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OVERCOMING CANCER: MENTAL IMAGERY FOR OTHER ILLNESSES

Since many readers of this book do not have cancer but may want to use mental imagery to help deal with pain and other ailments, here is a short mental imagery process, which can be substituted for steps 10 through 19, the cancer portion of the previous activity.1. Create a mental picture of any ailment or pain that you have now, visualizing it in a form that makes sense to you.2. Picture any treatment you are receiving and see it either eliminating the source of the ailment or pain or strengthening your body’s ability to heal itself.3. Picture your body’s natural defenses and natural processes eliminating the source of the ailment or pain.4. Imagine yourself healthy and free of the ailment or pain.5. See yourself proceeding successfully toward meeting your goals in life.6. Give yourself a mental pat on the back for participating in your recovery. See yourself doing this relaxation/mental imagery exercise three times a day, staying awake and alert as you do it.7. Let the muscles in your eyelids lighten up, become ready to open your eyes, and become aware of the room.8. Now let your eyes open and you are ready to resume your usual activities.As an example of how you can use mental imagery to deal with an illness other than cancer, if you have an ulcer, your mental picture of the ulcer might be a crater-type sore in the lining of the stomach or intestine, seeing it rough and raw. Picturing the treatment, visualize antacids coating the area, neutralizing the excess acid and having a soothing effect on the ulcer itself. Picture normal cells coming in and doubling, dividing, covering over the raw, ulcerated area. See your body’s white blood cells picking up any debris and cleaning the area, making it a pink, healthy lining. The next step is to see yourself free from pain and healthy, able to deal with the stresses of life without producing ulcer symptoms.If you have high blood pressure, you could use the imagery process to see the problem as little muscles in the walls of the blood vessels tightening down, so that it causes much higher pressure necessary for the blood to be driven through. Now, see the medication relaxing these little muscles in the blood vessels, your heart pumping evenly, with less resistance, and blood flowing smoothly through the vascular channels. See yourself as able to cope with the stresses of life without producing symptoms of tension.If your illness is arthritis, first picture your joints very irritated and having little granules on the surfaces. Then see your white blood cells coming in, cleaning up the debris, picking up the little granules, and smoothing over the joint surfaces. Then see yourself active, doing what you like to do, free of joint pain.When you complete one of these mental imagery processes for the first time, draw a picture of your imagery. It will help you identify your attitudes toward participating in your health.*43\347\2*

EMERGENCIES: SCARLET FEVER

Strep throat with a rashScarlet fever is caused by a streptococcal infection, usually of the throat  and gets its name from its characteristic red rash.It is highly contagious, so all members of a household should be tested for the infection if one member is found to have it. It requires a trip to the doctor for a throat culture and to get antibiotics.
Note the symptoms A high fever is sometimes accompanied by a headache or stomachache, vomiting and/or a sore throat.The rash is red and fine, sometimes described as feeling like sandpaper. It appears 12 to 48 hours after the illness begins and within 24 hours often covers the entire body. It is most prominent on the cheeks, chest, abdomen and groin. The area around the mouth is pale. Little bumps on the tongue get progressively bigger and redder, until the tongue looks like it’s coated with strawberries. It may become swollen. Glands in the neck may also become swollen.After the rash subsides, the skin may peel for several weeks, especially on the palms of the hands.
Final notes       Antibiotics are particularly important in treating scarlet fever because they can    prevent rheumatic fever, a complication caused by the streptococcal infection which can result in heart damage.*27\303\2*

