Endometrial Ablation Podcast

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Endometrial Ablation Podcast

Detailed information on endometrial ablation, including the reasons and preparation for the procedure, how the procedure is performed, after care, an anatomical illustration of the female pelvic organs, an illustration of the menstrual cycle, and an illustration of an endometrial ablation procedure.

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Nasal Surgery: Preparing for Surgery

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Nasal Surgery: Preparing for Surgery

Nasal surgery may be done at your doctor’s office, a surgery center, or a hospital. You will be told how to prepare for surgery. Follow these directions carefully. And be sure you have your questions answered before the procedure.

Before surgery

Follow all of the instructions you are given. In addition:

  • Tell your doctor about any medicines you take. This includes over-the-counter medicines, herbs, and supplements. You may need to stop taking some or all of them before surgery.

  • Tell your doctor if you have a pacemaker.

  • Do not take medicines containing aspirin or ibuprofen during the 14 days before surgery.

  • Don’t drink or eat for 8 hours before surgery.

  • Don’t wear makeup, jewelry, or contact lenses to surgery.

  • Arrange for an adult family member or friend to drive you home after surgery.

Be aware that you may spend the night in the hospital. This is uncommon. Your doctor can discuss this possibility with you. 

Anesthesia

You will be given medicine to keep you from feeling pain during surgery. This is called anesthesia. The type you will have will be discussed with you before the procedure. You may have one of 3 types.

  • Local anesthesia. This numbs the nose and area around it. You may also be given medicine to relax you. But you will remain awake. Expect to hear noises and see movement during the surgery.

  • Monitored anesthesia care. This makes you drowsy or lightly asleep during surgery. You can still expect to hear some sounds.

  • General anesthesia. This puts you into a state like deep sleep during surgery. You will hear and remember nothing.

High Blood Pressure/Hypertension

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Blood pressure is the force of the blood pushing against the
artery walls. The force is made with each heartbeat as blood is pumped from the
heart into the blood vessels.  This is called systolic blood pressure. Blood
pressure is also affected by the size of the artery walls and their elasticity. Each
time the heart beats (contracts and relaxes), pressure is created inside the
arteries.  When the heart is relaxed, the arteries stay at a lower resting tone to
maintain some pressure in the artery. This is called diastolic blood pressure. 

High blood pressure is when the force of the blood is too high
during heart contraction or relaxation within the arteries. The arteries may have
an
increased resistance against the flow of blood. This causes your heart to pump
harder to circulate the blood.

These factors may cause high blood pressure:

  • Being overweight
  • Having lots of salt in your diet
  • Not getting much physical activity
  • Family history of high blood pressure
  • High stress levels
  • Not getting enough sleep
  • Excessive alcohol use
  • Kidney disease

More than half of all adult Americans have high blood pressure.
You are at risk for it if you:

  • Have diabetes, gout, or kidney disease
  • Are African American, especially if you live in the
    southeastern U.S.
  • Are middle-aged or older
  • Have a family history of high blood pressure
  • Eat a lot of high-salt foods
  • Are overweight
  • Drink a lot of alcohol
  • Take birth control pills (oral contraceptives)
  • Have depression
  • Are pregnant
  • Smoke or use e-cigarettes
  • Use stimulant drugs such as cocaine or methamphetamine

High blood pressure often has no symptoms. But you can find out if
your blood pressure is higher than normal by checking it yourself or by having it
checked regularly by your healthcare provider.

Very high blood pressure can cause symptoms. These include
headache, changes in vision, or chest pain.

Blood pressure is measured with a blood pressure cuff and
stethoscope by a nurse or other healthcare provider. You can also take your own
blood pressure with an electronic blood pressure monitor. You can find one at most
pharmacies.

Two numbers are recorded when measuring blood pressure:

  • The top number is the systolic
    pressure.
     This is the pressure inside the artery when the heart
    contracts and pumps blood through the body.
  • The bottom number is the
    diastolic pressure.
     This is the pressure inside the artery when the
    heart is at rest and is filling with blood.

Both the systolic and diastolic pressures are recorded as mm Hg
(millimeters of mercury). This recording represents how high the mercury column in
the blood pressure cuff is raised by the pressure of the blood.

