BLEEDING DISORDERS; BOW LEGS

Blood clotting, which seems such a simple process is so complicated that some doctors have trouble remembering the exact mechanics.

Two or three routine laboratory tests can now identify most children with bleeding disorders.

Bow legs, usually associated with in-toeing, are so common as to be almost normal in a child under two.

It is often incorrectly thought that bow legs are due to the nappy forcing the baby’s legs apart.

Bowing occurs in the tibia, the main bone of the lower leg, not in the femur or thigh bone.

The cause is unknown but many doctors believe it is due to a baby’s habit of sleeping in the “knee-chest” position, that is, on his face, with his knees tucked under him and his feet turned inwards.

Most babies stop sleeping this way at around 18 months and so the condition corrects itself. However, if the bowing persists, correction may be achieved by strapping the legs together to alter the child’s sleeping posture.

In-toeing can occur when the baby sits on the floor with his knees turned in or when he sleeps on his face with his feet turned in.

There is no functional impairment from in-toeing, so correction is done only on cosmetic grounds. One way to help is to encourage the child to sit crosslegged on the floor and to avoid the other posture.

Out-toeing may be caused by sitting on the knees but with the feet turned in. Treatment is the same for in-toeing.

*14/71/1*

YOUR CANCER YOUR LIFE – RIGHT TO TREATMENT BY EXPERIENCED PRACTITIONERS (EXAMLE)

Every year, medical diagnosis and treatment become more and more complicated. No one doctor can possibly know everything about the diagnosis and treatment of cancer.-For this reason doctors specialise. Whenever you consider having any specialised diagnostic or treatment method you have the right to insist on referral to someone who is qualified and experienced in the use of that method.

For example, say you have a shadow in your lung which looks like cancer. You may be advised that, to make a diagnosis, a specimen must be taken with a needle passed through the skin and lung guided by X-rays. Make sure this is done by someone who has had plenty of experience with the method. An experienced person is more likely to succeed in getting a good specimen without puncturing your lung or causing undue pain.

You may have a cancer of the lower bowel and be advised to have this removed, leaving you with a colostomy (bowel ending in an opening on the abdominal wall). Ask to be referred to a surgeon who has done a lot of these operations. A well placed and well constructed colostomy is quite easy to look after, a poorly placed and badly constructed colostomy is a nightmare.

*23/40/1*