HEALTH

ADENOIDS

2009-05-23T12:07:00.000-07:00

What Are Adenoids?

The adenoids (say: add-eh-noids) are lumpy clusters of spongy tissue that help protect kids from getting sick. They sit high on each side of the throat behind the nose and the roof of the mouth. Although you can easily see your tonsils by standing in front of a mirror and opening your mouth wide, you can't see your adenoids this way. A doctor has to use a small mirror or a special scope to get a peek at your adenoids.

Like tonsils, adenoids help keep your body healthy by trapping harmful bacteria and viruses that you breathe in or swallow. Adenoids also contain cells that make antibodies to help your body fight infections. Adenoids do important work as infection fighters for babies and little kids. But they become less important once a kid gets older and the body develops other ways to fight germs.

Some doctors believe that adenoids may not be important at all after kids reach their third birthday. In fact, adenoids usually shrink after about age 5, and by the teenage years they often practically disappear.

When Adenoids Swell

Because adenoids trap germs that enter a kid's body, adenoid tissue sometimes temporarily swells (gets puffier) as it tries to fight off an infection. The swelling might go away on its own, but sometimes medical treatment is necessary. Adenoids can get so walloped by a bacterial invasion that they become infected themselves.

Swollen or enlarged adenoids are common. When this happens, the tonsils get swollen, too. Swollen or infected adenoids can make it tough for a kid to breathe and cause these problems:

* a very stuffy nose, so the kid can breathe only through his or her mouth
* snoring and trouble getting a good night's sleep
* sore throat and trouble swallowing
* swollen glands in the neck
* ear problems

Tell a grownup if you have any of these problems, so he or she can take you to the doctor.

What Will the Doctor Do?

At the doctor's office, the doctor will ask you how things feel in your ears, nose, and throat, and then take a look at these parts. Your doctor will listen to your breathing by using a stethoscope (say: steth-ah-scope) and may also feel your neck near your jaw.

Your doctor may use a small mirror or a bendable light to look at your adenoids, and might even send you for an X-ray to get a really close look at things. If it looks your adenoids are infected, the doctor may give you an antibiotic (a germ-fighting medicine) to take.
When Adenoids Come Out

Sometimes doctors recommend removing the adenoids if medicine doesn't help and they are making a kid sick a lot. This means going into the hospital and having surgery. Sometimes, a kid's tonsils and adenoids are removed at the same time. That's called a tonsillectomy (say: ton-seh-leck-teh-me) and adenoidectomy (say: add-eh-noid-eck-teh-me). Both are common surgeries for kids to have.

During these surgeries, kids get special medicine that makes them fall asleep and ensures that they don't feel any pain while the operation is being done. Usually, neither operation requires stitches. The cut areas will heal on their own. It takes a little time, though. After surgery, a kid will have a sore throat and will need to eat soft foods for a while.

Most kids are feeling back to normal after about a week. And do they miss their adenoids? Not one bit!

Reviewed by: Steven Dowshen, MD
Date reviewed: July 2006
Originally reviewed by: Neil Izenberg, MD

CAVITY

2009-05-23T11:59:00.000-07:00

Cavity.

That's the word no one wants to hear at the dentist's office. A cavity (say: ka-vuh-tee) develops when a tooth decays (say: dih-kaze), or breaks down. A cavity is a hole that can grow bigger and deeper over time. Cavities are also called dental caries (say: kar-eez), and if you have a cavity, it's important to get it repaired. But why would your tooth develop a hole? Blame plaque.

That's a sticky, slimy substance made up mostly of the germs that cause tooth decay. The bacteria in your mouth make acids and when plaque clings to your teeth, the acids can eat away at the outermost layer of the tooth, called the enamel (say: ih-na-mul). If you don't go to the dentist, the acids can continue to make their way through the enamel, and the inside parts of your tooth can begin to decay.

If you've ever had a toothache or heard an adult complain about one, it may have been because there was a cavity that reached all the way inside a tooth, where the nerve endings are. Ouch! Your dentist will carefully examine your teeth and may take X-rays. If your dentist discovers a cavity, he or she can repair it for you by first removing the rotted part of your tooth with a special drill. The dentist then fills the hole in your tooth with a special material. The result is called a filling.

Does it hurt?

Sometimes it does, but your dentist can give you an anesthestic. That's a kind of medicine that will numb the area around the problem tooth while you're getting your new filling. Though cavities can be repaired, try to avoid them by taking care of your teeth.
Here's how:
* Brush your teeth with fluoride toothpaste after every meal or at least twice a day. Bedtime is an important time to brush.
* Brush up and down in a circular motion.
* Gently brush your gums as well to keep them healthy.
* Floss your teeth once a day to remove plaque and food that's stuck between your teeth.
* Limit sweets and sugary drinks, like soda.
* See your dentist twice a year for regular checkups. We hope you'll hear those two wonderful words: "No cavities!"

Reviewed by: Steven Dowshen, MD
Date reviewed: April 2008
Originally reviewed by: Lisa A. Goss, RDH, BS, and Garrett B. Lyons Sr., DDS

HAVING YOUR TONSILS TAKEN OUT

2009-05-23T11:51:00.000-07:00

What Is a Tonsillectomy?

Have you ever had tonsillitis? That's when your tonsils, in the back of your throat, get sore and infected. If tonsillitis happens to you a lot, the doctor may suggest you have an operation to remove your tonsils. No tonsils, no more tonsillitis. Or maybe you have really large tonsils that make it hard for you to breathe at night.

That's another reason the doctor may say they should come out. Your tonsils are two lumps of tissue that work as germ fighters for your body. The trouble is that sometimes germs like to hang out there, where they cause infections. In other words, your tonsils start causing more problems than they solve. The surgery to remove tonsils is called a tonsillectomy (say: tahn-suh-lek-tuh-mee).

After this operation, kids usually don't have as many sore throats. And, if they were having trouble breathing at night, that problem goes away, too. Without tonsils, a kid won't look any different and he or she won't have any scars that anyone can see. You don't need your tonsils, so a kid's body keeps on working just fine even after they've been removed. But how do doctors get the tonsils out of your throat? Will it hurt? And what exactly do tonsils do back there? Let's find out.

Before the Tonsillectomy

Before you go to the doctor, you may need a blood or urine (pee) test. These tests might be done at your doctor's office, at a medical center or laboratory, or at the hospital a few days before your operation. The night before surgery, you won't be allowed to eat or drink anything after dinner — not even water. That's because your doctors don't want you to throw up during the operation. That would be a mess. So if you don't eat or drink, there's nothing in your stomach to throw up. You'll also need to pack your suitcase and bring anything you want to have with you.

If you have a special stuffed animal or blanket, go ahead and bring it. It's nice to have something that reminds you of home when you're in the hospital. You'll probably go to the hospital on the day of your surgery. Your mom or dad will help you get admitted. It's kind of like checking into a hotel. You let the hospital know you're there and they give you your room assignment. You'll also get a plastic bracelet that has your name on it. Once you're in your room, you'll meet the nurses and other hospital staff who will take care of you. Your mom and dad can stay with you.

Talking Tonsillectomies

Tonsils are removed in the operating room, so you'll have to take a ride on a gurney. A gurney is like a bed on wheels. When it's time for your operation, you'll get a medicine called anesthesia (say: an-is-thee-zhuh). It will help you fall asleep and keep you from feeling any pain during the operation. During the surgery, which takes only about 20 minutes, doctors will open your mouth and remove the tonsils. Hurray for anesthesia because you won't feel anything during the operation. The doctors will quickly take care of any bleeding, and before you know it, you'll wake up in the recovery room. You may feel sleepy and dizzy at first. But soon you will feel a lot better and your mom or dad will come in to see you. You'll probably have a sore throat and maybe a slight earache.

What Happens Afterward?

After your operation, it's important to drink fluids when you wake up. You should try to drink, even if it hurts a bit at first. This will help you feel better and get home faster. Sometimes kids stay in the hospital overnight, but most go home the same day as their operation. The first 2 days at home should be spent in bed. Drink fluids and eat soft foods. This will help keep your throat moist and your body fueled. Have your mom or dad stock the refrigerator with soft drinks, icepops, gelatin, ice cream, and pudding.

Other good things to eat are mashed potatoes, scrambled eggs, pasta, and warm soup. While you're getting better, you'll take a pain reliever, such as acetaminophen. You also may get antibiotics (say: an-tye-bye-ah-tiks) to prevent infection. You may see little white patches in the back of your throat. This is normal. After the first week, the white patches will fall off. You doctor may also have you return to his or her office for a checkup. After a week or two, you should feel much better. You'll be ready to go back to school and play with your friends again. You can tell them all about your tonsillectomy!

Reviewed by: Elana Pearl Ben-Joseph, MD

TONSILITIS

2009-05-23T11:45:00.000-07:00

What Are Tonsils?

The tonsils' job is to help fight germs that come in through our mouth or nose before they cause infections in the rest of the body. Usually, tonsils do their job well. But sometimes bacteria or viruses get into the tonsils and infect them. When this happens, you have tonsillitis.

How Can I Tell if I Have Tonsillitis? If you have tonsillitis, your throat usually hurts and it's hard to eat or drink or even swallow. You may also have a fever. Here are some other signs that bacteria or a virus are infecting your tonsils:
* redder-than-normal tonsils
* a yellow or white coating on the tonsils
* a funny-sounding voice
* swollen glands in the neck
* fever
* bad breath

What Will the Doctor Do?

The doctor will ask you how you've been feeling and then look at your tonsils. He or she will probably use a wooden stick called a tongue depressor to help hold your tongue down to get a good look at what's going on in there. The doctor might also look into your nose and ears, listen to your chest, feel your neck, and look for other signs of infection. Both bacteria and viruses can cause tonsillitis. It's important for your doctor to know if it's strep.

Strep is short for streptococci (say: strep-toh-kah-kye) bacteria. If you have this kind of infection, you need special treatment. To check for strep, the doctor will use a long cotton swab to swipe the back of your throat. This test doesn't hurt, but it might make you gag. It's called a throat culture. It usually takes 1–2 days to get the results, but some doctors will do a similar test called a rapid strep test. Within minutes, this test will tell your doctor if there are any strep bacteria in your throat.

How Is Tonsillitis Treated?

If the tonsillitis is caused by strep bacteria, the doctor will prescribe antibiotics, a type of medicine that kills bacteria. It's very important to take the antibiotics exactly as you're supposed to and finish the entire prescription to kill all the bacteria. If the tonsillitis is caused by a virus, antibiotics won't work and your body will fight off the infection on its own. Sometimes kids get an operation to remove their tonsils, but only if their tonsils get infected a lot during the year or are so big they make it hard for the kid to breathe at night.

If you get tonsillitis, here are some tips that can help you feel better:
* Drink plenty of fluids.
* Eat smooth foods, including flavored gelatin, soups, ice-pops, and applesauce.
* Avoid hard, crunchy, or spicy foods.
* Use a cool-mist vaporizer or humidifier in the room where you spend the most time.
* Rest. Soon your tonsils will be back in action and ready to fight germs again!

Reviewed by: Elana Pearl Ben-Joseph, MD

BAD BREATH

2009-05-23T11:21:00.000-07:00

What's That Smell?

Bad breath is the common name for the medical condition known as halitosis (say: hal-uh-toe-sis). Many different things can cause halitosis — from not brushing your teeth to certain medical conditions. Sometimes, a person's bad breath can blow you away — and he or she may not realize there's a problem.

There are tactful (nice) ways of letting someone know about bad breath. You could offer mints or sugarless gum without having to say anything. If you need to tell a friend he or she has bad breath, you could say that you understand foods can cause bad breath because you've had it before yourself. By letting someone know that bad breath isn't something unusual, you'll make the person feel more comfortable and less embarrassed about accepting your piece of chewing gum. If you suspect your own breath is foul, ask someone who will give you an honest answer without making fun of you. (Just don't ask your brother or sister — they just might tell you your breath stinks even when it doesn't!) Although everyone gets bad breath sometimes, if you have bad breath a lot, you may need to visit your dentist or doctor.

What Causes Bad Breath?

Here are three common causes of bad breath: * foods and drinks, such as garlic, onions, cheese, orange juice, and soda * poor dental hygiene (say: hi-jeen), meaning you don't brush and floss as you should * smoking and other tobacco use Poor oral hygiene leads to bad breath because when you leave food particles in your mouth, these pieces of food can rot and start to smell. The food particles may begin to collect bacteria, which can be smelly, too. Plus, by not brushing your teeth regularly, plaque (a sticky, colorless film) builds up on your teeth. Plaque is a great place for bacteria to live and yet another reason why breath can turn foul.

Preventing Smelly Breath

So what's a kid to do? Don't smoke or use tobacco products, of course. And take care of your mouth by brushing your teeth at least twice a day and flossing once a day. Brush your tongue, too, because bacteria can grow there. Flossing once a day helps get rid of particles wedged between your teeth. Also, visit your dentist twice a year for regular checkups and cleanings. Not only will you get a thorough cleaning, the dentist will look around your mouth for any potential problems, including those that can affect breath. For example, gum disease, also known as periodontal (say: per-ee-uh-don-tul) disease, can cause bad breath and damage your teeth.

If you're concerned about bad breath, tell your doctor or dentist. But don't be surprised if he or she leans in and take a big whiff! Smell is one way doctors and dentists can help figure out what's causing the problem. The way a person's breath smells can be a clue to what's wrong. For instance, if someone has uncontrolled diabetes, his or her breath might smell like acetone (the same stuff that's in nail polish remover). If you have bad breath all the time and the reason can't be determined by your dentist, he or she may refer you to a doctor to make sure there is no other medical condition that could be causing it.

Sometimes sinus problems, and rarely liver or kidney problems, can cause bad breath. Usually, there's a less complicated reason for a kid's bad breath — like what you had for lunch. So keep up with your brushing and flossing and you should be breathing easy — and odor free!

Reviewed by: Lisa A. Goss, RDH, BS, and Charlie J. Inga, DDS

E.COLI

2009-04-13T00:14:00.000-07:00

What Is E. Coli?

E. coli is a common type of bacteria that can get into food, like beef and vegetables. E. coli is short for the medical term Escherichia coli. The strange thing about these bacteria — and lots of other bacteria — is that they're not always harmful to you.

E. coli normally lives inside your intestines, where it helps your body break down and digest the food you eat. Unfortunately, certain types (called strains) of E. coli can get from the intestines into the blood. This is a rare illness, but it can cause a very serious infection.

Someone who has E. coli infection may have these symptoms:

* bad stomach cramps and belly pain
* vomiting
* diarrhea, sometimes with blood in it

One very bad strain of E. coli was found in fresh spinach in 2006 and some fast-food hamburgers in 1993. Beef can contain E. coli because the bacteria often infect cattle. It can be in meat that comes from cattle and it's also in their poop, called manure. Cow poop in your food? How does that happen? Not on purpose, of course, but it can happen if the manure is used for fertilizer (a common practice to help crops grow) or if water contaminated with E. coli is used to irrigate the crops.

Foods to Watch

E. coli can be passed from person to person, but serious E. coli infection is more often linked to food containing the bacteria. The person eats the contaminated food and gets sick.

Here are some foods that can cause E. coli poisoning:

* undercooked ground beef (used for hamburgers)
* vegetables grown in cow manure or washed in contaminated water
* fruit juice that isn't pasteurized (pasteurization is a process that uses heat to kill germs)

Heat can kill E. coli, so experts recommend that people cook beef (especially ground beef) until it is cooked through and no longer pink. Choosing pasteurized juice is another way to avoid possible infection.

Lastly, some experts recommend washing and scrubbing vegetables before eating them. But others say E. coli is hard to remove once it has contaminated produce, such as spinach, lettuce, or onions. The solution, they say, is to take more steps so that E. coli doesn't come in contact with crops.

What Will the Doctor Do?

If someone has symptoms of E. coli poisoning, the doctor will run some blood tests and take a sample of the person's stool (poop). The blood and stool can be checked to see if a harmful strain of E. coli is present. Even though diarrhea is one of the main symptoms, the person shouldn't take anti-diarrhea medicines because they can slow down recovery time.

Some people recover at home, while others need to be in the hospital. In some cases, E. coli poisoning can cause life-threatening kidney problems.

What Can Kids Do?

Adults are the main people in charge of preventing E. coli infection by serving well-cooked meat, cleaning countertops when preparing meats, and being aware of any recalls affecting contaminated vegetables or other products.

But kids can help, too. Here are three ways:

1. When you're at a restaurant, order your burger well done. Eat it only if it's brown, not pink, on the inside.
2. Don't swallow lake, ocean, or pool water. If the water contains any human waste, it can carry the E. coli bacteria.
3. Always wash your hands after you use the bathroom and before you eat. There are plenty of bacteria in your poop. Gross! You don't want to accidentally eat some of those bad bacteria!

Reviewed by: Steven Dowshen, MD
Originally reviewed by: M. Cecilia DiPentima, MD

FOOD POISONING

2009-04-13T00:04:00.000-07:00

What Is Food Poisoning?
Food poisoning comes from eating foods that contain germs like bad bacteria or toxins, which are poisonous substances. Bacteria are all around us, so mild cases of food poisoning are common. You may have had mild food poisoning — with diarrhea and an upset stomach — but your mom or dad just called it a stomach bug or stomach virus.

You might think the solution is to get rid of all the bacteria. But it isn't possible and you wouldn't want to do it, even if you could. Bacteria are all around us, including in food, and sometimes they can be good for you. It's confusing, but one thing is for sure — the bacteria in the rotten leftovers weren't good for you. But you can learn how to avoid those bad germs in food.

Which Germs Are to Blame?
Foods from animals, raw foods, and unwashed vegetables all can contain germs that cause food poisoning. The most likely source is food from animals, like meat, poultry (such as chicken), eggs, milk, and shellfish (such as shrimp).

Some of the most common bacteria are:

* Salmonella (say: sal-meh-nel-uh)
* Listeria (say: lis-teer-ee-uh)
* Campylobacter (say: kam-pe-low-bak-ter)
* E. coli (say: ee kole-eye)

To avoid food poisoning, people need to prepare, cook, and store foods properly.

Do I Have Food Poisoning?
Someone who has food poisoning might:

* have an upset stomach (called nausea, say: naw-zee-uh)
* have stomach cramps
* have diarrhea (say: dy-uh-ree-uh), which may contain blood
* have a fever

Sometimes feeling sick from food poisoning shows up within hours of eating the bad food. At other times, someone may not feel sick until several days later. With mild cases of food poisoning, you will not feel sick for very long and will soon be feeling fine again.

It can be hard to tell if you have food poisoning or something else. You might do a little detective work and see who else gets the same sickness. Did they eat the same thing you did? If only people who ate that food got sick, food poisoning could be the problem.

It's one thing to get food poisoning from something in your fridge, but imagine how many people could get sick if a restaurant served food that had these bad germs in it. When that happens, people from the health department might get involved and try to figure out what happened and make sure everyone gets the medical care they need.

What Will the Doctor Do?

If you go to the doctor, he or she will ask you a lot of questions about how you're feeling, when you first felt sick, what you ate in the past few days, and if anyone else you know is also sick. The doctor might also take a sample of your stool (poop) and urine (pee) to test for possible germs that might have caused food poisoning.

The type of treatment you'll get for food poisoning will depend on the specific germ that is making you sick. The doctor might give you medicine, but most of the time someone who has food poisoning doesn't need to take medicine.

It's also rare that a kid with food poisoning would need to go to the hospital. Usually, only people who get really dehydrated have to go to the hospital. Being dehydrated means your body has lost too much fluid due to diarrhea and vomiting. A dehydrated person can get fluids and medicine through an IV at the hospital. To keep from getting dehydrated, try to keep drinking fluids when you are sick.

You may also need to go to the hospital if you have blood in your poop. If you do see blood in your poop, you should definitely tell your parents about it.

How to Fight the Germs

Many things can be done to prevent food poisoning. These precautions should be taken at every stage a food takes — from preparation to cooking to storing leftovers. A lot of this responsibility falls on grown-ups, but kids can help fight germs, too. One of the best ways is to wash your hands if you're helping to prepare foods.

When should you wash? Before you start helping — so germs from your hands don't get on the food — and after so you don't pass along germs from the food to yourself or anyone else. If you don't, here's how germs can travel:

1. You help make hamburger patties.
2. You get bad bacteria from the raw ground beef on your hands.
3. You hold your little sister's hand.
4. She uses that hand to eat a snack.
5. Now the bacteria have made it inside and can make her sick.

Other steps you can take to keep your food safe include:

* Wash fruits and vegetables well before eating them.
* Only eat foods that are properly cooked. If you cut into chicken and it looks pink and raw inside, tell a grown-up.
* Look at what you're eating and smell it, too. If something looks or smells different from normal, check with an adult before eating or drinking it. Milk is a good example. If you've ever had a sip of sour milk, you know you never want to taste that again! Mold (which can be green, pink, white, or brown) is also often a sign that food has spoiled.
* If you're going to eat leftovers, ask a grown-up for help heating them up. By heating them, you can kill bacteria that grew while it was in the fridge.
* Check the date. Lots of packaged foods have expiration dates or "sell by" dates. Don't eat a food if today's date is after the expiration date. Use it before it expires. Some of these dates are "sell by," which means that the food should leave store shelves by that time. Ask an adult for help deciding if it's past the sell by date.
* Cover and refrigerate food right away. Bacteria get a good chance to grow in foods that sit at room temperature. By putting food in the fridge, you're putting the chill on those bad germs!

Reviewed by: Steven Dowshen, MD

STOMACH FLU

2009-04-12T23:56:00.000-07:00

Many people talk about the "stomach flu" when they're feeling sick to their stomachs. It isn't the same as influenza, or the flu. Stomach flu is an illness called gastroenteritis (say: gas-tro-en-tuh-rye-tus), which is usually caused by a virus.

Someone who gets gastroenteritis might have stomach cramps, nausea (say: naw-zee-uh), throwing up, and diarrhea (say: dye-uh-ree-uh). He or she will probably feel pretty sick for a day or 2 but will then get better.

There is no vaccine or cure for gastroenteritis. If you have it, you'll want to rest until you feel better. If you're throwing up, don't eat solid food. Instead, sip fluids, such as water, or chew on bits of ice. Your mom or dad also might give you an oral rehydration solution (say: or-ul ree-hye-dray-shun suh-loo-shun). That's a fancy name for those special fruit-flavored drinks and Popsicles that contain carbohydrates and electrolytes - stuff your body can get low on when you're dehydrated from diarrhea or throwing up.

Once you stop throwing up, drink more clear foods and drinks such as warm chicken broth, popsicles, and gelatin. When you start to feel better, try eating bland foods like toast, pretzels or crackers, bananas, and plain noodles. As your digestive system returns to normal, you can gradually go back to eating what you usually do.

Gastroenteritis is contagious (say: kun-tay-jus), which means that someone who has it can spread it to other people. That's why it's important to wash your hands, especially before you eat and after going pee or poop. If you don't wash up after using the bathroom, you might end up spending a lot more time in there - with a case of stomach flu! Gross!

Reviewed by: Mary L. Gavin, MD

YOUR SKIN

2009-04-06T17:37:00.000-07:00

What's the biggest organ in your body?

You might be surprised to find out it's the skin, which you might not think of as an organ. No matter how you think of it, your skin is very important. It covers and protects everything inside your body. Without skin, people's muscles, bones, and organs would be hanging out all over the place. Skin holds everything together. It also:

protects our bodies
helps keep our bodies at just the right temperature
allows us to have the sense of touch

Don't Miss Your Epidermis

The skin is made up of three layers, each with its own important parts. The layer on the outside is called the epidermis (say: eh-pih-dur-mis). The epidermis is the part of your skin you can see.

Look down at your hands for a minute. Even though you can't see anything happening, your epidermis is hard at work. At the bottom of the epidermis, new skin cells are forming.

When the cells are ready, they start moving toward the top of your epidermis. This trip takes about 2 weeks to a month. As newer cells continue to move up, older cells near the top die and rise to the surface of your skin. What you see on your hands (and everywhere else on your body) are really dead skin cells.

Bye-Bye Skin Cells

These old cells are tough and strong, just right for covering your body and protecting it. But they only stick around for a little while. Soon, they'll flake off. Though you can't see it happening, every minute of the day we lose about 30,000 to 40,000 dead skin cells off the surface of our skin.

So just in the time it took you to read this far, you've probably lost about 40,000 cells. That's almost 9 pounds (4 kilograms) of cells every year! But don't think your skin might wear out someday. Your epidermis is always making new skin cells that rise to the top to replace the old ones. Most of the cells in your epidermis (95%) work to make new skin cells.

And what about the other 5%? They make a substance called melanin (say: mel-uh-nun). Melanin gives skin its color. The darker your skin is, the more melanin you have. When you go out into the sun, these cells make extra melanin to protect you from getting burned by the sun's ultraviolet, or UV, rays.

That's why your skin gets tan if you spend a lot of time in the sun. But even though melanin is mighty, it can't shield you all by itself. You'll want to wear sunscreen and protective clothing, such as a hat, to prevent painful sunburns. Protecting your skin now also can help prevent skin cancer when you get older.

The Dermis Is Under the Epidermis

The next layer down is the dermis (say: dur-mis). You can't see your dermis because it's hidden under your epidermis. The dermis contains nerve endings, blood vessels, oil glands, and sweat glands. It also contains collagen and elastin, which are tough and stretchy.

The nerve endings in your dermis tell you how things feel when you touch them. They work with your brain and nervous system, so that your brain gets the message about what you're touching. Is it the soft fur of a cat or the rough surface of your skateboard?

