Question: How do you treat a black eye?

Answer: For pain, give acetaminophen ( Tylenol). Don't give aspirin or ibuprofen ( Advil, Motrin), because they can increase bleeding. There is drainage or bleeding on the white part of the eye or drainage from the eye. After 1 or 2 days, apply warm compresses to the bruised area instead.


Question: What causes ankle osteoarthritis?

Answer: Osteoarthritis of the ankle, unlike other parts of the body, isn't the "wear and tear" kind that goes along with aging. Instead, it's almost always due to an injury. You might hear your doctor call it "post-traumatic" arthritis. You can get ankle osteoarthritis after one injury, like a fracture, or after many injuries over time, like repeated sprains. If you're flat-footed, bow-legged, or knock-kneed or if you have high arches, you might also get ankle osteoarthritis, because these conditions put extra strain on your joints.


Question: What is ankle osteoarthritis like?

Answer: When you have ankle osteoarthritis, you might have inflammation or swelling of the joint that connects your foot with the lower part of your leg.


Question: How can cognitive tests help in the diagnosis of dementia?

Answer: There's no single test that will tell your doctor if you have dementia. It's a process. You may have several of the following, then your doctor will put all the information together to make a diagnosis. Cognitive tests: These measure your ability to think. They focus on things like memory, counting, reasoning, and language skills. For example, your doctor might ask you to draw a clock and mark the hands at a specific time, or give you a short list of words and ask you to remember and repeat them. She also might ask you to make easy calculations, such as counting backward from 100 by seven.


Question: What questions will your doctor ask to help them diagnose dementia?

Answer: Your primary care doctor might work with you to figure out what's behind your symptoms, or she might refer you to one or more of these doctors for certain tests: A neurologist, who specializes in the brain and nervous system A psychiatrist or another mental health specialist A psychologist or neuropsychologist, who specializes in memory and mental functions A geriatrician, who specializes in the care of older adults Your primary care doctor probably will start with a physical exam and ask questions about your medical history and other things like: Does dementia run in your family? When did the symptoms start? Have you noticed changes in behavior or personality? Are you taking any medications? She'll ask someone close to you, like a friend or family member, those same questions, too, because people with dementia aren't always aware of their condition.


Question: How can psychiatric evaluation help in the diagnosis of dementia?

Answer: There's no single test that will tell your doctor if you have dementia. It's a process. Psychiatric evaluation: Your doctor will ask questions about your mood and sense of well-being to see if depression or another mental health condition might be causing symptoms of dementia. She'll also probably ask about any behaviors that are causing concern: When do they happen, and how long do they last? And she'll talk with you about your relationships with your spouse, children, or friends.


Question: How can neurological tests help in the diagnosis of dementia?

Answer: There's no single test that will tell your doctor if you have dementia. It's a process. Neurological tests: Your doctor will test your balance, reflexes, eye movements, and see how well your sense work. To do this, she might ask you to push or pull her hands using your arms or to stand with your eyes closed and touch your nose. To check your reflexes, your doctor may tap a small rubber hammer against parts of your body and watch how you respond.


Question: Why do I need urine potassium test?

Answer: Your doctor may do it if your potassium was checked from a blood sample and your results showed something may not be right. A second test with urine can help her narrow down the reasons. Your doctor also may order the urine test if: You take diuretics or are on dialysis You have kidney or adrenal gland problems For the test, you'll need to either pee into a cup once or collect several samples over 24 hours and save them in a larger container.


Question: What does a radical prostatectomy to treat prostate cancer involve?

Answer: Radical prostatectomy involves surgically removing the entire prostate gland and some surrounding tissue. This treatment is recommended to treat early stages of the disease.


Question: What does minimally invasive surgery for prostate cancer involve?

Answer: Radical Prostatectomy for Prostate Cancer Laparoscopic prostate surgery is a type of minimally invasive surgery performed with the aid of a small camera.


Question: What can you do to stay safe when taking vitamins and supplements?

Answer: The FDA does not review these supplements for safety or efficacy before they hit the market. The bottom line: Do your research and be careful when you're shopping for new products. Other ways to stay safe: If you eat a balanced diet rich in whole grains, fruits, and vegetables, you likely do not need to take a multivitamin. Talk to your doctor to see if you need any specific vitamins if you have a restricted diet. Although these nutrients are essential to our bodies, some can be harmful in high doses. It's especially important to avoid getting too much of vitamins A, D, E, and K, because these build up in your body and can become toxic.


Question: What questions should I ask before taking vitamins and supplements?

Answer: Do I need it for a medical condition or to prevent disease? When and for how long do I need it? Should I take it as a pill, powder, or liquid? Which form of the vitamin (vitamin D2 or D3, for instance) is the best? Are there any side effects? What are the best brands of this supplement in terms of quality, safety, and how well they work? Can I take it along with my other medications? Should I avoid any foods? Will I need to stop taking it if I have to have surgery? The one you choose depends on how they work in your body and how you prefer to take them. Always talk with your doctor before you add any to your diet.


Question: What are tips for storing vitamins and supplements?

Answer: They also can keep some medications from working as well as they should. Avoid bathrooms and other damp spots. Make sure you keep them on a high shelf or in a locked cabinet, out of children's reach. Some vitamins and supplements wear out when they sit on the shelf for too long. Do a regular check of your stash and throw out any that are past their expiration date.


Question: What are some tips for buying vitamins and supplements?

Answer: When you're ready to purchase supplements, keep these tips in mind: Look for evidence about how well the product works in scientific studies from credible publications. Choose brands labeled with the NSF International, US Pharmacopeia, Underwriters Laboratory, or Consumer Lab seal. These verify that the product actually contains the ingredients that the label says it does, and that the product doesn't have any potentially harmful ingredients. Be wary of supplements made outside the United States. Many aren't regulated, and some may have toxic ingredients.


Question: Which vitamin form should I choose?

Answer: Will I need to stop taking it if I have to have surgery? Vitamins and supplements come in many forms, like pills, liquids, or powders. The one you choose depends on how they work in your body and how you prefer to take them. For example, some only work in a dry extract form, such as a capsule or pill. Others work faster and are more effective as a liquid. Also, there are several types of vitamin E. When in doubt, talk with your doctor about which supplement suits your needs.


Question: Who should avoid supplements and vitamins?

Answer: They also can keep some medications from working as well as they should. Always talk with your doctor before you add any to your diet. People who should avoid certain types include: Pregnant or breastfeeding women, because some supplements can be dangerous to the baby. People who are going to have surgery, because some products may lead to bleeding and other dangerous complications. People who've had cancer or are getting treated for it. Some supplements could help cancer cells grow or make treatments for the disease less effective.


Question: What is it like after a wisdom teeth removal?

Answer: Everyone responds differently to anesthesia. If you had a local anesthetic and feel alert, you might be able to drive home to begin your recovery. You might even be able to go back to work or do your normal activities. If you had general anesthesia or still feel drowsy, you'll need someone to drive you home. Most people have little to no pain after surgery. You'll likely have swelling and mild discomfort for 3 or so days. Your mouth may need a few weeks to completely heal. Follow your doctor's instructions for a quicker recovery.


Question: Why should I get my wisdom teeth removed?

Answer: Wisdom teeth are a third set of molars in the back of your mouth. They usually come in between the ages of 17 and 25, and they're spotted on X-rays. Most people have them removed for one of these reasons: They're impacted. Because they're so far back in your mouth, wisdom teeth may not come in normally. They can be trapped in your jawbone or gums, which can be painful. They come in at the wrong angle. They may press against your other teeth. Your mouth isn't big enough. Your jaw has no room for an extra set of molars. You have cavities or gum disease. You may not be able to reach your wisdom teeth with your toothbrush or dental floss.


Question: What is it like before a wisdom teeth removal?

Answer: You'll meet with the oral surgeon to talk about the process. At this appointment, make sure you: Talk about any health problems you have. List any drugs you take on a regular basis. Ask any questions you have about the surgery. Discuss what type of anesthesia you'll have. You can either be numb or asleep during your surgery. Plan time off from work or school to have your surgery and rest afterward at home. Set up child care, pet care, or a ride home if needed.


Question: What should I do to heal after a wisdom tooth removal?

Answer: Here are some tips for the first 3 days after surgery: Dos: Use an ice pack on your face to curb swelling or skin color changes. Use moist heat for a sore jaw. Gently open and close your mouth to exercise your jaw. Eat soft foods like pasta, rice, or soup. Drink plenty of fluids. Brush your teeth starting the second day. Don't brush against any blood clots. Take the drugs your doctor prescribes to ease pain or swelling. Call your doctor if you have a fever, or if your pain or swelling doesn't improve.


Question: What is the basis for diagnosis of multiple sclerosis?

Answer: Your diagnosis is based on the symptoms you have, how and when they flare up or improve, which of your body's functions give you trouble, and your test results. There's no way to predict how your condition will change throughout your life. It may take time, but as your doctor gets more clues about the type of MS you have, you can have a clearer idea of how it will affect you in the coming years.


Question: What is a plaque in the brain and how is it involved in multiple sclerosis?

Answer: A plaque in the brain or spinal cord changes the electrical signals that zip up and down nerves. They can get slower, distorted, or stop altogether. Those signal changes cause the symptoms of MS. One example of an MS flare is optic neuritis, inflammation of the nerve that connects the eye and the brain, which makes it harder to see. Flares can be mild and not cause major problems, or they can severely affect your day-to-day life. They usually last from a few days to several weeks, though some can stick around for months.


Question: What causes a multiple sclerosis relapse?

Answer: An MS relapse starts when nerves in the brain and spinal cord get inflamed (swollen or irritated). Then, those nerves lose the coating, called myelin, that surrounds and protects them. A plaque forms around them instead.


Question: What causes the symptoms of multiple sclerosis?

Answer: A plaque in the brain or spinal cord changes the electrical signals that zip up and down nerves. They can get slower, distorted, or stop altogether. Those signal changes cause the symptoms of MS. One example of an MS flare is optic neuritis, inflammation of the nerve that connects the eye and the brain, which makes it harder to see.


Question: What are the three different types of multiple sclerosis?

