Lymph nodes can swell in reaction to many different things, for example, cuts, scratches, burns and insect bites. They also become enlarged during certain infections such as a sore throat or glandular fever. Groups of lymph nodes usually function over a certain area — groin nodes are responsible for the legs and lower abdomen, nodes in the armpit drain the arms and chest, neck nodes drain the head and neck region. Lymph nodes can stay enlarged for up to a month after the infection has cleared. Cancer is a rare cause of swollen lymph glands in children.

When to see your doctor

• if there is no obvious cause for your child’s lymph glands to be enlarged;

• if the node is greater than 3 cm in diameter;

• if your child has trouble swallowing or breathing, and has enlarged lymph glands in the neck;

• if your child complains of pain over the area of swollen lymph glands;

• if your child is unwell in addition to having swollen lymph glands.

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Postnatal depression is now recognised as much more common than was once thought. It is believed to be due to hormonal changes, and in varying degrees to affect up to 15% of women postnatally, and can occur at any time during the initial postnatal period. The clinical features are similar to depression at other times. They include low energy, fatigue, loss of appetite, difficulty sleeping, and loss of interest in social relationships. Often there are feelings of sadness and sometimes hopelessness, and crying bouts for no apparent reason are common. To these symptoms are added often intense feelings toward the baby, ranging from ambivalence and disinterest, to outright anger.

In the majority of cases these symptoms are transient, passing after a period ranging from a few weeks to a few months. Doctors and nurses are now far more aware of the extent of this condition and are able to assist women suffering from postnatal depression at an early stage. Sometimes all that is required is support and understanding; if symptoms are more severe, more intensive help may be needed. Most large centres now have specialised mothers and babies units organised for the short-term admission of the mother and her baby, for appropriate treatment. Usually this consists of specialised counselling and therapy, though sometimes medications are prescribed.

If you do feel awful after the birth of your baby, make sure you discuss things with your doctor or maternal and child healtn nurse. Do not wait until things get out of hand. It is often most helpful to talk to an understanding health professional. Make sure that you talk to your partner too, and enlist the help of your support network.

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One husband stated, “What I liked was not touching just for sex. It was fun, almost a game, but we sort of merged, my hands, her hands, our thoughts. She led me to my spot, too, or I directed her with my thoughts. We just both knew when we found the spots. Just like you told us, when we found the spot, we gave it a gentle kiss and then switched who did the touching and who had the spot.”

Nongenitally focused touching, mutual cooperation, combining physical and mental processes, and learning to cooperate sensually can all result from this procedure.

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“You brought him over here, Sheila,” said her friend Pam, a veteran of three marriages and several years in what she now called “meat-ing places.” “You never look at one of them three times unless you want them to come over.”

“I wasn’t looking at him. He was looking at me,” said Sheila, still afraid to look up from her drink.

“Come on,” said Pam, “How did you know he was looking if you weren’t looking? I don’t believe you. If you look three times, he comes. Now you better go to the ‘shift.’ ”

“What is the shift?” Sheila could feel her heart pumping, skipping beats as it had done when she first used the word “divorce” seriously.

“It’s survival,” said Pam. “The shift means giving him to me. I can get rid of him, but you have to shift him to me.”

He arrived tableside, his glass of half-flat beer held between himself and Sheila. “I know this sounds like a line, but you look familiar.”

At any other time, Sheila would have been unable to hold back a giggle. He might as well have tried “Come here often?” Now, however, Sheila was a player, not an observer safely protected within a stable relationship. There was nothing funny about this. Her heart was beating faster, and her mouth was dry. She remembered this feeling from her speech class in college. She had failed to master this eye-contact thing then, too.

“I am,” she stammered, looking into his beer. “No, I mean, you think I am, but I’m not—familiar to you, that is.” She felt her face glowing. Unbelievable, she thought. I’m an English teacher and I can’t even talk.

“Now that I hear your voice, I guess I was mistaken.” he said. She could see his undershirt beneath his shirt. It was the old-fashioned type, with shoulder bands. She had never liked that style. In fact, she had never liked undershirts at all. This style in particular usually meant the man was wearing boxer shorts, the kind that goes down both legs and comes in weird prints. She hated those. Where do they put their penis in that kind of shorts? To which side?

