PTSD in Parents of Child

Published: March 8, 2016 

Post traumatic Stress Reactions in Parents of Children Esophageal Atresia

 The link below takes you to the full report with charts etc lots of info

The aim of this study was to investigate psychological stress in parents of children with esophageal atresia and to explore factors associated with the development of Post traumatic Stress disorder (PTSD).

Self-report questionnaires were administered to parents of children with EA. Domains included: (1) sociodemographic data, current personal difficulties, assessment scales for the quality of life and for the global health status of the child (2) French-validated versions of the Perinatal Post traumatic Stress disorder Questionnaire and of the State-Trait Anxiety Inventory. Associations between PTSD and severity of the neonatal course, presence of severe sequelae at 2 years of age, and quality of life and global health status of children according to their parents’ perception were studied. 

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0150760

Croup

Croup is a type of upper respiratory infection that causes a bark-like cough. The condition most commonly affects children and does not usually cause complications. Croup is a breathing problem medically called Laryngotracheo-bronchitis. It caused by viral infection, allergy, bacterial infection, and acid reflux.

However, in rare cases, croup can become serious enough to block the airways and prevent normal breathing. Croup symptoms usually last no longer than five days, and resemble cold-like symptoms when the infection first begins. Symptoms caused by the condition are the result of inflammation of or around the vocal cords and windpipe.

SymptomsOfCroup

It starts as a mild cough and gradually turns severe and sounds like seal barking. The child may not be able to sleep properly at night with shortness of breath. Unfortunately, croup symptoms are often worse at night and are easily made worse by crying, fussiness and coughing, which can make the condition very difficult to deal with for both you and your child. Fortunately, however, croup infection typically clears on its own in a matter of days and requires no treatment unless the child is having persistent breathing troubles. During the course of a croup infection, the most effective treatment is to make your child comfortable and calm to prevent excessive coughing. Encourage the child to sleep often and keep them hydrated. Because of inflammation of the airways, the child may make a noticeable whistling noise when taking in air. In some cases, croup may also be accompanied by fever, sore throat and hoarseness.

croup

Treatment is given based on the intensity of the disease. It can be managed by home remedies if it is mild cough. Do not give cough medications without consulting your doctor. In case of breathing difficulty, the doctor may want to hospitalize the child for putting him on artificial respiration. (Worse case) as there might be swelling in the upper respiratory tract.

If you have older children, offer them foods that will ease their sore throat, like something cold, or warm like soup or a ice cream. It may also help their breathing if they sit in an upright position, you might need to hold them. Do not hesitate to see your child’s doctor if their croup symptoms become worse, remember your child has to come first. However, if your child has severe croup, they will need to be admitted to hospital urgently.

http://diseasespictures.com/croup/

Treating croup 

Treatment of croup depends on how severe the symptoms are. Most cases are mild and can be managed at home.

Treatment at home

If your GP thinks your child has mild croup, they will usually recommend managing it at home. This will often involve using children’s paracetamol to ease any pain associated with the condition and may help lower your child’s temperature if they have a fever. You should also ensure your child is well hydrated by encouraging them to drink plenty of fluids. Comforting your child is also important because their symptoms may get worse if they are agitated or crying. If your child is distressed, sitting them upright on your lap will help to comfort and reassure them.

Your GP UK will usually prescribe a single dose of an oral corticosteroid medication called dexamethasone or prednisolone to help reduce swelling (inflammation) in your child’s throat. Side effects of these medications can include restlessness, vomiting, upset stomach and headache.

Steam treatment is not advised for the treatment of croup. There is no evidence that allowing your child to breathe in humid air, for example steam from a hot bath or shower in a closed room, will help. You should seek urgent medical advice if you notice your child’s symptoms getting worse.

