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Coil- Nightmare

  • February 28, 2010 7:36 pm

In attempt to stop my hellish periods, which are that bad I end up having to use maternity pads to deal with them, the doctors decided to try the Mirena Coil. I figured it was worth a try given I’ve tried the pill and the implant, neither of which worked.

So I went to the appointment went through all the routine questions not a problem, it was after that the problems started. With no warning what so ever the doctor performed a pelvic exam which had me climbing the walls. She then tried to fit the coil, unfortunately what should have been a straight forward procedure was extremely painful, unsurprisingly my cervix went into spasm and the whole thing had to be abandoned.

I had to book another appointment, this time I was told to take 6mg of Diazepam. So I turned up for the appointment, went through the same routine as the 1st attempt only this time after 6 attempts they finally managed to get the bloody thing in.

Since then it’s all gone downhill, I feel like crap, I’ve had bleeding heavier than my usual period; which I didn’t think was possible. To add insult to injury I found out that I’ve got a few torn ligaments in my pelvis and I have pelvic Inflammatory Disease from the damn thing. So all in all not a happy bunny.

For more information about the coil or PID see these websites:
Pelvic Inflammatory Disease
Mirena Coil

School Phobia – Fact or Fiction?

  • February 6, 2010 7:17 pm

A school is being asked to apologise to the family of a boy it prosecuted for truancy. The boy was diagnosed as having “school phobia”, but what is that?

Most adults can remember days when they didn’t want to go to school. There would be claims of illness, and of the danger of passing on an unpleasant disease, before the eventual acceptance that the journey into school was inevitable. So it is not surprising that many might react with scepticism to the idea that there is such a thing as “school phobia”.

According to Nigel Blagg, author of School Phobia and Its Treatment, it is a condition that has been recognised since the 1960s. “They will experience extreme anxiety. They are off school, typically with their parents’ knowledge and approval. And they often have symptoms like tummy aches, head aches and nausea. Some of them suffer severely with depression. “Any attempts to get them to school, when they are at their worst can lead to quite extreme behaviour – temper tantrums, screaming, kicking. It is very distressing for the adults.”

The sceptics categorise these children as truants, but, says Mr Blagg, a former local authority educational psychologist who now runs a private practice, they are quite distinct in background and behaviour: “They are typically well behaved, socially conforming who are usually doing quite well. Normally they come from caring families. The truant group are the ones who [miss] school because they want to… often involved in delinquent behaviour.”

It is thought the worst ages for school phobia are five to six and 11-14, says Mr Blagg. There are no precise numbers for how many children suffer the condition, but he notes one estimate is that 1% of children will have it at one point during their school careers. A day at school is not every child’s idea of fun.

But the diagnosis is not without controversy, and even the term is subject to dispute, says Mr Blagg. “In the psychological world the preferred term these days is school refusal. [But] school refusal doesn’t convey the extreme distress, anxiety and panic, the physical symptoms that these children experience or the fact that it isn’t a volitional state.” There is a recognition among psychologists and other education professionals that school phobia/school refusal covers a range of different problems.

Some of the younger sufferers can be diagnosed as having “separation anxiety”, leaving them distressed at parting from their parents at the school gate. But some psychologists say this is more about refusal, not phobia – a true school phobic will experience a reaction even if their parents are present. “Other children could be classified as having a social phobia to do with performance aspects of school – reading out loud or changing for PE,” says Mr Blagg. Other children might be off sick for a prolonged period, fall behind with work and fall out of a routine. Some might simply have changed school and lost friends they relied on to feel secure at school. Still others may have had a single distressing experience. “More typically what you have is an accumulation of stresses to do with home and school that add up over time and cause the child to be anxious,” says Mr Blagg.

School phobia – irrational fear of school or the school situation
School refusal – Refusal on the part of a child to attend school
Refusal to go to school may be caused by a school phobia but most school refusals due to separation anxiety
In a true school phobia a child will show the phobic reaction even if his or her parents are present
Source: Penguin Dictionary of Psychology

“The avoidance leads to greater problems. They fall behind with school work. They worry what friends will say. The longer they are out the worse the problems get. If they are told they don’t have to go they feel fine and the symptoms disappear.”

