Showing posts with label Remedies. Show all posts
Showing posts with label Remedies. Show all posts

An Artificial Heart

Researchers’ Quest for an Artificial Heart

By Alex O’Brien | June 2, 2015 12:47 pm



The need to mend broken hearts has never been greater. In the USA alone, around 610,000 people die of heart disease each year. A significant number of those deaths could potentially have been prevented with a heart transplant but, unfortunately, there are simply too few hearts available.

In 1967 the South African surgeon Christiaan Barnard performed the world’s first human heart transplant in Cape Town. It seemed like a starting gun had gone off; soon doctors all around the world were transplanting hearts.

The problem was that every single recipient died within a year of the operation. The patients’ immune systems were rejecting the foreign tissue. To overcome this, patients were given drugs to suppress their immune system. But, in a way, these early immunosuppressants were too effective: they weakened the immune system so much that the patients would eventually die of an infection. It seemed like medicine was back to square one.


Early Mechanisms

One solution that researchers have pursued since the late 1960s is an artificial heart. Perhaps the most influential device was kick-started by Willem Kolff, the physician-inventor who produced the first kidney dialysis machine. Kolff invited a fellow medical engineer, one Robert Jarvik, to work with him at the University of Utah, and the result was the Jarvik-7. Made up of two pumps, two air hoses and four valves, the Jarvik-7 was more than twice as big as a normal human heart and could only be implanted in the biggest patients – mainly adult men. It had wheels, was as big and heavy (although not as tall) as a standard household refrigerator, and was normally connected to sources of compressed air, vacuum and electricity.

In 1982, Jarvik and Kolff won approval from the US Food and Drug Administration to use it in human patients and implanted it that same year. Their first patient was a 61-year-old dentist called Barney Clark, who lived on the Jarvik-7 for 112 days. A second patient was implanted in 1984 and died after 620 days. History records a total of five patients implanted with the Jarvik-7 for permanent use, all of whom died within 18 months of the surgery from infections or strokes.

The device has been tweaked and renamed many times; at the time of writing, it was the world’s only FDA-approved total-replacement artificial heart device used as a bridge-to-transplant for patients. Another widely used artificial heart, a direct descendent of the Jarvik-7, is the SynCardia. And in the early 2000s, Massachusetts-based company Abiomed unveiled a new heart that (unlike the SynCardia) was designed to be permanent – a total replacement heart for end-stage heart failure patients who were not candidates for transplant and couldn’t be helped by any other available treatment.

But all these versions of artificial heart devices, whether they are meant to support the heart or replace it completely, are trying to copy the functions of the heart, mimicking the natural blood flow. The result is what’s called a pulsatile pump, the flow of blood going into the body like a native heart, at the average of 80 spurts a minute needed to sustain life. That’s the cause of the gentle movement you feel when you put your fingers to your wrist or your chest – your pulse, which corresponds with the beating of your heart.

Today, scientists are working on a new wave of artificial hearts with one crucial difference: they don’t beat.
Pulseless Hearts

The Archimedes’ screw was an ancient apparatus used to raise water against gravity. Essentially, it is a screw in a hollow pipe; by placing the lower end in water and turning it, water is raised to the top. In 1976, during voluntary medical mission work in Egypt, cardiologist Dr. Richard K. Wampler saw men using one such device to pump water up a river bank. He was inspired. Perhaps, he thought, this principle could be applied to pumping blood.

The result was the Hemopump, a device as big as a pencil eraser. When the screw inside the pump spun, blood was pumped from the heart to the rest of the body. It was the world’s first ‘continuous flow’ pump: Rapidly spinning turbines create a flow like water running through a garden hose, meaning the blood flow is continuous from moment to moment.

Because of this, there is no ejection of the blood in spurts. There is no ‘heartbeat’. The patient’s own heart is still beating but the continuous flow from the device masks their pulse, meaning it is often undetectable at the wrist or neck.

And the Hemopump lives on in spirit of newer devices. Abiomed’s newest heart prototype, Impella, uses similar technology boosted by leaps in modern engineering. It has a motor so small it sits inside the device at the end of the catheter, rather than outside of the body. The Impella is the smallest heart pump in use today – it’s not much bigger than a pencil – and as of March 2015 has been approved by the FDA for clinical use, supporting the heart for up to six hours in cardiac surgeries.

Meanwhile, at the Texas Heart Institute, the HeartMate II is being developed. Like the Hemopump, it doesn’t replace the heart but rather works like a pair of crutches for it. About the size and weight of a small avocado, the HeartMate II is suitable for a wider range of patients than the SynCardia and has, on paper, a significantly longer lifespan – up to ten years. Since its FDA approval in January 2010, close to 20,000 people – including former US Vice President Dick Cheney – have received a HeartMate II, 20 of whom have been living with the device for more than eight years. All with an almost undetectable pulse.
The Future of Heart Transplants

I try to imagine a world full of people with no pulse. How, in such a future, would we determine if a person were alive or dead? “That is very easy,” says William (Billy) Cohn, a surgeon at the Texas Heart Institute, bringing my existential philosophizing to a halt. “When we pinch our thumb and it goes from pink to white and immediately back to pink, this means blood is flowing through the body. You can also tell if someone is still alive if they are still breathing.”

He admits that once more of these devices are implanted into patients we will need a standard method of determining such a person’s vitals. Cohn imagines them wearing bracelets or even having tattoos to alert people to their pulseless state.

I wonder how people will take to hearts that literally don’t beat. Perhaps it will be the same as when patients were offered the first heart transplants: resistance, followed by acceptance due to overwhelming need.

“Any new procedure is going to have critics,” says surgeon Denton Cooley. “On the day that Christiaan Barnard did the first heart transplant, the critics were almost as strong, or stronger, than the proponents of [artificial] heart transplantation,” he says. “A lot of mystery goes with the heart, and its function. But most of the critics, I thought, were ignorant, uninformed or just superstitious.”