http://www.nhs.uk/conditions/Croup/Pages/Treatment.aspx

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Evaluation of aortopexy in the management of severe tracheomalacia after esophageal atresia repair

cover

Article first published online: 22 JAN 2014

Summary

Severe tracheomalacia (TM) is a difficult problem in esophageal atresia (EA) patients. We reviewed our experience with aortopexy and other interventions for severe TM in this population. With review ethics board approval, a retrospective review of TM in postoperative EA patients was conducted (1989–2010). Demographics, perinatal, and surgical information regarding EA repair was collected. TM infants were analyzed for symptomatology, clinical severity, investigations, interventions, and outcomes. Data are presented as proportions or median(range). One hundred and thirty-two EA patients were reviewed. Most had type C atresia (87.3%), and 18 patients (13.6%) died. Twenty-five patients (18.9%) had TM of whom five (20%) died. Median symptom onset was 18 days (0–729) after EA repair, with stridor (64%) or retractions/distress (44%) being most frequent. Four and two patients had airway obstruction or cardiorespiratory arrest, respectively. Median time from symptom onset to investigations was 11 days; these were most commonly rigid bronchoscopy (56%) and fluoroscopy (36%). Ten patients (40%) had severe TM on bronchoscopy. Six underwent aortopexy, one fundoplication, and three were treated medically. Length of hospital stay (LOS) post-aortopexy was 13 days (5–60), and ventilation time was 2 days (0–9). LOS was 60.5 (1–69) days postdiagnosis in non-aortopexy patients. Readmission rates for respiratory issues were significantly less in the aortopexy (median 0 vs. 5; P = 0.048) group over 2-year follow up after discharge. Complications of aortopexy included transfusion (1) and temporary diaphragmatic paresis (1), and one mortality secondary to severe congenital cardiac anomalies. Our experience suggests that aortopexy is safe and effective for the treatment of severe TM. It is associated with reduced LOS compared with other treatment strategies and few complications or long-term sequelae.

http://onlinelibrary.wiley.com/doi/10.1111/dote.12179/abstract

Predictive factors for complications in children with esophageal atresia and tracheoesophageal fistula

Summary

The objective of this study was to describe the incidence of complications in children with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) at a tertiary pediatric hospital and to identify predictive factors for their occurrence. A retrospective chart review of 110 patients born in or transferred to Sydney Children’s Hospital with EA/TEF between January 1999 and December 2010 was done. Univariate and multivariate regression analyses were performed to identify predictive factors for the occurrence of complications in these children. From univariate analysis, early esophageal stricture formation was more likely in children with ‘long-gap’ EA (odds ratio [OR] = 16.32). Patients with early strictures were more likely to develop chest infections (OR = 3.33). Patients with severe tracheomalacia were more likely to experience ‘cyanotic/dying’ (OR = 180) and undergo aortopexy (OR = 549). Patients who had gastroesophageal reflux disease were significantly more likely to require fundoplication (OR = 10.83) and undergo aortopexy (OR = 6.417). From multivariate analysis, ‘long-gap’ EA was a significant predictive factor for late esophageal stricture formation (P = 0.007) and for gastrostomy insertion (P = 0.001). Reflux was a significant predictive factor for requiring fundoplication (P = 0.007) and gastrostomy (P = 0.002). Gastrostomy insertion (P = 0.000) was a significant predictive factor for undergoing fundoplication. Having a prior fundoplication (P = 0.001) was a significant predictive factor for undergoing a subsequent aortopexy. Predictive factors for the occurrence of complications post EA/TEF repair were identified in this large single centre pediatric study.

Shah, R., Varjavandi, V. and Krishnan, U. (2015), Predictive factors for complications in children with esophageal atresia and tracheoesophageal fistula. Diseases of the Esophagus, 28: 216–223. doi: 10.1111/dote.12177

http://onlinelibrary.wiley.com/doi/10.1111/dote.12177/abstract

This has just been released, there is more, on this link, to read…….. but you will have to pay the on line library to be able to read the full reports. 

Diseases of the Esophagus

pages 234–239, April 2015

http://onlinelibrary.wiley.com/doi/10.1111/dote.12179/full

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When Your Baby Won’t Eat

When Your Baby Won’t Eat

(Whatever causes the initial interruption, the results seem to be the same: a child who no longer connects to her own internal sense of hunger and satiety, but instead relies on external cues to decide whether and how much to eat. In this way, successful eating requires both our most primal instinct and the right set of learned behaviors. When eating goes wrong, whether it’s a life-threatening aversion like Violet’s or a common case of pickiness, parents and medical professionals find themselves at a version of the same crossroads: Do you try to correct the behaviour — training a child to eat well, Pavlov-style — or do you try to rediscover that primal urge and trust her to take it from there? It’s a divisive question among the doctors and therapists who work with children like Violet, as well as a debate unfolding, consciously or not, around most kitchen tables in the country.)