Not only is there disagreement over the name for the condition, but also how to treat it, and whether it exists at all. Sociologist Prof Frank Furedi, author of Wasted: Why Education Isn’t Educating, is not convinced. “You take an understandable anxiety about going to school and turn it into a disease… Children will internalise it and play the role that’s been assigned to them. It cultivates the idea that these [exaggerated medically diagnosable] anxieties are normal. You do begin to encourage children to think in these terms.”

Even if you do accept that school phobia exists, there can still be disagreement over the best approach to tackling it. Mr Blagg insists that while educational psychologists, teachers and parents must be sensitive to the child’s needs, they must recognise that confrontation and getting the child back to school is necessary.
“They need that very firm handling and confronting them and getting them back to school. You might have to take them to school and escort them [in].” For those who have been away schools should assign tutors, help them catch up and offer them quiet space to be in while they are adjusting.

There are some advocates of home schooling who believe that rather than being a psychological aberration requiring a cure, the symptoms of school phobia may simply indicate that the child is best educated away from the school, at home. Ann Newstead, a spokesperson for the home tuition charity Education Otherwise, says school phobia is a “very real condition”. “I see a lot of families where they are in that situation – you only have to meet the children and families to see that it’s not a made up condition. It’s genuine. Not sending your child to school is something parents can be prosecuted for. You don’t risk prosecution lightly. You wouldn’t dream of forcing an adult to engage in an environment that wasn’t beneficial to them. So why do we think it’s ok to treat children in this way?”

But aren’t children more malleable? Doesn’t keeping them back from school indulge their fear rather than tackle the problem? “I agree with the tackling but not the forcing of it. That’s like treating someone who is scared of spiders by putting a spider in their hand. You tackle these things gradually, help someone to overcome a phobia and home education is a way of doing that.” More generally, many schools seek to make some of the changes for children less stressful, for example working on acclimatisation for children moving up to secondary school but Prof Furedi does not believe that such a sensitive treatment is necessarily always helpful. “Kids going from primary school to secondary school often get transitional counselling. If you tell them enough times this is an extremely difficult, painful step, you make the kids more anxious.”

The sceptics of this theory are making their voices heard here are just a few:

  • Bill Thorpe: “Thirty years of teaching in inner city schools has shown me that as soon as a “syndrome” is named, you can be sure that you’ll have a rash of ‘diagnosed’ sufferers within a few weeks. (Tourettes for example). Even if “School phobia” is real; and the pupil who have been prosecuted is a sufferer.. Why should the school apologise? Presumably the evidence of non-attendance was real and provable. The “syndrome” is a circumstance that can be considered by the court. The school is right to pursue truants, their only evidence is attendance records.”
  • Yes, phobias exist in school settings, but I don’t think that there is actually a school phobia. The reason why the profile of all these school phobiasts are “well behaved, socially conforming….” is for the simple fact that they are suck ups that probably get whatever they want, and their mommies and daddies cradle their kids until their out of college. I think everybody at some point or for a period of time didn’t want to go to school. This was probably because we had to deal with something we didn’t want to, like: giving a speech, a bully, or maybe getting up too early. These fears or anxieties are normal for everybody. Being afraid of a public institution is just another way to label something else we want to have as an excuse to coddle our kids.
  • This is ridiculous. There is always a name for anything that makes us as adults uncomfortable. I am a teacher and i have dealt with children who don’t want to come to school, one is now okay as he realised nobody was going to put up with his nonsense. The other left the school as he was very good at manipulating his mother who just did whatever her children wanted. We need to stop labelling children and helping them to come up with excuses. I am sure when they grow up with no qualifications and become yet again another burden on society we will think of another psychological condition to excuse. The problem with the west, too many excuses for bad and manipulative behaviour!!

