Category: Family Health

Addison’s Disease

by admin

What is Addison’s disease?
Addison’s disease is a condition that affects your body’s adrenal glands. These glands are located on top of your kidneys. They make hormones that affect your mood, growth, metabolism, tissue function, and how your body responds to stress.

Addison’s disease damages those glands. It causes your body to shut down production of the hormones. The disease commonly affects people 30 to 50 years of age. However, it can occur at any age and affects both men and women.

Symptoms of Addison’s disease
Symptoms appear over a period of several months. They are difficult to diagnose because they are vague. Symptoms include:

fatigue
muscle weakness
joint or muscle pain
fever
weight loss
nausea, vomiting, and or diarrhea (leading to dehydration)
headache
sweating
changes in mood or personality, such as irritability, anxiety, or depression
loss of appetite
darkening of the skin (called hyperpigmentation)
lightheadedness or fainting when standing up, due to low blood pressure
cravings for salty food
sudden, severe pain in the abdomen (lower stomach), lower back, or legs
confusion or slurred speech
sluggish movements
seizures
high fever.
When symptoms appear suddenly, or quickly get worse, it is called acute adrenal failure. Sometimes it’s called Addisonian crisis. This can lead to death if not treated. If you have any of the following symptoms, contact your doctor or go to an emergency room immediately.

sudden, intense pain in your lower back, abdomen, or legs
severe vomiting and diarrhea (which will lead to dehydration)
lower than normal blood pressure
unconsciousness
high levels of potassium and low levels of sodium.
What causes Addison’s disease?
Addison’s disease is caused by injury to your adrenal glands or when your glands are affected by another medical condition. This is called adrenal insufficiency. There are 2 types of adrenal insufficiency:

Primary adrenal insufficiency: This occurs through damage to your adrenal glands by an autoimmune disease (when your body attacks its own immune system). Other causes of primary adrenal insufficiency include:

Tuberculosis (or other infections) of the adrenal glands
Cancer of the adrenal glands
Bleeding of the adrenal glands
Secondary adrenal insufficiency: This occurs when another condition causes the adrenal glands to stop producing hormones. For example, a problem with your pituitary gland can cause secondary Addison’s disease. Or, you may develop Addison’s disease if you suddenly stop taking a corticosteroid medicine (such as prednisone). Corticosteroids are sometimes prescribed to treat conditions such as asthma, allergies, arthritis, cancer, and immune system problems.

How is Addison’s disease diagnosed?
Your doctor will ask you about your medical history and your symptoms. He or she may also perform laboratory tests to determine whether you have Addison’s disease. Those lab tests include:

Blood tests to measure your body’s hormone and mineral levels. Your doctor may check your blood before and after an injection to see if your body is responding normally to increased levels of certain hormones.
Computerized tomography (CT) scan or magnetic resonance imaging (MRI) to look at the size of your adrenal glands or pituitary gland. These scans are similar to an X-ray.
Can Addison’s disease be prevented or avoided?
Addison’s disease cannot be prevented or avoided.

Addison’s disease treatment
Treating Addison’s disease usually involves taking prescription hormones. This can include hydrocortisone, prednisone, or cortisone acetate. If your body is not making enough of the hormone aldosterone, your doctor may prescribe fludrocortisone. These medicines are taken every day by mouth (in pill form).

Your doctor may also recommend that you take a medicine called dehydroepiandrosterone. Some women who have Addison’s disease find that taking this medicine improves their mood and sex drive.

If you are experiencing an Addisonian crisis, you need immediate medical care. The treatment typically consists of intravenous (IV) injections of hydrocortisone, saline (salt water), and dextrose (sugar). These injections help restore blood pressure, blood sugar, and potassium levels to normal.

Living with Addison’s disease
Living with Addison’s disease involves learning to live with the unpleasant symptoms. In addition, you need to prepare for the possibility of Addisonian crisis. This is a medical emergency that requires you to:

Carry a medical alert card and bracelet at all times. This gives emergency medical workers information about your condition.
Keep extra medicine with you in case you forget to take your medicine. Ask your doctor for an injectable form of corticosteroids for use in an emergency.
Tell your doctor if your symptoms change or if your medicines stop working the way they used to.
Questions to ask your doctor
Is Addison’s disease hereditary?
Can the severity of my symptoms get worse over time?
Is Addison’s disease rare?
Can Addison’s disease cause long-term kidney failure?
Resources
National Institute of Diabetes and Digestive and Kidney Diseases, Adrenal Insufficiency & Addison’s Disease

U.S. National Library of Medicine, Addison’s Disease

Acute Bronchitis

by admin

What is acute bronchitis?
Acute bronchitis is inflammation of your bronchial tree. The bronchial tree consists of tubes that carry air into your lungs. When these tubes get infected, they swell and mucus (thick fluid) forms inside them. This makes it hard for you to breathe.

