Health and psy­chol­ogy

The Jerusalem Post - The Jerusalem Post Magazine - - CONTENTS - • RX FOR READ­ERS/ JUDY SIEGEL-ITZKOVICH Rx for Read­ers wel­comes queries from read­ers about med­i­cal prob­lems. Ex­perts will an­swer those we find most in­ter­est­ing. Write Rx for Read­ers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your ques­tion to Judy

My first daugh­ter is three years old. I have been tak­ing care of her at home since she was born and now have en­rolled her in a mu­nic­i­pal kinder­garten. I have no ex­pe­ri­ence with such fa­cil­i­ties and would like to know what to look for to make sure the place ob­serves safety rules. N.S., Ra’anana

The Is­rael Stan­dards In­sti­tute com­ments: One of the most im­por­tant indi­ca­tors for choos­ing a kinder­garten is the safety of chil­dren. Our ex­perts have col­lected a num­ber of tips that can help par­ents choose the safest kinder­garten, and we is­sue cer­tifi­cates to those that have met our stan­dards.

Make sure that there are no toys in the build­ing or gar­den that con­tain small parts that can be swal­lowed or cause chok­ing. No­tice whether the toys are clean look­ing and not bro­ken or torn. Make sure that the yard play equip­ment is lo­cated in a shaded area and not near an ex­ter­nal fence that can be climbed on.

En­sure that all door hinges are shielded so chil­dren’s fin­gers will not be caught in them. Check whether all elec­tri­cal out­lets are hid­den or in­ac­ces­si­ble to chil­dren. There should be a fire ex­tin­guisher or au­to­matic fire de­tec­tion and ex­tin­guish­ing sys­tem as well as a first-aid kit.

Make sure that there is a sepa­ra­tion or a blocked pas­sage be­tween the park­ing area and the gar­den area and that the en­trance gate to the gar­den has at least one lock­ing mech­a­nism. Note that the beds are ap­pro­pri­ate for the child’s age and that a lock­ing mech­a­nism pre­vents the fold­ing of the bed on the child’s fin­gers. The gar­den fence should be built of vertical bars to pre­vent climb­ing and the steps should be no higher than 10 cen­time­ters.

I’m an 85-year-old woman who looks a decade younger. I swim two or three times a week. I am healthy, ex­cept for daily, chronic nau­sea and migraine headaches, for which I of­ten take Ex­cedrin. My blood, urine and stool tests are all good. I’ve been to a gas­troen­terol­o­gist who couldn’t find any­thing wrong ex­cept a small spot in my stom­ach that was in­dica­tive of overuse of aspirin. The doc­tor told me to stop tak­ing Ex­cedrin. When I ex­plained that I’ve been a migraine headache suf­ferer for many years and that I sus­pected I also had a stom­ach migraine, he only replied “maybe.” My neu­rol­o­gist, an ex­pert in headaches, treated me for more than four years with “med­i­cal acupunc­ture,” which he learned in the US. This in­cluded more em­pha­sis on the nau­sea/stom­ach migraine than the headache. He showed me a cou­ple of stud­ies that found that older migraine suf­fer­ers of many years show a change more to the stom­ach than the head migraine. But nei­ther of us is sure whether the acupunc­ture re­ally did any good. In short, I find my life se­verely im­pacted by this con­stant nau­sea if I don’t take aspirin. I take med­i­ca­tion but can’t live on dom­peri­done (Motil­ium) in­def­i­nitely. I think I will go back to the neu­rol­o­gist and start the acupunc­ture again, but don’t know if it will help. Doc­tors look at me and see a healthy, young-look­ing, en­er­getic woman and they don’t seem to take me se­ri­ously – or else they don’t want to try or do much given my age. In the mean­time, I’m re­ally sick and I don’t know where to turn for an ac­cu­rate di­ag­no­sis. J.G., Ne­tanya

Dr. Me­nachem Ober­baum, di­rec­tor of the Cen­ter for In­te­gra­tive Com­ple­men­tary Medicine at Jerusalem’s Shaare Zedek Med­i­cal Cen­ter, replies:

If all the con­ven­tional pos­si­bil­i­ties have been ex­hausted, some com­ple­men­tary and al­ter­na­tive meth­ods can be used.

The in­di­ca­tions in which com­ple­men­tary and al­ter­na­tive med­i­cal meth­ods had been tested as pos­si­ble so­lu­tion of nau­sea and vom­it­ing were when these prob­lems ap­peared in preg­nant women and af­ter surgery and chemo­ther­apy.

The meth­ods that pro­vide the most sub­stan­ti­ated proof of ef­fi­cacy are acupunc­ture and acu­pres­sure. The Con­sen­sus De­vel­op­ment Con­fer­ence State- ment or­ga­nized by the US Na­tional In­sti­tutes of Health in 1997 con­cluded that “promis­ing re­sults have emerged, show­ing ef­fi­cacy of acupunc­ture in adult post­op­er­a­tive and chemo­ther­apy nau­sea and vom­it­ing.” A num­ber of clin­i­cal tri­als have since then sup­ported this con­clu­sion and con­firmed that they can be ef­fec­tive.

A few plants have been used for treat­ing nau­sea and vom­it­ing, es­pe­cially, in can­cer pa­tients re­ceiv­ing chemo­ther­apy, but also for such prob­lems not con­nected with can­cer. Orange blos­som ( Cit­rus au­ran­tium). hy­per­icum ( Hy­per­icum per­fo­ra­tum L.), achil­lea ( Achil­lea mille­folium L.) and gin­ger ( Zin­giber of­fic­i­nale) are the only plants that in­duced suc­cess­ful re­sults. In ad­di­tion, gin­ger is among the herbal plants ef­fec­tive in treat­ing nau­sea and vom­it­ing with­out any side ef­fects; in Ger­man phar­ma­copoeia, it is used to de­velop anti-nau­sea drugs.

The pos­i­tive ef­fect of acupunc­ture on head and stom­ach mi­graines (the lat­ter con­sist­ing of ab­dom­i­nal pain, nau­sea and vom­it­ing) and ten­sion headaches is well es­tab­lished. The ben­e­fit of acupunc­ture is the fact that its ef­fect can be eval­u­ated very fast. If there is no ef­fect af­ter eight to 10 treat­ments, it will most prob­a­bly not help. Nev­er­the­less, I would rec­om­mend that you switch to a well-trained acupunc­tur­ist be­fore de­cid­ing that it won’t work in your case.

Based on clin­i­cal stud­ies pub­lished in con­ven­tional lit­er­a­ture, it can be said that among the re­lax­ation meth­ods for al­le­vi­at­ing nau­sea and vom­it­ing is mas­sage ther­apy that brings the best re­sults with­out any side ef­fects. It also has de­sir­able men­tal ef­fects on pa­tients’ health.

But re­mem­ber that none of these sug­ges­tions should be fol­lowed be­fore a thor­ough med­i­cal ex­am­i­na­tion is per­formed. Nau­sea could hide a se­ri­ous med­i­cal prob­lem, and this should be con­sid­ered and ruled out. ■

Cyn­thia Greer/MCT Di­rect)

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