http://www.nytimes.com/2016/02/07/magazine/when-your-baby-wont-eat.html?smid=fb-share&_r=0

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Hidden Dangers of none spill cups

We found this on a News Feed, posted here so you the Parents are aware of these types of feeding items.

tippy

 No matter how hard parents try to keep their children safe, there always seems to be some new threat to our kids’ health that pops up. Last week, mothers Marie-Pier L’Hostie and Penny Powell from Montreal, Canada, shared pictures to Facebook of what they found hiding out inside their kids’ sippy cup lids, and now parents from all over are freaking out at what they find.

tippy cup

 http://www.newsfoxes.com/2016/02/dangerous-if-your-child-uses-this-sippy-cup-throw-it-out-immediately/

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Urodynamics

What is a urodynamic study? 

This is a test for finding out how your bladder, sphincter (the muscle around the neck of your bladder) and the urethra (the tube that carries urine out of the body) are working.  The test can help find out the cause for bladder problems such as incontinence, or difficulty in passing urine.

A urodynamic study is usually only done if other tests are inconclusive or if other treatments have failed. The test may include X-rays to help your consultant make a diagnosis.

The purpose of a urodynamic study is to find out: 

if your symptoms are due to involuntary contractions (squeezing) of your bladder muscles.  

if you have the bladder capacity we would normally expect.

 if your bladder pressure is normal during filling and emptying

A urodynamic study is usually done as an out-patient procedure. The test results will help you and your consultant decide if you need to alter your current treatment, or if you need surgery.Before you come to hospital you may be asked to keep a voiding diary for two or more days before you come to the hospital. A voiding diary is a record of how much you urinate. You will need to record what type of fluid you drink, when and how much, and the timing and volume of urine output. You may also be asked to give information about when you experience urgency or urinary leakage.

About the procedure

You will be asked to lie down on a special X-ray table, which can be moved into different positions.  Two thin tubes (catheters) are inserted into your bladder through your urethra.You may feel the sensation of needing to pass urine as the catheters are put in. Some consultants may use a local anaesthetic gel when inserting these catheters but this is not always needed.

One of the catheters going into your bladder is connected to a sterile water machine and the other is attached to a pressure monitor.  The pressure monitor is a special machine that measures how much liquid your bladder can hold and the pressure inside your bladder. A third catheter is placed in your vagina if you are female, or in your back passage (rectum) if you are male. This is also attached to the monitor and measures the pressure that the rest of your body is putting on your bladder.

Once the catheters are in place, your bladder is slowly filled with sterile water which contains an X-ray contrast dye. Whilst this is happening, you will be asked to tell the consultant when you feel the need to urinate. During the test you may be asked to cough, strain or squeeze to check how your bladder reacts under pressure.  Your consultant may take X-rays during this stage.

Some water may leak out during the test and wet you, but try not to be embarrassed by this. Remember your consultant is trying to find the cause of your bladder problem. Any fluid that leaks out is not urine but the sterile water that has been pumped into your bladder. You will then be asked to empty your bladder so that the catheters can measure the flow rate and pressure at which you urinate. At the end of the test, the catheters will be removed and you will have privacy to dress.

The test usually takes 15 to 30 minutes and it should not be painful, although it may be uncomfortable at times.

For more info

http://www.spirehealthcare.com/sussex/our-facilities-treatments-and-consultants/our-treatments/urodynamics/

http://www.atlantagynob.com/urodynamics-procedure.php

With diagrams

http://www.medicinenet.com/urodynamic_testing/article.htm

 

Swallowing Problems Diagnosed in Parkinson’s Disease

If you have Parkinson’s disease and are having trouble swallowing, contact your doctor. He or she will recommend a speech pathologist to carefully examine your swallowing abilities and evaluate your aspiration risk. A swallowing study using foods and liquids of varying consistency. The way you sit and the type of food you eat can influence your ability to swallow. Sit upright at a 90-degree angle, tilt your head slightly forward, remain sitting or standing upright for 15-20 minutes after eating a meal. This website is for people who struggle to swallow from birth, there is a good chance the info on here can help you, plus dysphagia can be a complication of Parkinson’s disease.