She was startled by her own thoughts. Why was she thinking these things now, about this stranger? Who cared anyway?

Pam took his beer glass and led him to the dance floor. She glanced back over her shoulder at Sheila with a “now look what you made me have to do” look.

Sheila looked around, hoping that no one else had seen this disaster. She wet her napkin with the bottom of her glass, lifted it, and let it drop, playing a lonely game, waiting for Pam to return.

She saw Pam coming back, putting her finger to her throat in a mock gesture of self-induced nausea. “Let’s join his table,” said Pam. “That’s where the action is.”

Sheila rose with her glass, napkin still attached. The three of them grouped around a small table already crowded with more than ten people. Someone shoved a chair into her thighs and she fell into it. She was two rows from the table, a bench player in the dating game. The man next to her offered her a pretzel.

Sheila summoned all of her courage. “You look familiar,” she said, and then bit into the pretzel. It shattered into little pieces, with one big piece left dangling from her mouth. Another piece n0w floated in her drink with the napkin still attached.

“Have you met Al?” asked the man. Sheila had just been shifted by an expert.

If you read this passage in disbelief, then you have not been on the dating circuit for a long time. The game goes on. Courtship in America is training for divorce, a hypocritical, stressful, dishonest, and sad attempt to find someone to love. It is based on five rules that can be learned only in the field of action. No one can teach you; you must learn by experience.

Take some time now to rethink your own courtship, to recall the bonding process in your own marriage. How, why, and where did you fall in love, bond, decided to commit to and with someone else? Failure to understand that process results in the continued reliving of the same errors within your own relationship. This chapter adds the bonding dimension to the intimacy and systems concepts you have learned in the first two chapters. This bonding is not a onetime thing; it goes on forever. The thousand couples learned much from reliving their bonding process on the way to super marital sex, on the way to a stronger, more adaptive martital bond.

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These chemicals should be left on the skin for several hours. There is a limit to how long the treatment should continue as they may irritate the skin. Usually, four day’s treatment should be sufficient.

Prolonged use may lead to a contact dermatitis and this may cause a reddened rash and lead the person to suspect the scabies is still present, so the anti-scabies treatment is continued and the secondary rash continues.

It is not usually necessary to disinfect clothing and bedding but all members of the family should be adequately treated. This includes those who have no symptoms, because the mite may be present on their skins but show no signs as sensitivity has not yet developed.

Antihistamine tablets may relieve the itch and sometimes cortisone creams are used to relieve the irritable skin.

If the diagnosis and treatment are correct, the condition can be rapidly brought under control.

There are varieties of scabies mites which affect animals and these may spread to man, but the mites do not thrive as do those which normally affect man. They usually die off and the condition settles of its own accord.

Don’t be horrified if you or yours are unfortunate enough to be infested with these parasites. Early treatment will result in full cure.

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Contact dermatitis is a common problem in industry — but almost as many cases come from housewives whose skins are irritated by chemicals they come in contact with in normal chores or from men and women tinkering around with chemicals in hobby pursuits.

Some skin is more sensitive. This may be as important as the irritant substance.

Contact dermatitis usually affects the face or the hands. These are the areas most exposed to chemicals and work may unfairly be blamed as the source of the problem because few people realise they can become sensitive to soap, detergents, cosmetics or even creams or ointments they use for some other rash.

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When a child is born with Down’s syndrome, the earlier diagnosis is made, the better. The parents will need counselling to cope with the normal human emotions.

The parents become depressed, they become angry and they often reject the child. Most parents overcome this initial emotion and accept the child.

Most children with Down’s syndrome can be managed at home. It is only the severely handicapped who may need institutional care.

Most children with Down’s syndrome are happy, contented individuals capable of giving and receiving love.

It is not easy for children in the type of society in which we live to feel free to discuss with their peers the fact that they have a retarded brother or sister. But in those families who adjust there is great happiness. Of course many families experience problems and the retarded child may require special schooling.

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