Health Infection

Caring for a Seriously Ill Child

2011-04-21T01:00:00.000-07:00

Taking care of a chronically ill child is one of the most draining and difficult tasks a parent can face. Beyond handling physical challenges and medical needs, you'll have to deal with the emotional needs your child may have and the emotional impact that the prolonged illness can have on the entire family. Luckily, this tough balancing act doesn't have to be done alone: support groups, social workers, and family friends often can lend a helping hand.

Explaining Long-Term Illness to a Child

Honest communication is crucial to helping a child adjust to a serious medical condition. It's important for a child to know that he or she is sick and will be getting lots of care. The hospital and the medicine may feel frightening, but they're part of helping your child feel better. As you explain the illness and its treatment, give clear and honest answers to all questions in a way your child can understand. It's also important to accurately explain and prepare your child for any treatments — and possible discomfort that might go with along with those treatments.

Avoid saying "This won't hurt" if the procedure is likely to be painful. Instead, be honest if a procedure may cause some discomfort, pain, pressure, or stinging, but then reassure your child that it will be temporary and that you'll be there to offer support while or after it's done. Many hospitals give parents the option to speak to their child about a long-term diagnosis alone, or with the doctor or the entire medical team (doctors, social workers, nurses, etc.) present. Your doctor or other medical professional probably can offer advice on how to talk to your child about the illness.

Tackling Tough Emotions

Your child will have many feelings about the changes affecting his or her body, and should be encouraged and given opportunities to express any feelings, concerns, and fears. Ask what your child is experiencing and listen to the answers before bringing up your own feelings or explanations. This kind of communication doesn't always have to be verbal. Music, drawing, or writing can often help kids living with a life-threatening disease express their emotions and escape through a fantasy world of their own design.

Kids may also need reminders that they're not responsible for the illness. It's common for them to fear that they brought their sickness on by something they thought, said, or did. Reassure your child that this is not the case, and explain in simple terms what caused the illness. (You may also want to reassure your other kids that nothing they said or did caused their sibling's illness.) For many questions, there won't be easy answers. And you can't always promise that everything is going to be fine. But you can help your child feel better by listening, saying it's OK and completely understandable to have those feelings, and explaining that you and your family will make him or her as comfortable as possible.

If a child asks "why me?" it's OK to offer an honest "I don't know." Explain that even though no one knows why the illness occurred, the doctors do have treatments for it (if that's the case). If your child says "it's not fair that I'm sick," acknowledge that your child is right. It's important for kids to know it's OK to feel angry about the illness. Your child may ask "am I going to die?" How you answer will depend on your child's age and maturity level. It's important to know, if possible, what specific fears or concerns your child has and to address them specifically. If it is reassuring to your child, you may refer to your religious, spiritual, and cultural beliefs about death. You might want to stay away from euphemisms for death such as "going to sleep." Saying that may cause children to fear going to sleep. Regardless of their age, it's important for kids to know that there are people who love them and will be there for them, and that they'll be kept comfortable.

Just like any adult, a child will need time to adjust to the diagnosis and the physical changes and is likely to feel sad, depressed, angry, afraid, or even to deny that they are sick. Think about getting professional counseling if you see signs that these feelings are interfering with daily function, or your child seems withdrawn, depressed, and shows radical changes in eating and sleeping habits unrelated to the physical illness.

Camps for Kids With Special Needs

2011-04-14T01:00:00.000-07:00

Ah, summer camp. The mosquitoes, the swim races, the friendships, the bug juice, the postcards home. What child wouldn't benefit from the fun and structured freedom camps provide? Kids with special needs are no exception. But the idea can seem challenging to parents and kids alike — how can you be sure that your child will get the attention he or she needs? Will your child be able to participate fully? What about the other kids? Will your child make friends? Will they understand your child's special needs?

The good news is that there are many camp choices for kids with special needs. From highly specialized camps to regular camps that accommodate kids with special needs, options abound.

Different Types of Camps

When it comes to camps, kids with special needs have as many choices as other kids. The Americans with Disabilities Act (ADA) requires all camps to make reasonable accommodations (such as the installation of wheelchair-accessible ramps) so that kids with special needs can attend. So, camps that previously couldn't host kids with special needs might now be on your list of possibilities. Inclusionary (or mainstream) camps do just what their name implies: They include kids with special needs in their groups of children with regular needs. These camps may have started out serving only a general population of kids, but they've gradually changed as the needs of the families they serve have changed.

Some camps are designed just for kids with special needs, including kids who have learning or behavioral problems, those with specific chronic illnesses, and kids with mental or physical impairments. Many accept kids with a variety of needs, but some only accept kids with specific problems (such as camps for kids with diabetes, cancer, speech or hearing impairment, cystic fibrosis, cerebral palsy, epilepsy, etc.). Within all of these categories, you'll have even more choices to consider regarding length of stay, philosophy, and cost. There are nonprofit and for-profit camps, religious camps, camps run by national organizations, private camps, day camps, camps that run weekend sessions, and sleepover camps that accept kids for the entire summer.

Benefits of Camp

The benefits of camp for kids with special needs are often the same as for any child:

increased confidence and independence
activity and exercise
the opportunity to interact with other kids, develop friendships, and build relationships
positive role modeling by adults
a chance for parents to have a much-needed break

Independence is an important camp benefit. For example, an overnight mainstream camp can give special-needs kids the chance to be without parents, doctors, or physical therapists for a week. They'll do more things for themselves and learn how to ask friends to help, which can boost problem-solving and communication skills. Also, camp provides the physical benefits of increased activity. Many kids with disabilities or chronic illnesses are sedentary and don't get to participate in the sports or recreational activities that their peers do. They therefore miss out on the social and health benefits that exercise brings.

Camp provides a variety of activities such as swimming, wheelchair racing, dancing, tennis, or golf. These give immediate health benefits (such as improved cardiovascular fitness) and recreational options that can carry over into adult life. Many camps combine learning environments with these physical activities, giving kids with behavioral or learning problems the chance to develop, or catch up on, needed skills during the summer.

Starting Your Camp Search

To find a camp, make lists of the basics you're looking for: a list of goals, a list of caretaking priorities, and a list of other considerations (such as cost). Then consider which type of camp might best suit your child:

inclusionary (or mainstream) camps
camps for kids with a specific special need
camps for kids with many different kinds of special needs

Consider whether your child has ever been away from home, for the weekend or even longer, and what experiences might have helped prepare him or her for camp. This will help you to decide not only the type of camp, but whether your child is ready for a day camp or a sleepover (residential) camp. Involving kids in the camp search will help to ensure that they get the most out of the camp selected. So, ask your child:

What do you want to get out of summer camp?
What are your preferences?
Do you want to go to a coed camp, or just be around kids of the same gender?
Are there any activities you really want to try?
Would you be more comfortable going to a camp with kids who do or don't have special needs?
Are you comfortable being away from home? If so, for how long?
Do you have classmates or friends who have gone to a summer camp? If so, which ones? And did they like it?

If it turns out that the idea of camp is a bit overwhelming for both you and your child, you might want to try starting small, like weekend sessions at a special-needs camp.

Birth Defect

2011-04-07T01:00:00.000-07:00

Like most expectant parents, you probably alternate between fantasies about a healthy baby and worries that your baby will have a health problem. Or perhaps you've been told through prenatal screening that your baby might be born with a birth defect. Many parents assume that all birth defects are severe or even fatal, but the fact is that many are treatable, often immediately after birth — and sometimes even before the baby is born.

It's especially important to know the risk factors involved and how to prevent birth defects. However, it's also important to realize that most babies born with congenital defects are born to two healthy parents.

About Birth Defects

Birth defects are defined as abnormalities of structure, function, or body metabolism that are present at birth. Major birth defects are abnormalities that lead to developmental or physical disabilities or require medical or surgical treatment. There are more than 4,000 different known birth defects, ranging from minor to serious, and although many can be treated or cured, they're the leading cause of death in the first year of life.

According to the March of Dimes, about 150,000 babies are born with birth defects each year in the United States. The American College of Obstetricians and Gynecologists (ACOG) says that 3 out of every 100 babies born in the United States have some kind of major birth defect. Birth defects can be caused by genetic, environmental, or unknown factors. For most birth defects, the cause is believed to be an interaction of a number of genetic and environmental factors.

Structural or metabolic defects are those in which a specific body part is missing or formed incorrectly; metabolic birth defects are those in which there is an inborn problem in body chemistry. The most common type of major structural defects are heart defects, which affect 1 in 150 babies in the United States. Other common structural defects include spina bifida, cleft palate, clubfoot, and congenital dislocated hip.

Metabolic defects affect 1 in 3,500 babies and usually involve a missing or incorrectly formed enzyme (a protein necessary for processing chemical substances in the body). Most children with a metabolic birth defect do not have any visible abnormalities, but metabolic defects are usually harmful or can be even fatal. Metabolic defects include Tay-Sachs disease, a fatal disease that affects the central nervous system, and phenylketonuria (PKU), which affects the way the body processes protein.

Defects caused by congenital infections result when a mother gets an infection before or during the pregnancy. Infections that can cause birth defects include rubella (German measles), cytomegalovirus (CMV), syphilis, toxoplasmosis, Venezuelan equine encephalitis, parvovirus, and, rarely, chickenpox. None of these affect 100% of babies whose mothers are infected during pregnancy. If the mother is infected during early pregnancy, rubella carries the highest risk for birth defects (approximately 20%). Because of nearly universal immunization in the United States, rubella is very, very rare and the congenital rubella syndrome is almost never seen. CMV is probably the most common congenital infection and may be associated with intellectual disability (mental retardation) and hearing loss.

Other causes of birth defects include alcohol abuse by the mother. Although a few medications, such as medicines used for epilepsy, are associated with increased risks for certain birth defects, most commonly prescribed drugs are not associated with a significant risk of birth defects.

Balancing Academics and Serious Illness

2011-03-30T01:00:00.000-07:00

When your child has a serious or chronic illness, it's hard to think beyond the next treatment. While health is the first priority, education also is important. You'll want to help your child stay on top of schoolwork as much as possible and plan for when he or she can return to school.

Not only does staying connected to school bring academic, cognitive, psychological, and social benefits — it's also your child's legal right. Under federal law, kids with disabilities are entitled to educational support, and your child might qualify for free services under the Individuals with Disabilities Education Act (IDEA).

With a little planning and a lot of communication, you can help your child balance treatment and academics.

Plan Ahead

First, talk to your doctor about how long your child is likely to be away from school and whether the treatment might interfere with concentrating, doing homework, and meeting deadlines. Are there side effects that might have an academic impact? What does your doctor recommend when it comes to attendance, tutoring, or studying?

Then talk to the teachers and school staff, and encourage your child, if well enough, to do the same. It may be necessary to set a reduced schedule or shift due dates for papers and tests. With your help, your son or daughter can work with teachers to help plan the workload. The more notice teachers have, the easier it will be to come up with a flexible solution.

Some kids who spend a lot of time away from school or in the hospital have Individual Education Plans (IEPs). These are customized goals and learning strategies created by the teachers, school psychologists (or other specialists), and counselors. IEPs take a child's individual needs into account. Under the IDEA, kids who qualify for an IEP will receive one at no cost, in addition to receiving free support services (such as a tutor) to help them reach educational milestones. IEPs can be requested by you or anyone on your child's education team.

Seek Out Hospital-Based Support

If your child will be spending long stretches in the hospital, ask a doctor, nurse, or child-life specialist about onsite schooling. Many hospitals provide this service free of charge to their patients. The two most common types of educational support include bedside schooling and classroom schooling. Typically, bedside schooling is for children who are too ill to leave their hospital rooms or have weakened immune systems due to chemotherapy. Other kids who are well enough might be educated individually or in small groups in an onsite hospital classroom.

Licensed teachers who are K-12-certified in a variety of subjects and special education work intensively with students to make sure that they don't fall behind in their studies. To stay on track, hospital-based teachers work closely with teachers from a child's school to maintain curriculum continuity and ease reentry into the classroom when the child is well again. School is scheduled around medical tests and therapies, and always takes a child's medical condition and strength into consideration. Whether your child is being educated at school, in the hospital, or at home, remember that getting better is the main priority. So be realistic about what he or she can handle. Kids may feel an unspoken pressure from parents, teachers, and themselves to continue with schoolwork, and this anxiety could hurt their recovery.

Stay Connected

Maintaining ties with classmates and teachers can help your child maintain a sense of normalcy during this difficult time. Your child might even be able to listen to a lesson or join a class over the computer. Programs nationwide offer free or low-cost laptops for use in the hospital; check with your doctor or medical staff to see if this service is available to you.

In addition to academic isolation, your child may feel cut off socially from friends and classmates. Online social networking sites, email, instant messaging (IM), text messaging, and talking on the phone can help kids stay connected. Also consider encouraging a letter-writing, email, or care package campaign from classmates — you might even set up a collection box at school where they can deposit notes and pictures. Arrange for visits from your child's friends and, if your son or daughter is up to it, take the group out to school plays, sports events, classroom parties, and other social gatherings. Staying connected will make for a smoother transition socially and academically when your child returns to school after treatment.

Reviewed by: Alycia Taggi

Pediatric Care

2011-03-23T01:00:00.000-07:00

You may remember, not too long ago, stepping into the pediatrician's office for your child's very first visit. And you might have been a little nervous as you got to know the person who'd be caring for your little one. But after years of interaction (complete with late-night phone calls, last-minute appointments, and trustworthy advice), your pediatrician probably feels like part of the family. So when the time comes for your child to transition into adult health care, it can be hard to say goodbye.

Done abruptly, this change can be overwhelming and anxiety-inducing for you and your child. But if you're both prepared and plan accordingly, it can be a smooth step on the path to adulthood.

Finding a New Doctor

Once kids become legal adults at age 18, they should visit an adult primary care physician (PCP), such as an internal medicine doctor (internist), a general practitioner, or a family medicine doctor. Your pediatrician, who is specifically trained to care for kids and teens, might be able to provide care for a little longer if your child is in college (usually until college graduation or age 21). But this varies from doctor to doctor, so be sure to ask.

Ask your pediatrician for a referral if you don't have a family doctor that your child wants to see or if your child has a chronic condition that will require an adult specialist's care. If your child has a rare condition, disability, or pediatric-onset condition (one that only develops in childhood), it may be challenging to find a PCP or adult specialist who is knowledgeable and comfortable caring for these complex needs. In this case, start searching for doctors early on, during the teen years.

Ask if your child can see a new doctor for a trial period; then, follow up with the pediatric specialist to discuss how things went and put both doctors in touch to plan for the transition of care. Allow plenty of time for this process — that way, if there is an issue your child can continue seeing the pediatric specialist until you find an adult provider who is a better fit.

Sport Physicals

2011-03-16T01:00:00.000-07:00

You know that playing sports helps keep kids fit and are a fun way for them to socialize and make friends. But you might not know why the physical kids may have to take at the beginning of their sports season is so important.

About Sports Physicals

In the sports medicine field, the sports physical exam — or preparticipation physical examination (PPE) — helps determine whether it's safe for kids to participate in a particular sport. Most states actually require that kids and teens have a sports physical before they can start a new sport or begin a new competitive season. But even if a PPE isn't required, doctors still highly recommend getting one.

The two main parts to a sports physical are the medical history and the physical exam.

Medical History

This part of the exam includes questions about:

serious illnesses among family members
illnesses that kids had when they were younger or may have now, such as asthma, diabetes, or epilepsy
previous hospitalizations or surgeries
allergies (to insect bites, for example)
past injuries (including concussions, sprains, or bone fractures)
whether the child has ever passed out, felt dizzy, had chest pain, or had trouble breathing during exercise
any medications taken (including over-the-counter medications, herbal supplements, and prescription medications)

The medical history questions are usually on a form that you'll fill out with your child. Looking at patterns of illness in a family is a good indicator of any potential conditions kids might have. Most sports medicine doctors believe the medical history is the most important part of the sports physical exam, so take time to answer the questions carefully. It's unlikely that any health conditions your child has will prevent him or her from playing sports completely.

Physical Examination

During the physical part of the exam, the doctor will usually:

record height and weight
take a blood pressure and pulse (heart rate and rhythm) reading
test your child's vision
check the heart, lungs, abdomen, ears, nose, and throat
evaluate your child's posture, joints, strength, and flexibility

Although most aspects of the exam will be the same for males and females, the doctor may ask girls and guys different questions if they've started or already gone through puberty. For example, if a girl is heavily involved in a lot of active sports, the doctor may ask her about her period and diet to make sure she doesn't have something like female athlete triad.

A doctor will also ask questions about use of drugs, alcohol, or dietary supplements, including steroids or other "performance enhancers" and weight-loss supplements, because these can affect a person's health. At the end of the exam, the doctor will either fill out and sign a form if everything checks out OK or, in some cases, recommend a follow-up exam, additional tests, or specific treatment for medical problems.

The Cardio

2010-12-29T01:00:00.000-08:00

I've been meaning to write this email for a long time. Today I'm going to give you the story of how I solved the problem of getting an efficient and effective fat loss program finished in 45 minutes. Essentially, how I invented Turbulence Training.

And then I'll end with a sample TT workout for you...

But first, let's take a trip down memory lane to the winter of 98-99. I was but a lowly grad student, studying the effects of androstenedione (the supplement taken by the might Mark McGwire during his record-breaking home run quest in '98).

In my study (which was published in the Canadian Journal of Applied Physiology for any science nerds like myself out there), we had guys use the supplement and go through a couple of weight training sessions. By February of '99 I was stuck in the lab, analyzing the blood samples using some fancy radio-active isotopes.

And when I say stuck in the lab, I mean STUCK. I'd get there at 7am, and record my last data point at 11pm. Sixteen hours of mad science. And if I wasn't there, I was downstairs in the medical library, studying papers on testosterone and training.

Now coming from a very athletic background, this sedentary lifestyle didn't sit well with me. But there I was, studing for a degree in Exercise Physiology and left with no time for exercise. Or so I thought.

Fortunately, I actually had a 50 minute window once per day of "down-time" while the lab's gamma-counter analyzed blood samples.

That left me 50 minutes to get to the gym (5 minutes across campus) and get a workout in the remaining 40 or so minutes. I knew that if I applied my studies to the workout, I could get maximum results in minimum time.

As a former athlete, I knew that I had to find a way to stay fit and to avoid the fat gain that comes with working long hours in a sedentary environment. And I also had to stay true to the high-school bodybuilder I once was, so there was no way I was willing to sacrifice my muscle to one of those long-cardio, low protein fat-loss plans that were popular at the time.

Instead, I had to draw on my academic studies and my experiences working with athletes as the school's Strength & Conditioning Coach.

I knew that sprint intervals were associated with more fat loss than slow cardio, and I knew that you could also increase aerobic fitness by doing sprints (but you can't increase sprint performance by doing aerobic training).

So clearly, intervals were (and ARE!) superior to long slow cardio.

I had seen first hand the incredible results of sprint intervals in the summer and fall, as the athletes made huge fitness improvements and shed winter fat in a short time using my interval programs. I knew that intervals had to be the next step in the evolution of cardio.

The biggest benefit of intervals? A lot of results in a short amount of time. I knew that I only had 40 minutes to train, and therefore I could only spend 15-20 minutes doing intervals.

Now onto the strength training portion of the workouts. I knew that a high-volume bodybuilding program wasn't going to cut it - I just didn't have time. But in the past year I had read so many lifting studies, that I knew exactly what exercises I needed to do to maximize my lifting time in the gym.

Those exercises were standing, multi-muscle, movements such as squats, presses, rows, power cleans, and plenty of other standing single-leg exercises. I knew that those exercises would bring me far more results than those people sitting on machines would ever achieve.

And I also knew that I had to lift heavier than the average Joe or Jane Gym-goer lifts. I just knew that doing lighter weights and high-reps wasn't going to cut it. And a research study from 2001 later showed that I was right - when women did 8 reps per set, they had a significantly greater increase in post-workout metabolism than if they did 15 reps per set.

So I had my plan. Bust my tail over to the gym, through the cold, dreary Canadian winter afternoon, and do a quick but thorough warmup (specific to my lifts - none of that 5 minutes on the treadmill waste of time).

Once I got through the warm-up, I did as many sets as I could in the remainder of the 20 minutes for strength training.

How Much Sleep Do You Need?

2010-12-22T01:00:00.000-08:00

We sleep for about a third of our day, and whether you love catching those z's or you wish that you didn't have to bother with it, you can't deny that we need it. Sleep gives your bodies a chance to heal and rest, and though the necessity for sleep still isn't fully explained, it is abundantly clear that without it, many problems start mounting up. If you live a busy life, there is a good chance that you are shorting yourself on sleep, but for many people this can be a difficult thing to really understand. What counts as enough sleep, and how can you be sure you are getting it?

The first thing to think about is what determines how much sleep you need. Chances are, you know someone who looks refreshed after about five hours of sleep and someone else who still looks groggy after nine. What creates this difference in people? Your need for sleep can be influenced by several different factors, including genetics, the quality of your sleep, how much sleep you've gotten the previous night and whether the activities you have conducted during the day are conducive to helping you get to sleep.

Exercise, for example, can affect your sleep a great deal. You'll find that if you tire yourself out a good hour before you head to bed that you sleep a little more soundly, but if you finish a long run and then try to fall into bed, your adrenaline will keep you up for another hour. Similarly, the amount of light you have seen during the day and whether or not you have been drinking caffeine or alcohol can go a long way towards determining what kind of sleep you will get.

Experiments were performed to see what people would sleep if they were kept in a "timeless" environment, one where they didn't have access to clocks or watches. In this condition, almost all participants eventually regulated themselves to a sleep cycle which lasted around eight hours. Assuming that every human being needs about eight hours of sleep, the sleep debt occurs when you end up getting less.

People are very different and one way to figure out how much sleep you specifically need, try getting a solid eight hours of sleep every night for a week. Make sure that you don't drink caffeine or smoke, which will influence your natural inclinations. Then, at the end of the week, don't set the alarm and find out how long your body wants to sleep. If you end up sleeping for nine or ten hours instead of rising after eight, there is a good chance that you need a bit more than eight hours of sleep a night.

Making sure you get the right amount of sleep can be very important when it comes to your own health and mental acuity. If you go too long without sleep, your reflexes will be very dulled and there is a good chance you will start to experience mood swings. If you constantly find yourself feeling grumpy and groggy and experiencing a constant run of low-grade illness, this is an indication that your sleep might be problematic!

Manage Stress

2010-12-15T01:00:00.000-08:00

Stress can do a lot of things to a person. The one thing that it should never be allowed to do though is control a person's life. Most people who are unable to handle the stress associated with everyday life tend to find themselves avoiding the things that at one point made them happy. You do not have to completely change the way you live in order to reduce or eliminate stress from your life, but it is important for any individual trying to handle stress to remember to actively take steps to reduce it. Here are a few ways to better handle stress and still be able to live your life:

1. Disorganization is a major source of stress for most people. Missing a meeting, forgetting an important date, or showing up late for an event can easily cause anyone to stress out. To avoid this, find yourself an organizer (daily, weekly, or monthly) to help you keep track of all the things that have to be done. Instead of trying to remember, you will have an easy way of tracking the things you need to do.

2. Be aware of your stressors and triggers. If certain places or situations tend to increase your stress levels, try to avoid them or try to find a less stressful time to visit them or participate in them. This doesn't mean avoid the mall, it just means to go to the mall when it isn't as crowded.

3. Make some time for yourself. An hour a day reading a book or listening to some soothing music can be the perfect remedy for relieving stress. Some people even find sweeping and washing dishes to be great stress-relieving activities.

4. Minimize the time you spend with stressful people. Some of these individuals are simply trying to pass their stress onto others. You are only playing into their hands by arguing with them or trying to beat them at their own game.

5. Consider the actual benefits of some of today's technological wonders. Cell phones and computers have made people's lives easier, but they also add to people's stress. Constantly having to answer the phone and check your email can interfere with the other aspects of your life. Make it a point to establish a cut-off point or time when cell phones and email will be declared off-limits.

6. If you are in a management or leadership position, don’t take on every task yourself. Be willing to delegate tasks and responsibilities to others and let them stress out for a change.

7. Certain foods have been shown to increase stress levels. That morning cup of coffee might help get you through the morning, but in the end, it can also contribute to increasing your body's levels of cortisol, which is a hormone known to be associated with stress.

8. If a trip to the gym is too stressful, consider an alternate way of exercising. Working-out does not have to be an exercise in stress. A nice walk is good for both the body and the mind. A simple walk is just as good as an intense weightlifting session when it comes to helping relieve and reduce stress.

9. You can't sleep because you're stressed, and you're stressed because you can't sleep. At some point, it is up to you to make the decision to put away all those things that are keeping you up at night (work, television, food, etc.) and get some sleep, especially since rest helps your body build the energy it needs to get you through the day.

10. Let the machines take over. Actually, just let them help. Today's technology has made it easier for us to complete tasks in the comfort of our own homes. Shopping, paying utilities, sending out mail, and even registering your car can now be done without having to leave home.

There are many things you can do to reduce and even eliminate stress from your life. Whether it means going out for a walk or getting more sleep, the important thing to consider it to be proactive. The stress will not eliminate itself without a little help from you.

Between Exercise and Youth

2010-12-08T01:00:00.000-08:00

Many people often wonder how exercise, something that can feel tiring and essentially involves the hard use of your body, can possibly help you look and feel younger. If you are a little bit reluctant to get involved in an exercise regimen because you think it will leave you feeling more tired than before, take a look at some of the results from a study that was conducted over a span of thirty years.

The Original Experiment

To test the effects of weightlessness on the diet and fitness of astronauts, five twenty year old men were placed on bed rest for twenty days. Their movement was very limited and in this short span of time they experienced loss in the ability of work they were able to do. Also, a decrease in their cardiovascular fitness was also noticed. It took them two months of intense exercise and training to bring them back to their original capacity.

The Follow-Up

Thirty years later, the researchers who ran the first experiment tracked down the original five men, now in their fifties. This time, the men in question were measured in terms of their cardiovascular fitness and their general aerobic capability; the results of this measurement suggested a strong correlation between their current state and the state they were in after twenty days of bed rest while they were in their twenties. Then, they underwent specifically designed training that was tailored to meet their needs, and within six months of moderate aerobic exercise, all five men were restored to the original level of fitness that they had started in, thirty years prior.