 Hard to swallow: dysphagia in Parkinson’s disease. swallowing changes occur from the earliest stages of Parkinson’s disease (PD), even in cases asymptomatic for dysphagia. Little empirical evidence exists concerning the individual’s own perception of changes, the impact these have on their life and coping strategies to deal with them. We hope what you read here on this website might help you in some way.

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Dysphagia

The term dysphagia, a Greek word that means disordered eating, typically refers to difficulty in eating as a result of disruption in the swallowing process.

What is dysphagia?

People with dysphagia have difficulty swallowing and may even experience pain while swallowing (odynophagia). Some people may be completely unable to swallow or may have trouble safely swallowing liquids, foods, or saliva. When that happens, eating becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body and can lead to additional serious medical problems.

What research is being done on dysphagia?

Scientists are conducting research that will improve the ability of physicians and speech-language pathologists to evaluate and treat swallowing disorders. Every aspect of the swallowing process is being studied in people of all ages, including those who do not have dysphagia, to give researchers a better understanding of how normal and disordered processes compare.

Research has also led to new, safe ways to study tongue and throat movements during the swallowing process. These methods will help physicians and speech-language pathologists safely evaluate a patient’s progress during treatment.

Studies of treatment methods are helping scientists discover why some forms of treatment work with some people and not with others. This knowledge will help some people avoid serious lung infections and help others avoid tube feedings.

Where can I get help?

If you have a sudden or gradual change in your ability to swallow, you should consult with your physician. He or she may refer you to an otolaryngologist—a doctor who specializes in diseases of the ear, nose, throat, head, and neck—and a speech-language pathologist. You may be referred to a neurologist if a stroke or other neurologic disorder is the cause of the swallowing problem.

Where can I find additional information about dysphagia?

Click on the RED underlined Words below

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

https://www.nidcd.nih.gov/health/dysphagia

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Some people with dysphagia have problems swallowing certain foods or liquids, while others can’t swallow at all.

Dysphagia is usually caused by another health condition, such as: a condition that affects the nervous system, such as a strokehead injury, or dementia cancer – such as mouth cancer or oesophageal cancer  gastro-oesophageal reflux disease (GORD) – where stomach acid leaks back up into the oesophagus

http://www.nhs.uk/conditions/Dysphagia/Pages/definition.aspx

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Source: hormelhealthlabsblog.com

Pathophysiology of Dysphagia

Deglutition refers to the process of swallowing. This process enables the liquid or food bolus to be moved from the moment it enters the mouth, to the pharynx and espohagus, until it arrives the stomach. Normally, deglutition happens in a manner which is smooth and coordinated. It involves series of neuromuscular contractions which may be classified as voluntary and involuntary.

Difficulty Swallowing After Stroke (Dysphagia)

A swallowing disorder called dysphagia often occurs as a result of stroke. Dysphagia may occur in up to 65 percent of stroke patients. If not identified and managed, it can lead to poor nutrition, pneumonia and increased disability.

http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/CommunicationChallenges/Difficulty-Swallowing-After-Stroke-Dysphagia_UCM_310084_Article.jsp#.V1LBa5ErKUk

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Dysphagia is the medical term used to refer to difficulty of swallowing. This may also be defined as the feeling of “food sticking” at the chest or throat. It is also described as taking more effort and time to move the liquid or food ingested from mouth to the stomach. This term is derived from Greek words, dys (disordered or bad), and phago (eat) .

There is more info on this website below that will help you understand what this condition is about, I have only tagged a wee bit from that site to here, the site has many links to other areas of help for you.

http://howshealth.com/dysphagia/

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Esophageal manometry:

It is also referred to as esophageal motility testing. This is a procedure which allows evaluation of the functioning of the muscles at the pharynx and esophagus.

How esophageal manometry is performed (Source: hopkinsmedicine.org)

dysphagea-esophageal manometry2

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Swallowing Disorders

Definition

Swallowing disorders include a number of diseases and conditions that cause difficulty in passing food or liquid from the mouth to the stomach.