Blood pressure is rated as normal, elevated, or stage 1 or stage 2
high blood pressure:

  • Normal blood pressure is systolic of less than 120 and
    diastolic of less than 80 (120/80).
  • Elevated blood pressure is systolic of 120 to 129 and
    diastolic less than 80.
  • Stage 1 high blood pressure is when systolic is 130 to 139
    or diastolic is 80 to 89.
  • Stage 2 high blood pressure is when systolic is 140 or
    higher or diastolic is 90 or higher.

Even higher blood pressure is called a hypertensive crisis. This
means the systolic blood pressure is 180 or higher, the diastolic blood pressure is
more than 120, or both. If you have this, you need a change in your medicine right
away or a stay in the hospital.

A single higher blood pressure measurement does not necessarily
mean you have a problem. Your healthcare provider will want to see several blood
pressure measurements over a number of days or weeks before diagnosing high blood
pressure and starting treatment. Ask your provider when you should call if your
blood pressure readings are not within the normal range.

Treatment for high blood pressure may involve:

Lifestyle changes

These healthy steps can help you control your blood
pressure:

  • Choose foods that are low in salt (sodium).
  • Choose foods low in calories and fat.
  • Choose foods high in fiber.
  • Stay at a healthy weight, or lose weight if you are
    overweight.
  • Limit serving sizes.
  • Get more exercise.
  • Drink fewer or no alcoholic beverages.
  • Reduce stress.
  • Get enough quality sleep.

Certain
medicines

Sometimes you may need to take 1 or more daily medicines to
control high blood pressure. Take it exactly as directed.

If you have high blood pressure, have your blood pressure
checked routinely and see your healthcare provider to watch the condition.

High blood pressure raises your risk for:

  • Heart attack
  • Heart failure
  • Stroke
  • Kidney failure
  • Loss of eyesight
  • Death

You can help prevent high blood pressure with many of the same
healthy steps used to treat it. These are:

  • Cut back on salt (sodium) in your diet.
  • Eat foods that are low in calories and fat, and high in
    fiber.
  • Stay at a healthy weight, or losing weight if you are
    overweight.
  • Exercise more.
  • Stop smoking tobacco and e-cigarettes.
  • Drink fewer or no alcoholic beverages.
  • Get enough sleep.
  • Don’t use stimulants or illegal drugs.
  • High blood pressure is when the force of the blood pushing
    against the artery walls is too high. This causes your heart to pump harder to
    circulate the blood.
  • Risk factors for high blood pressure include being
    overweight, having a family history of the disease, and being older.
  • High blood pressure often has no symptoms.
  • Two numbers are recorded when measuring blood pressure. The
    top number is the systolic pressure. The bottom number is the diastolic
    pressure.
  • High blood pressure is diagnosed when the systolic pressure
    is 130 or higher or the diastolic pressure is 80 or higher.
  • Lifestyle changes and medicines may help treat high blood
    pressure.

Tips to help you get the most from a visit to your healthcare
provider:

  • Know the reason for your visit and what you want to
    happen.
  • Before your visit, write down questions you want
    answered.
  • Bring someone with you to help you ask questions and
    remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and
    any new medicines, treatments, or tests. Also write down any new instructions
    your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how
    it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the
    results could mean.
  • Know what to expect if you do not take the medicine or have
    the test or procedure.
  • If you have a follow-up appointment, write down the date,
    time, and purpose for that visit.
  • Know how you can contact your provider if you have
    questions.

Adjustment Disorders in Children

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An adjustment disorder is an
unhealthy emotional or behavioral reaction to a stressful event or change in a person’s
life. The response happens within 3 months of the stressful event. Some events that may
lead to this problem in a child or teen are:

  • A family move
  • Death of a parent, sibling, grandparent, or other significant
    person
  • Parents’ divorce or separation
  • Death of a pet
  • A new brother or sister
  • A sudden sickness in the child or a
    family member
  • A long-lasting (chronic) illness in
    the child or a family member

Adjustment disorders are a reaction to stress. There is not one direct cause. Children and teens differ in their personalities, past experiences, vulnerability, and coping skills. Where they are in their development and ability to deal with a stressor may also play a part in how they react. Stressors also vary in how long they last, how strong they are, and what effect they have.

Adjustment disorders happen at all ages and are quite common in children and teens. They happen equally in boys and girls. They happen in all cultures. But the stressors and signs may vary based on cultural influences.

Children and teens have different
symptoms of an adjustment disorder than adults do. Children tend to have more behavioral
symptoms, such as acting out. Adults have more depressive symptoms. Age differences also
affect how long symptoms last, how strong they are, and what effect they have.