Conclusions

Though the fact that the men in question were all healthy to begin with, and had not suffered any debilitating illness in the thirty years between the two measurements should be kept in mind, there is a clear connection between bed rest and lack of cardiovascular health and between health and fitness. The men in this study produced some fascinating results when they showed that a level of youthful vigor could be retained and even regained with regular exercise.

What Does This Mean For Me?

The important thing to remember is that it is never too late to get started. Start small and you'll find that your endurance will increase day to day. There are many different programs of exercise that you can engage in, and with a little bit of tailoring and thinking, you'll be able to find the one that keeps you feeling great! Be patient and think constantly about how the exercise is helping you, and you'll soon start seeing some very impressive results!

10 Steps to Help You Get a Great Night's Sleep

2010-12-01T01:00:00.000-08:00

1. Make a list of what you need to do the next day, write it all down and keep that paper and pen near your bedside in case you think of anything else you need to do. When you write things down your giving your brain the signal that it no longer needs to think about those tasks.

2. Don't watch television or listen to the radio (especially the news) before retiring for the night - and certainly do not fall asleep with the TV or radio on.

3. Read some inspirational or self-growth material for at least 30 minutes prior to bed. Your goal is to fill your mind with inspirational thoughts before falling asleep so that the last thoughts you have before drifting off are uplifting thoughts - as opposed to the stressful thoughts that most people fall asleep thinking about.

4. Make sure the room that you're sleeping in is as dark as possible - the body is made to sleep when it's dark out - the darker the room the more potential for a deep sleep.

5. Make the room as silent as possible - turn off all electric devices and ask others in the house to be as quite as they can be.

6. Don't eat for at least 3 hours before going to bed. When there's undigested food in the stomach your body is forced to focus on digesting that food rather than being focused on repairing your body and mind - which is what sleep is all about! The body was designed to digest food best while moving - not while laying down.

7. Try to go to bed at approximately 10:00 pm and awake at approximately 6:00 am. In Ayurvedic medicine it's believed that there are cycles that are the most conducive for certain activities. Going to bed at 10:00 pm and arising at 6:00 am appears to allow the body to rest the deepest, rejuvenate the most, and gives the person the most energy throughout the day.

8. Don't take drugs or vitamins/herbs that are supposed to help you sleep (unless required by your physician). Most of these artificial sleeping aids do nothing more than deaden your senses - the goal of 'sleep' is to give your body the time and means to repair itself and prepare for the coming day. When you drug yourself to sleep, every system in your body is slowed down, including all those systems that are responsible for repairing you.

9. Make sure that there's a fresh air supply in the room. The air indoors is said to be some of the most toxic air around. When you sleep, you're only able to breath in the air that surrounds you in your enclosed bedroom. Try opening a window (if it's cold outside then just open the window a crack). The fresh air that comes in while you sleep will help your body repair itself because you'll have access to cleaner, more oxygenated air.

10. That day, do 60 minutes of mild exercise. If you don't have time to do 60 minutes in a row, then break it up into 2 - 30 minute sessions, or 3 - 20 minute session, or 6 - 10 minute sessions --- just get a full 60 minutes in. The best exercise when talking about general health and preparing your body for a great night's sleep is "walking".

You can get loads of other great tips on how to live a healthy lifestyle and sleep better from this day forward on my 4 hour www.LivingHealthWeightLoss.com audio program.

I wish you the best night's sleep tonight and every night from this day on.

"White Foods" - Friend or Foe for a Lean-Body?

2010-11-29T01:00:00.000-08:00

I'd like to start a little discussion today about carbohydrates... and in particular, "white foods" as well as potatoes. One reason I wanted to mention this is because so many health and fitness professionals trash talk potatoes about being a bad carbohydrate choice because of the high glycemic index. Some even say such ridiculous things as "avoid any and all white carbohydrates".

Ok, now while I certainly agree that white bread and refined white sugar are two of the worst things we can be feeding our bodies, I definately don't agree with avoiding any and all "white carbohydrates". Now I know all of the buzz lately has been about colorful foods and the protective antioxidants that they contain. They tell you to focus on colors and stay away from white.

It's true that colorful foods are great, but it is a big mistake to specifically avoid white foods! There are plenty of white foods that have specific nutrients that are hard to find elsewhere. Let's look at a few examples...

Onions & Garlic

What about onions and garlic? They are both white and they are chock full of protective phytonutrients, vitamins, and trace minerals that aren't easy to find elsewhere in a normal diet... such nutrients as allicin, quercetin (an important flavonoid), chromium, and other unique anti-inflammatory nutrients.

Cauliflower

Another example of something white that is great for you is cauliflower. Cauliflower is loaded with vitamin C, fiber, minerals, and special compounds such as glucosinolates and thiocyanates, which are specifically abundant in cruciferous vegetables such as broccoli, cauliflower, and cabbage. And a little-known fact is that some of the compounds in cruciferous vegetables help to combat other estrogenic compounds in our food supply and environment and can help prevent excess belly fat. So eat up on that cauliflower!

Mushrooms

Not many people realize this, but surprisingly, even white mushrooms have high levels of unique nutrients and antioxidants. White mushrooms are high in a couple types of antioxidants called polyphenols and ergothioneine.

Potatoes

Now that also leads us to another example - white potatoes (which by the way, can also be found in red, yellow, purple varieties, etc). Many health professionals claim that potatoes are a bad carbohydrate because they are thought to have a high glycemic index. First of all, if you've read Truth about Six Pack Abs book, then you understand that glycemic index is not necessarily the most important factor in choosing your carbohydrates.

While a generalization can be made that most low glycemic index carbohydrate choices will help you lose body fat easier than high glycemic index choices, it is not all that it's cracked up to be. There are many other factors that determine how your body will react-to and process the carbohydrates you ingest, such as glycemic load and also how you combine the high GI food with other foods.

For example, using glycemic load as an example... it is known that watermelon has a high glycemic index. However, the glycemic load of a normal serving of watermelon is just way too low for your body to start packing on body fat just because you ate a high glycemic index fruit. You would have to eat such an enormous quantity of watermelon just to get enough grams of carbohydrates to have any negative glycemic effect, that it is just non-sensical.

Not to mention that watermelon is also a great source of vitamins, minerals, and lycopene. There's just no reason to avoid it simply because it has a high GI. My point is... candy bars, cupcakes, and donuts make you fat... NOT watermelons, carrots or potatoes.

Also, as i mentioned, food combinations are important in how your body processes the carbohydrates and the associated blood sugar and insulin response you receive. For example, if you mix a high glycemic index carbohydrate with an extra source of fiber, healthy fats, or even certain proteins, many times the blood sugar and glycemic response will be slowed down considerably by the way you combined the food. Again, I talk in detail about this entire topic in my Truth about Six Pack Abs book

Alright, so back to my point that white potatoes are actually a healthy carbohydrate as long as you eat them in the right form... with the entire skin, and please don't ruin them by deep frying them into french fries either! French fries are one of the most evil things ever invented for your health, but only because we ruin them by soaking them in a scorching bath of trans fats in the deep fryer from the hydrogenated oils that are typically used.

Keep in mind that potatoes contain so many vitamins and minerals that the list is way too long to even try. Also, as long as you eat the skins, you get a decent shot of fiber too.

On the topic of potatoes not being so bad after all, I don't remember where I saw this referenced, but I recently saw a particular study that had participants eat something like 7-9 whole potatoes per day for several weeks.

At the conclusion of the study, the potato eaters had actually consistently lost weight! I'd venture a guess that the reason the people lost weight is that they were probably so full from eating all of those damn potatoes, that they actually consumed less calories than normal! An average sized potato only has about 100-120 calories, and I can surely imagine you'd be full constantly from eating 7-9 potatoes each day.

Now I would never recommend going to those extremes, but my point is that an occasional potato is not going to hurt your efforts to get lean, especially if you combine it with some other fibrous vegetables and maybe a healthy fat and some protein. On that note, I have one of my favorite recipes for you, using potatoes.

Geary's Lean-Body Potato Side Dish

Desired quantity of baby potatoes (I like to use this mixture I found recently at a health food store... it is a mixture of white, red, yellow, and purple baby potatoes)
1 red pepper
1 green pepper
1 yellow pepper
1 or 2 onions
a couple cloves of garlic, finely chopped
1 or 2 Tbsp extra virgin olive oil
a little salt and pepper to taste (I like using a sea salt instead of normal commercial salt)

Cut the baby potatoes into slightly smaller pieces and place in a steamer until soft all the way through. Slice up the peppers and onions into strips and add with the chopped garlic into a pan with the olive oil. Cook the peppers, onions, and garlic until tender, and then add the steamed baby potatoes. Stir it all together and serve. This is a delicious and healthy side dish that goes great with chicken or red meat.

I hope you've enjoyed this little topic today about potatoes, healthy carbohydrates, glycemic index, and my killer potato recipe idea!

10 Exercises For People Too Busy To Exercise

2010-11-22T01:00:00.000-08:00

As you begin to explore all the possibilities associated with enhancing your mind, body, and overall lifestyle - increasing the amount of exercise you receive on a daily basis is a must! Not only does exercise release completely harmless chemicals into your system, but you're also able to maintain your body weight, sculpt those abs you've always wanted, or shed the extra 'Christmas cookie' pounds.

However - in this day and age - the ups and downs regarding school, family, work, household, money, friends, and extracurricular commitments can make finding the time to squeeze in a bit of cardio seem impossible. In order to reclaim your youthful zest for life and boost your energy levels at the same time - you should definitely take a timeout to consider the many different exercises geared towards people on the go. Below you will find ten exercises you can easily incorporate into your hectic schedule:

1) Take Advantage of Your Chair

Some people spend hours upon hours in their chair at work - often overlooking the infinite exercise possibilities. Work your abs and hips by twisting side-to-side throughout the day. Vary your movements by rotating your neck and rolling your shoulders.

2) Mini -Kitchen Workout

While you're waiting for your water to boil for dinner or have just popped in a microwave popcorn - don't ignore all the exercise opportunities found within your kitchen. Heavy canned goods and liters of bottled water make decent dumbbells for when you're ready to add shape to your arms. Simply grab a can (or bottle) of equal weight in each hand and with arms at your sides - bring both upwards to where your hands meet over your head. Repeat until your water boils or your popcorn is complete.

3) Inner Thigh Crunch

The next time you sit at your desk, tuck a full water bottle between your knees and with abs tucked in - gently squeeze. The tighter the pinch - the more sculpted those thighs and abdominal muscles become.

4) Take the Stairs

Add a twist to this classic exercise tip by taking two steps at a time to really stretch your glutes, thighs, and calves.

5) Elevator Resistance

Did you know that balancing on one leg qualifies as resistance training? Every trip on the elevator can become a motivating exercise when standing on just the right leg when going up and switching legs when going back down. In the end, your quadriceps and hamstrings are forced to work overtime.

6) Maximize Your Driving Time

Make better use of traveling in the car when you take the time to add a little exercise. Try tucking in your ab muscles each time you use your brake. Make sure to hold the contraction until it's time to start moving again. Just imagine the workout you'll receive in rush hour traffic!

7) Work Your Gluteus Maximus

Squeezing your glutes (butt muscles) each time you ride an escalator or elevator can help work out the largest muscle in your body.

8) Countertop Push-Ups

How quick and easy is it to complete 20 upright push-ups using your kitchen countertop, as you finish cooking dinner or simply visit the refrigerator in the middle of the night?

9) Stretch Those Legs

Pull your shoulders back and tuck in your abs, as you make it a habit to rise slowly from any seated position. The ideal amount of time to spend on this mini-exercise is four counts going up and four counts when you return. The longer you take - the harder your leg muscles are forced to work. In the end, your glutes, pelvis, thighs, and abs will certainly thank you.

10) Kick Up Your Heels

At some point in the day - dishes need washing, which creates the perfect entryway to yet another quick exercise. Instead of running the dishwasher, stand at the sink and manually clean the dinner dishes while kicking your legs back (as if you're trying to reach your butt). As a result, you will work the front and back of your thighs, and also get your heart pumping.

Toning, Light Weights, & High Reps

2010-11-15T01:00:00.000-08:00

I guess you could say it is my mission to show people the value of intense strength training for fat loss.

Every month more research comes out to support intense training over slow cardio, and light weights. And each week, in real-life, more and more men and women (yes, women too!) see the benefits of pushing themselves with strength training.

The evidence from research and real-life continues to pile up that you need to put down those light weights and cut out those high reps.

Take really light weights, add in isolation exercises, and repeat for a large number of reps. Do this for 3, 6, or 12 months, and you're guaranteed to have the same physique you have today. This approach just does not work.

You need to step out of your comfort zone with strength training.

Research has shown using a weight that enables only 8 reps per set results in a greater post-exercise metabolism than using a weight that allows 12 reps per set. And this was in women! So lifting challenging weights is not just for men, but also for the ladies.

Another research study showed that a 30-minute, hard total-body strength training session can boost metabolism about 36 hours. You just don't get that from slow cardio or light, "toning" isolation exericses, I'm sorry to say.

But what if you are worried about "bulking up"? Just do one or two sets of 8 reps per exercise, rather than three or four.

Bodybuilders know that high-volume training builds muscle. But if you don't want massive amounts of muscle, just don't do a lot of volume. That's just one of the reasons I don't use bodybuilder workout programs for fat loss.

Another way to avoid "bulking up" while still boosting your metabolism is to use more bodyweight exercises.

As for exercise choice, say goodbye to biceps curls, hamstring curls, and triceps kickbacks. Seriously, I couldn't think of a more useless exercise for a fat loss program than triceps kickbacks.

Stick to full body movements. Use squats, lunges, split squats, pushups, chinups, rows, etc.

Remember, you don't have a lot of time to workout. So you can't be doing bodybuilding splits from the 80's that call for three exercises for the long head of the triceps, and two exercises for each of the anterior, medial, and posterior deltoid.

That's just not possible in the real-world. A pushup trains almost all those muscles, and more. It works your abs, chest, triceps, and shoulders. That's the type of exercise that is going to help you get more fat loss results in less workout time.

I train in the concept of a short time frame. That is, anyone that wants to use my programs has less than 3 hours per week to devote to structured exercise. So there just isn't much room for isolation training in that time frame.

But training should be fun too, and adding some curls as a reward for completing a hard workout is fine, but only if you want to. You don't need those types of exercises to get results.

But remember, isolation exercises are not actually going to burn fat, but they can build muscle and help you sculpt your body. Here's the list of methods that lead to fat loss, in order of importance:

i) Nutrition
ii) Burning calories with interval training
iii) Burning calories due to an increased metabolism from interval training and strength training (with multi-muscle movements)

As long as you understand that nutrition is the most important factor in fat loss, and that strength training is essential for sculpting your body, than you will have realistic expectations of success - based on how well you commit to each process.

5 Common Ab Myths

2010-11-08T01:00:00.000-08:00

Ab exercises aren't the only thing you have to do in order to get your 6-pack. You also have to work hard on your diet as well, sticking to a fat-burning, muscle-building diet all year round.

Here's a list of 5 common myths about abs.

Myth 1) You don't need to watch what you eat

Diet is first and foremost the key factor when trying to get 6-pack abs. Plan your nutrition in advance, to avoid dietary downfalls.

Myth 2) As long as you do a lot of ab exercises and repetitions, it doesn't matter how well you do them

It is important to do all repetitions with good form. Focus on quality, not quantity. Avoid sit-ups and an excessive number of crunches. Both exercises can damage the lumbar spine in your low back, and crunches are rarely effective anyways.

Myth 3) You can "Spot reduce" the fat on your abs with crunches

No matter how many crunches you do, you won't be able to get rid of your ab fat with crunches alone. You need a good diet and an increase in your calorie burning from strength training and interval training.

Myth 4) Infomercial products will help you get a 6-pack

You've probably seen dozens of ab gadgets on TV, but none are magic bullets. You can't expect anything you order from TV to help you get a 6-pack. You have to do the hard work with nutrition and training to get results.

Myth 5) You must do abs every day

You don't need to do abs every day. Instead, train them twice per week and use non-conventional exercises such as Mountain Climbers and Stability Ball Jackknives to reduce the stress on your low back.

To Getting A Six-Pack

2010-11-01T01:00:00.000-07:00

Abdominals Are A Muscle, Too!

You want your arms to be bigger, your shoulders to be broader and your chest to be fuller, correct? And what is the solution to making these muscle groups increase in size? High intensity weight training, overload, consistency and a healthy surplus of calories. Starting to sound familiar?

The same goes for your abdominals. Your abdominals are a muscle group that requires the same formula and attention and are not any different. For some reason many consider abdominals to be a 'special' body part that requires a different set of rules and a completely different formula for training. Abdominals were not given a 'secret code' to crack. To get thick, dense abs - those ones that 'pop' out - you must train them with intensity and overload. Here are some practical tips you can apply to your program so that you can be the 'man' or 'gal' at your gym with a ripped and muscular six-pack!

Prioritize By Sequence

If your abs are your worse body part, then why do you keep training them last, at the end of your workout? Which muscles groups will receive the highest priority when you train? The ones done at the start of your workout or the ones done at the end of the workout? Of course, the ones done at the start of the workout while you have the most energy and focus. If abdominals are the muscle group you wish to prioritize, then don't be afraid to disagree with the 'experts' who say "Never train your abdominals first because you'll weaken your core muscles for the rest of your workout...". I completely disagree with this and often reply, "Show me the evidence." The typical response is "Nobody does abdominals first...". That is pure BS. This just supports the notion that many people who work out don't ever question what they hear or do. They want to be spoon fed answers and follow the trends of others without thinking for themselves. I ALWAYS train abdominals first in a workout if they need the highest attention.

Prioritize By Frequency

What's going to receive better results? A muscle group that is trained one time a week or two times a week (assuming you are recovered prior to the second workout commencing)? Of course, the muscle that is trained 2x a week. The more stimulus on a muscle, the more growth. That is why professional athletes are professional athletes. They have conditioned their bodies to such a high amount of stress that they are able to train more frequently.

How often you train your abdominals is based on the inverse relationship of intensity and volume. The harder you train your abs, the more rest they need. The less intense you train your abs, the more frequently you can train them! If your goal is rehab or injury prevention, then you will be able to train them often with more frequent and lower loads. If your goal is to make your abs more muscular and dense, then a higher load and less frequency would be ideal. If your goal is maintenance, then a medium load and frequency would be ideal.

If building a sexy six-pack is on your 'to do' list for 2008, then start training abdominals 2-4x a week. I will teach you in a moment how to split your abdominals up into two different days based on movement.

Divide Your Abdominals Into Two Separate Workouts

To train your abdominals safely and effectively you must know the basic movement patterns of your abs and train them within all sub-categories:

• Truck Flexion (upper abs)
• Hip Flexion (lower abs)
• Rotation (obliques)
• Lateral Flexion (obliques)

The majority of books and articles you have read revolve the bulk of the ab exercises around trunk flexion that is better known as 'upper ab' exercises. A full sit up is a perfect example of this.

Bill Starr in his 1976 classic 'The Strongest Shall Survive' wrote that the abdominals "...can be strengthened in a wide variety of ways. Sit-ups of all types, leg raises, truck rotation movements all involve the abdominal muscles to a different degree..."

Enhance Your Health & Metabolism

2010-09-29T01:00:00.000-07:00

You cannot expect to improve your metabolism, lose weight permanently, or drastically increase your metabolism without first cleaning out all of the built up “sludge” that may have accumulated inside your eliminatory system/colon.

Skipping this step will make the weight loss/fat loss process far harder, and it will create a destiny for you of achieving only temporary results.

There are 3 initial steps to take for your cleanse to be most effective:

1st…Decide how long you want your cleanse to last. I usually recommend to my personal clients that their cleanse last no less than 1 full day and no longer than 7-10 days. For example, if they have lived a life of eating fast food and little or no physical activity, then their cleanse should last closer to the 7-10 day mark. But if they have lived a healthy! life, eating lots of fresh raw vegetables, exercising regularly, and possibly even doing another type of cleanse every now and then…then you need only follow this cleanse 1 or 2 days in a row (but most of my clients – even those who come to me in excellent condition, usually choose to stay on the cleanse longer than just 1 – 2 days…the average is 3 – 5 days initially, then once a month thereafter they can do a mini cleanse lasting 1 – 2 days).

2nd…Decide what you’re going to consume on the cleanse (this is a great time to get all the junk food cleaned out of your kitchen – give it away, throw it away, just get rid of it – but don’t get rid of it by eating it yourself!!!). After you’ve cleaned out your kitchen, you should stock it with healthy foods, and the only healthy foods you’ll be consuming on your cleanse are plain, fresh, clean water (preferably ‘distilled’ or ‘purified’ water), vegetable juices, and possibly some decaffeinated herbal tea (if you desire it).

The term “vegetable juice”, when used here, refers ONLY to juices that you juice yourself. So get yourself a vegetable juicer and a wide variety of fresh, raw, preferably organic vegetables. Then 2 or 3 times per day juice enough vegetables to fill a glass and drink it down (some people, including diabetics, find it beneficial to water down their juice with 50% water – this simply dilutes the sugar found in some vegetables).

You should add a small pinch of cayenne pepper to a few of your drinks throughout the day – this strengthens your blood, increases circulation, improves the assimilation of nutrients from the vegetable juices into your body, and helps your bowels eliminate the built up waste from your system (which gets rid of any constipation).

3rd…Do some light cardiovascular exercise like walking or bike riding for 20 – 30 minutes each day of your cleanse. Avoid any heavy physical exertion if possible – your goal is to relax and let your system rebuild an! d repair itself during your cleanse. Finally, rent a funny movie and laugh (a lot). When you have a good laugh, your body secretes chemicals that aid in digestion and promote good metabolic health.

Low Carb Diets

2010-09-22T01:00:00.000-07:00

There is no denying the fact that obesity is a problem in this country. Take a look down any street, in any office, in classrooms at school and you will see just how big of an issue weight is. This is part of the reason as to why there are so many diets on the market. It seems that everyone that has ever lost weight thinks they should write and book and promote a product or certain eating strategy. Many of those diets boost eating high protein and low carbohydrates is the best way to loose weight and get healthy. Here are seven arguments as to why you should drop that high protein, low carb diet.

1. Many high protein, low carb diets increase your fat consumption and decrease the nutritionally packed foods that you body needs.

On a long term basis this form of eating will rob your body of essential minerals and vitamins that your body needs for proper functioning.

2. There is no documentation showing that high protein low carb diets deliver the promise of sustained weight loss. While they provide quick weight loss, they have not been shown to help people long term. It is important that you realize that most of the weight you loose initially is water weight, not fat, and the longer you are on the diet the more muscle you will loose.

3. High protein low carb diets are rich in animal products that have not only protein but a lot of saturated fat. Eating large amounts of these foods over time has been shown to increase your risk of several cancers, diabetes, stroke and coronary heart disease.

4. As Americans we already eat more protein then our bodies need. This is especially dangerous for people that have any kidney or lover problems. Eating even more protein may worsen their ailment.

5. High protein low carb diets cause muscle loss and fatigue. The body needs glycogen to fuel the body. These diets force the body fluids out as it eliminates your consumption of carbohydrates causing a loss in glycogen and muscle deterioration.

6. Progression of diabetes and diabetic renal disease is also caused by the high protein low carb diets. Your liver and kidneys have to work over time to rid the body of the excess nitrogen that is being produced due to the high amounts of proteins.

7. Weaker bones result form high protein low carb diets. Harvard did an 18 year long study of over 110,000 nurses who ate a high protein diet, those that consumed large amounts of animal protein were shown to have weaker bones then nurses that did not eat a high protein diet.

Loosing water weight, destroying your heart, liver and kidneys as well as weakening your bones should be reasons enough for you to not want to continue your high protein low carb diet. There are healthy alternatives that will not only work at the beginning but will help you loose weight and maintain your lower weight for the rest of your life.

Seven Mistakes to Lose Fat

2010-09-15T01:00:00.000-07:00

1. They fail to consider the consequences of their actions.

Alwyn Cosgrove (one of the top trainers in the business) once told me, "I get my clients to think, "Will this help me or not? Is this a positive step or not?" If you can see that every action that you take is either helping you lose fat or stopping you from losing fat, then you will start to make better choices. So remember that everything you put in your mouth is either for or against fat loss. And every exercise choice you make is either for or against fat loss. "Get that", Alwyn says, "and you're a hit."

2. They neglect to control their insulin and blood sugar levels - 2 key factors in determining whether or not the body fat will come off.

If you eat processed foods you are guaranteed to elevate your insulin & blood sugar levels. If you do that, your body sends the message, "Store fat!", and you won't make any progress. So avoid white-flour based bakery products, sugary drinks, and almost any carbohydrate snack that comes in a bag or a box.

3. They train like it's the 80's.

Yes, I know. Eighties music is popular again. But that doesn't mean ineffective training methods from the 80's like light weights, low intensity steady state cardio, and endless low-intensity ab work should also make a comeback. That type of training should stay buried in the back issues of cheesy muscle magazines. Stick to strength training and interval training for efficient and effective body changing routines.

4. They don't take 30 minutes to plan their next day's food intake.

If you fail to do this, you will set your fat loss efforts back by a minimum of 72 hours. Without a good meal plan, you are left to hunt and gather food in the modern world. And that's a recipe for fat loss disaster. You are bound to eat something processed if you aren't prepared. You will lose the fat burning benefits from yesterday's workout and it will take until the end of the following day to get back on track. An entire 72-hour period wasted.

5. They don't eat enough vegetables.

We can thank John Berardi for making it common knowledge that you should eat fibrous vegetables at every meal to assist your fat loss efforts. By doing so, you'll control your blood sugar and insulin - thus supporting the optimal hormonal situation for fat loss.

6. They screw up their hormones with poor lifestyle choices.

If you are out boozing and staying up late on the weekend, you are shutting down your fat loss and messing up the optimal hormonal environment for fat burning. I will talk a lot more about the optimal hormonal levels for fat loss, as I believe this is the underrated key to building your best body ever.

7. They don't plan and monitor their training sessions.

If you are still going to the gym without a plan, then you are going to have a hard time losing fat. And if you aren't recording your workouts and eating habits, then you aren't losing as much fat as you probably can. To fix this mistake, start by getting on track with strength training and interval training. It's guaranteed to get you lean.

Gain Muscle and Lose Fat

2010-09-08T01:00:00.000-07:00

Are you ready for my famous "gain muscle or lose fat" chart?