HOW TO DIAGNOSE BDD IN CHILDREN AND ADOLESCENTS: BDDQ

Someone who appears to have BDD based on his or her answers on the BDDQ should then be asked questions from the adolescent version of the BDD Module to determine whether BDD is really present (see Appendix C). Because it’s common for adolescents to think a lot about their appearance, it’s important to be sure the adolescent is thinking in a negative way about a minimal or nonexistent appearance defect. It may also be helpful to put greater emphasis on impairment in functioning when diagnosing BDD in adolescents, to be sure that the appearance concerns truly are problematic and not just normal concerns.Kristin’s, Eric’s, and Holly’s concerns were clearly excessive and characteristic of BDD. Kristin avoided social interactions and dating, and she failed some of her courses and dropped out of school. Her suicide attempt and hospitalization were painfully clear signs that what she was experiencing wasn’t just “normal adolescence” or something she’d “grow out of.” Early on, Eric’s grades dropped, and he became anxious and depressed. While these signs weren’t dramatic, they signaled that something problematic and serious was occurring—that he wasn’t just “going through a phase” or having normal adolescent difficulties. When he dropped out of school and stopped playing soccer, it became crystal clear that his concerns were a serious problem. While Holly’s case was milder, the fact that she worried about her appearance for several hours a day and avoided friends signaled the presence of BDD.All three adolescents also had some typical BDD behaviors—mirror checking, camouflaging, reassurance seeking, and excessive grooming. These behaviors provided additional clues to the disorder’s presence.It’s equally important to be aware that BDD can easily be underdiagnosed in adolescents. In fact, in my experience this error is far more common than overdiagnosing BDD. To avoid underdiagnosing BDD in children and adolescents, it’s important to be aware that they may minimize BDD symptoms because they’re embarrassed by their concerns and reluctant to reveal them. Holly felt that she was selfish and shallow because she was so focused on how she looked, and she was very reluctant to tell anyone about her worries. While adults also have these feelings, secrecy may be particularly common during the teenage years because adolescents may hesitate to confide in and trust adults. Often, adolescents must develop a trusting relationship with an adult before they’re willing to divulge their concerns. The best approach to this problem is to simply ask. When adolescents show any signs of BDD, ask them whether they have any appearance concerns. The adolescent versions of the BDDQ and BDD Module can be a useful guide. The most important thing is to not consider such concerns a normal phase of development that will simply pass. It’s also important not to tease or criticise the adolescent because of their concerns. BDD is a serious disorder that needs to be treated.*160\204\8*

HOW ASTHMA MEDICATIONS CAN BE EFFECTIVELY DELIVERED? IHHALATION METHOD

ANTI-ASTHMA DRUGS are given in the form of tablets, liquids, inhalers and injections. Any or all of these modes of drug administration may be needed in a particular child. Liquids are more often used in infants and children, tablets in older children, inhalers are used in all age-groups. Injections are usually used if the symptoms are severe.Inhalers are used to administer medicines either as liquid aerosols or as a dry powder. Aerosols are given in metered dose inhalers or in nebulizers. Dry powder is given in rota-halers whereby dry powdered drug goes into the lung airways directly.Metered-dose inhalers (MDI) are the most frequently used mode of drug delivery in asthma patients all over the world.Inhalation MethodMedicines given through inhalation route have become the preferred method for administering drugs for relief from asthma. Inhalation therapy has several distinct advantages over the oral route.After a drug is taken orally, it is absorbed into the bloodstream, travels to the heart, and is then pumped to all parts of the body. Relatively large amounts of a drug need to be taken orally to ensure that a small dose reaches the selected target organ such as the lung. Since theHigh local concentrationLow systemic concentrationHigher efficacyHigher safetymedicine taken orally is absorbed into the bloodstream, it also travels to other healthy body organs and may cause undesirable side effects. For example, oral ephedrine works well in the lungs, but the brain reacts to ephedrine, leading to insomnia or tremors.The shortcomings of oral drugs prompted researchers to develop methods by which drugs could be delivered directly to the targeted organ. This search led to the development of asthma aerosols, which enable the drugs to be inhaled directly into the lung, leading to a faster onset of action and minimising any side effects.Inhalation can be learned easily by any child and self-administered without the help of a doctor or even the parent. This way, the child develops confidence in managing the condition by himself.The following modes of inhalation of anti-asthma drugs are available:1. Metered-Dose Inhalers (MDI)2. Space Inhalers3. Nebulizers*70\260\8*

