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How to give safe gifts to children during the holidays

As the holidays approach, parents often wonder what toys are safe for their little ones.  When making your list and checking it twice, here are some tips to ensure that toys are appropriate for the age and developmental stage of your giftees.

For younger children/infants:

  • Make sure all parts are larger than the child’s mouth.  Most children age 3 and under consistently put toys in their mouth, and some older children do as well.  A small-parts tester, or “no-choke tube” is about the size of a small child’s airway and can be purchased to test parts if you are unsure.  If a part or toy fits inside the tube, it’s too small to be safe.
  • When buying stuffed toys, look for embroidered or secured parts rather than pieces (such as eyes or noses) that could be removed and swallowed.  Remove all loose strings and ribbons.  Avoid animals with stuffing made of small pellets or material that could cause choking. Be aware that stuffed toys given away at carnivals, fairs, or in vending machines are not required to meet safety standards, so be especially careful with these!
  • When buying hanging toys for cribs, ensure that the child cannot grab any portion, and that strings or wires are short.  These types of toys should be removed when the infant can push up onto his or her hands and knees.
  • Keep plush toys and loose, soft bedding out of the cribs of infants and young children as these can cause suffocation.

For all children:

  • Look for labeling on the package that indicates what ages the toy is appropriate for.  Remember that this doesn’t have to do with how smart your child is, it is based on physical and developmental skills for his or her age group and should be followed.
  • Ensure that batteries are  ....

How to treat PFS runner's knee

Patellofemoral pain constitutes a quarter of the injuries to the knee.  Kneecap pain can be both debilitating and frustrating; prolonged pain can limit physical activity and cause those suffering from it to abandon their recreational and sporting activities. 

Patellofemoral pain usually manifests as a gradual onset of pain around the edge or underneath the kneecap during physical activities.  Common activities such as descending hills or stairs, squatting, running, or sitting for long periods of time can all aggravate the pain and cause soreness. 

How your knee works

patellofemoral pain image from http://www.moveforwardpt.com/The knee joint is made up of three bones: the femur (thigh bone), the tibia (shin bone), and the patella (kneecap).  The patellofemoral joint refers to the kneecap and the groove (trochlea) in the femur in which the patella sits.  The four muscles of the quadriceps all attach to the patella.  The patella is a sesamoid bone (the bone is embedded within the tendon) and it plays a crucial role in the function of the leg by lengthening the lever arm of the muscles and tendons of the quad to maximize power and function and by acting as a shield to protect the knee from direct trauma.  The cartilage covering the kneecap within the knee joint acts as a shock absorber, protecting the underlying bone from stress.  With running and jumping, the knee (and its overlying cartilage) can experience forces up to 8 times bodyweight.  The cartilage itself does not have a nerve supply, but the bone underneath has an extensive nerve supply and these nerves become painful when the cartilage is not functioning properly to pad and protect the bone.

In patellofemoral syndrome, or PFS (also known as runner’s knee), the cartilage undersurface of the patella become angry, inflamed, irritated, and the kneecap hurts.

How to treat PFS or runner’s knee

  1. Loosen things up.  Use a foam roller to roll out the quad muscle and the illiotibial (IT) band.  These tissues all hook into the kneecap and can contribute to pain when they are tight.
     
  2. Make things stronger.   In the early recovery period (the first several weeks when you are just starting out on your recovery journey) ....

Gluten allergy: myth or fact?

Gluten is a hot topic these days, and is hitting the headlines again. Why? At the American College of Allergy, Asthma, and Immunology annual meeting, Dr. David Stukus (a pediatric allergist) set out to clarify frequent myths that he encounters in his practice.  So, why is he saying that gluten allergies do not exist?

Gluten is a protein found in foods processed from wheat and related grain products.  In celiac sprue (affecting up to 1% of adults), gluten intake leads to damage of the small intestine, impairing its ability to absorb nutrients.  I like to imagine that a healthy small intestine is like a shag carpet, and small intestine affected by active celiac sprue is more like a tile floor.  Celiac sprue is not a gluten allergy, but rather an autoimmune condition where the gluten is triggering an inflammatory response in the body.

Studies find that ...

Bedwetting during travel or holiday season

It’s November already and the holidays are right around the corner.  For a lot of families, this means either traveling to visit others, or out of town family members will be coming to celebrate. For families who have a child experiencing wetting accidents (day or night time), this can pose a challenge for both. For the child, they can experience embarrassment and shame, with a fear of having an accident in someone else’s home, or in a different environment (i.e. sleeping in someone else’s bed). For the parent(s) it’s a concern of how to manage the logistics of the wetting accidents. This combined with the hustle and bustle of the holiday season adds stressors for everyone, taking away some of the fun and enjoyment of the season.