Acute bronchitis only lasts a short time (several weeks or less). Chronic bronchitis is long lasting and can reoccur. It usually is caused by constant irritation, such as from smoking.

Symptoms of acute bronchitis
The symptoms of acute bronchitis can include:

sore throat
fever
cough that brings up clear, yellow, or green mucus
chest congestion
shortness of breath
wheezing
chills
body aches.
Your cough can last for several weeks or months. This happens because the bronchial tree takes a while to heal. A lasting cough may signal another problem, such as asthma or pneumonia.

What causes acute bronchitis?
Viruses most often cause acute bronchitis. They attack the lining of the bronchial tree and cause inflammation. The same viruses that cause colds can cause acute bronchitis. You can catch a virus from breathing it in or skin contact. As your body fights these viruses, swelling occurs and mucus is produced. It takes time for your body to kill the viruses and heal damage to your bronchial tubes.

Lesser-known causes are bacteria or fungal infections. Exposure to irritants, such as smoke, dust, or fumes, also can cause acute bronchitis. You are at greater risk if your bronchial tree already has damage. If you have GERD (gastroesophageal reflux disease), also known as heartburn, you can get acute bronchitis when stomach acid gets into the bronchial tree.

How is acute bronchitis diagnosed?
Your doctor can confirm acute bronchitis. They will do a physical exam and review your symptoms. They might order an X-ray to rule out pneumonia.

Can acute bronchitis be prevented or avoided?
You can help prevent acute bronchitis by staying healthy and avoiding germs. Wash your hands often to kill any viruses. If you smoke, the best defense against acute bronchitis is to quit. Smoking damages your bronchial tree and puts you at risk for infection. Smoking also slows down the healing process.

Acute bronchitis treatment
Most cases of acute bronchitis can be treated at home.

Drink fluids, but avoid caffeine and alcohol.
Get plenty of rest.
Take over-the-counter pain relievers to reduce inflammation, ease pain, and lower your fever. Acetaminophen (Tylenol) also helps ease pain and lower your fever.
Use cough medicine, if your child is age 6 or older.
Increase the humidity in your home or use a humidifier.
Do not hold in a cough that brings up mucus. This type of cough helps clear mucus from your bronchial tree. If you smoke, you should quit. It will help your bronchial tree heal faster.

Antibiotics do not help treat viruses. They can help treat cases caused by bacterial infections. Some people who have acute bronchitis need medicine that treats asthma. You might need this if you are wheezing. It can help open your bronchial tubes and clear out mucus. You usually take it with an inhaler. An inhaler sprays medicine right into your bronchial tree. Your doctor will decide if this treatment is right for you.

Living with acute bronchitis
Most cases of acute bronchitis go away on their own. You should call your doctor if:

You continue to wheeze and cough for more than 2 weeks, especially at night when you lie down or when you are active.
You continue to cough for more than 2 weeks and have a bad-tasting fluid come up into your mouth. This may mean you have GERD. This is a condition in which stomach acid gets into your esophagus.
Your cough produces blood, you feel weak, you have an ongoing high fever, and you are short of breath. These symptoms may mean you have pneumonia.
Questions to ask your doctor
What is causing my acute bronchitis?
Are there over-the-counter medicines or prescriptions that can help relieve my symptoms?
Am I contagious?
Am I at risk for getting pneumonia or other lung infections?
What should I do if my couth doesn’t respond to treatment or gets worse?
Resources
American Lung Association, Acute Bronchitis

Depression in Children and Teens

by admin

What is depression?
Depression is a medical illness. It affects your mental and physical health. Anyone can have depression. It is important to know that it is not your fault. Children and teens who are depressed may have different symptoms than adults.

Younger children who are depressed may:

have a poor appetite and/or weight loss
feel sad or hopeless
not enjoy playing as much as usual
worry more.
Older children who are depressed may:

be anxious or have trouble focusing
be angry and act out or lose their temper more
have changes in appetite (eating more or less than usual)
not want to go to school or other social activities
complain of feeling sick often
seem less confident or feel like they can’t do anything right.
Things to consider
Young people can be depressed for many reasons. Genetics, health conditions, and life events can be factors. Below are other possible reasons for depression in children and teens.