Answer: The way the disease changes and gets worse is different for each of the three types of MS: Relapsing-remitting MS: People with this type have attacks when their symptoms get worse, called relapses, followed by full, partial, or no recovery. These flares seem to change over several days to weeks. Recovery from an attack takes weeks, sometimes months, but symptoms don't get worse during this time. Most people have this type when they're first diagnosed with MS. Secondary-progressive MS: People who get this type usually start with relapsing-remitting MS. Over time, symptoms stop coming and going and begin getting steadily worse. The change may happen shortly after MS symptoms appear, or it may take years or decades. Primary-progressive MS: In this type, symptoms gradually get worse without any obvious relapses or remissions. About 15% of all people with MS have this form, but it's most common type for people diagnosed after age 40.


Question: Can my multiple sclerosis affect my day-to-day life?

Answer: Flares can be mild and not cause major problems, or they can severely affect your day-to-day life.


Question: What is a pseudo-relapse in multiple sclerosis?

Answer: Sometimes a symptom flare has nothing to do with the course of your disease, but happens because something has aggravated your condition, like a fever, infection, or hot weather. It's called a pseudo-relapse or a pseudoexacerbation. For example, some people's symptoms get worse during or after times of intense stress.


Question: What is primary-progressive multiple sclerosis?

Answer: Primary-progressive MS: In this type, symptoms gradually get worse without any obvious relapses or remissions. About 15% of all people with MS have this form, but it's most common type for people diagnosed after age 40.


Question: How can my multiple sclerosis change throughout my life?

Answer: There's no way to predict how your condition will change throughout your life. It may take time, but as your doctor gets more clues about the type of MS you have, you can have a clearer idea of how it will affect you in the coming years.


Question: What is progressive-relapsing multiple sclerosis?

Answer: The way the disease changes and gets worse is different for each of the three types of MS: Relapsing-remitting MS: People with this type have attacks when their symptoms get worse, called relapses, followed by full, partial, or no recovery. Most people have this type when they're first diagnosed with MS. Secondary-progressive MS: People who get this type usually start with relapsing-remitting MS. Over time, symptoms stop coming and going and begin getting steadily worse.


Question: Are the symptoms for multiple sclerosis different for everyone?

Answer: The symptoms it causes and when they flare up vary not only between people but also throughout one person's life. This means it can be hard for doctors to diagnose someone with the condition. They might say you "probably" or "possibly" have MS. The way the disease changes and gets worse is different for each of the three types of MS: Relapsing-remitting MS: People with this type have attacks when their symptoms get worse, called relapses, followed by full, partial, or no recovery.


Question: How can someone avoid dehydration with cancer treatments?

Answer: When you're being treated for cancer, you have a chance for developing an infection that can cause a fever Make sure you drink enough water before, during, and after your treatment: Sip all day. It isn't enough to drink water when you're parched. You can get dehydrated and never feel thirsty. Some health experts suggest at least 8 glasses of liquid a day, even more if you have diarrhea or vomiting. Ask your doctor how much sounds right for you. Try other liquids. If water doesn't do it for you, try something else. Milk, juice, sports drinks, and decaf coffee or tea all count as fluids. Sometimes, drinks with ice are easier to swallow.


Question: What are some signs of dehydration from cancer treatment?

Answer: You can get dehydrated and never feel thirsty. Here are some other things to look for: Dry mouth, tongue, or lips Dizziness Feeling weak or tired Nausea Constipation Dry skin Swollen, dry, cracked tongue Fast weight loss Headache Dark yellow urine or less urine Irritability Dehydration can be serious if you don't get it under control.


Question: What are some other ways to stay hydrated during cancer treatments?

Answer: When there isn't enough water in your system, it can't work the way it should. Fluid has many jobs in your body. Some health experts suggest at least 8 glasses of liquid a day, even more if you have diarrhea or vomiting. Foods count, too. Soups, frozen pops, gelatins, fruits, and vegetables all have liquids. Choose foods with high water content, like watermelon, lettuce, and broccoli. Suck on ice chips. If you can't stomach the idea of drinking or eating, try ice chips. A few at a time will give you a little liquid. It takes a lot to add up to a glass of water, but every little bit helps. Log how many ounces you drink, and record how many times you throw up or have diarrhea. This will help if you have to call your doctor about symptoms.


Question: Does retinopathy of prematurity improve on its own?

Answer: For many babies, ROP often gets better on its own. But if it's severe and the risk of a detached retina is high, your child's doctor will want to start treatment. About 10% of babies screened for ROP will need to be treated.


Question: How will the doctor examine my baby with retinopathy of prematurity?

Answer: If your baby has ROP, the doctor will see where it is in the eye, how severe it is, and what the blood vessels in the eyes look like.


Question: What kinds of babies does retinopathy of prematurity affect?

Answer: ROP tends to affect premature babies who weigh less than 2 ¾ pounds and are born before the 31st week of pregnancy. ( A full-term pregnancy lasts 38-42 weeks.)


Question: How many babies born with retinopathy of prematurity in the United States will become legally blind?

Answer: Over time, these blood vessels and the associated scar tissue can cause serious vision problems, such as: Damage to the retina and detachment (the retina is moved from its normal place) that leads to permanent and severe loss of vision Crossed eyes (strabismus) Increased eye pressure (glaucoma) " Lazy eye" (amblyopia) Nearsightedness (myopia) Of the 14,000 babies in the U. S. born with ROP each year, 400 to 600 will become legally blind.


Question: What are the symptoms of retinopathy of prematurity?

Answer: Only an ophthalmologist can tell if your baby has ROP. All infants who are at risk for it should be screened shortly after birth and again once they go home from the hospital. Sometimes, ROP isn't spotted until a baby is 4 to 6 weeks old.


Question: Is laser surgery used to treat retinopathy of prematurity?

Answer: Small laser beams are used to treat the sides of the retina. This stops the growth of abnormal blood vessels. It takes 30-45 minutes per eye. This is the most common way ROP is treated, and it's been done safely for many years. But your baby may lose some or all of her peripheral (side) vision.


Question: What is retinopathy of prematurity?

Answer: The smaller a baby is at birth, the greater his chance of having retinopathy of prematurity ( ROP), an eye disorder that can lead to vision loss. But most babies who are born with it get better over time. Many don't need treatment at all.


Question: What are the causes of retinopathy of prematurity?

Answer: A baby's eyes begin to develop around the 16th week of pregnancy. If she's born very early, this process is cut short. The blood vessels in her eyes don't have enough time to develop as they should. Instead, they grow where they're not supposed to. Or they can be so fragile that they bleed or leak.


Question: Is cryotherapy used to treat retinopathy of prematurity?

Answer: Instead of burning away the scars, freezing cold temperatures are used to stop more blood vessels from spreading on the retina. This is an older form of ROP treatment. It also causes a loss of side vision.


Question: Is scleral buckling used to treat retinopathy of prematurity?

Answer: A small, stretchy band is placed around the white of the eye, causing it to compress slightly. This allows the torn retina to move closer to the outer wall of the eye where it belongs.


Question: Is vitrectomy used to treat retinopathy of prematurity?

Answer: During this surgery, the clear gel (vitreous) in the center of the eye is removed and replaced with saline solution. Then, the scar tissue that's pulling the retina out of place is removed.


Question: Is injection used to treat retinopathy of prematurity?

Answer: A newer way to treat ROP is to put an anti-cancer drug into each eye. Bevacizumab ( Avastin) blocks new growth of blood vessels in tumors, and it can do the same in eyes. This treatment is promising, but more research is needed to make sure there aren't long-term side effects. It's also unclear whether the ROP may come back over time.


Question: What are the stages of retinopathy of prematurity?

Answer: Stage 1 is the mildest form of ROP. Babies at this stage or stage 2 often don't need any treatment and will have normal vision. Babies with stage 3 have more blood vessels that are abnormal. These may be large or twisted, which means the retina could start to come loose. At stage 4, the retina is starting to move from its normal place. And at stage 5, the retina has come off, and severe vision problems or even blindness is likely.


Question: Is surgery necessary to treat retinopathy of prematurity?

Answer: If the retina is detached, your child's doctor may need to do a more complex surgery: Scleral buckling.


Question: Do children with retinopathy of prematurity have eye problems later in life?

Answer: Surgery often stops the disease from getting worse and prevents vision loss. But as many as 25% of all babies who have surgery for ROP do lose some or all of their vision. Because all children with ROP are at higher risk of eye problems later in life, your child should follow up with his eye doctor every year until he's an adult.


Question: How does Baclofen treat spasticity?

Answer: Normally, your muscles get electrical signals from your nerves that tell them when to tense and relax. Spasticity happens when these signals become uneven, usually because the nerves have been damaged. This makes muscles tense up or move when you don't want them to. Baclofen works by restoring the normal signals. It can help you move your muscles more normally.


Question: What are the risks of intrathecal Baclofen surgery?

Answer: They include: A bad reaction to anesthesia Infection Bleeding Trouble with bladder control Pump malfunction: If the pump stops working (this is rare), it may give you too much medicine at once. That can cause symptoms such as drowsiness, dizziness, weakness, trouble sleeping, lightheadedness, nausea, constipation, vomiting, loose muscles, trouble with vision, coma, respiratory depression, seizures, dry mouth, double vision, poor concentration, or diarrhea. If this happens, go to the nearest emergency room right away. A doctor can give you a drug called physostigmine to counteract baclofen. Kinked catheter: If the catheter stops working well, you may need surgery to replace it.


Question: What is Baclofen?

Answer: Baclofen ( Gablofen, Lioresal) is a medication that treats stiff muscles and spasms, a condition called spasticity, that can happen to people with multiple sclerosis ( MS) and other nerve diseases.


Question: For individuals with the intrathecal Baclofen pump, how often must they go back to the doctor's office for pump refills?

Answer: People with the pump must go back to their doctor's office for pump refills and medication adjustments, typically every 1 to 3 months. At the end of the battery's life span (usually 5 to 7 years), your doctor will remove and replace the system.


Question: How do I know if the Baclofen pump system is right for me?

