A parent who has RA may find the adventure of childrearing especially challenging. For one thing, children require structure and routine, and it’s hard to maintain consistency when you have a condition that fluctuates. On good days you may not need help from your kids, or you may be able to participate in activities with them. On bad days you may require their help and understanding. Despite the unpredictable nature of your arthritis, you must try to be consistent in your interactions with your children and your response to them.
For example, if one week you say, “Jimmy, I want you to clean up your room. I don’t feel well,” and a week later, when you’re feeling better, you say “Jimmy, why don’t you go watch cartoons while I clean up your room?” it’s not going to take too long for Jimmy to realize that he will have to do more when you are feeling bad and will be rewarded when you feel well. It’s far better to separate Jimmy’s responsibilities from your physical condition: “Jimmy, you’re six years old now, and we think you’re big enough to clean your room each week.”
Erase from your mind any feelings of guilt you may have for not doing everything for your children. Guilt provides no positive direction and only allows your children to manipulate you. Redirect your energy toward teaching lessons in responsibility and independence which will last your children a lifetime. A final note: there’s nothing to prevent you from rewarding children for taking on new responsibilities. This is another real-life lesson because we frequently are rewarded for a job well done.
A second caution to parents is to avoid making a promise such as ‘We’ll do this if I feel well.” When something’s coming up which is important to the child, develop a backup plan. This may entail something as simple as making it okay for the other parent and the child to participate in the activity without you. If you are a single parent, think about asking the parents of your child’s friend to help out if you are feeling ill. Do not wait until the day of the occasion to make alternate plans, as this may leave you feeling trapped. Again, the goal is not to link your child’s hopes too closely to your level of health on a given day.
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Pneumococcal
Pneumococcal vaccine should be a routine immunization for all adults over the age of 65 years and for younger adults with chronic cardiopulmonary disease, anatomic or functional asplenia, cirrhosis, and diabetes mellitus. Since antibiotic-resistant strains of Streptococcus pneumoniae are being increasingly reported throughout the world and access to effective antibiotics may be limited while abroad, the pneumococcal vaccine should also be considered for travelers to developing countries.Influenza
In the United States, vaccination against influenza is routinely recommended for persons 65 years of age or older, for those with chronic cardiopulmonary conditions, and for persons who anticipate disease exposure. The influenza vaccine is also recommended for all international travelers during influenza season. While influenza typically occurs from November until March in the Northern Hemisphere, the incidence of the disease peaks from April until September in the Southern Hemisphere. Furthermore, influenza may occur at any time of year in the tropics. Practitioners should administer the most current vaccine available, since this is formulated on the recent epidemiology of the influenza virus.
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Apart from vaginal changes I have just discussed, there are few physiological reasons why getting older should erode a woman’s sex life. The studies suggest that the main problem for women is staying interested in sex. Here are some ways to keep desire aflame.
Inject novelty into marital lovemaking. Many long-married women lose interest in making love because they have fallen into a rut. They have intercourse at the same time and place and in the same way year after year. When sexuality becomes predictable, the most fiery passion turns ho-hum. One antidote is to vary the sex act itself. Have intercourse on the floor, in the bath, or in the woods. Experiment with a vibrator. Read erotic literature together. Role play each other’s fantasies.
Everything may not work out, but experimenting may help bring back some sexual spice.
Bring back your courtship. Your romance may need rekindling too. Go away for a romantic weekend with your husband. Surprise him with a candlelight dinner, served in a filmy nightgown. Seduce him!
Take care of yourself. Keep physically healthy. Exercise. Spend time on how you look. Maintaining sexual desire depends on feeling sexually desirable – taking pride in your appearance, keeping your passion for life. In some ways becoming an older beauty is easier, because as we age how we look is increasingly tied to what we do. While nature has a firm hand at twenty, at fifty nurture (work!) takes over an increasing share. The saying that after forty we get the face and body we deserve has its bright side. If we take action to be attractive, attractive we really can be.
Keep sexually active. It you have no current partner, buy a vibrator. Masturbate; develop a fantasy life. If you have a partner, take the initiative sometimes. Don’t always wait passively to be seduced. In their classic studies, Masters and Johnson were surprised to find that the three most sexually active older women they tested produced just as copious amounts of lubrication when aroused as the twenty-year-olds. So they concluded that sexual activity itself may even prevent the physiological losses thought to be inevitable. Staying sexually active seems as much a cure for “losing it” sexually for women as it is for men.*4/159/5*
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