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Heat Overdressing babies aggravates eczema considerably. Once the skin warms up it can become quite itchy, and scratching it soon sets up an itch-scratch cycle. Children with eczema should be kept as cool as possible, especially if the skin is actively inflamed. It is best to keep clothing and bed clothes to a minimum and to turn off heaters overnight. As well, cool to tepid baths are preferable to hot baths.
Dryness Children with eczema tend to have dry skin with poor barrier function, which is easily irritated. The protective outer fatty layer of the skin is defective, so water evaporation occurs more easily. If children with eczema are exposed to further dryness from heaters, air-conditioners or excessive washing, their skin becomes even drier and so more irritable and itchy.In order to avoid excessive dryness heaters and air-conditioners should be turned off whenever possible, or a humidifier, which creates water vapour, should be used. Commercial humidifiers are available through chemists but you can create the same effect by placing a tray of water near the heating ducts. Steam is created as the water evaporates, which humidifies the atmosphere. The best room heaters are the Dimplex heating bars as they do not blow out dry heat.Children with eczema should have short, tepid baths containing a bath oil to help replace the deficient fatty layers of the skin. Examples include Alpha Keri Bath Oil, Aveeno Bath Oil, Hamilton’s Bath Oil and Q V Bath Oil. Normal soap should be avoided but moisturizing soaps such as Aveenobar, Dove and Oilatum bar can be used. After bathing the skin should he patted dry, rather than rubbed, and a non-perfumed moisturizing cream should be applied all over the body. Aquatain, E45 cream, QV cream, sorbolene cream and 10% glycerol in sorbolene cream are all good products. If the skin is excessively dry, a liquid and soft paraffin mixture works best. Urea-based creams should be avoided as they often cause stinging. Moisturizing creams which contain perfume, as many over-the-counter preparations do, should also be avoided as perfume is a major irritant to eczema skin.
Wool Wool is a major irritant to skin with eczema. All woolen clothing, woolen toys and sheepskin and lambs wool bed and pram covers are best kept well away from the skin. Woolen clothing may be worn over the top of cotton undergarments such as T-shirts and skivvies, as long as the wool does not come into direct contact with the skin. This can be a problem with school uniforms. To prevent eczema from flaring up, a long-sleeved cotton shirt should be worn inside the jumper or cotton sleeves sewn in under the woolen sleeves.Woolen carpets present a problem for babies at the crawling stage. Long, cotton trousers should be worn during this period.
Other clothing Synthetic fabrics, rough seams and labels often irritate skin with eczema. Children should wear soft, cotton clothes next to their skin. In addition, all seams should be soft and all labels removed. Nylon and other synthetic fabrics are best avoided.
Shoes With the increasing popularity of runners and jogging shoes, foot eczema is becoming very common. Runners do not allow the feet to breathe, causing sweat to irritate the soles of the feet. Children with eczema should therefore be encouraged to wear leather shoes and cotton socks as much as possible. Runners should only be worn for sporting activities.
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The person to whom you give a durable power of attorney for health care must be at least eighteen years old and willing to serve as your agent. Health care professionals—physicians and nurses who are involved in your care—are not usually considered appropriate.     The document assigning a durable power of attorney for health care generally contains the following: a statement that you are creating a durable power of attorney for your health care; the name of the person and any alternate person to whom you are giving durable power of attorney for health care; the conditions under which this document becomes effective; a statement of what authority you are granting this person; and a list of specific wishes. The durable power of attorney generally takes effect when two physicians, including the physician-of-record, certify that you are not capable of understanding or communicating decisions about your own health; it will apply as long as this condition continues.     This document can give the person with durable power of attorney the authority to withhold or withdraw any treatments or procedures—including mechanical ventilation (respirators or breathing machines), dialysis (artificial kidneys), antibiotics, operations—that sustain life. Medical treatment that would provide comfort or relieve pain is not included in a durable power of attorney for health care. The person to whom you give durable power of attorney may access your medical records and can place you in a nursing home. In the event of your death, the person to whom you give durable power of attorney can authorize an autopsy and can make decisions about your burial. The document assigning durable power of attorney can also include a section for any specific instructions you might have. For example, you could write, “In the event that I am in a coma, and have an incurable physical condition or lose my mental capacity, and have little hope of recovery, I do not wan treatment that will merely prolong my life.” You can also stipulate whether you do or do not want an autopsy and where you wish to be buried.     The document assigning durable power of attorney for health care must be dated and signed by you, by the person to whom you are giving durable power of attorney, and by two witnesses who are not interested parties. It is wise to have the document notarized by a notary public; some states may require this.     The original of the document assigning a durable power of attorney for health care should be kept by you or by your lawyer or by someone you trust. Copies of the document should be given to the person to whom you assign durable power of attorney, to any alternate person, and to members of your family. Your physician should know such a document exists; you may wish to consult your physician when drawing up the document.     Lawyers and hospital legal offices can provide examples of such documents that meet state laws.*215\191\2*

There are other forms of persistent DIMS that are not products of bad habits. Depression accounts for the greatest incidence of chronic insomnia attributable to psychiatric disorders. It has been called the “common cold of mental health.” Of course, a distinction must be drawn between clinical depression—a serious and sometimes debilitating condition—and sadness, which is a normal and transient reaction to unhappy experiences. The clinically depressed individual suffers a host of symptoms: anxiety, withdrawal from society, low energy, inability to function normally, loss of appetite and sexual drive. Often victims neglect their health and appearance. Physically they experience palpitations and shortness of breath. Their memory is poor, the ability to concentrate diminished; they are plagued with feelings of guilt, illogical thoughts, and a sense of isolation. Most patients with chronic insomnia show some type of depressed behavior; however, only a small percentage are actually diagnosed as having depression.Not surprisingly, depression affects circadian patterns. Several rhythms, including body temperature and circulating Cortisol, are abnormally advanced—they occur too soon—in the sleep-wake cycle. Secretion of prolactin and growth hormone is also affected. Some researchers feel that such disruptions in the various neuroendocrine rhythms could be related to the onset and intensity of mental illness. There may also be an association between the incidence of depression and the year-long cycle of melatonin. Statistics indicate that hospital admissions for depression are higher when patients have reached the low point in their annual melatonin rhythm.*114\226\8*