Cooley performed the first US heart transplant in May 1968. And at 94 years old he still treasures the memory of the day, in 1969, when he implanted the first artificial heart into Haskell Karp and the “satisfaction that came from seeing that heart supporting that man’s life.”

“I had always thought that the heart has only one function, and that is to pump blood,” he says. “It’s a very simple organ in that regard.”

Image by Ociacia/ Shutterstock

This article originally appeared on Mosaic and appears here in edited form.


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How to Be a Better Spouse

Being nice, paying attention and praising a partner’s strengths all pay off in a long-term relationship


Before you get married, everyone tells you that marriage takes work. I never really believed it until my husband and I landed in therapy after four years, two kids and one seismically stressful cross-country move.





Turns out you really can't just flip the switch to autopilot and trust love to take care of itself; you have to devote actual time and effort to understanding and appreciating your spouse. Anyone who is married knows that's not always a simple feat. Here's what relationship research (and a touch of game theory) tells us about how to become a better spouse.


#1 Be nice as often as you can.


A lot of modern relationship therapy is based on the research of John Gottman, a prolific psychologist famous for videotaping thousands of couples and dissecting their interactions into quantifiable data. One of his most concrete findings was that happier couples had a ratio of five positive interactions to every negative interaction. “That just leapt off the pages of the data analysis,” he says. It was true in very different types of relationships, including those in which the people were very independent and even distant or argumentative. These positive interactions don't have to be grand gestures: “A smile, a head nod, even just grunting to show you're listening to your partner—those are all positive,” Gottman says.


#2 Think about what your partner needs, even when fighting.


To resolve conflicts, Gottman says we can learn from game theory—the study of conflict and decision making used in political science, sociology and economics. It used to be widely accepted that negotiations were mostly zero-sum situations, meaning one party's gain was the other party's loss. In 1950 mathematician John Nash proved there was another, better outcome: a solution in which the parties may have to compromise, but in the end all of them come out satisfied. (This now famous “Nash equilibrium” won him a Nobel Prize in 1994.) I'm reminded of a recent situation in my own marriage—my husband hated the house we bought a couple of years ago and wanted to move to a different neighborhood; I liked the house just fine and didn't want to go anywhere. After much discussion, we realized that what we both really want is to settle in somewhere for the long haul. If the current house is not a place my husband feels he can settle in, then I can't truly settle in either. So we're moving next month, for both our sakes! Find the Nash equilibrium in your conflict, and you'll both get your needs met.


#3 Just notice them.


“People are always making attempts to get their partners' attention and interest,” Gottman says. In his research, he has found that couples who stay happy (at least during the first seven years) pick up on these cues for attention and give it 86 percent of the time.




Pairs who ended up divorced did so 33 percent of the time. “It's the moment we choose to listen to our partner vent about a bad day instead of returning to our television show,” explains Dana R. Baerger, assistant professor of clinical psychiatry and behavioral sciences at the Northwestern University Feinberg School of Medicine. “In any interaction, we have the opportunity to connect with our partner or to turn away. If we consistently turn away, then over time the foundation of the marriage can slowly erode, even in the absence of overt conflict.”


#4 Ignore the bad, praise the good.


Observations of couples at home reveal that people who focus on the negative miss many of the positive things that their partners are doing. Happy spouses, however, ignore the annoyances and focus on the good. “If your wife is irritable one morning, it's not a big deal. It's not going to become a confrontation,” Gottman says. “Then when she does something nice, you notice and comment on that.” Guess what that breeds? More of the good stuff.


It's this lesson that I'm going to try to implement right away. The guy I'm married to leaves dirty shirts balled up on the floor, never loads the dishwasher correctly and can be prickly when he hasn't had enough sleep—but he is an amazing husband. He's honest, shares his feelings, hugs and kisses me, and basically acts like I matter. I want to show him how much he matters, too, and that all the other stupid little stuff doesn't.


This article was originally published with the title "How to Be a Better Spouse."


Feb 12, 2015 |By Sunny Sea Gold                                        Scientific American





Are You Sleeping Correctly



#1 Decreased Performance


If you're not getting enough sleep you may notice that your performance during the day is not what it could and should be. Everything from work to physical activity is a struggle.



#2 Lack Of Alertness

Lack of proper sleep can affect metal alertness, making you foggy and not clear headed.


#3 Memory Impairment

When you sleep your brain reboots ... like a computer hard drive, cleaning out information and filing it. If you don't sleep enough you become overloaded.


#4 Unable To Cope With Stress

Everyday stresses seem to become monumental the less quality sleep you get.





#5 Accident Prone  

Your body is not working to it's full capacity on limited sleep, making you more apt to trip or fall.


#6 More Than One Cold A Year





Your immune system suffers from bad sleep habits making you prone to more colds.


Sleep limits the hormone cortisol which contributes to belly fat, in addition to increased hunger when your body is not well rested.






5 Ways to Treat Body Pain

Several options exist for managing persistent aches, ranging from straightforward lifestyle changes to major surgery.


More than 1.5 billion people around the world suffer from chronic aches and pains. Often these discomforts are felt daily, and their effects can be debilitating.


Unlike the agony associated with a specific injury or illness, chronic pain often persists regardless of any evident damage to the body. The underlying cause can be mysterious—and treatment is therefore challenging. Fortunately several approaches to chronic pain management may bring some relief.


1. Yoga

 The mental and physical discipline of contorting the body into geometric shapes not only limbers ligaments, it may also alleviate painful conditions. Scientists speculate that yoga may physiologically alter the experience of pain—although the mechanism is unknown—and decrease nervous system activity and heart rate.


