Antidepressants Blog

It used to be thought that a baby was incapable of very much interaction with the environment, and that he simply lay there sleeping and feeding until he began to develop more sophisticated capacities from about 6 weeks of age. It was also thought that young babies could not feel pain. Research over recent decades has shown that these theories are simply not correct. From the moment of birth, a baby has a rich and ever-expanding repertoire of physical and social responses to the environment. Far from lying there passively, each baby is capable of initiating and modulating interactions with care-givers. All parents will be aware of their baby being able to make and sustain eye contact, being alert to sounds, and responsive to feeding. He has a rich range of communication skills.

You need to take time to learn how your baby communicates. There is great variation in how babies react to the environment. Some like lots of stimulation — to be held, rocked, talked to — while others are easily overwhelmed and need ’space’ and time to themselves, so that they can self-regulate and readjust after a period of stimulation. Some babies will avert the gaze or become irritable with too much stimulation, and parents can read this as a signal that the baby wants to be left alone for a while (see Colic, p. 93).

You need to be very patient in the first few months as you learn how to ‘connect’ with your baby. Let him dictate the pace.

As the baby grows older, there is a rapid progression in all aspects of development. His capacity for social interaction becomes more sophisticated. There is increased eye contact, smiling, following, and the baby is more alert. He begins to vocalise and engage in reciprocal ‘talking’ with care-givers. Then follow more babbling and eventually, speech. As the baby learns to reach for toys, then pull himself along on the floor, then sit, crawl and walk, he is increasingly able to explore his environment. This is an important part of learning.

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When you check the chemical names of what is in your painkiller against the above list, you may not find one or more of the ingredients. A likely reason is that the missing ingredient is a sedative. Ask if you are not sure. If you have been prescribed a painkilling mixture that includes a sedative, I suggest you ask for a change. The sedative will just make you more sleepy and used without doing anything for your pain. If you want to have a sedative to help you relax it is better to take it separately. You will then be able to adjust your dose of painkiller according to your pain and your dose of sedative according to your degree of relaxation.

My advice is similar if you are prescribed a painkilling mixture of morphine and alcohol. If you are taking morphine in liquid form, ask whether it contains alcohol. If you want alcohol, you will probably prefer to take it separately in a form that you enjoy and in the amount that suits you, rather than mixed with your painkiller.

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Infantile scurvy is seen in children artificially fed without a Vitamin Ñ supplement.

There are groups who believe that large doses of Vitamin Ñ are beneficial to health and indeed can treat or prevent a large number of illnesses.

Orthodox medical and nutritional experts do not accept this.

If you eat a proper diet, it is not likely that you’ll suffer from a Vitamin Ñ deficiency.

However, it is worth noting that certain foods such as potatoes, which are rich in Vitamin C, also contain an enzyme, ascorbic acid oxidase.

When vegetables are heated slowly, the enzyme becomes active and destroys the ascorbic acid. But if the vegetables are rapidly blanched by immersing in boiling water, then the enzyme does not render the Vitamin Ñ inactive.

The  group vitamins have been claimed to be of use in nervous disorders and as a good pick-me-up for debility, nervous exhaustion and that run-down feeling.

Vitamin Bl, or thiamine, is found in cereals, meat and eggs. A lack of thiamine produces the disease known as beri-beri, a condition seen in World War 2 in prisoners of war fed on a diet of white rice and little else.

Now in our society, the same disease, which affects the heart and the peripheral nerves, is seen mainly in those addicted to alcohol.

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Fainting usually occurs in the standing or sitting position. It is rare when a person is lying down.

Fainting is a common occurrence at restaurants, especially if they are hot and stuffy.

A few alcoholic drinks cause dilatation of the skin and a diversion of blood to the gut. Suddenly decompensation takes place and there is an inadequate blood flow back to the heart, and the person may faint.

However, sometimes the fainting episode is due to some pathological cause. That is, there is some underlying disease process.

Sudden loss of blood, such as may occur from a severed artery in an accident or from a miscarriage, or even with a heavy period or a severe nosebleed may lead to fainting.

Bleeding may occur from a duodenal ulcer and the rapid loss of one or two pints of blood may lead to fainting.

If the blood is not vomited (haematemesis) the cause may not be obvious.

However, the blood may pass through the gut and the motion then passed is black and tarry (melaena).

