Let her know that periods are usually completely painless (no cramps) for the first year or longer, and that she should expect light or moderate bleeding for three to seven days in general. Ask her whether she prefers to use a sanitary pad or a tampon for her period, and show her how each method works. Your daughter may be interested in using tampons right away, especially if she is athletic, or wears tights, swimsuits or other close-fitting clothing.

Tampons are perfectly fine for girls to use from the first period, provided your daughter understands she should change the tampon at least three times daily, and should only use tampons that are clean and in undamaged wrappers. Toxic shock syndrome, an extremely rare but serious infection caused by the bacterium Staphylococcus, can occur with tampon use. However, millions of women have used billions of tampons over the past 50 years or more, without ill effects.

Once periods begin, they may or may not become regular and monthly right away. By two years after menarche, most girls have regular periods. Talk with your daughter’s pediatrician if her periods are quite irregular or unpredictable, if they routinely last longer than eight days, or are very heavy.

Girls often get a bit taller after menarche, but not much. A girl’s height is about 90 percent of her final height at the time she has her first period. The hormones that change her into a woman — estrogen and progesterone — also result in the completion of all bone growth. By age 14 or 15, or two years after menarche, almost all girls have reached their adult height. Teen-age girls usually gain about 10 to 15 pounds in the five years following the first period, mostly bone and muscle.

Your daughter can learn a lot from the expert in her own home who knows all about puberty and periods: her mother! Begin talking with her as soon as breast changes appear, at the latest.

Your daughter may have noticed changes occurring in other girls, and she will also pick up inaccurate information on the playground or the bus.

Browse your local bookstore or your public library for books on puberty and on sex education that you and your daughter can read together. Whatever book you choose, preview it yourself to be sure you are comfortable with the tone and the information.

And don’t forget, you are an expert. You’ll both be glad that you and she had these talks.

Sweat glands change in early puberty, too, and begin to produce sweat with an “adult” odor. Your daughter may notice the odor after playing competitive sports, after taking a test at school or in other stressful situations. I know a fifth grade teacher who sends a note home to all parents at the start of the school year asking that all students in the class use underarm deodorant!

During the next several years, girls experience rapid height and weight changes, and their appetites increase to provide them with enough nutrients for proper growth. You may notice that your once picky eater is now ravenous when she gets home from school, asks for more milk with supper, and is in the refrigerator constantly!

In the prepubescent years, girls grow about two to three inches and gain 4 to 8 pounds each year. But growth accelerates dramatically in puberty and usually peaks at age 11 or 12. That’s at least two years earlier than boys’ growth peaks, which is why sixth and seventh grade girls are often taller. At the peak of growth, which occurs in the year before the first period, girls grow three to five inches, and are likely to gain 15 to 20 pounds.

Pubic hair and darker, denser leg hair begin to appear within six to 12 months of breast development. For many black girls, pubic hair appears at about the same time as breast budding.

Underarm hair will appear a year or so later. Your daughter may appreciate advice about whether or not to remove underarm hair, and how to do it safely.

A girl’s first period is called menarche. Menarche occurs in the United States, on average, at age 12.5, about 2 to 2.5 years after the first breast changes appear — usually between age 10 and 16. Most girls experience menarche within a year of the age when their mothers and sisters experienced it.

Most clubs are a lot better prepared to deal with fitness than with fatness. Dealing with clients first about their fatness is like leading them through a minefield of self-loathing, past experiences of failure, defensiveness and resentment of you for calling their attention to it — any of which mines can destroy your business relationship. But fitness is quick to improve, and reduced fatness may follow.

Picking on fat upsets people as picking on fitness upsets some of us. San Francisco Chronicle columnist Scott Ostler may have been trying to even the score when he quipped: “Maybe 24 Hour Fitness is right; the aliens will eat the fat ones first. But when the creatures land and I run for my life, I hope to hell I’m not on a treadmill.”

We’re better off not giving clients a reason to get even.

Most of accidents happen at home or work so it is extremely important to be ready and to care for your friends, children, family. Choose appropriate, safe, reliable industrial first aid kits from a large variety of professional first aid resources.