Sometimes what you feel is dangerous, so the nerve endings work with your muscles to keep you from getting hurt. If you touch something hot, the nerve endings in your dermis respond right away: "Ouch! That's hot!" The nerves quickly send this message to the brain or spinal cord, which then immediately commands the muscles to take your hand away. This all happens in a split second, without you ever thinking about it.

Dermis=Lots of Blood Vessels

Your dermis is also full of tiny blood vessels. These keep your skin cells healthy by bringing them the oxygen and nutrients they need and by taking away waste. These blood vessels are hard to see in kids, but you might get a better look if you check out your grandparents' skin. As the dermis gets older, it gets thinner and easier to see through.

The dermis is home to the oil glands, too. These are also called sebaceous (say: sih-bay-shus) glands, and they are always producing sebum (say: see-bum). Sebum is your skin's own natural oil. It rises to the surface of your epidermis to keep your skin lubricated and protected. It also makes your skin waterproof — as long as sebum's on the scene, your skin won't absorb water and get soggy.

You also have sweat glands on your epidermis. Even though you can't feel it, you actually sweat a tiny bit all the time. The sweat comes up through pores (say: pors), tiny holes in the skin that allow it to escape. When the sebum meets the sweat, they form a protective film that's a bit sticky.

An easy way to see this film in action is to pick up a pin with your fingers. Then wash your hands well with soap and water and dry them off completely. Now try to pick up that pin again. It won't be so easy because your sticky layer is gone! Don't worry — it will be back soon, as your sebaceous and sweat glands create more sticky stuff.

The Third Layer Is Subcutaneous Fat

The third and bottom layer of the skin is called the subcutaneous (say: sub-kyoo-tay-nee-us) layer. It is made mostly of fat and helps your body stay warm and absorb shocks, like if you bang into something or fall down. The subcutaneous layer also helps hold your skin to all the tissues underneath it.

This layer is where you'll find the start of hair, too. Each hair on your body grows out of a tiny tube in the skin called a follicle (say: fah-lih-kul). Every follicle has its roots way down in the subcutaneous layer and continues up through the dermis.

You have hair follicles all over your body, except on your lips, the palms of your hands, and the soles of your feet. And you have more hair follicles in some places than in others — there are more than 100,000 follicles on your head alone!

Your hair follicles rely on your sebaceous glands to bring on the shine. Connected to each follicle in the dermis layer is a tiny sebaceous gland that releases sebum onto the hair. This lightly coats the hair with oil, giving it some shine and a little waterproofing.

Skin Can Warm and Cool You

Your skin can help if you're feeling too hot or too cold. Your blood vessels, hair, and sweat glands cooperate to keep your body at just the right temperature. If you were to run around in the heat, you could get overheated. If you play outside when it's cold, your inner temperature could drop. Either way, your skin can help.

Your body is pretty smart. It knows how to keep your temperature right around 98.6° Fahrenheit (37° Celsius) to keep you and your cells healthy. Your skin can respond to messages sent out by your hypothalamus (say: hy-po-thal-uh-mus), the brain's inner thermometer. If you've been running around on a hot day, your blood vessels get the signal from the hypothalamus to release some of your body's heat. They do this by bringing warm blood closer to the surface of your skin. That's why you sometimes get a red face when you run around.

To cool you down, sweat glands also swing into action by making lots of sweat to release body heat into the air. The hotter you are, the more sweat your glands make! Once the sweat hits the air, it evaporates (this means that it changes from a liquid to a vapor) off your skin, and you cool down.

What about when you're ice-skating or sledding? When you're cold, your blood vessels keep your body from losing heat by narrowing as much as possible and keeping the warm blood away from the skin's surface. You might notice tiny bumps on your skin. Most kids call these goosebumps, but the fancy name for them is the pilomotor (say: py-lo-mo-ter) reflex. The reflex makes special tiny muscles called the erector pili (say: ee-rek-tur pie-lie) muscles pull on your hairs so they stand up very straight.

Keep It Clean!

Unlike other organs (like your lungs, heart, and brain), your skin likes a good washing. When you wash your skin, use water and a mild soap. And don't forget to cover scrapes and cuts with gauze or a bandage. This keeps the dirt out and helps prevent infections. It's just one way to be kind to the skin you're in!

Reviewed by: Steven Dowshen, MD

TAKING CARE OF YOUR SKIN

2009-04-06T17:30:00.000-07:00

What is this wondrous stuff? Your skin, of course! And what does your skin ask for in return for all the wonderful things it does? Just a little care and consideration. So let's learn how to take good care of the skin you're in.

Why Be Nice to Your Skin?

Like the heart, stomach, and brain, your skin is an organ. In fact, it's the largest organ in your body, but it's still easy to take skin for granted. Unless there's a problem, you may not think about your skin very much. But skin has an important job to do.

Your skin is constantly protecting you. Your skin keeps infections out of your body and keeps you from getting sick. When you take care of your skin, you're helping your skin do its job. And taking care of your skin today will help prevent future problems, like wrinkles and even skin cancer.

Clean Skin Is Happy Skin

One simple way to take care of your skin is to keep it clean. Keeping your hands clean is especially important because your hands can spread germs to the skin on other parts of your body.

When washing your hands, use water that's comfortably warm. Wet your hands, then lather up with a mild soap. You should lather and rub everywhere, including the palms, the wrists, between the fingers, and under the nails. Rinse well, dry thoroughly with a clean towel, and you're done!

You'll also want to use water that's warm, not too hot, when you take a shower or bath. Use a gentle soap to clean your body. Don't forget under your arms and behind your ears! Your face needs attention, especially as you enter puberty and the skin on your face gets more oily. It's a good idea to wash your face once or twice daily with warm water and a mild cleanser.

If you look in the drugstore, you'll see shelf after shelf of skin care products, but kids don't usually need anything more than a gentle soap. Talk to a parent or your doctor if you have questions about what to use on your skin.

If you have dry, flaky, or itchy skin, you might use a moisturizing lotion or cream. When choosing a moisturizer, pick one without a lot of colors and perfumes. Petroleum jelly can work for some kids. If you are worried about pimples, look for a moisturizer that is non-comedogenic (won't cause pimples).

With pimples, you might think that scrubbing your face is the way to get rid of them. But actually, your skin will be less likely to break out if you clean it gently, using your fingertips, not a rough washcloth. If you have trouble with pimples, talk with your doctor about which cleansers are best to use.

Allergies to Skin Care Products

Sometimes when you use a new kind of soap or other skin product, your skin may get irritated or you may get an allergic reaction. If you get a rash or if your skin feels itchy, hot, dry, or like it's burning, tell an adult. Stop using the product and don't forget that it caused a reaction. You don't want to use it again or buy a product with the same active ingredient.

To test a new product, place a tiny bit of it on the inside of your wrist or arm. Watch for any redness or irritation over the next 24 hours. If your skin becomes red or irritated, don't use the product. Sometimes, your skin is fine with a new product the first time, or few times, you use it, but then your skin gets red or irritated later on. You'll want to stop using the product whenever redness or irritation occurs.

Screening Your Skin From Damage

There is one product that everyone needs: sunscreen. Even if your skin is naturally dark, you still need to use a sunscreen. Protecting your skin from the sun prevents sunburn, which hurts and is a kind of skin damage. Sunscreen also can help prevent wrinkles when you get older and can decrease the risk of skin cancer, which is caused by exposure to the sun's harmful rays.

Choose a sunscreen with a sun protection factor (SPF) of 30 or 45, and apply it evenly. Try not to miss any spots, such as your neck or the middle of your back. Have a friend or your parent help you with the hard-to-reach spots. Follow the directions on the sunscreen, which often recommend reapplying it, especially after swimming or sweating.

Because sunscreen cannot protect your skin completely from the sun, it's also a good idea to wear a brimmed hat and use a lip balm containing sunscreen. If you need more protection from the sun, wear long sleeves and pants. Also, avoid the sun between 10 AM and 2 PM.

Soothing Skin That's Sore

Everybody gets little scrapes and cuts on their skin. When this happens to you, be sure to wash the area with warm water and a mild soap. Talk to one of your parents about whether to use an antibiotic (say: an-tie-bye-ah-tik) cream or ointment. This can kill germs at the site of the cut and prevent an infection. Covering a cut with a bandage helps keep it clean.

When you have a more serious cut, you may need to go to the doctor or the emergency department. A deep cut might need stitches to heal properly. Instead of stitching a cut together with special thread, in some cases, doctors can use a special kind of glue.

Hot Stuff

Burns are another serious problem for your skin. Prevent them by staying away from fire (such as matches, candles, and fireplaces) and steering clear of stoves, irons, and other sources of heat. If you accidentally get burned, tell a grown-up so he or she can get you the care you need.

Solving Skin Problems

Bug bites, bee stings, and poison ivy are all common skin problems. Try not to scratch! Scratching can tear your skin and is another way for germs to get in there and possibly cause an infection. Your mom or dad can help you by applying an ointment or cream to fight the itch.

If it's chickenpox that's making you itch, your mom or dad can help you apply some calamine lotion. Taking a bath with a little oatmeal in it - or an oatmeal-based bath powder - also can make you more comfortable. Scratching chickenpox can cause infections. Scratching also can cause scars where your chickenpox were.

Eczema (say: ek-zuh-muh) is another itchy problem. You're more likely to have this dry skin condition if you have asthma, hay fever, or other allergies. If a moisturizing cream doesn't work, you may need to see your doctor or a dermatologist (say: dur-muh-tah-luh-jist), a doctor who specializes in skin care.

Urticaria (say: ur-tuh-kar-ee-ah), also known as hives, is a type of skin rash that causes red blotches or bumps that itch. Hives can be caused by an infection, or an allergic reaction to an insect bite, or something you ate, breathed in, or touched. Your mom or dad might give you medicine, such as an antihistamine, to reduce the swelling or itching related to the hives. If someone has hives and other symptoms, such as trouble breathing, the person needs to go to the emergency department.

You may not think of it as skin, but you have skin on your scalp, where your hair grows. Sometimes, this skin can get flaky and fall off. This might be dandruff, the little white flakes you can sometimes see if you are wearing a dark-colored shirt. Talk to your mom or dad about this and they can buy you a special shampoo, or talk to the doctor about getting a medicated shampoo to control dandruff.

Super Skin

We've been talking a lot about the problems your skin can have, but don't forget how super your skin is. Your skin has amazing healing ability. Remember the last time you had a cut? What happened to it? Let us guess - your skin completely healed or left only a small scar? See what we mean? Your skin is simply skintastic!

Reviewed by: Patrice Hyde, MD

ATHLETE'S FOOT

2009-04-06T17:19:00.000-07:00

Anyone can get athlete's foot if two things happen: 1. Their bare feet are exposed to a kind of fungus. 2. That fungus has the right environment to grow — like hot and sweaty sneakers!

A Fungus Is a Microorganism
Athlete's foot, or tinea pedis (say: tin-ee-uh peh-dus), is a common skin infection that is caused by a fungus (say: fun-gus), a plant-like microorganism (say: my-kro-or-guh-niz-um) too small to be seen by the naked eye.

This fungus eats old skin cells. And plenty of them can be found on the feet! Although athlete's foot occurs mostly among teen and young adult guys, kids and women can get it, too. People with sweaty or damp feet are at risk. Walking barefoot where others also walk barefoot is one way the fungus can get on your feet in the first place. That's why your mom or dad might say to wear your sandals when you're showering in a public shower.

Why Is It Called Athlete's Foot?
Athlete's foot gets its name because athletes often get it.
Why? The fungus that causes it can be found where athletes often are. The fungus grows on the warm, damp surfaces around pools, public showers, and locker rooms. People walk barefoot on these surfaces and fungus ends up on their feet. Or they might use a damp towel that has the athlete's foot fungus on it.

But just having the fungus on your feet isn't enough to cause the infection. The infection happens if conditions are right for the fungus to grow. The fungus likes it wet, so:
* Dry your feet properly after swimming, showering, or bathing.
* Do not wear tight shoes when your feet are sweaty.
* Do not wear the same pair of shoes or socks day after day.

What Are the Signs and Symptoms?
Cases of athlete's foot can be mild to severe. A person who has it may have a rash that itches and burns. Other signs and symptoms include:
* bumps on the feet
* cracked, blistered, or peeling areas, often between the toes
* redness and scaling on the soles of the feet
* skin between the toes may look "cheesy" and have an unpleasant odor
* a rash that spreads to the instep (inside part of the foot)
* raw skin from scratching (try not to scratch!) Athlete's foot may spread to other parts of your foot, including your toenails.

It can also infect other parts of the body — such as the groin (commonly called jock itch) and underarms — but only if someone scratches the infection and touches these places.

What Will the Doctor Do?
A doctor such as a dermatologist (say: dur-muh-tal-uh-jist), a skin doctor, or podiatrist (say: puh-dye-uh-trist), a foot doctor, can figure out if you have athlete's foot. It could be something other than athlete's foot, too. Kids can get other foot conditions or might be allergic to a material in the shoes they're wearing.

But a doctor will be able to tell by looking at the skin on your feet. Your doctor may swab or scrape off a skin sample to test for fungus or for bacteria. Don't worry, this won't hurt — you have lots of extra layers of skin on your feet! Treatment is usually simple.

For mild cases, your doctor may have you apply a powder that contains medicine or cream that kills fungus, which should make your feet feel better in a few days. Sometimes you'll need to use the medicine for up to a month to get rid of the athlete's foot completely. You'll also need to keep your feet dry and keep your shoes off as much as possible because fungus can't easily grow in dry, open air. If doing these things doesn't help clear up the infection, your doctor may then prescribe a stronger medicine.

This one will be the kind you swallow, not just something that you apply to your feet. It's important to see a doctor about your athlete's foot because if it goes untreated, it will continue to spread, making your feet feel really itchy and uncomfortable and will become harder to get rid of. Also, more serious infections can also develop on your feet.

Athlete's Foot Prevention
Many people will develop athlete's foot at least once in their lives. Some will get it more often. To help avoid it:
* Wash your feet every day.
* Dry your feet thoroughly, especially between the toes.
* Sometimes go barefoot at home — especially at night.
* Avoid wearing tight or synthetic footwear that doesn't allow your feet to "breathe."
* Wear sandals around pool areas, public showers, and gyms to steer clear of the fungus.
* Wear socks that soak up wetness. Cotton is one material that does this.
* Change your socks every day (or more frequently) if they get damp.
* Ask your parent to buy antifungal powder to put in your sneakers or shoes.
* Spray your shoes with a disinfectant and set them in out in the sun to help kill germs.
* Don't share towels or footwear.
* Keep home bathroom surfaces clean — especially showers and tubs.

Reviewed by: Patrice Hyde, MD

APPENDICITIS

2009-04-06T17:01:00.000-07:00

What Is Appendicitis?

Your appendix (say: uh-pen-dix) is a small, finger-shaped pouch connected to your large intestine, in the lower right part of your belly, also called your abdomen. The appendix really has no purpose. So if a kid needs to have it removed, his or her body will work just fine after the operation. Some researchers think that many, many years ago, the appendix was once a useful part of the digestive system, but we don't need it anymore.

When your appendix gets inflamed, or swells up, it's called appendicitis (say: uh-pen-di-sye-tis). Both kids and adults can get appendicitis. There isn't always an obvious reason why appendicitis happens. Sometimes it happens after there is an infection in the intestine. Sometimes something causes a blockage in the appendix, then it gets inflamed.

Appendicitis is not contagious. This means you can't catch it from anyone who has it. But there isn't much you can do to prevent appendicitis from happening.

How Do People Know if They Have It?

People have different types of symptoms when they have appendicitis. Someone with appendicitis might feel as if he or she is having stomach cramps or really bad indigestion.

Usually, the first symptom is a bellyache around the belly button. Sometimes, vomiting follows. After a few hours, the pains tend to move down to the lower right side of the belly. Sometimes the pain can become sharp and intense in this area — enough to keep a kid up at night.

A person with appendicitis will not feel very hungry and might have a slight fever. Some people do not want to move around because they feel better if they lie down and curl up.

What Do Doctors Do?

Any time you have belly pain, you should tell your mom, dad, or the adult who's caring for you. If your doctor thinks you could have appendicitis, you would need to go in for an office visit or go to the emergency department. At either place, a doctor will examine you, paying close attention to your belly.

The doctor can check for tenderness over your abdomen, especially over the lower right side of your belly, a spot known as McBurney's point. This spot hurts if a kid has appendicitis. The doctor also may test a small sample of the blood to see if there are a high number of white blood cells, which means there could be an infection in the body. Sometimes, doctors will take a special picture like an X-ray, CAT scan, or ultrasound of the abdomen.

If the doctor decides that a kid has appendicitis, the appendix will need to be removed in an operation. To prepare for an appendectomy (the name for surgery that removes the appendix), a kid will be given anesthesia. This puts him or her into a kind of deep sleep and keeps the kid from feeling pain during the surgery.

During the operation, a surgeon will make a small cut in the abdomen and remove the appendix. The operation will leave a tiny scar.

After the Appendix Is Gone

After an appendectomy, a kid will stay in the hospital for a few days. The time that kids need to recover from this operation varies, but they usually return to school in about 1 to 3 weeks.

A person who's had an appendectomy will feel better soon, and won't feel any different without an appendix. And here's some more good news: The kid won't ever have to worry about appendicitis again!

Reviewed by: Yamini Durani, MD
Originally reviewed by: Philip Wolfson, MD

MENSTRUATION

2009-04-03T18:52:00.001-07:00

A girl's first period, called menarche (say: meh-nar-kee), signals that she is growing up and her body is preparing so that she might have a baby someday. A period is the 2 to 7 days that a girl or woman experiences menstrual flow — blood and tissue that leaves the body through the vagina.

For most girls, it amounts to about 2 tablespoons (30 milliliters). To catch the blood and prevent stains on her clothes, a girl can wear a pad, which sticks to her underwear, or a tampon, which is inserted into the vagina.

What's Going On Inside?

The blood and tissue leaves the body because it's no longer needed. It comes from the uterus, the organ inside a woman's body where a baby grows. Each month, blood and tissue build up in the uterus in case the woman becomes pregnant. That lining would be needed if the woman's egg was fertilized by a man's sperm cell. A fertilized egg attaches to that cushiony lining and begins growing into a baby. But most of the time, the egg does not get fertilized, the lining is shed, and the girl or woman has her period.

Let's talk for a minute about eggs. They're not the kind you buy in a carton at the store! Girls and women have two ovaries. Each of these ovaries holds thousands of eggs, which are tiny (each no bigger than the tip of a pin). During the menstrual cycle, an egg is released from one of the ovaries and begins a trip down one of the fallopian (say: fuh-lo-pee-un) tubes to the uterus, also called the womb.

If a sperm cell does not fertilize the egg, the unfertilized egg and the lining from the uterus leave the body. In other words, a girl has her period. The cycle then begins again. The lining of the uterus will start building up, and about 2 weeks after the last period, another egg will be released.

What's a Cycle?

When people talk about the menstrual (say: men-strul) cycle, they usually mean the days when blood and tissue (menstrual fluid) leaves the body through the vagina. That's the most visible part of the process, and the part that girls and women need to manage. But the monthly cycle is exactly that — a process that takes about a month.

A normal menstrual cycle for girls and teens ranges from 21 to 45 days. At most, only a week of the cycle involves menstrual fluid exiting the body. A normal period lasts from 2 to 7 days. The rest of the time, the girl doesn't have any bleeding but other stuff is happening, like the lining building up and the egg being released.

When Periods Start

Most girls start to menstruate between ages 10 and 15 years. The average age is 12, but every girl's body has its own schedule. Although there's no one right age for a girl to get her period, there are some clues that menstruation will start soon. Typically, a girl gets her period about 2 years after her breasts start to develop. Another sign is vaginal discharge fluid (sort of like mucus) that a girl might see or feel on her underwear. This discharge usually begins about 6 months to a year before a girl gets her first period.

What's Normal?

Especially when menstrual periods are new to a girl, it can be tough to know what's normal and what's not. Talking to your mom or another grownup woman is a good idea since they've been through it. But for some problems, it's best to talk with the doctor. Here are some of them:

Your period lasts longer than a week.
You have to change your pad very often (soaking more than one pad every 1–2 hours).
You go longer than 3 months between periods.
You have bleeding in between periods.
You have an unusual amount of pain before or during your period.
Your periods were regular but became irregular.

Here are some additional concerns, which many girls have when they are just starting their periods.

What If My Periods Are Irregular?

For older girls and women, their periods pretty much stick to a regular pattern. The entire cycle lasts the same number of days (21 to 34) and they have bleeding for about the same number of days (less than a week). For the first year, a girl's periods are often irregular and hard to predict.

It's a good idea to keep track of your period with a calendar. Talk with your doctor if you're concerned about the length of your period or cycle. About 6 years after a girl's first period, the cycles usually get shorter and more regular.

What If I Have Cramps?

For minor pain, you can take over-the-counter medications like ibuprofen. Other things you can do that may help with menstrual cramps include:

regular exercise
heating pads on your lower abdomen
meditation or relaxation

Talk to your doctor if these solutions don't work for you, especially if your period is keeping you from going to school or participating in stuff you want to do, like activities and sports.

How Much Bleeding Is Too Much?

Menstrual flow can seem like a lot, but usually isn't. Most girls change their pad about three to six times a day over the course of the period — with more changes when the flow is heaviest and fewer changes when the flow is lighter — usually at the very beginning and end. Let your doctor know if your flow seems heavier than this or lasts more than a week.

What If I Get Moody Around My Period?

Hormone changes can cause girls to feel more sad or irritable before their periods start. Talk to your doctor if this happens to you. Being physically active is a natural mood lifter, so regular exercise often helps.

In Praise of Periods!

It's normal to be a little nervous about your first period. And if you've already had your period a while, it's OK to dislike the inconveniences it can cause. But don't forget to feel proud, too. Menstruation is a sign of normal growth and development. In other words, you're healthy and you're growing up just the way you should!

Reviewed by: Mary L. Gavin, MD
Originally reviewed by: Wayne Ho, MD

PUBERTY 2

2009-04-03T18:45:00.000-07:00

Face Up to Changes

Another thing that comes with puberty is acne (say: ak-nee) — or pimples — caused by all those hormones at work in the body. Skin gets oilier and pimples usually start showing up when puberty begins, and you may get them throughout the teenage years. You might see pimples on your face, your upper back, or your upper chest. To help control pimples, wash your face twice a day with warm water and a mild soap or cleanser. Don't squeeze, pick, or pop your pimples. Your doctor can also offer suggestions for clearing up acne. The good news is that acne usually gets a lot better as you get older.

Putting the P.U. in Puberty

P.U.! A lot of kids notice that they have a new smell under their arms and in other places when they hit puberty — and it's not a pretty one. That smell is body odor (you may have heard people call it B.O.) and everyone gets it. As you enter puberty, the puberty hormones stimulate the glands in your skin, including the sweat glands under your arms. When sweat and bacteria on your skin get together, it can smell pretty bad.

So what can you do to feel less stinky? Well, keeping clean can stop you from smelling. You might want to take a shower every day, either in the morning before school or at night before bed. Wearing clean clothes and showering after you've been playing sports or exercising is also a good idea. Another way to cut down on body odor is to use deodorant. If you use a deodorant with antiperspirant, it will cut down on sweat as well.

There's More?

Boys and girls will also notice other body changes as they enter puberty. Girls sometimes might see and feel white or clear snot-like stuff coming from the vagina. This doesn't mean anything is wrong — it's just another sign hormones are changing your body.

Boys will begin to get erections (this is when the penis fills with blood and becomes hard). Sometimes erections happen when boys think about sexual things or they can happen for no reason at all. Boys also may experience something called nocturnal emissions (or wet dreams). This is when the penis becomes erect when a boy is sleeping and he ejaculates. When a boy ejaculates, semen — the fluid that contains sperm — comes out of the penis. That's why they're called wet dreams — they happen when you're sleeping and your underwear or the bed might be a little wet when you wake up. Wet dreams occur less often as boys move through puberty and they eventually stop.

Change Can Feel Kind of Strange

Just as those hormones change the way your body looks on the outside, they also create changes on the inside. During puberty, you might feel confused or have strong emotions that you've never had before. You might feel overly sensitive or become upset easily. Some kids lose their tempers more often and get angry with their friends or families. You also may feel anxious about how your changing body looks.

Sometimes it can be hard to deal with all these new emotions. It's important to know that while your body is adjusting to the new hormones, so is your mind. Try to remember that people usually aren't trying to hurt your feelings or upset you on purpose. It might not be your family or friends — it might be your new "puberty brain" trying to adjust.

You might also have sexual feelings that you've never felt before. And you will probably have lots of questions about these new, confusing feelings about sex.

It's easy to feel embarrassed or nervous when talking about sex. It's important to get your questions answered, but you need to be sure you have all the right information. Some kids can talk to their parents about sex and get all their questions answered. But if you feel funny talking to your parents about sex, there are many other people you can talk to, like your doctor, a school nurse, a teacher, a school counselor, or some other adult you feel comfortable talking with.

Developing Differently

People are all a little different from each other, so it makes sense that they don't all develop in the same way. During puberty, everyone changes at his or her own pace. Maybe some of your friends are getting their period, and you haven't developed breasts yet. Maybe your best friend's voice has changed, and you think you still sound like a kid. Or maybe you're sick of being the tallest girl in your class or the only boy who has to shave.

In a few cases, kids who are developing very early or who are very late in starting have a problem that may need to be checked or treated. If you are concerned about that possibility, talk with your parents and schedule a visit with your doctor. Your doctor knows all about puberty and can help determine if you are developing normally.

But just about everyone catches up eventually, and most differences between you and your friends will even out. Until then, hang in there. Puberty can be quite a wild ride!

