As well as causing cold sores on the lipss, the herpes type I virus can infect the inside of the mouth.

Clinical features

Your child may complain of a sore mouth, and the lips, gums and throat may also be involved. Younger children may simply refuse food or drink, and drool a lot. The lining of the mouth may be swollen and red, with multiple tiny blisters or ulcers visible. Your child may be irritable and cry a lot.

When to see your doctor

• if your child is generally unwell or has a fever;

• if your child refuses food and liquids, and has passed urine less often than usual.

Treatment

There is no cure for herpes infections and the mainstay of treatment is the alleviation of symptoms. Paracetamol may help to ease the pain, but should only be given according to directions. Encourage your child to drink as much as possible, and if he is refusing food, give him high calorie drinks (such as milkshakes, lemonade or glucose drinks). A good way of providing additional fluid is to give your child flavoured ice blocks, ice cream or jelly. If your child is used to a bottle, it may be easier to feed him with a cup and spoon until the infection passes. Herpes mouth infections usually clear up within 7-10 days. If you have any concerns, you should see your doctor.

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The hips of a newborn baby are checked very carefully by the doctor to make sure that they are not dislocated.

Groin

Newborn baby girls sometimes have swollen labia, often accompanied by a vaginal discharge which is usually white, but may be reddish. This is due to hormones from the mother which have crossed into the baby’s bloodstream during pregnancy, and which fall to normal levels soon after birth.

Newborn baby boys can have an undescended testicle, a hydrocoele (fluid around the testicle) or a tight foreskin. Erections are also common.

Genitalia often appear to be proportionally large in the newborn period. This is also due to hormonal influence from the mother, and will diminish during the first few weeks.

Bow legs

This appearance is normal in newborn babies and soon corrects itself.

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Have it in mind, when trying to give advice to other people. They may not want it. Always ask if they need help.

Help only people who ask you for it or explicitly agree that you help them.

Even then, watch carefully // they listen to what you say. If they do not listen, it means that they are not yet ready to listen. Or perhaps you are not yet ready to give them advice.

Instead of trying to explain everything in a few sentences, give them this book, and suggest that you could perhaps answer some of their questions after they have read it. You will save a lot of time as well as avoid exhausting discussions and arguments.

If, after reading this book, people still miss the point, there is nothing you can do to help them. They should help themselves first. Their “bowl” is full. Any new information is just causing an overflow.

Note, that it may take years or even decades for some people to understand advice. Some people have to experience themselves consequences of all their mistakes before they understand. It is their best lesson.

Please notice, that in view of what we learned reading this book, “curing” other people does not really help them.

If they do not understand that all their diseases are caused by their own actions and ignorance, they will develop other diseases later on anyway.

It is clear, that it is much better to explain to them how they can heal themselves and never get sick again. The only difficulty in this approach is that they may not want to understand our advice.

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Inflammation of the iris or iritis, is not uncommon. It is not an infection. Conjunctivitis, or infection due either to viruses or to bacteria, usually affects both eyes and there is usually the production of pus, rather than just tears.

In iritis, there is pain in the eye, and sometimes around the orbit, even into the nose. There is photophobia, or dislike of light, an excess production of tears, and sometimes blurring of vision.

When the eye is examined, it has a diffuse pink flush around the cornea, the outer edges of the white of the eye are often unaffected.

In conjunctivitis, the eye is more red than pink, with prominent blood vessels and involving the whole of the white of the eye. The colored iris looks a greenish, muddy color and the normal markings on it are blurred. The pupil is often small and reacts sluggishly to light.

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It affects the bronchial tubes carrying the air in and out of the lungs.

Three things happen to these tubes — the muscles in the wall constrict or tighten, the lining is swollen, and there is an increase in the amount of sputum, all interfering with the air flow to the lungs.

The wheeze, the most noticeable feature, may be absent and some mild cases may show only shortness of breath or a chronic cough.

The wheeze is most marked in expiration, that is, when the person breathes out. Although there is always some difficulty in inspiration or breathing in, there may be no noisy wheezing.

Asthma is usually associated with allergy and, like the other atopic or allergic disorders of hay fever and eczema, tends to run in families.

Most asthma starts in childhood and, fortunately, many children outgrow it but it can start at any age and, sometimes, persists throughout life.

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Also known as Cutaneous Larva Migrans, this condition occurs when human skin is parasitized by the eggs of worms that normally infest other species (e.g: dog, cat, or cattle hookworms), the American Family Physician (35#6:163) reports. The same sort of situation arises when horse flies or deer flies lay eggs in human skin, but the resulting maggots that hatch and live there are much larger and cause “hot spot” lesions that resemble boils.

Larvae remain trapped under the surface of our skin only if their species are not adapted to ours. When “human” hookworms get into us, however, the larvae not only causes redness and irritation at the site of entry through the skin, but they soon move on through the bloodstream to the lungs (temporarily producing cough and bloody sputum) to settle ultimately in our intestines. There they develop into adult worms that cause us to bleed internally and become anemic. Only when parasites are in the wrong species are they unable to migrate and to complete their life cycles.

Fortunately, when any of these conditions is recognized, it can be cured with appropriate medications. The moral of this story, then, is to visit a dermatologist without delay if creams do not quickly take care of itchy red lesions of the skin.

