can be very frightening. Nobody really knows why panic attacks occur,
but experts think that traumatic life experiences like the death of a close family
member, unpleasant childhood experiences or changes in the chemicals within
your brain, for example, may play a role.

If you suffer from panic attacks, you may recognise some of the following
symptoms, at least four of which typically show during an attack:
✓ You suffer from a fast heart rate or palpitations.
✓ You feel short of breath or that you’re choking.
✓ You notice chest pain or discomfort.
✓ You feel dizzy, unsteady on your feet or faint.
✓ You feel sick or have stomach pain.
✓ You feel flushed or suddenly cold.
✓ You feel shaky and tremble.
✓ You’re afraid of doing something that you can’t control or that may
seem crazy to other people.
✓ You feel like you’re not yourself.
✓ You may feel as if you’re about to die.

During a panic attack, try to tell yourself that you’re not coming to any harm,
and that the symptoms you experience are due to anxiety. Remind yourself
that attacks will pass, and ‘ride it out’. Try not to leave the situation that is
causing you to have a panic attack and ‘confront’ your fear. By staying in the
situation you give yourself the opportunity to discover that nothing serious is
going to happen to you.

If you feel that you may suffer from panic attacks and that these attacks
impact on your life, consult your GP. She can then exclude any potential
underlying physical causes and discuss the different management options
with you.
Useful sources of more information are No More Panic (www.nomorepanic. and Anxiety Care at

Grappling with phobias

A form of anxiety that occurs only when you’re in a certain situation is called
a phobia. If you suffer from a phobia, you typically try to avoid the situation
that provokes your symptoms and you may become anxious even just thinking
about getting into that situation.

Some examples of phobias are as follows, starting with simple phobia and followed
by the more complex ones:
✓ Simple phobia: You’re inappropriately anxious when faced with an
object such as a spider or mouse, or in certain situations such as flying
or being in enclosed spaces. Simple phobias commonly start in the early
years of life following a stressful situation or some frightening life event,
although experts don’t always know why this type of phobia occurs.
✓ Agoraphobia: You feel panicky or may even faint when you’re part of a
crowd, out of the house or in a situation from which escape is difficult.
To avoid these situations, you may avoid going out altogether, which
can sometimes lead to depression and other mental health problems.
We don’t know exactly why agoraphobia occurs, but it’s thought that life
experiences, genetic reasons and changes of chemicals in the brain may
all play a role.

✓ Social phobia: You have a strong and persistent fear of being negatively
seen by others, and so you try to avoid social situations such as talking
to groups, speaking on the telephone or going out with friends. In
contrast to just being shy, social phobia can be quite disabling. Previous
anxious or intense experiences in certain social situations may cause
social phobias – particularly if you’ve always been shy since childhood
and haven’t been able to fully develop your social confidence.

To avoid a phobia getting out of hand, consult your GP to discuss the many
forms of treatment and therapy that are available. If you’re in a situation and
start to feel anxious, try to relax and take control of your breathing. Open
and stretch your hands, which can help release tension – our natural reaction
to stress and anxiety is to close our hands or make a fist.

To find out more, you can contact Triumph Over Phobia (TOP) on 0845
6009601 or visit their website at Turn to the next section
on ‘Handling panic attacks’ for info on dealing with more severe symptoms
that you may experience when you suffer from phobia.

Understanding anxiety

Feeling anxious can be quite normal, as long as any feelings of apprehension
or tension go away again by themselves or aren’t severe enough to impact on
your life. Anxiety often accompanies depression, and as with depression and
stress most people feel anxious at times, particularly when confronted with
a stressful situation. You can also experience symptoms of anxiety for no
apparent reason, and particularly when worries seem to take over your life
you may suffer from what’s known as generalised anxiety disorder. This can
be difficult to distinguish from depression and stress.

Anxiety isn’t always easy to recognise, and so consider these indicators:
✓ You feel nervous or on edge.
✓ You find relaxing and controlling your worries difficult.
✓ You tend to worry a lot, perhaps much more than you or other people
feel is ‘normal’, and tend to think the worst.

✓ You’re so fidgety that you find sitting still difficult at times.
✓ You suffer from mood swings or get easily wound up.
✓ Your worrying affects your day-to-day life significantly – including your
social life and work.
✓ You often think that something bad’s going to happen.
✓ You find your worries upsetting and stressful.
✓ You suffer nightmares or from increased sensitivity to noise.
Physical symptoms commonly develop when you suffer from anxiety, and so
you may also notice the following:
✓ Your hands are shaking and you may notice strange sensations such as
tingling or numbness.
✓ You easily get a dry mouth or find swallowing difficult.
✓ You get headaches or feel dizzy.
✓ You experience chest discomfort or palpitations.
✓ You pass urine or open your bowels frequently.

If you feel that you may be suffering from anxiety – particularly if you’ve had
symptoms of anxiety for a few months or longer – visit your GP for further
assessment and to discuss the treatment options. If appropriate, your GP
may want to exclude other possible causes that can also lead to symptoms of
anxiety, such as:

✓ Developing an overactive thyroid gland (called hyperthyroidism).
✓ Drinking too much coffee or tea.
✓ Experiencing low blood sugar (known as hypoglycaemia).
✓ Withdrawing from drugs or alcohol.

Anxiety is incredibly common, but many people with symptoms of anxiety
struggle to summon up the courage and seek professional help because
they’re anxious or because they’re ashamed or embarrassed about the way
they feel and think. Remember that your GP is well trained in dealing with
anxiety, and that lots of other people also have these symptoms.

Feeling on Edge: Stress, Anxiety and Panic

Feelings of tension and stress are common and may go hand in hand with
physical symptoms such as sweating, a racing heart or feeling unwell. Most
people get stressed at times in certain situations – admittedly some people
do so more than others – and usually this feeling doesn’t last for long.
However, if symptoms of stress seem to be taking over your life, or if you feel
increasingly anxious or even panicky, you may benefit from seeking professional
help. This section helps you to recognise the warning signs of stress and anxiety.

Identifying stress
Stress is pressure or worry caused by physical or emotional problems. Not
all stress is bad for you. For example, thinking of an upcoming deadline can
make you work harder, having to pick up the kids from school at a set time
may prompt you to get the shopping done beforehand and having a baby
may get you excited. A certain amount of stress can therefore be good for
you – it can be stimulating and actually improve your quality of life.

However, people react differently as regards tolerating stress; some people
seem to thrive on it, whereas others find that dealing with any change or
events outside their daily routine is difficult. When stress rises above a certain
level – perhaps when you’re going through a major life event such as
getting married, getting divorced, moving house or changing jobs, or when
you’re finding increasing stress more difficult to deal with – you may develop
actual symptoms of stress and suffer as a result.

Common causes of stress in the UK are as follows:
✓ Exams: Many people find that coping with the pressure of exams, or
having to speak or perform in public, is very stressful.
✓ Family issues: You may have problems with your children, difficulties in
a relationship or struggles in your role as a carer.
✓ Legal disputes: Court appearances in particular can be very stressful.
✓ Money: Financial difficulties can cause a lot of stress.
✓ Work: You may experience work problems such as bullying, employment
disputes or other problems with your colleagues or boss.

