Interpreter of Maladies

Dr. Nighat Ara, Psychiatrist

Q: Dear doctor, I love to shop, I mean since my teen years I've been shopping crazy with my pocket money or whatever I earned doing odd jobs. Now with a stable job and everything I am still shopping, as a result my savings are zero. So my husband with whom I run our house on joint finances decided that all the savings would be his responsibility. Lately I've been picking his money and spending our savings as well. And very naturally I had a fight with my husband. I just want to know if this spending is a sign of me being sick or what, please can you sort this one for me?

Ans: Excessive shopping is similar to any kind of addiction disease. The underlying pathology is the irresistible urge (obsessive thought) and a compulsive behavior despite the negative consequences (risking marital discord, pick pocketing). It appears that you are aware of this compulsive urge and feel helpless to control it. Deep down repressed or suppressed memory, stress in life or a mood disorder can give rise to this kind of self-defeating behavior. Feeling fragile and vulnerable to powerful emotions, instead of dealing with it people sometimes try to cope with a dysfunctional behavior. Transient relief may occur initially though in the long run it causes more damage in other aspects of life like relationships, reputation, marriage, finance, self-esteem etc. Take active step to change this self-defeating pattern of behavior by using healthier coping skills. Journaling your own thoughts and feelings can give you a clue. Monitor your response to stress, remind yourself of the consequences, avoid keeping money in hand or within reach etc can be some of the self-help techniques. If there is fear of getting things out of hand please seek professional help.

Q: My daughter is very quite while all her friends are chirpy. As a result, in school is she mostly bullied by the others. How can I help her? She is a very friendly person once she settles in and at home she is ok and very happy. However she is also happy at school, just that she doesn't speak her mind while others do.

Ans: Your daughter seems to be quiet by nature. You didn't indicate any other problems relating to her. If someone bullies her in the school for not being chirpy, I guess the bully needs to be confronted. I don't see any reason why she has to change her quiet nature just to please others! If everybody becomes chirpy, imagine how chaotic the world will be!! A quiet person can be a good listener, thinker and may have many other qualities that a chirpy person cannot share. We all are different from each other and that makes us unique. Those who do not allow her to be comfortable in her own space are actually showing aggressive behavior and need to be corrected. Your daughter needs to be assertive in dealing with aggressive people, which means she must stand up for who she is. You can talk to her and allow her to ventilate her anxieties and worries. Inform the school authority about the bullies (take precautions about the possible consequences), take support from other friends who understand her better and also from other victims in the class. Do not ignore the fact that she is suffering and it can cause long term damage to her mental health.

Dental wise

Dr. Mahfujul Haq Khan BDS, DDS(Dhaka), PhD(Japan) Oral & Dental surgeon BIRDEM Hospital

Q: My 18 months old daughter is quiet healthy and happy in respect to all norms of growth for a baby her age except in case of her teeth. A month ago one of her lower incisors has appeared and there is no sign of any other teeth up till now. We would like to know how long it takes for a child to get all the '' milk teeth''. Does she need any special treatment for this problem?

A: Sometimes it takes longer time than usual milk teeth eruption schedule. It takes about 24 months for a child to get all the milk teeth. I think there is nothing to be worried about her milk teeth as her lower incisor has already appeared. Please give her teether to bite and I strongly suggest you to consult with your dental surgeon. Your Dental surgeon may advice for a special type of X-ray (OPG) to reveal her future successor.

Q: What is a Composite resin (white filling) and what are the advantages and disadvantages of composite? How long will composites last?

A: A composite resins is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used for restoring decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

Advantages: aesthetics are the main advantage, since dentists can blend shades to create a color nearly identical to that of the actual tooth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes.

Disadvantages: Along with the higher cost and the extra placement time, the patient can experience post-operative sensitivity. Also, the shade of the composite can change slightly if the patient drinks tea, coffee or other staining foods. The dentist can put a clear plastic coating over the composite to prevent the color from changing if a patient is particularly concerned about tooth color. Another drawback: composites tend to wear out sooner than silver fillings in larger cavities, although they hold up just as well in small cavities.

Studies have shown that composites last 7-10 years, which is comparable to silver fillings except in very large restorations, where silver fillings last much longer than composites.

Q: What Can Gum Disease Mean For A Diabetic?