APPETITE VS. HUNGER – INTRODUCTION

While you don’t have to go to a Third World nation to see hunger, most overweight Americans suffer from a problem with appetite, not hunger.There is a crucial difference. You will need to learn this difference and later on, your husband must learn it:Hunger is a biological state in which your body requires food to keep on going.Appetite is a psychological state in which you think that you are hungry and end up eating to satisfy your mind, not your body.Appetite can be developed over a period of time, or can be associated with specific events. Work avoidance often triggers appetite.Those so-called hunger pangs that you give in to are regular stomach contractions that occur whether you are fasting or eating. These contractions are normal and mean absolutely nothing. (My doctor promised.) You have been falsely taught that this contraction means “hunger,” so your mind allows you to eat even when your body isn’t hungry. The stomach can stretch to accommodate a large meal, yet it always returns to its regular size. The ability to stretch is instigated by the psychological response that tells you to keep putting food into your mouth.*56/243/1*

STRIKE BACK AGAINST HEART ATTACK: HOW TO CUT YOUR RISKS

Watch those fats — and don’t overload on cholesterol. Two things in the foods you eat can affect your blood cholesterol; one is saturated fats, the other is cholesterol (from animal foods). Of the two, saturated fat is the more important. Over the last quarter of a decade, at least 230 studies done on around 24,000 people have confirmed that, in most healthy people, saturated fat influences blood cholesterol level more than dietary cholesterol does: more than twice as much, in fact?Saturated fats are those that are solid at room temperature: like the fats in meats, whole milk and whole-milk dairy products, and some vegetable oils such as coconut and palm oil.Saturated fats stimulate your body to produce more cholesterol, which clogs your arteries and raises your risk for a heart attack. A distinction is made between these “bad-for-your-heart” saturated fats, and the unsaturated fats which, studies show, rid your body of excess cholesterol and are therefore “good for your heart.” There are two types of unsaturated fats: Monounsaturated fats which are the main fats in groundnut, olive and canola oils; and polyunsaturated fats which are the main fats in corn, safflower, sunflower and soyabean oils, as well as in fish oils.In recent years, medical scientists have become concerned about a practice that’s become increasingly common among food manufacturers. In an effort to prevent the vegetable oils they use from turning rancid, manufacturers bubble hydrogen through them, making them “hydrogenated” and rich in what is called trans fats. The chemical change that ensues makes these fats more like animal fats. Vanaspati and margarine are two prime examples of hydrogenated vegetable oils. “Trans” fats are today found in all kinds of prepared foods, from potato chips to biscuits and “lite” butter. And, many researchers today believe that, gram for gram, trans fats are almost as bad for your cholesterol levels as saturated fat. Recent studies seem to back them up. One Harvard study, done on 90,000 women and reported in the Lancet, found that those who ate the most foods high in trans fats (especially margarine) had a more than 50% higher risk of heart disease than women who ate these fats rarely.Here are some ways to reduce your intake of both arterycloggers:Hold down your overall intake of fat and minimize yourintake of foods rich in saturated fat and trans fats in particular. Try to balance your fat intake in the proportions of one-third monounsaturated, one-third polyunsaturated, and one-third saturated. Research has found that those born with the high-risk apo E4 gene respond dramatically to very low-fat dietDon’t just add “heart-healthy” unsaturated fats to your diet — but do substitute them for saturated fats wherever possible.Remember that all oils are a combination of unsaturated and saturated fats: it is the predominance of one kind of fat that makes an oil ‘saturated’ or ‘monounsaturated’ or ‘polyunsaturated’.Find and minimize the trans fat that’s hidden in processed foods. Look for “hydrogenated fats,” “partially-hydrogenated vegetable oils” and similar indications on food labels. The labels however don’t tell you how much of trans fat the products contain.Not all vegetable oils are “heart-healthy” oils. Beware of those that are high in saturated fats, the so-called “tropical oils” — coconut oil, palm-oil and palm-kernel oil. And remember that all vegetable oils are high in fat calories — 126 calories per tablespoon — whether these come from saturated fats or unsaturated fats. And excess calories can cause weight gain.Reduce the use of all cooking oils by baking, boiling, steaming, poaching or microwaving foods instead of frying, deep-frying or saut?ing them.When you do saut?, use non-stick cookware which allows you to make do with less oil. Also, try saut?ing food in broth, fruit juices or wine, instead of oil.Say ‘Yes’ to Exercise. From being almost an afterthought, exercise is now among cardiac doctors’ top-of-the-list recommendations when they’re advising patients about lifestyle changes. With good reason, too. It is now beyond doubt