Description

Although normally swallowing is automatic, it is a complex process involving several phases and 29 muscles. Saliva helps soften food as it is chewed. The tongue helps move food to the back of the mouth, triggering a swallowing reflex that 

passes food through the pharynx. The epiglottis helps keep food from mistakenly going down the windpipe and into the esophagus, the canal that carries food to the stomach. 

Swallowing disorders can occur at any phase in the swallowing process. The medical term for difficult swallowing is dysphagia.

Each year, about 10 million people in the United States require medical evaluation for swallowing problems. Some experts say that about 10% of Americans develop symptoms of swallowing disorders in adulthood. 

Elderly people are the most likely to have problems with swallowing.

http://medical-dictionary.thefreedictionary.com/Swallowing+Disorders

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Breaking news for dysphagia

Breaking news – A potential game changer for patients with profound oropharyngeal dysphagia

Breaking news – The Swallow Expansion Device (SED) – a potential game changer for patients with profound oropharyngeal dysphagia. In early January 2015 the SED was implanted into Jeff Mauerman, a cancer survivor who is feeding tube dependent due to oropharyngeal dysphagia. This is the first FDA Approved Clinical Trial that allows a Medical Piercing to Control a Body Sphincter (Part 1 of 2)

Byline: Ed Steger, President, National Foundation of Swallowing Disorders

Disclosure: Dr. Peter Belafsky is the Medical Director of the National Foundation of Swallowing Disorders.

[Editor’s note. This story is based on an interview between Jeff Mauerman and Ed Steger that was conducted on February 4, 2015.  This is five weeks after surgery and two months before he will know the extent, if at all, to which he will be able to swallow again.]

 Like me, you may have many questions. Who’s Jeff Mauerman? What’s a sphincter? Why would one want to control a sphincter with a medicinal piercing? What does any of this that have to do with swallowing? FDA approved, really? We’ll begin with the question of who’s Jeff Mauerman.

Who is Jeff Mauerman?

Screen Shot 2015-06-12 at 3.10.25 PM

Jeff spent 30 years as an electronics engineer; he is also an oral cancer survivor. Concerned about a lump in his neck, Jeff was diagnosed with stage three squamous cell carcinoma in 2000 after a fine needle biopsy revealed cancer in lymph nodes in his neck. Further examination revealed a tumor at the base of his tongue. He was treated with concurrent radiation and chemotherapy which concluded in March 2001. Due to concerns by his radiologist about his ability to maintain proper nutrition and hydration following his treatment, a feeding tube (percutaneous endoscopic gastrostomy (PEG)) tube was implanted in Jeff’s abdomen. The PEG tube was removed in June 2001 after Jeff had recovered enough to consume food and liquid orally and maintain his weight and hydration needs. Jeff did well for the next 10 years. In 2007 he had his first swallow study and the results showed a more or less normal swallow. Although the study results were unremarkable, Jeff felt food stuck in his throat just above his esophagus. An endoscopy confirmed this suspicion and the food was dislodged without incident.

New health issues began to escalate in 2011 with bouts of pneumonia, fatigue, and weight loss. His physicians suspected lung cancer due to spots on his lungs from a CT scan. Jeff underwent a lung biopsy. The good news, there was no evidence of cancer; the bad news, one of the suspected spots was food which Jeff had inhaled into his lungs while eating. That was the point at which his physicians recognized his pneumonia as aspiration pneumonia. At this time, a new PEG tube was inserted into Jeff’s stomach.

By 2013, Jeff’s swallowing became unsustainable. He had his second swallow study which confirmed aspiration. Aspiration in this case is where food and liquid enters the lungs. He met with a speech-language pathologist who prescribed a set of oral exercises. When those failed, he went through an 8 week VitalStim therapy program. A swallow study following the exercise and VitalStim therapy showed no sign of improvement.

In mid-2014, a friend of a friend mentioned success he had had in treatment of a similar swallowing issue that had been treated by Dr. Peter Belafsky at the Center for Voice and Swallowing at UC Davis. In August 2014, Jeff had a swallow study that revealed esophageal stenosis. He subsequently underwent a dilation. In layman’s terms, this procedure involves the insertion of a long deflated balloon into the esophagus where it then is inflated to help break up fibrosis and stretch the esophagus with the intent of allowing food to more easily pass down the esophagus. This procedure did not improve Jeff’s swallow enough to allow Jeff to resume eating by mouth and the PEG tube remained in place.