A: Diabetics are known to have a decreased response to dental healing. Gingivitis is an infection within the gums caused by bacteria found in plaque. A diabetic's body doesn't respond as quickly to fight this type of infection as that of a non-diabetic. If the infection persists it can become worse leading to the infection of underlying bone that anchors the teeth in place. It has been shown that diabetics who keep their condition under control have a better chance of combating infections that those who are poorly controlled. In addition to controlling the condition of diabetes, the importance of maintaining good oral health is essential. Brushing and flossing help to reduce plaque and bacteria that cause infection and thereby decrease the risk of gum disease

Q: What are dental implants? Will I be able to chew and function normally? What are implants made of?

A: Dental implants are basically sophisticated screws made of a medically pure metal, Titanium. These screws are then placed in the jawbone and rest under the gum for 3 - 6 months. During this time they actually fuse to the jawbone and become osseo(bone)integrated. After the appropriate healing time, we uncover the implants and use them to replace one or more missing teeth by fabricating some sort of dental prosthesis. They allow you to function more normally than conventional dentures or bridges.

Yes. Once your implants have integrated, you will be able to function normally without any unusual sensations. Your chewing ability will really depend upon the type of prosthesis you have chosen.

Implants are made of commercially and medically pure Titanium. This is the same metal that has been successfully used in hip implants for many years. It is inert and is not known to cause any type of rejection phenomenon.

 

 

Under A Different Sky

Veils and Heels

“Wisconsin and M Street," I yell out hurriedly getting my ends together while shutting the door of the yellow cab that I jumped into. I get situated fixing my gray business skirt and sleeveless top that I have purchased with deep admiration for some Italian designer who knows how to highlight a woman's assets and hide the parts that's better not shown.

I was showing off my shaved bare legs and shoulder that I have worked out to make rounder, when all of a sudden my eyes hit the back of the head of my taxi driver. He wore a white embroidered cap, the ones men wear to say their prayers. He also had on a long white gown, a familiar costume representing Muslim Holiness worn mostly by Imams and Moulvis.

He had a long beard, black rimmed thick glasses and smelled strongly of Atar, the strong rose scented perfume again popular among the strict Muslim figures. I froze, my shaved legs felt more naked than a newborn's buttocks. The roundness of my shoulders was now two sore awkward bumps. I could hear my heart sinking while being hit by embarrassment and shame. I remembered the gentleman from my childhood who I referred to as "Hujur" who dressed very similarly and came to our house between 9-10:00 A.M to give me Koran lessons. I grew so attached to him as though he were a part of our family. My four-year-old body would be wrapped around salwar kamiz with a veil on my head and feeling so pure and obedient. And look at me now.

In last twenty-some years my body has gained height, curves and muscles and I am sitting here wearing fewer clothes than I did as a child. I felt like jumping out of the moving cab to avoid this uncomfortable situation I have created in the middle of fake leather seats and locked doors. I cursed myself for being lazy and not just walking the twelve blocks to my destination, or not picking the right taxi with a foreign driver from a country that is no where near ours. I hoped he didn't speak to me. But he did. He asked softly where I was from. I lied. I said I was from India. And looked away quickly hoping for no more questions. But he asked again what my name was. I thought quickly of a name that sounds eastern and not necessarily Muslim, so I blurred out, "Nondini," "Sangeeta," "Sheila," I don't remember which one I used but one of them. He looked back to take a quick look at me and said "we are all from the same land, India, Pakistan, Bangladesh."

I didn't have the nerve to ask where he was from, so I let him go on talking. He said "Before the division we were all together, Pakistan, Bangladesh, India, all the same people, same identity."
Normally I reply to these kind of comments as "No we are not; these are different countries and have achieved their own identities and freedom, please recognize that!" But I said nothing today, which made me even more upset that my freedom to voice my opinion has been taken away by no one but me.

The embedded ideas of superficial purity from my childhood have now made me mute and pale, to match the gray of my short skirt. The taxi driver, disappointed with my silence, stopped talking. I could imagine the thoughts inside his head, "Ignorant, sell out, Bimbo." I thought better a Bimbo than a believer acting as non. The ten blocks finally ended, gave a halt of my endless journey, I gave him a few more dollars extra than needed and almost ran out of the cab. I didn't look back and walked as fast as I could in my high heels. I stopped only after I knew he was no longer around.

I felt a sudden rush of despair climbing up my chest and choking my throat. How the sweet memories of childhood and the imposed right and wrong haunts you down even when no one is judging.

I caught a glimpse of my reflection on a glass window, looked hard into my eyes then into my soul to help me balance the new appropriate and the old improper.

By Iffat Nawaz