I know this is going to make a few people mad, but it's the truth about whether a guy should lose fat or gain muscle. If he doesn't stick to my recommendations, he won't get the ripped abs and muscles he wants.

I often get scrawny guys asking me how to lose fat, when they have no muscle underneath the fat...they think they will look good if they "get ripped", but in reality, will look like they are starving. They should focus on gaining muscle instead.

This is a harsh lesson in reality, but too many guys are trying to lose weight when the focus should be on gaining muscle.

In fact, through my experience in working with athletes and dozens of men in the gym trying to lose fat and gain muscle, I've come up with a height-weight chart that determines whether or not you should lose weight.

Here's the chart identifying the cut-off weight for muscle building, and the rule below.

5'6" - 140 pounds
5'7" - 145 pounds
5'8" - 150 pounds
5'9" - 155 pounds
5'10 - 160 pounds

And so on. For every inch taller, add 5 pounds. For every inch shorter, subtract 5 pounds.

For example, if you are 5'8", 150 pounds, you should NOT be focusing on losing weight. You need to gain muscle if you want to look good on the beach and have muscle. Focusing on weight loss would be the worst thing you could do. If you do, you'll look like crap, and practically anorexic, to be blunt.

Instead, you must focus on gaining muscle. This will improve the appearance of your body, and take you from a stick-figure to a lean, muscular physique with a better chance of seeing your abs.

And don't worry, you're not going to look huge. At 5'8", a guy would have to be at least 180 in order to be considered "jacked" or "huge".

And the best news of all? Because skinny guys are untrained, simply starting a muscle building program will give them maximum fat loss and muscle gain at the same time. They are going to get the best of both worlds.

To use Turbulence Training to gain muscle and lose fat, simply stick to the weight training workouts only. Avoid the hard interval cardio for at least 4 weeks as you gain muscle, and eat extra calories right after your workout (as well as having a bigger breakfast than normal). These two changes will
allow you to gain muscle and lose fat.

Addicted to Painkillers

2010-09-01T01:00:00.000-07:00

Each year, more than 2 million Americans are given powerful prescription painkillers that contain opiods (sometimes called narcotics) for the relief of pain and discomfort brought on by injury, surgery, menstrual cramps, and even headaches. But a growing number of people taking these medications are becoming addicted to them. And it's not hard to understand why.

Drugs such as Vicodin, Percocet, and Methadone block pain all the way from the nerve endings in the skin to the spinal cord to the brain. Once these drugs reach the brain, they open the floodgates for the chemical dopamine, which triggers feelings of well-being. Dopamine, in effect, rewires the brain to become accustomed to those pleasant feelings.

So when you stop taking the pain-killer, your body will still have a strong craving for the dopamine. This is what makes it so hard to quit. Symptoms of withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (which is the origin of the term "cold turkey"), and involuntary leg movements. Better to avoid getting hooked in the first place. Chemical dependency can happen to anyone, and it can easily sneak up on you. Here are 10 things you should look out for if you or someone you know is currently taking prescription painkillers:

1. An increase in usage

As time goes by, the effects of the initial dose will lessen, prompting a desire for stronger or more frequent doses of the prescribed medication. This is a clear indication that whatever amount they have been taking is no longer providing the same level of relief.

2. Personality changes

Changes in a person's normal behavior can be a sign of dependency. Shifts in energy, mood, and concentration may occur as every day responsibilities become secondary to the need for the relief the prescription provides.

3. Withdrawing socially

This is one of the clearest signs of a dependency problem. Spending more time alone and away from friends and family and social gatherings is a cause for concern.

4. Continuing meds too long

Extending the prescription beyond the initial period, especially after the condition has improved, can be the beginning of an endless cycle. The patient may even believe he or she is still in pain and simply needs to stay on the meds for a few more weeks or months. He or she might even express anger toward a doctor who questions the need to renew the prescription.

5. Too much time spent getting meds

There are no lengths to which a chemically dependent person will not go to obtain the drugs they think they need. This can become an all-consuming obsession, including traveling long distances and visiting many doctors. When getting the drugs seems to be the number one priority, the situation is getting out of hand.

6. Habits and appearance changes

A deterioration in physical appearance and grooming - including not bathing or shaving regularly - is a common result of drug addiction. There may be a general look of unhealthiness, such as persistent coughing and red eyes. Sleeping and eating patterns often become irregular.

7. Failure to meet responsibilities

Sudden changes in work or school attendance and a decline in quality of work or grades are common, as well as forgetting to pay bills and missing appointments.

8. Becoming oversensitive

One consequence of using potent drugs is that the body's response to any sort of stimulation is heightened. For example, a person may have an overly emotional reaction to traffic noise or bright lights - possibly including hallucinations.

9. Forgetfulness and blacking out

A person who is suffering from chemical dependency will forget things that have happened and may even experience memory gaps of several hours.

10. Denial and becoming defensive

Presented with even a hint that they may be addicted, those hooked on drugs will vehemently deny it. The harder you push, the more defensive they are like to get. They might even react to simple questions with an angry outburst.

Additional signs of chemical dependency include an inability to relax or have fun, talking incoherently or making inappropriate remarks, and expressing feelings of exhaustion, depression, and hopelessness.

Remember that painkillers are a blessing that can turn into a curse. And that it is a lot easier to avoid becoming addicted than it is to recover from drug addiction. As long as you follow your doctor's instructions (and you have others around you to make sure you do), these prescription medications will do what they were designed to do - and nothing more.

Back Pain

2010-08-29T01:00:00.000-07:00

It's getting to be so bad that by Monday afternoon, you're already tired of being at the office. You're not even thinking as far ahead as Friday. Just getting to hump day is going to be challenge enough.

In reality, it's not the folks you work with who are getting you down - they're tolerable, mostly, although there is that one guy in accounting. Where do they find these people?

It's not even your boss, who, if he knew even half as much as you do, would be a shoo-in for Executive of the Year.

No, the biggest pain in your neck is actually located a bit lower. And it's really what's making working where you do seem a lot worse than it actually is.

Face it. It's your aching back that's sucking the joy out of your nine-to-five existence and making you feel 10 years older to boot.

Sure, you've learned to tolerate the bad coffee, pointless meetings, and lame jokes in the course of your day. But you just can't tough it out when it comes to back pain, which can range from dull, nagging aches to those unexpected twinges that feel like you've been hit with a taser gun.

If it's any consolation, you're not alone. More than 31 million Americans have low back pain at any given time. The bad news about back pain is that it not only lives with you all day at the office but it also comes home with you at night. It may even dog your weekends.

How do you develop pain?

If you are experiencing back pain at the office, you may think that it is coming from all the sitting, standing, and lifting that you have to do. And, indirectly, it does. But it is actually more about how the body has to adapt to all the sitting, standing, and lifting than the activity itself. Let's take sitting as an example.

Because of the amount of time you spend sitting, your body must gradually adapt itself to that position. This happens in a number of ways. The first thing it must adapt to is how the weight goes through your hips and pelvis. Then, there is the way you sit - upright, slouching, or something in between. Most importantly, it's what happens to the muscles while you're sitting. For example, your hip flexors will get tight from being in a shortened position and your butt will get weak and flabby from being in a relaxed state.

That simple combination of tight hip flexors and weak glutes is called a "muscle imbalance." The result of these muscle imbalances will be postural dysfunctions of your pelvis and spine. These imbalances send both your spine and pelvis into abnormal positions, the combination of which can be devastating to a person with a healthy back and catastrophic for a person suffering from any form of back pain.

What can you do about it?

What you must also understand is that your imbalances are the result of what you do in your everyday life - your workouts, sitting, the activities of your job, and your own personal habits. I'm not going to tell you to stop going to work. But what if you changed the way you present yourself at your desk?

Instead of sitting at your desk, try kneeling. I kneel at least 30 percent of the time I spend at my desk. I have a small foam pad that puts me just high enough to type and see the monitor. I sit on a therapy ball - and guess what? I don't sit still like my momma told me to. I move my hips in every direction, which means I'm working on my core balance all day long.

Improve Your Memory

2010-08-22T01:00:00.000-07:00

The investigators said they hope that these findings will help guide the care of patients with chronic pain and encourage the development of skills to offset memory problems.

Here are a few quick tips to improve your memory:

Read out loud
If you want to remember something, saying the words out loud will help burn the information into your brain. If you can turn it into a rhyme, even better.

Write things down
Mental clutter makes it hard to recall data. Use address books, datebooks, and calendars. Jot down notes on more complicated material and reorganize your notes as soon as possible. The physical act of rewriting can help imprint facts into your memory.

Rehearse and review
Go over what you've learned the day you learn it, and review it periodically. Researchers call this "spaced rehearsal," which has proven to be more effective than cramming.

Get your vitamins
Nutrients such as vitamins B, C, and E can nurture brain function. Dietary sources of B include spinach and other dark leafy greens, strawberries, melons, and black beans. Vitamins C and E improve the flow of oxygen through the brain. Good natural sources are berries, sweet potatoes, red tomatoes, green tea, nuts, citrus fruits, and liver. Omega-3 fatty acids - found in cold-water fish such as salmon and tuna - are also associated with improved cognitive function.

Surprise your brain
Another way to help your brain perform better is to stimulate it through novelty. For example, brushing your teeth with your left hand (if you're right-handed) will fire up seldom-used connections on the nondominant side of your brain. Or try "neurobic" exercise, which forces you to use your faculties in unusual ways - say, getting dressed with your eyes closed, taking a course in a subject you know nothing about, or cooking a recipe in an unfamiliar cuisine

The brain maybe affected by pain but you should never let pain control how or what you think about. If pain relief is what you are after you must hold a firm belief that you can achieve your goals and if believe heart and soul and keep you're your thoughts concentrated and coordinated there is no way that you can not achieve what you are after.

Lower Back Pain

2010-08-15T01:00:00.000-07:00

Each year millions of people struggle with lower back pain and unfortunately, many of them unnecessarily.

The reason is most of the treatments that patients with back pain receive only address the symptoms. And while treating the symptoms can provide some pain relief, it is often only temporary. If you want to get lasting relief, you have to look deeper than just the symptom or even the condition.

The two words that are keeping you in pain

If you suffer from lower back pain, or any other physical condition or injury for that matter, I am willing to bet that you have never heard these two words from the mouth of your doctor, physical therapist or other health care provider.

So what are these two mysterious words? Muscle Imbalances.

See, what most people don't realize is that lower back pain is typically a process, meaning it develops over time. While people tend to attach it to an incident like shoveling snow, sneezing or picking up a box, the fact is the problem has been there for months or years but you are just now aware because there's now pain.

Here's what happens...

Over time, various muscle groups in our body become out of balance. One muscle gets stronger while the opposing muscle gets weaker. This imbalance pulls our bones, joints and spine out of alignment. These muscle imbalances force our body to function in a dysfunctional way and this places excessive, uneven and unnecessary strain and wear and tear on our muscles, ligaments, tendons, bones, cartilage and spinal discs.

While we can function with the imbalances, it usually isn't long before the body breaks down. A good analogy is to think about your car. What happens when your steering is out of alignment? Your car pulls to one side and the tires wear down unevenly and if you don't deal with the underlying problem, eventually you'll have a blow out. Well the same is true for your body.

The real key to eliminating lower back pain (or any other ache, pain or injury) is to start at the beginning and that means you need to identify and address the underlying cause, which is almost always, muscle imbalances. So if you are dealing with lower back pain, or any other condition, I suggest you make identifying your muscle imbalances your number one priority and once you do, you'll be on your way to lasting relief.

While this evaluation and treatment approach is extremely effective, it is not well known so you will likely have a very hard time finding a health care professional that is trained in this approach. The good news is, there are simple "self tests" you can do on your own to get very good idea of what dysfunctions you have and the underlying muscle imbalances that have created your condition and pain.

Jesse Cannone is a certified fitness trainer, rehabilitation specialist and co-founder of the Healthy Back Institute. He is recognized expert in the treatment of back pain and has been featured on both television news programs like NBC, radio programs across the US, magazines like Woman's World, Entrepreneur and on leading website like Spine-Health.com, Ediets.com and About.com. Over 32,000 people in 94 different countries around the world have used his "Lose The Back Pain" system to eliminate their pain.

Degenerative Disc Disease

2010-08-08T01:00:00.000-07:00

Degenerative disc disease is not actually a disease at all. It's a term that describes the natural changes the spinal discs undergo as a person ages. Degenerative disc disease usually occurs in the lower back and the neck, though it can take place anywhere along the spine. As a disc degenerates, it may put pressure on the spinal cord and nerves, which often leads to pain and may affect nerve function. While everyone will experience these changes in their discs, most people will not have pain.

What causes it?

Spinal discs break down with age, resulting in a loss of fluid that can prevent discs from acting as natural shock absorbers. This fluid loss makes discs thinner and shrinks the gap between the vertebrae. Muscle imbalances - essentially, one set of muscles overpowering another - create "postural dysfunctions" that put abnormal pressure on a disc and cause increased wear and tear over time. Eventually, the weak spot gives way and makes contact with the nerve, bringing pain. Barring trauma, degenerative disc disease does not happen overnight. It takes a long time for a nerve to be put under enough pressure to cause pain.

What are the symptoms?

The most common symptoms are back or neck pain. Many people have no pain, while others with the same degree of disc damage have severe pain that limits their activities. An affected disc in the neck area may result in neck or arm pain, while one in the lower back may bring pain to the back, buttocks, or leg. The pain often gets worse when you bend, reach, or twist. In some cases, there may be numbness or tingling in your leg or arm. Loss of bowel or bladder control is deemed a medical emergency, so you should get to the emergency room as quickly as possible if either of these things happens to you.

How is it diagnosed?

Degenerative disc disease is diagnosed with a medical history and physical examination. During the exam, your doctor should check for range of motion and pain associated with the affected area, as well as any tenderness, numbness, tingling, or weakness. Your doctor should also ask about underlying conditions, such as fractures, tumors, and infection. If this examination shows no signs of a serious condition, imaging tests - such as an X-ray - are probably unnecessary.

How is it treated?

Common treatments include cortisone injections, non-steroidal anti-inflammatory drugs (NSAIDs), hot packs, ultrasound, electrical stimulation, and therapeutic exercises. Surgery is also an option, with the two main goals being to take pressure off the nerve and stabilize the joints.

Why do traditional treatments fail?

Most traditional treatments fail because they simply address the symptoms and do not address the cause of the condition. Your degenerated disc is a physical problem, and it requires a physical solution. There are no pills or injections that can create postural balance in your body, which is what is necessary to reduce the pressure on the nerve.

Which treatments work best?

The principles of Muscle Balance Therapy ™ address both the pain of a degenerative disc and the root of the problem - in other words, what's causing the pressure in the first place. Through strategic body assessments, your individual muscle imbalances can be identified. Once that is done, a very targeted corrective program can be designed for your specific needs.

To learn more about how you can get lasting relief from your Back Pain by using Muscle Balance Therapy ™, we suggest you read the latest copy of our Back Pain Relief Guide, simply Fill out the form below now and you'll receive free instant access.

Scoliosis

2010-08-01T01:00:00.000-07:00

What is it?

Scoliosis is a lateral, or sideways, curvature of the spine, which in its normal state should be a straight vertical line when viewed from the front or back. Viewed from the side, a normal spine curves slightly backward to produce a mild degree of roundness in the upper back area and slightly inward curve in the lower back. When a person with scoliosis is viewed from the front or back, the spine appears to be curved to either side of its normal vertical line.

What causes it?

There are numerous causes and types of scoliosis. Neuromuscular scoliosis is caused by abnormal muscles or nerves. This is often seen in people with spina bifida or cerebral palsy, or in those with a number of conditions that include or lead to paralysis. Congenital scoliosis occurs as a result of a bone abnormality that is present at birth. Degenerative scoliosis is bone collapse due to an injury or illness, previous major back surgery, or osteoporosis (a disease that causes thinning of the bones). The most common type is called "idiopathic scoliosis," and a cause for this has not yet been identified. There is, however, substantial evidence that idiopathic scoliosis is inherited.

Who gets it?

Roughly 2 to 3 percent of American 16-year-olds have scoliosis, although less than one tenth of 1 percent have curves that might require surgery (a curvature measuring 40 degrees or higher). It is not known why, but girls are more likely to have scoliosis than boys. Idiopathic scoliosis, the most common kind, typically affects kids ages 10 through 16, and it usually gets worse as a child grows, though it rarely progresses into adulthood.

What are the symptoms?

Scoliosis does not have symptoms as such, but there are discernable warning signs. These include uneven shoulders or hips, a shoulder blade that juts out, noticeable leaning to one side, or walking with a rolling gait. Persons with scoliosis may experience back pain or tire easily during activities that require excessive chest and stomach movement.

How is your condition diagnosed?

Usually, scoliosis is first observed by a child's pediatrician, a parent, or it is discovered during a routine school screening exam. To establish the presence and type of scoliosis, a bone exam is necessary, as well as an X-ray to determine the extent of the curve.

What are the most common treatments?

Most adolescents who are diagnosed with idiopathic scoliosis need to be checked every four to six months, which should include a physical exam and an X-ray. For those with a spinal curve anywhere from 25 to 40 degrees - especially if they have at least two more years of growth ahead of them - bracing is the most common treatment. Braces are designed to stop the progression of the curvature and will occasionally produce a temporary correction. When the brace is removed, however, the curve usually will return to its previous position.

Surgery is often recommended for those with a spinal curve greater than 40 degrees. But surgery will only keep the curve from getting worse; it will not bring the spine back to perfect vertical alignment. During the procedure, metallic implants are used to correct some of the curvature and hold it in the proper position until a bone graft creates a rigid fusion in the area of the curve. Surgery usually involves joining the vertebrae together permanently - which is called spinal fusion. Because fusion prevents growth in the fused part of the spine, another technique may be used for younger children. In this case, a brace is always required after surgery.

Breast Cancer Detection

2010-05-09T01:00:00.000-07:00

How Do I Know if I Have Breast Cancer?

The most effective way to detect breast cancer is by mammography, and a clinical breast exam can complement mammography screening. But medical organizations don't agree on the recommendation for breast self-exams, which is an option for women starting in their 20s. Doctors should discuss the benefits and limitations of breast self-exams with their patients.

Breast Self-Exam
If you decide to do breast self-exam, make sure to go over how to perform it with your health care provider. Premenstrual changes can cause temporary thickening that disappears after the period, so it may better to check your breasts three to five days after your period ends. I If a breast self-exam makes you anxious or you have questions about how to perform it, consult your health care provider.

Look for dimpling or changes in shape or symmetry. This may be best done by looking in a mirror. The rest of the breast self-exam is easiest in the shower, using soap to smooth your skin. Using light pressure, you should check for lumps near the surface. Use firm pressure to explore deeper tissues. Squeeze each nipple gently; if there is any discharge -- especially if it is bloody -- see your doctor.

Any time you find a new or unusual lump in your breast, have your doctor check it to make sure it is not cancerous or precancerous. Most lumps are benign and do not signal cancer. The best test for distinguishing a cyst from a solid tumor is ultrasound; a needle biopsy may also be done. Have your breasts examined by a health care provider once every three years starting at age 20, and every year after age 40.

The American Cancer Society recommends yearly screening mammograms starting at age 40. However, the U.S. Preventive Services Task Force (USPSTF) does not recommend screening for women in their 40s. For women between the ages of 50 and 74, USPSTF experts say women should have mammograms every two years. When you need a mammogram is a personal decision between you and your doctor. If you're over 40, talk to you doctor about when you should begin mammogram screening. Breast lumps can be identified on a mammogram up to two years before they can be felt.

Several tests can help distinguish a benign lump from a malignant tumor. Because malignant and benign lumps tend to have different physical features, imaging tests such as mammography and ultrasonography can often rule out cancer. The only way to confirm cancer is to perform a needle aspiration or a biopsy and to test the tissue sample for cancer cells.

In the event of malignancy, you and your doctor need to know how advanced the cancer is. Various tests are used to check for the presence and likely sites of spread, or metastasis. Cancer cells can be analyzed for the presence or absence of hormone receptors, to find out if the cancer is likely to respond well to hormone therapy. Other tests can help predict the likelihood of metastasis and the potential for recurrence after treatment.

Breast Cancer Signs and Symptoms

2010-05-02T01:00:00.000-07:00

The signs and symptoms of breast cancer include:

A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
A mass or lump, which may feel as small as a pea.
A change in the size, shape, or contour of the breast.
A blood-stained or clear fluid discharge from the nipple.
A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed).
Redness of the skin on the breast or nipple.
An area that is distinctly different from any other area on either breast.
A marble-like hardened area under the skin.

These changes may be found during a breast self-exam.
Medical organizations don't agree on the recommendation for breast self-exams, which is an option for women starting in their 20s. Doctors should discuss the benefits and limitations of breast self-exam with their patients.

Depression and Chronic Pain

2010-04-25T01:00:00.000-07:00

Living with chronic or long-term pain is a tremendous burden. But when you have chronic pain and depression, the burden gets even heavier.

Depression magnifies pain. It makes it more difficult to cope with everyday living. The good news is that chronic pain and depression are not inseparable. Effective medications and psychotherapy can help relieve the depression and make chronic pain more tolerable.

What is chronic pain?
Chronic pain is pain that lasts much longer than would be expected from the original problem or injury. When pain becomes chronic, your body may react in several ways. Chronic pain may be characterized by abnormalities in brain hormone, low energy, mood disorders, muscle pain, and impaired mental and physical performance. Chronic pain worsens as neurochemical changes in your body increase your sensitivity to pain. Then you begin to have pain in other parts of your body that do not normally hurt.

Chronic pain can prevent sleep and cause you to awaken frequently at night. This lack of sleep results in daytime fatigue and low productivity. The ongoing pain will cause additional irritation and make it difficult to deal with others. If you have to care for children or work full time, chronic pain may make your life seem too challenging. The overwhelming feelings can lead to irritability, depression, and even suicide for those who feel no hope for relief is in sight.

What happens with chronic pain and depression?
If you have chronic pain and depression, you've got plenty of company. Depression is one of the most common psychological issues facing people who suffer from chronic pain, and it often complicates the patient's conditions and treatment. Consider these statistics:

According to the American Pain Foundation, about 32 million people in the U.S. report have had pain lasting longer than one year.
From one-quarter to more than half of the population that complains of pain to their doctors are depressed.
On average, 65% of depressed people also complain of pain.
People whose pain limits their independence are especially likely to get depressed.

Because depression in patients with chronic pain frequently goes undiagnosed, it often goes untreated. Pain symptoms and complaints take center stage on most doctor visits. The result is depression -- along with sleep disturbances, loss of appetite, lack of energy, and decreased physical activity, which may make pain much worse.

Is there a cycle of depression and pain?
Pain provokes an emotional response in everyone. If you have pain, you may also have high anxiety, irritability, and agitation. These are very normal feelings when you're hurting. Normally, as pain subsides, so does the stressful response.

But with chronic pain, you may feel constantly tense and stressed. Over time, the constant stress can result in different emotional problems associated with depression. Some of the problems individuals with both chronic pain and depression have include:

Altered mood
Anger
Chronic anxiety
Confused thinking
Decreased self-esteem
Family stress
Fatigue
Fear of injury
Financial concerns
Irritability
Legal issues
Physical deconditioning
Reduced sexual activities
Sleep disturbances
Social isolation
Weight gain or loss
Work issues

11 Tips for Living With Chronic Pain

2010-04-18T01:00:00.000-07:00

Learn deep breathing or meditation to help with chronic pain. Deep breathing and meditation are techniques that help your body relax, which eases pain. Tension and tightness seep from muscles as they receive a quiet message to relax. Although there are many to meditate, the soothing power of repetition is at the heart of some forms of meditation. Focusing on the breath, ignoring thoughts, and repeating a word or phrase -- a mantra -- causes the body to relax. While you can learn meditation on your own, it helps to take a class. Deep breathing is also a relaxation technique. Find a quiet location, a comfortable body position, and block out distracting thoughts. Then, imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon.
Reduce stress in your life. Stress intensifies chronic pain. Negative feelings like depression, anxiety, stress, and anger can increase the body's sensitivity to pain. By learning to take control of stress, you may find some relief from chronic pain. Several techniques can help reduce stress and promote relaxation. Listening to soothing, calming music can lift your mood -- and make living with chronic pain more bearable. There are even specially designed relaxation tapes or CDs for this. Mental imagery relaxation (also called guided imagery) is a form of mental escape that can help you feel peaceful. It involves creating calming, peaceful images in your mind. Progressive muscle relaxation is another technique that promotes relaxation.
Boost chronic pain relief with the natural endorphins from exercise. Endorphins are brain chemicals that help improve your mood while also blocking pain signals. Exercise has another pain-reducing effect -- it strengthens muscles, helping prevent re-injury and further pain. Plus, exercise can help keep your weight down, reduce heart disease risk, and control blood sugar levels -- especially important if you have diabetes. Ask your doctor for an exercise routine that is right for you. If you have certain health conditions, like diabetic neuropathy, you will need to be careful about the types of activities you engage in; your doctor can advise you on the best physical activities for you.
Cut back on alcohol, which can worsen sleep problems. Pain makes sleep difficult, and alcohol can make sleep problems worse. If you're living with chronic pain, drinking less or no alcohol can improve your quality of life.
Join a support group. Meet others living with chronic pain. When you're with people who have chronic pain and understand what you're going through, you feel less alone. You also benefit from their wisdom in coping with the pain. Also, consider meeting with a mental health professional. Anyone can develop depression if they're living with chronic pain. Getting counseling can help you learn to cope better and help you avoid negative thoughts that make pain worse -- so you have a healthier attitude. Asking for help is a sign of strength, not weakness.
Don't smoke. It can worsen chronic pain. Smoking can worsen painful circulation problems and increase risk of heart disease and cancer.
Track your pain level and activities every day. To effectively treat your pain, your doctor needs to know how you've been feeling between visits. Keeping a log or journal of your daily "pain score" will help you track your pain. At the end of each day, note your pain level on the 1 to 10 pain scale. Also, note what activities you did that day. Take this log book to every doctor visit -- to give your doctor a good understanding of how you're living with chronic pain and your physical functioning level.
Learn biofeedback to decrease pain severity. Through biofeedback, it's possible to consciously control various body functions. It may sound like science fiction, but there is good evidence that biofeedback works -- and that it's not hard to master. Here's how it works: You wear sensors that let you "hear" or "see" certain bodily functions like pulse, digestion, body temperature, and muscle tension. The squiggly lines and/or beeps on the attached monitors reflect what's going on inside your body. Then you learn to control those squiggles and beeps. After a few sessions, your mind has trained your biological system to learn the skills.
Get a massage for chronic pain relief. Massage can help reduce stress and relieve tension -- and is being used by people living with all sorts of chronic pain, including back and neck pain.
Eat a healthy diet if you're living with chronic pain. A well-balanced diet is important in many ways -- aiding your digestive process, reducing heart disease risk, keeping weight under control, and improving blood sugar levels. To eat a low-fat, low-sodium diet, choose from these: fresh fruits and vegetables; cooked dried beans and peas; whole-grain breads and cereals; low-fat cheese, milk, and yogurt; and lean meats.
Find ways to distract yourself from pain so you enjoy life more. When you focus on pain, it makes it worse rather than better. Instead, find something you like doing -- an activity that keeps you busy and thinking about things besides your pain. You might not be able to avoid pain, but you can take control of your life.