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The risk from oestrogens becomes greater the longer the drug is used and the bigger the dose. We are hesitant to use them beyond six months.

Oestrogens used regularly for longer than this may increase the risk of uterine cancer some five or more times.

The newer method of using oestrogens in the post-menopausal woman is to give it in a cyclical fashion — three weeks on and one week off. Progesterone, the other female hormone, is given during this week off oestrogen.

This routine will usually cause some bleeding. This method, by clearing away the whole lining of the womb each month, greatly lowers the risk of cancer.

The Pap smear is not a reliable test for cancer of the body of the uterus but, if women have one taken, it gives the doctor an opportunity to question them on the presence of symptoms such as bleeding or discharge and to examine the womb. Any suggestive symptoms or findings may lead to a curette or washing out of the lining of the womb to detect cancer cells.

Regular screening for breast and cervical cancer is possible without the need to set up special clinics.

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In Phase II studies, the aim is to find out what human cancers, if any, are sensitive to the new treatment. Although these tests are not usually as unpleasant and dangerous, again only patients who have already had all known effective anti-cancer treatments are asked to take part. Here, because researchers are now mainly trying to find out about effects against cancer, they concentrate on measuring size of cancer growths. If some patients’ growths do get smaller, further testing is carried out on their particular types of cancer in Phase III studies (see below). If none of the first fourteen patients with a certain type of cancer show any reduction in their tumours, the treatment is not usually tested any further. This is because it is most unlikely that the treatment will be effective in a worthwhile proportion of patients with that type of cancer. Again, if your main reason for agreeing to be a research subject is the hope that it will benefit you personally, you are likely to be disappointed.

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Naturally occurring sugars are those found in foods like fruit, vegetables and milk. Refined sugars are concentrated sources of sugar such as table sugar, honey or molasses. The rate of digestion and absorption of naturally occurring sugars is not different, on average, from that of refined sugars. There is wide variation within both food groups, depending on the food. The G.I. factor of fruits varies from 22 for cherries to 72 for watermelon. Similarly, among the foods containing refined sugars, some have a low G.I. factor and some a high one. The G.I. factor of sweetened yoghurt is only 33, while a Mars Bar™ has a G.I. factor of 65 (almost the same as bread).

Some nutritionists argue that naturally occurring sugars are better because they contain minerals and vitamins not found in refined sugar. However, new studies which have analysed high sugar and low sugar diets have dearly shown that they contain similar amounts of micronutrients. People who eat lots of refined sugars, tend to eat lots of food. Hence they eat more vitamins and minerals too.

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1. Physical activity should be seen as an integral part of any prescription for fat loss except where this may be contra-indicated or is difficult because of injury or other problems.

2. Physical activity should be seen as vital to the long term maintenance of fat loss.

3. The primary recommended form of physical activity for fat loss and long term maintenance of fat loss is long, low to medium intensity, gentle continuous aerobic exercise.

4. The appropriate level of intensity of physical activity for fat loss with optimal safety in someone who is fat and unfit is 40-60 per cent VO2 max.

5. Intensity of physical activity may increase with increasing fat loss and fitness, although this should be prescribed by a relevant medical or exercise specialist.

6. Physical activity prescription in the initial stages of a program is perhaps best based on distance covered in the case of walking, cycling, swimming, etc. With increasing fitness, heart rate and then perceived rate of exertion (PRE) can be used to determine the intensity of physical activity.

7. The frequency with which ‘planned’ activity needs to be carried out for significant fat loss is daily, or at least 6 days a week

8. Duration of planned physical activity will affect total calorie use as well as substrate utilisation and therefore no upper limit on duration at low intensity needs to be imposed. Upper limits would be determined by the level of comfort of the individual, as well as limiting medical and physical factors.

9. Non-weight-bearing activities such as cycling, swimming or rowing should be given less support in fat loss programs, except where patients may need this initially for comfort or motivation.

10. Anaerobic activity should never be prescribed for fat loss, particularly in cases where fitness levels and medical contraindications are unknown.

11. Variety in physical activity routines is recommended to maintain motivation and ensure a slower rate of energy adaptation to a single exercise form.

12. It may be necessary to allow time for physical adaptations to introduced forms of physical activity, such as sore knees, provided these problems do not get worse. Referral to appropriate professionals is necessary if problems persist.

13. Where planned physical activity is not possible as part of a fat loss prescription, more attention needs to be given to the control of amount and type of energy input.

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