Swallowed Objects and Infant Choking: Mayo Expert Offers Tips for Parents and Caregivers

Babies and young children learn a great deal about the world through their mouths. Unfortunately, this can lead to choking or swallowing dangerous objects. Choking is a leading cause of injury and death among children, especially children 3 years of age or younger. Food, toys and coins account for most of the choking-related events in young children, who put objects in their mouths as they explore new environments, according to the American Academy of Pediatrics.
MULTIMEDIA ALERT: For English-language and Spanish-language video of Dr. Grace Arteaga talking about swallowed objects and infant choking along with a PSA video: "Saving Lives with Gus — Heimlich Maneuver," please visit the Mayo Clinic News Network.
"Should a child choke or swallow something dangerous, parents and caregivers may want to offer liquids and/or solids, but this is not recommended. Also, parents should not force the child to vomit. Have the child see the doctor as soon as possible or take the child to the emergency room," says Grace Arteaga, M.D., a pediatrician at the Mayo Clinic Children's Center.
If a child is coughing forcefully after swallowing an object, parents and caregivers should encourage him or her to continue coughing and not interfere. But, if the swallowed object blocks the airway, and the child's condition worsens (the cough becomes silent or breathing becomes more difficult), Mayo Clinic experts recommend the "five-and-five" approach to first aid:

• Give 5 back blows. First, deliver five back blows between the victim's shoulder blades with the heel of your hand.
• Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver). For infants, use chest compressions because abdominal thrusts may cause injury.
• Alternate between 5 back blows and 5 abdominal thrusts until the blockage is dislodged, while someone calls for emergency assistance.

The advice for choking infants is different. Dr. Arteaga warns that objects can also cause infant choking, however food is the most common cause. She advises against the use of a finger sweep, which could lodge the object farther down in the airway.
Instead, if an infant is choking, Dr. Arteaga advises: Hold the infant or young child facedown on a forearm. The baby's head should be lower than his or her body. Then thump the baby firmly on the middle of the back using the heel of your other hand. The combination of gravity and the force from the hand helps to dislodge the object that's blocking a baby's airway. If there are any concerns about the baby's breathing, call 911 or a local emergency services provider.
Not everything that is swallowed requires medical attention. Many objects may pass through the gastrointestinal tract without causing harm. Other objects may injure or endanger the life of the child. An object that gets stuck in the esophagus — the muscular tube that connects your throat and stomach — may need to be removed, particularly if it is a pointed object or a battery that can rapidly cause nearby tissue injury. Usually the signs that an object is stuck include chest or abdominal pain, vomiting or fever.

Peanut allergy kills teen despite epinephrine injections

(CNN) -- Friday was the last day of vacation for Natalie Giorgi. The 13-year-old took a bite of a dessert at the summer camp where her family was staying, but spit it out because something didn't seem right.

Later that evening, she was pronounced dead.

Natalie died of a severe allergic reaction to peanut butter, CNN affiliate KXTV reported. Her sudden death in California is especially alarming for the food allergy community because, according to a family friend's account to KXTV, Natalie received three epinephrine injections. Epinephrine is the only treatment known to prevent a serious allergic reaction from turning deadly.

Anyone familiar with food allergies knows how important epinephrine auto-injectors are in emergency situations. Allergists recommend having multiple epinephrine auto-injectors available at all times for people with a risk of anaphylaxis.

Girl with peanut allergy dies at school

Twins suffer from severe allergies

Anaphylaxis symptoms include difficulty breathing, swelling of the throat or tongue, rapid pulse, nausea and vomiting. Allergies to medications, latex and insect venom, in addition to foods, can make the body go into shock in this way.

In general, a fatality is very unlikely if someone who's having a serious allergic reaction receives the appropriate dose of epinephrine quickly, said Dr. Clifford Bassett, director of Allergy & Asthma Care of New York, who did not treat Natalie.

"Any time we hear something like this, it's such a tragedy, because we all think in the allergy community that this stuff is preventable, treatable and so forth," he said. "And the answer is, there is no 100% in life."

Research has found that the effectiveness of epinephrine can be diminished if there is a delay in administering it, if an insufficient dose is given or if the medication has expired. More details of what happened to Natalie would need to be disclosed in order to make a definitive statement in her case, Bassett said.

Up to 40% of people need a second or third dose of epinephrine during a severe allergic reaction, he said, noting that it needs to be given in a timely fashion. After receiving a shot from an epinephrine auto-injector, the patient should get follow-up emergency care immediately.

Food allergies increased 18% between 1997 and 2007 in kids under 18 -- and no one knows why the condition is on the rise.

