Health related information and news from around the world.

The day of the review

On the day of the review it is essential that there is no risk of hypoglycemia and also that your blood glucose is not very high. Make sure that the examiner is told in advance that you may need to check your blood glucose level before, during or after the review and that you must have food and drink available during the examination. It is sensible to run your blood glucose around 7 or 8 mmol/1 (126 or 144 mg/dl) rather than 4 mmol/1 (72 mg/dl). You should take your blood testing kit, cans or containers of fruit juice, biscuits or crackers, glucose tablets or candies and tissues into the assessment with you. Make sure that you check your blood glucose before you go into the examination, and eat something if it is low. If yоu do, wipe your fingers – a sticky paper could lose you marks! Do not panic if your blood glucose level is higher than you would like – it is not a disaster and you will not fail because of it! Just think afterwards what you could have done to achieve better glucose control so that you can learn for the next time.

School trips

In the old days pupils with diabetes were sometimes left behind when the rest of the class went off on a school trip because the teachers were afraid that they would not be able to cope if something went wrong. This made the diabetic pupils feel very left out. Nowadays they should be able to share in all class activities. There is no problem if you can measure your blood glucose level and adjust your own insulin and food, and if the supervisors are all told how to recognize and treat a hypoglycemic episode.

For younger pupils or inexperienced diabetic teenagers, the teachers need to be given more information about coping with the diabetes. If parents are asked to help with the trip, your mother or father could come along. Supervisors may feel happier if they have a telephone number to call in an emergency, although few will have to use it.

Planning

The first thing to do on hearing of a school trip is to find out exactly what is planned and for how long you will be away. Then work out how much food you will need and add some extra snacks for extra energy and an extra meal in case of delays. Take your insulin and blood testing kit and some money. Of course, you will be carrying glucose tablets and some form of identity card, locket or bracelet.

*44/102/5*

Miscarriage

When the fetus is developing in the early stages, there is always the possibility of miscarriage or abortion. Sometimes this is not noticed by the mother-to-be as the developing fetus may miscarry at the time of the next period which may be just a little heavier than normal.

Vitamin E may prevent miscarriage. There is reasonable evidence that vitamin E may prevent habitual or recurring miscarriages. Vitamin E given to expectant mothers who had a history of miscarriages has been shown to reduce the incidence of miscarriage. Do not eat potatoes if they have any green spots as they may contain solanine. This is a poisonous narcotic alkaloid that can cause miscarriage.

Morning sickness

There is some evidence that vitamin B6 (pyridoxine) may help relieve the symptoms of morning sickness. The symptoms of morning sickness can include nausea and vomiting. Usually the amount of vitamin B6 contained in a good multi vitamin and mineral formula is sufficient to help relieve these symptoms. However, high doses of this vitamin should be avoided late in pregnancy as studies have shown that high doses of vitamin B6 may shut off breast milk. It must therefore be reduced before delivery in mothers who plan to breastfeed their new babies.

I have found that peppermint tea is helpful in relieving the symptoms of morning sickness. Drink one cup of peppermint tea and eat a piece of toast before getting out of bed in the morning and two more cups during the day. This will need the help of the father-to-be in the morning and he should remember that his duty to the unborn child started with conception. Another herb that I have found relieves morning sickness symptoms is ginger. Travel Calm Ginger is recommended. Take one tablet every 4 hours.

*12/199/5*

Nausea and vomiting have a number of causes, the most common being the drugs taken for complications of HIV infection. Drugs whose side effects include nausea and vomiting are: trimethoprim-sulfamethoxazole (Bactrim, Septra), pyrimethamine (Daraprim), ketoconazole (Nizoral), amphotericin B, pentamidine (Pentam), acyclovir (Zovirax), ganciclovir (DHPG), dapsone, and trimethoprim.

Usually the nausea and vomiting are dose-related, meaning that reducing the dose of the drug will reduce the nausea and vomiting. Or the drug can be taken at times that will not interfere with meals. Or, for many conditions, alternative drugs can be prescribed. Consultation with a physician will usually reveal which drug is likely to be the cause, which is expendable, which can be safely reduced in dose, and which can be safely substituted.

Some of the opportunistic infections—particularly infections that affect the head or the digestive system—can also cause nausea and vomiting. People who have nausea and vomiting, who are taking no medication, and who have additional symptoms such as fever or diarrhea should see their physicians.

In general, the person who has nausea or vomiting should eat small, frequent meals, and eat slowly. Avoid greasy, high-fat, and spicy foods. When symptoms are not severe, follow a soft and bland diet that is low in fat: rice, noodles, pasta, mashed potatoes, clear soups, jello, clear fruit juice, ginger ale, crackers, pretzels, tea, dry toast, oatmeal, boiled eggs. For breakfast, eat crackers, dry cereal, or dry toast. Cold meals that have little odor are often easier to eat than hot meals. When symptoms are severe, it is important to replace the liquids and electrolytes lost: try saltines, pretzels, clear fruit juices, ginger ale or colas, caffeine-free Gatorade, clear soups. All liquids should be clear—that is, they should not be thick liquids like vegetable juices, citrus juices, some fruit juices, or milk. Drink them between meals rather than during meals.

Many drugs reduce nausea and vomiting. Some can be given by suppository in the event that nothing is retained when taken by mouth. Such drugs should be timed to meals; take them as directed, but try taking the drug after eating meals. Some useful drugs do not require a prescription; these include Dramamine and Pepto-Bismol. Other drugs require a prescription: antihistamines (such as Phenergan, Haldol, or Vistaril) or phenothiazines (such as Compazine), which are drugs that also reduce anxiety. Most of these drugs cause drowsiness.

*127\191\2*