To be honest me and my partner accept that there is anxiety for some children with regards to school but we’re are uncertain about whether there is such a thing as school phobias. With things like this it raises concerns about the impact on both the education system and the NHS. The education system will become too afraid to act if they suspect truancy and the NHS will be inundated with claims of children who allegedly have school phobia; Not only that but you risk creating a self fulfilling prophercy, if you tell someone something often enough they start to believe it. You are also providing truants with another excuse to skip school

Children can imagine away pain

  • November 14, 2009 7:40 pm

American researchers have found that children can be taught to use their imagination to tackle frequent bouts of abdominal pain. It is thought that the technique works particularly well due to their fertile imaginations. The research suggests that 1 in 5 children suffer with frquent abdominal pain with no identifiable cause. There were 30 children aged between 6 and 15 in the study half had 20 minute sessions of “guided imagery” this is where the patient is prompted to imagine things which will reduce their discomfort. The other half had the mainstream care.

It is thought that the treatment is very positive because it is inexpensive and is able to be self administered, which potentially opens the door for easily enhancing treatment outcomes for a lot of children sufering from frequent stomach aches.

This technique is an amazing breakthrough because this means that children can be treated by other means instead of drugs which is definately a positive. Also it means that more children can be treated without massive waiting lists which can be a definate plus for the NHS and the parents of the children who are suffering from abdominal pain and there is nothing they can do

Child Swine Flu Jabs Trials

  • October 9, 2009 8:43 am

On Saturday 26th September a trial began involving 1,000 children to test two swine flu vaccines before the launch of a UK vaccination. The information is limited but the trial will allow the experts to observe immune reactions and any side effects which may occur.

The children participating in this trial are aged between six months and 12 years from Oxford, Southampton, London, Bristol and Devon. Participation in the trial is voluntary and consenting parents were be briefed on the risks. The children are given two doses of the vaccine three weeks apart, then a blood test three weeks after that.

The aim of the trial is to find out if one of the vaccines is better than the other in terms of immune reactions. They also want to ensure that the side effects are minimal before launching the UK vaccination programme.

One of the main problems the study seems to be having is recruiting enough children under the age of three, getting older children didn’t seem to be a problem just the younger ones, Doctor Saul Faust suggests that the younger children don’t usually respond to vaccines as well as adults and older children but says that they need to find out how the younger children respond before the vaccine becomes available to the UK. This could be because the younger children are deemed to be one of the high risk groups because young children, especially those that are under five, do seem to be at risk of serious illness. Also flu epidemics and pandemics are spread very efficiently by children.

The Department of Health has said that they will have enough vaccine for half of the population by the end of the year and that the high risk groups which are medical staff, the elderly and the very young will be immunised first.

RPOC – what is it?

  • August 5, 2009 1:57 pm

RPOC stands for retained products of conception. This is where all or part of the placenta or membranes are left in the uterus during the final stage of labour. In most cases this is detected following the examination of the placenta after delivery.

Retained placenta can be caused by:

  • failed separation due to failure of uterine contraction or morbid adherence e.g. to a fibroid or scar
  • separated but retained due to e.g. a snapped cord contracted uterus, closed cervix

Reports suggest that retained placenta is one of the mosts common causes of postpartum haemorrhage.

There are a number of options for treating RPOC here is the most commonly used

Women with a retained placenta oxytocin injection into the umbilical vein with 20 IU of oxytocin in 20 ml of saline is recommended, followed by proximal clamping of the cord. If the placenta is still retained 30 minutes after oxytocin injection, or sooner if there is concern about the woman’s condition, women should be offered an assessment of the need to remove the placenta. Women should be informed that this assessment can be painful and they should be advised to have analgesia or even anaesthesia for this assessment

It is worth pointing out that this is very rare and that it very rarely causes any problems however in few cases a hysterectomy may be needed as a PPH occurs or a severe infection.

Tamiflu causing side effects in kids

  • August 3, 2009 8:38 pm

There are claims that over half of the children taking Tamiflu to cure swine flu suffered side effects such as nausea, insomnia and nightmares. The statistics show that 1 in 5 children had a neuropsychiatric side effect, such as poor concentration, inability to think clearly, problems sleeping, and feeling dazed or confused. The research that was carried out was flawed as there was no control group therefore it is impossible to say whether the symptoms were a result of the drug or the virus; however, there were no serious long term side

Participants for the study were selected differently in the three schools. In two schools (one primary and one secondary school) the researchers selected all the classes who were offered prophylaxis, (age 4-11 years in the primary school), and all of one year group in the secondary school (age 13-14 years). In the other secondary school, the questionnaire was offered only to pupils in four of the classes in the year group (age range 11-13 years). This is a flawed sample as there is no fixed criteria for selecting the participants for the research.