At this point, Jeff had lost hope that he would ever be able to eat food again. The PEG tube would become part of him forever.  A call in late 2014 changed all that. Dr. Belafsky called and offered Jeff the opportunity to consider a recently approved phase I clinical trial. If he agreed, he would be Patient One.

What’s a sphincter?

A sphincter is a valve that maintains constriction of a natural body passage or orifice and which relaxes as required by normal physiological functioning. Sphincters are found in over 60 places in the body.

What does a sphincter have to do with swallowing?

One of those 60 plus sphincters in the human body is the Upper Esophageal Sphincter (UES). As its name implies, it is located at the top of the esophagus. During a normal swallow, it relaxes and allows food to pass from the pharynx (throat) to the esophagus in a normal manner without aspirating. The pharynx sits between one’s oral cavity and esophagus. When the UES is compromised, due to radiation, injury, neurologic damage, or other causes, it blocks the natural opening of the esophagus and can cause food and liquids to back up in the throat and enter the trachea (airway). This exposes one to aspiration (food and liquid entering the lungs). Each individual is different, but varying degrees of aspiration can cause pneumonia and even death.

What is the Swallow Expansion Device?

The swallow expansion device (SED) is a small titanium implant that is planted on the voice box through a small incision in the neck. The procedure to place the implant takes less than 15 minutes and is performed without the need for sedation. The implant has a small post (piercing) that protrudes through the skin. When a person swallows, the patient pulls the device forward and the upper esophageal sphincter opens to super-physiologic (greater than normal) proportions and allows food to pass. The procedure requires the patient to allow 8 weeks for the surgical site to heal and for the SED to integrate before attempting to use the device.

An FDA approved clinical trial

Click on the underlined RED writing

In June of 2014, the FDA approved a clinical trial (ClinicalTrials.gov Identifier: NCT02296528) – Safety and Efficacy of the Swallow Expansion Device (SED). This is a Phase I trial that is open to 5 patients with profound feeding tube dependent oropharyngeal dysphagia. The primary outcome measures are improvement in UES opening and swallowing safety as measured via fluoroscopy. If swallowing is improved and there is no aspiration, the patient will be taught how to coordinate pulling the SED with the correct amount of force at the appropriate time during swallowing. This training will be performed under the guidance of a speech and language pathologist.

There is some fascinating history behind this invention that is explained near the bottom of the clinical trial documentation. Click on NCT02296528 to read more about this trial on ClinicalTrials.gov.

Back to Jeff Mauerman

In early January 2015, Dr. Belafsky and his team at UC Davis placed the SED in Jeff Mauerman. It was done under a local anesthetic through a small 1.5 inch incision. The skin was lifted, the device inserted onto the cartilage, the post was pierced through the skin; the site was then sutured, cleaned, and bandaged. It took about 30 minutes start to finish.

I asked Jeff how he felt about being the “first” patient. He said there was a mixture of excitement at the prospect of being able to eat socially with the anxiety of being that first “trial” patient. The anxiety dissipated after a few days; now there is excitement tempered with the reality of, “will this really work? “ To find out, Jeff will need to wait the eight weeks from the time of the procedure to allow the site to heal properly and the device to integrate. After that there will be a prolonged training period for him to learn how to effectively use the device during meals. Jeff remains optimistic, but also realistic. In his own words, “if this works, I and my family are beyond fortunate; if it doesn’t, I haven’t lost anything.”

The NFOSD will report back on Jeff’s progress in April. Stay tuned!

Ed Steger would like to thank both the Mauerman’s and Dr. Belafsky for their courage in sharing their story mid way through patient #1 in a small phase 1 clinical trial with an outcome that will not be known until the April 2015 time frame.

http://swallowingdisorderfoundation.com/breaking-news-potential-game-changer-patients-profound-oropharyngeal-dysphagia/

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Iron Deficiency Anemia

Anemia is a condition in which the body does not have enough healthy red blood cells. Iron helps make red blood cells. When your body does not have enough iron, it will make fewer red blood cells or red blood cells that are too small. This is called iron deficiency anemia.