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Oral herpes (type 1 infection) causes multiple ulcers of the membranes of the mouth (lips, cheeks, tongue, and palate) or the eyeballs. The ulcers are painful and are accompanied by painful, red, swollen gums and swollen lymph nodes in the neck. The child’s fever may climb to 40.6°C. The canker sores have a distinctive appearance and are easily distinguished from other mouth sores such as gumboils. Canker sores are open, red ulcers which have a scooped-out appearance, unlike gumboils which protrude above the surface of the membranes. When oral herpes appears as fever blisters, the blisters can be mistaken for impetigo. Fever blisters, however, are usually more painful. To confuse the diagnosis, fever blisters may become further infected with impetigo.

Oral herpes lasts seven to ten days, but the virus remains in the body and may cause recurrent outbreaks. This recurrent condition is contagious each time it appears.

Genital herpes (type 2 infection) causes painful ulcers and blisters on the genitals. Like oral herpes, genital herpes is contagious when the blisters are present and often recurrent.

Home care

For oral herpes, give aspirin or paracetamol to relieve pain. Have the child eat bland, soothing foods such as ice cream, gelatin desserts, puddings, and milk. Encourage an older child to rinse the mouth with a mild table salt solution. Canker sores can be treated in older children with triamcinolone in dental ointment form, or with thick solutions of local anesthetic available from the pharmacy. Antibiotic ointment applied to fever blisters may prevent painful cracking and lessen the chances of impetigo developing. For genital herpes, warm soaks help relieve inflammation and pain. There is a drug that has been used by adults to lessen the recurring attacks, but this drug has not been tested in children.

Precautions

• Herpes simplex of the eyeball is serious and requires the immediate attention of an eye doctor.

• Herpes can be severe in an infant. Adults or children with herpes should be kept away from the baby. If a baby contracts herpes, consult a doctor.

• There is no cure for recurrent herpes.

Medical treatment

The doctor will probably prescribe eye drops to treat herpes of the eyeball. An experimental drug, Cytosine arabinoside (Ara-C) is available to treat life-threatening complications of herpes, such as may occur in infants. If a child with herpes has a severely ulcerated mouth, hospitalization may be necessary for intravenous fluids to be given until the child can swallow normally again.

A Caesarean section (delivery by surgery) may be performed in the case of a pregnant woman who has genital herpes and whose baby might be exposed to the disease during a normal delivery.

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In the final analysis, it seems that if you’re going to make it through war, you have to survive on two fronts: one, the physical battle of combat itself, and two, battling the memories and mental anguish that follow.

We’re not here to tell you how to survive a war if, God forbid, we should have another one. That’s a job for the drill sergeants and medics. We’re here to give you the experts’ advice on how to survive after a war (or for that matter, any long-term life-threatening trauma) and how to live with the memories that can torment for decades after the last bomb has dropped.

Even if you’ve made it home safe and seemingly sound, you may find yourself waging a whole new war- only this time the enemy is you. As one anonymous Vietnam vet puts it, “My marriage is falling apart…. I really don’t have any friends….

I usually feel depressed…. Crowds bother me, so I stay out of malls. And I can’t go to the movies either…. Loud noises irritate me, and sudden movements or noises make me jump and reach for a weapon…. Most of the time I feel like a walking time bomb just looking for a place where I can go off. What the f*** is wrong with me?”

The answer, says Jack Weber, team leader and readjustment counselor at the Vet Center in Evansville, Indiana, is nothing. “That is a perfectly natural response to an absolutely unnatural situation,” he says. “It’s what we used to call shell shock during World War I and battle fatigue during World War II. Today, we know it as post-traumatic stress disorder (PTSD), and it’s a problem that lingers years, often decades, after a soldier comes home.

What happens is that you go through something so horrible and stressful that you disassociate from it, as though it were happening to someone else, says Sylvia Mendel, a trauma consultant in private practice in New York City.

“That’s why war victims sound like they’re reading from a script when they talk about combat,” adds Weber. “Combat also brings your physical stress response to the point of fatigue. You lose your stress response like you would an arm or a leg, and you just can’t tolerate stress anymore,” Weber says.

As a result, when you return to “normal” conditions, you can’t adjust. “Most often, you can no longer get close to people,” says Weber. “It’s like if you took all of your friends, and each day you lost one. You’d stop having friends. That’s what they do.”

Veterans often respond suddenly, and often extremely, to what are called triggers-sights, sounds, or smells that remind them of the war. “It could be something obvious like the sound of a plane or a helicopter, or something subtle like the smell of gasoline,” says Mendel.

“Sometimes the worst thing is the relentless nightmares,” notes Weber.

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I could write a library of books on the immune system and the “doctor within.” But all the words, arguments, principles, lists and diagrams in the world won’t do a bit of good until you decide to take the steps necessary to protect and strengthen your “doctor within.” I’ve given you the pieces; it’s up to you to assemble them into a beautiful picture of lifelong health and happiness.

Yes, you may have to make many changes in your diet, your outlook on life, your exercise habits and so on, and that can be intimidating. I tell my patients to take it one day at a time. For example, every time you sit down to eat, think about how food helps or hurts you. Are there Super Foods on your plate? Which items should be removed from your diet? Which healthy foods can you eat instead? When you feel yourself becoming angry, ask yourself if this blowup is absolutely necessary for your safety and well-being. Review your progress before going to bed at night. Have you improved your diet? Are you becoming more of a stress handler? Did you exercise vigorously today? If you’ve made strides today, pat yourself on the back. If not, don’t get upset. Remind yourself that the changes I’m advising you to make are vital, and think of ways to make tomorrow a positive day for your health and happiness.

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