Reviewed by: Mary L. Gavin, MD

PUBERTY 1

2009-04-03T18:38:00.000-07:00

Time to Change

OK, so it's a funny word — but what is puberty, anyway? Puberty (say: pyoo-ber-tee) is the name for the time when your body begins to develop and change as you move from kid to adult. We're talking about stuff like girls developing breasts and boys starting to look more like men. During puberty, your body will grow faster than at any other time in your life, except for when you were a baby.

It helps to know about the changes that puberty causes before they happen. That way, you know what to expect. It's also important to remember that everybody goes through these changes. No matter where you live, whether you're a boy or a girl, whether you like vanilla or double-fudge-chunk ice cream, you will experience them. No two people are exactly alike, but one thing everyone has in common is that we all go through puberty.

Usually, puberty starts between ages 8 and 13 in girls and ages 10 and 15 in boys. This wide range in ages may help explain why some of your friends still look like young kids whereas others look more like adults.

When your body is ready to begin puberty, your pituitary (say: pih-too-uh-ter-ee) gland (a pea-shaped gland located at the bottom of your brain) releases special hormones. Depending on whether you're a boy or a girl, these hormones go to work on different parts of the body.

Changes for Boys and Girls

For boys, the hormones travel through the blood and tell the testes (say: tes-teez), the two egg-shaped glands in the scrotum (the sac that hangs under the penis), to begin making testosterone (say: tess-tahs-tuh-rone) and sperm. Testosterone is the hormone that causes most of the changes in a boy's body during puberty, and men need sperm to be able to reproduce (be the father of a baby).

In girls, these hormones target the two ovaries (say: o-vuh-reez), which contain eggs that have been in the girl's body since she was born. The hormones cause the ovaries to start making another hormone, called estrogen. Together, these hormones prepare a girl's body to start her periods and be able to become pregnant someday.

Boys and girls both begin to grow hair under their arms and their pubic areas (on and around the genitals). It starts out looking light and thin. Then, as kids go through puberty, it becomes longer, thicker, heavier, curlier, and darker. Eventually, boys also start to grow hair on their faces.

It's Just a Growth Spurt

A spurt is a short burst of activity or something that happens in a hurry. And a growth spurt is just that: Your body is growing and it's happening really fast! When you go through puberty, it might seem like your sleeves are always getting shorter and your pants are creeping up your legs. That's because you're having a growth spurt that lasts for about 2 to 3 years. When that growth spurt is at its peak, some kids grow 4 or more inches (10 or more centimeters) in a year! At the end of your growth spurt, you'll have reached your adult height — or just about. But your height isn't the only thing that changes during puberty.

With all this quick growth, it can seem like one part of your body — your feet, for instance — are growing faster than everything else. This can make you feel clumsy or awkward. This is normal, too! The rest of your body will eventually fill out and shape up, and you'll feel less klutzy.

Taking Shape

Your body also fills out and changes shape during puberty. A boy's shoulders will grow wider and his body will become more muscular. He may notice a bit of breast growth on his chest. Don't worry, this is normal — and it goes away for most boys by the end of puberty. In addition, boys' voices crack and eventually become deeper, their penises grow longer and wider, and their testes get bigger. All of these changes mean that their bodies are developing as they should during puberty.

Girls' bodies usually become curvier. Their hips get wider and their breasts develop, starting with just a little swelling under the nipples. Sometimes one breast grows more quickly than the other, but most of the time they even out. Girls may start wearing bras around this time, especially if they are involved in sports or exercise classes. With all this growing and developing going on, some girls may be uncomfortable with how their bodies are changing, but it's unhealthy for girls to diet to try to stop any normal weight gain. If you have any questions about puberty or worried about your weight, talk to your parent or doctor.

One question a girl will have is: When will I get my first period? This usually happens about 2 years after her breasts start to develop. The menstrual (say: men-strul) period, or monthly cycle, is when blood is released through the vagina. That may sound alarming, but it's normal and it signals that a girl is growing up and her body is preparing so that she can have a baby someday.

Here's what's going on: Each of a girl's two ovaries holds thousands of eggs. During the menstrual cycle, an egg is released from one of the ovaries and begins a trip down the fallopian (say: fuh-lo-pee-un) tube to the uterus, also called the womb. A girl has two fallopian tubes, one connecting each ovary to the uterus. Before the egg even leaves the ovary, though, hormones stimulate the uterus to build up its inner lining with extra blood and tissue. If the egg gets to the uterus and is fertilized by a sperm cell, it may plant itself in that lining and grow into a baby. The extra blood and tissue nourishes and protects the baby as it develops.

But most of the time the egg is only passing through. When the egg doesn't get fertilized, or if the fertilized egg doesn't become planted in the lining, the uterus no longer needs the extra blood and tissue, so the blood leaves the body through the vagina. This blood is known as a girl's period. A period usually lasts from 2 to 7 days. About 2 weeks after the last period a new egg is released as the cycle repeats itself.

HIPERACTIVITY 2 (ADHD MEDICINE)

2009-04-03T18:30:00.000-07:00

Have you ever been so bored that you didn't know what to do with yourself?
Maybe your parents wanted you to sit and watch an old movie where everyone is always breaking into song. Sitting there, you might have felt fidgety and squirmy and wanted to bounce off the walls. Imagine having that feeling a lot. That's what it can feel like to have attention deficit hyperactivity disorder (ADHD).

Feeling this way a lot of the time can make it difficult for someone to get work done at school or follow instructions given by a parent. A kid who has ADHD might yell out the answers to questions before other kids in class have a chance to raise their hands. They also can be disorganized, distracted, and forgetful. They might lose things and have trouble finishing assignments. They may move around a lot, talk nonstop, or interrupt other people's conversations.

Most kids do some of these things some of the time, but when the kid is acting this way a lot of the time, it's a good idea to talk to a doctor, psychiatrist, psychologist, or therapist. One of these people can figure out if the kid has ADHD. With help, a kid with ADHD can learn to act differently. Sometimes medicine can help a kid take control of his or her behavior, but only a doctor can decide if ADHD medicine is needed.

Medicine and the Mind

Some of the medicines for ADHD are stimulants, but instead of stimulating the person and making him or her more jittery, they help control ADHD symptoms. Other ADHD drugs are not stimulants, but like stimulants, they seem to affect chemicals in the brain called neurotransmitters (say: nur-o-tranz-mit-urz). Neurotransmitters help send messages between nerve cells in the brain. Doctors don't know exactly why, but the right dose of an ADHD medicine can make it easier for the person to concentrate and focus.

The medicine usually comes in pills or capsules. The doctor will explain how often the kid needs to take the medicine. Parents and kids will have to work out a schedule for taking it so it becomes part of the normal routine, like teeth brushing.

It might take a while to find the right medicine and the right amount (dose) that works best for a kid. While this is getting worked out, it can be frustrating for the kid and parents who want things to get better. Once the right medication is found, things often start to improve for someone with ADHD.

And just like with any medicine, the kid's parents and doctors will want to watch for side effects, which are other problems or symptoms that may be caused by the medicine. Common side effects from stimulant drugs include irritability (feeling grouchy), headaches, and stomach trouble.

How Therapy Can Help

Along with medicine, behavior therapy can help kids with ADHD. This means learning a different way of doing things and learning ways of staying calm and keeping focused. To do this, a kid and his or her parents might see a mental health professional (psychiatrist, psychologist, therapist, social worker, or counselor). As part of behavior therapy, teachers and parents might create charts or other systems for rewarding the kid for meeting goals that have been set.

At school, the kid might need to work on staying seated or finishing classwork. At home, the goals might be remembering to put dirty clothes in the hamper and keeping track of important things, like shoes and backpacks. Once a kid can meet these goals, he or she will probably feel happier, which is the best medicine of all!

Reviewed by: Richard S. Kingsley, MD

HIPERACTIVITY 1

2009-04-03T18:25:00.000-07:00

ADHD, those letters stand for a condition called attention deficit hyperactivity disorder.

Kids who have ADHD are not bad, lazy, or stupid. They have a disorder that means they may have problems paying attention or sitting still in their seats. They can also act on impulse - this means doing things without thinking about them first. Kids with ADHD may spend a lot of time in the principal's office. Sometimes they do things that cause them to get hurt. They might change their friends a lot.

Who Gets ADHD?

About 9% of kids have ADHD. That means out of 100 kids, about 9 of them may have ADHD. So if your school has 300 kids, 24 to 30 of them may have ADHD. Kids who have ADHD usually start having problems in preschool. Boys have ADHD more often than girls. In fact, three times as many boys have ADHD, but no one knows why.

A kid might have a greater chance of developing ADHD if one of his or her relatives already has ADHD or another type of behavior problem. But no one is sure why anyone has ADHD, although scientists and doctors think that it probably has to do with differences in the way people's brains work. No one gets ADHD on purpose, so it isn't ever anyone's fault. And ADHD isn't contagious - you can't catch it from someone like the flu.

What Are the Signs of ADHD?

ADHD can cause kids to act in different ways, depending on who has it. Most kids with ADHD have problems concentrating and paying attention. Some kids with ADHD might also have trouble sitting still in class and waiting for their turn. They might yell out the answers before other kids have a chance to raise their hands.

Sometimes they can be disorganized, distracted, or forgetful. They might lose things and have trouble finishing assignments. They may wiggle around in their seats, move around a lot, talk too much, or interrupt other people's conversations.

It's important to remember that everybody does these things once in a while. It doesn't mean you have ADHD. Checking It Out When parents and teachers suspect that a child has ADHD, the first step is to visit the doctor. He or she may then refer the kid to a specialist like a psychologist, psychiatrist, or neurologist who knows about kids who have ADHD and other kinds of behavior problems. Part of the doctor's job is to check for other illnesses that look like ADHD but need different kinds of treatment.

If the Doctor Says It's ADHD

Once the doctor determines that a kid has ADHD, then the doctor, parents, and teachers begin to work together to find out the best way to help. Often this means starting one of the medicines used to treat ADHD, deciding how much medicine is needed, and when to give it. Children with ADHD usually only have to take their medicine once before school, but some may have to go to the nurse in the middle of the school day for medicine.

But children who have ADHD need more than just medicine. They also need help learning how to change the way they act. Some kids with ADHD can learn to do this by using relaxation therapy or behavioral therapy. In relaxation therapy, counselors teach kids how to relax and stay calm by doing deep-breathing exercises and relaxing different muscle groups.

Behavioral therapy helps kids with ADHD by teaching them to set goals for themselves and by using rewards to help them reach those goals. Teachers can give a kid with ADHD a reward for sitting still in class, for example. And parents can do the same thing at home, by rewarding their children for paying attention, completing their chores, or keeping track of their things. Kids with ADHD may need extra help learning how to do things other kids find easy.

Kids who have ADHD can become depressed or anxious. So for many kids with ADHD, the key to success is not only following the treatment plan from the doctor, but working to build good friendships with other kids, too. Many kids with ADHD find that their symptoms get better as they get older. Adults with ADHD can have happy lives, and they can be very successful in whatever they decide to do.

Reviewed by: Steven Dowshen, MD

HORMONES AND GLANDS 3

2009-04-03T18:18:00.000-07:00

What Is the Thyroid?

The thyroid (say: thi-royd) is a gland, which is an organ where special chemicals are produced. These chemicals are called hormones (say: hor-moans). The major hormones that the thyroid makes and releases into the bloodstream are called T4 or thyroxine (say: thi-rocks-in) and T3 or triiodothyronine (say: tri-eye-o-doe-thi-row-neen).

All the cells in the body need thyroid hormones to work properly. These hormones control how fast the body uses up energy. They are also key factors in helping kids grow.

The thyroid is shaped like a little butterfly or bow tie and it sits under the skin in the front of your neck. To find it, touch your throat in the Adam's apple area with one finger and the top of your breastbone (the flat bone that runs down the middle of your chest) with another finger. The thyroid is in that small space in between your fingers. (And it bobs up and down when you swallow. See if you can feel it!)

The thyroid works like the thermostat in your house. If the thyroid is too active and produces too much T4 and T3, it's like having a thermostat that's set too high, so the house gets overheated. If it's not active enough, it's set too low and the house is too cold. And if it's making just the right amount of thyroid hormones, then it keeps the temperature just right.

What Is Thyroid Disease?

There are two main kinds of thyroid disorder or thyroid disease. Hyperthyroidism (say: hi-per-thi-roy-diz-em) happens when the thyroid is too active and releases too much thyroid hormone into the blood. Kids with the opposite problem have hypothyroidism (say: hi-po-thi-roy-diz-em). In this case, the thyroid isn't active enough, so not enough thyroid hormone is being made and released into the kid's bloodstream.

Why Do Kids Get Thyroid Disease?

In most cases, doctors and scientists can't say exactly why a kid gets thyroid disease. It's not something that you can catch from someone else like a cold, and usually it isn't caused by anything you've eaten (or didn't eat) or done to your body.

A kid with thyroid disease may have inherited the condition because the tendency to get thyroid disease may run in the family. That means that a kid's mom or dad, grandparents, or other close relatives might have thyroid problems, too.

A baby can have hypothyroidism from birth if he or she is born without a thyroid gland or if the thyroid didn't develop completely before birth. And sometimes a baby's thyroid is fully developed at birth, but it just can't make enough thyroid hormone.

Not having enough iodine (say: eye-o-dine) in the diet can cause thyroid problems. Iodine is a mineral that's needed by the body to make thyroid hormone. It's found naturally in foods like seafood and milk. After scientists discovered that iodine is so important to the thyroid, it was added to most kinds of salt we use to help make sure that people get enough iodine in what they eat. Because of this, it's very uncommon for a kid in the United States to get a thyroid problem from lack of iodine.

Some medications also can cause thyroid problems by blocking the thyroid from making enough hormone.

What Are the Symptoms of Thyroid Disease?

Kids with hyperthyroidism can feel jumpy and have trouble concentrating. Like Janie, their hearts might beat fast and their hands may tremble. They can sweat a lot and have trouble sleeping. And even though they might have more of an appetite, they often lose weight or stop gaining it as they grow. Sometimes kids with hyperthyroidism will have a wide-eyed stare all the time, as if they are frightened, and in some cases their eyes may bulge out somewhat.

Kids with hypothyroidism tend to feel tired and not have much energy. Their hearts might beat slower and they may feel cold when the temperature of the room is comfortable for everyone else. Their hair may become brittle and break off more easily, and their skin may be dry and look pale and yellowish. Constipation (infrequent, hard bowel movements) can be a problem.

Kids with hypothyroidism tend to grow more slowly and may not show the changes of puberty until they receive treatment. The doctor may suspect hypothyroidism if he or she sees that a kid's growth is not staying on track on the growth charts. Although kids with hypothyroidism may tend to gain weight more easily, thyroid disease is almost never the cause of the problem in kids who are overweight.

A goiter (say: goy-ter) is another symptom of thyroid disease. A goiter results when the thyroid gland gets swollen, or enlarged. A goiter can happen either when the thyroid is too active or when it's not active enough.

Sometimes a lump, called a nodule (say: nod-jool), can develop in the thyroid gland, indicating thyroid disease.

What Will the Doctor Do?

When Janie went for her checkup, the doctor examined her thyroid and found that she had a goiter. The doctor also did blood tests to check how much thyroid hormone her thyroid gland was making — it was making too much.

In most cases of thyroid problems in kids, the doctor doesn't need to do anything other than a physical examination and blood tests to find out what's wrong. But sometimes, especially if the kid has a nodule in the thyroid gland, the doctor may order other tests such as an ultrasound study or a special scan, called a thyroid scan, that's like an X-ray.

If the tests show that a kid has hyperthyroidism, the doctor will usually start him or her on medication that keeps the thyroid from making too much thyroid hormone. But if the thyroid problem doesn't go away after the person has taken the pills for about 2 years, the doctor may decide (along with the patient and the patient's family) that other treatment should be given to permanently keep the thyroid from overproducing thyroid hormone. This might involve taking a medicine by mouth that destroys the thyroid gland or removing most of the gland with surgery.

Whichever treatment is used, hyperthyroidism can be controlled and its symptoms will go away. A kid who has this condition will need to have blood tests done — usually a couple of times a year — to be sure the treatment is keeping the levels of thyroid hormone in the blood normal.

Blood tests are also done to diagnose hypothyroidism. All babies are tested for hypothyroidism right after they're born, even if they don't have symptoms. It's important to treat a baby with hypothyroidism in the first few weeks of life. Otherwise, the baby won't grow and develop normally.

The good news is that hypothyroidism is easy to treat. Kids with this disease will have to take a pill every day, but their symptoms will go away. They'll usually need to take this medicine for the rest of their lives, but it's a simple way to make sure the body has enough thyroid hormone to grow and develop normally.

Kids who have been growing slowly because of hypothyroidism will usually catch up to their correct height after they're treated. They'll go through puberty the way they should, too. Kids who have hypothyroidism will also need to have blood tests to measure their thyroid hormones once or twice a year to guide their treatment.

With a little care, the thyroid and the conditions it may cause can be easily managed. The end result? You'll feel like yourself again!

Reviewed by: Steven Dowshen, MD

HORMONES AND GLANDS 2

2009-04-03T17:36:00.000-07:00

Hormones and Growth Disorders

One of the glands in your body is called the pituitary gland (say: peh-too-eh-ter-ee). It's found at the bottom of your brain and is shaped like a peanut. It may be small in size, but it's pretty big in importance. One of the chemical messengers the pituitary gland sends out to your body is called growth hormone, which (no surprise) is essential for growth.

When the pituitary gland doesn't make enough growth hormone — and sometimes other pituitary hormones as well — the condition is called hypopituitarism (say: hi-po-peh-too-eh-ter-is-em). This can slow down a kid's growth. There are special tests to find out if children don't produce enough growth hormone. If they don't, daily shots of growth hormone can often help these kids grow to be normal-sized adults.

Another gland that produces hormones important for growth is your thyroid (say: thi-royd). You may be able to feel it if you press gently with your fingers across the front of your neck, just under your Adam's apple. It is shaped like a butterfly and moves up and down when you swallow.

Your thyroid makes a hormone called thyroxine (say: thi-rocks-in). If it makes too little, the condition is called hypothyroidism (say hi-po-thi-royd-is-em). Having too little thyroxine makes a kid grow more slowly. Doctors can do a simple blood test for hypothyroidism. If it's needed, a kid can take the missing hormone as a pill.

What Are Some Other Reasons Why Kids Do Not Grow Normally?

Although hormones play a major role in growth, there are lots of reasons why kids might not grow normally. Some others include:

* Chronic diseases.
These include heart and kidney problems, cystic fibrosis, juvenile rheumatoid arthritis, and sickle cell anemia, which may slow growth in some cases.

* Complications during pregnancy.
One of the reasons a pregnant woman is warned not to smoke or drink is because it may slow down her baby's growth. A baby may be too small when it's born and some remain small for life. This condition is called intrauterine (say: in-trah-yu-ter-in) growth retardation, or IUGR. Some infections during pregnancy, other pregnancy problems, and certain genetic diseases can also cause this problem.

* Failure to thrive.
Some babies don't grow and gain weight normally after they're born. This is called failure to thrive (FTT). FTT may happen when a child simply doesn't get enough to eat. Some babies may have an illness that needs to be treated, but most will grow normally after they start eating enough food.

* Genetic conditions.

Terbitkan Entri

Some genetic conditions can also cause children to not grow as they should. Some girls who are short may have Turner syndrome. This means they have one X chromosome instead of two, or that one of their X chromosomes is abnormal. Another genetic condition, called Marfan syndrome, makes a person tall, with very long legs and arms. The person may also have heart and eye problems.

Many of these growth disorders can be successfully treated today. With help, kids who might once have ended up very short or very tall can grow up more like other children. And that's a happy ending to any fairy tale!

Reviewed by: Steven Dowshen, MD

HORMONES AND GLANDS 1

2009-04-03T17:29:00.000-07:00

What's a Growth Disorder?

Everyone grows and matures differently. You may be taller than your best friend in fourth grade. But then in sixth grade, your best friend may be an inch taller than you. Usually, this is totally normal.

A growth disorder, however, means that a kid has abnormal growth — for example, growing a lot slower or a lot faster than other kids the same age. What's Normal Growth? If growth isn't the same for all kids, how do doctors know what's normal? By feet and inches (or meters and centimeters)! Over the years, lots of height and weight measurements have been taken for lots of children of different ages.

These measurements have been put together in what is called a standard growth chart, which tells doctors about how most kids grow. From the time you were a baby, your doctor has weighed and measured you whenever you've had a checkup. Because kids grow differently, your doctor checks your height against the standard growth chart. If you are in the 50th percentile on the growth chart, it means half of the kids your age are taller than you are and half are shorter.

If you fall in the 25th percentile that means 75% of the kids your age are taller and 25% are shorter, and so on. Most kids whose heights are between the 3rd percentile and the 97th percentile and who are growing at a steady rate are considered to have normal growth. Kids who are higher or lower than this on the growth chart are usually normal, too. But some children who are under the 3rd percentile or over the 97th percentile, or who are growing a lot slower or faster than most other kids, may have a growth problem.

In this situation, the doctor will usually want to check things out. One thing your doctor will want to know is how tall your mother and father are and how they grew when they were children. You may have inherited short or tall genes from them. You may also have inherited the tendency to have your growth spurt earlier or later than most other kids do.

Problems With Puberty

Glands in your body produce chemical messengers called hormones. Normal increases in the amounts of some of these hormones being produced trigger the changes your body goes through during puberty.

Puberty is the stage of your life when sexual development happens, like breast development and menstrual periods in girls and growth of the penis and testicles in boys. One of the body changes that happens during puberty is a big increase in your rate of growth — a growth spurt. The higher levels of hormones in your body tell your bones to grow, grow, grow!

When these changes happen before the age of 8 in girls or 9 in boys, it's called precocious (say: pree-ko-shes), or early, puberty. At first, these kids may be taller than their friends. Later, however, they may stop growing sooner than most other kids do, and they may not become as tall when they're adults as they might have been otherwise. Usually, kids with precocious puberty can be treated with medications that help correct this problem.

Delayed or late puberty occurs when the hormonal and body changes that should happen with puberty take place later than normal, or sometimes not at all. Girls who have not begun puberty by age 13 and boys who have not begun by age 15 have delayed puberty and are sometimes called late bloomers. When puberty finally occurs, either by itself or with treatment, these teens have a growth spurt and tend to catch up to their peers. Sometimes they even grow to be taller than their friends!

MEAL PLANS

2009-04-02T20:23:00.000-07:00

Following Meal Plans

Because healthy meals are so important, your diabetes health care team will probably give you a meal plan to follow. Meal plans don't tell you exactly which foods to eat, but they might give you general information like which food groups to pick and when you should eat.

Don't worry that this plan will include stuff you don't like. Your meal plan will include the foods that you already eat and like. The team will probably ask you to write down all the foods you eat in a food diary for a few days so that they know your tastes.

Your meal plan will help you think about healthy meals, but it may also help you reach other health goals. For example, if you need to lose weight, then the plan may suggest that you watch the number of calories and fat grams you eat to help you reach your goal.

Your parents or other grown-ups might make most of the meal-planning decisions. But if they ask for your advice, strive for balance. For instance, two baked potatoes don't make a balanced meal. But you could have half a baked potato along with some grilled chicken and some broccoli. Top it off with a dessert of fresh berries, and you have a great balanced meal.

Types of Meal Plans

There are three types of meal plans. Your diabetes health care team, including your doctor, will help you decide which one is best for you.

With the constant carbohydrate meal plan, the person eats a certain amount of carbohydrates (say: kar-bo-hi-drates), or carbs, in each meal and snack. Then he or she takes insulin (say: in-suh-lin) or other diabetes medicines at the same times and in similar doses each day. A kid — or the kid's parents — could use food labels to determine how many grams of carbohydrates are being eaten, so he or she stays on track.

Another option is the carbohydrate counting meal plan. With this plan, people with diabetes count carbs so they can match their insulin doses with the amount of carbohydrates that they eat. Counting carbs means the person counts the number of carbohydrate grams being eaten.

Food labels can tell you how many grams of carbohydrate are in a food. Knowing that, a person then matches the insulin dose with the amount of carbohydrates that he or she eats. This plan works best for people who take a dose of insulin (as a shot or with an insulin pump) with each meal.

Some people who have diabetes use the exchange meal plan. Rather than focusing only on carbs, a person on this meal plan needs to look at proteins and fats as well. With this meal plan, foods are divided into six groups: starch, fruit, milk, fat, vegetable, and meat.

The plan sets a serving size (amount) for foods in each group. Each serving has about the same amount of calories, proteins, carbohydrates, and fats. For instance, an apple or an orange would each be one serving of fruit. You could choose either one if your meal plan calls for a fruit serving. The number of servings from each food group that should be eaten at each meal is based on the number of calories the person needs per day.

How Food Labels Can Help

Food labels are easy to read, and they list a food's ingredients, nutritional information, and calories. So anyone concerned about eating healthy can learn a lot from them. For people with diabetes, food labels may also provide information they need to know to keep their blood sugar on track.

For example, if you are using the constant carbohydrate or the carb counting meal plan, you can look for carbohydrates on the food label. It will tell you how many grams of carbohydrates you are about to eat. The number of carb grams on the label applies to one serving, so be sure to multiply that number times the number of servings you're eating or drinking.

If you're using the constant carbohydrate or the carb counting plan, knowing the amount of carbs you've eaten can help you determine how much medicine to take.

Someone on an exchange plan also might use food labels. How? By looking at the food's breakdown of carbs, protein, and fat. It can help the person know how to classify this food — as a starch, fruit, vegetable, meat, or fat. Then the person knows how to "count" that food as he or she figures out how many more servings are left in the day.

Food labels also show you how much sodium (salt) is in a food. This is important because some people who have diabetes also have high blood pressure. Too much salt, or sodium, can worsen blood pressure problems.