Here are some tips to help both you and your child successfully manage this scenario:

  • Supplies to have on hand or pack when traveling:
    • Waterproof disposable underwear (pull ups) – pack more than you think you will need just in case
    • Protective vinyl pants – these look just like regular underwear and can be worn over pull ups for added protection
    • Waterproof overlays or disposable underpads – these protective pads have an absorbent layer and a waterproof layer. They can be placed right on top of regular sheets and can be swapped out for a clean one if they become wet or soiled.
    • If your child will be sleeping in a sleeping bag, there are waterproof sleeping bag liners available
    • Large plastic bags – pack plenty in case of an accident. They help isolate any odor and are a sanitary way to store any wet underwear, pajamas or bedding
    • Clothing that is machine washable
    • A urine stain or odor remover
       
  • Talk with your child about ...

How to manage tinnitus (when your ears are ringing)

Almost all individuals experience ”transient ear noises” which is the intermittent sensation of ringing (lasting less than 5 minutes), typically in one ear. At times this sensation is accompanied by a sensation of fullness or a momentary change in hearing. When this change is brief, it is a normal phenomenon.  If it lasts longer than 5 minutes twice week, you should be evaluated for tinnitus.

What should I do when my ear(s) start ringing? 

The first step is a comprehensive hearing evaluation by an audiologist.  Tinnitus can be caused by a variety of auditory disorders and a complete audiology evaluation will confirm and/or rule out many of these conditions.  Pending the hearing test results, you may be referred to an otolaryngologist (sometimes referred to as an ENT or an Ear, Nose and Throat physician) or other health care providers.  The otolaryngologist will further investigate your tinnitus for possible medical causes. 

It is normal for tinnitus to occasionally change in the pitch and intensity; however, significant and prolonged changes in tinnitus (increased loudness or tinnitus that is one-sided) should be (re)evaluated.   Tinnitus that is present in one ear (unilateral) or pulsatile will always require an otolaryngology evaluation after the hearing evaluation.  Tinnitus that is accompanied by a sudden hearing loss is considered an emergent condition and individuals should be evaluated by an audiologist and otolaryngologist as soon as possible.

How can I manage my tinnitus?

Tinnitus can evoke ...

What causes constipation and how is it treated?

People often fear the worst about constipation.  Constipation is very common and only rarely signifies something serious.  Just because the average person has a bowel movement daily doesn’t mean you have to—if normal for you is every 3, 5, or 7 days that is okay so long as it’s not adversely affecting your life. In many cases, people with constipation struggle with it all their lives and are looking to be certain nothing more serious is going on and for a way to treat their symptoms.  Even in people with relatively new onset of constipation, there usually is a simple solution.  It is certainly reasonable to have your constipation assessed but in the absence of other warning signs for more serious disease, additional testing related to constipation is not always essential.

What are the causes of constipation?

Colonic inertia

  • Most cases of constipation are caused by colonic inertia, which is simply a slow moving colon.  Different people are made differently, and the muscles and nerves that are supposed to act in concert to push stool along just work a little slower in people with constipation.  In such cases, if we could look at the colon under the microscope it would look normal but if we took an x-ray of how quickly it pushed stool through, it would on average move things along more slowly.

Pelvic floor dysfunction

  • If ...

Breast cancer awareness: What's good for our breasts is good for the rest

October is Breast Cancer Awareness month. Sports teams are wearing pink, survivors are telling their stories, and pink ribbons are everywhere. Women battling the disease and people who care for them are educating others about the importance of early detection. People who may never have been personally touched by breast cancer are showing their support by volunteering, raising funds for research and getting involved in other ways. It is a world of PINK! And that’s a good thing.

But……sometimes it feels like we spend so much time talking about breast cancer we forget to talk about our general health. Breasts are important, but so is the rest! There are things you can do to both decrease your risk of breast cancer and improve your health overall:

  • Get moving! You don’t have to run marathons. Even moderate walking 30 min, 4-5 days a week is beneficial. Adding resistance or weight training is ideal. Life is busy, but if you look you will find ways to fit exercise into your daily routine. You’ll be decreasing cancer risk and preventing osteoporosis. Plus, inactive women have more heart disease, stroke, type 2 diabetes, and depression than active woman.

  • Maintain a healthy weight. It can make a big difference - especially avoiding weight gain after menopause. Keeping your body mass index (BMI) <25 is ideal. (Click here for a tool to help calculate your BMI). Gaining even 20lbs during the course of adulthood has been shown to increase risk of breast cancer for some women.

  • Eat a healthy diet that is high in:
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