that exercise lowers your risk of heart disease, and of a heart attack, if you do it regularly and in moderation. The extent of reduction in risk is estimated to be between 35 and 55″% — more than what you can expect from dietary changes!Fears were fuelled a few years ago by a Harvard study that suggested heart attack risk was over 100 times greater in sedentary people who abruptly took up strenuous exercise than among those who did light or no exercise. The crucial factor here is that persons who were out of shape and sedentary engaged in vigorous physical exertion. The triggering activity was seldom exercise, but rather daily activity such as housework or climbing stairs. On the other hand, staying in shape has been found to progressively reduce the risk of a heart attack. Most heart attacks do not occur during exercise; the small number (4 per cent) that do, are brought on by strenuous activity — people overdoing it. Nobody really knows why, but it is theorized that when sedentary people engage in vigorous exertion, the strain increases blood flow and blood pressure, causing plaque to dislodge from an artery wall and to obstruct blood flow to the heart. Exercising just once or twice a week lowers the risk posed by a sedentary lifestyle by over 80%.Indeed, a large number of studies show that regular exercise over the long term reduces the risk of a heart attack quite as much as quitting smoking does. Brisk walking — for about half an hourseveral times a week — ideally meets the criterion of a workout that’s moderate in intensity yet packing enough punch to lower your heart disease risk.There are at least five ways in which exercise protects your heart: by increasing levels of “good” cholesterol and lowering levels of “bad” cholesterol and triglycerides, both implicated in the formation of clogged arteries.by lowering blood pressure, especially if it is only mildly elevated.by improving the capability of your heart in terms of its ability to pump blood and its ability to create new coronary arteries if existing ones are partially clogged.by helping you burn excess fat, which is one of the risk factors in heart disease.by lowering blood sugar levels in non-insulin-dependent diabetes (yet another risk factor for heart disease). The best thing you can do for your heart is not to be scared info stopping exercise, but — if you’re still leading an inactive life — to start moving. If you have more than one of the risk factors for heart disease, it is recommended that you take a stress test before starting an exercise programme. This is an electrocardiogram done while you exercise, and it helps to detect signs of heart disease. While the results are not always error-free, taken in conjunction with other clinical findings it can help your doctor guide you on your exercise options.Lose Weight. Whether you do it through dietary changes, or through a combination of healthy eating and exercise, losing weight will help you to raise your HDL level.Stop Smoking. Tobacco suppresses HDL levels and raises blood pressure. If you quit, your HDL number will rise. And your blood pressure numbers will improve.Ask your doctor about a vitamin B prescription. Prescription doses of niacin (vitamin B3) have been found to raise levels of HDL, and lower levels of LDL and triglycerides. But in the high doses required, niacin becomes a drug and can harm the liver; it should only be taken under medical supervision.Learn to relax. Stress appears to raise cholesterol levels, possibly by stimulating the release of stored fat into the blood;. Stress also releases high levels of the hormone, epinephrine, which constricts blood vessels and raises blood pressure.We don’t yet have definite proof that stress directly brings on heart disease, but the real connection may be indirect: the unhealthy ways in which some of us cope with stress, including junk food on the run, smoking/drinking heavily, even ignoring chest pain till it is too late.If you’re a menopausal woman, consider HRT. Hormone replacement therapy (HRT), by bolstering a menopausal woman’s declining levels of heart-protective estrogen, can reduce her cardiac risks. Because estrogen therapy alone can increase the risk for uterine cancer, it is usually combined with a second hormone, progestin (which blunts the cancer risk). The combination therapy has been found to be as effective as estrogen alone in cutting heart disease risk. In an important ongoing study (the Nurses’ Health Study), nearly 60,000 menopausal women were followed up; in those who took the estrogen-progestin combination, heart disease risk was cut by 61 per cent — a little higher, in fact, than the 55 per cent reduction in those who used estrogen alone.Pop a painkiller. After a century of service as a fever and pain reliever, aspirin has won its spurs as a life-saver — an inexpensive and powerful defense against heart attacks, strokes and even some forms of cancer. In the case of heart attacks — and strokes — aspirin appears to work by inhibiting the clotting process by which an artery nourishing a portion of the heart muscle (or brain tissue) is blocked. It is thought to do this by preventing platelet cells in the blood from sticking togther. In a recent study, a 20 per cent reduction in heart attack recurrence was achieved by those who popped half an aspirin a day.*53\332\2*

