Glandular fever is caused by a virus called the Epstein-Barr virus which is commonly transmitted through saliva (hence its nickname of ‘the kissing disease’).

Clinical features

The incubation period for glandular fever is from 3 days to 2 weeks. The onset of the illness is gradual and at first the child may just feel generally unwell and tired. A fever usually develops, followed by a sore throat and tender, swollen lymph glands. The sore throat tends to continue for a week or two, and does not respond to antibiotics. Occasionally your child may complain of upper abdominal pain due to enlargement of the liver and spleen.

A red, spotty rash may appear on the trunk. Symptoms, especially tiredness or general lethargy, can last for weeks or even months.

It is unusual to see complications with glandular fever, and most children recover completely with time. If the spleen is enlarged, it may be wise to avoid body contact sports, because of the increased risk of rupturing or tearing the spleen (although your child may be too tired to participate in sports). Other complications include hepatitis, meningitis and pneumonia.

Investigations

A blood test which is specific for glandular fever (Monospot) will usually confirm the diagnosis.

Treatment

Glandular fever is a viral illness, so there is no specific treatment or cure. It is unwise to use antibiotics; not only are they ineffective against viruses, but ampicil-lin in particular may cause a nasty rash. Treatment is geared towards the relief of symptoms, such as lowering the fever with paracetamol, and making sure that your child gets plenty of rest and eats well.

When to see your doctor

• if your child has a sore throat that does not improve after 3-4 days;

• if your child complains of extreme tiredness which does not improve after a day or two of rest;

• if your child has any combination of the symptoms described above;

• if you are concerned or have any questions.

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Tell me exactly, in no uncertain terms, what you hope they will do sexually Offer them the use of your home for sex. It’s your choice. They will do it somewhere. Where is up to you. Be explicit and direct. “If you’re going to make out, make out here in your room. It’s safer. Don’t do anything but make out. No intercourse. We won’t interrupt you if you don’t interrupt us when we make out. Of course, we can have intercourse. We’re married.” Don’t let the car, motels, or the homes of less caring or absent parents determine the sexual destiny of your children.

Sexual education does not have to be same-gender-oriented. The “talk to your father” or “go ask your mother” routine is totally unnecessary if both parents are comfortable with sexuality. Your sexual insignia, your genitals, are not prerequisites for sexual educating. As a matter of fact, both parents together are the best arrangement, because you are discussing sex and love education, best illustrated by a model of love and loving. *

The focus in sexual and love education must be on “do’s” and not “don’ts.” Presenting a list of fears and sanctions against sexual behaviors can result in a list of “sounds interesting, I should try that.” Give them ideas of what to do. “Touch, hold, kiss, and fondle” is much more intriguing than “don’t have sex until you’re married.” There are two exceptions to this focus on the “do.” Always teach two “don’ts” along with the “do’s.” Don’t have intercourse until you are married, and don’t ever hurt anyone else.

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WIFE

I hate the damn thing. Sometimes she wants me to use it on her. I can hear her using it sometimes. Buzz, buzz, buzz. What does she need me for anyway? She says she has better orgasms with her vibrator than with me. The damn thing has three speeds. It probably has an overdrive. I just hope she doesn’t use it near water. If she does, when she comes, she’ll go.

HUSBAND

Invention number two in the quest for quick, convenient female orgasms was the vibrator, an electrical or battery-operated device used to apply direct stimulation to the Ñ area. One sex therapist called it the greatest discovery for women, perhaps as important for sex as the discovery of Pompeii was to world history.

The concept of “vibratory orgasm” grew from the myth of the first perspectives of sexuality that men come by friction and women come by vibration. Men seldom report using vibrators on their penis, and, as the man above, sometimes report a form of “gadget envy” regarding this device.

Research indicates that many women find the vibrator enjoyable. Some women report that they find the vibrator painful, annoying, and distracting to their sexual response. It is not likely that there will be a successful invention for making men come quicker. The male inventions have more to do with making genitals bigger and less sensitive.