Here are a few of the questions that were asked to the sample:

  • Whether children who had been offered Tamiflu had taken it?
  • How long they took it for?
  • Were they taking any other medication with Tamiflu?
  • Were there symptoms after taking Tamiflu (including specific gastrointestinal and neuropsychiatric symptoms)?

Out of 256 schoolchildren, 103 replied which is 40% of the participants. The number of responses from the secondary school were higher than those from the primary school. The results show that only 48% of the primary schoolchildren in comparison to the 76%of the secondary schoolchildren. The most common side effects were nausea and vomiting, followed by mild neuropsychiatric effects such as difficulty sleeping, nightmares and poor concentration.

It is worth pointing out that Tamiflu has not been withdrawn and is still used to treat swine flu. All drugs come with side effects and not everybody experiences them, thus suggesting that Tamiflu is no different to any other medicine.

Symphysis Pubis Dysfunction (SPD)

  • May 4, 2009 4:41 pm

The pelvis consists of two halves which are connected at the front by a joint called the symphysis pubis, this joint is strengthened by ligaments which means that under normal circumstances, very little movement occurs, to make your baby’s passage through your pelvis as easy as possible, your body produces the hormone relaxin. This softens the ligaments which causes the joints to move more during and just after pregnancy. It is unclear what causes SPD but current thinking suggests that if one side of the pelvis moves more than the other when you move your legs, it can cause pain and inflammation of the symphysis pubis. Alot of women with SPD experience significant pain without any great separation of the joint which would suggest the amount of pain is not related to the degree of separation.

The most common symptoms of SPD are pain in the pubic area and groin. Other symptoms can include back pain, Pelvic Girdle Pain (PGP) or hip pain. It is common to feel a grinding or clicking in your pubic area and the pain may travel down the inside of the thighs or between your legs. The pain can be made worse by separating your legs, walking, going up or down stairs or moving around in bed, often it is worse at night and can stop you getting much sleep. Activities such as getting up to go to the toilet in the middle of the night can be especially painful.

If your doctor or midwife diagnoses you with SPD they should refer you to a physiotherapist. They will have experience in treating this complaint. SPD is diagnosed using your description of symptoms and a series of tests designed to look at the stability, movement and pain in your pelvic joints. SPD can’t be cured however the symptoms can be managed using:

  • a pelvic support belt
  • exercises for the tummy and pelvic floor muscles
  • mobilisation (a gentler form of manipulation) of your hip, back or pelvis
  • hydrotherapy

The physiotherapist will also give you advice on how to make daily activities less painful and on how to make the birth easier. In some cases a vaginal birth may not be possible so in these instances a Caesarean will be carried out.

There are a number of things you can do to help yourself

  • Don’t push through any pain; if it hurts, where possible don’t do it. This can make your symptoms worse and will take longer to settle down
  • Try to keep mobile, moving little and often.
  • Rest regularly by sitting reasonably upright with your back well supported.
  • Avoid heavy lifting or pushing

Research shows approximately 60% of women with SPD still experienced some symptoms after delivery. In the majority of cases women report their symptoms improve after the birth of their baby although a small percentage still have pain when their babies are a year old. You should continue with physiotherapy after the birth and get help with looking after your baby during the early weeks where possible. Some ex-sufferers find they experience pain every month just before their period is due, which is caused by hormones which have a similar effect to the pregnancy hormone relaxin.

The information on this page is the standard advice given for those of you where this isn’t your first child I know that the self help advice is easier said than done, just try to take it as easy as possible. It’s also worth pointing out that for some women as your baby gets bigger the SPD will deteriorate, in some cases you may be given crutches to help take some of the weight off your pelvis. You may find having warm baths and taking paracetamol may help your doctor may also be able to prescribe codeine to help ease the discomfort. Unfortunately in most cases it is simply a case of grit your teeth and bear it until the birth of your baby. For more information on various self help techniques and up to date information on this condition try visiting the Pelvic Partnership’s website

There is some queries with regards to the use of Tramadol to manage the pain, the simple answer in due to the fact that in it proved to be dangerous in the tests conducted on animals and the lack of human tests it is not advisable to use during pregnancy. It becomes less straightforward when looking at it as a treatment whilst breastfeeding the manufacturers advise against it because it passes into the breast milk. However it is believed that the amount is very low as so some argue that it is safe to use while breastfeeding.