In all adjustment disorders, the reaction to the stressor seems to be more than what is thought to be normal. Or the reaction greatly interferes with how the child functions day to day.

There are 6 subtypes of adjustment disorder. They are based on the type of major symptoms a child may feel. Each child’s symptoms may vary. These are the most common symptoms of each subtype:

  • Adjustment disorder with depressed mood. A child may feel depressed, tearful, and hopeless.
  • Adjustment disorder with anxiety. Symptoms may include nervousness, worry, and jitteriness. A child may also fear losing important people in his or her life.
  • Adjustment disorder with anxiety and depressed mood. A child has a mix of symptoms from both of the above subtypes (depressed mood and anxiety).
  • Adjustment disorder with disturbance of conduct. A child may violate other people’s rights or violate social norms and rules. Examples include not going to school, destroying property, driving recklessly, or fighting.
  • Adjustment disorder with mixed disturbance of emotions and conduct. A child has a mix of symptoms from all of the above subtypes.
  • Adjustment disorder unspecified. A child has reactions to stressful events that don’t fit in one of the above subtypes. These may include behaviors such as withdrawing from friends and school.

Symptoms of an adjustment disorder
can look like other health problems or mental illnesses. Have your child see his or her
healthcare provider for a diagnosis.

A mental health expert such as a
psychiatrist often makes the diagnosis after an evaluation. He or she talks with you,
your partner, and your child. He or she will ask for a full history of your child’s
development, life events, emotions, behaviors, school performance, and the stressful
event.

Treatment will depend on your
child’s symptoms, age, and health. It will also depend on how severe the disorder is.

Treatment may include:

  • Psychotherapy using cognitive behavioral
    methods.     A child learns how to better solve problems, communicate, and handle
    stress. He or she will also learn how to control impulses and anger.
  • Family therapy. This therapy is often
    focused on making needed changes in the family. It may include improving
    communication skills and family interactions. It may also boost support among family
    members.
  • Peer group therapy. This therapy
    develops social and interpersonal skills.
  • Medicines. These are not often used.
    But a child may need them for a short time if a certain symptom is severe.

It’s not known how to prevent an adjustment disorder in a child. But spotting it early and getting expert help for your child can ease severe symptoms. Taking these steps can enhance a child’s normal growth and development. It can improve your child’s quality of life.

You can do these things to help your child:

  • Keep all appointments with your
    child’s healthcare provider.
  • Talk with your child’s healthcare
    provider about other providers who will be included in your child’s care. Your child
    may get care from a team that may include counselors, therapists, social workers,
    psychologists, and psychiatrists. Your child’s care team will depend on your child’s
    needs and how serious the adjustment disorder is.
  • Work closely with school staff. Your
    child’s adjustment disorder may significantly interfere with his or her ability to
    learn. If this is the case, the Americans with Disabilities Act (ADA) or Section 504
    of the Civil Rights Act may allow the school to offer reasonable accommodations in
    the school setting.
  • Tell others about your child’s
    adjustment disorder. Work with your child’s healthcare provider and school to create
    a treatment plan.
  • Reach out for support from local
    community services. Being in touch with other parents who have a child with an
    adjustment disorder may be helpful.

Call your child’s healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms
  • An adjustment disorder is an unhealthy emotional or behavioral reaction to a stressful event or change in a child’s life.
  • Symptoms happen within 3 months of the stressful event.
  • There are 6 subtypes. They are based on the major symptoms a child may feel, such as depression or anxiety.
  • A psychiatric evaluation can help diagnose it.
  • Personal, family, and group therapy can help.

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Bulimia Nervosa in Children

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Bulimia nervosa is an eating disorder. It’s also called bulimia. A child with bulimia overeats or binges uncontrollably. This overeating may be followed by self-induced throwing up (purging).

A child who binges eats much larger amounts of food than would normally be eaten within a short period of time (often less than 2 hours). The binges happen at least twice a week for 3 months. They may happen as often as several times a day.

Bulimia has two types:

  • Purging type. A child with this type regularly binges and then causes himself or herself to throw up. Or the child may misuse laxatives, diuretics, enemas, or other medicines that clear the bowels.
  • Nonpurging type. Instead of purging after binging, a child with this type uses other inappropriate behaviors to control weight. He or she may fast or exercise too much.