The Evidence:

 In a controlled study in 2010 of 53 female fibromyalgia patients James Carson, a clinical health psychologist at Oregon Health & Science University, and his collaborators found that those who were randomly assigned to eight weeks of a tailored yoga program ended up with less intense fibromyalgia symptoms than patients who did not practice yoga. They experienced improvements in pain, fatigue and mood and developed positive coping strategies. Other studies have shown that yoga reduces biological markers of inflammation and stress. Carson cautions, however, that not enough research exists to confirm yoga’s benefits in relieving pain.


Image Credit: Thinkstock


2. Cognitive-Behavior Therapy

Scientists have recently recognized cognitive behavioral therapy (CBT)a form of psychotherapy that encourages patients to examine relations among their thoughts, feelings and behaviors—as a pain management tool. “In the last 10 years or so everyone’s been talking about [CBT],” says Karen Davis, a neuroscientist at the Toronto Western Research Institute. Guided therapeutic techniques may cultivate a patient’s sense of control over his or her pain.


The Evidence:

 Psychologist Julia Anna Glombiewski of Philipps University Marburg in Germany and her colleagues performed a meta-analysis of 23 studies of CBT treatments with a total of about 1,400 people in 2010. Glombiewski found CBT to be more effective at reducing fibromyalgia pain than other psychological treatments. “Research has shown that there are very real and strong brain effects that can be achieved using CBT,” says Davis, although she cautions that its effectiveness varies from person to person.
Image credit: Thinkstock


3. Antidepressants

 Antidepressant medications typically are used to treat mood disorders such as depression but research suggests that they may also alleviate nerve pain, headaches, lower back pain and fibromyalgia. In general, most antidepressants affect how chemical messengers, or neurotransmitters, perform in the brain.


The Evidence:

 Not all antidepressants have the same effect on pain. Studies suggest that a class of medications called tricyclic antidepressants may be particularly effective at easing neuropathic pain, which is caused by nerve injuries. In a 2010 review of about 60 randomized controlled trials using 31 types of antidepressants to treat this form of pain oncologist Tiina Saarto of Helsinki University Central Hospital and her collaborator found that both tricyclic antidepressants and venlafaxine, a member of the class of antidepressants called serotonin and norepinephrine reuptake inhibitors (SNRIs), provided at least moderate pain relief in one out of three patients.


Image credit: Thinkstock


4. Deep-Brain Stimulation

 For decades surgeons treated various types of pain by intentionally damaging tissues in specific parts of the brain. In the 1990s a less injurious technique emerged in the form of deep-brain stimulation (DBS). In this approach electrodes are surgically inserted into pain-modulating areas near the middle of the brain. A wire under the skin connects the electrodes to a pacemaker implanted in the chest. The pacemaker sends electrical pulses to the electrodes, which change the way neurons fire in that area.


The Evidence:

 Neuroscientist Sandra Boccard of John Radcliffe Hospital in Oxford, England, and her colleagues found in 2013 that DBS calms a range of pain conditions, including poststroke pain, headache and phantom limb pain. Of 59 patients who had DBS, 66 percent improved, according to quality-of-life surveys and pain questionnaires. The treatment seemed to work best in relieving phantom limb pain. Researchers are currently investigating this technique but the U.S. Food and Drug Administration has not yet approved DBS as a chronic pain treatment.


Image credit: Image provided courtesy of Saint Jude Medical, Inc.


5. Sympathectomy

 The sympathetic nerve chain is a lanky string of nerves that straddle the spine from the base of the skull to the tailbone. When this electrical highway is damaged, it can transmit surges of pain to the rest of the body. A surgeon can interrupt this process surgically or chemically. For example, the doctor can snip clusters of nerve cells to halt their painful transmissions. Sympathectomy was most popular in the 1980s and 1990s, although it is still practiced today.


The Evidence:

Scientists agree that malfunctioning sympathetic nerves contribute to chronic pain but sympathectomy remains controversial. Few scientifically strong studies of the procedure exist and it can have serious complications. Nevertheless, some researchers believe in the intervention’s potential. In one of the stronger studies to date, published in 2008, anaesthesiologist Prashanth Manjunath, now at Bingham Memorial Hospital in Idaho and his colleagues found that those who received a sympathectomy by either injecting an aesthetic into the nerve area or heating tissue with radio waves had a 50 to 75 percent reduction in pain that lasted more than four months.


Credit: Thinkstock


14 Powerful Natural Remedies For A Sinus Infection

14 Powerful Natural Remedies For A Sinus Infection

Treat the Symptoms

Though it is always more important to cure the underlying sickness rather than treat the symptoms, let’s face it: When you have a sinus infection, your number one concern is feeling better.  So before you try to focus on boosting your immune system and removing the causal factors of your sinus infection, let’s work on treating the symptoms.

Stay Hydrated

Drink plenty of water, no sugar added juices, clear broth, and hot tea.  These fluids will help to thin out mucus and help to drain it from irritated sinuses.  Avoid drinking alcohol, caffeine, and sugary beverages, as well as from smoking.  All of these substances will dehydrate your system causing mucus to thicken and clog already inflamed airways.

Dissolve Excess Mucus

Spicy foods such as cayenne pepper or horseradish can be mixed with apple cider vinegar and lemon juice to create a mucus dissolving elixir.

Pressure Point Activation

For temporary relief of closed nasal passages when none of these other options are available to you, try a quick face massage.  These five quick steps take less than two minutes to perform and, when done correctly, will allow you to breath more easily.

Steam Inhalation

Break up thick mucus with a few drops of Eucalyptus or Peppermint oil in hot water.  With your face down over the water, drape a towel over the back of your head and inhale the steam.
This also works with a few drops of either oil added to the water in a humidifier.  Some of these machines actually have a small tank included for just such a thing.