BACH FLOWER REMEDIES: CRAB APPLE – MRS MALHOTRA’S & MR. SHAM LAL’S CASES

Mrs Malhotra was just leaving with her husband to attend an evening party when looking back from the door-step she noticed that a picture on the opposite wall was slightly tilted to one side. She immediately walked back in the room, hurriedly collected a stool, climbed up to set the picture “right”. She slipped and badly bruised her arm.”What was the urgency”? chided her husband. “But I cannot stand a disorderly sight”, protested Mrs. Malhotra.The perfectionist mood called for Crab Apple. A few doses repaired the injury quickly.Mr. Sham lal was a perfect gentleman always helpful and sympathetic in other person’s problems. He was unusually sad and depressed one evening. On being asked the reason, he confessed that much against his usual calm, he lost his temper and scolded a persistent street beggar with very unkind epithets. He felt mentally polluted and wanted to get rid of the bad words which were still sticking in his mind. CRAB APPLE, 3 doses put him back on even keel.*101\308\8*

THE CARBOHYDRATE ADDICT’S DIET

This diet requires a willingness to learn a new way to eat and to forget lots of the old rules and myths about dieting that have failed to help you in the past. Remember: this diet is designed to treat the cause of your excess weight or recurring cravings.The Carbohydrate Addict’s Diet is an eating plan designed by carbohydrate addicts for carbohydrate addicts. It includes some new approaches to treating carbohydrate addiction and helping you to lose weight.No weighing, no measuring. The Carbohydrate Addict’s Diet is not a living-by-the-numbers approach to dieting. It does away with the weighing and measuring, calorie counting, and exchange plans common to many other diets. Instead, your body’s own biological mechanisms are used to reduce your carbohydrate cravings, your intake of calories, and the desire to cheat.You needn’t give up your favorite foods. In his first inaugural address, Franklin Delano Roosevelt said, in reference to the Great Depression, “The only thing we have to fear is fear itself.” In a similar vein, the Carbohydrate Addict’s Diet requires only that you give up the notion that dieting means you must be deprived. The Carbohydrate Addict’s Diet doesn’t require you to put your appetite on hold for weeks or months on end. It doesn’t require you to give up “forbidden” or fattening foods.The Carbohydrate Addict’s Diet is not one of those starvation diets that produce short-term weight loss usually followed by an appetite rebound—and by rapid weight gain. The Carbohydrate Addict’s Diet has proven that for one of your meals each day, every day, you can eat what you want, in the quantities that satisfy you— and still lose weight (in the short term) and keep it off (in the long term).You aren’t limited to small portions. Most diets advise eating small meals several times a day. In contrast, the Carbohydrate Addict’s Diet does not restrict you to small portions.The other diets base their advice on the assumption that all dieters will find small, frequent meals containing carbohydrates satisfying. Although this may be true for other dieters, such a regimen plays havoc with the metabolic chemistry of the carbohydrate addict. As a result, standard diets do not produce a comfortable and permanent weight loss for the carbohydrate addict. Instead, these diets, with their frequent small carbohydrate meals, actually feed the addiction and eventually lead to a loss of control of eating.That’s why such diets don’t work for the carbohydrate addict. Just as you can’t expect an alcoholic to drink small quantities of liquor several times a day, we have found that no one can expect the carbohydrate addict to eat small or “sensible” portions of carbohydrates several times daily.As you will see, our approach is different.You can adjust the diet to special situations. The Carbohydrate Addict’s Diet is a dynamic, flexible plan that can accommodate day-to-day changes in your life and your lifestyle.Important food-related events—whether it’s the once-a-year anniversary celebration at the fanciest restaurant in town or the everyday family dinner—can be enjoyed while you still follow your diet and lose weight. Business lunches, entertaining, holidays, parties, and special affairs will no longer present you with temptations to cheat: with a little planning, you can eat normally with your family or friends, and still remain true to the diet and to yourself.You don’t need to feel guilty anymore. The Carbohydrate Addict’s Diet offers the incredible experience of being blameless—something many of us have rarely felt. The hundreds of subjects who followed the diet in its first few years used it without guilt-ridden cheating sessions. The diet does not require that you deprive yourself; you don’t need to starve yourself for days or weeks; you don’t have to eat tiny “diet meals.”You won’t be left high and dry. The diet