Answer: If your treatment team recommends the baclofen pump system, you'll try it out to see how well it works. Your doctor will inject baclofen into your spine with a small needle. Then the team checks how well it works over 2 to 4 hours. If your muscles don't relax during the first try, you may get a larger dose to see if that makes a difference. If it works, you can decide with your doctor and family members if you should have a baclofen pump system implanted.


Question: What are the risks of implanting the baclofen for multiple sclerosis?

Answer: They include: A bad reaction to anesthesia Infection Bleeding Trouble with bladder control Pump malfunction: If the pump stops working (this is rare), it may give you too much medicine at once.


Question: How do I know if the baclofen pump system is right for my multiple sclerosis?

Answer: If your treatment team recommends the baclofen pump system, you'll try it out to see how well it works. Your doctor will inject baclofen into your spine with a small needle. Then the team checks how well it works over 2 to 4 hours. If your muscles don't relax during the first try, you may get a larger dose to see if that makes a difference. If it works, you can decide with your doctor and family members if you should have a baclofen pump system implanted.


Question: How is baclofen used to treat multiple sclerosis?

Answer: Baclofen ( Gablofen, Lioresal) is a medication that treats stiff muscles and spasms, a condition called spasticity, that can happen to people with multiple sclerosis ( MS) and other nerve diseases. Normally, your muscles get electrical signals from your nerves that tell them when to tense and relax. Spasticity happens when these signals become uneven, usually because the nerves have been damaged. This makes muscles tense up or move when you don't want them to. Baclofen works by restoring the normal signals. It can help you move your muscles more normally.


Question: What are the side effects of baclofen for multiple sclerosis?

Answer: Side effects may include: Dizziness Drowsiness Headaches Nausea Weakness You can take baclofen as a pill or get it directly into an area of your spine called the intrathecal space.


Question: What is intrathecal baclofen for multiple sclerosis?

Answer: This type of treatment, called intrathecal baclofen ( ITB), can help people who have a hard time with side effects of the pill form. It delivers the drug right to the spinal cord, so it doesn't circulate throughout the body first. You need only tiny doses for the drug to work. This keeps side effects to a minimum.


Question: Who should get intrathecal Baclofen?

Answer: You need only tiny doses for the drug to work. Before you get ITB, you will meet with a treatment team that may include a doctor who specializes in rehabilitation (a physiatrist or neurologist), a physical therapist, an occupational therapist, a nurse, and a social worker. All of these professionals work together to check your spasticity symptoms and to set a treatment plan that fits your personal needs. Many doctors who specialize in pain management, called anesthesiologists, also manage ITB pumps. If it works, you can decide with your doctor and family members if you should have a baclofen pump system implanted.


Question: Who should get an intrathecal baclofen for multiple sclerosis?

Answer: You need only tiny doses for the drug to work. If it works, you can decide with your doctor and family members if you should have a baclofen pump system implanted.


Question: What is the intrathecal baclofen pump system for multiple sclerosis?

Answer: This part of your body is filled with the fluid that surrounds your spinal cord and nerve roots. A surgeon puts the device -- a round metal disc, about 1 inch thick and 3 inches around -- under the skin of your belly near your waistline. The pump stores and releases the right amount of medicine through the catheter. A tiny motor moves the medication from the pump through the catheter. Your treatment team can use a small computer outside your body to send messages to the pump and make adjustments in the dose, rate, and timing of the medication. You can also turn the system off when you don't need it.


Question: Are all ADHD treatments for children the same?

Answer: That's because treatment for ADHD is personalized. Kids have different symptoms, and treatment depends on what a child needs.


Question: What stimulant medications do doctors use to begin treatment for children with ADHD?

Answer: Often, treatment starts with a drug such as: Amphetamine ( Adderall, Adderall XR, Adzenys XR- ODT) Dexmethylphenidate ( Focalin, Focalin XR) Lisdexamfetamine ( Vyvanse) Methylphenidate ( Concerta, Daytrana, Jornay, or Ritalin) These medications come in different forms: Short-acting (immediate-release).


Question: What medication do doctors typically try first for ADHD in children?

Answer: They're often helpful for children and teens who have a hard time at school, work, or home.


Question: What form and dosage of stimulant medication should my child take for ADHD?

Answer: Kids have different symptoms, and treatment depends on what a child needs.


Question: Do ADHD medications cause side effects?

Answer: Many medications that treat ADHD have side effects. Make sure you know what to expect and what to look for before your child starts a medicine. Watch for unusual behavior changes while your child is on any medicine, and report them to your doctor. Also let him know if a medicine isn't working or if it's causing side effects.


Question: How is atomoxetine (Strattera) used to treat ADHD?

Answer: ): Atomoxetine ( Strattera) Clonidine hydrochloride ER ( Kapvay) Guanfacine ( Intuniv) ER Atomoxetine ( Strattera) was the first nonstimulant medication approved by the FDA. It's for kids ages 6 and older. It works by increasing the amount of the chemical norepinephrine in the brain. This helps lessen ADHD symptoms such as hyperactivity and impulsive behavior.


Question: Does venlafaxine (Effexor) help children with ADHD?

Answer: In its extended-release form, this drug can be used for children with ADHD and mood or anxiety issues.


Question: What are the treatment options for children with ADHD?

Answer: The options include: A single medicine A combination of different types of medicine (adjunctive therapy) Medicine plus behavioral therapy Your doctor might try different treatments to find what works best for your child.


Question: If my child already takes a MAO inhibitor antidepressant, can they still add antidepressant medication for treatment of ADHD?

Answer: Children who already take a MAO inhibitor antidepressant shouldn't take these medications.


Question: What nonstimulant drugs are approved to treat ADHD in children?

Answer: ( All three can be used as adjunctive therapy, along with a stimulant. ): Atomoxetine ( Strattera) Clonidine hydrochloride ER ( Kapvay) Guanfacine ( Intuniv) ER Atomoxetine ( Strattera) was the first nonstimulant medication approved by the FDA.


Question: Do imipramine (tofranil) and nortriptyline (pamelor) help children with ADHD?

Answer: Imipramine ( Tofranil)and nortriptyline ( Pamelor) are two others. These are called tricyclic antidepressants, and they affect the neurotransmitters in your brain. They've been around for a while but are used less often due to their side effects.


Question: How are clonidine and guanfacine used to treat ADHD?

Answer: Clonidine and guanfacine were originally made to treat high blood pressure. But they affect certain chemical receptors in the brain and can help improve: Memory Attention Impulse control Hyperactivity Agitation Aggression They're long-acting extended-release drugs and can last for 12 to 24 hours.


Question: Which nonstimulant drugs are able to be taken in combination with stimulant drugs for ADHD?

Answer: ): Atomoxetine ( Strattera) Clonidine hydrochloride ER ( Kapvay) Guanfacine ( Intuniv) ER Atomoxetine ( Strattera) was the first nonstimulant medication approved by the FDA. Studies show that when taken with a stimulant, they can help the treatment work better.


Question: Does bupropion (Wellbutrin) help children with ADHD?

Answer: These medications can improve concentration and impulse control. In its extended-release form, this drug can be used for children with ADHD and mood or anxiety issues.


Question: What children should not take stimulant drugs for ADHD?

Answer: Make sure the doctor knows his complete medical and family history before he prescribes him anything. Children who already take a MAO inhibitor antidepressant shouldn't take these medications.


Question: What are warning signs of suicide in people with depression?

Answer: Talking about committing suicide Always talking or thinking about death Making comments about being hopeless, helpless, or worthless Saying things like " It would be better if I wasn't here" or " I want out" Depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse A sudden switch from being very sad to being very calm or appearing to be happy Having a "death wish," tempting fate by taking risks that could lead to death, like driving recklessly Losing interest in things one used to care about Visiting or calling people one cares about Putting affairs in order, tying up loose ends, changing a will


Question: Will ADHD medication affect my child's growth?

Answer: Whether ADHD drugs affect children's growth depends on which study you look at. Many studies have been done on the subject over the years, and there is a lot of disagreement among them. Overall, there is some evidence that ADHD drugs can interfere with growth in children, but that effect seems to be short-lived in most kids.


Question: When did researchers first come across ADHD medication affecting children's growth?

Answer: Researchers first made the connection between ADHD drugs and children's growth back in the early 1970s. That's when a small study showed that children who were on moderate-to-high daily doses of stimulant drugs gained less weight and height than children who weren't taking ADHD medications. When kids in the study went on a "drug holiday" -- that is, they stopped taking the ADHD drugs over the summer -- they gained about twice as much weight as the group that continued to take ADHD medications year-round.


Question: Should I switch my child's ADHD medications due to growth concerns?

Answer: Before you panic and switch your child's medication, know that the slowed growth doesn't seem to be permanent. The biggest impact on growth appears to be in the first year of taking the medications. After that, the impact starts to decline. Eventually, kids on ADHD medications go into a "growth spurt" and catch up to their peers in height and weight. A study that followed children with ADHD for 10 years into adulthood found that the kids who'd been taking stimulants ended up no shorter -- or thinner -- than peers without ADHD once they were adults.


Question: What can I do to keep ADHD medication from affecting my child's growth?

Answer: While your child is taking ADHD medications, the doctor should keep careful track of his or her growth. You might need to adjust your child's diet, adding more energy-dense, nutritious foods and snacks to balance out any weight loss that's occurring. In severe cases, medications that increase the appetite may be used for a short period of time.


Question: What does research suggest regarding the effect of ADHD medications on a child's growth?

Answer: Researchers first made the connection between ADHD drugs and children's growth back in the early 1970s. That's when a small study showed that children who were on moderate-to-high daily doses of stimulant drugs gained less weight and height than children who weren't taking ADHD medications. When kids in the study went on a "drug holiday" -- that is, they stopped taking the ADHD drugs over the summer -- they gained about twice as much weight as the group that continued to take ADHD medications year-round. The early studies on ADHD medications and children's growth lasted only a few months, making it difficult to determine whether the growth lag would be permanent. Findings from some studies with longer follow-up periods have been inconsistent, but suggest that differences in growth narrow over treatment time.


Question: Do experts agree of the effects of ADHD medications on a child's growth?