Salt Water Rinse

If you are prone to sinus infections and you don’t have a Neti pot , you’ll want to get one.  This handy little device makes it easy to irrigate your nasal cavity, clearing out unwanted mucus and any inhaled contaminants that may be caught in there.  Use your Neti pot twice a day for optimum relief!

Grapefruit Seed Extract

Grapefruit seed extract (GSE) is a natural antibiotic made from grinding dried grapefruit seeds and pulp into a fine powder.  When administered in nasal spray form (such as this one), GSE helps to clear out mucus and may prevent other microbial contaminants from taking root in weakened and inflamed sinus tissues.

Turmeric / Ginger Root

Turmeric root is a wonderful, fragrant spice commonly found in Indian and some Middle eastern dishes.  Not only does Turmeric contain the natural anti-inflammatory curcumin, this spice is also an anti-oxidant.  When combined with spicy ginger root and brewed for hot tea, this combination can help loosen mucus from clogged nasal passages, alleviate sinus pressure, and make you feel better all around.  Ginger root also has the added bonus of calming an upset stomach – a frequent side-effect of excessive nighttime sinus drainage.

Apple Cider Vinegar

Two or three tablespoons of raw, unfiltered Apple Cider Vinegar added to a cup of hot water or tea taken three times daily will help thin out excessive mucus relieving congestion an sinus pressure.  Mix with lemon and honey or Stevia to taste.
Once you have alleviated some of the pain and congestion, you will want to focus on bolstering your immune system to help your body fight off the infection.

Part II: Boost Your Immune System

There are several natural methods you can use to fortify your immune system.

Vitamin C

Available as caplets, liquid, chewables (as well as some other forms),Vitamin C is perhaps the most popular over-the-counter immune booster.  Studies have shown us that Vitamin C helps the body to resist immune system deficiencies and improves overall health.  For the best vitamin absorption, choose a supplement containing Acerola.

Fermented Cod Liver Oil

Fermented Cod Liver Oil (FCLO) is rich in vitamins A and D, as well as Omega-3 fatty acids.  The fermentation process by which this oil is extracted from the cod livers does not damage the nutrients, making the health benefits of this super-supplement a long list, indeed.  Some of those include the ability to clarify skin conditions, balance mood and hormones, and remedy auto-immune disorders.  For more information on FCLO, check out this great article.

Oregano Oil

Just a few drops of oregano oil in a cup of juice, water, or tea each day can make a huge positive impact on your health.  Not only does Oregano oil have anti-biotic, anti-viral, and anti-fungal properties when taken internally, it can also used topically to fight cold sores, nail fungus, and dandruff among other things.  Oregano oil may also be steam-inhaled as an alternative to ingestion (though some may not like the smell as much as peppermint or eucalyptus.)

Part III: Eliminate Possible Causes

If you experience frequent sinus infections or nasal irritation, there may be underlying environmental or dietary factors at work.  Here are a few possible culprits and the simple solutions to eliminate them.










Indoor Airborne Allergens

Animal dander, dust, mold spores, and pollen are the most common airborne irritants that cause sinus inflammation and congestion.  The easiest solution for this problem is to upgrade your air filter.  Also, make sure to change the filter at least once per month.  Mark your calendar on the day you change the filter or write the date somewhere on the out-facing side of your new filter before it is installed.
Keep your pets outside, or at least make sure that they are bathed and/or brushed often.  Vacuum at least once per week – more often if you have pets inside.
Sometimes indoor allergens hide in your air ducts.  Attach cheese cloth to the outside of air vents to act as a filter.  Not only will this prevent allergens from circulating through your home, it will also show you what might need to be cleaned out of your air system.
Get an air purifier for the room(s) where you spend the most time.  These devices circulate the air in a room through a HEPA filter and an ionizer to remove most common allergens.  Alternately, you can use an Activated Charcoal filter to clean the air in your home.

Outdoor Airborne Allergens

Pollen, smog, and car exhaust are some common outdoor irritants.  If you know you will be exposed to any of these allergens, consider wearing a mask to keep them out of your airways.  Drive with the windows up and set your car ventilation system to circulate so you don’t bring allergens from outside into the cab where you will inhale them.

Dietary Irritants

Food allergies and sensitivities such as those to gluten, dairy, and sugar can cause sinus infections.  Try eliminating these foods from your diet if you experience frequent sinus problems.
Of course, you don’t have to follow every part of each of the three steps.  Try one or two items from each list to see what works best for you.  When you find the right equation you will know as your headaches and stuffy nose fade away.  Then you can finally take the box of tissue off of the bedside table and say goodbye to sinus infections for good!









25 Uses for #EPSOM SALT......




1. Lawn and garden — Studies show that the magnesium and sulfur that comprise Epsom salt may help your plants grow greener, produce higher yields and have more blooms!

2. Pedicure — Combine 1/2 cup Epsom salt and warm soapy water, then soak your feet for 5 minutes to soften skin. Remove nail polish, push back cuticles, then cut and file your nails. Soak an additional ...5 minutes in a warm Epsom bath for super soft feet.

3. Hair volumizer — Combine equal parts conditioner and Epsom salt. Work the mixture through your hair and leave for 20 minutes. The result? Hair full of va-va-voom and volume!

4. Facial scrub — This is one of my favorite Epsom salt uses. Mix 1/2 tsp of Epsom salt with your favorite cleanser; massage into skin using small circles to give your pores a deep-cleaning. Rinse your face with cool water, pat dry. This is one of the most refreshing Epsom salt uses!

5. Relax — Add two cups of Epsom salt to your very-warm bath water and soak for 15 minutes. You can purchase Epsom salt with lavender or eucalyptus for an extra-soothing bath experience. Be careful when standing up, you’ll find that you are VERY relaxed after your Epsom salt bath.

6. Sea salt texturizing hair spray — Combine 1 cup of hot water, 2 tablespoons Epsom salt, 1 teaspoon aloe vera gel and 1/2 tsp conditioner in a spray bottle. Spray salt mixture into hair and scrunch hair with your hand for pretty beachy-waves.