Recognising stress can be difficult, particularly if it comes on gradually. But
when you’re stressed you may notice any of the following symptoms:
✓ You suffer from mood swings and feel low a lot of the time.
✓ You feel anxious or irritable (being ‘snappy’).
✓ You feel your self-esteem dropping.
✓ You find concentrating and remembering difficult.
✓ You feel tired and lethargic.
✓ You find getting to sleep difficult because you can’t switch off; alternatively,
you wake regularly in the middle of the night.
✓ You get headaches and other physical problems such as palpitations, a
‘knot’ in your stomach, other unexplained aches and pains, or increased
✓ You drink more alcohol, coffee or tea than you normally do.
✓ You eat more or much less than you usually do.
If you suffer from a chronic condition such as asthma, migraine or eczema,
these illnesses may get worse when you’re stressed.

Some of these symptoms overlap with those of depression that I cover in the
earlier section ‘Identifying symptoms of depression’ – and too much stress
can therefore lead to depression. If you find that you can’t function properly
due to stress, particularly if you don’t get better and your symptoms last for
longer than a couple of weeks, see your GP for further assessment.

Many people suffer from too much stress at times, which is nothing to be
ashamed of. Don’t hesitate to seek professional help if you feel too stressed
and this seems to affect your day-to-day life and your health in general – it can
make all the difference.

Looking at self-harming behaviour

Self-harming behaviour can take several forms, from self-cutting with a sharp
object or self-burning with a cigarette to attempted suicide. Such behaviour
can be an impulsive response to an argument or drinking alcohol, or
a response to emotional distress. People who self-harm often say that it
gives them a feeling of ‘release’ and makes them feel better. The extreme of
attempted suicide often follows a longer period during which a person may
have been experiencing suicidal thoughts for weeks or even months.

If you have thoughts of harming yourself, you may recognise any number of
the following feelings:
You don’t like yourself.
✓ You’re deeply embarrassed about something.
✓ You feel very ashamed for some reason.
✓ You feel socially isolated or lonely.
✓ You feel helpless, or you’re in a situation from which you can’t see a
way out.
✓ You’re angry with yourself or other people.
✓ You feel deeply frustrated for some reason.
✓ You may have particular worries, for example about your or other people’s
health, your finances, or about the future in general.

If you experience such thoughts of self-harm, the following factors increase
the risk that you’re in danger of hurting yourself:
✓ Bereavement: Losing a loved one is always a difficult situation, particularly
when you or someone close to you loses a partner or child.

✓ Chronic illness: If you suffer from chronic pain or illness and have dark
thoughts, particularly if your illness is getting worse or has a poor prognosis,
you may be at higher risk of suicide.

✓ Depression: Symptoms of severe depression, such as thoughts of guilt,
hopelessness or low mood can make self-harm more likely

✓ Hearing voices: Hearing voices commanding and encouraging selfharming
behaviour puts you at a higher risk of hurting yourself.

✓ Illegal drugs: Use of illegal drugs increases the risk of self-harm.
✓ Planning: If you find yourself planning self-harm or suicide, you’re at a
higher risk of carrying your plans through. Generally speaking, the more
detailed and prepared your plan is, the higher your risk.

✓ Previous attempts: You’re at increased risk of self-harm if you’ve selfharmed
in the past.

Thursday, April 27, 2017

How to Identify symptoms of depression ?

Spotting depression isn’t always easy. In this section I explain how you can
recognise the main symptoms of depression.
Finding out whether you may be depressed
To find out whether you may be depressed, try answering the following
✓ Over the past four weeks, have you regularly or more often than not felt
‘low’, ‘down’ or ‘hopeless’?

✓ Over the last month, have you often been bothered by having little interest
or pleasure in doing things that you normally enjoy doing?
If your answer is ‘no’ to these questions, you’re unlikely to be depressed.
However, if you answered ‘yes’ to one or both of them, you may suffer from

When you suffer from depression, you may not just feel low; a number of other
symptoms can also affect you:
✓ Appetite: You may lose your appetite or develop a tendency for

✓ Concentration: You may have difficulty concentrating on things such
as listening to the radio, watching television, reading the newspaper or
books, or talking to other people.

✓ Energy: You may feel tired all the time, have little energy and not be
bothered to do things, or do them only with a lot of effort on your part.

✓ Interest: You may lose interest in hobbies and sex, and find that nothing
really gives you pleasure anymore.

✓ Movement: You or other people may notice that you’re moving or
speaking much slower than you used to. Or, you may be more fidgety or
restless, moving around much more than usual.

✓ Self-worth: You may feel that you’ve let yourself or other people down
and feel bad about yourself. You may see yourself as a failure.

✓ Sleep: You may find getting to sleep difficult, or you wake up once
or more times in the middle of the night or too early in the morning.
Alternatively, you may find that you sleep too much, and struggle to
get up

Common eye problems in later life { Age-related cataracts, eye, Age-related macular degeneration, Diabetes and Dry eyes}

Eye problems are common in older age and can seriously affect your quality
of life. Many eye conditions are treatable, and some require urgent action.
Here are some of the more common eye conditions:

. Age-related cataracts : A cataract is a clouding of the lens in the front
bit of your eye. The causes are unknown. However, certain factors like
smoking, overexposing your eyes to sunlight, taking steroid drugs for a
long time, a history of cataracts in your family or poor diet may all play
a role. When you develop cataracts, you may notice a eglaref in bright
light or when you drive at night, and you may have difficulty distinguishing
objects in low light.

. Age-related macular degeneration: This condition affects an area in the
back of your eye called the macula. Youfre at higher risk of developing it
if, among other factors, you smoke, drink more than four units of alcohol
a day or have been exposed to lots of sunlight in your life. You may find
that straight edges such as bookshelves or door frames look distorted,
or that your vision is generally more blurred. You may also develop
blind spots.

in one or both of your eyes – often caused by fluid within your eye not
draining away freely. You may not notice this problem at first, but if left
for too long, glaucoma may permanently affect your vision (which is
why the condition is known as ‘the thief of sight’).

✓ Diabetes: Too much sugar in your blood (see ‘Diabetes mellitus’ earlier
in this chapter) can lead to chronic eye problems, with damage to the
back of your eye (called diabetic retinopathy) being an important one.

✓ Dry eyes: In dry eye syndrome (or keratoconjunctivitis sicca), your tears
drain away or evaporate too fast. You may notice grittiness, tearing of
your eyes and redness. We don’t know what causes dry eyes, but ageing,
hormonal changes, illnesses and medicines are all thought to play a role.