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Food allergy diagnosis: What parents should know

A 2010 study in the journal Pediatrics found that 8% of children younger than 18 in the United States have at least one food allergy. Among those with food allergies, about 39% had a history of severe reaction, and 30% were allergic to multiple foods.

Peanut allergy is the most common food allergy, according to the study, followed by milk and shellfish. In fact, according to the Centers for Disease Control and Prevention, more than 90% of allergic reactions come from just eight foods: milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat.

"Most of the fatalities that I'm familiar with have been associated with peanut," Bassett said.

Allergic reactions can appear to subside but reemerge much later, a phenomenon called "biphasic reactions." A second wave of an allergic reaction can occur up to 72 hours after the first one, Bassett said, but in most cases it's sufficient to monitor a patient for eight hours after a severe anaphylaxis episode.

People with extremely sensitive allergies cannot risk eating anything that may have come into contact with the foods they can't eat, Bassett said, which is why people should read food packaging labels extremely carefully and take seriously warnings like "May contain traces of peanuts."

Anyone with a history or risk of food allergy should get evaluated by a certified allergist and come up with an action plan for prevention and treatment, Bassett said.

Parents should communicate with camps, schools, relatives, restaurants and anyone who might be serving food to their allergic child about what foods to avoid and how serious the condition needs to be taken.

Dining out with food allergies

"It's essential when you have a serious, life-threatening problem like this to have a plan in place ahead of time," Bassett said. "With the best intentions, we generally get good outcomes, but this is an example of something that is obviously a horrible tragedy."

Natalie was aware of her food allergy and "took every care," the Rev. Michael Kiernan of Our Lady of the Assumption Church in Carmichael, California, told KXTV.

Natalie's symptoms didn't begin immediately when she spit out the treat at Camp Sacramento, according to the local station.

When she reached for the snack at camp, she didn't know that it was made with peanut butter. For about 20 minutes, she felt fine, but then she started vomiting, had difficulty breathing and went into cardiac arrest.

An ambulance took her to a hospital, where she was pronounced dead.

Her family told KXTV that Natalie had aspirations of becoming a neonatologist so that she could care for premature babies, such as herself and her twin sister.

"While our hearts are breaking over the tragic loss of our beautiful daughter Natalie, it is our hope that others can learn from this and realize that nut and food allergies are life threatening," Natalie's family said in a written statement to KXTV. "Caution and care for those inflicted should always be supported and taken."

Two die in China from bird flu strain not previously seen in humans-Xinhua

Two people in Shanghai, one of China's largest cities, died this month after contracting a strain of avian influenza that had never been passed to humans before, the official Xinhua News Agency reported on Sunday.  

The two men, aged 87 and 27, became sick late February and died in early March. Another woman in nearby Anhui province also contracted the virus in early March and is in a critical condition, Xinhua said, quoting the National Health and Family Planning Commission (NHFPC).

The strain of the bird flu virus found in all three people was identified as H7N9, which had not been transmitted to humans before, the commission said.

The three cases were confirmed to be human infection of the H7N9 strain by experts from the NHFPC, based on clinical observation, laboratory tests and epidemiological surveys, Xinhua said.

All three cases showed symptoms of fever and coughs that later developed into pneumonia.

Calls to the NHFPC on Sunday were not answered.

It is unclear how the three victims were infected. The virus does not seem highly contagious because no health abnormalities were detected among 88 of the victims' close contacts, Xinhua quoted the commission as saying.

There are no known vaccines against the H7N9 virus. (Reporting by Melanie Lee; Editing by Paul Tait)

via reuters.com

 

‘black henna’ tattoos not so temporary after all

Spring Breakers, beware. That henna tattoo might really not be henna at all. And it might not be as temporary as you think.

File photo. (Fareed Khan / AP)

The Food and Drug Administration warned Monday that the popular temporary tattoos, in which ink is applied to the skin in intricate patterns that last from several days to several weeks, can actually last a lot longer. And not in a good way.

“Just because a tattoo is temporary it doesn’t mean that it is risk free,” Linda Katz, director of FDA’s Office of Cosmetics and Colors, said in a consumer update.

The agency said some consumers have reported a range of adverse reactions that can outlast the tattoos themselves and, in some cases, have led to emergency room visits. Among them: Skin redness, blisters, raised red weeping lesions, loss of pigmentation, increased sensitivity to sunlight and even permanent scarring.

Traditional henna is a reddish-brown coloring made from a flowering plant found in parts of Asia and Africa. For centuries, people have ground henna into a paste and used it to decorate everything from leather to hair, fingernails and skin. The FDA attributed many of the problems that have occurred to the use of “black henna” that often is used in place of the more traditional henna. It can include hair dye with p-phenylenediamine, or PPD, which can cause an ugly range of skin reactions. A study last August in the Journal of the German Society of Dermatology found that PPD in hair and eyelash dye caused allergic reactions in a group of people.