7. Fabric softener crystals — Mix 4 cups of Epsom salt and 20 drops of essential oil to make DIY fabric softener crystals. Use 1/4 cup per load and add at beginning of wash. What a clever way to use Epsom salt, and also a way to save money!

8. Splinter removal — Soak your finger in an Epsom salt bath for easy splinter extraction.

9. Body scrub — After showering, massage handfuls of Epsom salt over wet skin to exfoliate the body. Get a spa treatment at home! Get more facial scrub recipes here.











10. Exfoliation — For exfoliation, mix 2 cups of Epsom salt with 1/4 cup of petroleum jelly and a few drops of lavender essential oil. Gently massage into dry patches for smoother skin.

11. Mosquito bites — Epsom salt can ease the symptoms of mosquito bites. Make a compress by soaking a washcloth in cold water that has been mixed with Epsom salt (2 tablespoons per cup of water), then gently apply to the bite area. This is yet another one of my favorite Epsom salt uses.

12. Sore muscles and arthritis — If your muscles or joints ache, an Epsom salt bath is a great way to find relief. Add 2 cups of Epsom salt to your very-warm bath water, agitate the water with your hands to dissolve it then soak for 15 minutes.

13. Tile cleaner — Mix equal parts of dish soap and Epsom salt for a super easy and effective tile cleaner. Rinse with clear water. This is one of the most frugal Epsom salt uses, a great way to save on cleaning supplies and to use a natural alternative to harsh chemical cleaners!

14. Bedtime bath for kids — Add one cup of Epsom salt to your kids’ evening bath to help them sleep more peacefully.

15. Headache relief — Evidence shows that that soaking in an Epsom salt bath can relieve headache symptoms.

16. Acne — Epsom salt has antibacterial, antifungal and antiviral properties making it a fantastic natural treatment for acne.

17. Remove odor on hands and feet — Add 3 Tablespoons of Epsom salt to 1 quart of warm water and soak your hands or feet for 15 minutes. This will makes your skin soft, your nails shine, and also help remove foul odors.

18. Relieve constipation — Pour 8 oz. of drinking water into a glass, mix with 1 to 2 tsp. of Epsom salt and drink the mixture for immediate relief of constipation. Mixing directions are also found on most Epsom salt packages, consult your physician before trying this.

19. Sunburn relief — Dissolve two tablespoons of Epsom salt in 1 cups of water and spray on minor sunburns.

20. Draw out infection — For simple infections on hands or feet, soak in a hot Epsom salt bath for 10 minutes to help clear the area. Note, some staph infections are worsened by soaking in hot water, consult your physician.

21. Cure for common cold — Did you know that Epsom salt baths can speed healing by detoxifying your body and increasing your white blood cell count? Try an Epsom salt bath the next time you feel those first symptoms of a cold.

22. Reduce swelling — Epsom salt baths can help the appearance of bruises and reduce swelling.

23. Deter slugs — Sprinkle a trail of Epsom salt around the area you want to be free of slugs.

24. Blackhead removal — Mix a teaspoon of Epsom salt, 3 drops iodine and half a cup of boiling water. Dab this solution to your blackheads with a cotton ball to help naturally extract them.

25. Insecticide — Mix Epson salt with water, add to a spray bottle and spray on plants to naturally deter insects.
(Photo ©iStockphoto/AdrianaCahova)










Constipation in Children











O n this page
Constipation is a very common problem for children. For most children, constipation means passing hard poo (faeces, stools or motions), with difficulty, less often than normal. Regular soiling (often mistaken for runny diarrhoea) may indicate that a child has bad constipation with impaction (a blockage of faeces). Where no particular disease or illness is the cause of the constipation, it is called idiopathic constipation. It is important that constipation be recognised early to prevent it from becoming a long-term (chronic) problem. Note: there is a separate leaflet called Constipation in Adults.
Parents often get very worried about their child's bowel habit. This anxiety can start when the child is a baby, with concern over the number of dirty nappies. The main thing to realise is that every child is different. Normal can vary quite a bit. It is a change in what is normal for your child, that suggests a problem.
Babies will open their bowels anything from several times per day, to once every few days. The frequency of bowel movements is not very important. What is important is that the poo (faeces, stools or motions) is soft and easily passed.
Breast-fed babies tend to pass runnier, mustard yellow-coloured stools. This is because breast milk is better digested than infant formula (bottle feeds). Newborn breast-fed babies may open their bowels with every feed. However, it is also normal for a breast-fed baby to go up to a week without a bowel movement.
Bottle-fed babies often need to open their bowels daily, as the stools are bulkier. Bottle-fed baby stools smell worse (more like an adult's).
It is not uncommon for your baby's stools to vary in colour and consistency from day to day. Any prolonged change to harder, less frequent stools might mean constipation.
As babies are weaned to solid foods, their stools will change in colour and smell. The frequency may again change. Generally, the stools become thicker, darker and a lot more smelly. You will notice that your baby's stools will alter depending upon what you have fed him or her. Some high-fibre foods, such as raisins, may even pass through your baby's bowels virtually unchanged, appearing in the nappy at the next change.
As your baby grows up, into a toddler and then a young child, you may see further changes in their stool frequency and consistency, often dependent on what they are eating.
As you can see, there is great variation in a child's bowel habit, dependent on their age and what they are fed. As already mentioned, it is a change in what is normal for your child, that suggests a problem. Anything from three times a day to once every other day is common and normal. Less often than every other day means that constipation is likely. However, it can still be normal if the stools are soft and well formed, and passed easily.
It may be normal for your baby to go a bit red in the face when straining to pass a stool. Constipation is more of a problem than this. Breast-fed babies seldom get constipated, as breast milk contains exactly the right balance of nutrients to keep the stools soft and easily passed.
Diarrhoea usually means very runny stools, often passed more frequently than normal. Breast-fed babies get diarrhoea less frequently than other babies, as breast milk has a protective effect against the germs that can cause diarrhoea.
Constipation in children or babies can mean any, or all, of the following:
  • Difficulty or straining when passing stools.
  • Pain when passing stools, sometimes with a tiny amount of blood in the nappy or on the toilet paper, due to a small tear in the skin of the back passage (anus).
  • Passing stools less often than normal. Generally, this is less than three complete (proper) stools per week.
  • Stools that are hard, and perhaps very large, or pellet-like and small, like rabbit droppings.