doesn’t just abandon you when you reach your target weight as many other diets do.We haven’t taken the Band-Aid approach that many other diets have. These diets fail to help dieters to keep their weight off and then blame dieters for regaining the weight. Losing weight isn’t like a small cut that can just be protected for a week or two and then will disappear forever. Weight problems in most people require ongoing attention and concern. The Carbohydrate Addict’s Diet will help you to change your lifestyle to treat your addiction for the rest of your life.The Carbohydrate Addict’s Diet isn’t a hit-and-run program that will leave you alone and defenseless after a while. Instead, the diet helps to curb your own biological urge for the rest of your life. Best of all, you need no longer fear bingeing, cheating, or regaining those pounds.The goal is permanent weight loss. The goal of the CarbohydrateAddict’s Diet isn’t quick weight loss; our purpose is permanent weight loss. Physicians and scientists agree that the faster you lose weight, the faster you are likely to regain it. It’s like the old story of the woman who lost 1,000 pounds—50 pounds, twenty times over. That’s just what our program is about.We have found the best way to lose weight (so it will remain lost) is to take it off at a measured and sensible pace. At the Carbohydrate Addict’s Center we have found that the best weekly rate of loss should be no more than about 1 percent of the dieter’s current weight. Thus, a 200-pound person should lose no more than two pounds a week, a 150-pounder no more than one and one-half pounds, and so on. This view is shared by the medical community and is endorsed by the National Council Against Health Fraud, Inc., which warns dieters to “beware of weight-loss programs that promise or imply dramatic, rapid weight loss.”Weight-loss programs that promise quicker rates of weight loss do so because their diets are difficult to follow for more than a limited time. On such deprivation diets, even the truly motivated dieter can continue for no more than a few weeks or months. Thus, on these diets, quick weight loss is important because it is the principal reward the diet offers.The result—and bitter experience is speaking here, both firsthand and on behalf of countless others—is money spent, a quick loss of weight, and then abandonment. It’s a lonely feeling, being left to the wiles of a metabolism that has slowed from the fast weight loss. And to the inevitable fear that you’re about to gain back the weight. And the self-blame that follows when you do.This diet isn’t for everyone. Most people do not have the same metabolic response to carbohydrates that the carbohydrate addict does. Nonaddicted people can eat “normally.” But if you’re a carbohydrate addict, you cannot eat “normally” without eventually losing control. Trying to eat and diet like a normal person can only lead to frustration and failure.Try it out. The authors of this book both suffer from carbohydrate addiction, and as scientists we were committed to finding a way out of our addiction by using our knowledge, skills, and training. “After all,” we reasoned, “if we are working on treatments for other kinds of disorders, why shouldn’t we be working on something that will help us as well?”As scientists, we knew that our personal success would not, in itself, provide sufficient clinical information for acceptance of the scientific community, so we tested the Carbohydrate Addict’s Diet on others. Over a seven-year period, hundreds of people who have used the diet under our guidance have, in more than eight out of every ten instances, found it a successful means to permanent weight loss. As they lost weight, our carbohydrate addicts also reported decreases in cravings and hunger, as well as great increases in energy levels.Dieters who use it have reported a number of other dividends as well. Some say they sleep better, waking more refreshed than they ever have. Others say they have discovered a renewed sense of energy, even a “sense of peace” upon adopting the diet.Such improvements aren’t surprising really, because a physical battle with an addictive substance is being brought to a successful end. This doesn’t mean that the Carbohydrate Addict’s Diet will solve all of your emotional or physical problems. It isn’t a substitute for diagnosis and treatment of physical or psychological ailments. But if carbohydrate addiction is your problem, the Carbohydrate Addict’s Diet may well contribute to an enjoyable and improved quality of life.Staying on the Carbohydrate Addict’s Diet is easy and fun. It does away with the triggers that have, in the past, brought about your failure. Instead of blaming you, the Carbohydrate Addict’s Diet works with your strengths—the strengths that every carbohydrate addict naturally has. The strengths are there, in the biochemistry of your metabolism, and we have found that you can make them work for you.*24\236\2*