Answer: One of the most talked about -- and controversial -- effects of these medications is on children's growth. Some researchers have suggested that it's not the drugs, but the ADHD itself that affects children's growth. The early studies on ADHD medications and children's growth lasted only a few months, making it difficult to determine whether the growth lag would be permanent.


Question: How can ADHD medications affect your child?

Answer: One of the most talked about -- and controversial -- effects of these medications is on children's growth. After a few studies found that kids taking ADHD medications don't grow as tall as their peers, many parents began to worry that the same drugs that were helping their kids focus were also stunting their growth. It's natural to worry about your child's size. But before you switch or stop ADHD medications, it's important for you to know what the research has shown about the effects of these medications on children's growth. One study showed that children with ADHD who aren't taking stimulant drugs are actually bigger than kids without ADHD. Researchers first made the connection between ADHD drugs and children's growth back in the early 1970s.


Question: How do I know if ADHD medication is affecting my child's growth and what should I do?

Answer: Researchers have a few theories about how ADHD drugs might affect a child's size. If your child is taking ADHD medication and is benefiting from the drugs, the improvement in behavior may outweigh any short-term effects on growth. That's something you need to discuss with your pediatrician or psychiatrist.


Question: What should parents do to lessen the effects of ADHD medications on child growth?

Answer: Researchers have a few theories about how ADHD drugs might affect a child's size. If your child is taking ADHD medication and is benefiting from the drugs, the improvement in behavior may outweigh any short-term effects on growth. That's something you need to discuss with your pediatrician or psychiatrist. While your child is taking ADHD medications, the doctor should keep careful track of his or her growth. You might need to adjust your child's diet, adding more energy-dense, nutritious foods and snacks to balance out any weight loss that's occurring. In severe cases, medications that increase the appetite may be used for a short period of time.


Question: How does ADHD medication affect children's growth?

Answer: Stimulant medications are one of the main treatments for children with ADHD. After a few studies found that kids taking ADHD medications don't grow as tall as their peers, many parents began to worry that the same drugs that were helping their kids focus were also stunting their growth. It's natural to worry about your child's size. Another theory is that ADHD medicine targets metabolic or growth factors that could affect a child's growth.


Question: What other types of biologics can your doctor give you for your rheumatoid arthritis (RA)?

Answer: These include: Adalimumab ( Humira) Adalimumab-atto ( Amjevita), a biosimilar to Humira Certolizumab ( Cimzia) Etanercept ( Enbrel) Golimumab ( Simponi) Infliximab ( Inflectra, Remicade) Infliximab-abda ( Renflexis), a biosimilar to Remicade Infliximab-dyyb ( Inflectra), a biosimilar to Remicade If the first anti- TNF you try doesn't work for you, your doctor will most likely try another one. If you still don't get relief, he may switch you to another type of biologic. These include: Abatacept ( Orencia), which blocks the immune system's T cells to lower inflammation Anakinra ( Kineret), which targets interleukin-1, a chemical your body makes that causes inflammation. Your doctor will call this type of drug an " IL-1 blocker." Rituximab ( Rituxan), which targets certain B cells, which are part of your immune system Tocilizumab ( Actemra), which targets IL-6, a chemical your body makes that causes inflammation. Your doctor will call this type of drug an " IL-6 blocker."


Question: What are usual biologic drugs used to treat rheumatoid arthritis?

Answer: When your doctor first prescribes you a biologic, it's usually an "anti- TNF" drug. These include: Adalimumab ( Humira) Adalimumab-atto ( Amjevita), a biosimilar to Humira Certolizumab ( Cimzia) Etanercept ( Enbrel) Golimumab ( Simponi) Infliximab ( Inflectra, Remicade) Infliximab-abda ( Renflexis), a biosimilar to Remicade Infliximab-dyyb ( Inflectra), a biosimilar to Remicade If the first anti- TNF you try doesn't work for you, your doctor will most likely try another one.


Question: Do some people get more help from biologics than other people?

Answer: Some people get more help from biologics than others. Experts can't predict who'll respond well and who won't.


Question: What are the next steps when biologic drugs don't help your rheumatoid arthritis (RA)?

Answer: And when you do, it may ease your symptoms or cause them to fade completely. You should start to feel better in 4 to 6 weeks, though sometimes it can take 3 to 6 months to work. Your doctor may also prescribe other medicines that work faster to help you in the meantime. But if your symptoms don't improve, let your doctor know. The goal is to find the best medicines for you as quickly as possible. Timely treatment helps protect your body from RA damage.


Question: What types of biologic drugs are used to treat rheumatoid arthritis if initial biologic drugs don't work?

Answer: These include: Adalimumab ( Humira) Adalimumab-atto ( Amjevita), a biosimilar to Humira Certolizumab ( Cimzia) Etanercept ( Enbrel) Golimumab ( Simponi) Infliximab ( Inflectra, Remicade) Infliximab-abda ( Renflexis), a biosimilar to Remicade Infliximab-dyyb ( Inflectra), a biosimilar to Remicade If the first anti- TNF you try doesn't work for you, your doctor will most likely try another one. If you still don't get relief, he may switch you to another type of biologic. These include: Abatacept ( Orencia), which blocks the immune system's T cells to lower inflammation Anakinra ( Kineret), which targets interleukin-1, a chemical your body makes that causes inflammation.


Question: What biologics do doctors prescribe to treat rheumatoid arthritis (RA)?

Answer: When your doctor first prescribes you a biologic, it's usually an "anti- TNF" drug. These include: Adalimumab ( Humira) Adalimumab-atto ( Amjevita), a biosimilar to Humira Certolizumab ( Cimzia) Etanercept ( Enbrel) Golimumab ( Simponi) Infliximab ( Inflectra, Remicade) Infliximab-abda ( Renflexis), a biosimilar to Remicade Infliximab-dyyb ( Inflectra), a biosimilar to Remicade If the first anti- TNF you try doesn't work for you, your doctor will most likely try another one.


Question: Why do biologic drugs seem to work for a while then become ineffective?

Answer: Sometimes, biologic drugs will help you for a while and then don't work as well. It's not clear why. If it happens to you, tell your doctor. He'll probably switch you to another biologic or add another type of RA drug, like methotrexate or sulfasalazine, so your treatment works better.


Question: What should I do if my biologic treatment doesnât help my rheumatoid arthritis?

Answer: It may take some trial and error to find the biologic drug that works best for your rheumatoid arthritis ( RA), but there's a good reason to keep at it. Most folks eventually find one that helps. And when you do, it may ease your symptoms or cause them to fade completely. You should start to feel better in 4 to 6 weeks, though sometimes it can take 3 to 6 months to work. Your doctor may also prescribe other medicines that work faster to help you in the meantime. But if your symptoms don't improve, let your doctor know. The goal is to find the best medicines for you as quickly as possible. Timely treatment helps protect your body from RA damage.


Question: Do biologics work best if you take them on a regular schedule?

Answer: Your doctor may also prescribe other medicines that work faster to help you in the meantime. If it happens to you, tell your doctor.


Question: Why do some biologics work for rheumatoid arthritis (RA) and others don't?

Answer: But if your symptoms don't improve, let your doctor know. The goal is to find the best medicines for you as quickly as possible. He'll probably switch you to another biologic or add another type of RA drug, like methotrexate or sulfasalazine, so your treatment works better. Some people get more help from biologics than others. Experts can't predict who'll respond well and who won't. But they know that people who get treatment in the earlier stages of RA tend to do better than those who've had the disease for many years. Biologics also work best if you take them on a regular schedule. If you can't do that due to side effects or the cost of the drugs, ask your doctor about your options.


Question: What questions might my pediatrician ask during my child's 15-month checkup?

Answer: Your baby has now entered the toddler years, and you're in for quite a ride! How's your child's appetite? Is she eating a variety of foods? Does she use her fingers to feed herself? Is she using a bottle? How many hours is your child sleeping, including naps?


Question: What should I expect from my baby's 15-month checkup?

Answer: Your baby has now entered the toddler years, and you're in for quite a ride! By now, she may be walking, throwing, exploring everything, and expressing feelings -- including anger. This is a good time to talk to your pediatrician about safety, behavior, and discipline. Weigh and measure your child Perform a physical exam of your child Give your child another dose of the diphtheria, tetanus, acellular pertussis ( DTa P) vaccine, Hib vaccine, or pneumococcal vaccine, and in the fall or winter, a flu shot Depending on the schedule being followed, the measles and chicken pox vaccines may also be given at this time Catch up on any other vaccines that have been missed As your child starts going on outings or to daycare, she will be exposed to many illnesses.


Question: What are some healthy feeding tips for my 15-month-old child?

Answer: Your baby has now entered the toddler years, and you're in for quite a ride! How can I encourage my child to try different foods? Keep offering new foods. If your child doesn't like a food one week, she may love it the next. It takes many times for a child to like some foods, so don't give up! Small children like to imitate their parents. If your child sees you eating a variety of foods, she may do the same. Stick to mostly unprocessed foods such as fruits and vegetables. These provide great nutrition for your baby's growing brain and body. Whole grains are also a good source of nutrition. Keep cutting your child's food into small pieces, staying mindful of potential choking hazards.


Question: What are the most common causes of proctitis?

Answer: Gonorrhea, syphilis, herpes, anal warts, and chlamydia are the most common cause of sexually transmitted proctitis.


Question: Where can I find resources for caregivers for multiple sclerosis?

Answer: Looking for more information on multiple sclerosis? Family Caregiver Alliance (800) 445-8106 www.caregiver.org Multiple Sclerosis Foundation (954) 776-6805 https://msfocus.org National MS Society (800) 344-4867 www.nationalmssociety.org National Caregivers Library www.caregiverslibrary.org National Alliance for Caregiving (301) 718-8444www.caregiving.org Caregiver Action Network (202) 454-3970www.caregiveraction.org Eldercare Locator (800) 677-1116www.eldercare.gov


Question: Can high cholesterol affect your eyes and skin?

Answer: They often form in tendons like the Achilles tendon in the back of your heel. You might also notice them in your hands, elbows, knees, and feet. When xanthomas form on the eyelids, they're called xanthelasmas. Cholesterol can also form deposits around the outside of your cornea -- the clear cover over the front of your eye. This is called corneal arcus, which looks like a silvery blue ring. You can see it as an arc that goes around the outside of your eye, but it won't affect your vision. At your visit your doctor will ask you: What symptoms do you have and when did you first notice them?