In case you were on another planet in mid-February when protesters had their say on national TV and the wire services carried the news for several days, here’s the nutshell: 24 Hour Fitness introduced a billboard campaign showing an alien creature stalking the earth, with the warning, “When they come, they will eat the fat ones first.” In San Francisco, fat-advocate protesters picketed the club with some counter-insulting signs. The “Honk If You’re Fat” poster added noticeably to the downtown traffic noise according to an Associated Press report. The few members of the club who were interviewed didn’t have much good to say about the ad campaign, and one even joined the protesters for a while.

Not to miss an opportunity, competitor World Gym ran a sidewalk aerobics class with some large participants at the protest. As of a couple of hours before this writing, our local ABC TV news affiliate in San Diego said that 24 Hour Fitness is not going to take down the billboard; it’s just the opening piece in a “funny” sci-fi-themed ad campaign. Presumably, the campaign could roll out to the chain’s 284 clubs in the western states and overseas. From a cold-blooded adman’s perspective the free publicity has been worth more than the billboards.

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They found that vitamins C and E somehow prevented cancerous changes. They’re not sure how the vitamins work on the prostate cell, and it’s too early to make any recommendations on their use.

But other studies have found a great deal of evidence about vitamin E preventing heart disease. And researchers recently reported that taking vitamins C and E before a fatty meal may reduce the bad effects the fat could cause.

Most people can take the vitamins without experiencing side effects. Ask your doctor what’s right for you.

If you decide not to circumcise your son, there is no special care needed for the penis and foreskin until the foreskin is completely retractable, which occurs any time from 4 months to 5 years of age or later. Do not forcibly retract the foreskin — and don’t let anyone, not even your baby’s doctor, ever pull the foreskin back forcibly! Growth and maturation of the penis will result in the foreskin retracting easily with just gentle manipulation later in infancy or childhood.

When the boy is old enough to bathe himself, he can be taught to pull back the foreskin for gentle cleansing in the shower or bath, and for urination, if desired. But until then, the flow of urine under the foreskin, and a gentle swish of the penis in the bath, is enough to keep the penis and foreskin clean. If your baby’s doctor has had no experience with the intact foreskin, or disagrees with your decision not to circumcise, find a doctor who is experienced and who supports your wishes.

If you decide that your baby should be circumcised, I strongly encourage you to find a doctor who uses local anesthesia (a dorsal penile block or a subcutaneous ring block using novocain; or a local anesthetic cream). For the last 50 years, most infant circumcisions have been done without anesthesia, in the mistaken belief that newborns don’t feel pain (any mother knows how incorrect that idea is!) or that even if they do feel pain, it doesn’t matter all that much. I disagree.

No infant should be strapped down to endure the pain of skin being cut off his penis without anesthesia. No other comparable procedure for adults or children would ever be done without anesthesia.

So whatever your decision, you can be sure it is the right one for your baby — provided the circumcision is done skillfully and painlessly, and provided the uncircumcised penis is not hurt and scarred by unnecessary and painful forcible retraction of the foreskin. Schedule a prenatal visit with your baby’s doctor to discuss your plans, to get more information, and to be sure your doctor supports your plans. Make your decision with love, and then rest easy.

Than 25 years of pediatric practice, and the advice I’ve provided to thousands of parents.Widespread infant circumcision is a relatively recent phenomenon in our country. Prior to the 1930s, babies were often born at home, and infant boys were rarely circumcised except for religious reasons. The vast majority of young American solders in both World Wars were not circumcised.

After World War II, however, nearly all babies were born in hospitals, and for a number of societal and cultural reasons, it became almost a “standard” that baby boys were circumcised, often immediately after birth, even before the baby was placed in his mother’s arms. Two other important cultural changes occurred in our country in the 1940s: Mothers giving birth in hospitals often received anesthetics and were not awake as their babies were born; and bottle-feeding, rather than breast-feeding, became the way most babies were fed.

Since the 1960s and ’70s, there have been major cultural changes in the way we give birth and feed our infants: the movement for “natural childbirth” and improvements in pain control so that mothers are awake during childbirth, and a return to breast-feeding. It seems very appropriate to reconsider our country’s cultural attitudes toward infant circumcision, which until recent years was the most frequently performed surgery in the United States. Even today, infant circumcision in the United States costs about $200 million a year.