Your family moves to a new place to live.
Your child has to change to a new school.
A pet, friend, or family member dies.
Someone in your family is very sick.
Your child experiences bullying or a form of abuse.
Your child suffers from behavioral problems, such as attention-deficit hyperactivity disorder (ADHD).
Currently, the American Academy of Family Physicians (AAFP) recommends depression screening for teens, ages 12 to 18, who have symptoms. The AAFP does not have enough evidence to assess the benefits and risks of screening children younger than 11 years of age for depression.

When to see the doctor
If you notice symptoms for 2 or more weeks, it might mean that your child is depressed. Your doctor can do an exam and refer your child to a specialist. This may include a counselor, therapist, psychologist, or psychiatrist. Your child can talk to them about what and how they feel. Family counseling can help everyone in your family. A combination of counseling and medicine can help treat depression in most young people.

Contact the National Suicide Prevention Lifeline if you think your child or teen is having thoughts of suicide. Call 911 if your child attempts suicide.

Questions to ask your doctor
How can I tell if my child or teen is depressed?
What can I do to help prevent depression?
What types of medicine help treat depression in children and teens? What are the side effects?
Can you recommend a support group for my child or teen who is depressed?
Resources
American Academy of Family Physicians, Clinical Recommendation for Depression

National Suicide Prevention Lifeline, 1-800-273-TALK (8255)

National Institute of Mental Health, Depression Studies for Children

National Institute of Mental Health, Teen Depression

This content has been supported by Forest Laboratories Inc.

Abusive Head Trauma

by admin

What is abusive head trauma?
Abusive head trauma is also called shaken baby syndrome. It’s a form of child abuse that can be deadly or leave a baby seriously injured for a lifetime. Most often, victims of this kind of abuse are less than 1 year old, but it can happen with children up to age 5.

Symptoms of abusive head trauma
A severe case of abusive head trauma in your baby or young child can cause unconsciousness, seizures, or shock.

Other initial symptoms of abusive head trauma can include the following:

vomiting
irritability
unusual drowsiness
trouble sucking or swallowing
no interest in eating
stiff appearance
changes in consciousness
no smiling, babbling, or talking
differently sized pupils
inability to lift his or her head
inability to focus eyes or track movement
In many cases, abusive head trauma also leaves a child with long-term problems that affect him or her physically and intellectually. A survivor of abusive head trauma may be dependent on medical, special education, and social services for the rest of his or her life.

What causes abusive head trauma?
Abusive head trauma happens when a baby is shaken violently, hit in the head, thrown, or dropped on purpose. It usually happens at the hands of an overwhelmed parent or caregiver who can’t cope with a baby’s long periods of crying and the demands of caring for a young child.

Violently shaking a young child or hitting him or her in the head causes the child’s brain to shake back and forth inside the skull. This is especially true in babies whose neck muscles aren’t fully developed. The movement causes your child’s brain to swell, bruise, and bleed from the tearing of blood vessels, nerves, and tissue.

How is abusive head trauma diagnosed?
You should go to the emergency room right away if you suspect your child is suffering from abusive head trauma. Because some symptoms of abusive head trauma (for example, vomiting or irritability) are also common in other illnesses, it is important for the doctor to know if your child may have been shaken or hit in the head. The doctor will ask questions about what happened. Unfortunately, the person responsible for the abuse may not be honest about his or her actions.

The doctor will use a number of visual clues and tests to make the diagnosis and find out how severe the damage is. Visual clues include checking the child’s eyes for bleeding; looking for marks on the skull, arms, or legs; and checking for bruises around the child’s neck or chest. Certain imaging tests (for example, an X-ray, CT scan, or MRI) can show evidence of swelling or bleeding in the brain. These tests also can show skull or rib fractures.

Can abusive head trauma be prevented or avoided?
Because this happens due to a caregiver’s actions, it is absolutely possible to prevent abusive head trauma. It is important for everyone who takes care of your baby or young child to learn how to handle stressful situations (for example, when your baby cries for a long time).

One way to handle stress is taking several deep breaths, finding a safe place for your child (for example, the crib), and walking to another room for 10 to 15 minutes to calm yourself. When you feel out of control, call a friend or family member to help with your child or help you regain control. Understanding the consequences of abusive head trauma can help you take an active role in preventing this with your child.

Soothing a crying baby is not easy. However, there are a number of things you can try to calm the baby, including the following:

sing
rock
swaddle
take him or her for a ride or a walk
offer a bottle or pacifier
breastfeed
lay the baby on his or her stomach across your lap and gently rub or pat the baby’s back
Combining these strategies with “white noise” or rhythmic sounds (for example, music, a hair dryer, or a clothes dryer) can help. You also can try putting your child down for a nap on his or her left side to help with digestion, or on his or her back. If all else fails, be sure to consider whether your child could be sick. Call your doctor for advice.