If you suffer from eye problems, consulting your optician or GP is usually best.
Seek medical advice immediately if you notice any of these symptoms:
✓ You suddenly lose your vision fully or partially.
✓ You have a headache in addition to any visual symptoms.
✓ You can’t think straight in connection with your eye problem.
✓ You have a painful eye at the same time as loss of vision.
These symptoms may indicate acute eye problems such as infection, inflammation
or blocked blood vessels, which can lead to temporary or permanent
loss of your vision unless you quickly receive treatment.

Many people wrongly believe that losing their vision is a normal part of ageing
and that nothing can be done – but that’s not true: many eye conditions can
be successfully treated. And good vision is important for continuing to be able
to drive, read or take part in certain leisure activities, which makes seeking
medical advice all the more important.

What is Parkinson’s disease ?

This condition is named after Dr James Parkinson, who was the first to
describe it. In essence, if you suffer from Parkinson’s disease, your brain struggles
to move certain muscles in a co-ordinated way. Parkinson’s disease most
commonly affects people over the age of 50, but can start at a younger age.
The condition is caused by damage to the part of the brain that produces dopamine,
a chemical substance that helps co-ordinate and control body movements.
Experts are still trying to find out why this damage happens.

The following symptoms are typical of this condition:
✓ Balance problems: Problems with balance and subsequent falls are
common in Parkinson’s disease.

✓ Depression: You may suffer from low mood:

✓ Dizziness: You may feel increasingly dizzy when you get up from sitting
or lying down.

✓ Reduced movements: You may find that starting and maintaining
repetitive movements is difficult, and that your muscles feel tense and
stiff. Walking becomes more tricky, and your gait may start to look as
if you’re shuffling. You may also find that your handwriting becomes
smaller. Other people may notice that you lose some of your facial
expressions. You may also find rising from a chair or turning in bed difficult,
and doing up or undoing buttons tends to become harder.

✓ Sleep problems: Sleep problems and vivid dreams can become very

✓ Swallowing: You may start to dribble and find swallowing difficult.

✓ Tremor: Tremor is often the first symptom. You may notice this problem
usually in one hand or arm initially, and the tremor may look as
if you’re rolling a pill between your fingers and thumb. Over time, the
tremor may spread to other limbs.

Dementia may occur with Parkinsonfs disease but isnft directly caused by it.
For symptoms of dementia, take a look at eRemembering memory problems
and dementia (including Alzheimerfs)f earlier in this chapter.

Ask to see your doctor for further assessment or review of the condition when
you spot any symptoms, particularly if you also notice the following:
. You fall once or more times.
. You suffer from symptoms of depression
. You become socially isolated.
. Youfre severely disabled by the condition.
. You donft respond to treatment (when you've already been diagnosed).

Tremor and suspected Parkinson’s disease

Movement disorders become more common as people get older. When a
part of your body starts to move or shake in ways that you can’t control, or
if your voice becomes more shaky, you may wonder what might be going on.
Many people think that if they develop problems with uncontrollable movements,
they must have a condition called Parkinson’s disease – which may or
may not sound familiar to you. In this section I tell you what such symptoms
may mean, how to tell them apart and what you should do about them.

A tremor is when any parts of your body shake uncontrollably. You may experience
a tremor as a shaking or trembling sensation in your hands, feet or
even your head. You may find it just annoying or embarrassing, but particularly
if the tremor gets worse over time, it can start to impact on your daily
activities. Many people seek medical advice only when the tremor affects
their work or hobbies such as painting or needlework – activities for which
your hands and fingers need to be able to make fine movements.

Various forms of tremor exist, so see if your symptoms compare with the
descriptions in the following list:
✓ Alcoholic tremor: Drinking alcohol over the recommended limits regularly
can cause you to develop a tremor over time (Chapter 23 contains
information on the dangers of excessive drinking).

✓ Essential tremor: A gradually worsening tremor that mainly affects both
your arms and hands may be benign essential tremor, which can run in
families. Typically, this type of tremor may improve when you drink
small amounts of alcohol.

✓ Medication-related tremor: Certain prescribed drugs (such as some
antidepressants) may cause tremor. Check the drug information sheet
or speak to your pharmacist or GP if you’re concerned.

✓ Physiological tremor: People tend to have a mild tremor (called physiological
tremor), barely noticeable because it’s so ‘fine’. This form is quite
normal. You may start to notice physiological tremor when:
• You feel tired.
• You feel anxious.
• You’ve been drinking lots of caffeine-containing drinks such as tea,
coffee or cola.

✓ Thyroid-related tremor: An overactive thyroid gland (known as hyperthyroidism)
may occasionally cause a fine tremor of your hands. You can
make this type of tremor more obvious by placing an A4 sheet of paper
on the backsides of your outstretched hands – the paper accentuates
the tremor and makes it more obvious.
Consult your GP particularly if you also have any of these symptoms:
• You feel tense or ‘on edge’, or more tired.
• You suffer from frequent loose stools or diarrhoea.
• You develop bulging eyes.
• You notice that your muscles have become weaker.
• You get palpitations and notice your heartbeat more.
• You sweat more than usual.
• You lose weight for no apparent reason.

✓ Tremor of Parkinson’s disease: This condition may cause a tremor that
looks like ‘pill-rolling’ between the fingers and thumb and usually affects
only one side of the body initially. Look at the following section for how
to spot other signs of Parkinson’s disease.

Clearing the air regarding acute confusion

If you’re suddenly unable to think clearly, you need to consider whether this
problem may be due to an underlying medical cause, such as those in the list
in this section. If in doubt, seek medical advice without delay so that you can
get treatment quickly if appropriate.

Compare your symptoms with the following descriptions:
✓ Acute infection: Urinary symptoms such as burning or stinging on passing
urine, perhaps together with a fever, suggest a urine infection (or
cystitis). If you have a cough, feel unwell, have a fever and find breathing
more difficult, you may have a chest infection (called pneumonia). Seek
medical help as soon as possible, because you may need antibiotics.

✓ Diabetic emergencies: If you suffer from diabetes mellitus, you may
become confused due to changes in your blood sugar level. Your blood
sugar can be too low or too high – read the ‘Diabetes mellitus’ section
earlier in this chapter for how to recognise important symptoms.

✓ Head injury: If you’ve recently injured your head and suddenly or gradually
become confused, your symptoms can be due to a bleed inside
your skull. You’re likely to have a headache as well and may vomit. Seek
medical help immediately.

Medication side effects: Starting new medication or medicinal side
effects can lead to acute confusion, and so always bear this possibility
in mind. Types of drugs that may be responsible include painkillers
(particularly the opiate type) or drugs used for depression or anxiety.
Always consider side effects from over-the-counter medication as well.
Remember that over-the-counter medication can be toxic if you take it in
higher than recommended doses and may react with your regular prescribed
medication. Consult your pharmacist or GP if you’re unsure.

✓ Stroke: You may suddenly become confused when you suffer a stroke.
The confusion usually comes on very suddenly, and important accompanying
signs are one-sided limb weakness, facial weakness, speech
problems and perhaps sudden loss of vision in one eye. For further
information about how to recognise a stroke.