On food labels, you'll also find information on the amount of fat, the type of fat, and the total calories in a food. It's a good idea for everyone, including people who have diabetes, to keep an eye on these. Eating too much of certain fats can make a person more likely to have problems with their heart, and their blood vessels. And eating too many calories can cause someone to gain weight. If you're curious, your parent, doctor, or nutritionist can help you figure out how many calories you need each day. Use them well!

Write it Down

As you've probably noticed, meal plans mean a lot of keeping track — of the carb grams or the exchange servings you've eaten. To make that easier, you might want to write down what you eat and your blood sugar readings on a record sheet.

Your mom or dad can use this record to help you balance food and insulin so you stay on track. And because it's written down, you won't have to say, "Uh, I don't know" when someone asks you what you ate or what your last reading was!

Reviewed by: Steven Dowshen, MD

MEDICINES FOR DIABETES

2009-04-02T20:18:00.000-07:00

Medicine, such as insulin, is a must for kids with type 1 diabetes. A kid with type 2 diabetes might need medicine, too. His or her doctor will say if it's necessary. And if a kid's doctor says to take diabetes medicine, it's very important that the kid take it just as the doctor suggests.

Not taking medicine - or not taking it correctly - can make a kid feel terrible and cause health problems. He or she even could end up in the hospital. But taking the medicine will keep blood sugar levels from getting too high or too low. And by doing this a kid will stay healthy and feel good.

All About Insulin

The most common diabetes medicine is insulin, which you can get through shots or an insulin pump. Insulin is a hormone that helps glucose get into the body's cells where it can be used for energy. Without insulin around, glucose stays in the blood and blood sugar levels get too high.

The types of insulin you use and how much you need to take each day depends on your diabetes management plan. Some kids with diabetes need to take two injections each day. Others may need more than two injections or an insulin pump to keep blood sugar levels under control. Your doctor will figure out what's best for you.

There are a few different kinds of insulin. The types of insulin differ from one another based on:

* how long they take to start working
* when they work their hardest to lower your blood sugar
* how long they last

Diabetes Pills

Some kids with type 2 diabetes need to take diabetes pills or tablets. Doctors sometimes call these oral medications. "Oral" means having to do with the mouth, which is how these medicines are taken. For kids with type 2 diabetes, these pills or tablets can help the body make more insulin or help the body do a better job of using the insulin it does make. These medicines work especially well if a kid also eats healthy and exercises regularly.

Glucagon

Insulin and other diabetes medicines help to keep your blood sugar levels from going too high. But sometimes kids with diabetes experience really low blood sugar, or hypoglycemia. That's bad news because, if it's not treated right away, it can cause seizures or make a kid pass out.

If a kid has really low blood sugar, he or she might need a glucagon shot. Glucagon (say: gloo-kuh-gon) is a hormone that helps raise blood sugar levels very quickly. Your doctor will tell your parents about these shots and explain how and when to give you one. It also might be a good idea for older brothers and sisters, babysitters, teachers, and other adults who take care of you to know about these shots. Everyone also should know when to call 911 because of a diabetes emergency.

And what can you do to prevent a diabetes emergency? You guessed it: Take your medicine just as the doctor tells you!

Reviewed by: Steven Dowshen, MD, and Elana Pearl Ben-Joseph, MD

DIABETES AND SPORTS

2009-04-02T20:11:00.001-07:00

People with diabetes are healthier if they get plenty of exercise. They also have the same chances of excelling at sports. Whether you want to go for the gold or just go hiking in your hometown, your diabetes won't hold you back.

How Exercise Helps People With Diabetes

Exercise is an important part of managing diabetes and staying healthy in other ways. Here are some of the benefits of exercise:

* It helps your body use insulin (pronounced: in-suh-lin), a hormone that helps your body get the energy from the foods you eat.
* It burns calories and builds muscle, which helps you reach and stay at a healthy weight.
* It strengthens your bones and muscles.
* It reduces your risk of heart disease and some types of cancer.
* It improves coordination, balance, strength, and endurance.
* It can increase your energy level.
* It helps you feel good about yourself and your abilities.
* It relieves tension and stress, relaxes you, and boosts your mood, too.

All exercise is great - from walking the dog or riding a bike to playing team sports - just be sure to be active every day. Changing your exercise habits might be hard at first, but once you start feeling how exercise helps your body, it'll be easier to continue.

Exercise Tips

Your doctor will help you get ready to exercise or join a sport. These tips can help:

* Test yourself. Your doctor will tell you when to test your blood sugar. You might need to do it before, during, and after exercise.
* Take insulin if you need it. Your doctor also might change your insulin dosage for exercise or sports. If you inject insulin, try not to inject a part of your body used for your sport before practice (like injecting your leg before soccer). If you wear an insulin pump, make sure that it's not in the way when you play. If it is, talk to your parents or doctor about what to do.
* Eat right. Your doctor will also help you figure out what to eat to keep going. You might need extra snacks before, during, or after exercise. Aside from that, you can just stick to your normal meal plan.
* Bring snacks and water. Whether you're playing a football game at school or swimming in your backyard, you should have snacks and water nearby.
* Pack it up. If you will be exercising away from home, have a parent help you pack testing supplies, medications, your medical alert bracelet, emergency contact information, and a copy of your diabetes management plan.
* Tell your coaches. If you're playing organized sports, be sure that your coaches know about your diabetes. Tell them the things that you need to do to control diabetes before, during, or after a game.
* Take control. You're in control of your own health. Feel free to stop playing a sport or exercising if you need to drink water, eat a snack for low blood sugar, go to the bathroom, or check your glucose levels. Also, stop if you feel any signs that something is wrong.

What to Watch For

When kids with diabetes exercise, a few things may happen in the body. Kids with diabetes can get get low blood sugar, called hypoglycemia (say: hi-po-gly-see-me-uh). Or they can get high blood sugar, called hyperglycemia (say: hi-per-gly-see-me-uh).

You may have low blood sugar if you are:

* sweating
* lightheaded
* shaky
* weak
* anxious
* hungry
* having a headache
* having problems concentrating
* confused

You may have high blood sugar if you:

* feel very thirsty
* have to pee a lot
* feel very tired
* have blurry vision

If you're starting a new exercise routine, like training for a sport, your doctor might have you change your insulin dosage to prevent these problems. Also, keep an eye on cuts, scrapes, or blisters and be sure to tell your parents or doctor right away if they're really red, swollen, or if they're oozing pus - they might be infected, which can make your diabetes harder to control.

Kids with type 1 diabetes shouldn't exercise if they have substances called ketones (say: kee-tones) in their blood. When this happens, exercise can make things worse, and you can get very sick. Your doctor will tell you how to figure out if you have ketones, treat this problem, and get back on track.

Your doctor will also write down what you should do if any problems happen. For example, you might need to take a break, drink water, or have a snack. If you notice any of these signs, stop exercising and follow your instructions.
You're All Set!

Your doctor says it's OK, and you know how to take care of your diabetes. You're all set to get plenty of healthy exercise. Now get moving!

Reviewed by: Steven Dowshen, MD

DIABETES TYPE 1

2009-04-02T19:55:00.000-07:00

Thousands of people all over the world do stuff like this every day because they have type 1 diabetes (say: dye-uh-be-tees). What is it? Let's find out.

What Is Diabetes?

Diabetes is a disease that affects how the body uses glucose (say: gloo-kose), a sugar that is the body's main source of fuel. Like a CD player needs batteries, your body needs glucose to keep running.

Here's how it should work.

1. You eat.
2. Glucose from the food gets into your bloodstream.
3. Your pancreas makes a hormone called insulin (say: in-suh-lin).
4. Insulin helps the glucose get into the body's cells.
5. Your body gets the energy it needs.

The pancreas is a long, flat gland in your belly that helps your body digest food. It also makes insulin. Insulin is kind of like a key that opens the doors to the cells of the body. It lets the glucose in. Then the glucose can move out of the blood and into the cells.

But if someone has diabetes, the body either can't make insulin or the insulin doesn't work in the body like it should. The glucose can't get into the cells normally, so the blood sugar level gets too high. Lots of sugar in the blood makes people sick if they don't get treatment.

Type 1 Diabetes

There are two major types of diabetes: type 1 and type 2.

In type 1 diabetes (which used to be called insulin-dependent diabetes or juvenile diabetes), the pancreas can't make insulin. The body can still get glucose from food. But the glucose can't get into the cells, where it's needed. Glucose stays in the blood. This makes the blood sugar level very high and causes health problems. To fix the problem, someone who has type 1 diabetes needs to take insulin through regular shots or an insulin pump.

Type 2 diabetes is different from type 1 diabetes. In type 2 diabetes, the pancreas still makes insulin. But the insulin doesn't work in the body like it should and blood sugar levels get too high.

No one knows for sure what causes type 1 diabetes, but scientists think it has something to do with genes. Genes are like instructions for how the body should look and work that are passed on by parents to their kids. But just getting the genes for diabetes isn't usually enough. Something else has to happen — like getting a virus infection — for a person to get type 1 diabetes.

Type 1 diabetes can't be prevented. Doctors can't even tell who will get it and who won't.
How Do People Know if They Have Type 1 Diabetes?

When people first have diabetes, they usually:

* pee a lot because the body tries to get rid of the extra blood sugar by passing it out of the body in the urine (pee)
* drink a lot to make up for all that peeing
* eat a lot because the body is hungry for the energy it can't get from sugar
* lose weight as the body starts to use fat and muscle for fuel because it can't use sugar normally
* feel tired a lot because the body can't use sugar for energy

Getting treatment for diabetes can stop these symptoms from happening. A doctor can do tests on a kid's blood to find out if he or she has diabetes. If your doctor thinks you might have type 1 diabetes, he or she might have you visit a doctor called a pediatric endocrinologist (say: pee-dee-ah-trik en-doh-krih-nah-leh-jist). A pediatric endocrinologist helps kids with diabetes, growth problems, and more.

Living With Type 1 Diabetes

Kids who have type 1 diabetes have to pay a little more attention to what they're eating and doing than kids without diabetes. They need to:

* check their blood sugar levels often
* give themselves insulin shots, have someone help give them shots, or use an insulin pump
* follow a healthy eating plan so they can keep blood sugar levels under control and grow normally
* exercise regularly
* have regular checkups with doctors and other people on their diabetes health care team so they can stay healthy and get treatment for any diabetes problems

Kids with diabetes will have to do special things sometimes, like eat a snack on the bus during a long school trip. Or they might have to wake up earlier than everyone else at a sleepover to take their insulin and have some breakfast to keep their blood sugars under control.

Although this might seem like a lot of work, the good news is that there are new products and equipment available that help make it easier for kids to take care of their diabetes. Scientists are working to invent ways to make it easier to check blood sugars and give insulin. They're also trying to find ways to get insulin into the body without shots. And there's hope that one day a cure will be found.

Even though kids with diabetes have to do some special things, diabetes doesn't keep them from doing the stuff they love. They can still play sports, go out with their friends, and go on trips. So if you have a friend with diabetes, let him or her know you can deal with it. Being friends is all about having fun together, not having a perfect pancreas!

Reviewed by: Steven Dowshen, MD

DIABETES TYPE 1 : HOW IS IT TREATED ?

2009-04-02T19:49:00.000-07:00

People have type 1 diabetes can help themselves stay healthy by taking these four very important steps:

* taking insulin (say: in-suh-lin)
* eating a healthy diet and following a meal plan
* checking blood sugar levels
* being active by playing and getting exercise

Doing all four can get a little confusing because there's a lot to remember. What comes in handy when you can't keep everything straight in your head? A plan, where everything is written down for you. That's why kids and adults with diabetes each get their own diabetes treatment plan.

This plan will help you and your parents know what to do so you stay healthy, active, and feeling good. You, your parents, and members of your diabetes health care team will work together to make a treatment plan that's right for you. Doing what your plan tells you to do will keep you healthy now — and help you avoid health problems later.
Taking Insulin Shots

Taking insulin shots is an important way that people with diabetes control the amount of glucose (sugar) in their blood. The body gets glucose (say: gloo-kose) from the food we eat. Glucose is carried through the bloodstream to all the cells in the body. Like batteries in a CD player, glucose provides energy for the body's cells to work.

But people who have type 1 diabetes can't make a hormone called insulin. Without insulin, glucose can't get into the cells, so it stays in the blood leading to high blood glucose levels. And when you have high blood glucose levels, you might feel sick. Insulin is the only medicine that can get blood sugar levels back to a healthier range in people with type 1 diabetes.

In a person who does not have diabetes, the pancreas (say: pan-kree-us) produces the right amount of insulin to keep blood sugar levels where they should be. But in someone with type 1 diabetes, the pancreas can't make insulin so the person needs insulin shots. Someone with diabetes also needs to know how much insulin to take and when to take it, depending on what the person is eating or doing. Where will you find these answers? Your diabetes treatment plan, of course!
Eating Healthy

As part of their treatment plan, kids with diabetes should eat a balanced diet full of nutritious foods, like anyone who wants to be healthy. But when kids eat more of certain foods, they may have to adjust their insulin doses. Carbohydrates, such as bread and pasta, will make blood sugar levels go higher.

Some kids may use a diabetes meal plan. A meal plan can help you keep breakfast, lunch, dinner, and snacks on a regular schedule, which helps make it easier to control your diabetes. It may also mention the food groups you should include in your meals and suggest some portion sizes right for you.

Even though it's OK to eat fast food or sugary treats once in a while, you won't find a lot of these foods on your meal plan if you have type 1 diabetes. Everyone who eats a healthy diet should limit these foods, anyway, because eating too much of them can make a person get too fat or cause other long-term health problems like heart disease. People with diabetes are already at risk for these problems.
Checking Blood Sugar Levels

Checking your blood sugar levels is the only way to see how well your insulin injections and meal plan are working. Most kids with type 1 diabetes should test blood sugar levels with a blood glucose meter (say: blud gloo-kose me-tur). Kids with type 1 diabetes usually need to test three or four times a day. Some kids test their blood sugar levels even more often. The meter works by taking a very small blood sample. When you test, you'll feel a quick pinch.

By keeping your blood sugar levels in a healthy range, you'll feel better. You'll also be less likely to have diabetes problems later. Your diabetes health care team will let you and your parents know what your blood sugar levels should be and when you should test.
Being Active

Kids with diabetes can and should play a lot, just like other kids. Exercise will be part of a kid's diabetes management plan because it can help prevent health problems now and later in life. But blood sugar levels can change during exercise, so kids need to know how to manage that.

Your diabetes health care team can give you some advice on what to do before, during, and after exercise. They can tell you what to do if you don't feel right while you're playing. But with the right combination of eating healthy, checking your blood sugar levels, and taking insulin, you can be active and feel great!

Reviewed by: Steven Dowshen, MD

DIABETES TYPE 2

2009-04-02T19:44:00.000-07:00

Type 2 Diabetes

Type 1 and type 2 diabetes cause high blood sugar levels in different ways.

In type 1 diabetes, the pancreas can't make insulin. The body can still get glucose from food. But the glucose can't get into the cells, where it's needed. Glucose stays in the blood. This makes the blood sugar level very high.

Type 2 diabetes is different. With type 2, the pancreas still makes insulin. But the insulin doesn't do its job as well in the body. Glucose just hangs around and builds up in the blood. The pancreas makes even more insulin to get glucose to go into the cells, but eventually gets worn out from working so hard. As a result, the blood sugar levels rise too high.

Most people who have type 2 diabetes are overweight. In the past, mainly overweight adults got type 2 diabetes. Today, more kids are being diagnosed with type 2 diabetes, probably because more kids are overweight.

Experts think that the tendency to get it is probably passed down through families. Kids with family members who have type 2 diabetes get diabetes more often. Also, kids from Native American, African American, Hispanic/Latino, or Asian/Pacific Island backgrounds are also more likely to get type 2 diabetes. Kids older than 10 are more likely to get type 2 diabetes than younger kids.

How Do People Know if They Have Type 2 Diabetes?

Some kids can have type 2 diabetes without knowing it. Some of the signs aren't easy to spot and can take a long time to develop. And a lot of kids don't have any symptoms at all.

But when a person first gets type 2 diabetes, he or she usually:

* feels tired a lot because the body can't use sugar for energy properly
* pees a lot because the body tries to get rid of the extra blood sugar by passing it out of the body in the urine (pee)
* drinks a lot to make up for all that peeing

The skin can look different in some kids with type 2 diabetes. They may notice a dark ring around their necks that doesn't wash off. They may also see thick, dark, velvety skin under the arms, between the legs, between fingers and toes, or on elbows and knees.

How do you find out whether you have diabetes? Doctors can say for sure if a person has diabetes by testing blood samples for glucose. Even if a kid doesn't have any symptoms of type 2 diabetes, doctors may use blood tests to check for it in kids who are more likely to get it — like those who are overweight.

If you have type 2 diabetes, you may visit a doctor called a pediatric endocrinologist (say: pee-dee-ah-trik en-doh-krih-nah-leh-jist). A pediatric endocrinologist helps kids with diabetes, growth problems, and more.

Living With Type 2 Diabetes

Kids with type 2 diabetes have to pay a little more attention to what they're eating and doing than kids without diabetes. They may need to:

* follow a healthy eating plan so they can keep blood sugar levels under control and grow normally
* exercise regularly
* take insulin shots or medicines that help insulin work better in their bodies
* check their blood sugar levels
* get treatment for other health problems that can happen more often in people with type 2 diabetes, like high blood pressure or problems with the levels of fats in their blood
* have regular checkups with doctors and other people on their diabetes health care team so they can stay healthy and get treatment for any diabetes problems

They might have to eat smaller amounts of foods than they had been and less salt or fat, too. The good news is that kids who eat healthy foods, stay active, and get to a good weight may be able to get their blood sugar levels into a healthier range. If that happens, their doctors may decide they don't have to take medicine for diabetes anymore.

Even though kids with diabetes have to do some special things, diabetes doesn't keep them from doing the stuff they love. They can still play sports, go out with their friends, and go on trips. So if you have a friend with diabetes, let him or her know you can deal with it. Being friends is all about having fun together, not having a perfect blood sugar level!

Reviewed by: Steven Dowshen, MD

DIABETES TYPE 2 : HOW IS IT TREATED ?

2009-04-02T19:38:00.000-07:00

Kids who have type 2 diabetes can help themselves stay healthy by taking these three very important steps:

* getting to a healthy weight (by eating healthy and getting exercise)
* taking medicine if the doctor feels it's necessary
* checking blood sugar levels often

Doing all three can get a little confusing because there's a lot to remember. What comes in handy when you can't keep everything straight in your head? A plan, where everything is written down for you. That's why kids (and adults) who have diabetes get their own diabetes treatment plan.

This plan will help you and your parents know what to do to help you stay healthy, active, growing, and feeling good. You, your parents, and members of your diabetes health care team will work together to make a treatment plan that's right for you. Doing what your plan tells you to do will help keep you healthy now — and help you avoid health problems later.

The plan's main goal is to keep blood sugar levels (also called blood glucose levels) from getting too high or too low. The body gets glucose (say: gloo-kose), a sugar, from the food we eat. Glucose is carried through the bloodstream to all the cells in the body. Like batteries in a CD player, glucose provides energy for the body's cells so that they can work. Insulin (say: in-suh-lin) is a hormone that helps the glucose get into the cells.

In kids who have type 2 diabetes, insulin doesn't do its job as well, so glucose is less able to enter the cells. It just hangs around and builds up in the blood, causing the blood glucose level to rise. And when blood sugar levels go too high, a person can feel sick and may have health problems. Nobody wants that, so let's look at the three steps that will help keep a kid with type 2 diabetes feeling good.

Getting to a Healthy Weight

A lot of kids with type 2 diabetes weigh more than they should. How can you get to a healthy weight? The first step is to talk with your doctor. He or she can tell you how to eat healthy and add exercise (also known as play) into your daily routine. If you take these steps, and your weight improves, you may be able to get your blood sugar levels into a healthier range. If that happens, your doctor may decide you don't have to take medicine for diabetes anymore.

Eating Healthy

To eat healthy, your doctor may suggest that you watch out for two "Cs" — carbohydrates and calories. You don't want too much of either one. Foods containing a lot of carbohydrates, such as pasta and candy, will make your blood sugar levels increase, which can make it harder to keep your diabetes under control. And calories — you probably know — are units of energy that each food contains. If you eat too many calories and don't burn off the extra energy, your body will store it as fat. Too much stored fat can cause someone to be overweight.

A diabetes meal plan can help you learn about balanced, healthy eating. It's a plan that's written down and designed especially for you. Meal plans can help guide you about what kinds of foods to eat for breakfast, lunch, dinner, and snacks. And the plan can also help you eat the right amounts to help you get to a healthy weight and control your blood sugar levels.

Being Active

Some kids might think they don't like exercise, but not all exercise is the same. Did you know that playing in an active way — like playing tag or being at the playground — is considered exercise? It is. Really, any kind of play that gets you moving is a kind of exercise. Even helping your mom or dad with chores around the house can be exercise. Hauling groceries in from the car? That's exercise, too.

Not only does exercise help kids stay at a healthy weight, it can lower blood sugar levels and help you feel more fit. Exercise can make blood sugar levels change, so you might be worried that you'll feel sick while being active. Your diabetes health care team can tell you what to do if you don't feel right while you're exercising. Knowing what to do before it happens can help you deal with it more easily and start feeling better faster.

Don't worry if you don't understand everything about diet and exercise. Between your doctor, other members of your health care team, and your family, you'll have lots of grown-ups to help you — just ask!

Taking Medicines

There are many types of medicines for adults with type 2 diabetes. These medicines help their bodies make or use insulin better. But sometimes pills still aren't enough to keep blood sugar levels under control.

Kids with type 2 diabetes might also have to take insulin shots. No one likes to get shots, but the good news is that kids with type 2 diabetes who eat healthy foods, stay active, and get to a good weight may be able to get their blood sugar levels back down to normal. If they do that, they might not even need to take any medicines at all.

Checking Blood Sugar Levels

Checking your blood sugar levels is like giving yourself a little checkup. How is your treatment plan working? Your blood sugar level can provide a clue. Testing your blood sugar level is the only way to know how you are doing with your diabetes control from day to day. Your doctor will also have you get a different kind of blood test a couple of times each year that shows how well your blood sugars are being controlled by your treatment plan over the past several months.

Your diabetes health care team will let you and your parents know what your blood sugar levels should be and when you should test them. Kids with type 2 diabetes usually test blood sugar levels with a blood glucose meter (say: blud gloo-kose me-tur) at least twice a day. You may have to test more often that that if you're taking insulin, have just been told you have type 2 diabetes, or are having some trouble keeping your blood sugar levels under control.

Does that sound like a lot to remember? It is — but remember that you have your plan to guide you and lots of adults to help you put that plan into action!

Reviewed by: Steven Dowshen, MD

DIABETES AND WEIGHT

2009-04-02T19:29:00.000-07:00

When kids with diabetes are at a healthy weight, they may have fewer diabetes symptoms and problems. This is true for all people with diabetes — whether they have type 1 or type 2.

Diabetes and Your Weight
Being overweight is directly related to type 2 diabetes. Most people are overweight when they first find out they have it. The extra weight can make it harder for their bodies to use sugar, or glucose (say: gloo-kose), the way it should.

That's why people who have type 2 diabetes will be encouraged to get to a healthy weight by eating right and getting regular exercise. Exercise not only burns calories, but it can also help the body use insulin (say: in-suh-lin) better. This makes it easier to keep blood sugar levels on track.

Being at a healthy weight makes it less likely that someone will get type 2 diabetes. And if someone already has type 2 diabetes, losing weight can make their diabetes easier to manage and can even reduce the amount of medicine they need.

With type 1, the person may have the opposite problem — weight loss. Before they know they have type 1 diabetes, kids may lose weight because their bodies can't use glucose properly. Once someone knows they have type 1 diabetes and gets treatment, he or she usually gets back to a healthy weight.

Though weight loss is the more typical problem before diagnosis, it's also possible a kid with type 1 diabetes might be overweight. If so, it can make it hard for the kid to keep his or her blood sugar levels under control.

Are You at a Healthy Weight?
Doctors use your weight and height to calculate your body mass index (BMI). The BMI is a number that helps doctors judge whether your weight is healthy.

Your doctor will tell you if you should lose weight to manage your diabetes. If it turns out you don't need to lose weight, you can still help your health by eating good-for-you foods and getting a lot of play time.

If your doctor wants you to lose some weight, you might feel upset or sad. But try to focus your energy on getting healthy. You can do it — with some help from your family, doctor, and the rest of your health care team!

Your diabetes meal plan already helps you know what to eat, so you may just need to eat a little less and be more active. You don't have to run on a treadmill, you can just do more fun stuff outside, like ride your bike and play outside with your friends.

Kids with diabetes should never try fad diets or skip meals or snacks to lose weight. These things aren't good for anyone, and they're especially bad for kids with diabetes. You need to keep your blood sugar levels on track, and extreme diets can mess them up. Also, never skip insulin injections to lose weight — it can make you get very sick in just a few hours!

If you follow your doctor's advice about food and exercise, you can reach your weight loss goal — safely and successfully.

Reviewed by: Steven Dowshen, MD

CARE TEAM FOR YOUR DIABETES HEALTH

2009-04-02T19:17:00.000-07:00

When you have diabetes, you and your family have a lot to learn. The good news is that people you can count on will help you and your parents understand diabetes and what you need to do to stay healthy.

Before you had diabetes, maybe you only met with a doctor or nurse when you went for a checkup. But now you may meet with many different people to help you understand your diabetes. Taking care of diabetes requires the know-how of many different health care workers. In fact, you'll have your very own team of experts to help you.

