Interpreter of Maladies

Dr. Nighat Ara, Psychiatrist

Q. After my father passed away, we shifted to my mother's we are on the 5th floor and she is on the 3rd. My child had lots of friends in the previous place but here she is all alone. Recently she has become very moody, and we are always fighting, few days back I was so angry I was really mean to her I slapped her very hard on the buttock few times and shook her hard. I know I did a wrong thing but I am also going through such stress and traumas. Please tell me how to handle my present situation and how to be friends with my only child.

A: You are still grieving the death of your father and it takes few months (usually around six months to one year) before a grieving person can internalise the image of the lost person and returns to normal daily activities. Moving to a new place is an additional stress and any change can actually make life a little bit chaotic. As time passes by, people get adjusted to new people and places gradually and life falls into a routine. Eventually life gets more stabilised. It seems to me that you are displacing your stress feelings on your daughter and with minor irritations losing control over your behaviour. It happens when one is not managing the stress feelings well enough. It is always easy to blame others (externalising) for our feelings and behaviour. However, excessive vulnerability could be related to other past and current issues of life too. Stress management capacity can be increased by cognitive behaviour therapy. Some steps in stress management are as follows- a) change the situation (e.g. leaving the spot or distract yourself to something else). Tell your daughter that you need time out for your sanity. Create distance unless you know you have control over your behaviour. b) Change how you react to the situation (e.g. what upsets you so much? what is in your daughter that makes you so intolerant?) A six-year-old girl is moody, is it all? If you lose temper that would be a bad role model for her and she will learn violence. Just telling her that you don't like what she is doing could be enough to communicate your disapproval. Spanking is sometimes used as a punishment method but shaking her could be quite dangerous. Explore other benign ways of discouraging her behaviour. c) Change how you look at the situation (e.g. reframe your perception. your daughter is misbehaving. So, you don't approve the behaviour but don't you love her as a person? Separate the person and her behaviour). She sometimes behaves badly but that is not all about her. Childhood physical and emotional abuse by parents can lead to serious mental health problems in later life. Relaxation practice, adequate self-care and sharing responsibility (participation from your husband is essential for proper parenting)- all these are important for improving stress management capacity. No parent is a perfect parent. Children can survive well despite lot of mistakes made by their parents. Communication problem between mother and daughter can be overcome by spending more time together in good mood, listening to her attentively and expressing love by hugging and caring. Involve her in different activities (e.g. swimming, art etc), boredom makes children restless. Encourage and appreciate her for participating in chores and spend some playful time together. Nothing will change instantly, believe that for every positive action results will follow eventually. Anxiety feeling in the parent is easily transmitted into the children, they act out to draw attention to their discomfort level. The more you gain control over yourself, children follow the course and situation gets better. Professional help and structured support is particularly important in case of single parenting.

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. Dear Dr. Mahfuj
I am a 42 years old male. I have five root canal treated teeth which has been done three years back and was advised for capping by my Dentist. Anyway, I was very reluctant to do this cap as there was no pain and other complains. But unfortunately last week one of my root canal treated teeth was fractured during biting simple biscuit. What to do now? Is it still possible to make a cap on that fractured tooth?
Ashfaque Dhanmondi

A. Dear Ashfaque
Well, your dentist gave you correct decision about making crown (Cap) of those root filled teeth three years back. Actually after root canal treatment tooth structure become very brittle and discolor. To restore the normal structure/anatomy, to protect possible fracture and to rebuild normal functions, we strongly recommend crowning/cap after root canal treatment. Without examining your teeth, it will be difficult job for me to give you correct decision whether it is possible to cover your fractured teeth by a cap or not. But if your root is healthy even after you loose your entire crown and if you don't have any pain complain , then it is still possible to restore your valuable teeth by cast core technology (this is a relatively new technology in Bangladesh). I think you should immediately consult with your dentist for his valuable opinion.

Q. Dear Doctor,
I can not drink cold water as it gives me a very abnormal sensation (a sort of pain) on my upper right jaw. Even I can not locate the exact teeth. I visited many dentist, but I am not satisfied with their explanation and line of treatment plan. Can you explain about abnormal sensation ? Why its happening?
Yakub Molla, Tutpara, Khulna

A. Dear Yakub Molla,
I will try to explain about the causes of abnormal sensation.
Abnormal sensation or Tooth Sensitivity

What is tooth sensitivity?
It can be defined as a painful reaction in one or more teeth triggered by hot, cold, sweet, or sour foods and drinks. This pain can be sharp, sudden and shoot deep into the nerve endings of your teeth.

Apart from a cavity or a missing filling, the most common cause of tooth sensitivity is exposed dentin on the roots of your teeth. Normally, the dentin (the second, more sensitive layer of the tooth) is surrounded and protected by your enamel, cementum(special root covering) and gums. The cause or mechanism of dentinal sensitivity is still not well understood. It is believed that the little tubes that connect the dentin to the nerve or pulp serve as sensory conductors. That sensation may be one of pain. OUCH!!!

Causes of exposed root surfaces, which may result in dentinal sensitivity:
· Brushing too hard - Over a period of time, brushing too hard or using a hard-bristled toothbrush may wear away enamel or cementum and cause the dentin to be exposed.
· Recession of the gums - Movement of gums away from the tooth due to periodontal disease will expose the root surface.
· Gum disease - Inflamed and sore gum tissue may also cause sensitivity due to the loss of supporting ligaments which exposes root surface.

