Interpreter of Maladies

Dr. Nighat Ara, Psychiatrist

Q. I have a 16-year-old daughter. During the second pregnancy my wife had some complications and lost her child. She will not be able to conceive any more. All this has made my wife a little mentally stressful. She is always extremely worried about our only child that something might happen to her. She controls her in every move. Our daughter is a teenager now and beginning to want some freedom, which my wife is reluctant to give. Some times my wife becomes totally frantic about the issue. All this has deteriorated the relationship between my wife and daughter. I am always in the middle of everything. I can understand my wife's concern and I understand my daughter as well but cannot seem to help the situation make better. Please help me. How can I assure my wife and mediate between them.

Ans: Mother-daughter relationship is indeed a very critical one particularly when it concerns your only child. Difficulties in the present relationship could be related to your wife's childhood and upbringing, her age and life-style as well as to total family dynamics. It also seems to be an issue of self-esteem and stress management capacity of your wife. I believe, you are a sensitive, caring husband and as a socially conscious person you are probably aware of the fact that our social attitudes and values make women emotionally vulnerable at this stage of their life. Losing the childbearing capacity is very threatening for women whose sense of self-worth rests completely on this capacity. Lot of women, in and around menopause, suffer from depression. Fear of losing (as it is perceived, not necessarily true!) attractiveness and reproductive capacity make them feel less than who they are. Growing children asking for more space compounds this sense of loss. Women who were totally absorbed in the task of parenting find it difficult to withdraw them from the controlling care giver role and adjust to a supportive but less involved role of a mother of an adult child. The life-style and self-image that revolved totally around the child for so many years, now leaves them in an intolerable vacuum or emptiness. I guess, your wife needs to improve her self-esteem. If she can divert her focus and energy to other creative activities that would help her to build self-esteem, affirmations from you are also important in this respect. Relationships can go through ups and downs, teenagers occasionally experience mood swings and their behaviour sometimes become unacceptable. Both the parents need to share the task of disciplining their children. However, it is important not to allow these minor irritations to upset them too much or make the life too stressful. Exercise, good friends and relaxation are helpful ways to release the stress. Cognitive behaviour therapy is used to enable people to switch from negative thinking pattern to a positive one. "Control" seems to be an important issue for your wife, she requires some self-awareness to understand the origin and influence of this "need for control" in her life.

Dental wise

DR. Mahfujul Haq Khan BDS, DDS, FSDCE (USA), PhD (Japan), Post Doc. (Japan) Specialised: Crown and Bridge work, and Periodontal plastic surgery (USA) Senior Medical Officer, Department of Dentistry, BIRDEM Hospital

Q. I am a diabetic, age 53 years. I have several loose teeth with occasional pain. I know that it should be removed but because of my diabetes, my dentist in Chittagong suggested me to go Dhaka for the extraction for better treatment. So I am planning to come Dhaka for my Dental treatment as it gives me lot of trouble since long time. As you are in BIRDEM hospital, I want to consult with you regarding my treatment plan. I know before going to dental surgery my blood sugar should be controlled, but can you tell me the control sugar level for Dental surgery? Is it possible to get admission in BIRDEM hospital for my dental surgery? Which day and what time I can get your appointment for consultation?
Shanti Kumar

Ans. Dear Mr. Shanti Kumar
Your dentist in Chittagong gave you the correct decision by referring you to BIRDEM hospital. I am sorry to say that right now I am out of Bangladesh for my special training and you can consult with me at the end of February'2004. Your case, however, seems to me emergency. For your kind information, the dental department of BIRDEM hospital is very well equipped and our dental surgeons all are well trained to manage any kind of oral and dental complications of diabetic group. It will be wise decision to come BIRDEM hospital right now for your dental treatment.

Actually many factors contribute to the loss of teeth in someone who has diabetes. A poor healing response combined with gum disease and the destruction of bone anchoring the teeth in place may result in teeth that become loose and eventually fall out. Another important factor is, if someone don't go for regular scaling (professional cleaning by your Dentist). Infection is a risk for the diabetic patient and can make it more difficult to control blood glucose levels. If you are having teeth extraction, your dentist may prescribe antibiotics to minimise the risk of infection. To help the healing process, keep your blood glucose levels under control before, during and after surgery. It's very difficult to predict whether you need admission or not without examining you.