You'll have team members who will help you know what to eat, tell you which medicine to take, teach you all about diabetes and how to take care of yourself, and help you deal with any feelings or frustrations you're having about taking care of your diabetes.

So, who's the captain of this team? You are! That's right — you are the most important member of your diabetes team. Your parents still play a very important role — think of them as your cocaptains. But mostly everyone on the team is working to help you take care of your diabetes.

Here are some other diabetes team members you may meet during your checkups:

Doctors
Your doctor is like your diabetes team coach. He or she can teach you all about diabetes and can come up with a game plan for taking care of your diabetes. This game plan is called a treatment plan, or diabetes management plan.

Your doctor might be a pediatric endocrinologist (say: pee-dee-at-rik en-doh-krih-nal-eh-jist). Pediatric endocrinologists help kids with diabetes, growth problems, and more. But other kinds of doctors like pediatricians and family doctors can also help kids with diabetes.

When you go to see your doctor, he or she will ask you questions about how you're feeling and will check different parts of your body. You'll also get your blood pressure taken with a cuff that goes around your arm. And to see how you're doing with your diabetes, your doctor may look at your diabetes records and check your blood sugar level or get a urine (pee) sample.

Just like the coach of a team, your doctor doesn't do it all alone. He or she will want to hear what the other team members have to say, then make changes to your diabetes plan if they're needed.

Certified Diabetes Educators (CDEs)
Certified diabetes educators (say: ser-tuh-fide dye-uh-be-tees eh-dyoo-kay-ters) are people who have special training in helping people manage their diabetes. These professionals will teach you what diabetes is and how it affects the body.

They'll also:

* help you and your parents learn how to give insulin (say: in-suh-lin) shots if you need them or use an insulin pump
* teach you and your parents what to do if you have high and low blood sugar levels
* show your parents how to adjust your insulin when you're exercising or not feeling well
* show you how to test your blood sugar levels and make sure your testing machines work right
* talk to you and your parents about any problems you might be having with your diabetes

Dietitians
Registered dietitians are experts in food and nutrition. They will:

* teach you about how food affects your blood sugar levels and make sure you're getting enough food to grow and develop properly
* ask you questions about the types of foods you like to eat and how much exercise you get each day
* help your parents plan meals and snacks that fit into your schedule
* give you some tasty snack ideas
* you learn how to make healthy food choices
* help you make changes to your meal plan when you have special occasions like sporting events, vacations, holidays, and parties

Make sure to tell the dietitian if you're feeling hungry all the time or have other questions about how and what you eat.

Mental Health Professionals
Mental health professionals are social workers, psychologists, psychiatrists, or counselors, and they can be a big help for kids dealing with diabetes. If you're feeling sad or frustrated about your diabetes, they can help you.

Mental health professionals may ask you about any troubles or problems you're having at home or at school. Or they may ask you if you think your friends or family members are doing anything that is making it hard for you to take care of your diabetes.

So now you know who's on your diabetes team. It's a good feeling to know that you have a lot of people to help you take care of yourself. This team is dedicated to helping you feel your best and be your healthiest. Go, team!

Reviewed by: Steven Dowshen, MD

SOME KINDS OF CANCER KIDS GET

2009-04-02T19:07:00.000-07:00

Cancer happens when cells start growing abnormally and dividing out of control. A group or mass of growing cells is called a tumor. A tumor in any part of the body is called benign (say: bih-nine) if it's not cancer, or malignant (say: meh-lig-nent) if it is cancer.

Kids don't get cancer very often. And many of those who do get it can be treated and cured. Common cancer treatments include chemotherapy, which means getting anti-cancer drugs through an IV, and radiation, which means powerful energy waves (like X-rays) are used to kill cancer cells. Surgery also might be done to remove tumors. And in some cases, such as leukemia, a bone marrow or stem cell transplant might be done to help a kid be healthy again.
Here are a few types of cancer that kids can get:

Leukemia
Leukemia (say: loo-kee-mee-uh) is the most common type of cancer kids get, but it is still very rare. Leukemia involves the blood and blood-forming organs, such as the bone marrow. Bone marrow is the innermost part of some bones where blood cells are first made. A kid with leukemia produces lots of abnormal white blood cells in the bone marrow.

Usually, white blood cells fight infection, but the white blood cells in a person with leukemia don't work the way they're supposed to. Instead of protecting the person, these abnormal white blood cells multiply out of control. They fill up the bone marrow and make it hard for enough normal, infection-fighting white blood cells to form.

Other blood cells — such as red blood cells (which carry oxygen in the blood to the body's tissues) and platelets (which allow blood to clot) — also get crowded out by the white blood cells of leukemia. These cancer cells may move to other parts of the body, including the bloodstream, liver, spleen, and lymph nodes. In those areas, cancer cells can continue to multiply and build up.

Brain Cancer
A brain tumor is a group or clump of abnormally growing cells that can be found in or on the brain. They're rare in kids. Of the more than 73 million kids and teens in the United States, about 3,100 are diagnosed with brain tumors every year.

Brain tumors can either start in the brain or spread there from another part of the body — some cancers that start in other parts of the body may have cells that travel to the brain and start growing there.

Lymphoma
Lymphoma (say: lim-foe-mah) is a general term for a group of cancers that start in the body's lymphatic (say: lim-fah-tik) system. The lymphatic system is made of hundreds of bean-size lymph nodes — also sometimes called glands — that work to fight off germs or other foreign invaders in the body. Lymph nodes are found throughout the body.

When we get colds or the flu, we can sometimes feel our lymph nodes along the front of the neck or under the jaw. That's because when the body is fighting off these germs, the lymph nodes grow larger. The spleen, an organ in your stomach that filters blood, and the thymus (say: thigh-mes), a gland in the upper chest, also are parts of the lymphatic system.

Lymphoma happens when a lymphocyte (say: lim-foe-site), a type of white blood cell, begins to multiply and crowd out healthy cells. The cancerous lymphocytes create tumors (masses or lumps of cancer cells) that enlarge the lymph nodes.

Getting Better
As doctors and researchers learn more about cancer, they're discovering better medicines and more successful ways of fighting it. The goal of cancer treatment is to kill or remove all the cancerous cells so healthy cells can take over again. When this happens, kids start feeling better and the people who care about them are relieved and happy.

Reviewed by: Andrew W. Walter, MD
Originally reviewed by: Donna Patton, MD

RADIATION THERAPY

2009-04-02T18:51:00.000-07:00

Radiation is tricky to understand because you can't see it. It's a process in which energy is given off in the form of particles or rays. For example, the sun emits a kind of radiation.

Radiation is everywhere - in soil, water, food, building materials, and even our own bodies. Too much of it can be harmful, but in the right amounts, radiation has many uses. It can be used to make X-rays, create electricity, and even power submarines. And radiation can also be used to help people with cancer.

Radiation therapy (say: ray-dee-ay-shun ther-ah-pee) is one form of treatment for kids or adults who have cancer. Both adults and kids can get cancer, but kids don't get it very often. Cancer is a disease that causes normal cells in the body to grow out of control. If left untreated, these cells can grow throughout the body, making the person very sick. Radiation therapy kills cancer cells and keeps them from growing and multiplying. The fewer cancer cells, the better, because then a person can start feeling well again.

How Is Radiation Given?

Cancer can be treated with radiation therapy alone or in combination with chemotherapy or surgery. Chemotherapy (say: kee-mo-ther-uh-pee) is a treatment that uses medicine to destroy cancer cells. Some people may first have surgery to remove cancer cells or tumors and then have radiation therapy. Each person's treatment depends on the kind of cancer they have.

A doctor called an oncologist (say: on-kah-loh-jist) will make the decision about whether radiation therapy is best for the patient. Sometimes people stay in the hospital to get radiation therapy, but in most cases, the patient comes to the hospital or doctor's office for treatment and goes home afterward.

Radiation therapy can be given in two ways. A person may receive radiation directed to the outside of the body called external radiation. Or a person may receive radiation therapy that places the radiation inside the body, which is called internal radiation therapy (putting radioactive material directly in the tumor). Some people may receive both types of radiation therapy, but internal radiation is rarely used to treat the kinds of cancer kids get.

What Happens During Radiation Therapy?

Because the radiation treatment needs to be just right, the patient must go through a simulation first. During this process, the person lies on an X-ray table while the radiation therapist uses a special machine called a simulator to define the treatment area. When the therapist knows exactly which area of the body will get the radiation treatment, he or she marks it with ink. This "tattoo" should not be wiped off because these spots help to position the radiation for each treatment.

At each appointment, a large machine is positioned to deliver the exact amount of radiation necessary to kill the cells. It usually takes only a few minutes for a person to receive the daily dose of radiation. During a radiation treatment, a person has to lie still.

People who are having external radiation therapy usually visit the hospital on weekdays for several weeks. These doses of radiation are small, but they are strong enough to kill cancer cells. The radiation also can damage normal cells. Weekend breaks from radiation treatments give normal cells a chance to recover and let new, healthy cells grow.

How Does Radiation Therapy Make a Person Feel?

Getting a radiation treatment doesn't hurt and you do not see, smell, or feel the radiation. But these treatments can cause some temporary health problems called side effects. The kinds of side effects experienced by the patient depend on the location of the radiation and the dose, or how much radiation the patient receives. Common side effects include hair loss, rash, nausea, vomiting, and diarrhea. All of these side effects get better as the effects of the radiation wear off.

For a kid getting radiation therapy, it's normal to feel a little nervous. One important thing to remember is that a kid's parents will be there to help. Also, doctors, nurses, and other health care workers can answer questions and help patients feel comfortable. It's a good idea to visit the center where the treatment will be done, so the patient can see the place and meet the people who work there. Here are some more tips to help a person feel better during treatment:

Get plenty of sleep.
Try to eat healthy meals and drink plenty of fluids.
Ask the doctor about medicine to help with nausea and stomach upset.
Keep affected skin protected from the sun and ask about getting a special cream if a rash develops.

After the radiation treatments, patients visit the doctor for follow-up care. In many cases, the person will be well on the way to being cancer free.

Reviewed by: Maureen F.Edelson.MD

CHEMOTERAPHY MEDICINES STOP CANCER

2009-03-28T09:24:00.000-07:00

Chemotherapy (say: kee-moe-ther-ah-pee) is the use of medicines to treat cancer. Cancer is a disease that causes normal cells in the body to grow out of control. If left untreated, these cells can grow throughout the body making the person very sick. Chemotherapy medicines stop the growth of cancer cells. As the cancer goes away, the patient starts to feel better.

Both adults and kids can get cancer. No matter what age a person is, chemotherapy (also called chemo) may be used to treat the cancer. Sometimes people need to stay in the hospital to get chemo. But often, a person can just come to the hospital or doctor's office for treatment and go home afterward.

How Is Chemo Given?

Just as you can get other medicines by taking a pill or getting a shot, there are several ways to get chemo. A doctor called an oncologist (say: on-kah-loh-jist) will make the decision about which type of chemo is best for the patient. A person might take a pill or liquid or get an injection (shot). Another way of giving chemo is through an IV line, which is short for an intravenous (say: in-truh-vee-nus) line.

An IV line is a tiny tube that's put into a vein through someone's skin, usually on the arm. The IV line is attached to a bag or pump that holds the medicine. The chemo medicine flows from the bag or pump into the vein, which puts the medicine into the blood. Once the medicine is in the blood, it can travel through the body and attack cancer cells.

Sometimes doctors will insert a permanent IV line into a larger vein in the upper chest. This type of IV line is also called a catheter (say ka-thuh-ter). It allows a person to get chemo and other medicines easily without having to get a needle in the arm each time. Although it's called permanent, this type of catheter only stays in place until the person is finished with his or her cancer treatments. In addition to letting a person get chemo without having a new IV line inserted each time, a catheter lets doctors and nurses take blood samples and give other treatments without sticking the person with a needle.

Some cancers are treated with chemo alone. Others require a combination of treatments including chemo, radiation, and surgery. Like chemo, radiation kills cancer cells. Surgery can be used to remove big lumps of cancer cells called tumors.

What's Chemo Like?

The kinds of treatment used to fight cancer depend on the type of cancer and in how many parts of the body the cancer is found. Chemo is given on a schedule. Some people receive chemo every day. Others receive it every week or every month. Doctors use the word cycles to describe chemo because the treatment periods happen between periods of rest when a person isn't getting any treatment. These breaks allows the person's body to heal from the effects the chemo has on the cancer and on the body's normal cells.

Breaks from treatment are important because, during chemo, a person might experience some temporary health problems. These temporary problems are called side effects. All medications can have side effects. In their effort to kill cancer cells, chemo drugs can make normal cells sick. Breaks during chemo cycles allow time for normal cells to get better.

Because everyone's different, some people will have fewer side effects than others. Common side effects of chemotherapy are loss of appetite, vomiting, and temporary hair loss. A person receiving chemo also might feel tired, bruise easily, and catch infections easily.

There are medicines available that can help people feel better if they have side effects from chemo. Just having family and friends around for support can also make a person feel better. Doctors, nurses, and other members of the cancer treatment team will try to answer a person's questions, help them get well, and make them comfortable.

Coping With Chemo

Here are some tips for a person who's getting chemo:

* Get plenty of sleep.
* Eat healthy meals and drink plenty of fluids.
* Wash hands regularly, especially before eating, after using the bathroom, and after touching animals. This helps to prevent infection.
* Avoid large crowds and anyone who has a cold, the flu, or chicken pox. It's not a good time to get sick.

After chemo is over, the person will need to visit the doctor for checkups. The doctor will want to know how the person is feeling and check to see if the chemo did its job treating the cancer.

If you know someone who has cancer, the person will appreciate your phone calls, email messages, cards and letters, and visits. Let the person know you care and still want to spend time together.

And if you're a kid who has cancer, let your friends know you want to see them. Sometimes, people stay away because they think they might get in the way, don't know if you're allowed to have visitors, or are worried they'll disturb you if you're resting. As long as your doctor and your parent say it's OK, get together with your friends and have some fun!

Reviewed by: Maureen F. Edelson, MD

HAIR LOSS

2009-03-28T09:14:00.001-07:00

Every day, you lose about 50 to 100 hairs. You've seen them. They swirl down the drain in the tub or get stuck on the back of your sweater. Or, worst of all, one might get in your mouth. Gross.

Normally, when hair falls out, new hairs start forming in the same place as the old ones. But when someone has hair loss, the hairs may not grow back. Or they do grow, but there aren't enough of them to take the place of what's already fallen out. This often happens to men, who start to go bald as they get older.

But anyone can have hair loss, even kids. The medical name for hair loss is alopecia (say: al-uh-pee-shuh).

The Hair-y Story

The hair on your head is made of keratin (say: kair-uh-tin), the same protein that makes up your nails. Hairs grow from follicles (say: fahl-ih-kulz), which are very tiny holes deep in your skin. Each follicle contains a hair root, the part of the hair that is alive and growing. The part of the hair you can see, the part above the skin, is dead. (That's why it doesn't hurt to get a haircut!)

This part is called the hair shaft, and it's the part of your hair that can get long. Most kids' hair grows about half an inch (2 centimeters) a month. About 85 out of 100 hairs on your head are growing (the anagen phase) at any time. When a hair is done growing it goes into its resting (telogen) phase and eventually falls out. Usually, 15 out of 100 hairs on your head are in the resting phase.

What Causes Hair Loss?

Men, especially older men, are the ones who are most likely to lose their hair. This kind of hair loss is called androgenetic (say: an-dro-jeh-neh-tik) alopecia, also known as male-pattern baldness. It's the most common type of hair loss and it doesn't affect kids. This type of baldness runs in families and happens when people get older.

So why do some kids lose their hair? A kid's hair may fall out if he or she uses harsh chemicals to dye, bleach, straighten, or perm the hair. Even drying hair with very high heat can hurt it and cause it to fall out. Too-tight braids, ponytails, and barrettes can also make hair hit the road. Hair also can be lost if a person combs or brushes the hair too hard, especially when it's wet.

Here are some other causes of hair loss:

* Telogen effluvium (say: teh-luh-jen eh-flu-vee-um).
This means that more hairs than usual are in the resting phase and fall out more easily. As a result, you lose more hair than usual. You might notice more hair on your brush or a big clump of hair in the drain after you shower. A fever, stress, or surgery can cause this change in your hair. The good news is that you're not going bald and your hair will be back to normal within 6 months.

* Ringworm.
Kids who have a fungus called ringworm on their scalp might lose their hair. This infection causes the hairs to break close to the scalp.

* Alopecia areata (say: ar-ee-at-uh).
In this condition, round patches of hair completely fall out. No one knows exactly what causes alopecia areata, but it looks like the body's own immune system attacks the hair follicles. It also runs in some families. In 95 out of 100 cases of alopecia areata, the hair grows back completely.

* Trichotillomania (say: trik-oh-till-oh-may-nee-ah).
This is the fancy name for the habit of pulling and twisting your own hair. Some kids may pull their hair because they're stressed out or anxious about something. Hair will grow back when it's not being pulled, but some kids find it hard to stop. For these kids, the doctor can recommend treatment.

* Hormone problems.
If your thyroid gland isn't working right, it can also cause hair loss. (The thyroid gland sits in the front of the lower neck and makes important hormones that keep the body healthy.) Severe problems with nutrition also can result in unhealthy hair that falls out or breaks easily.

* Cancer treatment.
Most people think about cancer when they see a kid who is bald. Cancer does not cause hair to fall out, but the powerful drugs and treatments used to kill cancer cells (chemotherapy and radiation) kill the cells that make hair grow, too. A kid getting chemotherapy may lose a lot of hair quickly, but the hair will grow back when the treatment is stopped.

What Will the Doctor Do?

If you think you're having some hair loss, talk with your doctor. Your doctor might look at a few strands of your hair under a microscope. This will give the doctor a better look at what's going on to help decide what to do next.

For a fungal infection (ringworm), the doctor will probably prescribe some medicine to treat it. Or if you are taking a medication that can cause hair loss, the doctor might stop it or prescribe something different. If the doctor thinks that an illness is causing the hair loss, you might need more tests.

Coping With Hair Loss

In some cases, it can take a while for hair to grow back on its own — especially if a kid has alopecia areata or is getting chemotherapy. Being bald can be upsetting and scary. Some kids wear wigs or hair extensions while they wait for their own hair to return. Others feel more comfortable just wearing a baseball cap, bandanna, or scarf.

It's always tough to be different, especially in a way that's easy for people to notice. Friends and classmates can make all the difference to someone who's dealing with hair loss. They can tease the person and make him or her feel even worse. Or they can support the kid, be kind, and remember that a person is more than just his or her hair.

Some kids have really gone the extra mile for a friend who had hair loss due to cancer treatment. How? They decided to shave their heads, too, so their friend wouldn't be the only one. What a bald and beautiful thing to do!

Reviewed by: Patrice Hyde, MD

WHEN CANCER KEEPS YOU HOME

2009-03-28T08:54:00.000-07:00

Lots of everyday illnesses can make you feel like staying home. The flu, a stomach virus, even a bad cold can make you want to stay in bed and pull the covers up over your head. Not only can these sicknesses make you feel lousy, but they're also contagious. Staying home when you have them not only lets you get the rest you need but also helps prevent other people from getting sick.

But when a person has a more serious illness, like cancer, it's a different story. Kids with cancer may have to stay home — not because their cancer can spread to other people (it can't), but because it can be dangerous if other people's germs spread to them.

Ordinarily, a healthy kid's body can handle germs just fine, especially with regular hand washing. But when a kid has cancer, the disease itself and the treatments used to fight it can weaken the body's immune system (the system that fights illnesses and infections). Even a simple cold can last an extra-long time in a kid with cancer and make him or her way sicker than usual.

To protect themselves, kids with cancer often have to stay home until their immune system gets strong again. But being stuck at home can certainly seem like a raw deal. Missing out on school, time with friends, and fun family outings — even for a while — can leave you feeling angry, sad, left out, and even jealous of siblings and friends.

The good news is that for many kids with cancer, having to stay home is only a temporary setback. Once the immune system recovers, they should be able to get back in the swing of things. Until that happens, we've got some advice on making the best of a not-so-great situation.

What Is Neutropenia?

If a kid has cancer and has to stay home, chances are it's because he or she has a condition called neutropenia (say: new-troh-pee-nee-ah). Neutropenia is when the body has very low levels of certain white blood cells called neutrophils (say: new-troh-fills), which are the body's main defense against illness and infection.

When a germ enters the body, a healthy immune system springs into action, sending an army of neutrophils to the area to attack. Even more amazing, the next time those same germs enter the body, the neutrophils will "remember" them and try to head them off before they can cause any serious trouble.

When a person has cancer, though, fewer neutrophils are on hand to protect the body. With fewer neutrophils, a kid who has cancer is more likely to get infections. But what happens to the neutrophils? In some cases, the cancer itself damages the bone marrow, the spongy material inside the bones where all new blood cells — including neutrophils — are made. (This is especially common with cancers like leukemia and lymphoma.)

Other times it may be the cancer treatments doing the damage. Both chemotherapy (or chemo, powerful cancer-fighting medicine) and radiation (high-energy X-rays) work by killing the fastest-growing cells in the body — both bad and good. Since blood cells are among the quickest growing cells in the body, they often get accidentally destroyed along with cancer cells.

How Doctors Check for Neutropenia

Doctors use a blood test called an absolute neutrophil count (ANC) to judge how careful kids with cancer should be about avoiding germs. Sometimes they can also give special medications to encourage a kid's body to produce more neutrophils. But often it's safest just to remain home for a while. The doctor will decide how long.

Places like schools, malls, and even church, where people are close together and germs spread easily, are just too risky. To your immune system, it would feel like standing at the edge of a forest fire with only a water gun for defense.
Making the Best of It

So what can a kid do to make the best of all that time at home? Plenty — though it may depend on how he or she feels. Some days, cancer treatments can make a person feel tired and worn out. Other days, a kid might have more energy. When that energy strikes, here are some ideas for beating boredom at home.

Stay connected.
With all the ways to keep in touch these days — texting, IM, and more — it's easy to stay in the loop with friends and family. Kids can chat, send photos, or make up funny quizzes for friends to take and return to them. If the doctor says it's OK, a friend may be able to come for a sleep-over.

Get creative.
Art is a great way to express feelings, so a kid can paint, draw, or make a scrapbook or a collage of favorite photos. Maybe a parent will join in a larger project, like building a model or making clothing or jewelry. Keeping a journal is a great way to keep track of experiences. Later, it can be a helpful reminder of how far the person has come.

Redecorate.
With help from mom or dad, try a room makeover. It's a good time for a kid to turn his or her room into a totally cool and comfy space that's full of personality. Some ideas include painting the walls a happy color or turning a bed into a funky sofa with lots of cozy pillows. Final touches might be hanging new posters and creating a spot for favorite music, books, and photos.

Get outside.
Even when a crowded place is off-limits, fresh air usually isn't. A kid can sit on the porch or in the yard and read a book or listen to music. Art projects can be taken outside. (But sunscreen and a hat are important because chemo can make skin more likely to burn.)

Keep up with schoolwork.
Keeping up with school — normally not cause for excitement — can be a good way for kids to keep some of their normal routine.

Find ways to feel strong.
What makes someone feel strong?
It depends on the kid, but here are some ideas for kids dealing with cancer:

* Coordinate a fundraiser for cancer research or something else, such as animals, the environment, school.
* With a parent's help, set up a website or a blog.
* Join an in-person or online cancer support group.
* Make a list of stuff you want to do when you're feeling better. Thinking beyond the here and now can help make the time go faster and keep spirits positive.

CANCER

2009-03-28T08:46:00.001-07:00

What Is Cancer?

Cancer is actually a group of many related diseases that all have to do with cells. Cells are the very small units that make up all living things, including the human body. There are billions of cells in each person's body.

Cancer happens when cells that are not normal grow and spread very fast. Normal body cells grow and divide and know to stop growing. Over time, they also die. Unlike these normal cells, cancer cells just continue to grow and divide out of control and don't die when they're supposed to.

Cancer cells usually group or clump together to form tumors (say: too-mers). A growing tumor becomes a lump of cancer cells that can destroy the normal cells around the tumor and damage the body's healthy tissues. This can make someone very sick.

Sometimes cancer cells break away from the original tumor and travel to other areas of the body, where they keep growing and can go on to form new tumors. This is how cancer spreads. The spread of a tumor to a new place in the body is called metastasis (say: meh-tas-tuh-sis).

Causes of Cancer

You probably know a kid who had chickenpox — maybe even you. But you probably don't know any kids who've had cancer. If you packed a large football stadium with kids, probably only one child in that stadium would have cancer.

Doctors aren't sure why some people get cancer and others don't. They do know that cancer is not contagious. You can't catch it from someone else who has it — cancer isn't caused by germs, like colds or the flu are. So don't be afraid of other kids — or anyone else — with cancer. You can talk to, play with, and hug someone with cancer.

Kids can't get cancer from anything they do either. Some kids think that a bump on the head causes brain cancer or that bad people get cancer. This isn't true! Kids don't do anything wrong to get cancer. But some unhealthy habits, especially cigarette smoking or drinking too much alcohol every day, can make you a lot more likely to get cancer when you become an adult.

Finding Out About Cancer

It can take a while for a doctor to figure out a kid has cancer. That's because the symptoms cancer can cause — weight loss, fevers, swollen glands, or feeling overly tired or sick for a while — usually are not caused by cancer. When a kid has these problems, it's often caused by something less serious, like an infection. With medical testing, the doctor can figure out what's causing the trouble.

If the doctor suspects cancer, he or she can do tests to figure out if that's the problem. A doctor might order X-rays and blood tests and recommend the person go to see an oncologist (say: on-kah-luh-jist). An oncologist is a doctor who takes care of and treats cancer patients. The oncologist will likely run other tests to find out if someone really has cancer. If so, tests can determine what kind of cancer it is and if it has spread to other parts of the body. Based on the results, the doctor will decide the best way to treat it.