Post-Partum Haemorrhage

  • May 2, 2009 11:00 am

Post-Partum Haemorrhage (PPH) is excessive bleeding following the birth of your baby. There are 2 types of PPH; primary and secondary.

Primary PPH is blood loss of over 500ml within 24 hours of delivery. It is the most common type of PPH, below are some of the most common causes:

  • Uterine Atony – for those of you who don’t know this is simply the loss of muscle tone in the uterus; normally the uterus contracts which compresses the vessels and reduces the blood flow; if you have a uterine atony the lack of contraction can cause acute bleeds. It is estimated that 75-80% of PPH is a result of uterine atony.
  • Retained Placenta – This can be all or part of the placenta.
  • Lacerations of the Vagina or Vulva
  • Hematoma – This is the collection of blood outside the blood vessels and can be caused by an internal bleed

Secondary PPH is defined as abnormal bleeding from 24 hours up to 6 weeks after giving birth.
The two most common causes of secondary PPH are:

  • Infection- endometritis. Occurs in 1-3% after spontaneous vaginal delivery. It is the most common cause of postnatal morbidity between day 2 and day 10. At this point I should point out that if you have an infection following delivery it does not mean that you have Secondary PPH or will necessarily develop it as you can see from the percentage of cases it is quite rare.
  • Retained products of conception (RPOC) – This is usually in cases where the placenta is incomplete or if the pregnancy has been terminated and there has been some foetal tissue left behind, again this is very rare and is usually detected before it causes any problems.

Both Primary and Secondary PPH are diagnosed following an examination of the genital tract, blood tests and in some cases a MSU (a urine sample). The good news is that both types of PPH are treatable having suffered from Primary PPH myself I know that if the facts are not explained to you it can seem very scary and this is perfectly normal if you experience either Primary or Secondary PPH and the medical professionals involved in your care don’t explain what is going just ask they will oblige and explain what is happening. I can verify this as when midwife realised I had a primary PPH it seemed like doctors and other medical staff seemed to appear from nowhere and it seemed like everyone had adopted panic stations and were talking amongst themselves, without telling me what was going on, I simply said “stop. Now, tell me what is happening.” The midwife apologised and explained what was going on and what they were going to about it.

It is important to point out that if you don’t understand you shouldn’t be afraid to ask because further down the line it may be relevant and it can save alot of time if you are able to supply them with the information rather them having to trawl through your entire medical file to gain the information. As I discovered with my second pregnancy because I had asked what was going on when I had complications with the first pregnancy I was able to answer the questions asked to gain treatment for a complication with this pregnancy faster as they didn’t have to trawl through over 20 years worth of notes.

Post-Natal Depression

  • April 29, 2009 8:32 pm

Post-Natal Depression also called Post Post-Partum Depression (PPD) is a relatively common condition that occurs following the birth of a baby it is estimated that it occurs in approximately 10-15% of women; the severity of the condition can vary from mild depressive episodes commonly termed the “baby blues” through the spectrum to a very rare condition called “postnatal psychosis”.

The symptoms of PPD are like those which occur in ‘ordinary’ depression. These include:

  • Feeling ‘low’, ‘miserable’ and tearful with no apparent reason. The feelings are present for most of the time, though they may be worse at certain times of day, particularly the morning.
  • The inability to enjoy yourself. It is particularly prominent in new mothers who feel they aren’t enjoying having a new baby in the way they expected to. Which can lead to feeling of guilt which can compound the problem
  • You may become irritable this could be with other children, the new baby and particularly with the partner.
  • Disturbed sleeping patterns are a part of looking after a new baby. Mothers with PPD may find the additional problems of finding it hard to go to sleep even though you are tired, or waking early in the morning. In addition the lack of energy may be worse if you have PPD
  • A decreased appetite can be another symptom of PPD which can become a problem since new mothers need all the energy they can get to look after their babies.
  • Anxiety is a frequently occurring symptom in PPD. It can take many forms from being tense and ‘on edge’ all the time. The normal concerns any mother feels for a new baby may become overwhelming. Also some mothers report that they experience ‘panic attacks’ which are episodes lasting several minutes when they feel as if something catastrophic is about to happen – such as collapsing, having a heart attack or stroke.
  • Feelings of being ‘worthless’ and ‘hopeless’. These are common in PPD. All mothers are faced with new and sometimes difficult problems with a new baby. However, mothers with PND feel all the more ‘not able to cope’ and unable to see a way through their difficulties.

Nobody knows what causes PPD; although it is likely that there are several factors. Following childbirth the hormone levels change combined with the stress of looking after a new baby and disturbed sleep. Mothers who have previously had mental health problems most commonly depressive episodes or if there is a family history of depression. Studies have also shown that significant life events during pregnancy, unplanned pregnancies and babies who are born with some kind of defect can also mean that the mother is more likely to develop PPD.

PPD is very treatable and is treated using the same methods as “normal” depression (antidepressants, therapy).Getting extra support and help with looking after the baby is also important. In instances where antidepressants are necessary it can cause problems with breastfeeding, since some drugs get into breast milk, however there are drugs that are safe. You should remember that the most important thing both from the baby’s and your point of view is to get better as quickly as possible. There are a few things that you are able to do to help. Depression is an illness and you are not suffering from it because you are weak or hopeless. Also remember that it is very common and that it will get better. Don’t worry that you will lose your baby. When mothers have PPD they often think that they are poor mothers and that if they speak to somebody like their GP, they will have their baby taken from them. This will NOT happen. What will happen is that you will get the help that you need to get rid of the PPD. Having a baby is tiring and stressful for any mother, you will not be able to manage all the things that you did before the birth. Reduce your commitments and accept help when it is offered. It is important that if you have a partner that you involve your partner. Having a young baby will be difficult for him too and he will be concerned about your illness. Encourage him to speak to your health visitor or GP so they can understand the illness you have, it is also important that you make time for yourself and with your partner. I can’t stress enough that if you have PPD it is NOT your fault and that with support it will help end the episode of illness as quickly as possible.

Mothers with PPD often worry about harming their babies, or not looking after them properly; generally they look after their children at least as well as other mothers. Unfortunately mothers and other family members do sometimes harm babies (battered babies). Very rarely a mother with postnatal psychosis may harm her child, this may be because she is suffering from false beliefs (delusions) such as that the child is terminally ill. Another option is that mothers may kill their babies before committing suicide themselves thinking that it is better for both of them to be dead. It is important to stress that cases are very rare and that PPD and postnatal psychosis are treatable illnesses and the sooner they are treated the better. If you have any worries that you may harm your baby, or you have worries that a mum you know may harm their child, speak to a health visitor or doctor as soon as possible. Due to the current system health professionals monitor the situation very closely however they are not mind readers if you feel that you may be experiencing PPD it is important to express these concerns to your health visitor.

Having suffered from PPD myself I can’t stress the importance of getting help as early as possible and it is NOT your fault and there is nothing you can do to prevent PPD and it is possible to have a normal life after the illness is treated and cured. My daughter is now 2 and we have a happy and healthy relationship

Croup

  • March 25, 2008 10:03 am

Croup, this is the inflammation of the tubes leading to your lungs.

My daughter started with what I thought was a cold she got progressively worse; wheezing and a barking cough with a temperature.
I took her to the doctors and was told she had croup, and was given some antibiotics. Here are some things that we tried and they worked.

  • Allow your child to inhale plenty of steam so take them in the bathroom while you shower
  • Try the vapour plugs they really seem to help
  • Turn the heating down….as mad as it sounds central heating dries out the air, but don’t freeze
  • We also gave her medised (it’s a paracetamol based medicine but it contains a mild antihistamine which helps dry up the mucus
  • Try and keep them entertained as it distracts them so they aren’t as niggly