Question: What statins can be used to treat heterozygous familial hypercholesterolemia (HeFH)?

Answer: Statins are the main drugs that treat He FH. They block an enzyme your body needs to make cholesterol. Some examples are: Atorvastatin ( Lipitor) Lovastatin ( Mevacor) Pravastatin ( Pravachol) Rosuvastatin ( Crestor) Simvastatin ( Zocor) Other drugs your doctor may suggest to lower cholesterol: Bile acid sequestrants (colesevelam, Welchol) Ezetimibe ( Zetia) Fibrates (fenofibrate, gemfibrozil) Nicotinic acid ( Niaspan, Slo- Niacin) PCSK9 inhibitors To protect your heart and prevent heart disease, you'll need to manage He FH throughout your life.


Question: Can eating right and exercising help to treat heterozygous familial hypercholesterolemia (HeFH)?

Answer: The goal is to lower your cholesterol levels and reduce your risk for heart disease. Part of your treatment will be to make lifestyle changes, such as: Eat a low-fat diet. Avoid foods high in saturated and trans fats, like beef, pork, coconut oil, egg yolks, and whole milk. Instead, eat more veggies, fruits, whole grains, nuts, seafood, lean poultry, and low-fat dairy. Exercise. Walk, bike ride, swim, and do other activities that make your heart pump harder.


Question: What can narrow blood vessels from heterozygous familial hypercholesterolemia (HeFH) cause?

Answer: Narrowed blood vessels can prevent enough blood from reaching your heart. Or a piece of plaque can break off and get stuck in a blood vessel that supplies blood to your heart. If blood flow to your heart gets blocked, parts of your heart muscle can die and you'll have a heart attack.


Question: How do you get heterozygous familial hypercholesterolemia (HeFH)?

Answer: If you have He FH, you inherit a faulty gene from one of your parents. If you're a parent yourself and you have the gene, you've got a 50-50 chance of passing it to each of your children.


Question: What can you expect if you have heterozygous familial hypercholesterolemia (HeFH)?

Answer: Some examples are: Atorvastatin ( Lipitor) Lovastatin ( Mevacor) Pravastatin ( Pravachol) Rosuvastatin ( Crestor) Simvastatin ( Zocor) Other drugs your doctor may suggest to lower cholesterol: Bile acid sequestrants (colesevelam, Welchol) Ezetimibe ( Zetia) Fibrates (fenofibrate, gemfibrozil) Nicotinic acid ( Niaspan, Slo- Niacin) PCSK9 inhibitors To protect your heart and prevent heart disease, you'll need to manage He FH throughout your life. You'll likely need to keep up a good diet, exercise, and take statins and other drugs to control your cholesterol. Tests can find out if your other family members have He FH.


Question: What are questions for your doctor regarding heterozygous familial hypercholesterolemia (HeFH)?

Answer: Your doctor will also do an exam to look for: Bumps in your knees, elbows, and knuckles Swelling in the back of your ankles Yellow growths on your eyelids White half-circles around the colored part of your eye Which medicines are best for me? Do the medications have side effects? How often should I see you? Do I need to see any other specialists? Which ones? Which foods should I avoid? How much exercise should I do and what types are best? Lose extra weight.


Question: How can you prevent diarrhea if you're lactose intolerant?

Answer: Lactose may be found in foods you don't expect, including: Calcium-fortified breads Cereals and baked goods Powdered meal replacements Instant potatoes, soups, and breakfast drinks Pancake, biscuit, and cookie mixes Margarine Salad dressings Products labeled ânon-dairy,â like whipped toppings and creamers, which may include milk-derived ingredients If you are lactose intolerant, the best way to avoid symptoms is to read food labels. Steer clear of products with: Whey Curds Milk by-products Nonfat dry milk powder Dry milk solids Lactose also is found in more than 20% of prescription drugs and in some over-the-counter medicines.


Question: If you're lactose intolerant, what non-dairy foods can help you get calcium?

Answer: They include: Dark, leafy greens and vegetables like broccoli, spinach, and kale Salmon and tuna Beans and legumes Calcium-fortified soy milk and cheeses Almond milk Oranges You may also be able to eat yogurt that has active cultures.


Question: How do low levels of lactase lead to symptoms of lactose intolerance?

Answer: Lactase, an enzyme in the small intestine, breaks down the sugar in dairy products. If your body doesn't make enough lactase, you may get diarrhea and an upset stomach when you eat or drink dairy products. You may have mild, moderate, or severe symptoms, depending on how much lactase your body makes.


Question: Which foods can lactose be found in besides dairy products?

Answer: Lactose may be found in foods you don't expect, including: Calcium-fortified breads Cereals and baked goods Powdered meal replacements Instant potatoes, soups, and breakfast drinks Pancake, biscuit, and cookie mixes Margarine Salad dressings Products labeled ânon-dairy,â like whipped toppings and creamers, which may include milk-derived ingredients If you are lactose intolerant, the best way to avoid symptoms is to read food labels.


Question: If you have lactose intolerance, what are the symptoms if you eat or drink dairy prodcuts?

Answer: Lactose intolerance symptoms include: Diarrhea Nausea Bloating Stomach cramps Gas But there are ways to manage lactose intolerance while still getting the nutrition of dairy foods.


Question: Do medications contain lactose?

Answer: Steer clear of products with: Whey Curds Milk by-products Nonfat dry milk powder Dry milk solids Lactose also is found in more than 20% of prescription drugs and in some over-the-counter medicines. Birth control pills may contain lactose. Even things lactose-intolerant people may take for relief, such as tablets to reduce stomach acid and gas, can contain lactose. Ask your doctor or pharmacist if a medicine has lactose before you take it.


Question: Can a a vagus nerve stimulator help treat complex partial seizures?

Answer: Devices: A vagus nerve stimulator is like a pacemaker for your brain -- it sends mild electrical pulses to a nerve in your neck. Your doctor might recommend this if other treatments haven't worked for you.


Question: Are there foods that can help prevent complex partial seizures?

Answer: Changes to your diet: A special diet -- like the high-fat and low-carb ketogenic diet -- may help prevent seizures in some people.


Question: When should you talk to your doctor about your anxiety and sleep issues?

Answer: If your anxiety does not improve after a few weeks, talk to your doctor. You may have an underlying medical problem (such as an overactive thyroid or a sleep disorder) or a treatable psychiatric condition (such as an anxiety disorder) causing you to feel this way.


Question: How effective are enemas for the treatment of encopresis?

Answer: The phosphate-sodium enema ( Fleet Enema) is probably the most widely used type. Note: Some gastrointestinal specialists discourage the use of enemas and suppositories or any anal intervention because the child associates fear and pain with the anal area. The child may struggle or feel additional trauma when these types of manipulations are performed. Eventually, all impacted stool can be dissolved or disimpacted by using medications taken by mouth.


Question: What is the outlook for encopresis?

Answer: Generally, the outlook for encopresis is excellent for children who undergo the treatment regimen outlined here. Many children who do not undergo treatment are able to resolve the problem on their own as they grow up, but this can take many years.


Question: How can you establish bowel movements for your child with encopresis?

Answer: Establishing regular soft and painless bowel movements is mostly a matter of retraining the child to give up the habit of retaining stool. This is accomplished by giving laxatives every day to produce soft bowel movements. The laxative must be given in doses large enough to produce one or two soft bowel movements every day. The soft stool will be passed easily and painlessly, encouraging the child to have regular bowel movements rather than holding the stool in.


Question: How are osmotic laxatives used to treat encopresis?

Answer: Osmotic laxatives: These laxatives contain agents that are not efficiently absorbed by the intestinal lining. This results in large amounts of extra water in the intestine, which softens the stool. Since all osmotic laxatives work by increasing the amount of water in the colon, it is important that your child drinks lots of fluid while taking any of these laxatives. Like any medication, these should be given only as recommended by your child's health care provider. If the laxative does not seem to be working, do not increase the dose without talking to your child's health care provider.


Question: How is an enema used to treat severe encopresis?

Answer: Evacuation can be accomplished in the following ways: Give an enema or series of enemas: An enema pushes fluid into the rectum. This softens the stool in the rectum and creates pressure within the rectum. This pressure gives the child a powerful urge to pass a bowel movement, and the stool is usually expelled rapidly. The fluid in most enemas is water. Something is usually added to keep the water from being absorbed by the intestinal lining. Widely used enemas include commercial sodium phosphate preparations (such as Fleet saline or Pedia- Lax enemas), saline, and mineral oil enemas. Daily enemas for several days may be needed to completely evacuate the colon.


Question: How does biofeedback work to help with encopresis?

Answer: Biofeedback: This technique has been used successfully to teach some children how to best use their abdominal, pelvic, and anal sphincter muscles, which they have so often used to retain stool.


Question: How do laxatives work to treat severe encopresis?

Answer: Give strong laxatives: Most laxatives work by increasing the amount of water in the large intestine. Some laxatives cause the lower intestine to secrete water and others work by decreasing the amount of water absorbed in the lower intestine. In either case, the end result is much more water in the lower intestine when using laxatives than when not using them. This large amount of water softens formed or hard stool in the intestine and produces diarrhea. Laxatives used for this purpose include magnesium citrate, Miralax, Go LYTELY, and COLYTE products. Treatment for several days may be needed to completely evacuate the colon.


Question: How do stimulant laxatives work to help with encopresis?

Answer: Stimulant laxatives: These agents have direct actions on the lining of the intestinal wall. They increase water and salt secretion into the colon and irritate the intestinal lining to produce contractions.


Question: How is encopresis treated at home?

Answer: Although parents will be following a regimen recommended by the child's health care provider, most of the work of treating encopresis is done at home. It is very important that parents and other caregivers keep a complete record of the child's medication use and bowel movements during the treatment period. This record can be very helpful in determining whether the treatment is working.


Question: What are the symptoms of encopresis?