One test that an oncologist (or a surgeon) may perform is a biopsy (say: by-op-see). During a biopsy, a piece of tissue is removed from a tumor or a place in the body where cancer is suspected, like the bone marrow. Don't worry — someone getting this test will get special medicine to keep him or her comfortable during the biopsy. The sample that's collected will be examined under a microscope for cancer cells.

The sooner cancer is found and treatment begins, the better someone's chances are for a full recovery and cure.

Treating Cancer Carefully

Cancer is treated with surgery, chemotherapy, or radiation — or sometimes a combination of these treatments. The choice of treatment depends on:

the type of cancer someone has (the kind of abnormal cells causing the cancer)
the stage of the tumor (meaning how much the cancer has spread within the body, if at all)

Surgery is the oldest form of treatment for cancer — 3 out of every 5 people with cancer will have an operation to remove it. During surgery, the doctor tries to take out as many cancer cells as possible. Some healthy cells or tissue may also be removed to make sure that all the cancer is gone.

Chemotherapy (say: kee-mo-ther-uh-pee) is the use of anti-cancer medicines (drugs) to treat cancer. These medicines are sometimes taken as a pill, but usually are given through a special intravenous (say: in-truh-vee-nus) line, also called an IV. An IV is a tiny plastic catheter (straw-like tube) that is put into a vein through someone's skin, usually on the arm. The catheter is attached to a bag that holds the medicine. The medicine flows from the bag into a vein, which puts the medicine into the blood, where it can travel throughout the body and attack cancer cells.

Chemotherapy is usually given over a number of weeks to months. Often, a permanent catheter is placed under the skin into a larger blood vessel of the upper chest. This way, a person can easily get several courses of chemotherapy and other medicines through this catheter without having a new IV needle put in. The catheter remains under the skin until all the cancer treatment is completed.

Radiation (say: ray-dee-ay-shun) therapy uses high-energy waves, such as X-rays (invisible waves that can pass through most parts of the body), to damage and destroy cancer cells. It can cause tumors to shrink and even go away completely. Radiation therapy is one of the most common treatments for cancer. Many people with cancer find it goes away after receiving radiation treatments.

With both chemotherapy and radiation, kids may experience side effects. A side effect is an extra problem that's caused by the treatment. Radiation and anti-cancer drugs are very good at destroying cancer cells but, unfortunately, they also destroy healthy cells. This can cause problems such as loss of appetite, tiredness, vomiting, or hair loss. With radiation, a person might have red or irritated skin in the area that's being treated. But all these problems go away and hair grows back after the treatment is over. During the treatment, certain medicines can help a kid feel better.

While treatment is still going on, a kid might not be able to attend school or be around crowds of people — the kid needs to rest and avoid getting infections, such as the flu, when he or she already isn't feeling well. The body may have more trouble fighting off infections because of the cancer or side effects of the treatment.

Getting Better

Remission (say: ree-mih-shun) is a great word for anyone who has cancer. It means all signs of cancer are gone from the body. After surgery or treatment with radiation or chemotherapy, a doctor will then do tests to see if the cancer is still there. If there are no signs of cancer, then the kid is in remission.

Remission is the goal when any kid with cancer goes to the hospital for treatment. Sometimes, this means additional chemotherapy might be needed for a while to keep cancer cells from coming back. And luckily, for many kids, continued remission is the very happy end of their cancer experience.

ACNE PREVENTION

2009-03-28T08:14:00.000-07:00

Acne usually isn't a serious medical condition. But you may want to seek medical treatment from a dermatologist for persistent pimples or inflamed cysts to avoid scarring or other damage to your skin. If acne or the scars it may have left are affecting your social relationships or self-esteem, you may also want to ask a dermatologist if your acne can be controlled or if your scars can be diminished.

Treatments and drugs
Acne treatments work by reducing oil production, speeding up skin cell turnover, fighting bacterial infection, reducing the inflammation or doing all four. With most prescription acne treatments, you may not see results for four to eight weeks, and your skin may get worse before it gets better. Your doctor or dermatologist may recommend a prescription medication you apply to your skin (topical medication) or take by mouth (oral medication). Oral prescription medications for acne should not be used during pregnancy, especially during the first trimester.

Types of acne treatments include:
* Topical treatments. Acne lotions may dry up the oil, kill bacteria and promote sloughing of dead skin cells. Over-the-counter lotions are generally mild and contain benzoyl peroxide, sulfur, resorcinol, salicylic acid or lactic acid as their active ingredient. These products can be helpful for very mild acne.

If your acne doesn't respond to these treatments, you may want to see a doctor or dermatologist to get a stronger prescription lotion. Tretinoin (Avita, Retin-A, Renova) and adapalene (Differin) are examples of topical prescription products derived from vitamin A. They work by promoting cell turnover and preventing plugging of the hair follicles. A number of topical antibiotics also are available. They work by killing excess skin bacteria. Often, a combination of such products is required to achieve optimal results.

* Antibiotics. For moderate to severe acne, prescription oral antibiotics may be needed to reduce bacteria and fight inflammation. You may need to take these antibiotics for months, and you may need to use them in combination with topical products.

* Isotretinoin.
For deep cysts, antibiotics may not be enough. Isotretinoin (Accutane) is a powerful medication available for scarring cystic acne or acne that doesn't respond to other treatments. This medicine is reserved for the most severe forms of acne. It's very effective, but people who take it need close monitoring by a dermatologist because of the possibility of severe side effects. Isotretinoin is associated with severe birth defects, so it can't be taken by pregnant women or women who may become pregnant during the course of treatment or within several weeks of concluding treatment.

In fact, the drug carries such serious potential side effects that women of reproductive age must participate in a Food and Drug Administration-approved monitoring program to receive a prescription for the drug. In addition, isotretinoin may increase the levels of triglycerides and cholesterol in the blood and may increase liver enzyme levels. Although cause and effect hasn't been proved, studies have reported the development of inflammatory bowel disease with isotretinoin use.

* Oral contraceptives.
Oral contraceptives, including a combination of norgestimate and ethinyl estradiol (Ortho-Cyclen, Ortho Tri-Cyclen), have been shown to improve acne in women. However, oral contraceptives may cause other side effects that you'll want to discuss with your doctor.

* Laser and light therapy.
Laser- and light-based therapies reach the deeper layers of skin without harming the skin's surface. Laser treatment is thought to damage the oil (sebaceous) glands, causing them to produce less oil. Light therapy targets the bacterium that causes acne inflammation. These therapies can also improve skin texture and lessen the appearance of scars, so they may be good treatment choices for people with both active acne and acne scars.

* Cosmetic procedures.
Chemical peels and microdermabrasion may be helpful in controlling acne. These cosmetic procedures — which have traditionally been used to lessen the appearance of fine lines, sun damage and minor facial scars — are most effective when used in combination with other acne treatments.

Acne scar treatment
Doctors may be able to use certain procedures to diminish scars left by acne.

These include fillers, dermabrasion, intense light therapy and laser resurfacing.
* Soft tissue fillers. Collagen or fat can be injected under the skin and into scars to fill out or stretch the skin, making the scars less noticeable. Results from this acne scar treatment are temporary, so you'd need to repeat the injections periodically.

* Dermabrasion. Usually reserved for more severe scarring, dermabrasion involves removing the top layer of skin with a rapidly rotating wire brush. Surface scars may be completely removed and deeper acne scars may appear less noticeable. Dermabrasion may cause pigmentation changes for people with darker skin.

* Microdermabrasion. This newer acne scar treatment involves a hand-held device that blows crystals onto skin. These crystals gently abrade or "polish" the skin's surface. Then, a vacuum tube removes the crystals and skin cells. Because just the surface cells are removed, the skin isn't damaged. However, results are subtle and scars may still be noticeable, even after several sessions.

* Laser, light source and radiofrequency treatments. In laser resurfacing, a laser beam destroys the outer layer of skin (epidermis) and heats the underlying skin (dermis). As the wound heals, new skin forms. Less intense lasers (nonablative lasers), pulsed light sources and radiofrequency devices don't injure the epidermis. These treatments heat the dermis and cause new skin formation. After several treatments, acne scars may appear less noticeable. This means shorter recovery times, but treatment typically needs to be repeated more often and results are subtle.

* Skin surgery. A minor procedure (punch excision) cuts out individual acne scars. Stitches or a skin graft repairs the hole left at the scar site.

Prevention
Once your acne improves or clears, you may need to continue your acne medication or other treatment to prevent new acne breakouts. In some cases, you might need to use a topical medication on acne-prone areas, continue taking oral contraceptives or attend ongoing light therapy sessions to keep your skin clear.
Talk to your doctor about how you can prevent new eruptions. You can also prevent new acne breakouts with self-care measures, such as washing your skin with a gentle cleanser and avoiding touching or picking at the problem areas.

Other acne prevention tips include:
* Wash acne-prone areas only twice a day. Washing removes excess oil and dead skin cells. But too much washing can irritate the skin. Wash areas daily with a gentle cleanser and use oil-free, water-based skin-care products.

* Use an over-the-counter acne cream or gel to help dry excess oil. Look for products containing benzoyl peroxide or salicylic acid as the active ingredient.

* Avoid heavy foundation makeup. Choose powder cosmetics over cream products because they're less irritating.

* Remove makeup before going to bed. Going to sleep with cosmetics on your skin can clog tiny openings of the hair follicles (pores). Also, be sure to throw out old makeup and clean your cosmetic brushes and applicators regularly with soapy water.

* Wear loosefitting clothing. Tightfitting clothing traps heat and moisture and can irritate your skin. Also, whenever possible, avoid tightfitting straps, backpacks, helmets or sports equipment to prevent friction against your skin.

* Shower after exercising or doing strenuous work. Oil and sweat on your skin can trap dirt and bacteria.

Lifestyle and home remidies
You can avoid or control most acne with good basic skin care and the following self-care techniques:

* Wash problem areas with a gentle cleanser. Products such as facial scrubs, astringents and masks generally aren't recommended because they tend to irritate skin, which can worsen acne. Excessive washing and scrubbing also can irritate skin. If you tend to develop acne around your hairline, shampoo your hair frequently.

* Try over-the-counter acne lotion to dry excess oil and promote peeling. Look for products containing benzoyl peroxide or salicylic acid as the active ingredient.

* Avoid irritants. You may want to avoid oily or greasy cosmetics, sunscreens, hair-styling products or acne concealers. Use products labeled "water-based" or "noncomedogenic." For some people, the sun worsens acne. Additionally, some acne medications can make you more susceptible to the sun's rays. Check with your doctor to see if your medication is one of these, and if so, stay out of the sun as much as possible and anytime you have to be in the sun, use sunscreen that doesn't clog your pores.

* Watch what touches your face. Keep your hair clean and off your face. Also avoid resting your hands or objects such as telephone receivers on your face. Tight clothing or hats also can pose a problem, especially if you'll be sweating. Sweat, dirt and oils can contribute to acne.

* Don't pick or squeeze blemishes. Picking or squeezing can cause infection or scarring. Most acne will clear up without this kind of intervention. If you need aggressive treatment, see your doctor or dermatologist.

BACK

ACNE

2009-03-28T07:49:00.000-07:00

Zits. Pimples. Blemishes. No matter what you call them, acne can be distressing and annoyingly persistent. Acne lesions heal slowly, and when one begins to resolve, others seem to crop up. This ongoing battle and long-lasting cycle is both wearisome and frustrating.

Hormones likely play a role in the development of acne, making the condition most common in teenagers. But people of all ages can get acne. Some adult women experience mild to moderate acne due to hormonal changes associated with pregnancy, their menstrual cycles, or starting or stopping birth control pills.

Teenage and adult acne can take months or years to treat successfully. Depending on its severity, acne can cause emotional distress and lead to scarring of the skin.

The good news is that effective treatments are available. Acne treatment for mild cases usually involves self-care measures, such as washing your skin daily with a gentle cleanser and using an over-the-counter acne cream. Acne treatment for severe cases usually includes one or more prescription medications. Once acne is under control, prevention strategies can help keep your skin clear of breakouts.

Symptoms

Acne typically appears on your face, neck, chest, back and shoulders, which are the areas of your skin with the largest number of functional oil glands. Acne can take the following forms:

Comedones (whiteheads and blackheads). Comedones (kom-uh-DO-neze) are created when the openings of hair follicles become clogged and blocked with oil secretions, dead skin cells and sometimes bacteria. When comedones are open at the skin surface they're called blackheads because of the dark appearance of the plugs in the hair follicles. When comedones are closed, they're called whiteheads — slightly raised, skin-colored bumps.
Papules. These are small raised bumps that signal inflammation or infection in the hair follicles. Papules may be red and tender.
Pustules. Similar to papules, pustules are red, tender bumps with white pus at their tips.
Nodules. These are large, solid, painful lumps beneath the surface of the skin. They're formed by the buildup of secretions deep within hair follicles.
Cysts. These are painful, pus-filled lumps beneath the surface of the skin. These boil-like infections can cause scars.

Causes

Three factors contribute to the formation of acne:

Overproduction of oil (sebum)
Irregular shedding of dead skin cells resulting in irritation of the hair follicles of your skin
Buildup of bacteria

Acne occurs when the hair follicles become plugged with oil and dead skin cells. Each follicle is connected to sebaceous glands. These glands secrete an oily substance known as sebum to lubricate your hair and skin. Sebum normally travels up along the hair shafts and then out through the opening of the hair follicle onto the surface of your skin. When your body produces an excess amount of sebum and dead skin cells, the two can build up in the hair follicle and form together as a soft plug.

This plug may cause the follicle wall to bulge and produce a whitehead. Or, the plug may be open to the surface and may darken, causing a blackhead. Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected. Blockages and inflammation that develop deep inside hair follicles produce lumps beneath the surface of your skin called cysts. Other pores in your skin, which are the openings of the sweat glands onto your skin, aren't normally involved in acne.

It's not known what causes the increased production of sebum that leads to acne. But a number of factors — including hormones, bacteria, certain medications and heredity — play a role.

Contrary to what some people think, foods have little effect on acne. Acne also isn't caused by dirt. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse.

Risk Factors

Hormonal changes in your body can provoke or aggravate acne. Such changes are common in:

Teenagers, both in boys and girls
Women and girls, two to seven days before their periods
Pregnant women
People using certain medications, including cortisone

Other risk factors include:

Direct skin exposure to greasy or oily substances, or to certain cosmetics
A family history of acne — if your parents had acne, you're likely to develop it too
Friction or pressure on your skin caused by items such as telephones or cell phones, helmets, tight collars and backpacks

ASTHMA ACTION PLAN

2009-03-27T18:33:00.000-07:00

Having a plan makes almost anything easier, even asthma. An asthma action plan is a set of instructions your doctor will write down for you and your family. It will tell you how to prevent asthma flare ups and deal with flare-ups when they happen. Your doctor might give you a plan, or you can print out a sample plan and ask him or her to complete it with you.

An asthma action plan helps you keep your asthma under control. And when your asthma is controlled, breathing problems won't keep you from playing sports, having fun, and doing whatever you want to do. Following your plan can also mean fewer trips to your doctor or to the emergency department.

What's in the Plan?

A key part of the plan will tell you exactly what to do if you have a flare-up. It will say which medicine to take and how much of it to take. It also will say when someone needs to call the doctor or take you to the emergency department.

You may need your mom, dad, or another adult to help you put the plan into action. Talk with your parents about which parts of the plan you are going to handle by yourself and when you need to ask for help.

A typical asthma action plan also would cover:

how to avoid the things that make you have flare-ups (also called triggers)
how to catch flare-ups early and treat them

Because each kid's asthma is different, each kid's plan is different. Here's some other stuff that might also be in your plan:

steps you should take before exercising
how to use your peak flow meter
the names of your medicines and how to take them
your doctor's phone number and other important numbers

Understand Your Plan

Talk with your doctor about your plan and ask questions if something doesn't make sense. Some instructions in the plan will apply every day, not just when you're having breathing problems. For example, you'll want to stay away from stuff that makes your asthma worse and take controller medicine regularly, if your doctor has prescribed it for you.

Your mom or dad may give a copy of the action plan to your school nurse, your teacher, and anyone else who takes care of you. You should probably keep a copy of it with you, too. Following this plan will help keep you in action!

Reviewed by: Elana Pearl Ben-Joseph, MD

ASTHMA AND TRAVELLING

2009-03-27T18:28:00.000-07:00

If you have asthma, you'll be packing more than your clothes for these adventures. You'll want to be sure that you have your asthma medicine and that you know what to do if you have any breathing problems while you're away. But asthma doesn't have to get in the way of travel fun. Let's find out how to be prepared when you're out and about.

Pack Your Medicine

Having your medicine with you is very important. You'll want to pack both your rescue and controller medicines. Keep them handy, so if you're traveling by car, keep them where you can get to them.

If you're traveling by plane or train, be sure to keep your medicine with you in your carry-on bag. If you don't, and your luggage is lost, you won't have your medicine. Even if your luggage isn't lost, not having it with you on the plane or train means you can't take it when you need it.

When you're packing your medicine, pack more than you need. It doesn't hurt to have extra. Your mom or dad can help you decide how much is enough.

Other Important Items

If you use a peak flow meter to keep track of how you're doing, be sure to pack it, too. It's also a good idea to bring along a copy of your asthma action plan with you. This plan will tell you what to do if you have breathing trouble and it has your doctor's phone number on it, in case you need to call.

Home Away From Home

If you will be staying in a hotel, you may find that something in the room triggers your asthma. It's best to have a sunny, dry room that's away from the hotel's pool. But you can't always control where your room is. If animals trigger your asthma, ask for a room that has never had pets in it. Also, request a nonsmoking room. It might help to bring your blanket and pillow from home.

If you will be staying with friends or family, make sure they know about your asthma triggers before you get there. For instance, your grandma can limit dust mites and mold by dusting and vacuuming carefully, especially in the room you'll sleep in. Tell your hosts about any other triggers you have, such as scented candles or fire from a wood fireplace or woodstove. Speaking of smoking – no one should smoke around you. They should go outside.

Having Fun Outdoors

Keep your triggers in mind if you'll be outside a lot. For instance, you don't want to do lots of walking or hiking when the air pollution or pollen counts are high or if the weather is very cold. If you will be camping, you should sit away from the fire. Wherever you go in the great outdoors, carry your rescue medicine all the time.

Going Solo

If you'll be staying somewhere – like camp – without your parents, you'll have a little more responsibility for your asthma. The best approach is to have your parents tell the adults you'll be staying with (such as relatives or camp counselors) about your asthma. Your mom or dad can tell them about your medicine and when you need to take it. You might ask them to help remind you about it – or to keep the medicine in a safe place.

Your parents can also tell the adults about your triggers, give them a list of instructions, and provide emergency phone numbers. All of this information should be on your asthma action plan, so if you have one, your parent could just make a copy.

If you think your asthma would be too hard for you to manage at camp, there may be a solution. In many parts of the country, the American Lung Association has special asthma camps that have nurses and doctors on staff as well as counselors. That way, if their asthma flares up, kids will get the care they need so they can go back to having all kinds of summer camp fun!

Reviewed by: Elana Pearl Ben-Joseph, MD

MY PET AND ASTHMA

2009-03-27T18:25:00.000-07:00

Austin loves watching TV with his dog, Max. They hang out on the sofa together for hours on rainy days. Sometimes, Austin lies with his head right on Max's soft furry belly. What a pillow!

But Austin just found out he's allergic to animal allergens. That means he's allergic to stuff animals produce. This stuff is found in:

* animal dander, or skin flakes (kind of like animal dandruff)
* animal saliva (spit)
* animal urine (pee)

Because he's allergic to this stuff, spending time with Max is probably making his asthma worse. Lots of kids with asthma are allergic to animals - and not just furry animals. Feathered animals, too, can cause allergic reactions.

Animal hair or fur by itself isn't the problem, but hair and fur can collect dust mites (tiny bugs), pollen (from plants), mold (like the stuff that makes your basement smell), and other stuff that causes allergies. And any animal that lives in a cage - from birds to gerbils - will have droppings that get mold and dust mites on them.

Finding out that you're allergic to animals can be sad because, if your asthma is really bad, you may have to find a new home for your pet. Because that's such a tough thing to do, your doctor might suggest that you try allergy medicine or shots first. Those, in addition to your regular asthma medicines, can help control your asthma flare-ups.

You also can take steps to keep your bedroom free of allergens and reduce the allergens in your home. They are:

* Keep your pet out of your room. If possible, keep your pet outside.
* Even if it's a small pet, like a bird or gerbil, don't keep the animal in your room.
* For caged animals, have someone else clean the cage.
* If there's a pet in your classroom, let your teacher know about your allergies.
* Play with your pet, but try not to hug or kiss the animal.
* Wash your hands when you're done playing with your pet.
* Get rid of any rugs or wall-to-wall carpeting in your room.
* Clean your room so it's free of household dust.
* Have someone else wash and brush your pet every week (cats as well as dogs).

If you try all these things and are still having lots of asthma flare-ups, you may need to find another home for your pet. This may make you feel a lot of different feelings. At first, you may feel nothing at all. Or you may feel like crying. You may feel lonely or mad. All of these feelings are OK.

You may want to talk to your parents about how you are feeling. They might be feeling sad and missing your pet, too. Talking might help you start feeling better. You might decide to write a poem or make a scrapbook to remember your pet.

It takes months for all of the allergens to leave the house, so your allergies might not get better right away. Even if you don't have animals at home, you'll probably still come in contact with them from time to time. When going over to a friend's house where there is a pet, be sure to take your allergy medicine before going over. Also, bring your asthma inhaler along, just in case.

If you're missing your pet, it may take a long time before you want a new one. But someday, if you do, your best bets are turtles, snakes, lizards, or fish. They're less likely to cause allergies.

Reviewed by: Elana Pearl Ben-Joseph, MD
Originally reviewed by: Stephen J. McGeady, MD

HOW DO ASTHMA MEDICINES WORK ?

2009-03-27T18:15:00.000-07:00

People with asthma have what is called a chronic (say: krah-nik) problem, or a problem that is always there, even when they feel OK. Everyday stuff such as exercise, animal dander or cigarette smoke can cause an asthma flare-up.

During an asthma flare up, the airways in the lungs get swollen (puffy). These narrowed airways (breathing tubes) also can get clogged with mucus. And even the muscles around the airways tighten up. All of this makes it tough to breathe.

But medicine can help. There are two different kinds of medicines for treating asthma.

Rescue Medications

Rescue medications can loosen the muscles around the airways. That opens up the airways and makes it easier to breathe. Rescue medicines are usually inhaled right into the lungs, where they stop wheezing, coughing, and shortness of breath quickly. In other words, they rescue a person who's having trouble breathing!

Controller Medications

These medicines work over a long period of time by keeping the airways from getting swollen in the first place. They may be inhaled or taken as a pill or liquid.

Rescue medications are important during a flare-up because they help someone breathe more easily right away. That means anyone who has asthma and has been prescribed rescue medications should always have them along - at school, on the basketball court, at the mall, and even on vacation.

But rescue medications don't do anything to help stop an asthma flare-up before it happens. That's where controller medications come in. These medicines may not seem to be doing anything. In fact, a person with asthma might not feel anything at all when he or she takes them. But these medicines are quietly doing important work to control asthma every day.

Some people with mild asthma use only rescue medications when they have flare-ups. Others who have more severe asthma must take rescue medication when they have breathing problems and they need to take controller medications every day. If you have asthma, your doctor will decide which type of medication you need and how often you need to take it.

Reviewed by: Elana Pearl Ben-Joseph, MD

HANDLING AN ASTHMA FLARE UP

2009-03-27T18:09:00.000-07:00

If you have asthma, you probably know about flare-ups. That's when your asthma symptoms get worse.
During a flare-up, you might have:

* trouble breathing
* a tight or painful feeling in the chest
* a whistling sound when you breathe (wheezing)
* a cough

Flare-ups happen because the airways in your lungs have become more irritated and swollen (puffy) than usual.
The lungs may make sticky mucus, which clogs the airways. And the muscles around the airways tighten up, making the airways really narrow. These troubles in the lungs make it tough to pull air in and push air out.

You can learn to handle asthma flare-ups. Here are three ways to be prepared:

1. Learn how spot clues that mean you're likely to have a flare-up.
2. Have a plan for how you will deal with a flare-up, no matter where you are (home, school, a friend's house, or on vacation).
3. Find out how to prevent future flare-ups by taking your controller medicine and avoiding triggers.

Spot the Clues

After you've had a few flare-ups, you may notice that you feel a certain way when a flare-up is coming on. You might have a tight chest, an itchy throat, or a tired feeling. Or do you have a cough, even though you don't have a cold? If you have a peak flow meter, this might be a good time to use it.

Have a Plan

Get help if you feel like a flare-up is about to happen. Let people around you know what's going on, and then remember your asthma action plan. That's the written plan created with your doctor that tells you which medicine to take and what to do next. Don't ignore the flare-up or hope it will go away on its own. It won't and you might end up in the emergency room.

Prevent Flare-Ups

Asthma flare-ups can be handled, but it's even better if you can prevent them from happening. One way to do that is to avoid triggers. We're not talking about triggers on guns! Many kids who have asthma also have allergies, so common triggers include things that cause allergies. Some of these are pets, dust mites (little bugs that live in dust), mold, or cockroaches.

Other triggers do not cause allergies, but they simply irritate the airways. These include tobacco smoke, cold air, exercise, and infections, such as colds. If you try to avoid your triggers, you may sometimes be able to prevent asthma flare-ups.

If your doctor prescribed controller medicine for you, taking it as directed is another important way to prevent flare-ups. Controller medicine needs to be taken regularly, even on days when you feel fine.