Understanding Allergy and Hay Fever Medications

2010-04-11T01:00:00.000-07:00

Antihistamines

Many antihistamine drugs are available without a prescription. Examples include the first-generation antihistamines such as brompheniramine (Dimetapp, Bromphen, Dimetane, Nasahist), chlorpheniramine (Chlor-Trimeton), clemastine (Allerhist, Tavist), and diphenhydramine (Benadryl), and a second-generation antihistamine loratadine (Claritin). Loratadine (Claritin) does not cause drowsiness.

Common prescription antihistamines (all second-generation antihistamines) include cetirizine (Zyrtec), desloratadine (Clarinex), and fexofenadine (Allegra). These antihistamines (and loratadine) are less likely to cause adverse effects like drowsiness or dry mouth.

Several antihistamine nasal sprays (for example, azelastine [Astelin]) are also available to treat symptoms such as runny nose, sneezing, and itchy nose.

How antihistamines work: These drugs compete with histamine for histamine receptor sites. By occupying the histamine receptor sites, they prevent histamine from causing allergic symptoms. Antihistamines are most effective when taken continuously during the allergy season.

Who should not use these medications: Antihistamines are contraindicated in individuals allergic to them. They may cause unwanted side effects in the following:

Individuals currently using a monoamine oxidase inhibitor (MAOI)
Individuals with narrow-angle glaucoma
Individuals who are breastfeeding

Use: Antihistamines come in tablet, chewable tablet, capsule, and liquid forms. How often an antihistamine should be taken each day depends on the individual antihistamine's characteristics and the type of preparation (that is, the dosage form).

Drug or food interactions: Avoid taking other drugs that cause drowsiness, such as alcohol, sleep preparations, sedatives, or tranquilizers. Avoid taking MAOIs (for example, isocarboxazid [Marplan], phenelzine sulfate [Nardil], or tranylcypromine [Parnate]) within 14 days of antihistamines. For drug interactions specific to a particular antihistamine, talk with a doctor or pharmacist.

Side effects: Many antihistamines (particularly the first-generation agents) may cause the following side effects:

Drowsiness
Dry mouth
Urine retention
Blurred vision
Before driving a car or operating machinery, be sure to know if the antihistamine affects the ability to concentrate and stay awake.
Check with a doctor before taking antihistamines.

Mental Health and Hypnosis

2010-04-04T01:00:00.000-07:00

Hypnosis -- or hypnotherapy -- uses guided relaxation, intense concentration, and focused attention to achieve a heightened state of awareness that is sometimes called a trance. The person's attention is so focused while in this state that anything going on around the person is temporarily blocked out or ignored. In this naturally occurring state, a person may focus his or her attention -- with the help of a trained therapist -- on specific thoughts or tasks.

How Does Hypnosis Work?
Hypnosis is usually considered an aid to psychotherapy (counseling or simply therapy), rather than a treatment in itself. It helps with psychotherapy because the hypnotic state allows people to explore painful thoughts, feelings, and memories they might have hidden from their conscious minds. In addition, hypnosis enables people to perceive some things differently, such as blocking an awareness of pain.

Hypnosis can be used in two ways, as suggestion therapy or for patient analysis.

Suggestion therapy: The hypnotic state makes the person better able to respond to suggestions. Therefore, hypnotherapy can help some people change certain behaviors, such as to stopping smoking or nail-biting. It can also help people change perceptions and sensations, and is particularly useful in treating pain.
Analysis: This approach uses the relaxed state to find the root cause of a disorder or symptom, such as a traumatic past event that a person has hidden in his or her unconscious memory. Once the trauma is revealed, it can be addressed in psychotherapy.

What Are the Benefits of Hypnosis?
The hypnotic state allows a person to be more open to discussion and suggestion. It can improve the success of other treatments for many conditions, including:

Phobias, fears, and anxiety
Sleep disorders
Depression
Stress
Post-trauma anxiety
Grief and loss

It also might be used to help with pain control and to overcome habits, such as smoking or overeating. It also might be helpful for people whose symptoms are severe or who need crisis management.

What Are the Drawbacks of Hypnosis?
Hypnosis might not be appropriate for a person who has psychotic symptoms, such as hallucinations and delusions, or for someone who is using drugs or alcohol. It should be used for pain control only after a doctor has evaluated the person for any physical disorder that might require medical or surgical treatment.

Some therapists use hypnosis to recover repressed memories they believe are linked to the person's mental disorder. However, hypnosis also poses a risk of creating false memories -- usually as a result of unintended suggestions by the therapist. For this reason, the use of hypnosis for certain mental disorders, such as dissociative disorders, remains controversial.
Is Hypnosis Dangerous?

Hypnosis is not a dangerous procedure. It is not mind control or brainwashing. A therapist cannot make a person do something embarrassing or that the person doesn't want to do. The greatest risk, as discussed above, is that false memories can be created.
Who Performs Hypnosis?

Hypnosis is performed by a licensed or certified mental health professional who is specially trained in this technique.

Allergies and Hives (Urticaria and Angioedema)

2010-03-28T01:00:00.000-07:00

Hives, also known as urticaria, are an outbreak of swollen, pale red bumps, patches, or welts on the skin that appear suddenly -- either as a result of allergies, or for other reasons.

Hives usually cause itching, but may also burn or sting. They can appear anywhere on the body, including the face, lips, tongue, throat, or ears. Hives vary in size (from a pencil eraser to a dinner plate), and may join together to form larger areas known as plaques. They can last for hours, or up to several days before fading.

Angioedema is similar to hives, but the swelling occurs beneath the skin instead of on the surface. Angioedema is characterized by deep swelling around the eyes and lips and sometimes of the genitals, hands, and feet. It generally lasts longer than hives, but the swelling usually goes away in less than 24 hours.

Occasionally, severe, prolonged tissue swelling can be disfiguring. Rarely, angioedema of the throat, tongue, or lungs can block the airways, causing difficulty breathing. This may become life threatening.

What Causes Hives and Angioedema?
Hives and angioedema form when, in response to histamine, blood plasma leaks out of small blood vessels in the skin. Histamine is a chemical released from specialized cells along the skin's blood vessels.

Allergic reactions, chemicals in foods, insect stings, sunlight exposure, or medicines can all cause histamine release. Sometimes it's impossible to find out exactly why hives have formed.

There are several different types of hives and angioedema, including:

Acute urticaria and/or angiodema: Hives or swelling lasting less than six weeks. The most common causes are foods, medicines, latex, or infections. Insect bites and internal disease may also be responsible. The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame. Medicines that can cause hives and angioedema include aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs, such as ibuprofen), high blood pressure medications (ACE inhibitors), or painkillers such as codeine.
Chronic urticaria and/or angioedema: Hives or swelling lasting more than six weeks. The cause of this type of hives is usually more difficult to identify than those causing acute urticaria and/or angioedema. The causes can be similar to those of acute urticaria but can also include autoimmunity, chronic infections, hormonal disorders, and malignancy.
Physical urticaria: Hives caused by direct physical stimulation of the skin -- for example, cold, heat, sun exposure, vibration, pressure, sweating, and exercise. The hives usually occur right where the skin was stimulated and rarely appear anywhere else. Most of the hives appear within one hour after exposure.
Dermatographism: Hives that form after firmly stroking or scratching the skin. These hives can also occur along with other forms of urticaria.
Hereditary angioedema: This is painful swelling of tissue. It is passed on through families.

How Are Hives and Angioedema Diagnosed?
Your doctor will need to ask many questions in an attempt to find the possible cause of hives or angiodema. Since there are no specific tests for hives -- or the associated swelling of angioedema -- testing will depend on your medical history and a thorough examination by your primary care doctor, allergist, immunologist, or dermatologist.

Skin tests may be performed to determine the substance that you are allergic to. Routine blood tests are done to determine if a system-wide illness is present.

What Is the Treatment for Hives and Angioedema?
The best treatment for hives and angioedema is to identify and remove the trigger, but this is not an easy task. Antihistamines are usually prescribed by your doctor or dermatologist to provide relief from symptoms. These drugs may also be taken on a regular schedule to help prevent hives and associated swelling from forming in the first place.

Chronic hives may be treated with antihistamines or a combination of medications. When antihistamines don't provide relief, oral corticosteroids may be prescribed. For severe hive or angioedema outbreaks, an injection of epinephrine or a steroid medication may be needed.

How Can Hives Be Managed?
While you're waiting for the hives and swelling to disappear, here are some tips:

Avoid hot water; use lukewarm water instead.
Use gentle, mild soap.
Apply cool compresses or wet cloths to the affected areas.
Try to work and sleep in a cool room.
Wear loose-fitting lightweight clothes.

When Should I Call the Doctor About Hives or Angiodema?
If hives or angioedema occur with any of the following symptoms, contact your doctor right away:

Dizziness
Wheezing
Difficulty breathing
Tightness in the chest
Swelling of the tongue, lips, or face

Mental Health and Psychotherapy

2010-03-21T01:00:00.000-07:00

Psychotherapy is often used either alone or in combination with medications to treat mental illnesses. Called "therapy" for short, the word psychotherapy actually involves a variety of treatment techniques. During psychotherapy, a person with a mental illness talks to a licensed and trained mental health care professional who helps him or her identify and work through the factors that may be triggering their illness.

How Does Psychotherapy Help?

Psychotherapy helps people with a mental disorder:

Understand the behaviors, emotions, and ideas that contribute to his or her illness.
Understand and identify the life problems or events -- like a major illness, a death in the family, a loss of a job, or a divorce -- that contribute to their illness and help them understand which aspects of those problems they may be able to solve or improve.
Regain a sense of control and pleasure in life.
Learn coping techniques and problem-solving skills.

Types of Therapy
Therapy can be given in a variety of formats, including:

Individual: This therapy involves only the patient and the therapist.
Group: Two or more patients may participate in therapy at the same time. Patients are able to share experiences and learn that others feel the same way, and have had the same experiences.
Marital/couples: This type of therapy helps spouses and partners understand why their loved one has a mental disorder, what changes in communication and behaviors can help, and what they can do to cope.
Family: Because family is a key part of the team that helps people with mental illness get better, it is sometimes helpful for family members to understand what their loved one is going through, how they themselves can cope, and what they can do to help.

Approaches to Therapy
While therapy can be done in different formats -- like family, group, and individual -- there are also several different approaches that mental health professionals can take to provide therapy. After talking with the patient about their disorder, the therapist will decide which approach to use based on the suspected underlying factors contributing to the condition.

Different approaches to therapy include:

Psychodynamic Therapy
Psychodynamic therapy is based on the assumption that a person is mentally ill because of unresolved, generally unconscious conflicts, often stemming from childhood. The goal of this type of therapy is for the patient to understand and cope better with these feelings by talking about the experiences. Psychodynamic therapy is administered over a period of three to four months, although it can last longer, even years.

Interpersonal Therapy
Interpersonal therapy focuses on the behaviors and interactions a patient has with family and friends. The primary goal of this therapy is to improve communication skills and increase self-esteem during a short period of time. It usually lasts three to four months and works well for depression caused by mourning, relationship conflicts, major life events, and social isolation.

Psychodynamic and interpersonal therapies help patients resolve mental illness caused by:

Loss (grief)
Relationship conflicts
Role transitions (such as becoming a mother, or a caregiver)

Cognitive-Behavioral Therapy
Cognitive-behavioral therapy helps people with mental illness to identify and change inaccurate perceptions that they may have of themselves and the world around them. The therapist helps the patient establish new ways of thinking by directing attention to both the "wrong" and "right" assumptions they make about themselves and others.

Cognitive-behavioral therapy is recommended for patients:

Who think and behave in ways that trigger and perpetuate mental illness.
With mild-to-moderate depression as the only treatment or in addition to treatment with antidepressant medication
Who refuse or are unable to take antidepressant medication.
Of all ages who have mental illness that causes suffering, disability, or interpersonal problems.

Therapy Tips
Therapy works best when you attend all of your scheduled appointments. The effectiveness of therapy depends on your active participation. It requires time, effort, and regularity.

As you begin therapy, establish some goals with your therapist. Then spend time periodically reviewing your progress with your therapist. If you don't like your therapist's approach or if you don't think the therapist is helping you, talk to him or her about it and seek a second opinion if both you and your therapist agree, but don't discontinue therapy abruptly.
Tips for Starting Therapy

Here are some tips to use when starting therapy for the first time:

Identify sources of stress: Try keeping a journal and note stressful as well as positive events.
Restructure priorities: Emphasize positive, effective behavior.
Make time for recreational and pleasurable activities.
Communicate: Explain and assert your needs to someone you trust; write in a journal to express your feelings.
Try to focus on positive outcomes and finding methods for reducing and managing stress.

Remember, therapy involves evaluating your thoughts and behaviors, identifying stresses that contribute to your condition, and working to modify both. People who actively participate in therapy recover more quickly and have fewer relapses.

Also, keep in mind, therapy is treatment that addresses specific causes of mental illness; it is not a "quick fix." It takes longer to begin to work than medication, but there is evidence to suggest that its effects last longer. Medication may be needed immediately in cases of severe mental illness, but the combination of therapy and medicine is very effective.

Food Allergies and Food Intolerance

2010-03-14T01:00:00.001-08:00

Food allergies or food intolerances affect nearly everyone at some point. People often have an unpleasant reaction to something they ate and wonder if they have a food allergy. One out of three people either say that they have a food allergy or that they modify the family diet because a family member is suspected of having a food allergy. But only about 3% of children have clinically proven allergic reactions to foods. In adults, the prevalence of food allergy drops to about 1% of the total population.

This difference between the clinically proven prevalence of food allergy and the public perception of the problem is in part due to reactions called "food intolerances" rather than food allergies. A food allergy, or hypersensitivity, is an abnormal response to a food that is triggered by the immune system. The immune system is not responsible for the symptoms of a food intolerance, even though these symptoms can resemble those of a food allergy.

It is extremely important for people who have true food allergies to identify them and prevent allergic reactions to food because these reactions can cause devastating illness and, in some cases, be fatal.

How Food Allergies Work

Food allergies involve two features of the human immune response. One is the production of immunoglobulin E (IgE), a type of protein called an antibody that circulates through the blood. The other is the mast cell, a specific cell that occurs in all body tissues but is especially common in areas of the body that are typical sites of allergic reactions, including the nose and throat, lungs, skin, and gastrointestinal tract.

The ability of a given individual to form IgE against something as benign as food is an inherited predisposition. Generally, such people come from families in which allergies are common -- not necessarily food allergies but perhaps hay fever, asthma, or hives. Someone with two allergic parents is more likely to develop food allergies than someone with one allergic parent.

Before an allergic reaction can occur, a person who is predisposed to form IgE to foods first has to be exposed to the food. As this food is digested, it triggers certain cells to produce specific IgE in large amounts. The IgE is then released and attaches to the surface of mast cells. The next time the person eats that food, it interacts with specific IgE on the surface of the mast cells and triggers the cells to release chemicals such as histamine. Depending upon the tissue in which they are released, these chemicals will cause a person to have various food allergy symptoms. If the mast cells release chemicals in the ears, nose, and throat, a person may feel an itching in the mouth and may have trouble breathing or swallowing. If the affected mast cells are in the gastrointestinal tract, the person may have abdominal pain or diarrhea. The chemicals released by skin mast cells, in contrast, can prompt hives.

Food allergens (the food fragments responsible for an allergic reaction) are proteins within the food that usually are not broken down by the heat of cooking or by stomach acids or enzymes that digest food. As a result, they survive to cross the gastrointestinal lining, enter the bloodstream, and go to target organs, causing allergic reactions throughout the body.

The complex process of digestion affects the timing and the location of an allergic reaction. If people are allergic to a particular food, for example, they may first experience itching in the mouth as they start to eat the food. After the food is digested in the stomach, abdominal symptoms such as vomiting, diarrhea, or pain may start. When the food allergens enter and travel through the bloodstream, they can cause a drop in blood pressure. As the allergens reach the skin, they can induce hives or eczema, or when they reach the lungs, they may cause asthma. All of this takes place within a few minutes to an hour.

Which Food Allergies Are Most Common?

In adults, the most common foods allergies include: shellfish such as shrimp, crayfish, lobster, and crab; peanuts (a legume that is one of the chief foods to cause severe anaphylaxis, a sudden drop in blood pressure that can be fatal if not treated quickly); tree nuts such as walnuts; fish; and eggs.

In children, the food allergy pattern is somewhat different. The most common food allergens that cause problems in children are eggs, milk, and peanuts. Adults usually do not lose their allergies, but children can sometimes outgrow them. Children are more likely to outgrow allergies to milk or soy than allergies to peanuts, fish, or shrimp.

The foods that adults or children react to are those foods they eat often. In Japan, for example, rice allergy is more frequent. In Scandinavia, codfish allergy is more common.

Blueberry Juice May Boost Memory

2010-03-07T01:00:00.000-08:00

Drinking Wild Blueberry Juice Improves Memory and Learning in Older People With Age-Related Memory Decline

Blueberry Benefits

Researchers say blueberries contain a wealth of phytochemicals that have antioxidant and anti-inflammatory effects. In addition, animal studies have shown that the polyphenols found in blueberries, anthocyanins, have been shown to increase signaling in brain centers associated with memory as well as improve how the brain gets rid of glucose, all of which may help slow memory decline.

In the study, researchers looked at the effects of drinking wild blueberry juice on memory decline in nine adults in their 70s who were experiencing age-related memory decline problems, such as memory lapses.

The participants drank about two and a half cups each day of blueberry juice made from commercially available frozen wild blueberries for 12 weeks. A comparison group of seven older adults drank a similar amount of placebo non-juice beverage for the same time period.

Researchers conducted memory tests, such as word association and list learning and recall tasks, at the beginning and end of the study.

The results showed that those who drank blueberry juice showed significant improvement on learning and memory tests compared to the placebo group.

Researchers say there were also trends suggesting reduced symptoms of depression and lower glucose levels among the wild blueberry juice drinkers, but further research will be needed to confirm these results.

11 Surprising Sneezing Facts

2010-02-28T01:00:00.000-08:00

11 Surprising Sneezing Facts

"Sneezes start in your nerves," says Neil Kao, MD, an allergy and asthma specialist at the Allergic Disease and Asthma Center in Greenville, S.C. Everyone's nervous system is basically wired in the same way, Kao explains. But signals traveling along nerves can take slightly different paths to and from the brain, resulting in different sneeze scenarios from person to person. "It's a nerve transmission that tells your brain something is in your nose that needs to come out," Kao tells WebMD.
Sneezing helps keep your body safe. "Sneezing is an important part of the immune process, helping to keep us healthy and sniffle-free" Kao says. Sneezes protect your body by clearing the nose of bacteria and viruses, Kao explains. When something enters your nose or you encounter a trigger that sets off your "sneeze center" in your brain, located in the lower brain stem, signals are rapidly sent to tightly close your throat, eyes, and mouth. Next, your chest muscles vigorously contract, and then your throat muscles quickly relax. As result, air -- along with saliva and mucus -- is forced out of your mouth and nose. Voila, you've sneezed.
Sneezes are speedy. "Sneezes travel at about 100 miles per hour," says Patti Wood, author of Success Signals: Understanding Body Language. She adds that a single sneeze can send 100,000 germs into the air.
Plucking your eyebrows may make you sneeze. Plucking may set off a nerve in your face that supplies your nasal passages. As a result, you sneeze.
You don't sneeze in your sleep. When you sleep, so do your sneezing nerves -- which means you usually don't sneeze when you doze.
Your workout may make you sneeze. "Exercise can make you sneeze," Kao says. "You hyperventilate when you're over-exerted, and as a result, your nose and mouth start to dry up. So your nose reacts by starting to drip, making you sneeze."
The longest sneezing spree: 978 days, a record set by Donna Griffiths of Worcestershire, England, according to background information on the Library of Congress' web site.
Sunshine may make you sneeze. "Bright sunlight causes one out of three people to sneeze," Wood says. "The light sneezers are called 'photics,' from the Greek meaning ‘of light.' And in fact, light sensitivity is an inherited trait -- just one more thing we can blame on our parents."
Sex can be a sneezing trigger. Have sex, must sneeze? It happens more often than you might think. Researchers believe that the stimulation of the parasympathetic nervous system fires off signals in some people to not only enjoy the act of sex, but to sneeze when it's over.
The sneeziest animal: the iguana. Iguanas sneeze more often and more productively than any other animal, according to Wood's research. Sneezing is how they rid their bodies of certain salts that are the normal byproduct of their digestive process, Woods says.
How do you stop a sneeze? While it's not foolproof, "Try breathing through your mouth and pinching the end of your nose," Kao says.

Sneezing Superstition
Strange sneezing facts aside, there are some beliefs about sneezing that just aren't true. For instance, it's not true that your heart stops when you sneeze. When your chest contracts because of a sneeze, your blood flow is momentarily constricted as well. As a result, the rhythm of your heart may change, but it definitely doesn't stop. And your eyeballs cannot pop out of your head when you sneeze. Most people naturally close their eyes when they sneeze, but if they are able to keep them open, their eyes stay firmly planted in their heads where they belong. "While a person's blood pressure behind the eyes may increase slightly when he sneezes, it's not enough force to dislodge the eyeballs from the head," Kao says.

Wood has heard of other sneezing folklore, including the notion that if you sneeze, company is coming over, and if your cat sneezes, it's going to rain. As for the blessing many people say after someone sneezes, Wood explains that the Greek word for sneeze is "pneuma," which means "soul or spirit." "A post-sneeze blessing stems from the ancient belief that sneezing is a near-death experience, and that a blessing will prevent your soul or sneeze from escaping your body and will deter the devil from entering in," Wood says.

Source webmd

New Gene Linked to ADHD

2010-02-21T02:45:00.001-08:00

Gene May Be Tied to Attention Deficit Hyperactivity Disorder and Response to Stimulant Drug
By Jennifer Warner
WebMD Health News
Reviewed by Louise Chang, MD

Feb. 16, 2010 -- A newly discovered genetic link may offer new information on the causes of attention deficit hyperactivity disorder (ADHD) as well as help determine who might best respond to treatment.

Researchers have found that a genetic variant on the latrophilin 3 gene (LPHN3) is associated with ADHD in several different populations. Previous studies have also shown that this gene plays a role in how people respond to the stimulant medications often used to treat the childhood behavioral disorder.

"It is very intriguing that the same variant (SNP marker rs6551665) associated with susceptibility to ADHD is also associated with response to stimulant medication," write researcher M. Arcos-Burgos of the National Human Genome Research Institute at the National Institutes of Health in Bethesda, Md., and colleagues in Molecular Psychiatry. "This opens a window for the evaluation of molecular substrates of ADHD and development of new drugs targeting new genes and brain pathways involved in ADHD."

Although several other genes have been linked to ADHD in previous studies, few of these linkages have been confirmed by replication in other populations.

In the study, researchers showed an association between LPHN3 in an isolated population in Colombia and then were able to replicate those results in five different populations from other areas of the world, including Germany, Norway, Spain, and the U.S.

Further brain testing results were also able to confirm this connection by showing that LPHN3 is expressed in brain regions involved in attention and activity as well as how the brain responds to ADHD stimulant medication treatment.

Researchers say the results could help identify people who are susceptible to ADHD and those who would be more likely to respond to stimulant medications as a part of their ADHD treatment.

Health Insurance

2009-10-08T01:00:00.000-07:00

Health insurance is insurance that pays for medical expenses. It is sometimes used more broadly to include insurance covering disability or long-term nursing or custodial care needs. It may be provided through a government-sponsored social insurance program, or from private insurance companies. It may be purchased on a group basis (e.g., by a firm to cover its employees) or purchased by individual consumers. In each case, the covered groups or individuals pay premiums or taxes to help protect themselves from high or unexpected healthcare expenses. Similar benefits paying for medical expenses may also be provided through social welfare programs funded by the government.

By estimating the overall risk of healthcare expenses, a routine finance structure (such as a monthly premium or annual tax) can be developed, ensuring that money is available to pay for the healthcare benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity.

How it works

A health insurance policy is a contract between an insurance company and an individual or his sponsor (e.g. an employer). The contract can be renewable annually or monthly. The type and amount of health care costs that will be covered by the health insurance company are specified in advance, in the member contract or "Evidence of Coverage" booklet. The individual insurered person's obligations may take several forms:

Premium: The amount the policy-holder or his sponsor (e.g. an employer) pays to the health plan each month to purchase health coverage.
Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. For example, a policy-holder might have to pay a $500 deductible per year, before any of their health care is covered by the health insurer. It may take several doctor's visits or prescription refills before the insured person reaches the deductible and the insurance company starts to pay for care.
Copayment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service. For example, an insured person might pay a $45 copayment for a doctor's visit, or to obtain a prescription. A copayment must be paid each time a particular service is obtained.
Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a copayment), the co-insurance is a percentage of the total cost that insured person may also pay. For example, the member might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80%. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain.
Exclusions: Not all services are covered. The insured person is generally expected to pay the full cost of non-covered services out of their own pocket.
Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maximums. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.
Out-of-pocket maximums: Similar to coverage limits, except that in this case, the insured person's payment obligation ends when they reach the out-of-pocket maximum, and the health company pays all further covered costs. Out-of-pocket maximums can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.
Capitation: An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.
In-Network Provider: (U.S. term) A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or copayments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers.
Prior Authorization: A certification or authorization that an insurer provides prior to medical service occurring. Obtaining an authorization means that the insurer is obligated to pay for the service, assume it matches what was authorized. Many smaller, routine services do not require authorization.
Explanation of Benefits: A document sent by an insurer to a patient explaining what was covered for a medical service, and how they arrived at the payment amount and patient responsibility amount.