The American Academy of Pediatrics and other experts have stated that there are no medical reasons to recommend routine and universal newborn circumcision — and in fact, there are very few reasons to recommend circumcision for older children and adults. The old arguments in favor of circumcision have been disproved:

Circumcision doesn’t prevent sexually transmitted diseases, it doesn’t prevent cancer of the penis and it doesn’t prevent cancer of the cervix in wives.

Yes, there is a mildly increased chance that an uncircumcised boy will have a urinary tract infection in the first six months of life, but it is hard to justify universal circumcision on this basis alone — only 1 percent of uncircumcised baby boys develop a urinary tract infection. There is no justification, either, for removing the foreskin at birth in an effort to promote “cleanliness” — one could argue, in a ridiculous way, that removal of the toenails at birth would also result in improved cleanliness in children.

3.The tempo and complexity of doing our jobs, and even of living, is constantly on the increase. In the past six and a half years, the total accumulated knowledge in the world has doubled. Researchers believe that it will redouble again in the next five. In other words, this time pressure thing is not just for the next few years, but will actually be life long;

4. Increasing time pressures will call for more than a “gimmick solution. The answers to time pressures can only be found by re-examining our basic working principles. Many time management books, for example, say that if we are handling a piece of paper more than once, we are wasting our time;

5. The principle of overcoming time pressures is this: “TIME IS RELATED TO OUTPUT – INCREASE YOUR OUTPUT AND YOU WILL HAVE MORE TIME. This implies continuous quality improvement so we should strive to constantly improve the way we do our jobs;

6. The principle of increasing our output is this: OUTPUT IS RELATED TO REFINEMENT OF TECHNIQUE – AS YOU REFINE YOUR TECHNIQUES OF SELF-MANAGEMENT, YOU WILL INCREASE YOUR OUTPUT. Have you ever seen a jogger who is expending double the energy and running slower than someone with a smooth, relaxed technique? Getting some coaching will help because we are sometimes too close to our time pressures to be able to see how to change technique;

7. We live in a world where it is easy to get stuck and become calcified. We’ve been taught that if you’ve succeeded in the past and are up against a similar problem, adapt the old solution and try harder. The difficulty is, (see the book “If It Ain’t Broke, Break It”), that this is no longer working and we need to totally re-think how we do our jobs if we are to reduce time pressures.

Next month in this space we’ll take this further and look at how we can overcome our increasing time pressures successfully.

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There are several time management books published each year. Some offer you new and improved formulas for improving your use of time. Others tell of the need to change your whole life as the only effective method to control the stress of time. There are some basic principles that we can follow though without turning our lives upside down. The following are drawn primarily from the work of James McKay and Alan Lakein. They believe that we must first understand the meaning of time pressures, then learn to overcome them generally and specifically, finally creating a personalized plan to assist.

From their point of few let’s begin by looking at the meaning of time pressures. There are seven things we can examine:

1. To achieve or hold your position in the work force in this time of accelerated innovation, we need to spend part of each day in self-development. This may involve spending time on professional growth, like reading journals or may be in the form of personal growth, through things like exercise or meditation. To do these things we will need to be aware of our body clock and our learning styles so that the time we invest is productive;

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What to Look for:

itching or hives
flushed face or warm skin
dizziness

swollen face or tongue
nausea, vomiting or abdominal cramps
wheezing or difficulty breathing
increased heart rate
loss of consciousness
What to Do:

Call 911 immediately and try to keep the victim calm.
Check the victim’s ABCs: Lift the victim’s chin to open the airway, check his or her breathing capability and check for circulation (a pulse).
If the person is not breathing, or does not have a pulse or heartbeat, begin CPR.
If the person is breathing and has a pulse:

Lay the victim on his or her back, with feet elevated 12 inches.
Recheck the victim’s airway. If choking or vomiting begins, turn the head to one side so vomit will not block the airway.
Do not place a pillow under his or her head; a bend in the neck could block the airway.
If the victim is bleeding externally, apply pressure to the wound.
Loosen any tight clothing and cover the victim with a blanket (not electric), sheet or additional clothing; do not use any form of direct heat.
Do not give the victim anything to eat or drink.

Important note: Some people know they have severe allergic reactions and may have emergency supplies on hand. If so, help the person take the medicine, which may be a shot of epinephrine. Follow the instructions included with the medication.

Also, check for a medical bracelet or necklace on the victim; you might learn the source of the reaction.