Some flare-ups are serious, but others are mild. Flare-ups can happen suddenly, but can also build up over time, especially in kids who aren't taking the asthma medicine they need. You won't be able to stop all flare-ups, so do your best to be prepared for one.

Reviewed by: Elana Pearl Ben-Joseph. MD

DEALING WITH ASTHMA TRIGGERS

2009-03-27T18:04:00.000-07:00

What's a Trigger?

A trigger on a gun makes the bullet fire out. A trigger in asthma is something that causes asthma symptoms. People with asthma have what is called a chronic (say: krah-nik), or continuing, problem with their airways (the breathing tubes in a person's lungs). The airways become swollen and full of mucus. This problem is made worse by asthma triggers.

Triggers are things that don't bother most people, but they can make people with asthma cough, wheeze, and have trouble breathing. Triggers don't cause asthma (no one knows exactly what does) but they can lead to asthma flare-ups.

Every person with asthma has different triggers. Some people have one or two. Others have a dozen. Triggers may change from winter to summer. Some kids even outgrow triggers as they get older.

Common asthma triggers include:

* allergens (say: ah-lur-jenz) - things that cause allergic reactions
* stuff in the air, like smoke and pollution
* colds or the flu
* weather conditions
* exercise

Managing Asthma

Asthma can't be cured but it can be managed. Managing asthma means doing everything you can to keep the symptoms (say: sim-tums) of asthma, like wheezing and coughing, from happening. One way to manage asthma is to stay away from triggers.

Your doctor will help you figure out your specific triggers. He or she may suggest that you keep an asthma diary for a couple of weeks. This means you or an adult will write down when and where you have symptoms and flare-ups. You also may see a special doctor called an allergist (say: ah-lur-jist), who can figure out if you have any allergies that might be causing your symptoms.

Learning about your triggers is one part of your asthma action plan that your doctor will help you write down. This plan will look at all the things you need to do to manage your asthma, from staying away from triggers to taking medicines.

Dealing With Triggers

Allergens are a very common trigger.
They include:

* mold
* dust mites (tiny insects that live in dust)
* cockroaches
* pollen (a kind of dust that comes from plants)
* animal dander (skin flakes that are kind of like dandruff)
* animal saliva and urine
* feathers

You won't be able to stay away from all allergens, but there are some things you can do.

* Keep your room as clean and free of dust as possible. This means vacuuming and dusting weekly and getting rid of clutter. Your old stuffed animals may need to go into a box in the attic.
* Wash your sheets weekly in hot water. You can get covers for your mattress, box spring, and pillows that will help too.
* Get rid of carpets. Any kind of rug or carpeting can collect allergens that cause asthma symptoms.
* Keep any pets out of your room. Before you spend the night at a friend's house, find out what kinds of pets he or she has.

If your asthma symptoms are triggered by allergies, you might also need to take allergy medication or have allergy shots. Your doctor will let you know.

Irritants Can Irritate

Stuff in the air, also called irritants (say: ir-uh-tunts), are different from allergens because they bother people who don't have allergies or asthma, too. For most people, irritants aren't a serious problem, but for people with asthma, they can lead to flare-ups. Common irritants include perfumes and aerosol (say: ar-uh-sol) sprays, such as hair spray and cleaners. Other irritants include wood and tobacco smoke, the smell given off by paint or gas, and air pollution.

If you notice that an irritant triggers your asthma, let an adult know, so he or she can keep it away from you. This might mean switching to different hair sprays or cleaning products. If smoke bothers you, it's probably a good idea to avoid fires in the fireplace or woodstove. And of course, no one should smoke cigarettes or other tobacco products around you.

If outdoor air pollution is a problem, running the air conditioner or an air cleaner can help. Having an adult check air quality reports on the news might also be a good idea. On days when the quality is especially bad, you might want to stay indoors.

Colds and the flu are harder to avoid, but you can cut down on the number of sicknesses you catch by washing your hands regularly and staying away from people who are sick. Getting a flu shot each year is a good idea, too.

Weather Woes

Weather can also be a trigger. Windy conditions may stir up pollens and molds. Rain can wash pollen from trees and grasses so it starts moving around in the air. Very cold or very hot weather may trigger asthma and so can humidity (when the air has a lot of moisture in it).

If you know that certain weather conditions make your asthma worse, an adult can help you avoid your triggers. An adult should keep an eye on the forecast - on some days, you may need to spend less time outdoors. If cold weather is the problem, you'll want to have a scarf that will cover your nose and mouth when you go outside.

Exercise like running or playing a sport is another common trigger. But this is one trigger that you shouldn't avoid because it's important for your health. Your doctor will want you to be active, so talk with him or her about what to do before playing sports. For instance, you might need to take medicine 10 or 15 minutes before you exercise or play sports. And, of course, you'll want to have your rescue medication with you all the time.

You won't be able to keep away from all triggers all the time. But by staying away from triggers as much as possible, you can help prevent flare-ups. In other words, you can keep those triggers from getting pulled!

Reviewed by: Elana Pearl Ben-Joseph, MD

CAN KIDS WITH ASTHMA PLAY SPORTS ?

2009-03-27T17:57:00.000-07:00

You probably know that asthma can cause breathing problems. So can kids with asthma play sports? You bet they can! Being active and playing sports is an especially good idea if you have asthma. Why? Because it can help your lungs get stronger, so they work better.

Some athletes with asthma have done more than develop stronger lungs. They've played professional football and basketball, and they've even won medals at the Olympic Games! Some sports are less likely to bother a person's asthma. Golf and yoga are less likely to trigger flare-ups, and so are sports like baseball, football, and gymnastics.

In some sports, you need to keep going for a long time. These activities may be harder for people with asthma. They include cycling, long-distance running, soccer, basketball, cross-country skiing, and ice hockey. But that doesn't mean you can't play these sports if you really like them. In fact, many athletes with asthma have found that with the right training and medicine, they can do any sport they choose.

But before playing sports, it's important that your asthma is under control. That means you aren't having lots of symptoms or flare-ups. To make this happen, it's very important that you take all asthma medicine just like your doctor tells you to, even when you are feeling OK.

Your doctor will also tell you some other things you can do to avoid flare-ups. This may mean skipping outdoor workouts when there is lots of pollen in the air, wearing a scarf or ski mask when you play outside during the winter, or making sure you always have time for a careful warm up and cool down.

Make sure your coach and teammates know about your asthma. That way, they will understand if you need to stop working out because of breathing trouble. It's also helpful if your coach knows which steps to take if you have a flare-up. Listen to your body and follow the instructions your doctor gave you for handling breathing problems. And if you keep your asthma in good control, you'll be in the game and not on the sidelines!

Reviewed by: Elana Pearl Ben-Joseph, MD

HOW TO MAKE IT ASTHMA SAFE

2009-03-27T17:50:00.000-07:00

What's a Trigger?

People with asthma have what is called a chronic (say: krah-nik), or continuing, problem with their airways (the breathing tubes in the lungs), which can get swollen and full of mucus. This problem is made worse by asthma triggers.

Triggers can be things like:

* pollen (the fine dust from plants)
* dust mites (tiny insects that live in dust)
* mold (a type of small living thing that lives and grows in damp places)
* stuff in the air (like smoke)

Triggers don't hurt most people, but they can make people with asthma cough, wheeze, and have trouble breathing. Triggers don't cause asthma (no one knows exactly what does) but they can lead to asthma flare-ups. Your doctor will help you figure out what your triggers are.

As you probably already guessed, the idea is to control the triggers in your house. This is especially important in rooms where you spend a lot of time, like your bedroom.

The Air Indoors

Keeping the air at home clean is important. It can contain irritants (say: ir-uh-tunts), such as:

* tobacco smoke or woodsmoke
* perfumes
* aerosol sprays (say: ar-uh-sol; some kinds of hairspray and cleaners come in aerosol cans)
* cleaners
* the smell given off by paint or some gases

Air pollution and pollen are triggers that can come into your home from outside if you leave your windows and doors open in warmer weather.

How can your family make sure the indoor air is clean?

* Don't allow anyone to smoke in the house.
* Avoid wood fires in the fireplace or wood stove.
* Run the air conditioning because it filters the air.
* Keep the windows shut when there's a lot of pollen or air pollution outside (an adult can help you figure this out).

Dealing With Dust Mites

Dust mites are tiny insects that live in dust. You'll find lots of them where there is food, in some kinds of bedding, and in rugs. Bedrooms usually have the most dust mites in a house.

You and your family won't be able to get rid of all the dust mites at home but there are some steps you can take if they are a trigger for your asthma:

* Vacuum and dust (especially your bedroom) at least once a week.
* Stay away from feather or down pillows or comforters.
* Every few weeks, wash all of your bedding in hot water and then dry it on a high setting.
* Get special covers for your mattresses, pillows, and box springs.
* Get rid of carpeting, especially wall-to-wall or shag carpeting in your room.
* Clean up the clutter in your room. Get rid of knickknacks, picture frames, and stuffed animals that collect dust. If you can't part with them, store them somewhere other than your room.

Making Mold Dry Up

Mold is a type of tiny living thing that is kind of like a plant. It grows very well in damp places like bathrooms and basements. Mold makes more mold by sending what are called spores into the air. Mold spores can be an asthma trigger.

The key to getting rid of mold in your home is keeping things as dry as possible.
Your parents can:

* Run a dehumidifier (say: dee-hyoo-mih-duh-fy-ur; this is a machine that dries out the air) in the basement or other damp areas.
* Get rid of wallpaper and wall-to-wall carpeting in bathrooms and basement rooms.
* Run the air conditioner.
* Get rid of houseplants, which may have mold in their soil.
* Clean visible mold or mildew with a bleach solution.
* Replace or wash moldy shower curtains.

Coping With Cockroach and Animal Allergens

Animals can be a big asthma trigger. The animal parts that can trigger asthma symptoms are dander (which are skin flakes — kind of like dandruff), saliva, urine, and feathers.

And pets aren't the only living triggers at home — cockroaches can be a major asthma trigger that can be difficult to avoid in apartments.

Unfortunately, if your pet is an asthma trigger for you, you may need to find another home for the animal. Short of that, these steps may be taken, but they are not as effective.

* Keep pets outside. At the very least, keep them out of your bedroom.
* Have someone else wash and brush your pet every week.
* Don't play with or touch your pet and stay far away from the litter box.
* Ask other people in your household to wash their hands after touching your pet.
* If you have an animal that lives in a cage, keep it in a room that you don't spend time in. Someone other than you should clean the cage daily.

Cold-blooded pets, such as turtles, lizards, snakes, and fish are all OK for kids with asthma.

If cockroaches are a problem:

* Don't save boxes, paper bags, or newspapers.
* Don't leave open food or dirty dishes lying around your kitchen. Keep counters free of crumbs or spills.
* Keep garbage containers closed and wash recyclables before putting them in the bin.

You want to be comfortable at home — where you spend most of your time — so try to remove as many asthma triggers as you can. When your house doesn't cause asthma flare-ups, it's really home, sweet home!

Reviewed by: Elana Pearl Ben-Joseph, MD

COMA ?

2009-03-27T17:42:00.000-07:00

A coma can be difficult to understand, especially because people sometimes jokingly use the words coma and comatose (say: ko-muh-tose, which means in a coma or coma-like state) to describe people who aren't paying attention or who are drowsy or sleeping. But a coma is a serious condition that has nothing to do with sleep.

What Happens When Someone Is in a Coma?

Someone who is in a coma is unconscious and will not respond to voices, other sounds, or any sort of activity going on nearby. The person is still alive, but the brain is functioning at its lowest stage of alertness. You can't shake and wake up someone who is in a coma like you can someone who has just fallen asleep.

What Can Cause a Coma?

Comas can be caused by different things, including:

* a severe injury to the head that hurts the brain
* seizures
* infections involving the brain
* brain damage caused by a lack of oxygen for too long
* an overdose (taking too much) of medicine or other drugs
* a stroke

When one of these things happens, it can mess up how the brain's cells work. This can hurt the parts of the brain that make someone conscious, and if those parts stop working, the person will stay unconscious.

How Do People Take Care of Someone in a Coma?

Someone in a coma usually needs to be cared for in the intensive care unit (ICU) of the hospital. There, the person can get extra care and attention from doctors, nurses, and other hospital staff. They make sure the person gets fluids, nutrients, and any medicines needed to keep the body as healthy as possible. These are sometimes given through a tiny plastic tube inserted in a vein or through a feeding tube that brings fluids and nutrients directly to the stomach.

Some comatose people are unable to breathe on their own and need the help of a ventilator (say: ven-tih-lay-ter), a machine that pumps air into the lungs through a tube placed in the windpipe. The hospital staff also tries to prevent bedsores in someone who is comatose. Bedsores are open sores on the body that come from lying in one place for too long without moving at all.

It can be very upsetting and frustrating for a person's family to see someone they love in a coma, and they may feel scared and helpless. But they can help take care of the person. Taking time to visit the hospital and read to, talk to, and even play music for the patient are important because it's possible that the person may be able to hear what's going on, even if he or she can't respond.

What Happens After a Coma?

Usually, a coma does not last more than a few weeks. Sometimes, however, a person stays in a coma for a long time — even years — and will be able to do very little except breathe on his or her own.

Most people do come out of comas, however. Some of them are able to return to the normal lives they had before they got sick. On TV, someone in a coma usually wakes up right away, looks around, and is able to think and talk normally. But in real life, this rarely happens. When coming out of a coma, a person will often be confused and can only slowly respond to what's going on. It will take time for the person to start feeling better.

Whether someone fully returns to normal after being in a coma depends on what caused the coma and how badly the brain may have been hurt. Sometimes people who come out of comas are just as they were before — they can remember what happened to them before the coma and can do everything they used to do. Other people may need therapy to relearn basic things like tying their shoes, eating with a fork or spoon, or learning to walk all over again. They may also have problems with speaking or remembering things.

Over time and with the help of therapists, however, many people who have been in a coma can make a lot of progress. They may not be exactly like they were before the coma, but they can do a lot of things and enjoy life with their family and friends.

Reviewed by: Steven Dowshen, MD
Originally reviewed by: Marcy E. Yonker, MD

A KIDS GUIDE TO FEVER

2009-03-27T17:35:00.000-07:00

It All Begins in Your Brain

To really understand what a fever is, you need to say hello to the hypothalamus (say: high-po-tha-luh-mus). The hypothalamus is in the center of your brain. Think of it as your body's thermostat — like that thing on the wall in your house that you use to set the heat or the air conditioning. Your hypothalamus knows what temperature your body should be and will send messages to your body to keep it that way.

Most human beings have a body temperature of around 98.6° Fahrenheit (37° Celsius). Some people will have a normal temperature that's a little higher; others will have a normal temperature that's a little lower.

Most people's body temperatures even change a little bit during the course of the day: It is usually a little lower in the morning and a little higher in the evening. For most kids, their body temperature stays pretty much the same from day to day — until germs enter the picture.

The Germs March In

Remember that strep throat that made you feel so rotten? Or another time when the flu made you feel tired and achy? These kinds of infections are caused by germs that make their way into your body, usually in the form of bacteria (say: bak-teer-ee-uh) or viruses.

Once these germs march in and make you sick, they can sometimes cause certain chemicals to flow into your blood. When your hypothalamus gets word that these chemicals are on the scene, it automatically sets your body's thermostat higher. Instead of saying your body should be 98.6° Fahrenheit (37° Celsius), your body's thermostat might say that it should be 102° Fahrenheit (38.9° Celsius).

Why does the hypothalamus tell your body to change to a new temperature? Researchers believe turning up the heat is the body's way of fighting the germs and making your body a less comfortable place for them. A fever is also a good signal to you, your parents, and your doctor that you are sick. Without fever, it would be much more difficult to tell if a person had an infection and how severe it was. That's why grown-ups are concerned when you have a fever.

Shiver, Then Sweat

Once your hypothalamus sets a new temperature for your body, your body takes action and starts to heat up. When a fever starts, your body tries to get hotter and you may shiver without thinking about it to create more heat. You may feel very cold even though the room isn't cold and even though you have your pajamas or nightgown on and lots of blankets around you.

If your body reaches the new temperature that's been set by the hypothalamus — say 102° Fahrenheit (38.9° Celsius) — you won't feel cold anymore. According to your hypothalamus, your temperature is where it should be!

After the cause of the fever disappears, your hypothalamus will set everything back to a normal temperature. When your strep throat medicine starts to work, for instance, your body will begin to cool down and you'll no longer have the chills. You'll begin to feel warm and will need to get rid of the extra heat that's been in your body. You may sweat and decide to change into some lighter-weight pajamas.

Fighting a Fever

For almost all kids, fevers aren't a big problem. Once the cause of the fever is treated or goes away on its own, your body temperature comes back down to normal and you feel like your old self again. Most doctors say that kids with a fever less than 102° Fahrenheit (38.9° Celsius) don't need to take any special medication unless their fevers are making them uncomfortable.

It's a different story for newborns and very young infants, though. They should be evaluated by a doctor for any fever that reaches 100.4° Fahrenheit (38° Celsius) or higher.

If a kid has a higher fever, the doctor usually will tell a parent to give the child medicine. The two medicines most often recommended are acetaminophen (say: uh-see-tuh-mih-nuh-fen) or ibuprofen (say: eye-byoo-pro-fen). The medicine blocks the chemicals that tell the hypothalamus to turn up the heat. Kids should never take aspirin to treat a fever because it can cause a rare but serious illness.

If you have a fever, your mom or dad will probably ask you to drink fluids. That's important because as your body heats up, it's easy for it to get dehydrated (say: dee-hi-drayt-ed), which means there isn't enough water in your body. You have a lot of choices when it comes to fluids — juice, water, sports drinks, soup, flavored gelatin, and even ice pops. Before you know it, your mom or dad will pull the thermometer out of your mouth and say, "Your temperature is normal. No more fever!"

Reviewed by: Mary L. Gavin, MD

MENINGITIS

2009-03-27T17:25:00.000-07:00

What Is Meningitis?

The central nervous system (brain and spinal cord) is surrounded by cerebrospinal (say: suh-ree-bro-spy-nul) fluid. This fluid acts to cushion and protect the central nervous system when you move around. Even more protection is given by the meninges (say: muh-nin-jeez), which are the membranes that cover the brain and spinal cord.

Meningitis (say: men-un-jye-tus) is a disease involving inflammation (swelling), or irritation, of the meninges. There are different kinds of meningitis, but most of the time it is caused by germs, especially viruses.

Meningitis gets attention because it not only makes a person feel sick, it can have lasting effects on a person's ability to think and learn. It also can cause hearing loss. But many people recover from the infection without permanent damage. And the illness is so rare, you may never know anyone who gets it.

How Does Someone Get Meningitis?

The body has natural defenses against infections — and usually even if someone comes across a virus or bacteria that can cause meningitis, the body can fight it off. Everyone has lots of germs living on and in their bodies. Most of the time, these germs don't cause any illness. In fact, some of them, like some of the bacteria normally found in the intestines, help the body to work properly. However, some germs do cause infections.

If a person gets an infection, the body's immune system will go to work to fight it. That's why you might feel sick one day, but then you start to feel better. The immune system is doing its job.

Some germs, however, are tricky. They can outsmart the body's defenses and spread inside of the body. Some of these germs can even invade the central nervous system, infecting the meninges and causing meningitis.

Bacteria and Viruses

Many viruses can cause viral meningitis. They include a family of viruses known as enteroviruses (say: en-teh-row-vye-rus-ez). Like most viruses, enteroviruses infect your body through saliva (spit), feces (poop), and nasal discharge (snot). This is why washing your hands after you go to the bathroom, after you sneeze, and before you eat is so important.

It's also possible to get viral meningitis as a complication of chickenpox, but this is also very rare in healthy kids. These days, many kids are vaccinated with two shots to prevent chickenpox before starting school.

Bacterial meningitis is contagious, which means it can be passed to someone else by spit or snot. It can be spread when you sneeze or cough, when you share cups or utensils, or when you kiss someone. Vaccines are given to kids to help protect them from serious diseases like meningitis.

What Are the Symptoms of Meningitis?

Usually, someone with meningitis is very sick. Symptoms may include:

* a very bad headache that won't go away
* neck stiffness
* back stiffness
* eye pain or irritation when exposed to light
* nausea, or being sick to the stomach
* vomiting, or throwing up
* body aches
* fever
* feeling very sleepy or unable to fully wake up
* feeling very confused or out of it

Symptoms of meningitis can come on very quickly or take a couple of days to appear. Anyone who is ill with symptoms of meningitis needs to seek medical care right away.
What Will the Doctor Do?

When someone is ill and may have symptoms of meningitis, a doctor will ask many questions to figure out how long the person has been sick and what may have caused the illness. The doctor will do a complete physical examination and if he or she suspects that meningitis might be causing a person's illness, a spinal tap is usually done.

A spinal tap allows the doctor to collect some of the cerebrospinal fluid that surrounds the brain and spinal cord. During a spinal tap, a person usually lies on his or her side curled into a ball. First, the doctor will numb the skin with medication. (This is done to prevent pain.)

The person needs to lie very still while the doctor inserts a very thin needle into the spinal column. The needle is placed between two vertebral bones in the lower back away from the spinal cord. Fluid is removed and collected in some tubes. Then the needle is removed and the doctor puts a bandage over the area.

After it is collected, the spinal fluid will be examined under a microscope to see if any bacteria, cells, or substances that indicate inflammation or infection are there. Usually by looking at the spinal fluid in this way, a doctor will be able to tell if it seems like someone has meningitis. The fluid will also be sent to a laboratory to be tested for bacteria and sometimes for viruses. Once the doctors know what germ is causing the meningitis, they can choose the best medicine to treat the infection. Treatment depends on the type of meningitis.

Bacterial meningitis is very serious and a person will need to be in the hospital during treatment. Strong antibiotic medicine will be given through an IV (a thin tube that goes into a vein to give medicine) to get rid of the bacteria. Fluids containing glucose (sugar) and minerals may also be given through the IV to help a person recover.

Viral meningitis can also be serious, but usually is not as bad as meningitis caused by bacteria. A person with viral meningitis may still need to be in the hospital for a few days and it may take weeks before he or she is feeling better. Antibiotics do not work against viruses, so a person with viral meningitis will need lots of rest to fight off the infection.

Can Meningitis Be Prevented?

If someone gets bacterial meningitis in your neighborhood or school, doctors will want to know who was in close contact with this person. Close contact means living with or spending a lot of time with the person, or sharing the same utensils or cups. This is important because people who have been in close contact should take antibiotics for a few days, just in case they were infected with the bacteria, too. The medicine can help prevent them from developing meningitis. But that won't prevent sickness if a virus caused the meningitis.

If you've had all your vaccinations, they will help protect you from getting meningitis. But there's another way to prevent those germs from getting inside your body: Wash your hands. Wash up regularly with warm, soapy water — especially before eating, after using the bathroom, and whenever your hands are dirty. It's also smart to cover your mouth and nose when you cough or sneeze. Then — you guessed it — wash your hands!

Reviewed by: Larissa Hirsch, MD
Originally reviewed by: Joel Klein, MD

MEMORY MATTERS

2009-03-27T16:24:00.000-07:00

What Is Memory?

When an event happens, when you learn something, or when you meet someone, your brain determines whether that information needs to be saved. If your brain judges the information important, it places it in your memory "files."

You probably know your brain has different parts. Some of them are important for memory. The hippocampus (say: hih-puh-kam-pus) is one of the more important parts of the brain that processes memories. Old information and new information, or memories, are thought to be processed and stored away in different areas of the cerebral cortex, or the "gray matter" of the brain - the largest, outermost part of the brain.

What Can Go Wrong With Memory?

As wonderful as memory is, it isn't always perfect. It's normal to occasionally forget the name of somebody you just met or where you put your shoes. And of course, everyone has forgotten an answer on a test. Darn! You knew that one, too!

It's also typical for people to forget more things as they grow older. Your parents or grandparents might joke about having a "senior moment." That's when they forget something.

But some memory problems are serious, such as when a person has Alzheimer's disease. Strokes, which also affect older people, are another medical problem that can affect someone's memory. A stroke is when blood doesn’t get to all the parts of the brain, either because there is a blockage in the pathway, or because a blood vessel (which carries the blood) bursts.

Brain Injuries Affect Memory

And, at any age, an injury to the head and brain can cause trouble with a person's memory. Some people who recover from brain injuries need to learn old things all over again, like how to talk or tie their shoes. That's why it's so important to protect your head by wearing your seat belt in the car and wearing a helmet when you skate, play football, ride your bike, skateboard, or wear roller sneakers.

You may have heard about a memory problem called amnesia (say: am-nee-zhuh). This is when someone can't remember things that happened a short time ago. This happens sometimes, but it's not usually like you see on TV or in the movies. People rarely forget their own names and they usually get better slowly, instead of all at once because something dramatic happens - like getting kissed by a dreamy prince or princess!

The most common cause of amnesia is a traumatic brain injury (TBI). A TBI is caused by a severe hit to the head. Traumatic brain injuries can happen in a lot of ways and can be severe enough to cause a coma (prolonged unconsciousness), or a person may just be stunned without even being knocked out (like in some concussions).

Car accidents, bike accidents, and falls can cause TBIs. If you've ever seen someone take a hit to the head in a National Football League game, you may have seen the player being questioned on the sidelines. The doctor may ask the person some basic questions - like what happened, where they are, and what team they're playing. Not knowing the correct answers could be the first sign of a brain inury.

Abusing alcohol or using illegal drugs is another way to injure the brain and cause memory problems. Hallucinogens (like LSD or PCP) can alter certain chemicals in the brain that actually make memories harder to recall.

