Children’s winter coughs
Winter is a time when many respiratory (chest) infections seem to become
more common. As well as colds and influenza, other nasties like croup and
bronchiolitis often crop up, especially in younger children and babies.
Both bronchiolitis and croup are chest infections caused by viruses.
Bronchiolitis is a viral infection of the smaller airways inside the
lungs. It is most common in babies under a year of age. In cooler parts of
the world it occurs mainly in winter and spring; in more tropical climates
it is more common in the wet season. The virus damages cells lining the
small airways and causes swelling and increased mucous. It usually starts
as a runny nose and fever with cough increasing over several days.
Breathing can become rapid and wheezy. Babies can be distressed with
breathing, have trouble feeding and may become dehydrated.
There is no specific treatment – antibiotics do not help, as it is a
viral infection. Improvement usually occurs after 5 or 6 days and most are
better within 2 weeks. Hospital treatment is usually only needed for more
severe cases and involves oxygen and fluid replacement until the child
recovers. Some children will go on to have recurrent bouts of ‘wheeziness’
with subsequent viral infections, usually settling by adolescence.
Bronchiolitis does not lead to adult asthma.
Croup is seen mostly in older children aged between 6 months and 6
years. It may also follow several days of ‘cold’ symptoms, developing into
a characteristic ‘barking’ cough, particularly at night. The virus causes
swelling of the larger, upper airways including the trachea (windpipe) and
the larynx (voice box). Coughing gets worse if the child is upset so it is
important to stay calm. Steam used to be recommended but there is no
evidence that it helps and it carries the risk of scalds. Corticosteroid
medications are given to reduce upper airway blockage and sometimes
several doses may be needed.
Croup can get worse quite rapidly so seek urgent medical attention if
you are concerned about breathing difficulty. Some signs of more severe
problems include:
Noisy breathing, even at rest.
Child struggling to breathe.
‘Caving-in’ of soft tissues at the neck and between the ribs as the
child breathes in.
Restlessness, anxiety or sweating.
Bluish looking skin/lips.
Other causes of cough include influenza, bronchitis, whooping cough
(especially in those not immunised) and pneumonia. Most respiratory
infections are caused by viruses and do not initially require antibiotics.
Cough mixtures are not recommended for young children as they do not help
and can cause drowsiness and other unpleasant side effects. Asthma can
flare up in association with respiratory infections and medications may
need to be adjusted accordingly. This needs to be considered as part of
every child’s asthma management plan.
Fortunately most children with respiratory infections recover naturally.
However, never hesitate to seek medical advice for a child you are worried
about.
Pulses provide plenty of protein
Pulses (also known as legumes) including beans, peas and lentils, are
the dried seeds of certain plants. They are low in fat and are an
inexpensive source of nutrients such as complex carbohydrates, fibre,
vitamins and minerals (especially iron). Iron from vegetables is more
readily absorbed by the digestive system when eaten with foods rich in
Vitamin C such as capsicum and tomatoes.
Pulses are also an inexpensive source of protein. Proteins from plants
do not contain all of the amino acids found in animal proteins. Combining
different plant proteins can ensure a diet with adequate protein content.
Examples include beans on toast, rice with lentils and hummus – a mixture
of chickpeas and tahini (sesame paste).
Sprouting some pulses, such as mung or soybeans, will increase their
vitamin C levels. To do this, soak overnight in plenty of water. Pour off
the water and cover the container with a piece of light fabric. Keep in a
dark place for about three days until sprouts are a few centimetres long.
Rinse with fresh water each day. Enjoy raw in salads and sandwiches.
Some people complain of “wind” when eating pulses. This problem may be
helped by careful preparation and cooking. Long soaking, preferably
overnight, in plenty of cold water helps to make them more digestible and
reduces the cooking time. Rinse thoroughly in cold water before cooking in
fresh water or stock. Boil vigorously for 10 mins then simmer gently until
soft. Split peas and lentils do not need to be soaked before cooking.
Do not add salt or any acidic foods such as tomato before pulses are
cooked or they will toughen.
Good Health on the Menu
This recipe makes an economical meal when served with a green salad (try
adding some fresh sprouted pulses to the salad).
Chilli Con Carne
(serves four)
1 tsp oil
1 onion, chopped
1 clove garlic, crushed
1 tsp cumin seeds
500g low-fat minced beef
1 green capsicum, chopped
1 large carrot, chopped
120g tomato paste
1-2 tsp chilli powder or crushed chilli
2 cups home cooked or canned kidney beans
Method:
Heat oil then add onion, garlic, cumin seeds and meat and brown,
stirring frequently.
Add remaining ingredients except beans. Stir and cook for 30 mins.
Add beans and heat.
Myth and Fact
Myth
Having chickenpox as a child means you won’t get shingles.
Fact
You can only get shingles if you have had a chickenpox infection.
Chickenpox is an infection with the Varicella-zoster virus. It causes a
blistering skin rash that is often extremely itchy. Chickenpox can be a
severe illness in older people, newborns and those who have decreased
immunity due to disease or certain medications. If a pregnant woman gets
chickenpox, there may be serious effects on the baby depending on the
stage of pregnancy. Once infected, a person will become immune to the
virus. However, in some cases the virus can remain in the body in
particular
nerve cells.