Answer: Children with encopresis are no more likely than other children to have major behavioral or emotional problems. More than 80% of children with encopresis have experienced constipation or painful defecation in the past. In many cases, constipation or pain occurred years before the encopresis is brought to a doctor's attention. Most children with encopresis say they have no urge to pass a bowel movement before they soil their underwear. Soiling episodes usually occur during the day, while the child is awake and active. Many school age children soil late in the afternoon after returning home from school. Soiling at night is uncommon. In many children with encopresis, the colon has become stretched out of shape, so they may intermittently pass extremely large bowel movements.


Question: What is the follow-up care for encopresis like?

Answer: The extent of follow-up needed for encopresis varies by situation. Your child's health care provider will probably want to see him at least once after treatment is well under way to ensure that the treatment is working or to alter treatment if necessary.


Question: What are the principles for treating encopresis?

Answer: Although many different regimens have been developed for the treatment of encopresis, most rely on the following principles: Empty the colon of stool Establish regular soft and painless bowel movements Maintain very regular bowel habits While there is almost always a large behavioral component to chronic encopresis, behavioral therapy alone, such as offering rewards or reasoning with the child, usually is not effective.


Question: When should you see a doctor about encopresis?

Answer: Any of the following warrants a visit to your child's primary care provider: Severe, persistent, or recurrent constipation Pain during bowel movements Reluctance to have bowel movements, including straining to hold stool in Soiling in a child who is at least 4 years old To diagnose enopresis, your child's health care provider will ask many questions about his medical history, toilet training history, diet, lifestyle, habits, medications, and behavior.


Question: How is an anorectal manometry used to diagnose encopresis?

Answer: With this test, a small tube is inserted into the child's rectum. The tube has several pressure sensors in it. During the test, the doctor can determine how the child is using his or her abdominal, pelvic, and anal muscles during defecation. Many children who have chronic constipation and/or encopresis do not use their muscles in a coordinated fashion during bowel movements. The main objective of manometry is to confirm increased pressure within the anus. Manometry can also show whether the nerves controlling the anal sphincter, anus, and rectum are present and working by measuring reflexes in this area. Manometry can measure how far the rectum is distended and whether sensation in this area is normal. Abnormal contractions of the muscles in the pelvic floor can be documented by using manometry.


Question: How long does it take to treat encopresis?

Answer: The duration of encopresis treatment varies from child to child. Treatment should continue until the child has developed regular and reliable bowel habits and has broken the habit of holding back his or her stool. This usually takes at least several months. Generally, it takes longer in younger children than in older children.


Question: How can encopresis affect a child?

Answer: Over time, the child with encopresis may also develop incoordination of the muscles used to pass bowel movements. In many children, the anal sphincter contracts rather than relaxes when they are trying to push out bowel movements. This disturbed coordination of muscle function, which causes fecal retention, is a key to the diagnosis and is also called anismus or paradoxic contraction of the pelvic floor to defecation.


Question: What causes constipation related to encopresis?

Answer: Some experts believe children become constipated when they do not eat enough fiber, available in fruits, vegetables, and whole grain foods. Many doctors think that some children become constipated because they do not drink enough water.


Question: What should parents expect from encopresis?

Answer: Encopresis is a very frustrating condition for parents. Many parents become angry at the repeated need to bathe the dirty child and to clean or discard soiled underwear. Many parents assume the soiling is the result of the child being lazy or that the child is soiling intentionally. In most cases, this is not the case. Children with encopresis are no more likely than other children to have major behavioral or emotional problems.


Question: What is encopresis like?

Answer: As the colon stretches more and more, the child loses the natural urge to pass a bowel movement. Eventually, looser, partly formed stool from higher up in the intestine leaks around the large collection of harder, more formed stool at the bottom of the colon (rectum) and then leaks out of the anus (the opening from the rectum to the outside of the body). Often in the beginning, only small amounts of stool leak out, producing streaks in the child's underwear. Typically, parents assume the child isn't wiping very well after passing a bowel movement and aren't concerned. As time goes on, the child is less and less able to hold the stool in-more and more stool leaks, and eventually the child passes entire bowel movements into his or her underwear. Often the child is not aware that he or she has passed a bowel movement. Because the stool is not passing normally through the colon, it often becomes very dark and sticky and may have a very foul smell.


Question: When should you see a specialist for encopresis?

Answer: Most cases of encopresis respond to the treatment regimen outlined above. If the soiling does not resolve, your child's health care provider may refer you to a specialist in digestive and intestinal disorders (pediatric gastroenterologist), a behavioral psychologist, or both.


Question: How do emollient laxatives work to help with encopresis?

Answer: Emollient laxatives: These products decrease the absorption of water from the colon, and thus soften the stool, making it easier to pass.


Question: How else can an anorectal manometry help with encopresis?

Answer: Anorectal manometry can also be helpful to rule out Hirschsprung disease, a very rare cause of constipation without encopresis. If Hirschsprung disease is seriously considered as a cause of your child's encopresis, a biopsy of the rectum may be necessary. A biopsy is the removal of a very tiny piece of tissue for examination under a microscope. This is done to look for the absence of nerve function in the rectum, a characteristic sign of Hirschsprung disease.


Question: What works best to treat encopresis?

Answer: Although many different regimens have been developed for the treatment of encopresis, most rely on the following principles: Empty the colon of stool Establish regular soft and painless bowel movements Maintain very regular bowel habits While there is almost always a large behavioral component to chronic encopresis, behavioral therapy alone, such as offering rewards or reasoning with the child, usually is not effective. Rather, a combination of medical and behavioral therapy works best.


Question: How can you establish regular bathroom times to treat encopresis?

Answer: Establish regular bathroom times: The child should sit on the toilet for 5-10 minutes after breakfast and again after dinner EVERY DAY. Some families must alter their daily routines to accomplish this, but it is a crucial step, particularly for school-aged children. Sitting on the toilet right after a meal takes advantage of the âgastrocolic reflex,â intestinal contractions that naturally occur after eating.


Question: What behavioral techniques can help with encopresis?

Answer: Behavioral techniques: Offer age-appropriate positive reinforcement for developing regular toilet habits. For young children, a star or sticker chart can be helpful. For older children, earning privileges, such as extra television or video game time, may be useful.


Question: How is a suppository used to treat severe encopresis?

Answer: Give a suppository or a series of suppositories: A suppository is a tablet or capsule that is inserted into the rectum. The suppository is made of a substance that may stimulate the rectum to contract and expel stool or it may soften the stool by drawing extra water from the body into the bowel. Popular stimulant suppositories include Dulcolax or Fleet Bisacodyl. Popular stool softening suppositories with glycerin are provided by Fleet or Pedia- Lax. Daily suppositories for several days may be needed to completely evacuate the colon.


Question: How does magnesium hydroxide work to help with encopresis?

Answer: Magnesium hydroxide ( Philip's Milk of Magnesia, Pedia- Lax) -- Besides causing retention of fluid in the intestine, this laxative promotes the release of a hormone that stimulates movement of stool through the intestine. Some children experience abdominal cramping. This laxative is flavorless but has a thick chalky texture that may be more acceptable when mixed with a fluid such as milk or chocolate milk. It should be avoided by children with kidney problems.


Question: How can you train your child to help with encopresis?

Answer: Training: Children may respond to teaching about the appropriate use of muscles and other physical responses during defecation. This helps them learn how to recognize the urge to have a bowel movement and to defecate effectively.


Question: What tests are done to diagnose encopresis?

Answer: In some cases, an X-ray of the child's abdomen or pelvis is performed to determine how much stool is present in the colon and assess if the colon and rectum are enlarged. Occasionally, a barium enema is performed. This is a special type of X-ray. A small tube is inserted into the child's rectum, and the colon is slowly filled with a radiopaque dye (barium). X-rays are taken throughout the procedure to see if areas of narrowing, twisting, or kinking in the lower intestine are causing the child's symptoms. In some cases, anorectal manometry may be performed. With this test, a small tube is inserted into the child's rectum. The tube has several pressure sensors in it. During the test, the doctor can determine how the child is using his or her abdominal, pelvic, and anal muscles during defecation. Many children who have chronic constipation and/or encopresis do not use their muscles in a coordinated fashion during bowel movements.


Question: How is encopresis diagnosed?

Answer: Any of the following warrants a visit to your child's primary care provider: Severe, persistent, or recurrent constipation Pain during bowel movements Reluctance to have bowel movements, including straining to hold stool in Soiling in a child who is at least 4 years old To diagnose enopresis, your child's health care provider will ask many questions about his medical history, toilet training history, diet, lifestyle, habits, medications, and behavior. A thorough physical exam will be done to assess the child's general health as well as the status of the colon, rectum, and anus. The examiner may insert a gloved finger into the child's rectum to feel for stool and make sure the anal opening and rectum are of normal size and that the anal muscles are of normal strength.


Question: What causes encopresis?

Answer: Rarely, encopresis is caused by an anatomic abnormality or disease that the child is born with. In the great majority of cases, encopresis develops as a result of chronic (long-standing) constipation. However, each person has his or her own schedule for bowel movements, and many healthy people do not have a bowel movement every day. A constipated child might pass a bowel movement every third day or less often. Constipation implies not only infrequent bowel movements, but also having difficulty or experiencing pain when doing so.


Question: What are other treatments for encopresis?

Answer: Most cases of encopresis respond to the treatment regimen outlined above. It is used rarely and under close supervision in children. For encopresis, fiber supplements and certain foods, such as fruit juices and prunes, can have a laxative effect. These foods and juices function as osmotic laxatives. They all contain various sugars that are not efficiently absorbed by the intestinal lining, thus increasing the amount of water in the colon. Given in large enough doses, all of these foods and juices are very effective laxatives. The best way to prevent encopresis is to prevent constipation in the first place.


Question: What is the final step in treating encopresis?

Answer: Over time, the child with encopresis may also develop incoordination of the muscles used to pass bowel movements. This step is just as critical as the first two steps and must not be abandoned just because the soiling has improved after the previous steps.


Question: What is encopresis?

Answer: This stool or fecal soiling usually has a physical origin and is involuntary -- the child doesn't do it on purpose. However, each person has his or her own schedule for bowel movements, and many healthy people do not have a bowel movement every day. More than 80% of children with encopresis have experienced constipation or painful defecation in the past.