Prescription drug plans are a form of insurance offered through some employer benefit plans in the U.S., where the patient pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan.

Some, if not most, health care providers in the United States will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn't pay. The insurance company pays out of network providers according to "reasonable and customary" charges, which may be less than the provider's usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider's standard charges. It generally costs the patient less to use an in-network provider.

Health plan vs. health insurance

Historically, HMOs tended to use the term "health plan", while commercial insurance companies used the term "health insurance". A health plan can also refer to a subscription-based medical care arrangement offered through HMOs, preferred provider organizations, or point of service plans. These plans are similar to pre-paid dental, pre-paid legal, and pre-paid vision plans. Pre-paid health plans typically pay for a fixed number of services (for instance, $300 in preventive care, a certain number of days of hospice care or care in a skilled nursing facility, a fixed number of home health visits, a fixed number of spinal manipulation charges, etc.) The services offered are usually at the discretion of a utilization review nurse who is often contracted through the managed care entity providing the subscription health plan. This determination may be made either prior to or after hospital admission (concurrent utilization review).

Comprehensive vs. scheduled

Comprehensive health insurance pays a percentage of the cost of hospital and physician charges after a deductible (usually applies to hospital charges) or a co-pay (usually applies to physician charges, but may apply to some hospital services) is met by the insured. These plans are generally expensive because of the high potential benefit payout — $1,000,000 to 5,000,000 is common — and because of the vast array of covered benefits.

Scheduled health insurance plans are not meant to replace a traditional comprehensive health insurance plans and are more of a basic policy providing access to day-to-day health care such as going to the doctor or getting a prescription drug. In recent years, these plans have taken the name mini-med plans or association plans. These plans may provide benefits for hospitalization and surgical, but these benefits will be limited. Scheduled plans are not meant to be effective for catastrophic events. These plans cost much less than comprehensive health insurance. They generally pay limited benefits amounts directly to the service provider, and payments are based upon the plan's "schedule of benefits". Annual benefits maximums for a typical scheduled health insurance plan may range from $1,000 to $25,000.

MMR (measles, mumps, rubella) Vaccine

2009-10-01T01:00:00.000-07:00

The MMR vaccine protects against measles, mumps, and rubella (German measles). MMR vaccinations are given by injection in two doses. The first is administered at age 12 to 15 months; the second generally is given at age 4 to 6 years.

Why the Vaccine Is Recommended

Measles, mumps, and rubella are infections that can lead to significant illness. More than 95% of children receiving MMR will be protected from the three diseases throughout their lives.

Possible Risks

Serious problems are rare. Potential mild to moderate adverse effects include rash, fever, swollen cheeks, febrile seizures, and mild joint pain.

When to Delay or Avoid Immunization

if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
if your child has an allergy to eggs, gelatin, or to the antibiotic neomycin that has required medical treatment
if your child has recently received gamma globulin or a blood transfusion
if your child has immune system problems related to cancer
if your child is taking prednisone, steroids, or other immunosuppressive drugs
if your child is undergoing chemotherapy or radiation therapy

Caring for Your Child After Immunization

If a rash develops without other symptoms, no treatment is necessary and it should resolve within several days. Pain and fever may be treated with acetaminophen or ibuprofen. Check with your doctor about the appropriate dose.

When to Call the Doctor

if you aren't sure if the vaccine should be postponed or avoided
if there are problems after the immunization

Influenza Vaccine

2009-09-25T01:00:00.000-07:00

Influenza, commonly known as "the flu," is a highly contagious viral infection of the respiratory tract.

Immunization Schedule

These groups, who are at increased risk of flu-related complications, should receive the flu shot every year:

all children between 6 months and 18 years old, especially those 6 to 59 months old
any child or adult with chronic medical conditions, such as asthma, cystic fibrosis, diabetes, sickle cell anemia, and HIV/AIDS
children and teens on long-term aspirin therapy
anyone age 50 and older
women who will be pregnant during the flu season
anyone who lives or works with infants (especially those under 6 months old)
residents of long-term care facilities, such as nursing homes
health care personnel who have direct contact with patients
out-of-home caregivers and household contacts of anyone in any of these high-risk groups

In the past, there have been times when there were vaccine shortages and delays. So talk with your doctor about availability.

For kids younger than 9 who are getting a flu shot for the first time, it's given in two separate shots a month apart. It can take about 2 weeks after the shot is given for the body to build up protection to the flu.

Another non-shot option called the nasal mist vaccine came on the market in 2003 and is now approved for use in healthy 2- to 49-year-olds. But this nasal mist isn't for everyone, and can't be used by high-risk children and adults or pregnant women.

Why the Vaccine Is Recommended

The flu vaccine reduces the average person's chances of catching the flu by up to 80% during the season. Getting the shot before the flu season is in full force gives the body a chance to build up immunity to, or protection from, the virus.

The shot usually becomes available between September and mid-November. Although you can get a flu shot well into flu season, it's best to try to get it earlier rather than later, if your doctor thinks it's necessary. However, even as late as January there are still 2 to 3 months left in the flu season, so it's still a good idea to get protection.

Even if you or your child got the vaccine last year, that won't protect you from getting the flu this year, because the protection wears off and flu viruses constantly change. That's why the vaccine is updated each year to include the most current strains of the virus.

Possible Risks

Given as one injection in the upper arm, the flu shot contains killed flu viruses that will not cause someone to get the flu, but will cause the body to fight off infection by the live flu virus. Getting a shot of the killed virus offers protection against that particular type of live flu virus if someone comes into contact with it.

Some of the most common side effects from the flu shot are soreness, redness, or swelling at the site of the injection. A low-grade fever and aches are also possible. Because the nasal spray flu vaccine is made from live viruses, it may cause mild flu-like symptoms, including runny nose, headache, vomiting, muscle aches, and fever. Very rarely, the flu vaccine can cause serious side effects such as a severe allergic reaction.

When to Delay or Avoid Immunization

People who should not get the flu shot include:

infants under 6 months old
anyone who's severely allergic to eggs and egg products because the ingredients for flu shots are grown inside eggs. Tell the doctor if your child is allergic before he or she gets a flu shot.
anyone who's ever had a severe reaction to a flu vaccination
anyone who's had Guillain-Barré syndrome (GBS, a rare medical condition that affects the nerves) within 6 weeks of getting a flu shot
anyone with a fever

Caring for Your Child After Immunization

Pain and fever may be treated with acetaminophen or ibuprofen. Check with your doctor about the appropriate dose. Some doctors recommend a dose just before the immunization. A warm, damp cloth or a heating pad also may help minimize soreness. Moving or using the limb that has received the injection often reduces the soreness as well.

When to Call the Doctor

if you aren't sure if the vaccine should be postponed or avoided
if there are problems after the immunization

IPV

2009-09-18T01:00:00.000-07:00

Polio is a viral infection that can result in permanent paralysis.

Immunization Schedule

The inactivated poliovirus vaccine (IPV) is usually given at ages 2 months, 4 months, 6 to 18 months, and 4 to 6 years.

Until recently, the oral poliovirus vaccine (OPV) was given in the United States. Updated recommendations by the Advisory Committee on Immunization Practices now call for IPV injections. This change eliminates the previous small risk of developing polio after receiving the live oral polio vaccine.

Why the Vaccine Is Recommended

Protection against polio occurs in more than 95% of children immunized.

Possible Risks

Side effects include fever and redness or soreness at the site of injection.

When to Delay or Avoid Immunization

IPV should not be given to kids with severe allergy to neomycin, streptomycin, or polymyxin B.

Caring for Your Child After Immunization

IPV may cause mild fever, and soreness and redness at the site of the injection for several days. Depending on the age of your child, pain and fever may be treated with acetaminophen or ibuprofen. Check with your doctor to see if you can give either medication, and to find out the appropriate dose.

When to Call the Doctor

if you aren't sure whether the vaccine should be postponed or avoided
if moderate or severe adverse reactions occur after the immunization

Hib Vaccine

2009-09-11T01:00:00.000-07:00

Haemophilus influenzae type b bacteria were the leading cause of meningitis in children until the Hib vaccine became available.

Immunization Schedule

The Hib vaccine is given by injection at ages 2 months, 4 months, and 6 months (however, some of the Hib vaccines do not require a dose at 6 months). A booster dose is given at 12 to 15 months.

Why the Vaccine Is Recommended

Long-term protection from Haemophilus influenzae type b occurs in more than 90% of infants receiving three doses of the vaccine. Those immunized have protection against Hib meningitis, pneumonia, pericarditis (an infection of the membrane covering the heart), and infections of the blood, bones, and joints caused by the bacteria.

Possible Risks

Minor problems, such as redness, swelling, or tenderness where the shot was given, may occur.

When to Delay or Avoid Immunization

if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
if severe allergic reaction occurs after an injection of the Hib vaccine, further Hib immunizations may not be given to your child

Caring for Your Child After Immunization

The vaccine may cause mild soreness and redness in the area where the shot was given. Depending on the age of your child, pain and fever may be treated with acetaminophen or ibuprofen. Check with your doctor to see if you can give either medication, and to find out the appropriate dose.

When to Call the Doctor

if you aren't sure whether the vaccine should be postponed or avoided
if moderate or serious adverse reactions appear after the Hib injection

Mumps part 2

2009-09-04T01:00:00.000-07:00

Contagiousness

The mumps virus is contagious and spreads in tiny drops of fluid from the mouth and nose of someone who is infected. It can be passed to others through sneezing, coughing, or even laughing. The virus can also spread to other people through direct contact, such as picking up tissues or using drinking glasses that have been used by the infected person.

People who have mumps are most contagious from 2 days before symptoms begin to 6 days after they end. The virus can also spread from people who are infected but have no symptoms.

Prevention

Mumps can be prevented by vaccination. The vaccine can be given alone or as part of the measles-mumps-rubella (MMR) immunization, which is usually given to children at 12 to 15 months of age. A second dose of MMR is generally given at 4 to 6 years of age. As is the case with all immunization schedules, there are important exceptions and special circumstances.

If they haven't already received them, students who are attending colleges and other post-high school institutions should be sure they have had two doses of the MMR vaccine.

During a measles outbreak, your doctor may recommend additional shots of the vaccine, if your child is 1 to 4 years old. Your doctor will have the most current information.

Incubation

The incubation period for mumps can be 12 to 25 days, but the average is 16 to 18 days.

Duration

Children usually recover from mumps in about 10 to 12 days. It takes about 1 week for the swelling to disappear in each parotid gland, but both glands don't usually swell at the same time.

Mumps part 1

2009-08-27T01:00:00.000-07:00

Mumps is a disease caused by a virus that usually spreads through saliva and can infect many parts of the body, especially the parotid salivary glands. These glands, which produce saliva for the mouth, are found toward the back of each cheek, in the area between the ear and jaw. In cases of mumps, these glands typically swell and become painful.

The disease has been recognized for several centuries, and medical historians argue over whether the name "mumps" comes from an old word for "lump" or an old word for "mumble."

Mumps was common until the mumps vaccine was licensed in 1967. Before the vaccine, more than 200,000 cases occurred each year in the United States. Since then the number of cases has dropped to fewer than 1,000 a year, and epidemics have become fairly rare. As in the pre-vaccine era, most cases of mumps are still in kids ages 5 to 14, but the proportion of young adults who become infected has been rising slowly over the last two decades. Mumps infections are uncommon in kids younger than 1 year old.

After a case of mumps it is very unusual to have a second bout because one attack of mumps almost always gives lifelong protection against another. However, other infections can also cause swelling in the salivary glands, which might lead a parent to mistakenly think a child has had mumps more than once.

Signs and Symptoms

Cases of mumps may start with a fever of up to 103° Fahrenheit (39.4° Celsius), as well as a headache and loss of appetite. The well-known hallmark of mumps is swelling and pain in the parotid glands, making the child look like a hamster with food in its cheeks. The glands usually become increasingly swollen and painful over a period of 1 to 3 days. The pain gets worse when the child swallows, talks, chews, or drinks acidic juices (like orange juice).

Both the left and right parotid glands may be affected, with one side swelling a few days before the other, or only one side may swell. In rare cases, mumps will attack other groups of salivary glands instead of the parotids. If this happens, swelling may be noticed under the tongue, under the jaw, or all the way down to the front of the chest.

Mumps can lead to inflammation and swelling of the brain and other organs, although this is not common. Encephalitis (inflammation of the brain) and meningitis (inflammation of the lining of the brain and spinal cord) are both rare complications of mumps. Symptoms appear in the first week after the parotid glands begin to swell and may include: high fever, stiff neck, headache, nausea and vomiting, drowsiness, convulsions, and other signs of brain involvement.

Mumps in adolescent and adult males may also result in the development of orchitis, an inflammation of the testicles. Usually one testicle becomes swollen and painful about 7 to 10 days after the parotids swell. This is accompanied by a high fever, shaking chills, headache, nausea, vomiting, and abdominal pain that can sometimes be mistaken for appendicitis if the right testicle is affected. After 3 to 7 days, testicular pain and swelling subside, usually at about the same time that the fever passes. In some cases, both testicles are involved. Even with involvement of both testicles, sterility is only a rare complication of orchitis.

Additionally, mumps may affect the pancreas or, in females, the ovaries, causing pain and tenderness in parts of the abdomen.

In some cases, signs and symptoms are so mild that no one suspects a mumps infection. Doctors believe that about 1 in 3 people may have a mumps infection without symptoms.

Conditions Associated With Apnea

2009-08-20T01:00:00.000-07:00

Apnea can be seen in connection with:

Apparent Life-Threatening Events (ALTEs)

An ALTE itself is not a sleep disorder — it's a serious event with a combination of apnea and change in color, change in muscle tone, choking, or gagging. Call 911 immediately if your child shows the signs of an ALTE.

ALTEs, especially in young infants, are often associated with medical conditions that require treatment Examples of these medical conditions include gastroesophogeal reflux (GERD), infections, or neurological disorders. ALTEs are scary to observe, but can be uncomplicated and may not happen again. However, any child who has an ALTE should be seen and evaluated immediately.

Apnea of Prematurity (AOP)

AOP can occur in infants who are born prematurely (before 34 weeks of pregnancy). Because the brain or respiratory system may be immature or underdeveloped, the baby may not be able to regulate his or her own breathing normally. AOP can be obstructive, central, or mixed.

Treatment for AOP can involve the following:

keeping the infant's head and neck straight (premature babies should always be placed on their backs to sleep to help keep the airways clear)
medications to stimulate the respiratory system
continuous positive airway pressure (CPAP) — to keep the airway open with the help of forced air through a nose mask
oxygen

Premature infants with AOP are followed closely in the hospital. If AOP doesn't resolve before discharge from the hospital, an infant may be sent home on an apnea monitor and parents and other caregivers will be taught CPR. The family will work closely with the child's doctor to have a treatment plan in place.

Apnea of Infancy (AOI)

Apnea of infancy occurs in children who are younger than 1 year old and who were born after a full-term pregnancy. Following a complete medical evaluation, if a cause of apnea isn't found, it's often called apnea of infancy. AOI usually goes away on its own, but if it doesn't cause any significant problems (such as low blood oxygen), it may be considered part of the child's normal breathing pattern.

Infants with AOI can be observed at home with the help of a special monitor prescribed by a sleep specialist. This monitor records chest movements and heart rate and can relay the readings to a hospital apnea program or save them for future examination by a doctor. Parents and caregivers will be taught CPR before the child is sent home.

If You Think Your Child Has Apnea

If you suspect that your child has apnea, call your doctor. If you suspect that your child is experiencing an ALTE, call 911 immediately.

Although prolonged pauses in breathing can be serious, after a doctor does a complete evaluation and makes a diagnosis, most cases of apnea can be treated or managed with surgery, medications, monitoring devices, or sleep centers. And many cases of apnea go away on their own.

Apnea

2009-08-13T01:00:00.000-07:00

Everyone has brief pauses in their breathing pattern called apnea. Usually these brief stops are completely normal.

Sometimes, though, apnea can cause a prolonged pause in breathing, making the breathing pattern irregular. Someone with apnea might actually stop breathing for short amounts of time, decreasing oxygen levels in the body and disrupting sleep.

Types of Apnea

The word apnea comes from the Greek word meaning "without wind." Although it's perfectly normal for everyone to experience occasional pauses in breathing, apnea can be a problem when breathing stops for 20 seconds or longer.

There are three types of apnea:

obstructive
central
mixed

Obstructive Apnea

A common type of apnea in children, obstructive apnea is caused by an obstruction of the airway (such as enlarged tonsils and adenoids). This is most likely to happen during sleep because that's when the soft tissue at back of the throat is most relaxed. As many as 1% to 3% of otherwise healthy preschool-age kids have obstructive apnea.

Symptoms include:

snoring (the most common) followed by pauses or gasping
labored breathing while sleeping
very restless sleep and sleeping in unusual positions
changes in color

Because obstructive sleep apnea may disturb sleep patterns, these children may also show continued sleepiness after awakening in the morning and tiredness and attention problems throughout the day. Sometimes apnea can affect school performance. One recent study suggests that some kids diagnosed with ADHD actually have attention problems in school because of disrupted sleep patterns caused by obstructive sleep apnea.

Treatment for obstructive apnea involves keeping the throat open to aid air flow, such as with adenotonsillectomy (surgical removal of the tonsils and adenoids) or continuous positive airway pressure (CPAP), which is delivered by having the child wear a nose mask while sleeping.

Central Apnea

Central apnea occurs when the part of the brain that controls breathing doesn't start or properly maintain the breathing process. In very premature infants, it's seen fairly commonly because the respiratory center in the brain is immature. Other than being seen in premature infants, central apnea is the least common form of apnea and often has a neurological cause.

Mixed Apnea

Mixed apnea is a combination of central and obstructive apnea and is seen particularly in infants or young children who have abnormal control of breathing. Mixed apnea may occur when a child is awake or asleep.

DTaP Vaccine

2009-05-31T01:00:00.000-07:00

DTaP

The DTaP vaccine protects against:

diphtheria — a serious infection of the throat that can block the airway and cause severe breathing difficulty
tetanus (lockjaw) — a nerve disease, which can occur at any age, caused by toxin-producing bacteria contaminating a wound
pertussis (whooping cough) — a respiratory illness with cold symptoms that progress to severe coughing (the "whooping" sound occurs when the child breathes in deeply after a severe coughing bout); serious complications of pertussis can occur in children under 1 year of age, and those under 6 months old are especially susceptible. Teens and adults with a persistent cough may not realize they have pertussis, and may pass it to vulnerable infants.

Immunization Schedule

DTaP immunizations are given as a series of five injections and are usually administered at ages 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years. After the initial series of immunizations, a vaccine called Tdap (the booster shot) should be given at ages 11 to 12, or to older teens and adults who haven't yet received a booster with pertussis coverage. Then, Td (tetanus and diphtheria) boosters are recommended every 10 years.

Why the Vaccine Is Recommended

Use of the DTaP vaccine has virtually eliminated diphtheria and tetanus in childhood and has markedly reduced the number of pertussis cases.

Possible Risks

The vaccine frequently causes mild side effects: fever, mild crankiness, tiredness, loss of appetite, and tenderness, redness, or swelling in the area where the shot was given. Rarely, seizures can occur following DTaP. Most of these side effects result from the pertussis component of the vaccine. Severe complications caused by DTaP immunization are rare. Most kids have little or no problem.

When to Delay or Avoid Immunization

if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
if your child has an uncontrolled seizure disorder or certain neurologic diseases or seems not to be developing normally — the pertussis component of the vaccine may not be given, and your child may receive a DT (diphtheria and tetanus) vaccine instead

If your child experienced any of the following after an earlier DTaP, consult with your doctor before your child receives another injection of the vaccine:

seizures within 3 to 7 days after injection
worsening of seizures
an allergic reaction after receiving the vaccine, such as mouth, throat, or facial swelling
difficulty breathing
temperature of 105° Fahrenheit (40.5° Celsius) or higher during the first 2 days after injection
shock or collapse during the first 2 days after injection
persistent, uncontrolled crying that lasts for more than 3 hours during the first 2 days after injection

Caring for Your Child After Immunization

Your child may experience fever, soreness, and some swelling and redness in the area where the shot was given. Depending on the age of your child, pain and fever may be treated with acetaminophen or ibuprofen. Check with your doctor to see if you can give either medication, and to find out the appropriate dose.

A warm, damp cloth or a heating pad also may help reduce soreness. Moving or using the limb that has received the injection often reduces the soreness.

When to Call the Doctor

if you aren't sure whether the vaccine should be postponed or avoided. Children who have had certain problems with the DTaP vaccine usually can safely receive the DT vaccine.
if complications or severe symptoms develop after immunization, including seizures, fever above 105° Fahrenheit (40.5° Celsius), difficulty breathing or other signs of allergy, shock or collapse, or uncontrolled crying for more than 3 hours

Pneumococcal Vaccine

2009-05-24T01:00:00.000-07:00

Pneumococcal Vaccine (PCV)

The pneumococcal conjugate vaccine (PCV) protects against pneumococcal infections. The bacterium is a leading cause of serious infections, including pneumonia, blood infections, and bacterial meningitis.

Children under 2 years old, adults over 65 years old, and people with certain medical conditions are most susceptible to serious pneumococcal infections. The pneumococcus bacterium is spread through person-to-person contact. The vaccine not only prevents the infection in children who receive it, it also helps stop its spread.

Immunization Schedule

PCV immunizations are given as a series of four injections starting at 2 months of age and following at 4 months, 6 months, and 12 to 15 months. Kids who miss the first dose or may have missed subsequent doses due to vaccine shortage should still receive the vaccine, and your doctor can give you a modified schedule for immunization.

Why the Vaccine Is Recommended

The most serious infections affect children younger than 2 years old, and the vaccine will protect them when they're at greatest risk.

PCV also is recommended for kids between 2 and 5 years of age who are at high risk for serious pneumococcal infections because they have medical problems such as:

sickle cell anemia
a damaged spleen or no spleen
HIV/AIDS
cochlear implants
a disease that affects the immune system, such as diabetes or cancer
receiving medications that affect the immune system, such as steroids or chemotherapy

In addition, these high-risk children may also receive the pneumococcal polysaccharide vaccine (PPV) in addition to the PCV when they're older than 24 months.

The PCV vaccine should be considered for all other unvaccinated 2- to -5-year-olds, especially those who are under 3 years of age; are of Alaska Native, American Indian, or African American descent; or who attend group childcare centers.

Possible Risks

Children who receive the PCV vaccine may have redness, tenderness, or swelling where the shot was given. A child may also have a fever after receiving the shot.

When to Delay or Avoid Immunization

if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
if your child has had a severe allergic reaction to a previous dose of the vaccine

Caring for Your Child After Immunization

The vaccine may cause mild fever, and soreness and redness in the area where the shot was given. Depending on the age of your child, pain and fever may be treated with acetaminophen or ibuprofen. Check with your doctor to see if you can give either medication, and to find out the appropriate dose.

When to Call the Doctor

if your child missed a dose in the series
if a severe allergic reaction or high fever occurs after immunization

Hepatitis B Vaccine

2009-05-17T01:00:00.000-07:00

Hepatitis B

Hepatitis B virus (HBV) affects the liver. Those who are infected can become lifelong carriers of the virus and may develop long-term problems such as cirrhosis (liver disease) or cancer of the liver.

Immunization Schedule

Hepatitis B vaccine usually is given as a series of three injections. The first shot is often given to infants shortly after birth. If the mother of a newborn carries the hepatitis B virus in her blood, the infant needs to receive the first shot within 12 hours after birth, along with another shot (HBIG) to immediately provide protection against the virus. If a newborn's mother shows no evidence of HBV in her blood, the infant may receive the hepatitis B vaccine any time prior to leaving the hospital. It may also be delayed until the 1- or 2- month visit to your doctor.

If the first dose is given shortly after birth, the second shot is given at 1 to 2 months and the third at 6 to 18 months. For infants who don't receive the first shot until 1 to 2 months, the second shot is given at 3 to 4 months and the third at 6 to 18 months. In either case, the second and third shots are usually given in conjunction with other routine childhood immunizations.

Why the Vaccine Is Recommended

The hepatitis B vaccine usually creates long-term immunity. Infants who receive the HBV series should be protected from hepatitis B infection not only throughout their childhood but also into the adult years. Eliminating the risk of infection also decreases risk for cirrhosis of the liver, chronic liver disease, and liver cancer. Young adults and adolescents should also receive the vaccine if they did not as infants.

Possible Risks

Serious problems associated with receiving the HBV vaccine are rare. Problems that do occur tend to be minor, such as fever or redness or tenderness at the injection site.

When to Delay or Avoid Immunization

if your child is currently sick, although simple colds or other minor illnesses should not prevent immunization
if a severe allergic reaction (called anaphylaxis) occurred after a previous injection of the HBV vaccine

Caring for Your Child After Immunization

The vaccine may cause mild fever, and soreness and redness in the area where the shot was given. Depending on the age of your child, pain and fever may be treated with acetaminophen or ibuprofen. Very young infants should not be given either medication, but for older infants or children, you can check with the doctor about the appropriate dose.

When to Call the Doctor

if you're not sure of the recommended schedule for the hepatitis B vaccine
if you have concerns about your own HBV carrier state
if moderate or serious adverse effects appear after your child has received an HBV injection

Staph Infections part 3

2009-05-10T01:00:00.000-07:00

MRSA

You may have heard about methicillin-resistant Staphylococcus aureus (MRSA), a type of staph bacteria with a resistance to the antibiotics usually used to treat staph infections. Although MRSA infections can be harder to treat, in most cases they heal with proper care.

Most MRSA infections involve the skin, but sometimes MRSA can cause more serious problems, such as bone infections or pneumonia. MRSA pneumonia is rare, but is more of a risk for kids already sick with the flu.

Scalded Skin Syndrome

Scalded skin syndrome (SSS) most often affects newborns and kids under age 5. The illness usually starts with a localized staph skin infection, but the staph bacteria manufacture a toxin that affects skin all over the body. The child has a fever, rash, and sometimes blisters. As blisters burst and the rash passes, the top layer of skin is dislodged and the skin surface becomes red and raw, like a burn.

