SIDS affects about 1 in every 500 infants, although the incidence has dropped in the past few years all over the world. It is generally more common in winter, in colder climates, in families from lower socio-economic groups, and in babies who have been born very prematurely.

Cause

The exact cause of SIDS is unknown, despite an enormous amount of research. There have been literally dozens of theories advanced over the years, but none have been found to explain adequately why an apparently normal baby dies suddenly. The most common theories have been to do with the possible role of viral infections, the immaturity or vulnerability of the baby’s breathing control centre, or the erratic control or regulation of the baby’s sleep patterns. It is likely that SIDS is due to a number of different causes, one or more of which may be responsible in an individual case.

Clinical features

There are no specific features, before the death or afterwards, that either predict the event or explain why it happened. In about half the cases parents report a mild cold — perhaps a snuffly or runny nose or mild fever — in the days preceding the event, but in most instances this has been so mild that they have not been concerned enough to seek medical attention. Some have been seen just before the event by a doctor or community nurse, and the parents have been assured that all is going well.

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What do we mean by healthy?

Your general health is very important during pregnancy, and special attention should be paid to good nutrition, adequate rest and moderate regular exercise.

Most things that a pregnant woman eats, drinks or breathes in will pass through her bloodstream, cross the placenta, and finally reach the baby. The baby is at increased risk of being harmed by exposure to certain substances. It is safest to avoid the following altogether during your pregnancy:

• alcohol

• smoking

• painkillers (such as paracetamol, aspirin, codeine)

• drugs of addiction (heroin, morphine, LSD, barbiturates, amphetamines).

Be careful about taking any medications while you are pregnant. Always check with your doctor.

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As we mature, we are able to accept what life is giving and balance that with what we do not want to take. You may have more time in your later years to monitor those who are still trying to save

Sex and Problems of Dally Living: Why Nobody Has a Sex Life 267 or destroy our worid. Watching, reporting, writing, and serving as a watchperson for social values can be a healthy phase of life no less important than the more physically active tasks of younger years. We don’t have to sit back, but sit up and take notice. If you don’t do it, who will? Younger people are too busy doing things to pay much attention to what they are doing and its long-term impact. They don’t have the perspective of the older adult. The same holds true sexually. A slower, less physically vigorous sexuality is not the only sex available during our later years. It is an option all of us should consider at any time in our life.

After you have discussed these phases with your partner, sit back—better yet, lie back—and review each phase, silendy. Where are you now anyway?

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Say, for example, you have had a breast removed. You have been told it was the common type of breast cancer—an adenocarcinoma. If it was confined completely to the breast, the chance of cure is about two in three. If it has spread to the lymph nodes in the armpit, the chance of cure is about one in three, even less if many of the nodes were affected. The chance is possibly improved by having some chemotherapy as well as the surgery. If it had grown into the nearby skin or muscle, or spread to the nodes in the neck, there is only a tiny chance of complete and permanent cure, whatever treatment is used. Before your operation you would not have been sure which of these facts applied to your particular case. After your operation you can be sure.

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A persistent rise in pressure is either primary or secondary. Primary or essential high blood pressure is by far the commonest and the cause is unknown.

We know there is an hereditary factor, as it tends to run in families and is often associated with being overweight. A high salt intake is another factor thought to play a part.

Essential hypertension may occur in the young but becomes more common after the age of 40. It affects women more than men but is more severe in the latter.

It is a slowly progressive condition and may not cause symptoms until it has been present for many years. Occasionally, in less than one per cent, it rises rapidly and causes severe and dangerous symptoms and, if untreated, may cause death. This is called malignant essential hypertension.

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It is named from Achilles, the son of Peleus in Greek mythology. His mother, Thetis, dipped him in the river Styx when he was a baby, so as to make him invulnerable. His only weak spot was that part of the heel where she held him and which was not bathed by the waters.