✓ Withdrawal symptoms: If you’ve recently stopped medication or drinking
alcohol (particularly if you’ve been drinking over the recommended
limits previously), you may suffer from acute confusion because of a
withdrawal effect. Medication that can cause withdrawal symptoms
when stopped suddenly include sedatives (such as diazepam or some
sleeping tablets), antidepressants or opiate-type painkillers.

Plenty of other medical conditions can cause acute confusion, and in most
cases seeking medical help straight away is best, instead of trying to figure
out the underlying cause. If you’re passing out, feel very unwell, you deteriorate
quickly or don’t know what’s going on but are very worried, call your GP
or ‘999’ immediately.

Tuesday, April 25, 2017

Remembering memory problems and dementia (including Alzheimer’s)

Most people occasionally can’t put a name to someone’s face or forget where
they’ve put the house keys, and that’s quite normal. Such lapses can be due
to tiredness, lack of concentration or just because you have so many other
things on your mind. But when this type of lapse happens more and more
often or you can’t remember things that you experienced recently (for example,
what was on TV last night or details of a recent conversation), but your
longer-term memory is unaffected, you may wonder whether you’re starting to
lose your powers of thinking (known as dementia), or getting a form of dementia
called Alzheimer’s disease. Having a bad memory throughout your life, however,
is unlikely to be due to dementia.

Any of the following conditions can cause dementia and affect brain function:
✓ Alzheimer’s disease: Named after the doctor who first described this
condition, Alzheimer’s disease is the most common cause of dementia.
This condition leads to some shrinking of the brain and a reduction of
certain chemicals that your brain needs to think and function properly.

✓ Lewy-body dementia: Lewy-body dementia is caused by abnormal protein
deposits inside your brain (called Lewy bodies). Experts are unsure
how this condition develops, but these deposits certainly lead to problems
with brain function.

✓ Vascular dementia: If the blood vessels supplying your brain clog up
and don’t supply your brain sufficiently with nutrients such as oxygen,
you’re suffering from vascular dementia – the most common form of
dementia. Smokers are at a greater risk of dementia. In a stroke
a blood vessel supplying your brain blocks up completely
so that no blood can get through, leading to damage or the death of the
tissues that this vessel supplies. Vascular dementia is the result of a succession
of small strokes, and so your mental abilities become affected.
The risk factors for cardiovascular disease also apply to vascular
dementia (Chapter 5 contains a list of these risk factors).

✓ Other causes: Many other potential causes exist for dementia, but these
ones tend to be quite rare. One example is alcohol-related dementia,
which you can prevent or stop from getting worse by drinking alcohol
sensibly (check out Chapter 23 for alcohol-related information).
Remember that depression and other physical conditions, such as
an underactive thyroid gland, may also sometimes be responsible for
memory problems or other temporary reduction in brain function (such
as problems with concentration), and can also be treated.

If you’re suffering from dementia, you may in addition to loss of memory
notice one or more of the following symptoms:

✓ Change in personality: You may become more moody, feel low all the
time or get irritated easily. You may also sometimes or regularly say
things that are a bit out of character for you.

✓ Concentration: You may find sticking with mental tasks such as reading,
doing crosswords or knitting harder.

✓ Confusion and disorientation: You may find coping with new surroundings
or remembering new people difficult, which can be very confusing.
You may feel much more comfortable if you can stick to your routines
and be in familiar surroundings. You may also find that keeping track of
the time is difficult, and may at times not know what day or what time of
day it is.

✓ Not looking after yourself: Because of dementia you may not look after
yourself as well as you used to. Forgetting to change your clothes or
wash yourself are quite common.

✓ Reduction in intellect: Even if you’ve always thought of yourself as
being quite clever, you may find that acquiring new skills or grasping
new ideas becomes tricky.

✓ Various other signs: Other features of dementia include losing weight,
falling, mood changes (low or excessively cheerful) and later speech
problems, as well as physical conditions such as incontinence, reduced
mobility and becoming generally frail.

If you suffer from thinking or memory problems, and any of the following scenarios
apply to you, seek medical advice straight away:
✓ You’ve lost some of your memory because of a fall.
✓ You’ve suffered a recent head injury.

Raised cholesterol

As with high blood pressure, raised cholesterol increases the risk of blocking
up your blood vessels. Also similarly, you unfortunately can’t feel when your
cholesterol is too high.

Because of the lack of symptoms, having a cholesterol check is a good idea if
you’re at an increased risk of heart attack or stroke (also known as cardiovascular
risk). Important risk factors include:

✓ You’re aged 40 or more: the risk of cardiovascular disease rises with age.

✓ You’re any age, and raised cholesterol or other related conditions
(called lipid disorders) run in your family.

✓ You have a strong family history of early heart disease or stroke.
If you haven’t already been invited, contact your GP surgery to arrange a
simple blood test. For further information about hypertension check out the
Patient UK website ( or NHS Choices (

High blood pressure

Raised blood pressure, or hypertension, increases the risk of heart attack,
stroke and other potentially serious conditions. For 90 per cent of people
with hypertension, no underlying cause can be found, but sometimes chronic
alcohol misuse or medical problems such as kidney or heart disease may be
to blame. In the short-term, anxiety, exercise, caffeine, smoking or stress can
make your blood pressure go up, but this effect is usually short-lasting.

Because high blood pressure usually doesn’t cause any symptoms, checks in
later life are important. Indeed, whenever you see your practice nurse or GP,
they’re likely to check whether you’ve had a recent blood pressure measurement.
A number of readings over a period of time are usually necessary to
confirm a diagnosis of high blood pressure.

Generally speaking, the higher your blood pressure, the higher your risk of
developing problems in the future. If your blood pressure is borderline, your
GP may recommend lifestyle measures such as losing weight or increasing
exercise to try and bring your blood pressure down. Reducing your alcohol
intake, stopping smoking and reducing your salt and caffeine intake are all
likely to help. If your blood pressure is very high or doesn’t improve with
these measures, your GP can prescribe various forms of blood pressure lowering

Checking Out Fertility and Pregnancy Concerns

Difficulties conceiving and pregnancy-related problems are common. In this
section I give you a broad overview of these topics and some sources of additional
information, but speak to your GP or midwife – if you’re currently pregnant
– if you need further help and advice.

Finding out about fertility problems
If you’ve been trying for a baby for a year or so and you haven’t been able to
conceive, you’re not alone. For a woman to take a year or so to conceive is
quite normal, but sometimes an underlying physical cause – in the man or
the woman – can make conceiving more difficult, and in rare cases impossible.
Lots of reasons may be responsible, and so in this section I offer an
overview of the common ones. (You can find more information on the topic
in Pregnancy For Dummies by Sarah Jarvis, Joanne Stone, Keith Eddleman and
Mary Duenwald).

Consider whether any of these causes of failure to conceive may apply
to you:
✓ Blocked tubes: If you’ve ever suffered from a pelvic infection (such as
infection of your fallopian tubes, which is called salpingitis), your tubes
may be blocked, impeding an egg from travelling from your ovaries
to your womb. Sometimes, a previous ectopic pregnancy outside your
womb or a termination of pregnancy may also play a role. See your GP
for further assessment and to discuss the management options.