Signs of a Memory Problem

A person might - or might not - be able to notice signs of his or her own memory problem. If a person has suffered a brain injury, doctors, nurses, and family members will be on the alert for signs of trouble.

If someone has a memory problem, he or she will be unable to remember important things for varying lengths of time. The more severe the injury, the longer the memory loss is likely to last. Some people forget just the moments right before and after the injury, which is not unusual with a concussion. Sometimes, these memories come back. More significant problems with memory may make it hard to remember what happened days, weeks, months, or even years ago, and it can be difficult to learn and remember new things.

What Will the Doctor Do?

Any time a person has been hit in the head, it's important to see a doctor. A doctor will test the person's ability to recall events, names, or places by asking lots of questions. In the case of a brain injury, a doctor may also want to take a picture of the patient's brain and skull using something called a CT scan.

If the person has memory loss from a head injury, the doctor will design a treatment plan to help the brain heal and, if necessary, to help the person relearn things that have been forgotten. If the memory problem is due to a person using drugs or alcohol, the person needs to stop abusing these substances before his or her memory will improve.

With strokes, memory can return but it depends on severity and location of the stroke in the brain. With Alzheimer's, lost memory cannot be restored, but scientists are working on medicines they hope someday will prevent this kind of memory loss.

Most memory problems affect older people, so what can you do for your memory if you're 8, not 88? In addition to remembering to wear your helmet, use your brain! By doing challenging activities, like reading and doing puzzles, you can exercise your mind so you'll be remembering great memories for many years to come!

By : Larissa Hirsch, MD

BONE 3

2009-03-27T16:18:00.000-07:00

Your Joints

The place where two bones meet is called a joint. Some joints move and others don't.

Fixed joints are fixed in place and don't move at all. Your skull has some of these joints (called sutures, remember?), which close up the bones of the skull in a young person's head. One of these joints is called the parieto-temporal (say: par-eye-ih-toh tem-puh-rul) suture — it's the one that runs along the side of the skull.

Moving joints are the ones that let you ride your bike, eat cereal, and play a video game — the ones that allow you to twist, bend, and move different parts of your body. Some moving joints, like the ones in your spine, move only a little. Other joints move a lot. One of the main types of moving joints is called a hinge joint. Your elbows and knees each have hinge joints, which let you bend and then straighten your arms and legs. These joints are like the hinges on a door. Just as most doors can only open one way, you can only bend your arms and legs in one direction. You also have many smaller hinge joints in your fingers and toes.

Another important type of moving joint is the ball and socket joint. You can find these joints at your shoulders and hips. They are made up of the round end of one bone fitting into a small cup-like area of another bone. Ball and socket joints allow for lots of movement in every direction. Make sure you've got lots of room, and try swinging your arms all over the place.

Have you ever seen someone put oil on a hinge to make it work easier or stop squeaking? Well, your joints come with their own special fluid called synovial fluid (say: si-no-vee-ul) that helps them move freely. Bones are held together at the joints by ligaments (say: lih-guh-mints), which are like very strong rubber bands.

Taking Care of Bones

Your bones help you out every day so make sure you take care of them. Here are some tips:

Protect those skull bones (and your brain inside!) by wearing a helmet for bike riding and other sports. When you use a skateboard, in-line skates, or a scooter, be sure to add wrist supports and elbow and knee pads. Your bones in these places will thank you if you have a fall!

If you play sports like football, soccer, lacrosse, or ice hockey, always wear all the right equipment.
Never play on a trampoline. Many kids end up with broken bones from jumping on them. Broken bones can eventually heal, but it takes a long time and isn't much fun while you wait.

Strengthen your skeleton by drinking milk and eating other dairy products (like low-fat cheese or frozen yogurt). They all contain calcium, which helps bones harden and become strong.

Be active! Another way to strengthen your bones is through exercise like running, jumping, dancing, and playing sports.

Take these steps to be good to your bones, and they will treat you right!

Reviewed by: Elana Pearl Ben-Joseph, MD

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BONE 2

2009-03-27T16:11:00.000-07:00

Your Ribs

Your heart, lungs, and liver are all very important, and luckily you've got ribs to keep them safe. Ribs act like a cage of bones around your chest. It's easy to feel the bottom of this cage by running your fingers along the sides and front of your body, a few inches below your heart. If you breathe in deeply, you can easily feel your ribs right in the front of your body, too. Some thin kids can even see a few of their ribs right through their skin.

Your ribs come in pairs, and the left and right sides of each pair are exactly the same. Most people have 12 pairs of ribs, but some people are born with one or more extra ribs, and some people might have one pair less.

All 12 pairs of ribs attach in the back to the spine, where they are held in place by the thoracic vertebrae. The first seven pairs of ribs attach in the front to the sternum (say: stur-num), a strong bone in the center of your chest that holds those ribs in place. The remaining sets of ribs don't attach to the sternum directly. The next three pairs are held on with cartilage to the ribs above them.

The very last two sets of ribs are called floating ribs because they aren't connected to the sternum or the ribs above them. But don't worry, these ribs can't ever float away. Like the rest of the ribs, they are securely attached to the spine in the back.

Your Skull

Your skull protects the most important part of all, the brain. You can feel your skull by pushing on your head, especially in the back a few inches above your neck. The skull is actually made up of different bones. Some of these bones protect your brain, whereas others make up the structure of your face. If you touch beneath your eyes, you can feel the ridge of the bone that forms the hole where your eye sits.

And although you can't see it, the smallest bone in your whole body is in your head, too. The stirrup bone behind your eardrum is only .1 to .13 inches (2.5 to 3.3 millimeters) long! Want to know something else? Your lower jawbone is the only bone in your head you can move. It opens and closes to let you talk and chew food.

Your skull is pretty cool, but it's changed since you were a baby. All babies are born with spaces between the bones in their skulls. This allows the bones to move, close up, and even overlap as the baby goes through the birth canal. As the baby grows, the space between the bones slowly closes up and disappears, and special joints called sutures (say: soo-churs) connect the bones.

Your Hands

As you sit and type at the keyboard, while you swing on a swing, even when you pick up your lunch, you're using the bones in your fingers, hand, wrist, and arm.

Each arm is attached to a shoulder blade or scapula (say: sca-pyuh-luh), a large triangular bone on the upper back corner of each side of the rib cage. The arm is made up of three bones: the humerus (say: hyoo-muh-rus), which is above your elbow, and the radius (say: ray-dee-us) and ulna (say: ul-nuh), which are below the elbow.

Each of these bones is wider at the ends and skinnier in the middle, to help give it strength where it meets another bone. At the end of the radius and ulna are eight smaller bones that make up your wrist. Although these bones are small, they can really move! Twist your wrist around or wave and you'll see how the wrist can move.

The center part of your hand is made up of five separate bones. Each finger on your hand has three bones, except for your thumb, which has two. So between your wrists, hands, and all your fingers, you've got a grand total of 54 bones — all ready to help you grasp things, write your name, pick up the phone, or throw a softball!

Your Legs

Sure, your arm, wrist, hand, and finger bones are great for picking up the phone, but how are you supposed to run to answer it? Well, with the bones of the legs and feet!

Your legs are attached to a circular group of bones called your pelvis. The pelvis is a bowl-shaped structure that supports the spine. It is made up of the two large hip bones in front, and behind are the sacrum and the coccyx. The pelvis acts as a tough ring of protection around parts of the digestive system, parts of the urinary system, and parts of the reproductive system.

Your leg bones are very large and strong to help support the weight of your body. The bone that goes from your pelvis to your knee is called the femur (say: fee-mur), and it's the longest bone in your body. At the knee, there's a triangular-shaped bone called the patella (say: puh-tel-luh), or kneecap, that protects the knee joint. Below the knee are two other leg bones: the tibia (say: tih-bee-uh) and the fibula (say: fih-byuh-luh). Just like the three bones in the arm, the three bones in the leg are wider at the ends than in the middle to give them strength.

The ankle is a bit different from the wrist; it is where the lower leg bones connect to a large bone in the foot called the talus (say: tal-iss). Next to the talus are six other bones. But the main part of the foot is similar to the hand, with five bones. Each toe has three tiny bones, except for your big toe, which has just two. This brings the bone total in both feet and ankles to 52!

Most people don't use their toes and feet for grabbing stuff or writing, but they do use them for two very important things: standing and walking. Without all the bones of the foot working together, it would be impossible to balance properly. The bones in the feet are arranged so the foot is almost flat and a bit wide, to help you stay upright. So the next time you're walking, be sure to look down and thank those toes!

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BONE 1

2009-03-27T16:03:00.000-07:00

What Are Bones Made Of?

If you've ever seen a real skeleton or fossil in a museum, you might think that all bones are dead. Although bones in museums are dry, hard, or crumbly, the bones in your body are different. The bones that make up your skeleton are all very much alive, growing and changing all the time like other parts of your body.

Almost every bone in your body is made of the same materials:

The outer surface of bone is called the periosteum (say: pare-ee-os-tee-um). It's a thin, dense membrane that contains nerves and blood vessels that nourish the bone.

The next layer is made up of compact bone. This part is smooth and very hard. It's the part you see when you look at a skeleton.

Within the compact bone are many layers of cancellous (say: kan-sell-us) bone, which looks a bit like a sponge. Cancellous bone is not quite as hard as compact bone, but it is still very strong.

In many bones, the cancellous bone protects the innermost part of the bone, the bone marrow (say: mair-oh). Bone marrow is sort of like a thick jelly, and its job is to make blood cells.

How Bones Grow

When you were a baby, you had tiny hands, tiny feet, and tiny everything! Slowly, as you grew older, everything became a bit bigger, including your bones.

A baby's body has about 300 bones at birth. These eventually fuse (grow together) to form the 206 bones that adults have. Some of a baby's bones are made entirely of a special material called cartilage (say: kar-tel-ij). Other bones in a baby are partly made of cartilage. This cartilage is soft and flexible. During childhood, as you are growing, the cartilage grows and is slowly replaced by bone, with help from calcium.

By the time you are about 25, this process will be complete. After this happens, there can be no more growth — the bones are as big as they will ever be. All of these bones make up a skeleton that is both very strong and very light.

Your Spine

Your spine is one part of the skeleton that's easy to check out: Reach around to the center of your back and you'll feel its bumps under your fingers.

The spine lets you twist and bend, and it holds your body upright. It also protects the spinal cord, a large bundle of nerves that sends information from your brain to the rest of your body. The spine is special because it isn't made of one or even two bones: It's made of 26 bones in all! These bones are called vertebrae (say: ver-tuh-bray) and each one is shaped like a ring.

There are different types of vertebrae in the spine and each does a different kind of job:

The first seven vertebrae at the top are called the cervical (say: sir-vih-kul) vertebrae. These bones are in the back of your neck, just below your brain, and they support your head and neck. Your head is pretty heavy, so it's lucky to have help from the cervical vertebrae!

Below the cervical vertebrae are the thoracic (say: thuh-ras-ick) vertebrae, and there are 12 in all. These guys anchor your ribs in place. Below the thoracic vertebrae are five lumbar (say: lum-bar) vertebrae. Beneath the lumbar vertebrae is the sacrum (say: say-krum), which is made up of five vertebrae that are fused together to form one single bone.

Finally, all the way at the bottom of the spine is the coccyx (say: cok-siks), which is one bone made of four fused vertebrae. The bottom sections of the spine are important when it comes to bearing weight and giving you a good center of gravity. So when you pick up a heavy backpack, the lumbar vertebrae, sacrum, and coccyx give you the power. When you dance, skip, and even walk, these parts help keep you balanced.

In between each vertebra (the name for just one of the vertebrae) are small disks made of cartilage. These disks keep the vertebrae from rubbing against one another, and they also act as your spine's natural shock absorbers. When you jump in the air, or twist while slamming a dunk, the disks give your vertebrae the cushioning they need.

KIDS PROBLEMS BODY PARTS

2009-03-27T15:47:00.000-07:00

Sometimes, kids have problems with these important body parts. Their legs and feet might look different or might not work exactly the way they should. The good news is that these problems usually aren't serious. They either go away on their own or the kid learns to handle them by using stuff like special shoe inserts.

Pigeon Toes

Pigeon toes, or inwardly turning toes, is a common foot condition in kids. It occurs when the front of the foot is turned inward, facing the other foot. Boys and girls both experience pigeon toes. Most kids' feet straighten naturally without any medical treatment.

Bowlegs

When someone stands with the feet and ankles together but the knees widely apart, we call that being bowlegged. Many babies are born bowlegged because their legs were folded tightly across their bellies while they were growing inside their mom. Bowlegs usually straighten once babies with this condition start to walk and their legs bear weight. By age 3, most kids grow out of the condition.

Knock-Knees

Knock-knees is a condition where the legs curve in at the knees so much that the ankles are separated. Lots of kids become knock-kneed between the ages of 3 and 5. But around age 6, the body begins to straighten naturally, and within a few years most kids can stand with their knees and ankles touching at the same time.

Flatfeet

Stand sideways in front of a mirror. Rise up on your toes. Can you see the arch (curve) in the bottom your feet? Most of us have some sort of arch on the bottom of the feet between our toes and heel. Someone who doesn't have this curve might have flexible flatfeet. That means more of the person's foot surface is in contact with the ground. In a typical foot, the arch part wouldn't touch the ground.

Most babies are born with almost no arch in their feet. Within 2 to 3 years, after kids have been walking for a while, the arch develops. Wearing the right kind of shoes — ones that are flexible, not stiff — helps kids' feet develop the way they should.

About 1 in 7 kids never develop a full arch. Very rarely, this requires surgery. Some kids might wear arch supports if their feet hurt. But most of the time, flatfeet don't cause pain or problems. In other words, if your feet are flat, they're fine!

Reviewed by: Peter G. Gabos, MD
Originally reviewed by: Richard J. Bowen, MD

ANEMIA

2009-03-26T20:49:00.000-07:00

What Is Anemia?

Anemia occurs when a person doesn't have the normal amount of red blood cells or if the person is low on hemoglobin (say: hee-muh-glow-bin). Hemoglobin, a protein, is an important part of RBCs because it gives the oxygen something to stick to.

A kid who has anemia may not know it because he or she may not have any symptoms. Looking pale can be a sign of anemia because there is less blood flowing through the blood vessels in the skin. A fast heartbeat can be another sign of anemia, because when you don't have as many RBCs, the heart has to work harder to get the same amount of blood and oxygen to the body. If anemia worsens, a kid who was once very active may become worn out quickly. He or she may feel weak or tired.

Why Do Kids Get Anemia?

The bone marrow in a person's body makes new red blood cells to replace the old ones that die off after about 120 days.

A person may get anemia if:

not enough RBCs are made
too many RBCs are destroyed
too many RBCs are lost (bleeding)

Not enough being made: There are several reasons why a person might not make enough red blood cells, but often it's because the person isn't getting enough iron. Iron is a nutrient found in meat, dried beans, and green leafy vegetables. Without iron, the body can't make hemoglobin, the oxygen-carrying part of a red blood cell.

Besides iron, your body needs the vitamins B12 and folic acid to make RBCs. You get these vitamins in the foods you eat. Vitamin B12 is found in animal products, so vegetarians who don't eat meat, eggs, or dairy products have to look for other ways to get enough of this important vitamin. Folic acid is found in a variety of foods, such as citrus fruits, green vegetables, and fortified cereals.

Anemia also can develop if the bone marrow is not working properly. This may be because of an infection or a chronic illness, such as arthritis or kidney disease. In rare cases, someone might be born without the ability to make enough red blood cells. Certain medications like chemotherapy for cancer can keep the bone marrow from being able to make enough RBCs.

Too many being destroyed: If the life of a red blood cell is cut short for any reason, the bone marrow may not be able to keep up with the increased demand for new ones. One reason RBCs get destroyed is because their shape changes. If you looked at them through a microscope, you would see that they are round and flattened. That's a good shape for moving through tight spaces as blood circulates around the body.

If the shape changes, as is the case in sickle cell anemia, the red blood cells get stuck and break. Sickle cells are curved like crescent moons. This shape makes it hard for them to move throughout the body. Sickle cell anemia is one of several genetic conditions that can shorten the life span of RBCs. Certain medications, infections, and chronic diseases also may cause this type of anemia.

Too much lost: When you lose a little blood, like when you cut yourself or have a nosebleed, your bone marrow is able to make more blood so you don't develop anemia. But if you lose a lot of blood, which may happen in a serious accident, your bone marrow may not be able to replace the red blood cells quickly enough.

If someone loses a little blood over a long period of time, it can also lead to anemia by losing more iron in the lost blood than is taken into the body by food you eat. Without enough iron in the body, the bone marrow can't make enough RBCs. This can happen in girls who have heavy menstrual periods, especially if they don't get enough iron in their diets, or in people who have inflammatory bowel disease (IBD).

What Do Doctors Do?

When you see the doctor, he or she will examine you and ask questions about how you have been feeling, what you eat, and if you are taking any medicines. If a doctor thinks a kid has anemia, he or she can order a simple blood test called a hematocrit (say: hih-mah-tuh-krit).

The blood sample then can be studied in the laboratory where the number of RBCs can be counted, the amount of hemoglobin can be measured, and the size and shape of the cells can be examined. A doctor may order additional tests, depending on what he or she suspects is the problem.

How Is Anemia Treated?

The treatment of anemia depends on the cause. In kids, the most common cause of anemia is not getting enough iron in their diets. Some kids may need to take medicine containing iron to help their bodies make more red blood cells. It is also important to eat more foods that are rich in iron, like meat, enriched grains and cereals, dried beans, and tofu.

If the anemia is caused by an infection, usually the anemia will go away when the infection is treated and the body gets healthy again. For some other types of anemia, the kid may need to see a specialist and have additional tests before treatment can start.

Whatever the cause, someone with severe anemia may need a blood transfusion. A transfusion means that donated blood, which is stored at a place called a blood bank, is given through tube in a vein. This may sound a little scary, but millions of kids and adults have blood transfusions every year. Except for inserting the tube, they don't hurt. And getting a blood transfusion is the fastest way to get blood to deliver oxygen to all the cells in the body.

Kids who have anemia may have to take it easy for a while. But once their bodies start making enough red blood cells, oxygen can reach all their tissues again, and they'll get some of that kid energy back!

Reviewed by: Christopher N.Frantz, MD

EPILEPSY

2009-03-26T20:43:00.000-07:00

What Is Epilepsy?

It's a strange word, isn't it? Epilepsy comes from a Greek word meaning "to hold or seize," and people who have epilepsy have seizures. You might also hear a seizure called a convulsion, fit, or spell.

Seizures happen when there is unusual electrical activity in the brain. Your brain cells are constantly sending out electrical signals that travel along nerves to the rest of the body.

These signals tell the muscles to move. During a seizure, a person's muscles tighten and relax rapidly or stop moving completely. Seizures come on suddenly, and people who have them cannot control their muscles while they are having a seizure. If too many brain cells are sending signals at the same time, it causes an overload and a person may pass out and shake all over. People who have epilepsy may have seizures only once in a while or as frequently as every day.

What's a Seizure?

Most seizures occur without warning, although some people have a funny feeling, an upset stomach, or a weird smell or taste right before a seizure. This is called an aura. Others find that certain things may bring on a seizure, like not getting enough sleep or playing video games.

Even though a seizure may look scary, it's not painful. During a seizure, the person may fall down, shake, stiffen, throw up, drool, urinate (pee), or lose control of their bowels. Other seizures are less dramatic. The person may just stare into space or have jerking movements in one part of the body. When the seizure is over, the person may feel sleepy and won't remember what happened.

Who Has Epilepsy?

About 2 million Americans have epilepsy, including boys and girls and people of all races and ages. Seizures can start at any age, but often they begin before age 15 or after age 65. Doctors often cannot explain why a person has epilepsy. They do know that epilepsy is not contagious - you can't catch it from somebody. Epilepsy is not passed down through families (inherited) in the same way that blue eyes or brown hair are. But if somebody's mom or dad or brother or sister has epilepsy, then he or she has a slightly higher risk for epilepsy than somebody whose family has no history of seizures.

How Can Doctors Help?

If a person has a seizure, doctors may do some tests, such as a CAT scan, an MRI, or an electroencephalogram (EEG). A CAT scan or MRI help a doctor look at a person's brain and an EEG records brain waves. Don't worry - these tests don't hurt at all. Blood tests may also be done.

All of these tests can help doctors try to find out what caused the seizure and if a person might have more seizures. But sometimes seizures are a one-time thing for a kid. Half of the kids who have one seizure never have another one.

For people who are diagnosed with epilepsy, most of them can control their seizures by taking medicines. As they get older, many kids with epilepsy get better and can stop taking medicine. For some kids, it may be difficult to get the seizures under control. A special diet or surgery may be needed.

Are Kids With Epilepsy Different?

People who have epilepsy may need to be careful in places where they could get hurt if they have a seizure, like a high place or in the bathtub. And they may not be able to do certain sports, such as boxing or scuba diving.

But other than that, people with epilepsy can live normal lives and do what everyone else does. They can go to school, attend college, and get jobs. They can get married and have children. Epilepsy does not limit a person's ability, but it may make a person feel different. So, if you know someone who has it, you can help a lot by just being a good friend.

Reviewed by:Steven Dowshen,MD
Originally reviewed: Michael Goodman,MD

AUTISM

2009-03-26T20:30:00.000-07:00

What Does Autism Mean?

Autism (say: aw-tih-zum) causes kids to experience the world differently from the way most other kids do. It's hard for kids with autism to talk with other people and express themselves using words. Kids who have autism usually keep to themselves and many can't communicate without special help.

They also may react to what's going on around them in unusual ways. Normal sounds may really bother someone with autism — so much so that the person covers his or her ears. Being touched, even in a gentle way, may feel uncomfortable.

Kids with autism often can't make connections that other kids make easily. For example, when someone smiles, you know the smiling person is happy or being friendly. But a kid with autism may have trouble connecting that smile with the person's happy feelings.

A kid who has autism also has trouble linking words to their meanings. Imagine trying to understand what your mom is saying if you didn't know what her words really mean. It is doubly frustrating then if a kid can't come up with the right words to express his or her own thoughts.

Autism causes kids to act in unusual ways. They might flap their hands, say certain words over and over, have temper tantrums, or play only with one particular toy. Most kids with autism don't like changes in routines. They like to stay on a schedule that is always the same. They also may insist that their toys or other objects be arranged a certain way and get upset if these items are moved or disturbed.

If someone has autism, his or her brain has trouble with an important job: making sense of the world. Every day, your brain interprets the sights, sounds, smells, and other sensations that you experience. If your brain couldn't help you understand these things, you would have trouble functioning, talking, going to school, and doing other everyday stuff. Kids can be mildly affected by autism, so that they only have a little trouble in life, or they can be very affected, so that they need a lot of help.

What Causes Autism?

Autism affects about 1 in every 150 kids, but no one knows what causes it. Some scientists think that some kids might be more likely to get autism because it or similar disorders run in their families. Knowing the exact cause of autism is hard because the human brain is very complicated.

The brain contains over 100 billion nerve cells called neurons (say: nur-ahns). Each neuron may have hundreds or thousands of connections that carry messages to other nerve cells in the brain and body. The connections and the chemical messengers they send (called neurotransmitters) let the neurons that help you see, feel, move, remember, and work together as they should.

For some reason, some of the cells and connections in the brain of a kid with autism — especially those that affect communication, emotions, and senses — don't develop properly or get damaged. Scientists are still trying to understand how and why this happens.

What Do Doctors Do?

Figuring out if a kid has autism can be difficult. A parent is usually the first to suspect that something is wrong. Maybe the kid is old enough to speak but doesn't, doesn't seem interested in people, or behaves in other unusual ways. But autism isn't the only problem that can cause these kinds of symptoms. For example, kids who have hearing problems might have trouble speaking, too.

Usually, the results of lab tests and other medical tests are normal in kids with autism, but doctors may do them to make sure the kid doesn't have other problems. These medical tests can include blood and urine tests, a hearing exam, an EEG (a test to measure brain waves), and an MRI (a picture that shows the structure of the brain). Intelligence (IQ) tests also might be done.

Often, specialists work together as a team to figure out what is wrong. The team might include a pediatrician, a pediatric neurologist, a pediatric developmentalist, a child psychiatrist, a child psychologist, speech and language therapists, and others. The team members study how the child plays, learns, communicates, and behaves. The team listens carefully to what parents have noticed, too. Using the information they've gathered, doctors can decide whether a child has autism or another problem.

How Is Autism Treated?

There is no cure for autism, but doctors, therapists , and special teachers can help kids with autism overcome or adjust to many difficulties. The earlier a kid starts treatment for autism, the better.

Different kids need different kinds of help, but learning how to communicate is always an important first step. Spoken language can be hard for kids with autism to learn. Most understand words better by seeing them, so therapists teach them how to communicate by pointing or using pictures or sign language. That makes learning other things easier, and eventually, many kids with autism learn to talk.

Therapists also help kids learn social skills, such as how to greet people, wait for a turn, and follow directions. Some kids need special help with living skills (like brushing teeth or making a bed). Others have trouble sitting still or controlling their tempers and need therapy to help them control their behavior. Some kids take medications to help their moods and behavior, but there's no medicine that will make a kid's autism go away.

Students with mild autism sometimes can go to regular school. But most kids with autism need calmer, more orderly surroundings. They also need teachers trained to understand the problems they have with communicating and learning. They may learn at home or in special classes at public or private schools.

Living With Autism

Some kids with mild autism will grow up and be able to live on their own. Those with more serious problems will always need some kind of help. But all kids with autism have brighter futures when they have the support and understanding of doctors, teachers, caregivers, parents, brothers, sisters, and friends.

Reviewed by: Steven Dowshen, MD
Originally reviewed by: Wendelin A.Burdo-Hartman.MD