Researchers don’t know what causes bulimia. Some things that may lead to it are:

  • Cultural ideals and social attitudes about body appearance
  • Self-evaluation based on body weight and shape
  • Family problems

Most children with bulimia are girls in their teens. They tend to be from a high socioeconomic group. They may have other mental health problems, such as an anxiety or mood disorders.

Children with bulimia are more likely to come from families with a history of:

  • Eating disorders
  • Physical illness
  • Other mental health problems, such as mood disorders or substance abuse

Each child may have different symptoms. But the most common symptoms of bulimia are:

  • Usually a normal or low body weight but sees him or herself as weighing too much
  • Repeated episodes of binge eating, often in secret
  • Fear of not being able to stop eating while bingeing
  • Self-induced throwing up, often in secret
  • Excessive exercise or fasting
  • Strange eating habits or rituals
  • Improper use of laxatives, diuretics, or other medicines to clear the bowels
  • In girls, irregular periods, or no period at all
  • Anxiety
  • Discouragement because he or she is not satisfied with his or her appearance
  • Depression
  • Obsession with food, weight, and body shape
  • Scarring on the back of the fingers from self-induced throwing up
  • Overachieving behaviors

The symptoms of bulimia nervosa may look like other health problems. Make your child sees his or her healthcare provider for a diagnosis.

Parents, teachers, and coaches may be able to spot a child with bulimia. But many children with it first keep their illness hidden. If you notice symptoms of bulimia in your child, you can help by seeking a diagnosis and treatment early. Early treatment can often prevent future problems.

A child psychiatrist or a mental health expert can diagnose bulimia. He or she will talk with you, your partner, and teachers about your child’s behavior. Your child may need psychological testing.

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment often involves a mix of the following:

  • Individual therapy
  • Family therapy
  • Behavior changes
  • Nutritional rehabilitation
  • Medicine for depression or anxiety, if needed

Bulimia can lead to malnutrition. It can harm nearly every organ system in the body. That’s why early diagnosis and treatment is important. Some health problems it may cause are:

  • Damage to the throat, stomach, and bowels
  • Dehydration
  • Tooth decay

Health complications may happen during treatment. Because of this, both your child’s healthcare provider and a registered dietitian nutritionist (RDN) must be part of the care team. You as a parent play a vital role in treatment.

Experts don’t know how to prevent bulimia. But early detection and treatment can lessen symptoms. They can also help your child’s normal development. It can also improve his or her quality of life. Encouraging your child to have healthy eating habits and realistic attitudes toward weight and diet may also help.

Here are things you can do to help your child:

  • Keep all appointments with your child’s healthcare provider.
  • Talk with your child’s healthcare provider about other providers who will be involved in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, psychiatrists, and registered dietitian nutritionists. Your child’s care team will depend on your child’s needs and how serious the bulimia is.
  • Tell others about your child’s bulimia. Work with your child’s healthcare provider and schools to develop a treatment plan.
  • Reach out for support from local community services. Being in touch with other parents who have a child with bulimia may be helpful.

Call your child’s healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms
  • Bulimia nervosa is an eating disorder.
  • A child with this eating problem overeats or binges uncontrollably. He or she may also engage in other activities to control weight. He or she may cause himself or herself to throw up or exercise too much.
  • Social attitudes toward body appearance and family problems may lead to bulimia.
  • A mental health expert can diagnose this eating problem.
  • A child may need therapy and nutritional rehab.

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
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Open Neural Tube Defects (ONTDs) in Children

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Open neural tube defects (ONTDs) are problems with the way the brain, spinal cord, or spine forms while a baby is growing in the mother’s uterus. These problems occur in about 1 in every 1,500 newborn babies each year.   

The types of neural tube defects include:

  • Spina bifida. This is when the spine doesn’t grow normally over the spinal cord. Babies born with spina bifida may have minor or short-term problems. Or they may have lasting (permanent), serious physical problems. These may include paralysis, lack of bowel and bladder control, club feet, a buildup of spinal fluid in the head (hydrocephaly), and intellectual disability. In most cases, a child may need 1 or more surgeries after birth. This is the most common kind of ONTD.
  • Anencephaly. This defect is when part of the brain and skull don’t form. It occurs when the neural tube doesn’t close at the base of the skull. Babies with anencephaly often die in the uterus after 20 weeks of pregnancy (stillborn). Or they only live for a very short time after birth.
  • Encephalocele. This is a very rare condition. With this defect, the brain or its coverings poke through the skull. This can occur anywhere from the forehead to the lower back of the skull. But it may also occur in the front of the skull, near the nose and sinuses. In most cases, a child may need multiple surgeries after birth.