✓ Hormone problems: Irregular or infrequent periods suggest that you
may suffer from a hormone imbalance, which may affect your fertility.
A condition called polycystic ovary syndrome, or PCOS, is the most
common hormone disorder affecting women in their reproductive years
and often presents with fertility problems. Check out Managing PCOS For
Dummies by Gaynor Bussell and consult your GP for advice if you have
PCOS and are having a hard time conceiving.

✓ Long-term illness: Some chronic illnesses such as diabetes, thyroid
gland disorders or chronic infections can affect your fertility. See your
GP for further advice if you suffer from any of these illnesses and you’re
trying without success for a baby.

✓ Stress: Sometimes, couples can get into a real rut (pun not intended!)
about trying for a baby. Instead of enjoying sex, intercourse may become
a matter of routine when sex is dictated by the diary rather than because
you both feel in the mood. Try to take your time even if your reason for
having sex is for you to become pregnant – your partner is likely to have
an increased volume of ejaculate when he’s more aroused, and your
sexual organs may become more receptive if you take it slowly, don’t rush
and are more stimulated. Other ‘stresses’ in your life, such as worries
about your job or money, may also adversely affect your fertility.

Generally speaking, if you’ve been pregnant in the past and particularly when
you’ve had one or more babies, the chances of any medical causes are less
compared to when you’ve never been pregnant, although you may still want
to get checked out by your doctor. If appropriate, your GP can arrange further
investigation and refer you to a fertility expert.
If you want to read up about this topic, check out the Patient UK (www. or the NHS Choices website at
conditions/infertility/pages/introduction.aspx, which
have additional useful information about infertility.

Understanding eating disorders and weight problems

include anorexia nervosa, bulimia and binge eating, which are often triggered
by life events such as bereavement, parents divorcing, bullying at school or
major illness.

Bulimia is around five times more common than anorexia and tends to start
around the age of 18 or 19. The majority of sufferers – around 90 per cent, in
fact – are female. Both conditions can severely affect quality of life and cause
severe health problems, which is why taking them seriously is so important.
However, many teenagers with eating disorders often don’t recognise that
they may have one, and usually the people around them are the ones to voice
their concern.

Anorexia nervosa
Anorexia nervosa is a psychological condition, which can lead to sometimes
serious physical problems. Around 1 in 250 women and 1 in 2,000 men suffer
from anorexia nervosa at some point, which usually develops around the age
of 16 or 17. In anorexia, teenagers can have an intense fear of gaining weight,
even when their body weight is normal or already lower than normal for their
age. Young people with anorexia have a disturbed experience of their body
shape or weight that may affect their self-image excessively and lead to constant
worries about body weight. If you suffer from anorexia, you may start
to worry only when symptoms develop, and it may take a long time before
you find the need – or the courage – to talk about your concerns with your
friends, parents or a health professional.

Any of the following warning signs can indicate that you may be suffering from
anorexia, starting with the ‘typical’ ones:

✓ You have what others may perceive as an excessive pre-occupation with
food, eating and mealtimes.
✓ You suffer from low mood, withdraw from some or all of your usual
activities and have low energy levels.
✓ You suffer period problems and absent periods (although these symptoms
are unreliable guides).
✓ You persistently lose weight, which you may find difficult to acknowledge
or perhaps even try to hide from others – for example by wearing
wide and baggy clothes. (Remember that maintaining a stable weight
during your teenage years is equivalent to weight loss in an adult, so
weight loss at this age is a serious matter.)
✓ Preference for eating alone.
✓ You develop ritualistic patterns of eating and other ‘compulsive’
✓ You feel cold a lot of the time.
✓ You exercise a lot (with the aim of losing weight).
✓ You feel sick a lot of the time.
✓ You become constipated and find it difficult to open your bowels (due
to reduced food intake and malnutrition), or you get runny stools from
using laxatives.

Additionally, a number of physical signs may be present in anorexia, such as:
✓ Your puberty is delayed compared to many of your friends. If you’re
female, this can mean that you’re late in starting to have your periods
compared to your friends.
✓ Your glands at both sides of your face near the angle of the jaw swell up
(known as parotid swelling), which can be a result of not eating enough
or not eating healthily enough.
✓ Your skin becomes less elastic due to not drinking enough (known as
✓ Your skin looks pale due to anaemia (lack of blood) as a result of a poor
✓ If you’re a woman, your breasts shrink.
✓ Your hair becomes thin, and you grow soft hair (also known as lanugo
hair) on your face and body.

Anorexia nervosa can cause numerous and often severe health problems; in
rare cases it can even be fatal. Here’s a list of some main complications of
✓ Serious heart problems.
✓ Increased risk of infections.
✓ Kidney problems including kidney failure.
✓ Lack of blood (anaemia).
✓ Low blood pressure and feeling faint.
✓ Low blood sugar.
✓ Low potassium in the blood (which can lead to problems with heart
rhythm and can be caused by laxatives and other medication).
✓ Weak bones (or osteoporosis).

For these reasons, if you suspect that you may suffer from anorexia, try to
answer the following questions:
✓ How much would you like to weigh? If you aim for a weight that is
below what’s regarded as a ‘healthy’ weight (refer to Chapter 7 on how
to calculate this for your height and age), you’re at risk of anorexia.
✓ How do you feel about your weight? Having a normal weight but being
unhappy about it makes you more prone to developing anorexia.

Dealing With Acne

A change in hormones during adolescence not only leads to the development
of physical sexual characteristics, but also to skin changes – greasy
skin and spots in particular. Acne is the main skin condition that affects
young people and can cause a lot of unhappiness.

Many teenagers suffer from acne to some degree. In most cases the condition
is mild and a number of effective treatments are available, which – although
they may not always make your spots disappear completely – can improve
your skin considerably.

When your spots are painful, tender and unsightly, or they affect larger parts
of the body, treatment is best to prevent scarring. Acne typically affects your
face, but you may also develop spots on your back and chest.
In acne, various types of spots may be present – sometimes all at the same
time. The most common ones are as follows, starting with the less severe

✓ Blackheads: Small black spots called blackheads may occur on or
around your nose or chin. Blackheads alone don’t usually cause any
longer-term problems and may not need treatment at all, but if they
cover wider areas or bother you in terms of your appearance, various
creams, lotions and gels may help. Your pharmacist or GP can advise on
suitable preparations. Try not to squeeze blackheads by hand, because
this action may lead to infection and possible scarring.

✓ Pustules: Pustules tend to be a bit larger than blackheads, are usually
slightly raised and may have a white centre. Their appearance suggests
that some mild underlying infection may exist within a spot, which – if
extensive or severe – may require slightly more aggressive treatment,
including topical (this means you apply them as a cream or gel directly
to your skin) or oral antibiotics available on prescription from your GP.