Other causes of sensitive teeth:
· Cracked teeth - Chipped or broken teeth may fill up with bacteria from plaque and enter the pulp causing an inflammatory reaction.
· Grinding your teeth - Grinding or clenching your teeth may wear down the enamel and expose underlying dentin.
· Plaque- The presence of plaque on the root surfaces can cause sensitivity.

What to do at home:
· Maintain good oral hygiene - Continue to clean all parts of your teeth and mouth thoroughly.
· Use a soft bristled toothbrush -This will result in less toothbrush abrasion of the tooth surface.
· Use desensitizing toothpaste - There are many on the market. With regular use you should feel a decreased sensitivity.
· Consider what you eat- If you frequently eat foods high in acids, such as citrus fruits (example: sucking on lemons), they can gradually dissolve the enamel over time, leading to dentin exposure. The citric acids may aggravate the hypersensitivity and initiate a painful reaction.
· Use fluoridated dental products - As an example, with a daily application of a fluoridated mouthrinse, hypersensitivity usually decreases.

Professional Care:
Ask your oral health professional, about professional products that may be used to help reduce sensitivity. Some of the most common treatments are:
· white fillings (Glass inomer or composite filling) to cover exposed root surfaces.
· fluoride varnish applied to the exposed root surface.
· dentin sealer applied to the exposed root surface.
You don't have to suffer with sensitivity after this.

BY THE WAY

Who do you want to be?

Think carefully about the question first. Who do you actually want to be? Go through the ideal and real images and then build a bridge between the two. A compromise between aspiration and reality is the alchemy, which fabricates personal style. Sometimes finding your unique charms involves ignoring others' well-meaning advice. If you want to flip your image everyday, then don't forget to experiment with it. There is plenty of time for fashion uniforms later.

 

UNDER A DIFFERENT SKY

Lost in Translation

After making fifty different gestures and expressions and desperately struggling to speak a few words of Spanish, I gave up. He looked at me like he was almost entertained, he felt sorry for me I guess. But he still looked clueless and I was misunderstood as usual, lost in translation.

The story is simple, it was a rare occasion when I stayed late at work and lost track of time. Usually I am out by 5:30 pm sharp but that day I was consumed. All my colleagues had left one by one, after a couple of hours I was ready to go myself when I heard the cleaning crew getting their odds and ends out to vacuum and neat-up the place.

When I started working at this place, along with thousands of paper works to fill out some speech was also given to me about making sure to lock up the place if I am ever the last one to leave, and I couldn't quite remember the consequences of not following that rule. I was definitely not going to find out as it probably wouldn't be anything rewarding.

So that's how the conversation (lack off) started, me walking up the cleaning man, a male in his early 20s, big glasses, square broad face, he looked Bengali almost, in the Mexican sort of way. I was trying to ask him if he can lock the door behind him after he leaves, a simple question, with a known answer. I knew he had the keys, he is Mr. cleaning man, he gets into suites and cleans up after-hours, so of course he had the keys, but I wanted to make sure, I didn't want to be in trouble for something this minute.

But I couldn't explain, frustrated I left, tracked down his supervisor whose English was just slightly better and he assured me they would lock the door behind them. I went home an hour later, thinking about not the security of my work place but the security of the cleaning man, about the ground he stands on, how shaky and unknown it must be for him.

Sure Spanish is the second most spoken language in America but with the lack of spoken and written English you are sure to be stuck in one circular social status in USA. The first generation Spanish workers cleaning American bathrooms and carpets, washing dishes or doing construction work making roads they will not drive a fancy car on, or building houses which they will never be able to afford. It struck me as an under-rated tragedy of Spanish immigrants of certain education and social levels.

I was thinking maybe I should offer our cleaning man some options, I thought about picking up brochures for him for night school, free ESL (English as Second Language) classes, I felt like it was not fair for him to go through the rest of his life dusting desk tops and collecting trash.

Then I thought about each time I had bumped into a first generation Bangladeshi immigrant working in an odd job, how I had silently laughed about the way they pronounced certain English words, (i.e. furking (parking), beep (beef)) about how their broken English made me discomfited, they seemed so uncouth and raw, I walked away criticizing them and their poor English and the way they failed to adapt.

I thought hard if I had ever seen a Bangladeshi male or female working for a cleaning company, and couldn't recall any. It's easily understandable the way a person with a decent background can feel cleaning toilets for living… I know it hurts many Bangladeshis egos already to be taxi or bus drivers leaving their much higher in aesthetic value jobs in Bangladesh…

For the first time I felt proud of the first generation Bangladeshis and their thick accents. Even though they can not speak English properly or speak it with a miserable accent, they still endeavor and they continue learning. There are a few Bangladeshi immigrants who with their slurred accents started working at McDonalds and eventually with hard work and high goals became owners of popular franchises and restaurants. Success stories of embarrassingly bad English speaking Bangladeshi immigrants, untold and hidden under their twisted heavy treacherous tongues with poor pronunciations.

The next day I printed out brochures for English lesson classes and gave it to the much deserving Cleaning man, I do not know if he will take the lessons but I will feel an ounce of satisfaction that I tried. And for all the Bangladeshi immigrants with thick diacritical marks surviving everyday with undeserved mockery and in economical and social traps, I am not sure if you will get to read this column, but I am out there along with a few others like me, carrying around brochures for adult education and free ESL lessons, if you don't find me, I will find you…

 

By Iffat Nawaz
*You can contact the writer by emailing nituta@hotmail.com