Signs and symptoms

The common wart is a rough, raised growth that ranges in size from 3 to 25 millimeters and occurs anywhere on the skin. A juvenile wart is a small, smooth, pinkish wart that is common on the hands. Warts on the soles of the feet are plantar warts. They may be pressed into the foot (sometimes to a depth of 6 millimeters or more) and are often surrounded by a callus. Groups of plantar warts are known as “mosaic warts.” Many warts are unmistakable, but some are not. When they are tiny, plantar warts may be mistaken for small brown splinters on the sole of the foot. Also you may not be able to see them if they’re surrounded by a callus.

Home care

Leave warts alone. If they have to be removed, it is probably safest to have a doctor do it or instruct you in the use of an appropriate ointment. Usually, treatment must continue for many days or weeks.

Precautions

• If excessive pain or redness occurs on the surrounding skin, stop treatment.

• Do not treat any warts on the face or eyelids at home.

• Warts that involve the cuticles or extend under the nails should not be treated at home.

Medical treatment

No treatment is successful in all cases. Treatment may even spread warts or they may recur following treatment. In general, your doctor will remove warts with acids, podophyllin, electric cauterization (burning away), surgery (curetting), liquid nitrogen, solid carbon dioxide, or phenol.

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Every baby is different.

One thing that is easy to forget is how tiny even the healthiest, heftiest baby really is. A newborn usually is only 45 to 55 centimeters long, stretched out. And very young babies often keep their legs in the pre-birth, folded-up position for several months, which makes the baby seem even smaller. The baby was in that position for many months before birth, and it takes a while to get used to an uncramped environment.

Remember that at birth the baby has left a warm, dark, still, safe environment, been pushed through a narrow birth canal, and been suddenly thrust into light, noise, and a new degree of independence. It’s a difficult adjustment to make, even more difficult than the adjustment you must make as new parents.

There are some other things about a new baby’s appearance that may worry you if you’re not prepared. It is perfectly normal for a newborn baby to be:

• born with a bluish tinge to the skin, which soon turns to pinkish-red;

• born with a slightly lopsided head;

• born with soft spots, called “fontanelles,” above the forehead and at the top of the head.

It is also quite common for a new baby to have jaundice, which gives a yellowish color to the skin and the whites of the eyes. Also, at birth the baby still has a lot of growing and developing to do. Many bones are still unformed; they are made of tough, elastic tissue called cartilage that will gradually harden into bone. The legs are often bowed, and shorter than you’d expect when you compare them to the arms. The head may seem too big for the body. The baby’s face may seem abnormally plump in the cheeks and flat in the nose. The eyes will not move together well and may seem to be crossed. The genitals, especially on a baby boy, may seem abnormally large.

In a few months, the baby will begin to look more like an individual. Movements of limbs, eyes, and neck will become more controlled as muscles develop, and the face will become more alert and expressive.

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I have heard that common childhood infections can be more dangerous for children with diabetes. Is this so?

No. It is probable that your child will have the usual childhood infections, and that he will become sick in the same way as other children. The main problem that you may encounter is the need to adjust the insulin dose during infection; usually a child’s insulin requirement increases when he is sick. Your doctor will tell you how to do this, and you will be guided by the blood glucose and urine ketones. Be sure to adjust the insulin dose back towards its previous level as soon as the illness is over and the blood tests are normal.

Also during an illness it is likely your child may lose his appetite. It will then be necessary to replace his ordinary meals with emergency fluids and other replacements for the carbohydrate part of his diet. You should consult the dietary section for details.

I want my child to have as good an education as possible, but he wants to leave school early and start earning. Should the fact that he has diabetes influence his decision?

It is always hard to generalize on such an important subject as a career or life occupation for a child. However we should realize that in the long run training and skills gained from education can lead to more interesting and better paid jobs with greater security. A child who is tempted to leave school because he is impatient to be earning may find he is worse off as an adult because of lack of education for advancement and promotion. Having diabetes may make the problem more difficult as he may require time off for illnesses as he gets older; security in one’s occupation is important for a person with diabetes in later life. Certainly skills may be learnt on the job and leaving school to become apprenticed may well be the correct decision for your child. Having diabetes should not affect this.

At all events it is wise to discuss the very important business of employment very fully with your child and perhaps discuss it with his schoolteacher and with his doctor. Sometimes it is helpful to have an interview with a vocational guidance officer who will assess both your child’s abilities and his inclinations. He can then make recommendations and suggestions about the type of work for which he is most likely to be suited, and the best way to become trained for it.

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