✓ Cysts: Inflamed and tender lumps suggest cysts, which can lead to scarring.
Arrange further assessment with your GP, because appropriate
stronger treatment can prevent scars from developing. If you need more
intensive treatment, your GP can explain the options to you and may offer
to refer you to a skin specialist (known as a dermatologist) if necessary.
You can take several measures to manage mild acne:

✓ Don’t wash too much – gently washing the face with lukewarm water
once or twice a day is enough. Strong or abrasive soaps, excessive
scrubbing, very hot water and using rough flannels can all make your
skin worse rather than better. Contrary to popular belief, antiseptic
washes don’t do much good.

✓ Use only preparations that your pharmacist or doctor recommends,
which may include non-perfumed creams and lotions.
You can do a lot to treat acne and prevent scarring, and so facing up to the
problem and seeking medical help when simple over-the-counter treatments
don’t help is important and can really make your skin look much better.
Unfortunately, no ‘quick fix’ for acne is available, and treatment may last for
several weeks, months or sometimes years.

Removing the worry about cancer in children

When a child falls ill for no apparent reason or develops ‘odd’ symptoms,
some parents worry that cancer – where cells in the body start growing
‘out of control’ – may be to blame. The possibility that your child may have
cancer can creep into your mind, because cancer is potentially serious or
perhaps because you know someone whose child has been affected by it.
You’ve probably also seen stories on TV or read about youngsters with
cancer in newspapers and magazines.

Reassuringly, cancer in children is rare, and the vast majority of health problems
in children aren’t due to cancer.

Cancer is a serious diagnosis, however, with implications for the whole family
and people close to you, as well as the affected child. It can make your child
very ill and, although highly advanced treatments are available, cancer can
lead to premature death. Many different types of cancer can occur, but most
are very rare. The main types of cancer in children and adolescents include:

✓ Bone cancer.
✓ Brain tumour.
✓ Cancer of soft tissues.
✓ Leukaemia (cancer of the blood).
✓ Lymphoma (cancer of the lymph tissue).

The main features of cancer – in adults as well as children – are symptoms
that tend to develop gradually and that you can’t explain otherwise, and
health problems that may be ‘unusual’ and unlike anything that you’ve noticed
before in your child. Because symptoms tend to develop slowly, spotting
cancer can be quite difficult, even for health professionals. To help, here’s a
list of some danger signs. Consult your GP for further assessment, to rule out
the possibility of cancer, if you’re in doubt or if your child:

✓ Complains of an ongoing and worsening headache, which may be accompanied
by vomiting, limb weakness or other ‘odd’ symptoms such as
problems with vision, concentration or performing simple tasks.
✓ Complains of unexplained constant bone pains that aren’t due to injury.
✓ Develops lumps and bumps anywhere on her body that get bigger with
time or don’t disappear – and that you can’t explain.
✓ Feels increasingly unwell and tired for more than a couple of weeks or
so, for which you can find no other explanation (remember, though, that
tiredness is rarely due to cancer).
✓ Loses weight for no apparent reason.
✓ Starts to look very pale without apparent reason (many kids look pale
and ‘off colour’ at times due to simple viral or other infections, which is
normal – in these cases, the colour returns when the illness is over).
✓ Suffers from bad regular night sweats that soak her pyjamas and mild,
unexplained fevers that aren’t due to a cold or other minor infection.
✓ Suffers from unexplained ‘nervous’ symptoms such as numbness, tingling,
limb weakness, new squinting, seizures, ‘strange’ behaviour or any
other symptoms that gradually appear and refuse to go away, or become
worse with time.
✓ Suffers from unexplained shortness of breath.

Perusing General Health Issues in Children

In this section I cover two conditions. The first – obesity – is increasingly
common and of concern to health professionals because children may
become ill and are more likely to die from this condition and its consequences
than from the second one – cancer. Cancer is rare, but dangerous:
the thought of it can worry anyone. The concern is often unjustified, but
spotting signs of cancer early can make all the difference.

Overcoming obesity
Obesity – when too much body fat affects health or wellbeing – in childhood
has become increasingly common in the UK. Apart from risks to physical
health, obesity in children may lead to psychological and social problems
and to a greater likelihood of being obese in adulthood.

Calculating the body mass index, or BMI , can help in diagnosing
obesity so contact your GP practice if you think that your child may be
too heavy for her height and age. Alternatively, you can calculate your child’s
BMI yourself and find out if she’s a healthy weight by using the calculator on
the MEND (Mind, Exercise, Nutrition – Do it) website at www.mendcentral.

If you’re concerned that your child is overweight or obese, consider the
following causes:
✓ Dietary habits: Eating too much of the wrong types of food (including
‘ready-made’ meals, some of which contain a lot more calories, fat and
sugar than freshly prepared food), drinking lots of sugary drinks, having
out-of-control eating habits and bingeing on food are common causes of
childhood obesity. Having dedicated mealtimes instead of always eating
in front of the TV, where people tend to eat more, is one way of changing
your dietary habits.

✓ Genetic causes: If your child is obese for no apparent reason, particularly
if she’s under the age of two and is also quite short, a genetic familial
trait may in rare cases be responsible. Learning difficulties, unusual
body appearance and vision or hearing problems are additional signs.
Consult your GP if you suspect genetic causes.

✓ Hormonal conditions: If your child suddenly and rapidly gains weight,
particularly if her height and weight were normal before, consider hormonal
causes. Ask your GP for an assessment.

✓ Lack of exercise: Obesity is almost always a mismatch between intake
(the amount and type of food and drink that your child eats) and output
(moving around), and if your child is more couch potato than fitness
fanatic, lack of exercise can be the cause. You can do a lot to encourage
exercise in your children, though, including:

• Engaging non-competitive family exercise. Kicking a ball around or
playing frisbee, hide-and-seek or tag, for example, are great ways to
get your kids moving
• Putting your kids’ favourite music on and dancing together.
• Considering walking to school – or part of the journey – together
instead of taking the car.

• Going outside to play or walk with your children after a meal
instead of lounging in front of the television.

For more ways to keep children healthy, check out Nutrition For Dummies,
Raising Happy Children For Dummies and Children’s Health For Dummies.
If you’re concerned that your child may be overweight, contact your school
nurse or GP surgery. These health professionals can properly measure and
assess your child’s height and weight, and also help if you and your child
are being negatively affected by obesity – perhaps due to tensions within the
household or bullying at school. Seeking help sooner rather than later can
help to avoid longer-term problems such as depression or low self-esteem.
Muscle and joint problems are also common in obese children, particularly in
the back, hips, knees and feet. Various other health conditions can develop
in your obese child, and weight reduction can go a long way to prevent these
problems from happening.

The NHS Choices website ( has video footage of how to measure
your child’s height and weight and the National Obesity Forum website at has information about and steps
you can take to tackle obesity. Your school nurse or GP can offer help and
advice, too

Understanding autism in Children - Autism Treatment Solutions

Autism is a condition in which children and adults have problems with everyday
social interactions, which can affect communication with and relating to
other people. The exact causes of autism are unknown, but experts believe
that both genetic and environmental factors play a role.