Question: How are severe cases of encopresis treated?

Answer: Eventually, looser, partly formed stool from higher up in the intestine leaks around the large collection of harder, more formed stool at the bottom of the colon (rectum) and then leaks out of the anus (the opening from the rectum to the outside of the body). Evacuation can be accomplished in the following ways: Give an enema or series of enemas: An enema pushes fluid into the rectum.


Question: What are concerns about using laxatives for encopresis?

Answer: Laxatives do not stop working if they are used every day for a long time. Osmotic laxatives: These laxatives contain agents that are not efficiently absorbed by the intestinal lining. Since all osmotic laxatives work by increasing the amount of water in the colon, it is important that your child drinks lots of fluid while taking any of these laxatives.


Question: What is the best way to prevent encopresis?

Answer: Drinking plenty of fluid helps keep stools soft and may help prevent constipation in the first place. Make sure the child gets a varied diet with plenty of fruits and vegetables and whole grain breads and cereals. The child should drink water and other fluids frequently and be physically active every day. Finally, make sure the child has a regular time every day when he or she sits on the toilet. After a meal is the best time for this.


Question: How does encopresis develop?

Answer: This âholding inâ becomes a habit that often remains long after the constipation or pain with passing bowel movements has resolved. As more and more stool collects in the child's lower intestine (colon), the colon slowly stretches (sometimes called megacolon). Over time, the child with encopresis may also develop incoordination of the muscles used to pass bowel movements. In most cases, this is not the case. Children with encopresis rarely need surgery.


Question: Who is more likely to be affected by encopresis?

Answer: Many more boys than girls experience encopresis; approximately 80% of affected children are boys. Generally, it takes longer in younger children than in older children.


Question: Should I go to the doctor if my congestion and headache aren't going away?

Answer: Colds and allergies that block your nose with mucus can lead to a sinus infection. If your cold medicine doesn't give you relief, see your doctor for more treatment.


Question: Should I go to the doctor if my cough isn't going away?

Answer: If it doesn't go away, it's likely due to postnasal drip -- mucus that moves from your nose into your throat. It can be treated with antihistamines. But it could also be related to asthma or GERD (gastroesophageal reflux disease). Your doctor can tell you what to do for it. A lasting, severe cough is also the main symptom of whooping cough, a disease that's become more common in many parts of the U. S. So, if you've been hacking away for more than 2-3 weeks, your doctor may give you a test to see if you've got it.


Question: Should I go to the doctor if I can't eat or drink without vomiting?

Answer: If you can't drink anything without vomiting, you may need to go to your doctor's office or the hospital to get fluids through an IV.


Question: Should I go to the doctor if my sore throat makes it hard to swallow?

Answer: Although a sore throat can make it hurt a little to swallow, severe pain can be a sign of an infection or injury that needs to be treated by a doctor.


Question: What are some tips to prevent winter allergies?

Answer: But if you know you're allergic, you can take steps to avoid a reaction. Use these tips: Throw out shower curtains, wallpaper, and carpeting that have mold. Wash showers and sinks with a solution containing 5% bleach and a little detergent. To help control dust mites and mold, use a dehumidifier to keep the humidity in your home below 50%. Use a HEPA air filter to clean dust from the air. Wash bedding in hot water (130 F) each week. Use allergy-proof covers on mattresses, pillows, and comforters. If someone in your household is allergic to pet dander and you really want a pet, the best choices are animals without fur, such as fish. If you already have a cat or dog, don't let it sleep in your bedroom, and give it a bath at least once a week.


Question: What are common indoor winter allergy triggers?

Answer: Some common indoor allergy triggers are: Dust mites . These microscopic bugs flourish in mattresses and bedding. When their droppings and remains become airborne, they can cause allergy symptoms. Mold. This fungus thrives in damp, humid areas such as basements and bathrooms. When mold spores get into the air, they can trigger allergy symptoms. Animals. Most people are not allergic to animal fur, but rather to a protein found in the pet dander, saliva, and urine.


Question: How are winter allergies diagnosed?

Answer: A cold usually doesn't last for more than 10 days. Allergies can linger for weeks or even months. He may refer you to an allergist, who will ask you about your health history and symptoms. The allergist may do a skin test where he scratches your skin with a tiny bit of an allergen or injects it just under your skin. If the area turns red and itchy, you're allergic. There's also a blood test to diagnose some allergies.


Question: What are treatments for winter allergies?

Answer: Some common indoor allergy triggers are: Dust mites . Treatments for winter allergies include: Antihistamines , which reduce sneezing, sniffling, and itching Decongestants , which clear mucus to relieve congestion and swelling Immunotherapy (allergy shots or under-the-tongue tablets), which expose your body to gradually bigger doses of the allergen. This approach can curb your symptoms for a longer period of time than allergy drugs.


Question: What is winter allergies?

Answer: But if you have indoor allergies such as mold and dust mites, you may notice your allergy symptoms more during winter, when you spend more time inside. But if you know you're allergic, you can take steps to avoid a reaction.


Question: What are things to do during  holidays to prevent winter allergies?

Answer: Some common indoor allergy triggers are: Dust mites . Live ones can have chemicals and mold on them. Wash dust off of ornaments before you hang them. Buy glass or plastic ornaments rather than fabric, which can collect more dust. If you have a pet allergy and you'll be visiting people who have cats or dogs, take your allergy medication with you and keep up with your immunotherapy before you go. Bring your own pillow with you, too.


Question: What heart conditions can be treated with beta-blockers?

Answer: Acebutolol ( Sectral) Atenolol ( Tenormin) Bisoprolol ( Zebeta) Carvedilol ( Coreg) Esmolol ( Brevibloc) Labetalol ( Normodyne, Trandate) Metoprolol ( Lopressor, Toprol- XL) Propranolol ( Inderal) Doctors often prescribe beta-blockers for these heart conditions: Heart failure High blood pressure Angina Abnormal heart rhythms Heart attack Beta-blockers can also treat: Glaucoma Migraine headaches Anxiety Certain types of tremors Hyperthyroidism (overactive thyroid) If you have asthma or COPD, your doctor may not prescribe a beta-blocker because it may make your breathing symptoms worse.


Question: How are beta-blockers used to treat heart disease?

Answer: Beta-blockers are one of the most widely prescribed classes of drugs to treat hypertension (high blood pressure) and are a mainstay treatment of congestive heart failure. Beta-blockers work by blocking the effects of epinephrine (adrenaline) and slowing the heart's rate, thereby decreasing the heart's demand for oxygen. Long-term use of beta-blockers helps manage chronic heart failure.


Question: What should you do while you are taking a beta-blocker for heart disease?

Answer: While you're taking a beta-blocker, you may need to check your pulse every day. If it's slower than it should be, contact your doctor about taking your beta-blocker that day. Never stop taking a beta-blocker without speaking to your doctor first, even if you feel that it's not working. Sudden withdrawal can worsen angina and cause heart attacks.


Question: Do other drugs interact with beta-blockers for heart disease?

Answer: Typically, those are for a diuretic (''water pill'') or other medications such as ACE inhibitors and angiotensin receptor blockers ( ARBs), which lower blood pressure and improve heart failure symptoms. If you have side effects and you're taking your heart drugs together, talk to your doctor or pharmacist. You may need to change when you take each medication, so they're at different times. It's important to tell your doctor about everything you're taking -- including over-the-counter drugs, herbs, and supplements -- because they might affect how your beta-blocker works.


Question: What beta-blockers are used to treat heart disease?

Answer: Acebutolol ( Sectral) Atenolol ( Tenormin) Bisoprolol ( Zebeta) Carvedilol ( Coreg) Esmolol ( Brevibloc) Labetalol ( Normodyne, Trandate) Metoprolol ( Lopressor, Toprol- XL) Propranolol ( Inderal) Doctors often prescribe beta-blockers for these heart conditions: Heart failure High blood pressure Angina Abnormal heart rhythms Heart attack Beta-blockers can also treat: Glaucoma Migraine headaches Anxiety Certain types of tremors Hyperthyroidism (overactive thyroid) If you have asthma or COPD, your doctor may not prescribe a beta-blocker because it may make your breathing symptoms worse.


Question: When should you not use beta-blockers for heart disease?

Answer: Acebutolol ( Sectral) Atenolol ( Tenormin) Bisoprolol ( Zebeta) Carvedilol ( Coreg) Esmolol ( Brevibloc) Labetalol ( Normodyne, Trandate) Metoprolol ( Lopressor, Toprol- XL) Propranolol ( Inderal) Doctors often prescribe beta-blockers for these heart conditions: Heart failure High blood pressure Angina Abnormal heart rhythms Heart attack Beta-blockers can also treat: Glaucoma Migraine headaches Anxiety Certain types of tremors Hyperthyroidism (overactive thyroid) If you have asthma or COPD, your doctor may not prescribe a beta-blocker because it may make your breathing symptoms worse. If you have heart failure and severe lung congestion, your doctor will treat your congestion before prescribing a beta-blocker. You shouldn't take beta-blockers if you have low blood pressure or a slow pulse, because bringing down your heart rate more can cause dizziness and lightheadedness.


Question: How common is bedwetting?

Answer: About 40% of 3-year-olds wet the bed.


Question: What should I tell my child during bedwetting treatment?

Answer: Assure your child that bedwetting in children is common. It's nothing to be ashamed of and almost all children eventually outgrow it. Make sure siblings understand this as well. Don't allow them to tease the bedwetter.


Question: Can you get potassium naturally from foods?

Answer: Good natural food sources of potassium include: Bananas Avocados Nuts, like almonds and peanuts Citrus fruits Leafy, green vegetables Milk Potatoes Keep in mind that some types of cooking, such as boiling, can decrease the potassium content in some foods.


Question: Who is more likely to get potassium deficiencies?

Answer: Potassium deficiencies are more common in people who: Use certain medicines, such as diuretics Have physically demanding jobs Athletes exercising in hot climates and sweating excessively Have health conditions that affect their digestive absorption, such as Crohn's disease Have an eating disorder Smoke Abuse alcohol or drugs The Institute of Medicine has set an adequate intake for potassium.