SSS is a serious illness that needs to be treated and monitored in a hospital. It affects the body in the same way as serious burns. After treatment, most kids make a full recovery.

Treating Staph Infections

Most localized staph skin infections can be treated by washing the skin with an antibacterial cleanser, warm soaks, applying an antibiotic ointment prescribed by a doctor, and covering the skin with a clean dressing. To keep the infection from spreading, use a towel only once when you soak or clean an area of infected skin, then wash it.

Your doctor may prescribe an oral antibiotic for your child's staph skin infection. If so, give the antibiotic on schedule for as many days as the doctor directs. More serious staph infections may require hospitalization.

Call the doctor whenever your child has an area of red, irritated, or painful skin, especially if you see whitish pus-filled areas or your child has a fever or feels sick. Also, call the doctor if skin infections seem to be passing from one family member to another or if two or more family members have skin infections simultaneously.

Staph Infections part 2

2009-05-03T01:00:00.000-07:00

Complications of Staph Infections

Staph bacteria can cause toxic shock syndrome, cellulitis, and these infections:

Folliculitis and Boils

Folliculitis is an infection of hair follicles, tiny pockets under the skin where hair shafts (strands) grow. In folliculitis, tiny white-headed pimples appear at the base of hair shafts, sometimes with a small red area around each pimple. This infection often occurs in areas where there's been friction or irritation, such as with shaving.

Folliculitis often clears up on its own with good skin hygiene. Sometimes, it can progress to become a boil. With a boil, the staph infection spreads deeper and wider, often affecting the skin's subcutaneous tissue (deeper tissue under the skin) and the oil-producing glands, which are called sebaceous glands. In the first stage, which parents and kids often miss, the area of skin either begins to itch or becomes mildly painful. Next, the skin turns red and begins to swell over the infected area. Finally, the skin above the infection becomes very tender and a whitish "head" may appear. The head may break, and the boil may begin to drain pus, blood, or an amber-colored liquid. Boils can occur anywhere on the skin, especially under the arms or on the groin or buttocks in kids.

To help relieve pain from a boil, try warm-water soaks, a heating pad, or a hot-water bottle applied to the skin for about 20 minutes, three or four times a day. Make sure that the washcloths used for the soaks are washed after each use. Boils are occasionally treated with oral antibiotics and in some cases need to be surgically drained.

Impetigo

Impetigo can affect skin anywhere on the body but commonly occurs around the nose and mouth. It usually affects preschoolers and school-age kids, especially in the summer months.

Impetigo caused by staph bacteria is characterized by large blisters containing fluid that is first clear, then cloudy. The blisters may burst, ooze fluid, and develop a honey-colored crust. Impetigo may itch and can be spread by scratching. Doctors usually prescribe a topical ointment to treat it and may, depending on the severity, add oral antibiotics.

Staph Infections part 1

2009-04-26T01:00:00.000-07:00

What Are Staph Infections?

Staph infections are caused by the bacteria Staphylococcus aureus, which many healthy people carry on their skin and in their noses without getting sick. But when skin is punctured or broken, staph bacteria can enter the wound and cause infections, which can lead to other health problems.

You can help prevent staph infections in your family by encouraging regular hand washing and daily bathing, and by keeping areas that have been cut clean or covered.

How Staph Infections Spread

Staph bacteria can spread through the air, on contaminated surfaces, and from person to person. Kids can carry staph bacteria from one area of their body to another — or pass it to other people — via dirty hands or fingernails. So good hand washing is vital to preventing staph infections.

It's also important to encourage kids to keep their skin clean with a daily bath or shower. If your child has a skin condition such as eczema that makes frequent bathing difficult, ask your doctor for advice.

Keep areas of skin that have been injured — such as cuts, scrapes, and rashes caused by allergic reactions or poison ivy — clean and covered, and follow any directions given by your doctor.

Smallpox

2009-04-19T01:00:00.000-07:00

Smallpox is an infection caused by the variola virus. For centuries, epidemics of smallpox affected people all over the globe, and the disease was often serious. But in 1796, an English doctor named Edward Jenner discovered a way to protect people from getting smallpox, which led to the development of the first smallpox vaccine.

The vaccine worked so well that there hasn't been a case of smallpox in the United States since 1949. The United States stopped vaccinating the general population against smallpox in 1972 because the disease was no longer a threat.

The world's last known case of smallpox was reported in Africa in 1977. In 1980, the World Health Organization (WHO) announced that smallpox was wiped out — the first (and only) time in history that an infectious disease was declared eliminated from the planet.

Worries About Smallpox

Although smallpox infection was wiped out many years ago, samples of the variola virus that causes smallpox were saved in laboratories. Some people have expressed concern that terrorists may try to get access to these stored virus samples with the aim of spreading smallpox infection.

Despite talk about the possibility of terrorists spreading smallpox as a biological weapon, the reality is that this probably wouldn't happen for a couple of reasons. First, terrorists would need access to the virus samples, and the few research laboratories that keep them have security measures to guard them. Also, it would be extremely difficult for a group to take the time to produce a large amount of the variola virus without being detected.

The smallpox vaccine also would prevent the spread of disease because it can:

prevent people from becoming infected if they're vaccinated quickly after exposure to the virus
make the illness less severe in people who do become infected if they're vaccinated within a few days

After the September 11, 2001, terrorist attacks and the anthrax scare that same year, the U.S. government took the precaution of asking several companies to begin making smallpox vaccine again. Today, there's enough vaccine on hand to protect the American people in the event of a smallpox outbreak.

Public health officials have a rapid response plan ready to vaccinate anyone exposed to the disease, as well as people who come into contact with them. So although a person doesn't need to get vaccinated at the moment, the vaccine is there in case it's needed.

Given that the vaccine can stop the spread of the disease, experts believe it's unlikely that terrorists will go to the trouble of producing and using smallpox as a biological weapon — it would take too long and have little effect.

Smallpox Infections

If someone becomes infected with smallpox, it may take anywhere from 7 to 17 days for symptoms to develop. At first a person may have flu-like symptoms such as high fever, fatigue, headaches, and backaches.

Within 2 to 3 days after symptoms start, a rash develops that typically affects the face, legs, and arms. It starts with red marks that become filled with pus and crust over. Scabs develop and then fall off after about 3 to 4 weeks.

Smallpox is very contagious, particularly during the first week a person has the rash. It is most commonly spread in infected drops of saliva when people cough or sneeze. Someone is contagious until after all the scabs have fallen off.

What Works Against Smallpox?

Antibiotics don't work against viruses — they're only effective against bacteria — so taking them won't help someone with smallpox. Vaccination is the only effective weapon against the spread of smallpox. Immunization successfully wiped out smallpox before and, should it become necessary, can help stop any future outbreaks. Researchers are also working to develop other treatments, too.

It's very unlikely that you or your child will ever be exposed to the virus that causes smallpox. But if you're worried about it, talk to a medical professional, who can help you find the answers to any questions you may have.

Sinusitis

2009-04-12T01:00:00.000-07:00

Sinuses are moist air spaces within the bones of the face around the nose. When sinuses swell or become irritated, the infection is called sinusitis. These infections usually follow colds or bouts with allergies.

Cases of sinusitis are common and can be easily treated.

Causes

The sinuses are four sets of hollow spaces that are located in the cheekbones, the forehead, behind the nasal passages, and deep in the brain. Sinuses are lined with the same mucous membranes that line the nose and mouth.

When someone has a cold or allergies and the nasal passages become swollen and make more mucus, so do the sinus tissues. The drainage system for the sinuses can get blocked, and mucus can become trapped in the sinuses. Bacteria, viruses, and fungi can grow there and lead to sinusitis.

Symptoms

Sinusitis can cause different symptoms for kids of varying ages.

Younger kids often have cold-like symptoms, including a stuffy or runny nose and slight fever. If your child develops a fever 5-7 days after cold symptoms begin, it could signal sinusitis or another infection (like bronchitis, pneumonia, or an ear infection), so call your doctor.

Many parents mistake cold-related headaches in young kids for sinus infections. But the sinuses in the forehead don't start developing until kids are 6 or 7 years old and aren't formed enough to get infected until the early teen years, so headaches in kids who have colds usually aren't sinus infections.

In older kids and teens, the most frequent symptoms of sinusitis are a daytime dry cough that doesn't improve after the first 7 days of cold symptoms, fever, worsening congestion, dental pain, ear pain, or tenderness in the face. Sometimes teens who have sinusitis also develop upset stomachs, nausea, headaches, and pain behind the eyes.

Prevention

Simple changes in your lifestyle or home environment can help lower the risk of sinusitis. For example, during the winter, when the cold air outside and your heating system make the air inside your home abnormally dry, consider using a humidifier to keep home humidity at 45%-50%. This will stop dry air from irritating the sinuses and make them less of a target for infection. It's important to clean your humidifier regularly to prevent mold growth.

Although sinusitis itself is not contagious, it is often preceded by a cold, which can spread easily, particularly among family or friends. The most effective way to prevent germs from spreading is to teach kids the importance of frequent hand washing, particularly when they're sick.

Treatment

Doctors may prescribe oral antibiotics to treat cases of sinusitis that are believed to be caused by bacteria. Some doctors may recommend decongestants and antihistamines to help reduce the symptoms.

Cases of sinusitis that are caused by viruses usually go away on their own without medical treatment. Acetaminophen, ibuprofen, and/or warm compresses may help reduce any pain your child may be experiencing. But over-the-counter cold preparations have not been found to be effective in reducing symptoms in kids and may cause unwanted side effects.

Call the doctor whenever your child has:

a cold that lasts for more than 10 days without improvement
a cold that seems to be getting worse after 7 days of symptoms
symptoms of allergies that don't clear with the usual allergy medication

Also call the doctor if your child shows any other signs of sinusitis, like pain or stiffness in the cheeks, a fever, or a cold that seems worse than usual.

Syphilis

2009-04-05T01:00:00.000-07:00

Syphilis, a sexually transmitted disease (STD), can be frightening because if it goes untreated, it can lead to serious health problems and increase a person's risk for getting human immunodeficiency virus (HIV), the virus that causes AIDS.

A syphilis infection can be treated in its early stages with antibiotics, and can be prevented by avoiding sexual contact with someone who is infected. Unfortunately, people don't always know that they are infected, so anyone having sex (oral, anal, or vaginal) should take precautions against STDs and get screened for them regularly.

Symptoms

Syphilis, which is caused by the bacteria Treponema pallidum, often doesn't cause any symptoms in the early stages. If the infection goes untreated, it can progress to affect the entire body.

Syphilis typically has three stages, and there can be different symptoms in each.

Primary Syphilis

The symptoms of the first stage of the infection, which is called primary syphilis, typically appear 2 to 12 weeks after sexual contact with an infected person. A painless red sore called a chancre can appear on the genitals, at the area where the infection occurred. Enlarged lymph nodes (swollen glands) also might be present in the area. Depending on the type of sexual contact, a chancre might also develop on the mouth or in the rectal area. Chancres are the primary way that syphilis is transmitted between people, but often are unrecognized. Even without treatment, chancres will heal after 3 to 6 weeks, but if the infection isn't treated the disease will progress to the second stage.

Secondary Syphilis

The secondary stage usually begins weeks to months after the chancre sore appears. Syphilis bacteria enter the blood and spread through the body, causing many different symptoms, including rash (small red spots), fever, headache, loss of appetite, weight loss, sore throat, muscle aches, joint pain, a generally ill feeling, and enlarged lymph nodes.

The rash of secondary syphilis can develop on the palms and on the soles, in addition to the trunk, arms, and legs. Gray or white wart-like patches of skin called condylomata can appear on the moist areas around the mouth, anus, and vagina. These lesions are full of bacteria and very contagious. In the secondary stage, syphilis may also affect the liver, kidneys, and eyes, or cause meningitis. The symptoms of secondary syphilis will eventually go away. But without treatment, the infection can advance to the third stage. This is true even if an infected person did not have symptoms of primary or secondary syphilis.

Late (Tertiary) Syphilis

After the secondary stage, some people with syphilis progress to the latent stage, where they have no more symptoms but are still infected. Some of them go on to have symptoms of late syphilis, which can appear even years later and can damage the eyes, large blood vessels, heart, bones, and central nervous system (called neurosyphilis). Symptoms of this late stage of syphilis may include memory loss, problems with mental function, walking, balance, bladder control, and vision, in addition to impotence and loss of feeling, particularly in the legs.

Treatment

A doctor can test for syphilis with a physical exam and blood tests and treat it with antibiotics. The doctor can also check for any other STDs, such as gonorrhea, chlamydia, and HIV.

Anyone who is sexually active should see the doctor to be screened for syphilis and other STDs. Someone who has had sexual contact with a person who has syphilis, or has any symptom of the illness, should be seen by a physician for testing and treatment as soon as possible.

Preventing STDs

Because syphilis is an STD, the best way to prevent getting it is to abstain from having sex. Sexual activity with more than one partner or with someone who has more than one sex partner also increases the risk of contracting an STD.

When properly and consistently used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.

Using douche can actually increase a woman's risk of contracting STDs because it can change the natural flora of the vagina and may flush bacteria higher into the genital tract.

Because many STDs often don't have obvious symptoms, often teens don't know when they're infected, so sexually active teens should get screened regularly for STDs so that they don't lead to other more serious health problems.

A teen who is being treated for syphilis also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it's important to encourage them to talk to a trusted adult who can provide the facts.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it's important to talk with him or her about it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don't have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It's also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your local area also may be able to offer some guidance.

Shigella

2009-03-29T01:00:00.001-07:00

Shigella are bacteria that can infect the digestive tract and cause a wide range of symptoms, from diarrhea, cramping, vomiting, and nausea, to more serious complications and illnesses. Infections, called shigellosis, sometimes go away on their own; in others, antibiotics can shorten the course of the illness.

Shigellosis, which is most common during the summer months, typically affects kids 2 to 4 years old, and rarely infects infants younger than 6 months old.

These infections are very contagious and can be prevented with good hand washing practices.

Signs and Symptoms

Shigella bacteria produce toxins that can attack the lining of the large intestine, causing swelling, ulcers on the intestinal wall, and bloody diarrhea.

The severity of the diarrhea sets shigellosis apart from regular diarrhea. In kids with shigellosis, the first bowel movement is often large and watery. Later bowel movements may be smaller, but the diarrhea may have blood and mucus in it.

Other symptoms of shigellosis include:

abdominal cramps
high fever
loss of appetite
nausea and vomiting
painful bowel movements

In very severe cases of shigellosis, a person may have convulsions (seizures), a stiff neck, a headache, extreme tiredness, and confusion. Shigellosis can also lead to dehydration and in rare cases, other complications, like arthritis, skin rashes, and kidney failure.

Some children with severe cases of shigellosis may need to be hospitalized.

Contagiousness

Shigellosis is very contagious. Someone may become infected by coming into in contact with something contaminated by stool from an infected person. This includes toys, surfaces in restrooms, and even food prepared by someone who is infected. For instance, kids who touch a contaminated surface such as a toilet or toy and then put their fingers in their mouths can become infected. Shigella can even be carried and spread by flies that have touched contaminated stool.

Because it doesn't take many Shigella bacteria to cause an infection, the illness spreads easily in families and child-care centers. The bacteria may also spread in water supplies in areas where there is poor sanitation. Shigella can be passed in the person's stool for about 4 weeks even after the obvious symptoms of illness have resolved (although antibiotic treatment can reduce the excretion of Shigella bacteria in the stool).

Prevention

The best way to prevent the spread of Shigella is by frequent and careful hand washing with soap, especially after they use the toilet and before they eat. This is especially important in a child-care setting.

If you're caring for a child who has diarrhea, wash your hands before touching other people and before handling food. (Anyone with a diarrhea should not prepare food for others.) Be sure to frequently clean and disinfect any toilet used by someone with shigellosis.

Diapers of a child with shigellosis should be disposed of in a sealed garbage can, and the diaper area should be wiped with disinfectant after use. Young children (especially those still in diapers) with shigellosis or with diarrhea of any cause should be kept away from other kids.

Proper handling, storage, and preparation of food can also help prevent Shigella infections. Cold foods should be kept cold and hot foods should be kept hot to prevent bacterial growth.

Diagnosis and Treatment

To confirm the diagnosis of shigellosis, your doctor may take a stool sample from your child to be tested for Shigella bacteria. Blood tests and other tests can also rule out other possible causes of the symptoms, especially if your child has a large amount of blood in the stool.

Some cases of shigellosis require no treatment, but antibiotics often will be given to shorten the illness and to prevent the spread of bacteria to others.

If the doctor prescribes antibiotics, give them as prescribed. Avoid giving your child nonprescription medicines for vomiting or diarrhea unless the doctor recommends them, as they can prolong the illness. Acetaminophen (such as Tylenol) can be given to reduce fever and make your child more comfortable.

To prevent dehydration, follow your doctor's guidance about what your child should eat and drink. Your doctor may recommend a special drink called an oral rehydration solution, or ORS (such as Pedialyte) to replace body fluids quickly, especially if the diarrhea has lasted 2 or 3 days or more.

Children who become moderately or severely dehydrated or those with other more serious illnesses may need to be hospitalized to be monitored and receive treatment such as intravenous (IV) fluid therapy or antibiotics.

When to Call the Doctor

Call the doctor if your child has signs of a Shigella infection, including diarrhea with blood or mucus, accompanied by abdominal pain, nausea and vomiting, or high fever.

Children with diarrhea can quickly become dehydrated, which can lead to serious complications. Signs of dehydration include:

thirst
irritability
restlessness
lethargy
dry mouth, tongue, and lips
sunken eyes
a dry diaper for several hours in infants or fewer trips to the bathroom to urinate in older children

If you see any of these signs, call the doctor right away.

Scarlet Fever

2009-03-22T01:00:00.000-07:00

Scarlet fever is caused by an infection with group A streptococcus bacteria. The bacteria make a toxin (poison) that can cause the scarlet-colored rash from which this illness gets its name.

Not all streptococci bacteria make this toxin and not all kids are sensitive to it. Two kids in the same family may both have strep infections, but one child (who is sensitive to the toxin) may develop the rash of scarlet fever while the other may not. Usually, if a child has this scarlet rash and other symptoms of strep throat, it can be treated with antibiotics. So if your child has these symptoms, it's important to call your doctor.

Symptoms of Scarlet Fever

The rash is the most striking sign of scarlet fever. It usually begins looking like a bad sunburn with tiny bumps and it may itch. The rash usually appears first on the neck and face, often leaving a clear unaffected area around the mouth. It spreads to the chest and back, then to the rest of the body. In body creases, especially around the underarms and elbows, the rash forms classic red streaks. Areas of rash usually turn white when you press on them. By the sixth day of the infection the rash usually fades, but the affected skin may begin to peel.

Aside from the rash, there are usually other symptoms that help to confirm a diagnosis of scarlet fever, including a reddened sore throat, a fever above 101° Fahrenheit (38.3° Celsius), and swollen glands in the neck. The tonsils and back of the throat may be covered with a whitish coating, or appear red, swollen, and dotted with whitish or yellowish specks of pus. Early in the infection, the tongue may have a whitish or yellowish coating. A child with scarlet fever also may have chills, body aches, nausea, vomiting, and loss of appetite.

When scarlet fever occurs because of a throat infection, the fever typically stops within 3 to 5 days, and the sore throat passes soon afterward. The scarlet fever rash usually fades on the sixth day after sore throat symptoms began, but skin that was covered by rash may begin to peel. This peeling may last 10 days. With antibiotic treatment, the infection itself is usually cured with a 10-day course of antibiotics, but it may take a few weeks for tonsils and swollen glands to return to normal.

In rare cases, scarlet fever may develop from a streptococcal skin infection like impetigo. In these cases, the child may not get a sore throat.

Preventing Scarlet Fever

The bacterial infection that causes scarlet fever is contagious. A child who has scarlet fever can spread the bacteria to others through nasal and throat fluids by sneezing and coughing. If a child has a skin infection caused by strep bacteria, like impetigo, it can be passed through contact with the skin.

In everyday life, there is no perfect way to avoid the infections that cause scarlet fever. When a child is sick at home, it's always safest to keep that child's drinking glasses and eating utensils separate from those of other family members, and to wash these items thoroughly in hot soapy water. Wash your own hands frequently as you care for a child with a strep infection.

Treating Scarlet Fever

If your child has a rash and the doctor suspects scarlet fever, he or she will usually take a throat culture (a painless swab of throat secretions) to see if the bacteria grow in the laboratory. Once a strep infection is confirmed, the doctor will likely prescribe an antibiotic for your child to be taken for about 10 days.

Caring for a Child With Scarlet Fever

A child with severe strep throat may find that eating is painful, so providing soft foods or a liquid diet may be necessary. Include soothing teas and warm nutritious soups, or cool soft drinks, milkshakes, and ice cream. Make sure that the child drinks plenty of fluids.

Use a cool-mist humidifier to add moisture to the air, since this will help soothe the sore throat. A moist warm towel may help to soothe swollen glands around your child's neck.

If the rash itches, make sure that your child's fingernails are trimmed short so skin isn't damaged through scratching.

When to Call the Doctor

Call the doctor whenever your child suddenly develops a rash, especially if it is accompanied by a fever, sore throat, or swollen glands. This is especially important if your child has any of the symptoms of strep throat, or if someone in your family or in your child's school has recently had a strep infection.

Salmonella Infection

2009-03-15T01:00:00.000-07:00

A salmonella infection is a foodborne illness caused by the salmonella bacteria carried by some animals, which can be transmitted from kitchen surfaces and can be in water, soil, animal feces, raw meats, and eggs. Salmonella infections typically affect the intestines, causing vomiting, fever, and other symptoms that usually resolve without medical treatment.

You can help prevent salmonella infections by not serving any raw meat or eggs, and by not keeping reptiles as pets, particularly if you have very young children.

Hand washing is a powerful way to guard against salmonella infections, so it's essential to teach kids to wash their hands, particularly after trips to the bathroom and before handling food in any way.

Salmonella Basics

Not everyone who ingests salmonella bacteria will become ill. Children, especially infants, are the most likely candidates to get sick from it. About 50,000 cases of salmonella infection are reported in the United States each year and about one third of those are in kids 4 years old or younger.

The type of salmonella most commonly associated with infections in humans is called nontyphoidal salmonella. It is carried by chickens, cows, and reptiles such as turtles, lizards, and iguanas.

Another, rarer form of salmonella, typhoidal salmonella (typhoid fever), is carried only by humans and is usually transmitted through direct contact with the fecal matter of an infected person. This kind of salmonella infection can lead to high fever, abdominal pain, headache, malaise, lethargy, skin rash, constipation, and delirium. It occurs primarily in developing countries without appropriate systems for handling human waste.

Signs and Symptoms

A salmonella infection generally causes nausea, vomiting, abdominal cramps, diarrhea (sometimes bloody), fever, and headache. Because many different kinds of illnesses can cause these symptoms, most doctors will take a stool sample to make an accurate diagnosis.

Symptoms of most salmonella infections usually appear within 3 days of contamination and typically go away without medical treatment.

In cases of typhoid fever caused by salmonella bacteria, early symptoms are the same. But in the second week, the liver and spleen can become enlarged, and a distinctive "rose spotted" skin rash may appear. From there, the infection can cause other health problems, like meningitis and pneumonia.

People at risk for more serious complications from a salmonella infection include those who:

have compromised immune systems (such as people with HIV)
take cancer-fighting drugs
have sickle cell disease or an absent or nonfunctioning spleen
take chronic stomach acid suppression medication

In these higher-risk groups, most doctors will treat an infection with antibiotics to prevent it from spreading to other parts of the body and causing additional health problems.

Prevention

You have many ways to help prevent salmonella bacteria from making your family sick. Most salmonella bacteria appear in animal products and can be killed by the heat from cooking. So it's important to make sure that you don't serve raw or undercooked eggs, poultry, or meat. Microwaving is not a reliable way to kill the salmonella bacteria.

Because salmonella bacteria can contaminate even intact and disinfected grade A eggs, avoid serving poached eggs or eggs that are served sunny-side up.

Salmonella also can be spread through cross-contamination, so when you're preparing meals, keep uncooked meats away from cooked and ready-to-eat foods. In addition, thoroughly wash your hands, cutting boards, counters, and knives after handling uncooked foods.

Some foods may contain unrecognized raw-food products and should be avoided. Caesar salad dressing, the Italian dessert tiramisu, homemade ice cream, chocolate mousse, eggnog, cookie dough, and frostings can contain raw eggs. Unpasteurized milk and juices also can be contaminated with salmonella.

Fecal matter is often the source of salmonella contamination, so hand washing is extremely important, particularly after using the toilet and before preparing food.

Take care to avoid contact with the feces of family pets — especially reptiles. Wash your hands thoroughly after handling an animal and ensure that no reptiles are permitted to come into contact with an infant. Even healthy reptiles (especially turtles and iguanas) are not appropriate pets for small children and should not be in the same house as an infant.

Treatment

If your child has a salmonella infection and a healthy immune system, your doctor may let the infection pass without treatment. But any time your child develops a fever, headache, or bloody diarrhea, call the doctor to rule out any other problems.

If your child is infected and has a fever, you may want to give acetaminophen to reduce his or her temperature and relieve cramping. As with any infection that causes diarrhea, it's important to give your child plenty of liquids to avoid dehydration.

Rubella

2009-03-03T01:00:00.000-08:00

Rubella — commonly known as German measles or 3-day measles — is an infection that primarily affects the skin and lymph nodes. It is caused by the rubella virus (not the same virus that causes measles), which is usually transmitted by droplets from the nose or throat that others breathe in. It can also pass through a pregnant woman's bloodstream to infect her unborn child. As this is a generally mild disease in children, the primary medical danger of rubella is the infection of pregnant women, which may cause congenital rubella syndrome in developing babies.

Before a vaccine against rubella became available in 1969, rubella epidemics occurred every 6 to 9 years. Kids ages 5 to 9 were primarily affected, and many cases of congenital rubella occurred as well. Now, due to immunization of children, there are much fewer cases of rubella and congenital rubella.

Most rubella infections today appear in young, non-immunized adults rather than children. In fact, experts estimate that 10% of young adults are currently susceptible to rubella, which could pose a danger to any children they might have someday.

Signs and Symptoms

Rubella infection may begin with 1 or 2 days of mild fever (99–100° Fahrenheit, or 37.2–37.8° Celsius) and swollen, tender lymph nodes, usually in the back of the neck or behind the ears. A rash then appears that begins on the face and spreads downward. As it spreads down the body, it usually clears on the face. This rash is often the first sign of illness that a parent notices.