Other symptoms of constipation

As well as less frequent, hard (and perhaps painful) stools, constipation can cause:
  • Tummy ache (abdominal pain).
  • Poor appetite.
  • General malaise (feeling 'off colour').
  • Behavioural changes, such as being more irritable or unhappy.
  • Fidgeting, restlessness and other signs that the child needs to go to the toilet.
  • Feeling sick (nausea).
Severe constipation can cause impaction (where a very large stool is stuck in the rectum). This can cause further symptoms. In particular, this can cause a child to soil their pants regularly with very soft faeces, or with faecal-stained mucus. This is often mistaken by parents as diarrhoea. Impaction is discussed in detail later.
  • Idiopathic constipation. This is common. The word idiopathic means of unknown cause. Various factors may be involved (discussed later), but many children become constipated for no known reason.
    • Short bouts of constipation. It is common for children and babies to have a bout of mild constipation for a day or so. This may settle quickly, often without the need for medical treatment.
    • Long-term constipation. In about 1 in 3 children who become constipated, the problem becomes more long-term (persistent). This is also called chronic idiopathic constipation.
  • Constipation due to an underlying disease or condition. This is uncommon. The constipation is said to be secondary to this other problem. Some examples of conditions and problems that can cause constipation are:
    • Some neurological conditions.
    • An underactive thyroid gland (hypothyroidism).
    • Cystic fibrosis.
    • Rare diseases with abnormal development of the bowel, such as Hirschsprung's disease.
    • As a side-effect of certain medications that a child has to take for another condition.
Treatment may involve treating the underlying condition (if that is possible) in addition to tackling the constipation. Worrying symptoms or signs that may indicate a secondary cause include the following. These should be mentioned to your GP. It is also possible that some of these symptoms could mean your child is more seriously unwell:
  • Being sick (vomiting).
  • Weight loss or failure to gain weight (thrive).
  • A swollen, stretched tummy.
  • Severe pain.
  • A baby that does not pass its first stool (called meconium) within the first 48 hours of life.
  • Abnormalities of the back passage (anus) - for example, if it is closed over.
  • Nervous system (neurological) problems such as weak or paralysed legs.
  • Sores or ulcers near the anus.
  • Excessive thirst.
  • Urinary symptoms - such as passing huge volumes of urine, urine that is very dark or painful urination with smelly urine.
  • Very pale-coloured stools (especially if the urine is very dark too).
The rest of this leaflet is about idiopathic constipation.
Tests are not normally needed to diagnose idiopathic constipation. Your GP is likely to ask various questions and do a general examination to rule out secondary causes of constipation. By examining your child's tummy (abdomen), a GP can tell if there are lots of stools in the bowel. This can give an indication if blockage (impaction - discussed later) has developed. (If an underlying cause of constipation is suspected, your GP will refer your child to a children's doctor (a paediatrician) and further tests may be done.)
Idiopathic means that there is no disease or known cause for the constipation. However, it is thought that various factors may contribute to constipation developing, or make it worse. These include diet, stool holding and emotional factors.

Diet

Dietary factors that may play a part in constipation are:
  • Not eating enough foods with fibre (the roughage part of the food that is not digested and stays in the gut).
  • Not having enough to drink.
Stools tend to become harder, drier, and more difficult to pass if there is little fibre and fluid in the gut.

Stool holding

This means the child has the feeling of needing the toilet, but resists it. The child holds on to the stool, trying to ignore the desire to empty the bowels. This is quite common. You may see your child crossing their legs, sitting on the back of the heels, or doing similar things to help resist the feeling of needing the toilet. Your child may clench his or her buttocks to try to stop the stool from coming out, and may seem quite fidgety. You may notice smudges of stool on your child's pants, often when they are unable to hold on any longer. The longer the child holds on, the bigger the stool gets. Eventually the child has to go, but the large stool is more difficult to pass, and often more painful. This may lead to a bit of a vicious cycle where the child is even more reluctant to open his or her bowels the next time. There are a number of reasons why children may hold on to stools:
  • A previous stool that they passed may have been a struggle or painful. So, they try to put off doing it again.
  • Their back passage (anus) may be sore or have a crack (anal fissure) from passing a previous large stool. It is then painful to pass further stools. So, the child may resist the urge to pass a stool.
  • They may have a dislike of unfamiliar or smelly toilets, such as at school or on holiday. The child may want to put things off until they get home.

