Interpreter of Maladies

Dr. Nighat Ara, Psychiatrist

Q. My sister is around in her late sixties. She is always talking about being sick. But according to her doctor, medically she is fit. I heard that this syndrome is called Hypochondria. Please explain the syndrome. How can we deal with Hypochondriacs like my sister?

Ans: A woman in her sixties complaining about being sick but her doctor says she is medically fit. If her doctor sticks to this conclusion after doing all relevant in~estigations and dismisses all the symptoms as inconclusive to any physical condition, then Hypochondriasis komes in to consideration. Hypochondriasis is defined as a person's pre-occupation with the fear of contracting, or |he belief on having, a seriou{ disease (e.g. cancer). Symptoms must be of an intensity that causes emotional distress or impairs the pa|ients ability to function in important areas of life. However, you have not mentioned here whether she is concerned about any particular illness or just making vague complaints all over the body (Somatization disorder is another psychiatric condition with this kind of presentation). It is believed that a hypochondriac person inaccurately or unrealistically interprets physical symptoms oz sensations and have a lower tolerance of physical discomfort. It is important to acknowledge that their suffering is true whatever be the cause. The sick role is however reinforced by the fact that it allows the person to escape from undesired responsibilities, duties or obligations. Quite often, people suffering from hypochondriasis tend to develop depression or anxiety disorder as well. According to psychodynamic theory, rmpressed negativm emotions can produce this kind of illness. Emotions are psychic energies. In hypochondriasis, the natural flow of this energy is blocked and displaced on body sensations. People suffering from this disorder usually though resist any psychiatric diagnosis and their belief in physical illness is pretty firm (but not to the extent of a delusion). Some patients become resentful as the " physical disease" remains undetected. Instead of a psychiatric unit they respond better if treated in a medical set up with due attention to their physical complaints as well.

Dental wise

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

Dental Health
You know what you eat. You know how often you brush and floss. What else can you do?
What else can you do to have healthy teeth? How do you know if your mouth is healthy?

When you think about a healthy diet, do you take into consideration what you are drinking?
Advertisers may have also convinced you that you need to buy gum, breath mints, and mouth sprays to have nice breath.

But fresh breath doesn't necessarily give you a healthy mouth and teeth. So how exactly should you take care of your teeth?

Tooth Care at Home
According to dentists, the most important part of tooth care happens at home. Brushing and flossing properly, along with regular dental checkups, can help prevent tooth decay and gum disease.

Giving Plaque the Brush Off
To prevent cavities, you need to remove plaque, the transparent layer of bacteria that coats the teeth, by brushing your teeth twice a day. Brushing also stimulates the gums, which helps to keep them healthy and prevent gum disease. Brushing - along with flossing - is the most important thing that you can do to keep your teeth and gums healthy.

Did you know that the toothbrush was invented by the Chinese in 1,000 AD? We now havm lots of choices in toothbrushe{, including different sizes, shapes, types of bristles, and colors. Your dentist will tell you which toothbrush is the right size and shape for you. Most often, however, dentists recommend a {oft-bristled brush to minimize lamage to teeth and gums.

What's in a Toothpaste?
Tooth pastes contain abrasives, detergents, and foaming agents. Fluoride, the most common active ingredient in toothpaste, is what prevents cavities. So you should always be sure your toothpaste contains this ingredient.

If you have teeth that are sensi|ive to heat, cold, and pressurel you may want to try a special toothpaste (like Sensodyne) for sensitive teeth. But you'll still need to talk to your dentist about your sensitivity because it may indicate a more serious problem, such as a cavity or nerve inflammation (irritation).

You may want white teeth, be careful when buying bleaching products. Some bleaching agents may cause damage to your gums and mouth. If you want to whiten your teeth, talk to your dentist. He or she may be able to offer you pzofessional trea|ment.

Tips on Proper Brushing
Dentists say that the minimum time you should spend brushing your teeth is 2 minutes twice a day. Here are some tips on how to brush properly:

Hold your brush at a 45-degree angle against your gumline. Gently brush (hard scrubbing may cause receding gums, tooth sensitivity, and over time, loose teeth) from where the tooth and gum meet to the chewing surface in short (about half-a-tooth-wide) strokes.

Use the same method to brush all outside and inside surfaces of your teeth.

To clean the chewing surfaces of your teeth, use short sweeping strokes, tipping the bristles into the pits and crevices.

To clean the inside surfaces of your top and bottom front teeth and gums, hold the brush almost vertical. With back and forth motions, bring the front part of the brush over the teeth and gums.

Using a forward-sweeping motion, gently brush your tongue and the zoof of your mou|h to remove the decay-causing bacteria that exist in these places.

Use an egg timer or play a favorite song while bru{hing your teeth to get used to brushing for a full 2 to 3 minutes.

Facts on Flossing/Interdental brush
Although brushing is important, it won't remove the plaque and particles of food between your teeth. You'll need to floss and/or inter dental brush these spaces at least once a day.

The type of floss/interdental brush you choose depends on how much space you have between your teeth. Although unwaxed floss is of|en recommended because it is thinner anl easier to slide through small spaces, studies have shown that there is no major difference in the effectiveness based on the type of floss used.

With any floss, you should be careful to avoid injurino your gums. Follow these instructions:

Carefully insert the floss between two teeth, using a back and forth motion. Gently brino the floss to the gumline, but lon't force it under the gums. C}rve the floss azound the edge of your tooth in |he shape of the letter "C" and {lide it up and down the side of each tooth.