Black henna often can be found in temporary tattoo kiosks common in tourists areas, such as beach boardwalks. The FDA noted that while some states have put in place regulations governing temporary tattooing, others have not.

So be careful with those henna tattoos out there, kids.

A few examples of bad reactions can be found on Twitter:

 

 

via washingtonpost.com

 

Tired in the Afternoon? Here’s What You Can Do

by Samantha Montpetit-Huynh

Sometimes I think I am obsessed with it and I can’t get enough. Add the fact that it “seems” like this is the winter that will never end, and the thought of curling up on the couch with a giant bowl of buttered popcorn and a movie sounds like bliss.

However, we ALL know how we feel after we binge.

Put crap in and guess what??? Get crap out. Never mind the feeling of guilt than can take over faster than you can get off that couch, but after you’re initial high from all the butter and starch, you get a nice crash that just begins the domino effect of trying to stay awake. And we wonder why we’re tired!

Energy comes from two main things; exercise and food. I would even say food is the predecessor as it has the vital role of whether or not you keep your blood sugar levels steady (awake) or up and down (crash).

Ever wonder why you tend to grab crackers, cereal or other sweets when you are tired? You could say that it’s “just a snack”, but when quick fixes are what you “crave” before any thought is put in it, you are in survival mode.

So how does one curb this? How do you take energetic throughout the day without a “treat” in the afternoon and buckets of coffee at your disposal?

Well just like the rest of it; it’s REALLY complicated. Not. No rocket science here. It’s plain and simple planning. Shocking I know.

Here are 4 ways to boost your energy in the afternoon:

1. Out of sight, out of mind.

 

If those unhealthy snacks are not in the house, you are way more likely not to eat them. JUST DON’T BUY THEM!

2. Plan your meals and snacks.

I never leave my house without my lunch and at least two snacks. Yes I am human and once in a while I don’t crave what I have but I eat in anyway because half the time it’s just hunger; thus the craving is gone.

3. Don’t over-eat.

Ever wonder why you crave sweets after a big meal? If you are eating a meal high in protein and low in carbohydrates (which is good for weight loss), you could be decreasing your serotonin levels (the happy hormone). Serotonin is increased following a sugary, carbohydrate diet. Eating too large of a meal can increase this risk and drive you towards a “fix” after.

4. Protein protein protein!!!

Yes I know I just said too much can lower serotonin, but “too much” of anything is never a good idea. Balance is key. If you have some protein with every meal AND snack, you balance your blood sugar because protein slows down the digestive process, slowing down the production of insulin thus lowering the amount of sugar that is released in the blood. The slower the process, the fuller you feel longer and less likely to crash.

 

Now none of this is new but sometimes people need a friendly “kick in the pants” as to why they would rather nap at 3pm than finish that last report.

And here’s a nice little FYI… for all of you trying desperately to stay awake on coffee; you’re almost doing yourself a disservice as caffeine lowers serotonin too.

Don’t say I didn’t warn ya.

Samantha Montpetit-Huynh is the mother of two beautiful girls and the founder of Core Expectations, Toronto‘s only full services wellness team that delivers personal training, abdominal rehabilitation and other support services to the homes and offices of pregnant women and new moms across the GTA.

 

 

 

 

 

 

 

 

 

 

 

via amotherworld.com

 

CrossFit Review

By Michael Esco, PhD, HFS, CSCS*D
WebMD Expert Review

Preparing the body “not only for the known, but also the unknown” is the mantra for CrossFit, one of the fastest growing strength and conditioning programs today. It is not a traditional, specialized training program like doing isolated weight lifting for a certain muscle or aerobics.

“Our specialty is not specializing," says CrossFit founder and former gymnast Greg Glassman.

It's also a very tough workout -- not one to take lightly, especially if you're not active right now.

Here's what you should know before you get started.

Slideshow: The No-Gym Workout

 

What is CrossFit?

CrossFit combines strength training, explosive plyometrics, speed training, Olympic- and power-style weight lifting, kettle bells, body weight exercises, gymnastics, and endurance exercise.

By doing this, CrossFit targets what it calls the major components of physical fitness: cardiorespiratory fitness, stamina, muscular strength and endurance, flexibility, power, speed, agility, balance, coordination, and accuracy.

Training the CrossFit way requires you to work out 3 to 5 days per week. The workouts are highly intense and short, taking about 5 to 15 minutes to complete.

CrossFit workouts typically combine explosive exercises done in a circuit format: One exercise follows right after the next, with very little rest in between.  

The main CrossFit exercises involve the whole body and include pushing, pulling, running, rowing, and squatting.

