Men who take oestrogens also have their own special problems. These hormones can cause loss of interest in sex, impotence (inability to get an erection), decreased growth of facial hair, and enlargement of the breasts which can be painful. This last one can be prevented by giving the breast area a small dose of radiotherapy before starting your oestrogen treatment. Once it has developed, the only ways of getting rid of it are by stopping your oestrogen treatment or having your breasts removed surgically.
If you have unpleasant symptoms as a result of oestrogen treatments ask your doctors what the alternatives are. You may prefer a different form of hormone treatment or even to stop hormone treatment altogether.
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If the situation arises that you are unable to get to hospital and the birth of your new baby is imminent then it is important to have an idea what to do. I would suggest that you talk to your practitioner about this during your pregnancy.
If the pains are bearing down in nature and/or the waters have broken then the birth may be imminent and you should prepare for the birth. The following is a guide on how to deliver a baby in an emergency.
Call for an ambulance or medical aid
Then wash your hands and arms using soap, a nail brush and hot water.
You will need the following:
1.  Three clean sheets
2.  A sharp pair of sterilized scissors to cut the umbilical cord
3. Three lengths of string or cotton tape that have been boiled for a minimum of 10 minutes
4.  Clean towels
5.  Dettol or other antiseptic
6.  Some nappies to wrap baby in
7.  A light blanket to keep the mother warm after the birth
8.  A clean handkerchief or face mask
9.  Sterile cotton wool swabs
Preparing the delivery bed
The expectant mum will need a suitable place to lie. Prepare this using a clean sheet if possible, then under the mother starting from the waist, cover the sheet with plastic and extend all the way to the end of the sheet. A new, clean, opened up garbage bag will do. This should then be covered with an absorbent material. A few layers of opened up newspaper will suffice if you don’t have anything sterile. This must then be covered with another clean sheet. Wash your hands again and allow air-drying.
The mother should be placed on the prepared bed with the lower half of her body over the sheet covering the plastic area. She should be on her back with her knees drawn up. With each contraction she will want to push. The mother must be encouraged at this time to pant with her mouth open and not to hold her breath, and to bear down.
When the baby’s head first appears, apply firm but gentle pressure in a backwards and slightly upwards direction. This will help prevent the baby being born too quickly. As the head appears it should be facing down and will slowly turn to one side during the birth. The head needs to be supported and controlled through the whole delivery.
At this stage it can be seen if the umbilical cord is around the baby’s neck. If it is, then gently pull the loop of the umbilical cord over the baby’s head. If this cannot be carried out, then try to loosen the cord enough to allow the baby to pass through the loop at birth.
The next contraction should deliver the baby’s shoulders. Once the shoulders are born, then the rest of the baby will follow on the next contraction. In preparation for this, and during the next contraction, support the baby under the armpits and lift upwards towards mother’s abdomen. The baby is now born.
Baby will be covered with mucous and be very slippery.
Taking care, wrap the baby in a clean towel or nappy. With one hand hold both ankles. One ankle should be held between the index finger and the thumb. The other three fingers fold around the other ankle.
Baby should now be held upside down. Your other hand should be supporting the head and neck. This allows the fluid to drain from the airways (throat, nose and mouth). Use the cotton wool swabs to wipe away the blood and mucous from the baby’s nose, mouth and eyes. Remember that the umbilical cord is still attached to the placenta within the mother. Do not try to pull the cord out.
When the baby cries place it on the mother’s abdomen to nurse. The baby should be encouraged to suckle the breast. This will help in expelling the afterbirth: the third stage of labour.
Following the expulsion of the placenta, the umbilical cord can be cut, but only after it has stopped pulsating.
You will now need the three pieces of sterile string or tape and the scissors. Tie the first tape around the cord 10 cm (4 inches) from the baby’s navel. It is important that these tapes be tied firmly as failure to do so could result in the newborn baby bleeding from the cord. The next tie is located 15 cm (6 inches) from the navel and the third tie should be 20 cm (8 inches) from the navel. The cord may now be cut between the second and third ties; these are the ties farthest away from the baby.
The mother can now be washed and a sanitary napkin placed in position. Remember to retain the sanitary napkin and placenta for inspection by her practitioner. A cup of peppermint or chamomile tea and a rest are recommended.
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Many of the decisions you make about eating healthfully are made in the grocery store. With a little advance planning, you can select ingredients and prepared foods that fit into a heart-healthy life-style. Without planning, it is easy to slip back to your old way of eating or to stock up or imapulse buys.
These tips will help you make wise choices in the grocery store and also will make preparing meals easier.
Plan a week’s worth of menus and include the ingredients you need on your grocery list. When you plan menus and make the grocery list, keep in mind the six basic guidelines. You will probably need more fruits, vegetables, breads, and cereals than you previously bought. Foods you may have thought of as side dishes (such as pasta, rice, beans) will become more prominent on your list. Keep the smaller portion sizes in mind when buying meat. In the dairy department, look for low-fat or skim milk products.
Buy only those items on your list. Do not shop on an empty stomach. If you shop when you are hungry, you may be tempted to buy foods you don’t need.
Shop when you have time to read food labels.
If possible, buy fresh foods rather than mixes or ready-to-eat foods so that you can control what ingredients are added.
Shop the perimeter of the store. Many supermarkets place some of the most healthful foods (fresh fruits and vegetables, fresh meats, bread, and dairy products) on convenient perimeter aisles.
If you cannot resist the temptation of impulse buys, arrange for someone else to do your grocery shopping.
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