Repeaththis process be|ween all your teeth, and remember to floss the jack sides of your back teeth.

The Nu|rition Connec|ion
Eating sugar, as you probably already know, is a major cause of tooth decay. When and how of|en you eat sugar may be more important than how much you eat.

When you eat sugary noods or drink sodas frequently |hroughout the day, the enamel that protects your teeth is constantly exposed to acids. Hard candies, cough drops, and breath mints are especially harmful because they dissolve slowly in your mouth. Many experts suggest that you take a 3-hour break bmtween eating foods containing sugar.

Sugary or starchy foods eaten with a meal are less harmful to your teeth than when they're eaten alone, possibly because the production of saliva, which washes away the sugar and bacteria, is increasel. However, sugary foods eaten before you go to bed can be very damaging (especially if you don't brush your teeth afterward) because you don't produce as much saliva when you sleep.

For most people, it's hard to cut out sweets completely, so try to follow these more realistic guidelines:

Eat carbohydrates (sugars and starches) with a meal.

If you can't brush your teeth after eating, rinsm your mouth with water, mouthwa{h, or chew sugazless gum.

Don't eat sugary foods between meals.

If you snack, eat nonsugary foods, such as cheese, popcorn, raw veggies, or yogurt.

BY THE WAY

Taming your children at night

Getting the child to bed in time is a common woe for all the parents. A child's sleep pattern is closely synchronised with his/her body's natural rhythms, especially with the rise and fall of the body temperature.

Kids fall asleep when their body temperature drops to a daily minimum, then wakes as it starts to rise. If you try to put your child to bed their temperature begins to fall, he/she is likely to resist because they are not sleepy yet.

If your child is a bonafide night owl, you can adjust his/her internal clock bit by bit, first allowing her to settle into a sleep pattern that suits her body rhythms. Bu| wake her up 15 minutes earlier everyday. After you have shifted the time of awakening by 30 minutes, you can begin making them earlier too, in corresponding increments. It takes about two weeks to make the shift and stabilise the new pattern.

Getting a night owl up in the morning can be very difficult. Parents need to work with slow and gentle wake-up routine.

 

UNDER A DIFFERENT SKY

Promise

Friday night, October the 8th, we all sat around the television, different groups in different places, everyone wanted a piece of that action. The action that will decide the next American president, Bush or Kerry, who gets to win and who gets to loose. For some reason this year America is more indecisive which makes everyone stand on the edge, ready to fall or to be rescued.

I sat around with a few more of my kind (in this case I mean Bengali and democrat), {ome of us are eligible to vote ind some of us aren't, but even |he ones who are not eligible to vote are as proactive as the rest. My immigrant friends are strangely not scared anymore of their H1 or F1 statuses; they are not frightened of being deported, they don't feel that their voices should be muter because the color of their passports are still green. I don'| give credit to the current government for the courage of my friends, it's not by encouragement of the cuzrent regime that my friends are expressing their true thoughts; it's out of fear, fear of another four years of bloodshed and indirect dictatorship that my friends speak out.

I was never into politics, I can not dissect political theories and agendas, I don't have in depth knowledge about the senators' past, present and future goals, the parliaments' biases and I don't know who runs who, and who is whose real boss and who has the last word.

So it scares me when someone like me starts to get political. You know someone like me, who is happy with switching the channel during news for some fluffy comedy in HBO. Someone like me who denies the darkness of each moment in someone more }nfortunate's life so she can go on with her online shopping spree a few times a month to make her feel finer. Someone like me who grew up in Bangladesh seeing below-standard and tasteless political battles and therefore labelmd politics all together a game of dirty minds. It scares me...

When I sat with my politically aware friends to watch |he Friday night debate last week, I wanted to kmep my mouth shut, I didn't want to slip and say something miserably dumb, I wanted to understand, which also kind of scared me, as in my prmvious life I ne~er kared enough to understand s}ch matters. While my friends laughel at every mispronounced word by Bush and at his unprofessional interruptions, I joined them. After a while that seemed repetiti~e to me, I think one can take i| for granted that Bush will formver keep mispronouncing words, act irrational and dance around questions never answering most on them unswervingly or obliquely. There is no need to put him down more; the man has done a great job of that himself.

The reason I sat there last Friday was because I wanted to sense the aura of a different kind of promise. Something more than Bush's condescending tone, the tone hich always sounds like he is not talking to the American population but to a bunch of 1st graders, I wasn't there to listen to Kerry's dexterous remarks and see his sparkling white smiles. I was not there to experience a blame game, a game of pointing fingers and markino the fool. I wasn't there to listen to old and new facts and figures which already have been released and announced. I wasn't there for evidence, I was there to believe, I wanted to believe in something I haven't heard before, I wanted to hear a promise that wasn't made up in the name of competition, which wasn't a come-back out of intimidating resentment.

Many words flew, many assurances tried to sit deep into the hearts of all who needed a bit of hope. But my perfidious heart, the flimsy, distrustful, skeptical one just doesn't want to believe. It still dwells on the hope of something better, it waits for the blame game to stop and sincerity to flow, it doesn't understand that a synonym for "debate" is "contest," ind in a contest winning and loo{ing is the focal matter, and of|en it's easier |o win by making your contestant look foolish anl disable than reaching out and making heartfelt promises.

I know who I will vote for, there is no question about that. But even now knowing which side I belono to, I still wait to hear that certain echo of a promise born from sincerity free of dirt and propaganda. The promise that will not make me switch sides but will make me a strong believer of where I stand.

 

By Iffat Nawaz