Shingles is a painful, localised rash caused by the reactivation of
these viruses. Reactivation of the virus can be triggered by various
factors including stress and other infections. If a person who is not
immune to chickenpox is exposed to the virus from someone with active
shingles, they may develop chickenpox – but they will not get
shingles.
Chickenpox vaccination is now available for children and those at risk
who have not already had chickenpox. There is also a shingles vaccine for
those over 50.
Health Reminder!
Heart attack one of the main killers in Western Society
There are six main risk factors for this disease. They are:
Hereditary Factors
Smoking
High Blood Pressure
Fats in the blood
Obesity
Lack of exercise
Apart from the first, all of these risk factors are in our own control.
Are you giving yourself the best chance of avoiding a heart attack?
Prevent vision loss with regular health checks
Loss of vision and blindness occur with increasing frequency every
decade in those over 40. Vision loss is associated with depression, loss
of mobility and an increased risk of falls and injury. The good news is
that most vision loss can be prevented if problems are detected and
treated early. Some eye conditions that can cause vision loss include:
Glaucoma, which causes damage to the optic nerve due to raised pressure
within the eyeball. It often runs in families. There are usually no
symptoms in the early stages and it can only be diagnosed by measuring
‘intra-ocular pressure’ with a specialised instrument. Treatment with
daily eye drops will prevent or delay vision loss.
Age-related macular degeneration (AMD), which affects many older people
and leads to loss of central vision. Treatment can help retain the
remaining vision.
Cataracts, which are treatable with surgery to remove the clouded lens.
Prevention involves protecting the eyes from sun damage throughout life. A
healthy diet and avoiding cigarette smoke are also important for good
eye health.
Diseases that can cause vision problems if not well treated include
diabetes and high blood pressure.
A regular eye test for those over 40 is recommended to detect problems
early. Those with diabetes will usually be referred to a specialist
ophthalmologist for assessment. Any visual symptoms, including eye pain,
sudden change in or loss of vision, require prompt medical attention.
Did You Know?
New dads can get depressed too
While depression in pregnancy or the postnatal period is well described
in women, this is also a risk time for men. A recent American study found
that in the pre and postnatal period, one in ten fathers had depression –
twice the normal incidence for men. The time of greatest risk seems to be
in the 3-6 months after the birth.
Depression in men may lead to withdrawal, anger and irritability. It is
important to be aware of the possibility of depression as a treatable
cause of a range of problems. Talk to your doctor about diagnosis and
treatment options that may make all the difference to the whole
family.
Dr Norman Swan
A matter of health
Aspirin and Your Health
There are thousands – perhaps millions – of Australians on low dose
aspirin to lower the risk of heart attacks and strokes. The indications
for low dose aspirin include having a stroke, heart attack, angina (chest
pain due to lack of blood supply to the heart) or a short-lived mini
stroke called a transient ischaemic attack (TIA).
In the past it’s been argued that all men over 50 or 55 benefit from low
dose aspirin, as do women over 65. But that is now in question.
Over the last year or two there have been several studies suggesting
that, even if you are at increased risk of a heart attack, say from high
cholesterol or blood pressure, taking daily aspirin doesn’t protect you
against a future heart attack or stroke. This means that you risk aspirin
related side effects, like bleeding, for no benefit. More recently, a
review of the available evidence in people with diabetes has suggested the
same lack of protection from low dose aspirin, although in the case of
diabetes it’s a closer call.
Let’s be clear about the message here. There is absolutely NO doubt that
aspirin can save your life if you’ve already had a heart attack or stroke,
angina or a TIA. That’s because there’s been a break in the lining of the
artery and aspirin prevents clots forming there. But if you haven’t had
one of these ‘events’, even if you are at risk of a future heart attack or
stroke, there’s no point in low dose aspirin as a preventive measure.
Help for painful feet
Bunions are one of the common conditions to produce pain in one or both
feet, affecting women more often than men. A bunion is a swelling, usually
over the joint between the big toe and the rest of the foot. The big toe is
usually deviated (bent) towards the other toes, making a sharp angle
between it and the first metatarsal (the long bone of the foot). This
creates a pressure point when shoes are worn, producing a red, painful
swelling.
Bunions are usually attributed to wearing high heels or tight shoes but
may have other underlying causes, including a family tendency to bunions,
developmental abnormalities of the foot and arthritis. Pain may be
intermittent or constant and is made worse by ill-fitting shoes. Corns and
calluses can develop where toes start to overlap due to pressure from the
abnormal big toe angle. The smaller toes can also become bent (hammertoes)
and a bunionette may develop on the little toe.
There are a variety of ways of treating bunions. Shoes that are wide
enough to avoid pressure on the bunion are the obvious first step.
Sometimes protective bunion pads will help. For more severe cases surgery
is often necessary. Several different operations have been used to treat
bunions. These include simply ‘shaving’ excess bone, removing the end of
one of the bones, re-aligning the bones or permanently joining the bones
of the affected joint.
It is a pity to put up with the pain of bunions when so much can be done
to help.