If you have a caregiver for your child, it’s important to teach your caregiver about the dangers of shaking a baby or young child. Be sure he or she knows what to do if he or she feels stressed while caring for your child. Choose a caregiver carefully and continue to monitor your child’s safety under his or her care.

Abusive head trauma treatment
For more mild cases of abusive head trauma, your child may need medicine, a hospital stay, and at-home observation. In the most severe cases, treatment may begin in the hospital emergency room or operating room with life-saving steps. These steps might include inserting a breathing tube down your child’s throat or doing surgery to stop bleeding or reduce swelling in your child’s brain.

Living with abusive head trauma
Depending on how severe the trauma is, your child may have to be monitored over time. Survivors of abusive head trauma may suffer long-term health problems, such as:

permanent hearing loss
visual impairment (including blindness)
seizures
developmental, speech, and academic delays
severe intellectual disability
memory and attention challenges
cerebral palsy
Questions to ask your doctor
How can I tell whether my baby’s symptoms are caused by abusive head trauma or a normal illness?
Can brain damage be reversed?
What are some local resources for helping parents cope?
Resources
The National Center on Shaken Baby Syndrome

Abnormal Uterine Bleeding

by admin

What is abnormal uterine bleeding?
Abnormal uterine bleeding is any heavy or unusual bleeding from the uterus (through your vagina). It can occur at any time during your monthly cycle, including during your normal menstrual period.

Symptoms of abnormal uterine bleeding
Vaginal bleeding between periods is one symptom of abnormal uterine bleeding. Having extremely heavy bleeding during your period can also be considered abnormal uterine bleeding. Very heavy bleeding during a period and/or bleeding that lasts more than 7 days is called menorrhagia. For example, women may bleed enough to soak through 1 or more tampons or sanitary pads every hour.

What causes abnormal uterine bleeding?
A variety of things can cause abnormal uterine bleeding. Pregnancy is a common cause. Polyps or fibroids (small and large growths) in the uterus can also cause bleeding. Rarely, a thyroid problem, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding.

In most women, abnormal uterine bleeding is caused by a hormone imbalance. When hormones are the problem, doctors call the problem dysfunctional uterine bleeding, or DUB. Abnormal bleeding caused by hormone imbalance is more common in teenagers or in women who are approaching menopause.

These are just a few of the problems that can cause abnormal uterine bleeding. These problems can occur at any age, but the likely cause of abnormal uterine bleeding usually depends on your age.

Women in their teens, 20s, and 30s

A common cause of abnormal bleeding in young women and teenagers is pregnancy. Many women have abnormal bleeding in the first few months of a normal pregnancy. Some birth control pills or the intrauterine device (IUD) can also cause abnormal bleeding.

Some young women who have abnormal uterine bleeding do not release an egg from their ovaries (called ovulation) during their menstrual cycle. This is common for teenagers who have just started getting their periods. This causes a hormone imbalance where the estrogen in your body makes the lining of your uterus (called the endometrium) grow until it gets too thick. When your body gets rid of this lining during your period, the bleeding will be very heavy. A hormone imbalance may also cause your body not to know when to shed the lining. This can cause irregular bleeding (“spotting”) between your periods.

Women in their 40s and early 50s

In the years before menopause and when menopause begins, women have months when they don’t ovulate. This can cause abnormal uterine bleeding, including heavy periods and lighter, irregular bleeding.

Thickening of the lining of the uterus is another cause of bleeding in women in their 40s and 50s. This thickening can be a warning of uterine cancer. If you have abnormal uterine bleeding and you’re in this age group, you need to tell your doctor about it. It may be a normal part of getting older, but it’s important to make sure uterine cancer isn’t the cause.

Women after menopause

Hormone replacement therapy is a common cause of uterine bleeding after menopause. Other causes include endometrial and uterine cancer. These cancers are more common in older women than in younger women. But cancer is not always the cause of abnormal uterine bleeding. Many other problems can cause bleeding after menopause. For this reason, it’s important to talk to your doctor if you have any bleeding after menopause.

How is abnormal uterine bleeding diagnosed?
The tests your doctor orders may depend on your age. If you could be pregnant, your doctor may order a pregnancy test. If your bleeding is heavy, in addition to other tests, your doctor may want to check your blood count to make sure you don’t have a low blood count from the blood loss. This could lead to iron deficiency and anemia.