Causes

Iron deficiency anemia is the most common form. Red blood cells bring oxygen to the body’s tissues. Healthy red blood cells are made in your bone marrow. Red blood cells circulate through your body for 3 to 4 months. Parts of your body like your spleen remove old blood cells. Iron is a key part of red blood cells. Without iron, the blood cannot carry oxygen effectively. Your body normally gets iron through your diet. It also reuses iron from old red blood cells.

You get iron deficiency anemia when your body’s iron stores run low.

This can occur because:

http://www.nytimes.com/health/guides/disease/anemia/overview.html

Iron-Deficiency Anemia

Click the underlined RED Wrighting 

Iron-deficiency anemia is a common, easily treated condition that occurs if you don’t have enough iron in your body. Low iron levels usually are due to blood loss, poor diet, or an inability to absorb enough iron from food.

Routine Iron Supplementation and Screening for Iron Deficiency Anemia in Children Ages 6 to 24 Months

 This holds a lot of info for Children.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0073392/

Good Foods

Just to give you an idea on what to eat to help.

Hope this helps.

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Gastroschisis

What Is Gastroschisis? 

Gastroschisis is a birth defect that develops in a baby while a woman is pregnant. This condition occurs when an opening forms in the baby’s abdominal wall. The baby’s bowel pushes through this hole. It then develops outside of the baby’s body in the amniotic fluid.

The opening is most often on the right side of the baby’s belly button. It can be large or small, but is typically 1-2 inches in size. In more severe cases, the stomach and/or liver can sometimes make their way through the opening as well.

Because the bowel is outside of the baby’s body, it is unprotected. That means there is a chance it can become irritated, swollen and damaged. 

This condition is relatively rare, but has seen an increase in recent years. It occurs in about one in every 2,000 babies. It develops early in pregnancy, during the fourth through eighth weeks. Gastroschisis occurs due to a weakness in the baby’s abdominal wall muscles near the umbilical cord. If your baby develops this condition during your pregnancy, you will not experience any symptoms related to it.

Gastroschisis can be repaired with surgery after your baby is born. It is usually not associated with other malformations.

What Causes Gastroschisis? 

The exact cause of gastroschisis is not known. It does not appear to be inherited. Having one baby with gastroschisis does not make it more likely that you would have another baby with the condition. 

For more help understanding this

https://www.cincinnatichildrens.org/health/g/gastroschisis/

For a Facebook Group

https://www.facebook.com/averysangels

Support website//  http://averysangels.org/

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Vesicoureteral Reflux

What is Vesicoureteral Reflux?

Normally, urine flows one way, down from the kidneys, through tubes called ureters, to the bladder. But what happens when urine flows from the bladder back into the ureters? This is called vesicoureteral reflux. With vesicoureteral reflux, urine flows backward from the bladder, up the ureter to the kidney. It may happen in one or both ureters. When the “flap valve” doesn’t work and lets urine flow backward, bacteria from the bladder can enter the kidney. This may cause a kidney infection that can cause kidney damage. When the flow of urine back up the ureters is more severe, the ureters and kidneys become large and twisted. More severe reflux is tied to a greater risk of kidney damage if there is an infection present.

With photo’s

http://www.urologyhealth.org/urologic-conditions/vesicoureteral-reflux-(vur)

http://emedicine.medscape.com/article/1016439-overview

What are the types of VUR?

The two types of VUR are primary and secondary. Most cases of VUR are primary and typically affect only one ureter and kidney. With primary VUR, a child is born with a ureter that did not grow long enough during the child’s development in the womb. The valve formed by the ureter pressing against the bladder wall does not close properly, so urine refluxes from the bladder to the ureter and eventually to the kidney. This type of VUR can get better or disappear as a child gets older. As a child grows, the ureter gets longer and function of the valve improves.

Secondary VUR occurs when a blockage in the urinary tract causes an increase in pressure and pushes urine back up into the ureters. Children with secondary VUR often have bilateral reflux. VUR caused by a physical defect typically results from an abnormal fold of tissue in the urethra that keeps urine from flowing freely out of the bladder.

VUR is usually classified as grade I through V, with grade I being the least severe and grade V being the most severe.

With Photo’s

https://www.niddk.nih.gov/health-information/health-topics/urologic-disease/vesicoureteral-reflux-vur/Pages/facts.aspx

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