THE KINDS OF SEIZURE: GENERALIZED SEIZURES – TONIC-CLONIC SEIZURES

Tonic-clonic seizures, formerly called grand mal seizures, are the sort most people think of when “seizure” is mentioned. The most memorable and frightening type of seizure to the observer, they are the most common seizure type in children, although not in adults, and despite common misconceptions are unlikely to result in brain damage or in death.In a tonic-clonic seizure, the person initially stiffens and simultaneously loses consciousness (and thus is unaware of events). The stiffening is called the tonic phase and causes the individual to fall to the ground. The eyes “roll back in the head,” the head goes back, the back arches, and the arms stiffen, as do the legs. This is similar to what happens during a myoclonic, extensor seizure, but this tonic phase of a tonic-clonic seizure happens more slowly. The extension is continued for what seems like an eternity but rarely lasts more than thirty seconds.Since during this tonic (stiff) phase all the muscles are contracted, the chest muscles contract as well, and it is difficult for the person to breathe. He often turns somewhat blue about the lips and face (due as much to the face being flushed with the bluish blood of the veins as to the lack of oxygen). A child’s saliva may cause a gurgling sound in his mouth or throat.It is the blueness and gurgling sound that may cause observers to exclaim, “My God, he’s swallowed his tongue!” This is a common misconception. A person can’t swallow his tongue since it is attached to the back of the throat. “Quick, stick something in his mouth to keep him from biting his tongue!” someone else may advise, but this is bad advice. At the onset of the tonic phase of a seizure, the jaw becomes tightly clenched, and attempts to pry it open and put something in are likely to result in broken teeth.After the tonic phase of a tonic-clonic seizure, rhythmic jerking begins. This is the clonic phase. The fists are tightly clenched, the arms repeatedly flex at the elbows and then briefly relax. The legs flex at the hip and knee joint in a similar fashion; the head may flex and then fall backwards. These movements are rhythmic and rapid, initially several per second, but then slowing. They are not the flailing movements or trembling often seen in imitation (pseudo) seizures. This rhythmic jerking seems to last forever, although only occasionally does it last more than a few minutes. Then the jerking becomes less severe and occurs at a slower rate, finally ceasing. The end of the jerking is usually accompanied by a deep sigh, after which normal breathing resumes.*61\208\8*

INFECTIOUS DISEASES: GERMAN MEASLES, RUBELLA

It is an infectious disease usually appearing in children of grade school and high school age, seldom in children under five years of age. The condition is highly contagious, spreading rapidly from one person to another. The eruption appears on the chest as pale pink spots which spread rapidly and finally become bright scarlet. In this condition, the lymph glands at the back of the neck become swollen. Occasionally German measles is mistaken for scarlet fever or ordinary measles. The condition is seldom serious. Patients put to bed recover rapidly, with the fall of temperature and the disappearance of the rash.German measles has come to be considered more serious nowadays, because a connection has been developed between infection with the virus of German measles during pregnancy and serious damage to the body of the unborn child. A high incidence of disturbances of vision, hearing and of the heart has been found in babies whose mothers have had German measles during pregnancy.*30/318/5*

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