Emotional problems

Constipation problems may be made worse with upset due to change in surroundings or routine. Common examples are moving house and starting nursery. Potty training may be a factor if a child becomes scared of using the potty. Fears and phobias are usually the underlying reasons for these problems.
Impaction means that the bowel is, in effect, blocked by a large amount of hard stool. Idiopathic constipation with impaction most commonly develops in children between the ages of 2 and 4 years, but older or younger children can be affected. Symptoms and features include:
  • Recurrent episodes when the child is uncomfortable or distressed trying to pass a stool.
  • The child soils their pants regularly with very soft faeces, or with faecal-stained mucus. This is often mistaken by parents as diarrhoea.
  • The child may also become irritable, not eat much, feel sick, have tummy pains from time to time, and may be generally out of sorts.
  • A doctor can often feel a backlog of hard, lumpy stools when he or she examines the child's tummy (abdomen).
The diagram below shows how a child may develop impaction, and the symptoms this may cause.
chronic constipation in children
  • Normally, stools build up in the lowest part of the bowel.
  • When stools accumulate, they start to pass into the last part of the bowel (the rectum), which stretches. This sends nerve messages to the brain, telling you that you need to empty your bowels.
  • If the stool is not passed out then more stools from higher up also reach the rectum.
  • Eventually, large hard stools may build up in the rectum.
  • The rectum may then stretch and enlarge (dilate) much more than normal, to cope with the excessive amount of stools.
  • A very large stool may develop and get stuck (impacted) in an enlarged rectum.
  • If the rectum remains enlarged then the normal sensation of needing the toilet is reduced. The power to pass out a large stool is also reduced (the rectum becomes 'floppy').
  • More stools build up in the colon behind the impacted stool in the rectum.
  • The lowest part of an impacted stool lies just above the back passage (anus). Some of this stool liquefies (becomes runny) and leaks out of the anus. This soils the child's pants or bedclothes. Also, some softer, more liquid stools from higher up the colon may bypass around the impacted hard stool. This also leaks out and soils the pants or bedclothes and can be mistaken for diarrhoea. The child has no control of this leaking and soiling.
  • When a stool is eventually passed, because the rectum is distended and weakened, it simply fills up fairly quickly again with more hard stool from the backlog behind.

Laxatives

Idiopathic constipation that has lasted for more than a few days is usually treated with laxatives. Your doctor will advise on the type and strength needed. This may depend on factors such as the age of the child, severity of the constipation and the response to the treatment. Laxatives for children commonly come either as sachets or a powder that is made up into a drink, or as liquid/syrup. The laxatives used for children are broadly divided into two types.
  • Macrogols (also called polyethylene glycols) are a type of laxative that pulls fluid into the bowel, keeping the stools soft. They are also known as osmotic laxatives. For example, Movicol® Paediatric Plain is one brand that is commonly used first. This is mixed into water to make a drink to which cordial, such as blackcurrant squash, can be added to make it taste nicer. Lactulose is another type of osmotic laxative.
  • Stimulant laxatives. These encourage (stimulate) the bowel to pass the stools out. There are several different types of stimulant laxative. Sodium picosulfate, bisacodyl, senna and docusate sodium are all examples. A stimulant laxative tends to be added in addition to a macrogol if the macrogol is not sufficient on its own.










Laxatives are normally continued for several weeks after the constipation has eased and a regular bowel habit has been established. This is called maintenance treatment. So, in total, the duration of treatment may be for several months. Do not stop the laxatives prescribed abruptly. Stopping laxatives abruptly might cause the constipation to quickly recur. Your doctor will normally advise a gradual reduction in the dose over a period of time depending on how the stools have become in their consistency and frequency. Some children may even require treatment with laxatives for several years.

Treatment of impaction - if needed

Similar treatments are used for the the treatments listed above. The main difference is that higher doses of laxatives are needed initially to clear the large amount of faeces blocking the last part of the bowel (the rectum). Secondly, laxatives are also usually needed for much longer, as maintenance treatment. The aim is to prevent a build-up of hard stools recurring again, which will prevent impaction returning.
As a result of maintenance treatment:
  • The enlarged rectum can gradually get back to a normal size and function properly again.
  • Constipation is then unlikely to recur.
If laxatives are stopped too soon, a large stool is likely to recur again in the weakened 'floppy' rectum which has not had time to get back to a normal size and strength.
Treatment to clear impacted stools from the rectum can be a difficult time for you and your child. It is likely that your child will actually have a few more tummy pains than before, and that there will be more soiled pants. It is important to persevere, as these problems are only temporary. Clearing the impacted stools is an essential part of treatment.
In rare instances, where treatment of impacted stools has failed, a child may be treated in hospital. In hospital, stronger medicines to empty the bowel, called enemas, can be given via the rectum. For very hard to treat cases, a child can have a general anaesthetic and the bowel can be cleared out manually by a surgeon.










Diet

Dietary measures should not be used on their own to treat idiopathic constipation, as it will be unlikely to solve the problem. However, it is still important to get a child into a habit of eating a good balanced diet. This is to include plenty of drinks (mainly water) and foods with fibre. This will help to prevent a recurrence of constipation once it has cleared.
Eating foods with plenty of fibre and drinking plenty makes poo (faeces, stools or motions) that is bulky, but soft and easy to pass out. Getting plenty of exercise is also thought to help.

Food and fibre

This advice applies to babies who are weaned, and children. Foods which are high in fibre are: fruit, vegetables, cereals, wholemeal bread. A change to a high-fibre diet is often 'easier said then done', as many children are fussy eaters. However, any change is better than none. Listed below are some ideas to try to increase your child's fibre intake:
  • A meal of jacket potatoes with baked beans, or vegetable soup with bread.
  • Dried (or semi-dried) apricots or raisins for snacks.
  • Porridge or other high-fibre cereals (such as Weetabix®, Shredded Wheat® or All Bran®) for breakfast.
  • Offering fruit with every meal - perhaps cut up into little chunks to make it look more appealing.
  • Perhaps do not allow sweets or desserts until your child has eaten a piece of fruit.
  • Another tip for when children are reluctant to eat high-fibre foods is to add powdered bran to yoghurt. The yoghurt will feel grainy, but powdered bran is tasteless.