Question: What causes heartburn in children and infants?

Answer: Heartburn in infants and young children is usually a sign of gastroesophageal reflux (also called GER or acid reflux). That's a condition that occurs when stomach acid backs up into the esophagus -- the tube that connects the mouth to the stomach. There is a muscle at the bottom of the esophagus called the lower esophageal sphincter ( LES) that normally keeps acids in the stomach. But if the LES relaxes too much, the harsh stomach acids can rise up and irritate the delicate lining of the esophagus. That leads to heartburn and other symptoms.


Question: What are the symptoms of heartburn in children?

Answer: Heartburn feels like a burning sensation in the chest, neck, and throat. If the cause of heartburn is GERD, the infant or child may also experience other symptoms, such as: Arching of the back during feedings Chest pain Coughing Fussiness Hoarse voice Painful swallowing Poor eating Sore throat Vomiting Wheezing Keep in mind that these symptoms are seen in other conditions, so may not necessarily be a sign of GER or GERD.


Question: How do I know if my child is having heartburn?

Answer: It's often hard to clearly diagnose heartburn in young children. That's because they have more difficulty articulating their symptoms than adults. Instead of feeling a burning in their chest, they may experience heartburn as a stomachache higher in their belly. If your child is displaying any symptoms of heartburn or GERD, start with a visit to the pediatrician. You may get a referral to a specialist called a gastroenterologist.


Question: How often does GERD occur in children?

Answer: Heartburn in infants and young children is usually a sign of gastroesophageal reflux (also called GER or acid reflux). The baby's spit-up is stronger, often repetitive, and babies may also experience the discomfort of heartburn. This can be seen with fussiness during feeding. In very young children, the cause of heartburn is usually an immature digestive tract.


Question: What usually causes heartburn in children?

Answer: Heartburn in infants and young children is usually a sign of gastroesophageal reflux (also called GER or acid reflux). In older children, risks include being overweight, exposure to secondhand smoke, and eating certain types of foods (for example, spicy foods). Children with neurological conditions, such as cerebral palsy, are also at greater risk.


Question: What tests might a child get for GERD?

Answer: The doctor will examine your child and ask about symptoms. Tests for heartburn caused by GERD include: Upper GI (gastrointestinal) series. Endoscopy. Esophageal p H probe. The doctor inserts a thin flexible tube through the child's nose and into the esophagus to test acid levels in the esophagus. Gastric emptying study. After your child drinks milk that contains a special radioactive material, the doctor uses a camera to watch the substance move through the digestive tract.


Question: Should children with ADHD be involved in their treatment plans?

Answer: Every child diagnosed with attention deficit hyperactivity disorder ( ADHD) should be involved in his own treatment plan. For most kids, that treatment involves medication. From the start, your child should understand what ADHD is, how it affects him, and how his medicine helps his symptoms. He should also know what his treatment plan is and how it works.


Question: Is it ok for my child to allow other students to take his ADHD medication?

Answer: No one else can take his medication. Other students who don't have ADHD may want to take his stimulant medication to help them focus while they study. But giving pills to another person is illegal and can get him into trouble with school and legal authorities.


Question: Is it ok for me to let my child take their own medication if they are in middle or high school?

Answer: If your child is in middle school or high school, you may want to let him take his medication on his own. It's still best for you to monitor how many pills are in the bottle, and watch to see that he takes them as prescribed. If he manages that well, he may be ready to take pills without supervision. You know your child best, but talk to his doctor and other people involved in his ADHD treatment, like therapists and teachers, before you make that call.


Question: What should I tell my child regarding drugs and alcohol use while taking ADHD medication?

Answer: He can't drink or use illegal drugs while on ADHD medication. ADHD medications are safe, but they can have serious side effects if he takes them with alcohol or other drugs.


Question: What should I tell my child about medication dosages before allowing him to manage his own medication?

Answer: If you decide it's time to let him manage his meds, make sure he understands these key things before you hand over the pill bottles: He has to take ADHD medication as prescribed. More is not necessarily better. Make sure he or she knows it may be dangerous to increase the dose without talking to your doctor.


Question: Can my child be in charge of their own ADHD medication?

Answer: Every child diagnosed with attention deficit hyperactivity disorder ( ADHD) should be involved in his own treatment plan. Many ADHD experts think it's best for you, not your child, to dispense pills each day as long as he's living with you.


Question: What should I tell my child regarding his ADHD medication before going to college?

Answer: Kids who feel involved are more likely to take their medication as prescribed. They may also be more aware of their symptoms. That can make it harder to study or do tasks that require concentration. It can even increase the odds he'll engage in risky behavior. If he thinks he doesn't need as much medication, or is ready to go off it altogether, he should talk to his doctor before making any changes.


Question: How do dietitians combat cancer-related fatigue?

Answer: Make an appointment with a dietitian. A registered dietitian provides suggestions to work around any eating problems that may be interfering with proper nutrition (such as early feeling of fullness, swallowing difficulty, or taste changes). A dietitian can also suggest ways to maximize calories and include proteins in smaller amounts of food (such as powdered milk, instant breakfast drinks, other commercial supplements, or food additives).


Question: How can someone being alert to the warning signs of fatigue combat cancer-related fatigue?

Answer: Be alert to the warning signs of fatigue. Fatigue warning signs may include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety, or impatience.


Question: How does meeting calorie needs combat cancer-related fatigue?

Answer: Cancer-related fatigue is often made worse if you are not eating or drinking enough or if you are not eating the right foods. Maintaining good nutrition can help you feel better and have more energy. The following are strategies to help improve nutritional intake: Meet your basic calorie needs. The estimated calorie needs for someone with cancer is 15 calories per pound of weight if your weight has been stable. Add 500 calories per day if you have lost weight. Example: A person who weighs 150 lbs. needs about 2250 calories per day to maintain his or her weight; active people need 20 calories per pound of weight to maintain their body weight.


Question: How does breathing evenly and wearing comfortable clothes combat cancer-related fatigue?

Answer: Beverages containing caffeine do NOT count.


Question: How does immobility cause cancer-related fatigue?

Answer: Immobility can reduce endurance and decondition muscles.


Question: How do vitamins combat cancer-related fatigue?

Answer: Take a vitamin supplement if you are not sure you are getting enough nutrients. A recommended supplement would be a multivitamin that provides at least 100% of the recommended daily allowances ( RDA) for most nutrients. Note: vitamin supplements do not provide calories, which are essential for energy production. So vitamins cannot substitute for adequate food intake. Also, some doctors are strict about vitamin intake during chemotherapy so be sure to discuss what vitamins should be taken.


Question: How does hypothyroidism cause cancer-related fatigue?

Answer: If the thyroid gland is under-active (hypothyroidism), metabolism may slow down so that the body does not burn food fast enough to provide adequate energy. This is a common condition in general, but may happen after radiation therapy to the lymph nodes in the neck or some targeted therapies. Symptoms include feeling cold and unexplained weight gain, in addition to severe fatigue.


Question: How does evaluating your energy level combat cancer-related fatigue?

Answer: Evaluate your energy level. Think of your personal energy stores as a "bank." Deposits and withdrawals have to be made over the course of the day or the week to balance energy conservation, restoration and expenditure. Keep a diary for one week to identify the time of day when you are either most fatigued or have the most energy. Note what you think may be contributing factors.


Question: How do hormonal changes cause cancer-related fatigue?

Answer: Pain.


Question: How does anemia cause cancer-related fatigue?

Answer: Hemoglobin is a substance in the red blood cells that enables the blood to transport oxygen through the body. When the blood can't transport enough oxygen to the body, fatigue can result.


Question: When should someone with cancer-related fatigue talk to their doctor?

Answer: Be sure to let your doctor or nurse know if you have: Increased shortness of breath with minimal exertion Uncontrolled pain Inability to control side effects from treatments (such as nausea, vomiting, diarrhea, or loss of appetite) Uncontrollable anxiety or nervousness Ongoing depression


Question: How does overworking yourself cause cancer-related fatigue?

Answer: When the blood can't transport enough oxygen to the body, fatigue can result.


Question: How does protein combat cancer-related fatigue?

Answer: Include protein in your diet. Protein rebuilds and repairs damaged (and normally aging) body tissue. The estimated protein needs are 0.5 to 0.6 grams of protein per pound of body weight. Example: A 150 lb. person needs 75 to 90 grams of protein per day; active people need 1-1.5 grams of protein per pound of body weight. The best sources of protein include foods from the dairy group (8 oz. milk = 8 grams protein) and meats (meat, fish, or poultry = 7 grams of protein per ounce).


Question: What are some other ways to combat cancer-related fatigue?

Answer: Plan ahead and organize your work. Change storage of items to reduce trips or reaching. Delegate tasks when needed. Combine activities and simplify details. Schedule times to rest. Balance periods of rest and work. Rest before you become fatigued. Remember that frequent, short rests are beneficial. Pace yourself. A moderate pace is better than rushing through activities. Alternate sitting and standing.


Question: How does limiting work combat cancer-related fatigue?

Answer: Limit work that requires reaching over your head. Use long-handled tools, store items lower and delegate activities. Limit work that increases muscle tension (isometric work).


Question: How does talking to the doctor combat cancer-related fatigue?

Answer: Fatigue is one of the most common side effects of cancer and its treatment. Other times, there may be medical interventions to assist in controlling some of the causes of fatigue.


Question: How does a tumor-induced hypermetabolic state cause cancer-related fatigue?

Answer: In addition to fatigue, weight loss and decreased appetite are common effects of this condition. Hemoglobin is a substance in the red blood cells that enables the blood to transport oxygen through the body.


Question: How do pain and stress cause cancer-related fatigue?

Answer: When the blood can't transport enough oxygen to the body, fatigue can result. Research shows that chronic, severe pain increases fatigue.


Question: How does fatigue affect cancer patients?

Answer: It can be acute (lasting a month or less) or chronic (lasting from one month to six months or longer). Fatigue can prevent a person from functioning normally and impacts a person's quality of life. Fatigue warning signs may include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety, or impatience.