Eventually, after the battle of Troy, he was slain by an arrow, shot by Paris, which hit him in the heel. We use the term “Achilles heel” to mean a weak spot in someone’s personality.

Injury to the Achilles tendon is a common injury suffered by sportsmen, particularly squash players.

The modern mania for jogging is producing a new crop of sufferers.

Complete or partial rupture of this tendon may occur. Adequate rest is necessary for healing and the injury may be treated by placing the foot in a plaster boot for about eight weeks, then raising the heel about 2 cm (1 in.) for a further four weeks. Early operative repair of a ruptured tendon also gives good results.

In the past, sprains of this tendon were often treated by an injection of cortisone. This has been abandoned, as sometimes complete rupture of the tendon has followed.

Those taking high doses of cortisone for some other condition have occasionally suffered a spontaneous rupture.

Athletes, and particularly those going back to active sport after many years, should pay particular attention to warming-up and stretching exercises.

One exercise to stretch the calf muscles and Achilles tendon is to stand about one metre away and stretch out the hands to touch a wall. The elbows are then bent so that the body rocks forward, keeping the heels flat on the ground. This position is held for 10 seconds.

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Victims of endometriosis experience an unnatural biological phenomenon: the misplacement of endometrial cells that normally line the uterine cavity. These cells are pushed backward from the uterus during menstruation and run wild, implanting themselves on pelvic organs, where they not only grow but proliferate. Eventually, clumps of endometrial1 masses spread more and more with each menstrual cycle, contorting organs and making normal functioning difficult or impossible. This invasive process results in severe cramps, pain, and, if the ovaries and fallopian tubes are gravely involved, sterility.

Along the way, women who suffer from endometriosis often are subjected repeatedly to unnecessary surgery, endure years of drug therapy that may not be of much benefit or can even worsen the disorder, develop other stress-related problems from unrelenting abdominal discomfort, and relinquish chances for fulfilling personal and professional goals because of ill health.

Dr. Donald Chatman, an obstetrician and gynecologist at the Michael Reese Hospital and Medical Center in Chicago, specializes m treating women with pelvic pain. He, too, is concerned that a problem exists in medical circles when it comes to understanding this disease. “There is no question that endometriosis is often misdiagnosed or underdiagnosed,” he told. “Primarily, I think physicians are not aware of the potential presence of the disease. For example, a mother calls her doctor and says, ‘My teenage daughter has recurrent menstrual pain.’ He might well say, ‘That’s a woman’s curse,’ and prescribe a drug like ibuprofen or Motrin and assume the girl’s pain is of no consequence. Similarly, a woman in her thirties with severe menstrual pain can race the same kind of put-off response when she sees her gynecologist.

Misdiagnosis is predictable when physicians don’t have the heightened awareness needed to make the correct diagnosis. In fact, a study was done on pelvic inflammatory disease (PID), a sexually transmitted disorder, in which it was found chat the error rate of diagnosis was 35 to 50 percent! Many of those women actually had endometriosis, not PID.

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Taking advantage of the many delicate electronic devices now available, doctors and psychologists have set up systems in which patients are kept continuously informed of what is going on within certain organs. For example, a blood pressure monitor may be set up in front of the subject. By concentrating on the monitor, the subject may learn to moderate the blood pressure. Nobody knows how this is done, and the theories are many. The feedback signal is the vital element, the tool by which a patient learns control, and having learned it, the subject can sometimes then go back into the stressful world and control his visceral response without needing the visible feedback signal.

The brain itself emits different electrical signals during different activities. The highest frequency signal, called beta, is emitted under pressure to complete tasks. Next down the scale is alpha, reflecting a more relaxed and contemplative mood. Then comes theta, associated with creative thinking; and delta, the lowest frequency, which comes with sleep. This brainwave activity can be monitored with special instruments. It has been demonstrated that people can be trained, through feedback, to shift their brains from beta to alpha, and sometimes even to theta waves. Here again, then is a method which some people may use in certain circumstances to modify their anxiety levels.

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