As an occasional source of fun, variety, and different stimulation, the vibrator seems to be enjoyable for the women in my group of couples. When it, like anything else, becomes a focus, a replacement, even an expediter to save erotic time, problems result.

“He knows the vibrator always works,” reported one wife.

“Now he just tells me to get it out and start it up. It gets me more than ready, saves us time. We always use it now. I can’t remember a time when we just made love the two of us, without the vibrator. It has gotten so I hate the sound of it. I associate it with orgasm, but not with lovemaking. It’s group sex, and one of us is a sex robot. The thing used to be mine; now it seems to be his, some type of sexual power buffer.”

As you consider the husband’s and wife’s sexual response systems in Chapters Six and Seven, you will see the orgasmic focus for women and ejaculatory focus for men that was so strongly emphasized in the early sexual perspectives. This focus resulted in the destructive effort by men to “hold back” and by women to “hurry up.” Men mislearned that pelvic contractions and emission of fluid were synonymous with sexual fulfillment, while women experienced an obligation to have intense, rapid, and multiple orgasms as a sign not only of their own sexual fulfillment but of the sexual skill of their male partner.

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It is best to experience a sauna in short 10-15 minute sessions, with 5-10 minute “cooling down” intervals, repeating such a cycle 3-4 times. During the “cooling down” intervals do not use pool or showers which have chlorinated water. Ozone treated water, clean river, rain, lake or sea water is OK. Your skin has been cleansed by the flow of the sweat and in such a clean state it will absorb the chlorine from the water into your body. It is best to use a towel to dry the sweat from your body. Do not allow the sweat to evaporate, because it contains toxins your body has just excreted, and you do not want any of them to be reabsorbed back.

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Myalgia means painful muscles, and encephalomyelitis means inflammation of the brain and spinal nerves.

This disease is uncommon and the cause unknown, but it is believed to be either a viral infection or a reaction of the body to recent infection with a virus.

The symptoms vary widely and are often present without specific signs. It is not surprising that many sufferers have been thought to be overreacting to some simple illness or to have emotional rather than physical problems.

Following what appears to be a simple respiratory or bowel infection, the symptoms of ME may come on suddenly or slowly.

There may be headache and muscle pains, but particularly muscle weakness and fatigue.

While there may be sporadic cases, often there is a minor epidemic with a cluster of cases eventually being recognised.

There is no specific treatment. Most sufferers do get better, but relapses are common. In a few, the condition runs a chronic course.

Both sexes and all age groups are susceptible.

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To the sufferer, it seems as if he is looking through glass which is gradually frosting. Even when fully developed, light can always be perceived and shadowy movements may be seen.

The opacity is more marked in the middle of the lens so that vision is often better in dim light when the pupil is dilated and vision is perceived through the edges of the lens.

In bright light, the pupil contracts and light entering the eye must pass through the centre of the lens where the opacity is more marked and so vision is not as clear.

Because the cataract progresses so slowly, treatment may not be necessary for years. Operation is the only effective treatment. Vitamins or drops are of no use. At operation, the lens and sometimes its capsule are removed.

The operation may be done under local or general anaesthetic. After this glasses are necessary to focus the light rays on the retina.

A newer operation is the insertion of an artificial lens following removal of the opaque natural one. This removes the need for thick glasses which may distort vision.

The timing of the operation may depend on how far the vision has deteriorated, the level of vision in the other eye and how important clear vision is to the lifestyle of the person.

The use of contact lenses after the removal of cataracts in association with glasses may avoid the need for very thick glasses and improve vision.

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Home care:

Give aspirin or paracetamol for pain.

Encourage the girl to follow her normal schedule of activities during her period.

Consult her doctor.

-    After a girl starts to menstruate it may take months or even years for her periods to become regular. This does not necessarily indicate a problem.