Autism Treatment Solutions
You may suspect autism when your child is as young as 18 months or so,
but symptoms often become apparent only much later. Look at the following
areas to decide whether your child is showing any signs of autism:
✓ Behaviour: Children with autism throw tantrums more often than you’d
expect, and you may notice odd movement patterns in them. Your child
may also show little interest in people.

✓ Communication: Children and adults with autism find that making sense
of the world around them and joining in with everyday conversations
and chitchat is difficult. Your child’s likely to be slower in terms of language
development, can appear deaf and have difficulty talking with
others, and may not respond in a way that you’d expect when you talk
to her.

✓ Co-ordination: Children with autism find acquiring common skills such
as handwriting or using cutlery difficult.

✓ Imagination: Children with autism typically struggle with imaginative
play, such as ‘pretend’ games (for example, peek-a-boo and hide-and
seek); they’re more likely to focus on trivial and minor things around
them. For example, instead of playing with a toy car, your child may be
fascinated by and only pay attention to the car’s wheels. Looking back,
your child may not have enjoyed being swung or bounced on a knee as a
toddler. Another typical feature is that children with autism don’t come
to their parents to show them objects or things that they’ve created.

✓ Routines: Repetitive behaviours are common in autistic children, who
often feel uncomfortable without routines and resist changes to their
regular activities. To a degree this behaviour is normal in young children
but non-autistic children become more relaxed as they get older.

✓ Social communication: Children with autism often talk at others rather
than with them and tend to find appreciating thoughts and feelings in
other people difficult.

✓ Social interaction: Children with autism may appear indifferent to other
people, especially to other children, and rarely initiate contact with
others. When they do interact with other children, it may often appear
‘odd’ or repetitive, and they may behave inappropriately without being
concerned about the reactions that this behaviour may provoke. Poor
eye contact during conversations is typical, ‘social smiling’ is rare and
children may prefer to play alone rather than with others.

Recognising autism in your child early on enables her to get the support and
care she needs, to avoid problems at school and to help prevent depression
as she gets older. Then, identifying the main problems in your child’s life
helps you as well as teachers and support staff to explore and develop imaginative
solutions. For these reasons, and because autism can have a negative
effect on your child and your family as a whole, recognising the condition and
getting help is very important. Your school nurse or GP can refer your child
for further specialist assessment. In addition, The National Autistic Society
has lots of information available on their website

Dealing with hyperactivity with children

About 5 in every 100 children in the UK suffer from Attention Deficit
Hyperactivity Disorder, or ADHD – a condition in which children are restless,
act impulsively or have difficulty sustaining attention. Of course, children
all do these things at times to a lesser degree, but in ADHD the behaviour is
more exaggerated.

ADHD may appear as one of three types:
✓ Combination type: A combination of both inattention and hyperactiveimpulsive

✓ Hyperactive-impulsive type: Your child may be very fidgety and run
around in situations where sitting still is more appropriate. Quiet play
may be an ‘alien concept’ for your child, and to your ‘delight’ she may
talk endlessly! Children of this type may also have difficulty waiting their
turn, and often interrupt others.

✓ Inattention type: Your child may find concentrating and paying attention
difficult. She may not seem to listen properly, be easily distracted
and may not follow instructions (realistically, no child responds or
listens all the time, but I mean ‘not following instructions’ in an ‘abnormal’
kind of way). As a result, your child may appear forgetful and keep
losing things.

As a result of such behaviours, your child may suffer developmental problems,
intellectually and socially. Experts aren’t sure what causes the condition,
but they think that problems during pregnancy, familial factors, birth
complications and severe emotional or physical neglect may all increase the
chance that a child may develop ADHD.

Whatever people may say or think, your parenting skills, emotional stress
within the family and watching television certainly don’t cause ADHD,
although these factors may possibly aggravate certain behaviours.

In a child who suffers from ADHD, the features are present in more than one
setting or environment, for example, both at home and at school. The impulsiveness,
restlessness and lack of attention can significantly affect school
performance and your child’s relationships with others, so that the overall
effect on your child’s life can be considerable.

Because any child with ADHD has a higher chance of developing depression
and behavioural problems than other children, early recognition of the condition
and treatment are important. If you’re concerned, consult your school
nurse, teacher or GP who can advise you whether your child may have a
problem and what needs to be done about it, if anything. When your child’s
behaviour is outside of what you or your child’s teachers would describe as
normal, your child may require assistance at school to improve behaviour.

In some cases, your child may need assessment by a specialist, who can
exclude physical causes such as hearing problems, epilepsy or an overactive
thyroid gland that may be affecting your child’s behaviour. Such an assessment
is also useful for making sure that your child doesn’t have any additional
issues such as low self-esteem, anxiety or depression. To confirm an
ADHD diagnosis, your child needs to fulfil strict criteria, and symptoms have
to have been present for at least six months.

Various treatment options are available, which include support in terms of
behavioural strategies as well as drug treatment. For further information
about the condition, check out the website of the charity ADHD Information
Services at

Coping with urinary problems and bed-wetting in Children

Children are all different as regards passing urine – some seem to ‘go’ all the
time, whereas others have little problem lasting for hours without needing
to go to the toilet. Small children in particular usually have to go quite often
and may not be able to give you much warning (you may be used to hearing
‘I really really need to go!’), whereas older children become much better at
controlling their bladder. Obviously, if your child drinks often she’s going to
produce more urine and need to go to the loo more than if you continuously
need to remind her to drink.

Common urinary problems
The most common urinary symptoms in children are as follows:
. Complaining of pain or a burning sensation when passing urine.
. Passing urine more frequently.
. Wetting the bed after having been edryf for a while (see the following
eBed-wettingf section).

If your child develops urinary problems, consider these possible causes,
starting with the more common ones:
. Urinary tract infection: If your child complains of burning or stinging
when passing urine, goes to the toilet much more frequently and has
cloudy or even smelly urine, shefs likely to have a urinary tract infection.
Your child may also be feverish and feel slightly unwell, and may have
some pain or discomfort in the middle of the lower abdomen over the
bladder area. Starting to wet the bed at night again after being edryf for a
while is another important sign. This infection is much more common in
girls than in boys.

. Emotional problems: Many people go to the toilet more often when
stressed, and children are no exception. If your child is going through a
difficult period consider the possibility of underlying psychological stress
as a reason for needing to go to the toilet frequently. However, emotional
problems never cause pain or discomfort on passing urine, and so if the
problem doesnft pass quickly or youfre concerned, consult your GP to
make sure that no other underlying medical condition is present.

. Diabetes: On rare occasions, passing urine more frequently or in larger
volumes may be a sign of diabetes mellitus . a condition in which your
child has too much sugar in her blood because of a lack of the hormone
insulin. This condition is fairly rare in children, but getting your child
checked is important when her urinary symptoms donft settle and no
other obvious underlying cause is present, particularly if she also complains
of tiredness and has been drinking much more than usual.
Unless your childfs urinary problems are mild and settle quickly and completely
by themselves, or when youfre not sure what the problem may be, see
your GP whofs likely to test your child's urine and check for underlying conditions.