The rubella rash can look like many other viral rashes. It appears as either pink or light red spots, which may merge to form evenly colored patches. The rash can itch and lasts up to 3 days. As the rash clears, the affected skin occasionally sheds in very fine flakes.

Other symptoms of rubella, which are more common in teens and adults, may include: headache; loss of appetite; mild conjunctivitis (inflammation of the lining of the eyelids and eyeballs); a stuffy or runny nose; swollen lymph nodes in other parts of the body; and pain and swelling in the joints (especially in young women). Many people with rubella have few or no symptoms at all.

When rubella occurs in a pregnant woman, it may cause congenital rubella syndrome, with potentially devastating consequences for the developing fetus. Children who are infected with rubella before birth are at risk for growth retardation; mental retardation; malformations of the heart and eyes; deafness; and liver, spleen, and bone marrow problems.

Contagiousness

The rubella virus passes from person to person through tiny drops of fluid from the nose and throat. People who have rubella are most contagious from 1 week before to 1 week after the rash appears. Someone who is infected but has no symptoms can still spread the virus.

Infants who have congenital rubella syndrome can shed the virus in urine and fluid from the nose and throat for a year or more and may pass the virus to people who have not been immunized.

Prevention

Rubella can be prevented by a rubella vaccine. Widespread immunization against rubella is critical to controlling the spread of the disease, thereby preventing birth defects caused by congenital rubella syndrome.

The vaccine is usually given to children at 12 to 15 months of age as part of the scheduled measles-mumps-rubella (MMR) immunization. A second dose of MMR is generally given at 4 to 6 years of age. As is the case with all immunization schedules, there are important exceptions and special circumstances. Your child's doctor will have the most current information.

The rubella vaccine should not be given to pregnant women or to a woman who may become pregnant within 1 month of receiving the vaccine. If you are thinking about becoming pregnant, make sure that you are immune to rubella through a blood test or proof of immunization. If you're not immune, you should receive the vaccine at least 1 month before you become pregnant.

Pregnant women who are not immune should avoid anyone who has the illness and should be vaccinated after delivery so that they will be immune during any future pregnancies.

Incubation

The incubation period for rubella is 14–23 days, with an average incubation period of 16–18 days. This means that it can take 2–3 weeks for a child to get rubella after they are exposed to someone with the disease.

Duration

The rubella rash typically lasts 3 days. Lymph nodes may remain swollen for a week or more, and joint pain can last for more than 2 weeks. Children who have rubella usually recover within 1 week, but adults may take longer.

Professional Treatment

Rubella cannot be treated with antibiotics because antibiotics do not work against viral infections. Unless there are complications, rubella will resolve on its own.

Any pregnant woman who has been exposed to rubella should contact her obstetrician immediately.

Home Treatment

Rubella is typically a mild illness, especially in kids. Infected children usually can be cared for at home. Monitor your child's temperature, and call the doctor if the fever climbs too high.

To relieve minor discomfort, you can give your child acetaminophen or ibuprofen. Avoid giving aspirin to a child who has a viral illness because its use in such cases has been associated with the development of Reye syndrome, which can lead to liver failure and death.

When to Call the Doctor

Call the doctor if your child develops a fever of 102° Fahrenheit (38.9° Celsius) or above (in a child younger than 6 months, call for a fever above 100.4° Fahrenheit, or 38° Celsius), or if your child appears to be getting sicker than the mild course of symptoms described above.

Roseola

2009-02-26T01:00:00.000-08:00

Roseola (also known as sixth disease, exanthem subitum, and roseola infantum) is a viral illness in young children, most commonly affecting those between the ages of 6 months and 2 years. It is typically marked by several days of high fever, followed by a distinctive rash just as the fever breaks.

Two common and closely related viruses can cause roseola: human herpesvirus (HHV) type 6 and possibly type 7. These two viruses belong to the same family as the better-known herpes simplex viruses (HSV), but HHV-6 and HHV-7 do not cause the cold sores and genital herpes infections that HSV can cause.

Signs and Symptoms

A child with roseola typically develops a mild upper respiratory illness, followed by a high fever (often over 103° Fahrenheit, or 39.5° Celsius) for up to a week. During this time, the child may appear fussy or irritable and may have a decreased appetite and swollen lymph nodes (glands) in the neck.

The high fever often ends abruptly, and at about the same time a pinkish-red flat or raised rash appears on the child's trunk and spreads over the body. The rash's spots blanch (turn white) when you touch them, and individual spots may have a lighter "halo" around them. The rash usually spreads to the neck, face, arms, and legs.

The fast-rising fever that comes with roseola triggers febrile seizures (convulsions caused by high fevers) in about 10% to 15% of young children. Signs of a febrile seizure include:

unconsciousness
2 to 3 minutes of jerking or twitching in the arms, legs, or face
loss of control of the bladder or bowels

Contagiousness

Roseola is contagious and spreads through tiny drops of fluid from the nose and throat of infected people. These drops are expelled when the infected person talks, laughs, sneezes, or coughs. Then if other people breathe the drops in or touch them and then touch their own noses or mouths, they can become infected as well.

The viruses that cause roseola do not appear to be spread by kids while they are exhibiting symptoms of the illness. Instead, someone who has not yet developed symptoms often spreads the infection.

Prevention

There is no known way to prevent the spread of roseola. Because the infection usually affects young children but rarely adults, it is thought that a bout of roseola in childhood may provide some lasting immunity to the illness. Repeat cases of roseola may occur, but they are not common.

Duration

The fever of roseola lasts from 3 to 7 days, followed by a rash lasting from hours to a few days.

Professional Treatment

To make a diagnosis, your doctor first will take a history and do a thorough physical examination. A diagnosis of roseola is often uncertain until the fever drops and the rash appears, so the doctor may order tests to make sure that the fever is not caused by another type of infection.

The illness typically does not require professional treatment, and when it does, most treatment is aimed at reducing the high fever. Antibiotics cannot treat roseola because a virus, not a bacterium, causes it.

Home Treatment

Until the fever drops, you can help keep your child cool using a sponge or towel soaked in lukewarm water. Do not use ice, cold water, alcohol rubs, fans, or cold baths. Acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) can help to reduce your child's fever. Avoid giving aspirin to a child who has a viral illness because the use of aspirin in such cases has been associated with the development of Reye syndrome, which can lead to liver failure and death.

To prevent dehydration from the fever, encourage your child to drink clear fluids such as water with ice chips, children's electrolyte solutions, flat sodas like ginger ale or lemon-lime (stir room-temperature soda until the fizz disappears), or clear broth. If you are still breastfeeding, breast milk can help prevent dehydration as well.

When to Call the Doctor

Call the doctor if your child is lethargic or not drinking or if you cannot keep the fever down. If your child has a seizure, seek emergency care immediately.

Rocky Mountain Spotted Fever

2009-02-19T01:00:00.000-08:00

Rocky Mountain spotted fever (RMSF) is a bacterial infection that's transmitted to people by tick bites. It occurs most often in the spring and summer, during months when ticks are active — between April and early September.

Although RMSF is most common in the southeastern part of the United States (Virginia, Georgia, and the Carolinas), it occurs in other states as well. It's relatively rare (about 250–2,000 cases per year in the United States), but can be a serious disease if not treated properly.

The bacteria Rickettsia rickettsii that causes RMSF is transmitted by the dog tick (Dermacentor variabilis) in the eastern United States and by the wood tick (Dermacentor andersoni) in the Rocky Mountain states. On the West Coast, the lone star tick (Amblyomma americanum) also can transmit the bacteria.

RMSF gets its name from the trademark rash it causes — small red spots and blotches that begin on the wrists, ankles, palms, and soles. In addition to the rash, the infection can cause fever, chills, muscle aches, vomiting, and nausea. Typically, RMSF is treated with antibiotics and patients recover without any complications. But with late or no treatment, RMSF can cause serious health problems. If your child has fever, achiness, stiff neck, or rash and has or may have been bitten by a tick, it's important to talk with your doctor.

Signs and Symptoms

The symptoms of RMSF typically develop within 1 week of a tick bite but can take up to 2 weeks to appear. In many cases, the person doesn't even remember being bitten by a tick.

Symptoms of RMSF usually begin suddenly. There is a high fever — often 103° Fahrenheit (39° Celsius) to 105° Fahrenheit (40° Celsius) — with chills, muscle aches, and a severe headache. Eyes can become red, muscles may feel tender, and there may be abdominal pain, nausea, vomiting, poor appetite, and fatigue.

The trademark rash of this infection can begin anytime up to 10 days after the fever and headache start, but it most often appears on the third to fifth day. The rash looks like small red spots or blotches that begin on the wrists, ankles, palms, and soles. It spreads up the arms and legs toward the trunk. As the RMSF infection progresses, the original red spots might start to look more like bruises or bloody dots or patches under the skin.

Treating Rocky Mountain Spotted Fever

Doctors usually diagnose Rocky Mountain spotted fever based on enough symptoms to indicate infection. Test results for RMSF can take a while to be sent to the doctor, so treatment often starts before the results are available.

RMSF is typically treated with oral or IV antibiotics, depending on the severity of the infection. Complications may require prolonged treatment.

Untreated, RMSF can lead to serious health problems, so it's important to call your doctor promptly if you notice any symptoms of RMSF, such as:

high fever
headache
chills
muscle aches
red eyes
rash

Without antibiotic treatment, RMSF can lead to health problems that involve the heart, lungs, and brain. In the most severe case, it can be fatal.

If your child is recovering from RMSF at home, follow the doctor's instructions for giving antibiotics. Allow your child to rest in bed until the fever and other symptoms are gone.

Prevention

RMSF can be prevented by avoiding tick-infested areas, like woods and tall grasses, brush, shrubs, and low tree branches, and by taking precautions when spending time outdoors.

When they're playing outdoors, have kids wear light-colored clothing that makes ticks more visible if they get onto them and, if it's practical, long-sleeved shirts and long pants. Use an insect repellant that fends off ticks, being careful to follow the label instructions. Be sure to use a repellent that contains 10% to 30% concentration of DEET (look for N,N-diethyl-meta-toluamide).

Not all ticks carry the RMSF bacteria, but it's a good idea to remove any immediately. The longer a tick stays attached to the skin, the greater the chance of infection. It usually takes several hours for a tick to transmit the bacteria that cause RMSF once it has become attached to the skin.

To remove a dog tick, use tweezers to grasp it by the head (not just the body) as close to the skin as possible. Pull steadily until the tick dislodges. Without touching the tick, preserve it in a jar or plastic bag until you can show it to your doctor. Disinfect the bite area with alcohol, wash your hands, and call your doctor.

Since pets can also bring ticks into your home, check their skin and fur for ticks whenever they have been playing in tick-infested areas. Follow your veterinarian's advice about collars and other products that can be used to keep your pet tick-free.

If you have any concerns, talk with your doctor.

Reye Syndrome

2009-02-12T01:00:00.000-08:00

Reye syndrome, an extremely rare but serious illness that can affect the brain and liver, occurs most commonly in kids recovering from a viral infection.

Named after Australian pathologist R. Douglas Reye, who first reported it as a distinct syndrome in 1963, Reye syndrome is still not well understood. Studies have linked the use of aspirin or aspirin-containing medications during viral disease to development of Reye syndrome.

Cases have dropped dramatically since the finding of a link between the illness and aspirin use in children.

About Reye Syndrome

Reye syndrome predominantly affects kids between 4 and 14 years old, and occurs most frequently when viral diseases are epidemic, such as during the winter months or following an outbreak of chickenpox or influenza B.

Duration varies with the severity of the disease, which can range from mild and self-limiting to, rarely, death within hours. Although severity varies, Reye syndrome is a potentially life threatening disorder that should be treated as a medical emergency. Early detection and treatment are critical — the chances for a successful recovery increase greatly when Reye syndrome is treated in its earliest stages.

Signs and Symptoms

The signs and symptoms of Reye syndrome are almost always preceded by a viral illness, such as an upper respiratory tract infection (a cold, the flu, etc.), a diarrheal illness, or chickenpox. Many cases are mild and may even go undetected; others can be severe, requiring aggressive care.

Reye syndrome can occur from 1 day to 2 weeks after a viral infection. The viral illnesses that lead to it are contagious, but the syndrome itself is not.

Symptoms include:

persistent vomiting
lethargy or sleepiness
in infants, diarrhea and rapid breathing

In the later stages, a child may exhibit irrational behavior, confusion, severe weakness, seizures, and loss of consciousness. There is usually no fever.

Reye syndrome is now very rare: only a few cases a year are reported in the United States. It should be considered, however, in a child with frequent vomiting or a change in mental status — particularly after a recent viral illness.

Prevention

Aspirin and other drugs from the salicylate family should never be used in the treatment of chickenpox, influenza, and other viral diseases.

In general, aspirin should not be used for kids or teenagers except on the advice of a doctor for certain conditions.

Treatment

Children with Reye syndrome are usually treated in a hospital; if seriously ill, in a hospital intensive care unit (ICU).

Treatment is supportive as there is no cure for the illness. The clinical care team focuses on making sure a child with Reye syndrome maintains proper fluid and electrolyte balance, nutritional, and cardiorespiratory status. Chances of recovery are greatest when these systems are as balanced as possible.

Mechanical ventilation (a breathing machine or respirator) may be necessary if breathing becomes too sluggish. Intracranial pressure (pressure of the fluid within the brain) and blood pressure may be monitored. Small quantities of insulin may be given to increase glucose metabolism, corticosteroids to reduce brain swelling, and diuretics to increase fluid loss.

The prognosis for children with Reye syndrome has improved. Earlier diagnosis and better treatment have increased the survival rate to about 80%. The earlier the syndrome is detected, the better the chances for survival. Children who progress to the late stages of the syndrome may suffer brain damage and disability.

When to Call the Doctor

If your child has vomiting, behavioral changes, or extreme sleepiness, especially after a viral illness such as the flu or a cold, contact your doctor immediately. Of course, many kids with viruses will have some of these symptoms, and most will not have Reye syndrome. Nevertheless, early detection is the key to successful treatment of Reye syndrome.

Respiratory Syncytial Virus

2009-02-05T01:00:00.000-08:00

Respiratory syncytial virus (RSV) is a major cause of respiratory illness in young children. RSV causes infection of the lungs and breathing passages. In adults, it may only produce symptoms of a common cold, such as a stuffy or runny nose, sore throat, mild headache, cough, fever, and a general feeling of being ill. But RSV infections can lead to other more serious illnesses in premature babies and kids with diseases that affect the lungs, heart, or immune system.

RSV is highly contagious, and can be spread through droplets containing the virus when a person coughs or sneezes. The virus can also live on surfaces such as countertops or doorknobs, and on hands and clothing. RSV can be easily spread when a person touches an object or surface contaminated with the virus. The infection can spread rapidly through schools and child-care centers. Infants often get it when older kids carry the virus home from school and pass it to them. Almost all kids are infected with RSV at least once by the time they are 2 years old.

RSV infections often occur in epidemics that last from late fall through early spring. Respiratory illness caused by RSV — such as bronchiolitis or pneumonia — usually lasts about a week, but some cases may last several weeks. Doctors typically diagnose RSV by taking a medical history and doing a physical exam. Generally, in healthy kids, it's not necessary to distinguish RSV from a common cold. But in cases where a child has other health conditions, a doctor might want to make a specific diagnosis. RSV is typically identified in nasal secretions, which can be collected either with a cotton swab or by suction through a bulb syringe.

Preventing RSV

Because RSV can be easily spread by touching people or surfaces that are infected, frequent handwashing can go a long way toward preventing the virus from spreading around a household. It's best to wash your hands after having any contact with someone who has any cold symptoms. And keep your school-age child with a cold away from younger siblings — particularly infants — until the symptoms pass.

To prevent serious RSV-related respiratory disease, at-risk kids can be given a monthly injection of a medication consisting of RSV antibodies during peak RSV season (roughly November to April). Because its protection is short-lived, it has to be given in subsequent years until the child is no longer at high risk for severe RSV infection. Ask the doctor if your child is considered high risk.

Treating RSV

Fortunately, most cases of RSV are mild and require no specific treatment from doctors. Antibiotics aren't used because RSV is a virus and antibiotics are only effective against bacteria. Medication may sometimes be given to help open airways.

In an infant, however, an RSV infection can be more serious and may require hospitalization so that the baby can be watched closely, receive fluids, and, if necessary, be treated for breathing problems.

At home, make a child with an RSV infection as comfortable as possible, allow time for recovery, and provide plenty of fluids. The last part can be tricky, however, because babies may not feel like drinking. In that case, offer fluids in small amounts at more frequent intervals than usual.

To help your child breathe easier, use a cool-mist vaporizer during the winter months to keep the air moist — winter air can dry out airways and make the mucus stickier. Avoid hot-water and steam humidifiers, which can be hazardous and can cause scalding. If you use a cool-mist humidifier, clean it daily with household bleach to discourage mold.

If your child is uncomfortable and too young to blow his or her own nose, use a nasal aspirator (or bulb syringe) to remove sticky nasal fluids.

Treat fever using a nonaspirin fever medicine like acetaminophen. Aspirin should NOT be used in children with viral illnesses since its use in such cases has been associated with Reye syndrome, a life-threatening illness.

When to Call the Doctor

Call the doctor if your child has any of these symptoms:

high fever with ill appearance
thick nasal discharge that is yellow, green, or gray
worsening cough or cough that produces yellow, green, or gray mucus

Call also if you think your child might be dehydrated.

In infants, besides the symptoms already mentioned, call the doctor if your baby is unusually irritable or inactive, or refuses to breastfeed or bottle-feed.

Seek immediate medical help if you feel your child is having difficulty breathing or is breathing very rapidly, is lethargic, or if his or her lips or fingernails appear blue.

Recurrent Urinary Tract Infections

2009-01-29T01:00:00.000-08:00

Urinary tract infections (UTIs) are common in kids. By age 5, about 8% of girls and 1%-2% of boys have had at least one UTI. They occur when the kidneys, ureters, bladder, or urethra

become infected.

Symptoms of a UTI can include:

pain when urinating
changes in frequency, appearance, or smell of urine
fever
chills
loss of appetite
nausea
vomiting
lower abdominal pain
lower back pain or discomfort

UTIs can also cause bedwetting in kids who were previously dry at night. Infants and young children may only show nonspecific signs such as fever, vomiting, or decreased appetite or activity.

Some kids experience UTIs again and again — these are called recurrent UTIs. If left untreated, recurrent UTIs can cause kidney damage, especially in kids younger than 6. So it's important to know how to recognize the signs of these infections and get help for your child.

Types of UTIs

Common types of UTIs include:

cystitis, the most common type of UTI, is a bladder infection that can occur when bacteria move up the urethra (the tube-like structure that allows urine to exit the body from the bladder) and into the bladder
urethritis, when bacteria infect the urethra
pyelonephritis, a kidney infection that can occur when infected urine flows backward from the bladder to the kidneys, or when an infection in the bloodstream reaches the kidneys

Related Conditions Associated With Recurrent UTIs

Recurrent UTIs are sometimes seen in conjunction with other conditions, such as:

vesico-ureteral reflux (VUR), which is found in 30%-50% of kids diagnosed with a UTI and is a congenital (present at birth) condition in which urine flows backward from the bladder to the ureters (the thin, tube-like structures that carry urine from the kidney to the bladder) and sometimes reaches the kidneys. If the urine in the bladder is infected with bacteria, VUR can lead to pyelonephritis.
hydronephrosis, which is an enlargement of one or both kidneys due to backup or blockage of urine flow and is usually caused by severe VUR or a blocked ureter. Kids with hydronephrosis are sometimes at risk of recurrent UTIs and may need to take daily low doses of antibiotics to prevent them.

But not all cases of recurrent UTIs can be traced back to these body structure-related abnormalities. For example, dysfunctional voiding — when a child doesn't urinate frequently enough or doesn't relax his or her muscles properly while urinating — is a common cause of UTIs.

Unrelated conditions that compromise the body's natural defenses, such as diseases of the immune system, can also lead to recurrent UTIs. In addition, using a nonsterile urinary catheter can introduce bacteria into the urinary tract and cause an infection.

Detecting Abnormalities

Although UTIs can be treated with antibiotics, it's important for your child's doctor to rule out any underlying abnormalities in the urinary system when these infections occur repeatedly.

Some abnormalities can be detected even before birth. Hydronephrosis, when it occurs as a congenital condition, can be detected in a fetus by ultrasound as early as 16 weeks of gestation. When hydronephrosis poses significant danger to the developing kidneys, surgery may be performed while the baby is in the womb; however, in most cases, doctors wait until after birth before treating the condition because almost half of all cases that are diagnosed prenatally disappear by birth.

Once a baby suspected to have hydronephrosis or another urinary system abnormality is born, the baby's blood pressure will be monitored carefully because some kidney abnormalities can cause high blood pressure. An ultrasound may be used again to get a closer look at the bladder and kidneys.

Diagnosis and Treatment

If your doctor suspects that your child may have an abnormality of the urinary tract, he or she may order tests to make an accurate diagnosis including:

Ultrasound

Using high-frequency sound waves to "echo," or bounce, off the body and create a picture of it, an ultrasound can detect some abnormalities in the kidneys, ureters, and bladder. It can also measure the size and shape of the kidneys. When an ultrasound suggests VUR, a voiding cystourethrogram (VCUG) or a renal scan (see below for descriptions of both) may be performed for further evaluation.

Renal scan (nuclear scan)

Radioactive material is injected into a vein and followed through the urinary tract. The material can show the shape of the kidneys, how well they function, if there is damaged kidney tissue, and the course of the urine. A small amount of radiation is received in the study and leaves the body in the urine.

Voiding cystourethrogram (VCUG or cystogram)

A catheter (a hollow, soft tube) is used to inject an opaque dye into the bladder. This X-ray test can diagnose VUR and identify problems with the bladder or urethra.

Cystoscopy

A cystoscope uses lenses and a light source within a tube inserted through the urethra to directly view the inside of the bladder. It's used when other tests or symptoms indicate a possible bladder abnormality.

Intravenous pyelogram

Opaque dye is injected into a vein and then X-rays are taken to follow the course of the dye through the urinary system. Although this test is still used sometimes, the renal ultrasound and renal scan have replaced intravenous pyelogram in most cases.

Because VUR can lead to kidney infection (pyelonephritis) and subsequent kidney damage, children with the condition must be monitored closely. Usually, surgery isn't necessary because many kids will outgrow the condition. Even in those who don't, surgery may be unnecessary because antibiotics are often successful in warding off UTIs.

The most common type of surgery to correct VUR is ureteral reimplantation, in which one or both ureters are reattached to the bladder to decrease backflow of urine from the bladder to the ureters and kidneys. Although the success of ureteral reimplantation is greater than 90%, only those who have recurrent UTIs while on antibiotic prophylaxis (preventive therapy) will be considered for surgery.

Blockages can interfere with normal urine flow, which serves to wash bacteria out of the urinary tract. Because severe blockages in the ureter or the urethra may ultimately lead to repeated kidney infections and kidney damage, they may require surgical intervention. Kidney stones are another source of blockage that may obstruct the path of urine.

When anatomical defects have been ruled out, antibiotics may be prescribed for months or even years to prevent recurrent infections.

The Future for Managing Recurrent UTIs

Doctors have started to use a less-invasive way to correct VUR than implantation. The procedure involves the injection of such materials as Teflon, Delflux, or collagen through a cystoscope. This procedure was considered experimental a few years ago, but is rapidly gaining wider acceptance.

Recent studies have found that women and children who get recurrent UTIs may lack certain immunoglobins (a group of proteins that fight infections). Some researchers are optimistic that a vaccine may be developed that could help boost production of antibodies that fight UTIs. A promising vaccine that would protect against E. coli (the most common bacterium that causes UTIs) is being tested.

Home Treatment

Additional things to consider to help prevent recurrent UTIs in kids:

Diet Modifications

Encourage kids to drink 8 to 10 glasses of water and other fluids per day. Cranberry juice is often suggested because it may prevent E. coli from attaching to the walls of the bladder. Always ask your doctor, though, if your child should drink cranberry juice because it can interfere with some medicines.

Multivitamins

Vitamin C acidifies the urine, making the environment less friendly to bacteria. Vitamins designed for kids are generally safe, but always ask your doctor before increasing the dose beyond the currently recommended daily allowance.

No Bubble Baths

Kids should avoid bubble baths and perfumed soaps because they can irritate the urethra.

Frequent Diaper Changes

Kids in diapers should be changed frequently to prevent stool from having prolonged contact with the genital area, which can increase the chance that bacteria will move up the urethra and into the bladder.

Proper Wiping Technique

In females, wiping from front to back after using the toilet will reduce exposure of the urethra to UTI-causing bacteria in the stool.

Cotton Underwear

Breathable cotton underwear is less likely to encourage bacterial growth near the urethra than nylon or other fabrics.

Frequent Bathroom Visits

Some kids may object to using the school bathroom or may become so engrossed in a project that they delay urination. Kids with UTIs should urinate at least every 3 to 4 hours to help flush bacteria from the urinary tract.

Follow-Up Visits

Your doctor may advise performing another urine culture after treatment of a UTI is completed to be sure that the infection has cleared.

When to Call the Doctor

As soon as you suspect a UTI in your child, it's important to contact your doctor.

If your child suffers from recurrent UTIs, consult a pediatric nephrologist or urologist who can perform a thorough evaluation and, if necessary, order tests for urinary system abnormalities. In the meantime, follow your doctor's instructions for treating a UTI.

Rabies

2009-01-22T01:00:00.000-08:00

Rabies infections in people are rare in the United States. However, worldwide about 50,000 people die from rabies each year, mostly in developing countries where programs for vaccinating dogs against rabies don't exist. But the good news is that problems can be prevented if the exposed person receives treatment before symptoms of the infection develop.

Rabies is a virus that in the U.S. is usually transmitted by a bite from a wild infected animal, such as a bat, raccoon, skunk, or fox. If a bite from a rabid animal goes untreated and an infection develops, it is almost always fatal.

If you suspect that your child has been bitten by a rabid animal, go to the emergency department immediately. Any animal bites — even those that don't involve rabies — can lead to infections and other medical problems. As a precaution, call your doctor any time your child has been bitten.