-    Cramps and backaches may be related to tension or anxiety rather than to menstruation itself. However, these symptoms can also be caused by a hormone imbalance or an abnormal condition of the pelvis.

-    Make sure that your daughter fully understands the process of menstruation.

Girls begin to menstruate sometime between nine and 17 years of age. The average age is 12. Following the onset of menstruation (menarche), it may take from several months to five years for the hormones to balance and produce regular menstrual periods. Menstrual irregularity during this time is to be expected and is not necessarily abnormal.

Signs and symptoms

For about 5 percent of adolescent girls abdominal cramps and backaches – which last one or two days at the start of a menstrual period – may be severe enough to interfere with normal activities. In many instances cramps and backaches are related to emotional factors such as tension or anxiety. They also may be due to a hormonal imbalance or pelvic disease.

Because the range of normal is so broad, it is difficult to judge whether a menstrual abnormality exists or not. Symptoms that warrant investigation are: menstruation before age nine or failure to menstruate by age 17; absence of menstrual periods for six months (or for one month in a sexually active teenager where the failure to menstruate may indicate pregnancy); repeated excessive bleeding; or pain severe enough to interfere with normal activity.

Precautions

• Explain the facts about menstruation to your preteen daughter; this way you can counteract any “old wives’ tales” she may have heard from others, and prepare her for this important part of growing up.

• There are good books available (for both parents and teenagers) that can help explain the process of menstruation and provide accurate information.

Medical treatment

If a girl is having menstrual problems the doctor should conduct a complete physical examination, which includes a rectal and a limited pelvic examination. Chromosome and hormone studies may also be required. In some cases the doctor will order blood tests or tests of thyroid function. (The thyroid gland, located in front of the throat, regulates the body’s temperature, energy production, growth, and fertility.) If the girl is sexually active and has missed a period, a pregnancy test will be called for.

Your doctor may well find no abnormality and no treatment will be necessary. In some cases, the doctor will prescribe hormone medications to be taken over a period of several months. In other cases an iron supplement or a thyroid medication may be prescribed.

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•     Avoid public lavatories if possible. Some recent work has shown that herpes virus can survive on lavatory seats for a number of hours and on cotton gauze for 72 hours.

•     If someone has sores of any kind, skin contact should be avoided. The sufferer from recurrent herpes should not have intercourse during an attack. Many people with recurrent attacks have a warning when one is about to occur. This varies from individual to individual but can be an itch, tingle or burning in the genital area. This type of sensation rules out sex until the sores have healed. These precautions also apply to kissing (not just on the genitals) someone with a cold sore on the lips.

•     Oral sex increases the risk of getting genital herpes because the mouth is such a reservoir for the virus. Some people overcome this by using a sheath on the man before fellating him. Unfortunately, although this confers some protection it is not totally safe because the pores in the latex of the sheath are larger than the herpes virus and some could pass through.

All of this may sound daunting but in fact the risks involved in sexual activity between individuals who have no sores are very small indeed. Unfortunately, lesions inside the woman’s vagina or on her cervix are not visible and it can be impossible to know if she is ’safe’.

•     Vaccines are being researched but so far the outlook is not very encouraging and experts think that a safe, effective vaccine is a long way off, and possibly may never be found.

•     Wash your hands thoroughly with soap and water after touching the sores.

•     Don’t share towels-it is just possible to pass the virus to someone else via a towel.

•     Never use saliva to wet your contact lenses.

•     Not everyone who has one attack of herpes goes on to have another-about half of all sufferers never get another attack. Keep a record of when you have your attacks (if you have them repeatedly). You may find that you get them under specific conditions. These can be avoided, at least to some extent, to prevent more attacks. Here are some conditions that some people find make their herpes worse or brings on an attack:

1. Tiredness or stress.

2. A particular time of the menstrual cycle.

3. Friction from intercourse or masturbation.

4. Sunlight and sun beds.

5. Tight clothing.

6. Nylon knickers.

The avoidance of any or all of these will help prevent herpes in at least some people.

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