Drink

If a bottle-fed baby has a tendency to become constipated, you can try offering water between feeds. (Never dilute infant formula (milk) that is given to bottle-fed babies.) Although it is unusual for a breast-fed baby to become constipated, you can also offer water between feeds. Older, weaned babies can be given diluted fruit juice (preferably without added sugar). Pureed fruit and vegetables are the usual starting points for weaning, after baby rice, and these are good for preventing constipation.
Encourage children to drink plenty. However, some children get into the habit of only drinking squash, fizzy drinks or milk to quench their thirst. These may fill them up, and make them less likely to eat proper meals with food that contains plenty of fibre. Try to limit these kinds of drinks. Give water as the main drink. However, fruit juices that contain fructose or sorbitol have a laxative action (such as prune, pear, or apple juice). These may be useful from time to time if the stools become harder than usual and you suspect constipation may be developing.

Some other tips which may help

  • Try to get children into a regular toilet habit. After breakfast, before school or nursery, is often best. Try to allow plenty of time so they don't feel rushed.
  • Some kind of reward system is sometimes useful in younger children prone to holding on to stools. You could give a small treat, or use stickers or star charts to reinforce the message.
  • Praise your child for passing a stool in the potty or toilet, but do not punish accidents. It is easy to become frustrated with soiled pants or a child who refuses to pass a stool.
  • Try to keep calm and not make a fuss over the toilet issue. If your child can see that you are stressed or upset, they will pick up on this feeling, and the toileting issue can become even more of a fraught battle. The aim is to be 'matter of fact' and relaxed about it.

Further help & information

Original Author:
Dr Tim Kenny
Current Version:
Peer Reviewer:
Dr John Cox
Last Checked:
28/02/2013
Document ID:
4584 (v41)
© EMIS

All about vaccination and immunisation

Vaccinations are important. Before they were available, many children died or became very sick. Although babies and children can still contract diseases and die, vaccination programs have been effective in controlling this.
 
All about vaccination and immunisation
 
 
    
The human body has a natural immune system, which is acquired by the unborn child from its mother. Further immunity from various diseases is acquired either from exposure to, and recovery from these infections, or through immunisation.
The body produces antibodies to that infection, which remain in the tissues as part of the body’s immune system, which is able to “remember” these infectious organisms. These anti-bodies combat subsequent invasions of the same disease.
Immunisation by vaccine is produced by the introduction of a dead or weakened form of this organism into the body. The immune system is simulated to respond by producing antibodies to thwart any future infections of the same disease.

In the past

Before vaccinations were available many children died or developed severe complications after suffering from infectious diseases. Even with modern medical care, a child contracting any of these diseases would suffer dangerous complications or die.

The benefits of vaccination

Vaccination programmes have been extremely effective in controlling some dangerous diseases and it is hoped by health authorities that once certain diseases are completely killed off there will be no need for vaccination.










The downside of immunisation

The downside of immunisation is that adverse events or problems have been reported after their administration.
For example, vaccines cause a change to the immune-response system, which may result in an alteration to the body’s natural immunity, particularly in those families that have a history of autoimmune disorders. However, these cases appear to be unusual in the vast majority of children and occur in about one child for about 2 million doses of vaccines administered.

About the additives in vaccines

Many parents are concerned about the safety of vaccinations. Some claim that it’s the additives in the vaccines, for example, gelatine or formaldehyde, rather than the vaccine itself that causes the problems.
Thimerosal (a mercury-based preservative found in certain vaccines) has also caused some concern that its use can result in developmental problems such as autism. Despite exhaustive studies this has been found not to be the case.
A dramatic increase in diagnosed cases of the autism-spectrum disorders have been noted by researchers globally, but this has not been linked to any vaccination.

In support of vaccinations

The majority of medical professionals worldwide seem to be of the opinion that the benefits of vaccination to the whole community and the prevention of the appalling consequences of the outbreak of infectious disease far outweigh any risks, which are minimal and affect only a few.
In deciding whether to have your child immunised you need to weigh up the risks of the vaccine against those from the disease.
Most vaccines have no side effects or only mild side effects, such as swelling and redness at the site of the injection or a mild fever. Some crying and irritability is fairly common. A dose of paracetemol 30 minutes before the vaccination and 4-6 hourly thereafter for a day should alleviate these effects, which should disappear within 24 hours. No child should receive any vaccine when ill.

Allergies

Any child who is known to be allergic to the antibiotics streptomycin, neomycin or polymyxin B should not receive the oral polio vaccine.
Certain vaccines, such as the influenza (flu) vaccine, contain egg proteins and gelatine. These may provoke a reaction in children allergic to these substances
The pertussis vaccine is never given to children who suffer from convulsions (fits) or any active (ongoing) central nervous system disorder, other than febrile convulsions (those suffered as a result of a high fever.)

About the MMR vaccine

The MMR vaccine has received a lot of bad press as it is rumoured to be linked to autism. No sound evidence has been found to substantiate this claim. Children who have experienced a life-threatening allergic reaction to gelatine, the antibiotic neomycin or to a previous dose of the MMR vaccine should not have it.
South Africa’s recommended Childhood Vaccination Schedule is adopted from the World Health Organisation. These vaccines are available free of charge at local clinics and community health centres.

Vaccinations

  • Birth: OPV 0 and BCG
  • 6 weeks: OPV 1 and DPT 1 and HepB 1 and Hib 1
  • 10 weeks: OPV 2 and DPT 2 and HepB 2 and Hib 2
  • 14 weeks: OPV 3 and DPT 3 and HepB 3 and Hib 3
  • 9 months: Measles 1
  • 18 months: OPV 4 and DPT 4 and Measles 2
  • 5 years: OPV 5 and DT

Abbreviations

  • BCG: Bacillus Calmette Guerin vaccine
  • OPV Oral polio vaccine
  • DPT: Diphtheria, pertussis and tetanus vaccine
  • HepB: Hepatitis B vaccine
  • Hib: haemophilus influenzae B vaccine
Additional vaccines that you can opt to buy at your own cost include Measles, mumps, rubella (MMR) and Varicella (chicken pox).










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