An ultrasound exam of your pelvic area shows both the uterus and the ovaries. It may also show the cause of your bleeding.

Your doctor may want to do an endometrial biopsy. This is a test of the uterine lining. It’s done by putting a thin plastic tube (called a catheter) into your uterus. Your doctor will use the catheter to remove a tiny piece of the uterine lining. He or she will send that lining to the lab for testing. The test will show if you have cancer or a change in the cells. A biopsy can be done in the doctor’s office and causes only mild pain.

Another test is a hysteroscopy. A thin tube with a tiny camera in it is put into your uterus. The camera lets your doctor see the inside of your uterus. If anything abnormal shows up, your doctor can get a biopsy.

Can abnormal uterine bleeding be prevented or avoided?
If your abnormal uterine bleeding is caused by hormonal changes, you will not be able to prevent it. But if your hormonal changes are caused by being overweight, losing weight could help. Your weight affects your hormone production. Maintaining a healthy weight can help prevent abnormal uterine bleeding.

Abnormal uterine bleeding treatment
There are several treatment options for abnormal bleeding. Your treatment will depend on the cause of your bleeding, your age, and whether you want to get pregnant in the future. Your doctor will help you decide which treatment is right for you. Or, if your doctor decides that a hormone imbalance is causing your abnormal bleeding, you and your doctor may decide to wait and see if the bleeding improves on its own. Some treatment options include the following:

Intrauterine device (IUD). Your doctor may suggest an IUD. An IUD is a small, plastic device that your doctor inserts into your uterus through your vagina to prevent pregnancy. One type of IUD releases hormones, and this type can significantly reduce abnormal bleeding. Like birth control pills, sometimes IUDs can actually cause abnormal bleeding. Tell your doctor if this happens to you.

Birth control pills. Birth control pills contain hormones that can stop the lining of your uterus from getting too thick. They also can help keep your menstrual cycle regular and reduce cramping. Some types of birth control pills, especially the progestin-only pill (also called the “mini-pill”) can actually cause abnormal bleeding for some women. Let your doctor know if the pill you’re taking doesn’t control your abnormal bleeding.

A D&C, or dilatation and curettage. A D&C is a procedure in which the opening of your cervix is stretched just enough so a surgical tool can be put into your uterus. Your doctor uses this tool to scrape away the lining of your uterus. The removed lining is checked in a lab for abnormal tissue. A D&C is done under general anesthesia (while you’re in a sleep-like state).

If you’re having heavy bleeding, your doctor may perform a D&C both to find out the problem and to treat the bleeding. The D&C itself often makes heavy bleeding stop. Your doctor will decide if this procedure is necessary.

Hysterectomy. This type of surgery removes the uterus. If you have a hysterectomy, you won’t have any more periods and you won’t be able to get pregnant. Hysterectomy is major surgery that requires general anesthesia and a hospital stay. It may require a long recovery period. Talk to your doctor about the risks and benefits of hysterectomy.

Endometrial ablation is a surgical procedure that destroys the lining of the uterus. Unlike a hysterectomy, it does not remove the uterus. Endometrial ablation may stop all menstrual bleeding in some women. However, some women still have light menstrual bleeding or spotting after endometrial ablation. A few women have regular menstrual periods after the procedure. Women who have endometrial ablation still need to use some form of birth control even though, in most cases, pregnancy is not likely after the procedure.

Your doctor can do endometrial ablation in several different ways. Newer endometrial ablation techniques do not require general anesthesia or a hospital stay. The recovery time after this procedure is shorter than recovery time after a hysterectomy.

Living with abnormal uterine bleeding
Abnormal uterine bleeding can impact your life in a negative way. Not being able to predict when bleeding will begin can cause you to be anxious all the time. Also, heavy menstrual bleeding may limit your daily activities during your period. For some women, it even prevents them from leaving the house.

If you have heavy menstrual bleeding, try taking ibuprofen (Advil, Motrin) during your period (or a few days before you expect your period, if you know). Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs can work to reduce the bleeding during your period.

You also should make sure that you are getting enough iron in your diet. Your doctor may prescribe an iron supplement to ensure that you don’t become anemic.

Questions to ask your doctor
What is the likely cause of my abnormal uterine bleeding?
Is my condition serious? Am I at risk for any other health problems?
Based on the cause, what treatment options do you recommend?
What are the risks and benefits of this treatment?
Will the treatment affect my chances of getting pregnant in the future?
Resources
Centers for Disease Control and Prevention, Heavy Menstrual Bleeding

National Institutes of Health, MedlinePlus: Vaginal Bleeding, Hormonal