During pregnancy, the brain and spine begin as a flat plate of cells. This plate rolls into a tube, called the neural tube. The tube is completely formed 28 to 32 days after conception. If all or part of the neural tube fails to close, this leaves an opening. The opening is called an open neural tube defect. The opening in the tube may be left exposed or covered with bone or skin.

Neural tube defects are caused by genes passed on from both parents and from environmental factors. Some of these factors include obesity, uncontrolled diabetes in the mother, and some prescription medicines. In most cases, a child with a neural tube defect has no family history of this problem. ONTDs happen 5 times more often in girls than boys.

Once a child with a neural tube
defect has been born in the family, the chance that this problem will happen in another
child rises to 1 in 25. The type of neural tube defect can differ the second time. For
example, a family’s first baby could be born with anencephaly. A second baby could have
spina bifida instead.

Other risk factors for neural tube defects include:

  • Mother’s
    age.     Spina bifida is more common in teen mothers.
  • History of
    miscarriage.    A woman who has had miscarriages in the past has a higher risk of having a baby
    with neural tube defects.
  • Birth
    order.     First-born babies are at higher risk.
  • Socioeconomic status. Children born into lower socioeconomic families
    are at higher risk for spina bifida. Researchers think that poor diet may be a
    factor.

Symptoms depend on the type of ONTD. And they can occur a bit differently in each child.

Symptoms of spina bifida can include:

  • Area on the back that looks abnormal, such as a small hairy patch, dimple, or birthmark, or a pouch-like bulge (sac)
  • No feeling below the place on the spine where the sac is
  • No ability to move the legs (paralysis)
  • Constipation or incontinence

The baby may also have other problems such as:

  • Increased fluid and pressure in the head area (hydrocephalus)
  • Heart problems
  • Bone problems
  • Intellectual disability                                     

Symptoms of anencephaly can include:

  • No bones on the back of the head
  • Missing bones on the front and sides of the head
  • Large areas of brain missing
  • Folding of the ears
  • Split in the roof of the mouth (cleft palate)
  • Congenital heart defects

Symptoms of encephalocele can include:

  • Bulging sac at back of skull
  • Face defects
  • Fluid on the brain (hydrocephaly)
  • Small head
  • Weakness of arms or legs
  • Trouble moving, walking, reaching
  • Intellectual disability
  • Vision problems
  • Delayed growth and development
  • Seizures

The signs and symptoms of open neural tube defects can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

ONTDs can be diagnosed before birth with tests that include:

  • Blood
    test.    A test called a quad screen measures 4 substances in the mother’s blood. This
    can see if there is an increased risk for neural tube defects and other problems.
    This test is done between 16 and 18 weeks of pregnancy. It measures levels of
    alpha-fetoprotein (AFP) and other things in the blood. AFP is a protein made by the
    baby growing in the uterus. If a baby has an open neural tube defect, the AFP level
    in the mother’s blood will be higher than normal. The test isn’t conclusive. This
    means it can’t prove that your baby has an open neural tube defect. But it can show
    if your baby is at risk for an ONTD. The test can show if you need more testing. The
    American College of Obstetrics and Gynecology (ACOG) advises that this blood test be
    offered to all pregnant women.
  • Prenatal
    ultrasound.    This imaging test uses high-frequency sound waves and a computer to make images
    of blood vessels, tissues, and organs. Ultrasounds let healthcare providers see the
    internal organs as they function. They also show blood flow through blood vessels.
    Prenatal ultrasound may be able to find an open neural tube defect. Your provider may
    also use ultrasound to look at some of the baby’s other organs and body systems.
  • Amniocentesis. This test looks at a small sample of the fluid that
    surrounds the baby in the uterus. The healthcare provider uses a long, thin needle to
    reach the amniotic sac. He or she takes the sample of fluid and checks it for AFP.
    The test may not be able to find small or closed defects.

After birth, a healthcare provider makes a diagnosis with a physical exam.

If your baby has an ONTD, you may need to have a cesarean section to deliver your baby. This is often done to lower the risk for damage to the spinal cord that may occur during a vaginal delivery.