Q. Dear Dr. Mahfujul Haq Khan
I have few questions about crown. My dentist advised me for making several crowns and I am in dilemma about crown, would you please explain those? What are Crowns? How is a crown placed? Will it look natural? What is the difference between a cap and a crown? How long do crowns last? How should I take care of my crowns?
Shirin Akhter, Malibag Choudhury para

Ans. I believe your dentist can explain you more clearly by showing some model. Anyway still I will try my best to explain.

What are crown? A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. After root canal treatment we usually advice for crown. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to support a large filling when there isn't enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discoloured teeth.

How is a crown placed? To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of teeth and gums is made and sent to the lab for the crown fabrication. On the next visit cements the permanent crown onto the tooth.

Will it look natural? Yes. The dentist's main goal is to create crowns that look like natural teeth. That is why dentists take an impression. To achieve a certain look, a number of factors are considered, such as the colour, bite, shape, and length of your natural teeth. Any one of these factors alone can affect your appearance. If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

What is the difference between a cap and a crown? There is no difference between a cap and a crown.

How should I take care of my crowns? To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.

How long do crowns last? It depends on your care and from where you did. But usually 10 to 20 years.

 

UNDER A DIFFERENT SKY

"Security Bubbles"

She heard knocking in her door at 1 0' a.m. in the morning, first a few soft ones and then the calling bell buzzed repeatedly following loud pounding. Mrs. Nawaz lives alone, her son and daughter in different places being independent or dependent on others. She looked out the window to see who it was that needed her attention at this hour of the morning. She saw the dark image of a man in his 30's, covered in dirty baggy clothes, with scars on his face. She picked up her phone, dialled 911. In three minutes, the man was caught. The police stayed on the phone with her from the point she called to the point they showed up, all in the space of three minutes. The arrested man claimed he was searching for his mother's house and mistakenly knocked on this door. Mrs. Nawaz lost her night's sleep. She called her son, who came to her rescue a bit too late, but gave her company all night, both of them shaken by worry. The unknown motive of the man made him seem all the more dangerous.

Mrs. Nawaz's daughter was told of this incident two days later. By then my mother had installed security device in her house and started feeling a bit safer living there again. I was naturally upset and worried, but she assured me, things were better now. I told her how I hate the fact that she lives alone. I told her that maybe she should think about moving to Dhaka. Then she reminded me that the same thing could happen in Bangladesh, except the police might have taken longer than three minutes, and with prolonged time things would have been much worse. I understood.

After the 9/11 attack here in U.S.A we all wondered how we would be affected as Bangladeshi Americans. At that time I lived with a few other girls near the University of Maryland. My name and skin tone obviously categorises me with a certain group of people who were not very well received for obvious reasons at that particular time. My landlord wanting to make sure I am not a victim of hate-crime requested police watches on our house for the whole week. There was no harassment directed to me, I heard stories from others about hate crimes on East Asian Muslims which gave me the chills, and I was grateful even at that time that I resided in U.S.A not at any emotional and impulsive country where would be a definite riot if the same incidents as 9/11 occurred.

Here in U.S.A you will be surprised to discover the number of people who have issued restraining orders against an ex or a plain-old-stalker or in opposition to anyone who intended to invade their privacy. It is almost as though if you don't have a restraining order issued on one of your ex, you haven't had a proper relationship and dating history. The obsession of a certain person in one's personal life, the intention of physically hurting someone or just the possibility of it is enough to issue a restraining order. A restraining order usually means you can not go fifty feet near the individual who issued the order against you, you can not communicate with them via any form, and this order applies to both parties, the party who orders and the party who it is ordered against. Can you imagine if such a practice existed in Bangladesh how many of our acid victims would be walking with their old smiles and faces, not fearing what waits for them in the next street corner.

Here in U.S.A, cops can be called on you at any given instant. You are an inconsiderate neighbour, blasting your music and partying loudly, after a warning by your annoyed neighbour if you don't tone it down, the cops can be called on you and you might be left sorry with a big fat amount to pay. Or, you are a rude customer at a store, cursing and yelling about some deal not given or some missing service you excepted, the cops can be called on you the moment you crossed the line of decency.

I had two six year old cousins, terrors unleashed from hell, the only thing that calmed them down and made them sit still was if you picked up the phone and said "I am calling the cops on you." That phrase is actually the most efficient one I have learnt in the years I have spent in this country, the safety and the fear derived from that one phrase keeps us together under this different sky.

By Iffat Newaz