There are hundreds of CrossFit exercises. Here are a few examples:

• Power Cleans: Pulling a weighted bar from the floor and bringing it up to and in front of your shoulders in a quick and forceful manner.
• Burpees: This is a body-weight-only exercise that involves beginning in a standing position, quickly dropping to the floor and doing a push-up, then coming up to a squatting position and explosively jumping straight-up.
• The Snatch: A weighted bar is rapidly pulled from the floor to directly over your head with the arms held straight.
• Thruster: This exercise begins with standing upright with weighted bar held in front of your shoulders. You squat down to the point where your thighs are parallel to the floor, then quickly standing back-up and pressing the weighted bar over your head.

Other examples are variations of push-ups, sit-ups, and pull-ups. CrossFit also often uses kettle bells (a weighted bell with a handle on top), medicine balls, climbing ropes, jump ropes, and rowing machines.

The CrossFit WOD

CrossFit posts a Workout of the Day (WOD) on its web site. Some of the WOD are specially named after women or military heroes. The WOD changes each day and there are a lot of them. And they can be quite demanding.

• The Barbara involves five circuits of 20 pull-ups, 30 push-ups, 40 sit-ups, and 50 body weight-only squats performed in order, while only resting at the end of each circuit for a 3-minute period.
• The Angie - 100 pull-ups, 100 push-ups, 100 sit-ups, 100 bodyweight-only squats to be accumulated (not performed in a row, unless you are fit enough) during the entire workout.  
• The Murph - a timed 1-mile run, followed by 100 pull-ups, 200 push-ups, 300 body weight squats, finished off by another 1-mile run.
• The Jackie - 1,000 meter row, 50 thrusters with a selected weight, and 30 pull-ups: preferably performed without any rest between each exercise.  

via webmd.com

 

Banish the Bags Under Your Eyes

Noticing bags or dark circles under your eyes? You're not alone.

Dermatologists and plastic surgeons get asked about dark circles and under-eye bags all the time. "I hear patients voice complaints several times a day," says dermatologist Valerie Goldburt, MD, PhD, of NYU Langone Medical Center.

Good news: There are fixes for under-eye flaws. The first step is figuring out just what the problem is.

 

Morning-After Puffy Eyes

Seasonal allergies, a cold, a sinus infection: These are some of the things that can lead to water building up under the eye.

"We have the thinnest skin around our eyes, so it's the area that's most influenced by the in-and-out flow of fluids," Goldburt says.

A dinner heavy with salty food or a night of crying while watching a tearjerker movie can also cause morning-after puffiness. The reason is osmosis. "Water always travels from areas in the body where there's low salt concentration to tissues where there's more salt, Goldburt explains. That principle holds true whether the salt comes from tears or from soy sauce.

Simple Fixes for Under-Eye Bags

Addressing the underlying cause will help treat these temporary eruptions of puffiness.

Here are steps to try:

• Treat hay fever, if that's the problem. There are non-sedating, over-the-counter allergy medications that may help. If you have or suspect hay fever, talk with your doctor about how to treat it (whether or not it's affecting your eyes' appearance).
• Try a neti pot. Irrigating the nasal cavity with a neti pot -- a device that looks like a small teapot -- can help relieve fluid buildup caused by allergies, sinus congestion, or a cold.
• Switch your sleep position. Your sleep position may be contributing to under-eye bags. Thanks to gravity, sleeping on your side or stomach can encourage fluids to collect under your eyes. If you're a side sleeper, you may notice a heavier bag on the side you sleep on. Goldburt advises her patients who wake up with puffy eyes to sleep on their back and add an extra pillow under their head.

Changing your sleep position takes some getting used to, says Goldburt, a self-described "former eye-bag sufferer" and stomach-sleeper herself. Still, she says, "The earlier you start changing your sleep position, the better, because after a few years under-eye bags can became permanent."

Other everyday habits, including rubbing your eyes frequently, going to bed with makeup on, and excessive drinking, can contribute to under-eye bags, too. "Sleeping in eye makeup can irritate your eyes, causing fluids to pool," Goldburt says. Heavy alcohol drinking causes dehydration. That weakens the delicate skin around the eyes, making it more likely to sink into a pouch.

Eye bags are very common, and are usually not related to your health. But if your bags appear suddenly and you're not suffering from allergies, a sinus infection, or a cold -- and they don't ease up when you try the lifestyle steps mentioned above -- it's a good idea to see your doctor. Some thyroid or kidney problems can cause under-eye fluid retention, notes New York dermatologist Craig Austin, MD.

 

 

Tired of being told you look tired? Here's how to get rid of eye bags, puffiness, dark shadows, and circles.

By Shelley Levitt
WebMD Feature

Reviewed by Hansa D. Bhargava, MD

via webmd.com