Transmission

Approximately 7,000 cases of rabies in animals are reported each year to the Centers for Disease Control and Prevention (CDC). Raccoons are the most common carriers of rabies in the United States, but bats are most likely to infect people. Almost three quarters of rabies cases between 1990 and 2001 came from contact with bats.

Skunks and foxes also can be infected with rabies, and a few cases have been reported in wolves, coyotes, bobcats, and ferrets. Small rodents such as hamsters, squirrels, chipmunks, mice, and rabbits are very rarely infected with the virus.

Because of widespread vaccination programs in the United States, transmission from dogs to people is very rare. Outside the United States, exposure to rabid dogs is the most common cause of transmission to humans.

An infected animal has the rabies virus in its saliva and can transmit it to a person through biting. In rarer cases, an animal can spread the virus when its saliva comes in contact with a person's mucous membranes (moist skin surfaces, like the mouth or inner eyelids) or broken skin such as a cut, scratch, bruise, or open wound.

After a bite, the rabies virus can spread into surrounding muscle, then travel up nearby nerves to the brain. Once the virus reaches the brain, the infection is fatal in almost all cases.

Signs and Symptoms

The first symptoms can appear from a few days to more than a year after the bite occurs.

One of the most distinctive signs of a rabies infection is a tingling or twitching sensation around the area of the animal bite. It is often accompanied by a fever, headache, muscle aches, loss of appetite, nausea, and fatigue.

As the infection progresses, someone infected with rabies may develop any of these symptoms:

irritability
excessive movements or agitation
confusion
hallucinations
aggressiveness
bizarre or abnormal thoughts
muscle spasms
abnormal postures
seizures (convulsions)
weakness or paralysis (when a person cannot move some part of the body)
extreme sensitivity to bright lights, sounds, or touch
increased production of saliva or tears
difficulty speaking

In the advanced stage of the infection, as it spreads to other parts of the nervous system, these symptoms may develop:

double vision
problems moving facial muscles
abnormal movements of the diaphragm and muscles that control breathing
difficulty swallowing and increased production of saliva, causing the "foaming at the mouth" usually associated with a rabies infection

If Your Child Is Bitten by an Animal

If your child has been bitten by an animal, take the following steps right away:

Wash the bite area with soap and water for 10 minutes and cover the bite with a clean bandage.
Immediately call your doctor and go to a nearby emergency department. Anyone with a possible rabies infection must be treated in a hospital.
Call local animal-control authorities to help find the animal that caused the bite. The animal may need to be detained and observed for signs of rabies.
If you know the owner of the animal that has bitten your child, get all the information about the animal, including vaccination status and the owner's name and address. Notify your local health department, particularly if the animal hasn't been vaccinated.
If you suspect that your child has been bitten by an unknown dog, bat, rat, or other animal, contact your doctor immediately or take your child to the emergency department.

Treatment

At the hospital, it is likely that the doctor will first clean the wound thoroughly and make sure that your child's tetanus immunizations are current.

To keep any potential infection from spreading, the doctor may decide to start treating your child right away with shots of human rabies immune globulin to the wound site and vaccine shots in the arm. This decision is usually based on the circumstances of the bite (provoked or unprovoked), the type of animal (species, wild or domestic), the animal's health history (vaccinated or not), and the recommendations of local health authorities.

Prevention

You can reduce the chances that your family is exposed to rabies. Vaccinate your pets — dogs, cats, and ferrets can be infected by rabies. Report any stray animals to your local health authorities or animal-control officer. Remind kids that animals can be "strangers," too. They should never touch or feed stray cats or dogs wandering in the neighborhood or elsewhere.

As a precaution against rabies or any other infections, call your doctor if:

your child has been exposed to an animal that might have rabies, but is too young to describe the contact with the animal
your child has been exposed to bats, even if there is no bite
you plan to travel abroad and may come into contact with rabid animals, particularly if you're traveling to an area where you might not have access to health care

Poliomyelitis

2009-01-17T01:00:00.000-08:00

Polio (also called poliomyelitis) is a contagious, historically devastating disease that was virtually eliminated from the Western hemisphere in the second half of the 20th century. Although polio has plagued humans since ancient times, its most extensive outbreak occurred in the first half of the 1900s before the vaccination, created by Jonas Salk, became widely available in 1955.

At the height of the polio epidemic in 1952, nearly 60,000 cases with more than 3,000 deaths were reported in the United States alone. However, with widespread vaccination, wild-type polio, or polio occurring through natural infection, was eliminated from the United States by 1979 and the Western hemisphere by 1991.

Signs and Symptoms

Polio is a viral illness that, in about 95% of cases, actually produces no symptoms at all (called asymptomatic polio). In the 4% to 8% of cases in which there are symptoms (called symptomatic polio), the illness appears in three forms:

a mild form called abortive polio (most people with this form of polio may not even suspect they have it because their sickness is limited to mild flu-like symptoms such as mild upper respiratory infection, diarrhea, fever, sore throat, and a general feeling of being ill)
a more serious form associated with aseptic meningitis called nonparalytic polio (1% to 5% show neurological symptoms such as sensitivity to light and neck stiffness)
a severe, debilitating form called paralytic polio (this occurs in 0.1% to 2% of cases)

People who have abortive polio or nonparalytic polio usually make a full recovery. However, paralytic polio, as its name implies, causes muscle paralysis - and can even result in death. In paralytic polio, the virus leaves the intestinal tract and enters the bloodstream, attacking the nerves (in abortive or asymptomatic polio, the virus usually doesn't get past the intestinal tract). The virus may affect the nerves governing the muscles in the limbs and the muscles necessary for breathing, causing respiratory difficulty and paralysis of the arms and legs.

Contagiousness

Polio is transmitted primarily through the ingestion of material contaminated with the virus found in stool (poop). Not washing hands after using the bathroom and drinking contaminated water were common culprits in the transmission of the disease.

Prevention

In the United States, it's currently recommended that children have four doses of inactivated polio vaccination (IPV) between the ages of 2 months and 6 years.

By 1964, the oral polio vaccine (OPV), developed by Albert Sabin, had become the recommended vaccine. OPV allowed large populations to be immunized because it was easy to administer, and it provided "contact" immunization, which means that an unimmunized person who came in contact with a recently immunized child might become immune, too. The problem with OPV was that, in very rare cases, paralytic polio could develop either in immunized children or in those who came in contact with them.

Since 1979 (when wild polio was eliminated in the United States), the approximately 10 cases per year of polio seen in this country were traced to OPV.

IPV is a vaccine that stimulates the immune system of the body (through production of antibodies) to fight the virus if it comes in contact with it. IPV cannot cause polio.

In an effort to eradicate all polio, including those cases associated with the vaccine, the Centers for Disease Control and Prevention (CDC) decided to make IPV the only vaccine given in the United States. Currently, the CDC and American Academy of Pediatrics (AAP) recommend three spaced doses of IPV given before the age of 18 months, and an IPV booster given between the ages of 4 to 6, when children are entering school.

If you're planning to travel outside the United States, particularly to Africa and Asia (where polio still exists), be sure that you and your child have received a complete set of polio vaccinations.

Duration

Although the acute illness usually lasts less than 2 weeks, damage to the nerves could last a lifetime. In the past, some patients with polio never regained full use of their limbs, which would appear withered. Those who did fully recover might go on to develop post-polio syndrome (PPS) as many as 30 to 40 years after contracting polio. In PPS, the damage done to the nerves during the disease causes an acceleration of the normal, gradual weakness due to aging.

Treatment

In the height of the polio epidemic, the standard treatment involved placing a patient with paralysis of the breathing muscles in an "iron lung" - a large machine that actually pushed and pulled the chest muscles to make them work. The damaged limbs were often kept immobilized because of the confinement of the iron lung. In countries where polio is still a concern, ventilators and some iron lungs are still used.

Historically, home treatment for paralytic polio and abortive polio with neurological symptoms wasn't sufficient. However, asymptomatic and mild cases of abortive polio with no neurological symptoms were usually treated like the flu, with plenty of fluids and bed rest.

The Future of Polio

The World Health Organization (WHO) is working toward eradicating polio throughout the world. Significant strides have already been made. In 1988, 355,000 cases of polio in 125 countries were reported. By the end of 2004, there were just 1,255 cases.

Six countries (Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan) still have polio circulating, and the virus could be introduced to other countries. If the polio virus is imported into a country where not enough people have been immunized, there's the risk that it could spread from person to person. That's what has happened in some countries in Africa and Asia. So until it has been eliminated worldwide, it's important to continue vaccinating kids against polio.

Pinkeye

2009-01-12T01:00:00.000-08:00

Conjunctivitis, commonly known as pinkeye, is an inflammation of the conjunctiva, the clear membrane that covers the white part of the eye and the inner surface of the eyelids.

While pinkeye can sometimes be alarming because it may make the eyes extremely red and can spread rapidly, it's a fairly common condition and usually causes no long-term eye or vision damage. But if your child shows symptoms of pinkeye, it's important to see a doctor. Some kinds of pinkeye go away on their own, but other types require treatment.

Conjunctivitis can be caused by infections (such as bacteria and viruses), allergies, or substances that irritate the eyes.

Causes of Pinkeye

Pinkeye can be caused by many of the bacteria and viruses responsible for colds and other infections, — including ear infections, sinus infections, and sore throats — and by the same types of bacteria that cause the sexually transmitted diseases (STDs) chlamydia and gonorrhea.

Pinkeye also can be caused by allergies. These cases tend to happen more frequently among kids who also have other allergic conditions, such as hay fever. Some triggers of allergic conjunctivitis include grass, ragweed pollen, animal dander, and dust mites.

Sometimes a substance in the environment can irritate the eyes and cause pinkeye; for example, chemicals (such as chlorine and soaps) and air pollutants (such as smoke and fumes).

Pinkeye in Newborns

Newborns are particularly susceptible to pinkeye and can be more prone to serious health complications if it goes untreated.

If a baby is born to a mother who has an STD, during delivery the bacteria or virus can pass from the birth canal into the baby's eyes, causing pinkeye. To prevent this, doctors give antibiotic ointment or eye drops to all babies immediately after birth. Occasionally, this preventive treatment causes a mild chemical conjunctivitis, which typically clears up on its own. Doctors also can screen pregnant women for STDs and treat them during pregnancy to prevent transmission of the infection to the baby.

Many babies are born with a narrow or blocked tear duct, a condition which usually clears up on its own. Sometimes, though, it can lead to conjunctivitis.

Symptoms of Pinkeye

The different types of pinkeye can have different symptoms. And symptoms can vary from child to child.

One of the most common symptoms is discomfort in the eye. A child may say that it feels like there's sand in the eye. Many kids have redness of the eye and inner eyelid, which is why conjunctivitis is often called pinkeye. It can also cause discharge from the eyes, which may cause the eyelids to stick together when the child awakens in the morning. Some kids have swollen eyelids or sensitivity to bright light.

In cases of allergic conjunctivitis, itchiness and tearing are common symptoms.

Contagiousness

Cases of pinkeye that are caused by bacteria and viruses are contagious. (Conjunctivitis caused by allergies or environmental irritants are not.)

A child can get pinkeye by touching an infected person or something an infected person has touched, such as a used tissue. In the summertime, pinkeye can spread when kids swim in contaminated water or share contaminated towels. It also can be spread through coughing and sneezing. Doctors usually recommend keeping kids diagnosed with contagious conjunctivitis out of school, day care, or summer camp for a short time.

Someone who has pinkeye in one eye can also inadvertently spread it to the other eye by touching the infected eye, then touching the other one.

Preventing Pinkeye

To prevent pinkeye caused by infections, teach kids to wash their hands often with warm water and soap. They also should not share eye drops, tissues, eye makeup, washcloths, towels, or pillowcases with other people.

Be sure to wash your own hands thoroughly after touching an infected child's eyes, and throw away items like gauze or cotton balls after they've been used. Wash towels and other linens that the child has used in hot water separately from the rest of the family's laundry to avoid contamination.

If you know your child is prone to allergic conjunctivitis, keep windows and doors closed on days when the pollen is heavy, and dust and vacuum frequently to limit allergy triggers in the home. Irritant conjunctivitis can only be prevented by avoiding the irritating causes.

Many cases of pinkeye in newborns can be prevented by screening and treating pregnant women for STDs. A pregnant woman may have bacteria in her birth canal even if she shows no symptoms, which is why prenatal screening is important.

Treating Pinkeye

Pinkeye caused by a virus usually goes away on its own without any treatment. If a doctor suspects that the pinkeye has been caused by a bacterial infection, antibiotic eye drops or ointment will be prescribed.

Sometimes it can be a challenge to get kids to tolerate eye drops several times a day. If you're having trouble, put the drops on the inner corner of your child's closed eye — when the child opens the eye, the medicine will flow into it. If you continue to have trouble with drops, ask the doctor about antibiotic ointment. It can be applied in a thin layer where the eyelids meet, and will melt and enter the eye.

If your child has allergic conjunctivitis, your doctor may prescribe anti-allergy medication, which comes in the form of pills, liquid, or eye drops.

Cool or warm compresses and acetaminophen or ibuprofen may make a child with pinkeye feel more comfortable. You can clean the edges of the infected eye carefully with warm water and gauze or cotton balls. This can also remove the crusts of dried discharge that may cause the eyelids to stick together first thing in the morning.

When to Call the Doctor

If you think your child has pinkeye, it's important to contact your doctor to try to determine what's causing it and how to treat it. Other serious eye conditions can mimic conjunctivitis, so a child who complains of severe pain, changes in eyesight, or sensitivity to light should be reexamined. If the pinkeye does not improve after 2 to 3 days of treatment, or after a week when left untreated, call your doctor.

If your child has pinkeye and starts to develop increased swelling, redness, and tenderness in the eyelids and around the eye, along with a fever, call your doctor. Those symptoms may mean the infection has started to spread beyond the conjunctiva and will require additional treatment.

Mumps

2009-01-07T01:00:00.000-08:00

The disease has been recognized for several centuries, and medical historians argue over whether the name "mumps" comes from an old word for "lump" or an old word for "mumble."

Mumps was common until the mumps vaccine was licensed in 1967. Before the vaccine, more than 200,000 cases occurred each year in the United States. Since then the number of cases has dropped to fewer than 1,000 a year, and epidemics have become fairly rare. As in the prevaccine era, most cases of mumps are still in children ages 5 to 14, but the proportion of young adults who become infected has been rising slowly over the last two decades. Mumps infections are uncommon in children younger than 1 year old.

Signs and Symptoms

Additionally, mumps may affect the pancreas or, in females, the ovaries, causing pain and tenderness in parts of the abdomen.

In some cases, signs and symptoms are so mild that no one suspects a mumps infection. Doctors believe that about 1 in 3 people may have a mumps infection without symptoms.

Contagiousness

People who have mumps are most contagious from 2 days before symptoms begin to 6 days after they end. The virus can also spread from people who are infected but have no symptoms.

Prevention

If they haven't already received them, students who are attending colleges and other post-high school institutions should be sure they have had two doses of the MMR vaccine.

During a measles outbreak, your doctor may recommend additional shots of the vaccine, if your child is 1 to 4 years old. Your doctor will have the most current information.

Incubation

The incubation period for mumps can be 12 to 25 days, but the average is 16 to 18 days.

Duration

Children usually recover from mumps in about 10 to 12 days. It takes about 1 week for the swelling to disappear in each parotid gland, but both glands don't usually swell at the same time.

Professional Treatment

If you think that your child has mumps, call your doctor, who can confirm the diagnosis and work with you to monitor your child's progress and watch for any complications. The doctor can also notify the health authorities who keep track of childhood immunization programs and mumps outbreaks.

Because mumps is caused by a virus, it cannot be treated with antibiotics.

At home, monitor and keep track of your child's temperature. You can use nonaspirin fever medications such as acetaminophen or ibuprofen to bring down a fever. These medicines will also help relieve pain in the swollen parotid glands. Unless instructed by your child's doctor, aspirin should not be used in children with viral illnesses because the use of aspirin in such cases has been associated with the development of Reye syndrome, which can lead to liver failure and death.

You can also soothe your child's swollen parotid glands with either warm or cold packs. Serve a soft, bland diet that does not require a lot of chewing and encourage your child to drink plenty of fluids. Avoid serving tart or acidic fruit juices (like orange juice, grapefruit juice, or lemonade) that make parotid pain worse. Water, decaffeinated soft drinks, and tea are better tolerated.

When mumps involves the testicles, the doctor may prescribe stronger medications for pain and swelling and provide instructions on how to apply warm or cool packs to soothe the area and how to provide extra support for the testicles.

A child with mumps doesn't need to stay in bed, but may play quietly. Ask your doctor about the best time for your child to return to school.

When to Call the Doctor

Call the doctor if you suspect that your child has mumps. If your child has been diagnosed with mumps, keep track of your child's temperature and call the doctor if it climbs above 101° Fahrenheit (38.3° Celsius).

Because mumps can also involve the brain and its membranes, call the doctor immediately if your child has any of the following: stiff neck, convulsions (seizures), extreme drowsiness, severe headache, or changes of consciousness. Watch for abdominal pain that can mean involvement of the pancreas in either sex or involvement of the ovaries in girls. In boys, watch for high fever with pain and swelling of the testicles.

Mononucleosis

2009-01-02T20:22:00.000-08:00

Mononucleosis — or "mono" — is an infection that produces flu-like symptoms, and usually goes away on its own in a few weeks with the help of plenty of fluids and rest.

Mono is usually caused by the Epstein-Barr virus (EBV), a very common virus that most kids are exposed to at some point while growing up. Infants and young kids infected with EBV usually have very mild symptoms or none at all. But teens and young adults who become infected often develop mono.

Mono is spread through kissing, coughing, sneezing, or any contact with the saliva of someone who has been infected with the virus. (That's how mono got nicknamed "the kissing disease.") It can also be spread through other types of direct contact, like sharing a straw or an eating utensil.

Symptoms

Symptoms of mono can often be mistaken for the flu or strep throat. Call your doctor if your child has a fever, a sore throat, swollen lymph nodes (in the neck, underarms, and groin), and unexplained constant fatigue or weakness.

Other symptoms of mono can include:

headaches
sore muscles
larger-than-normal liver and spleen
skin rash
abdominal pain

Kids with mono may have different combinations of these symptoms, and some teens may have symptoms so mild that they are hardly noticeable. Your doctor will likely perform a blood test to make a firm diagnosis.

Mono symptoms usually go away on their own within 2 to 4 weeks, but the enlarged lymph nodes and spleen can last longer. And in some kids, especially teens, the fatigue and weakness can last for months.

Doctors usually recommend that kids who get mono avoid sports for at least a month after symptoms are gone because the spleen is usually enlarged temporarily from the illness. An enlarged spleen can rupture easily — causing bleeding, fever, and abdominal pain — and require emergency surgery.

Complications

Most kids who get mono recover completely with no problem, but in rare cases, complications can occur. These can include blood disorders, such as hemolytic anemia, which involves the premature destruction of red blood cells, and Bell's palsy, an inflammation of a facial nerve that can weaken and paralyze the face muscles (but is usually temporary).

Other rare complications of mono include rupture of the spleen and inflammation of the heart muscle (myocarditis).

Prevention and Treatment

There is no vaccine for the Epstein-Barr virus, but you can try to prevent your child from getting mono by making sure that he or she avoids close contact with other kids who have it.

The best treatment for mono is plenty of rest, especially early in the course of the illness when symptoms are the most severe. Acetaminophen or ibuprofen can help to relieve the fever and aching muscles. Remember, never give aspirin to a child who has a viral illness because this has been associated with the development of Reye syndrome, which may lead to liver failure and can be fatal.

In most cases, the symptoms of mono go away in a matter of weeks with plenty of rest and fluids. If the symptoms seem to linger, or if you have any other questions, talk with your doctor.

Meningitis

2008-12-29T01:00:00.000-08:00

Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord. It is usually caused by bacteria or viruses, but it can also be caused by certain medications or illnesses.

Bacterial meningitis is rare, but is usually serious and can be life-threatening if it's not treated right away. Viral meningitis (also called aseptic meningitis) is relatively common and far less serious. It often remains undiagnosed because its symptoms can be similar to those of the common flu.

Kids of any age can get meningitis, but because it can be easily spread between people living in close quarters, teens, college students, and boarding-school students are at higher risk for infection.

If dealt with promptly, meningitis can be treated successfully. So it's important to get routine vaccinations, know the signs of meningitis, and if you suspect that your child has the illness, seek medical care right away.

Causes of Meningitis

Many of the bacteria and viruses that cause meningitis are fairly common and are typically associated with other routine illnesses. Bacteria and viruses that infect the skin, urinary system, gastrointestinal or respiratory tract can spread by the bloodstream to the meninges through cerebrospinal fluid, the fluid that circulates in and around the spinal cord.

In some cases of bacterial meningitis, the bacteria spread to the meninges from a severe head trauma or a severe local infection, such as a serious ear infection (otitis media) or nasal sinus infection (sinusitis).

Many different types of bacteria can cause bacterial meningitis. In newborns, the most common causes are Group B streptococcus, Escherichia coli, and Listeria monocytogenes. In older kids, Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are more often the causes.

Another bacteria, Haemophilus influenza type b (Hib), can also cause the illness but because of widespread childhood immunization, these cases are now rarer.

Similarly, many different viruses can lead to viral meningitis, including enteroviruses (such as coxsackievirus, poliovirus, and hepatitis A) and the herpesvirus.

Symptoms of Meningitis

The symptoms of meningitis vary and depend both on the age of the child and on the cause of the infection. Because the flu-like symptoms can be similar in both types of meningitis, particularly in the early stages, and bacterial meningitis can be very serious, it's important to quickly diagnose an infection.

The first symptoms of bacterial or viral meningitis can come on quickly or surface several days after a child has had a cold and runny nose, diarrhea and vomiting, or other signs of an infection. Common symptoms include:

fever
lethargy (decreased consciousness)
irritability
headache
photophobia (eye sensitivity to light)
stiff neck
skin rashes
seizures

Infants with meningitis may not have those symptoms, and might simply be extremely irritable, lethargic, or have a fever. They may be difficult to comfort, even when they are picked up and rocked.

Other symptoms of meningitis in infants can include:

jaundice (a yellowish tint to the skin)
stiffness of the body and neck (neck rigidity)
fever or lower-than-normal temperature
poor feeding
a weak suck
a high-pitched cry
bulging fontanelles (the soft spot at the top/front of the baby's skull)

Viral meningitis tends to cause flu-like symptoms, such as fever and runny nose, and may be so mild that the illness goes undiagnosed. Most cases of viral meningitis resolve completely within 7 to 10 days, without any complications or need for treatment.

Treatment

Because bacterial meningitis can be so serious, if you suspect that your child has any form of meningitis, it's important to see the doctor right away.

If the doctor suspects meningitis, he or she will order laboratory tests to help make the diagnosis. The tests will likely include a lumbar puncture (spinal tap) to collect a sample of spinal fluid. This test will show any signs of inflammation, and whether a virus or bacteria is causing the infection.

A child who has viral meningitis may be hospitalized, although some kids are allowed to recover at home if they are not too ill. Treatment, including rest, fluids, and over-the-counter pain medication, is given to relieve symptoms.

If bacterial meningitis is diagnosed — or even suspected — doctors will start intravenous (IV) antibiotics as soon as possible. Fluids may be given to replace those lost to fever, sweating, vomiting, and poor appetite, and corticosteroids may help reduce inflammation of the meninges, depending on the cause of the disease.

Complications of bacterial meningitis can require additional treatment. For example, anticonvulsants might be given for seizures. If a child develops shock or low blood pressure, additional IV fluids and certain medications may be given to increase blood pressure. Some kids may need supplemental oxygen or mechanical ventilation if they have difficulty breathing.

Some patients who have had meningitis may require longer follow-up. One of the most common problems resulting from bacterial meningitis is impaired hearing, and kids who've had bacterial meningitis should have a hearing test following their recovery.

The complications of bacterial meningitis can be severe and include neurological problems such as hearing loss, visual impairment, seizures, and learning disabilities. The heart, kidneys, and adrenal glands also may be affected. Although some kids develop long-lasting neurological problems, most who receive prompt diagnosis and treatment recover fully.

How Does Meningitis Spread?

Most cases of meningitis — both viral and bacterial — result from infections that are contagious, spread via tiny drops of fluid from the throat and nose of someone who is infected. The drops may become airborne when the person coughs, laughs, talks, or sneezes. They then can infect others when people breathe them in or touch the drops and then touch their own noses or mouths.

Sharing food, drinking glasses, eating utensils, tissues, or towels all can transmit infection as well. Some infectious organisms can spread through a person's stool, and someone who comes in contact with the stool — such as a child in day care — may contract the infection.

The infections most often spread between people who are in close contact, such as those who live together or people who are exposed by kissing or sharing eating utensils. Casual contact at school or work with someone who has one of these infections usually will not transmit the infectious agent.

Prevention

Routine immunization can go a long way toward preventing meningitis. The vaccines against Hib, measles, mumps, polio, meningococcus, and pneumococcus can protect against meningitis caused by these microorganisms. Some high-risk children also should be immunized against certain other types of pneumococcus.

Doctors now recommend that kids who are 11 years old get vaccinated for meningococcal disease, a serious bacterial infection that can lead to meningitis. The vaccine is called quadrivalent meningococcal vaccine, or MCV4. Children who have not had the vaccine and are over 11 years old should also be immunized, particularly if they're going to college, boarding school, camp, or other settings where they are going to be living in close quarters with others. This vaccine may also be recommended for people who are traveling to countries where meningitis is more common.

Many of the bacteria and viruses that are responsible for meningitis are fairly common. Good hygiene is an important way to prevent any infection. Encourage kids to wash their hands thoroughly and often, particularly before eating and after using the bathroom. Avoiding close contact with someone who is obviously ill and not sharing food, drinks, or eating utensils can help halt the spread of germs as well.

In certain cases, doctors may decide to give antibiotics to anyone who has been in close contact with the person who is ill to help prevent additional cases of illness.

When to Call the Doctor

Seek medical attention immediately if you suspect your child has meningitis or if your child exhibits symptoms such as vomiting, headache, lethargy or confusion, neck stiffness, rash, and fever. Infants who have fever, irritability, poor feeding, and lethargy should also be assessed by a doctor right away.

If your child has had contact with someone who has meningitis (for example, in a child-care center or a college dorm), call your doctor to ask whether preventive medication is recommended.