If your child has spina bifida or encephalocele, he or she may need surgery to:

  • Fix and close the defect
  • Treat hydrocephalus
  • Treat bone (orthopedic) problems
  • Repair bowel and bladder problems

A baby may also need:

  • Rehabilitation
  • Positioning aids that help the child sit, lie, or stand
  • Braces and splints that help prevent deformity and give support or protection to areas of the body
  • Medicines

Talk with your child’s healthcare
providers about the risks, benefits, and possible side effects of all treatments.

There is no cure or standard treatment for anencephaly. Treatment is supportive. This means efforts are made to keep the baby as comfortable as possible. Anencephaly most often leads to death in days or weeks. Grief counseling services are available to help parents cope with the loss of their child.

Babies with spina bifida are at high risk of developing a latex allergy. This is because they are exposed to latex during the many medical and surgical procedures they need. Your baby’s healthcare team will do their best to limit how much latex your baby is exposed to. Your baby’s healthcare providers can help you find out which products contain latex and also find products that are latex-free.

Up to 3 in 4 babies with anencephaly are stillborn. Anencephaly most often leads to death in days or weeks.

The neural tube closes 28 to 32 days after a baby is conceived. This is before many women know that they are pregnant. Normal development of the brain and spinal cord may be affected during these first 3 to 8 weeks of pregnancy by:

  • Not getting enough vitamins such as folic acid and other nutrients
  • Infection
  • Using prescription medicine or alcohol
  • Being around hazardous chemicals and other substances
  • Genetic problems

Folic acid is in prenatal vitamins. Getting this vitamin early in pregnancy is important to prevent an ONTD. Researchers have found that a woman who gets enough folic acid (vitamin B-9) can help lower the risk for neural tube defects. Folic acid is found in some leafy green vegetables, nuts, beans, citrus fruits, and fortified breakfast cereals. Experts recommend that all women of childbearing age take a daily multivitamin containing 400 to 800 micrograms of folic acid.

If you have had a child with a neural tube defect, your healthcare provider may recommend taking a larger amount of folic acid before your next pregnancy. Your provider may tell you to take this extra amount for 1 to 2 months before conception and then through the first trimester.

Your healthcare provider may also
advise genetic counseling. You can talk with a counselor about the risk of a neural tube
defect in a future pregnancy. Also talk with your provider about getting a prescription
for folic acid to lower the risk for another open neural tube defect.

 Your child’s healthcare providers will work to prevent deformities or keep them to a minimum. They will also work to help your child make the most of his or her capabilities. Physical and occupational rehabilitation, plus extra support in school, can help a child function as well as possible.

If your baby is born with an ONTD, there are things you can do to take care of yourself and your baby:

  • Keep all appointments with your baby’s healthcare provider.
  • Talk with your baby’s healthcare
    provider about other providers who will be part of your child’s care. Your child may
    get care from a multidisciplinary team that may include counselors, social workers,
    clergy, genetic counselors, and physical or occupational therapists. Your child’s
    care team will depend on your baby’s condition.
  • Call your baby’s healthcare provider if you are concerned about your baby’s symptoms.
  • Consider genetic testing and counseling to understand your risk.
  • Tell others about your baby’s condition. Work with your child’s healthcare provider to develop a treatment plan.
  • Ask for support from local community services, such as your faith community, and organizations that specialize in birth defects, such as the March of Dimes.

A diagnosis of anencephaly can be overwhelming and upsetting. You will face difficult decisions about how to care for your baby. Because many babies born with anencephaly may not live beyond the first few days or weeks of life, you may have to cope with your baby never coming home from the hospital.

Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms
  • Open neural tube defects (ONTDs) are problems with the way the brain, spinal cord, or spine forms while a baby is growing in the womb.
  • The types of neural tube defects include spina bifida, anencephaly, and encephalocele. Treatment for an ONTD depends on the type of defect your child has.
  • Neural tube defects are caused by genes passed on from both parents and from environmental factors.
  • Symptoms can include a bulging sac on the back of the neck or head, or a very small head.
  • Experts recommend that all women of childbearing age take a daily multivitamin containing 400 to 800 micrograms of folic acid. Getting this vitamin early in pregnancy is important to prevent an ONTD.
  • ONTDs can be diagnosed before birth with tests that include a blood test, prenatal ultrasound, or amniocentesis.

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.