Director, Emergency Services, Bikur Cholim Hospital
Our readers ask: Children are starting school earlier and
earlier. Many are in day care and play groups at very tender
ages. Are there any psychological effects from this?
I can say I haven't seen any research on this, but I am sure
it is very individualized. Some children in some households
are encouraged to be very mature and we are not so sure it is
damaging. What is damaging — again this is only my
opinion — I believe that pushing a child ahead in
school who is not ready for it is very damaging. I also
believe that labels such as ADD and AHD are thrown around too
much.
The BMJ this week has found that older people will live
longer on the Mediterranean diet: high in fruits and
vegetables, salads and oils that are not saturated.
Are happier people healthier? Yes. Stress definitely causes
the release of harmful chemicals in the body and is a link
— albeit a weak one — to heart disease. Many
people who lead stressful lives also smoke or eat too
much.
Speaking of smoking, it does affect children worse than
adults. They may develop asthma from this and there is
evidence that pregnant women may even affect their unborn
children. Since science has discovered the dangers of
secondhand smoke, pregnant women should avoid their smoking
husbands as well.
By the way, while we are on the subject, many years ago
people thought that chewing tobacco was better than smoking
it. Perhaps there is less lung cancer, but it causes very
disfiguring cancers of the jaw, mouth, tongue and voicebox.
Another danger: children chewing on cigarette butts can get
acute nicotine poisoning.
I am asked on low blood salt. Blood sodium levels can reach
dangerously low levels and this is usually due to
medications, in particular, diuretics. But careful monitoring
can make these safe. Other causes are brain problems (stroke,
hormonal disorders such as SIADH), lung problems such as
pneumonia and cancer or kidney problems such as problems with
concentrating the urine. This may cause confusion especially
in the older person.
A simple blood count reveals the problem, and the treatment
is discontinuation of the medication and/or fluid
restriction. Sometimes a different diuretic is given to treat
the problem, as some diuretics cause more water wasting as
opposed to salt wasting in the urine.
Write me in care of the Yated.
A message from GlaxoSmithKline, sponsor of this
column. Lately in the pediatric literature, Phenergan
— commonly used for vomiting — is being attacked
as being unsafe. The safe alternative is Zofran, an effective
drug for the problem of vomiting.