Most children are edryf at night at around the age of seven, and both children
and their parents get distressed when bed-wetting (also known as nocturnal
enuresis) persists into school-age. A number of reasons may be responsible,
some of which you may be able to address and influence yourself.

Contrary to common belief, physical conditions only rarely cause bed-wetting,
and emotional or so-called functional reasons – those without an underlying
disease – are much more common.
Here’s a quick guide to help you spot some of the causes of bed-wetting,
starting with the common ones:

✓ Constipation: If your child is complaining about having hard stools and
has infrequent bowel movements, constipation may be the underlying
problem – hard stool in the back passage may be putting pressure on
the bladder (called faecal impaction). Turn to Chapter 11 for more information
on constipation and bowel problems.

✓ Emotional factors: Some children start wetting their bed again in times
of emotional distress, for example, when their parents go through a
divorce, someone close to them or their pet dies, or they are being bullied
at school. Where emotional factors are the cause of the problem,
the bed-wetting usually improves after a week or two.

✓ Urinary tract infection: A urine infection is a common cause of bedwetting
in a child who has been dry at night before. See the preceding
‘Common urinary problems’ section.

✓ Lack of arousal from sleep: Your child may just not wake up when her
bladder gets full – she may sleep through even if the bed is wet. In this
case your child may benefit from what’s called an enuresis alarm (for
further information check out the ERIC (Education and Resources for
Improving Childhood Continence) website,

✓ Increased urine production at night: When increased urine production
at night is the cause, your child usually doesn’t show any urinary
symptoms during the day, but may wet the bed early in the night with
large wet patches. Excess drinking in the evening can bring this problem
on, and so try restricting your child’s fluid intake before bedtime. If this
tactic fails, your child may respond to treatment with a drug called desmopressin
or other medication.

✓ Overactive bladder: Children with an overactive or small bladder often
also show urinary symptoms during the day.

✓ Physical causes: On rare occasions, an obstruction in the ‘plumbing’ or
other rarer medical conditions can cause bed-wetting.

Try to speak openly with your child about the problem and find out what she
thinks about it. And don’t worry – most children grow out of wetting their
beds and become ‘dry’. Their bladders grow bigger and can hold more urine,
and the muscles that ‘seal’ the bladder get stronger with age. Children’s sleep
also becomes lighter as they get older, and they become more sensitive to the
urge to go to the toilet at night or in the early hours of the morning.

If your own attempts to fix the problem fail and you’re still concerned, consult
your school nurse or GP for further assessment and to talk about the management
options, of which many are available. Seeing a health professional with
your child is especially important if:
✓ You suspect a physical underlying cause.
✓ Your child (or you!) suffers severe emotional distress.
✓ Your child still wets the bed as an adolescent.
✓ Your child wets herself during the daytime.

Many parents worry about the negative social and emotional effects of bedwetting
on their child. Nocturnal enuresis can affect whole families due to feelings
of shame and embarrassment, which may become apparent when your
child goes on a school trip or gets invited to a sleepover. You and your child
may find that building up the courage to consult a health professional is difficult,
or you may never have thought of speaking to someone before.

For your and your child’s sake, don’t be afraid to seek advice if you’re worried.
A number of strategies and treatments are available, including timing
your child’s fluid intake, periodically waking your child at night, moisture
alarms, hypnosis, star charts, and retention and control training. For more
information on treatment options and how to introduce them, take a look at
Children’s Health For Dummies by Nicci Talbot, Katy Holland and Dr Sarah
Jarvis (Wiley), which contains a lot of practical advice. Also check out the
ERIC website ( which has lots of additional information.

Looking at Tummy and Urinary Troubles in Children

Any parent whose school-age child doesn’t have tummy pain at least once
can count themselves extremely lucky! Although stomach pain is a common
symptom, thankfully, most tummy problems are minor and not due to any
serious underlying cause. Knowing some of the symptoms and signs that may
indicate a more serious problem helps you to manage your child more confidently,
and in this section I explain what symptoms to look out for, and what
they may mean.

Attacking abdominal pain
Plenty of conditions can cause stomach pain in your child. Only a handful
or so are relatively common or important to know about. Here are some
common causes of abdominal pain in school-age children, starting with the
more frequently occurring ones:

✓ Emotional causes: Often, abdominal pain has no obvious physical cause,
and stress and emotional problems may be to blame. Emotional causes
often bring on relatively mild recurrent tummy aches that can be present
for weeks or months with pain that tends to come and go, but with
no other physical symptoms. Consult your GP if you’re concerned.

✓ Gastroenteritis: This tummy bug may also bring on diarrhoea and/or
vomiting, and your child may have a mild fever.

✓ Urinary tract infection: See the following ‘Coping with urinary problems
and bed-wetting’ section.

✓ Infections: Almost any kind of infection can cause abdominal pain in
children, so if your child has a cold or flu-like symptoms, this problem
may be the reason for the stomach ache. Ask your pharmacist for suitable
over-the-counter preparations to help ease your child’s symptoms.

✓ Testicular torsion: If your son develops abdominal pain suddenly and
in addition has a very tender and perhaps swollen testicle, seek medical
help immediately. Your boy’s testicle may have twisted around itself,
cutting off the blood supply to the testicle, and unless operated on
within a few hours, the testicle may ‘die’ and become useless. Therefore,
don’t hesitate to call for medical help immediately.

✓ Appendicitis: The appendix is a small finger-like pouch attached to the
large bowel. For reasons that aren’t well understood, the appendix can
become inflamed and infected – a condition called appendicitis. Because
the appendix may then burst, your child usually needs an operation
(called an appendicectomy) to remove it before it causes a potentially
serious infection called peritonitis inside your child’s tummy.

Appendicitis may be difficult to spot – particularly in the early stages –
and symptoms vary from child to child. Here are some important additional
clues to look out for:

• A raised body temperature of 37.3 degrees Celsius (99 degrees
Fahrenheit) or more (note that this is lower than the usual definition
of fever in children ).

• Continuous stomach pain for a few hours, or pain that gets worse
quickly, particularly if accompanied by lack of appetite, nausea
and vomiting.

• Dislike of anyone touching the tummy or pressing even lightly on
the right lower abdomen.

• Pain that typically starts in the middle of the stomach near the belly
button, before shifting to the lower right area of the abdomen.
• Preference for laying very still without moving and pain that gets
worse on walking.

• Worsening pain when you ask your child to suck in her tummy and
pop it out as far as possible.

If you suspect appendicitis, call your GP or take your child to the nearest
Accident & Emergency (A&E) department. Chapter 11 has more on

For mild abdominal pain that shows up without any danger signs, rest,
paracetamol and perhaps a well-padded and wrapped hot water bottle may
be all that your child needs. But if you notice any red flag symptoms or are
concerned, call for medical help immediately.

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