Endometrial Ablation Podcast

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

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

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

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.

Obesity in Teens

Obesity is when a teen has too much body fat. Obesity is a serious, long-term disease.

In many ways, childhood obesity is a puzzling disease. Doctors do not fully understand how the body controls weight and body fat. On one hand, the cause seems simple. If a person takes in more calories than he or she uses for energy, then he or she will gain weight.

But a teen’s obesity can be caused by a combination of things. It can be linked to:

  • Genes
  • Socioeconomic issues
  • How the body turns food into energy (metabolism)
  • Not getting enough sleep
  • Lifestyle choices

Some endocrine disorders, diseases, and medicines may also have a strong effect on a child’s weight.

Things that may put your teen at risk for obesity are:

  • Genes. Obesity may be passed down through families. Having even one obese parent may raise a child’s risk for it. Experts are looking at the link between genes, the ever-changing environment, and obesity.
  • Metabolism. Each person’s body uses energy differently. Metabolism and hormones don’t affect everyone the same way. They may play a role in weight gain in children and teens.
  • Socioeconomic factors. There is a strong tie between economic status and obesity. Obesity is more common among low-income people. In some places, people may have limited access to affordable healthy foods. Or they may not have a safe place to exercise.
  • Lifestyle choices. Overeating and an inactive lifestyle both contribute to obesity. A diet full of sugary, high-fat, and refined foods can lead to weight gain. So can a lack of regular exercise. In children, watching TV and sitting at a computer can play a part.

Too much body fat is the main symptom of obesity. But it’s hard to directly measure body fat. A guideline called the body mass index (BMI) is used to estimate it. The BMI uses a teen’s weight and height to come up with a result. The result is then compared with standards for children of the same gender between the ages of 2 and 20.

A teen who is overweight has a BMI between the 85th and 95th percentile for age and gender. He or she is obese if the BMI is greater than the 95th percentile for age and gender.

Obesity is diagnosed by a healthcare provider. BMI is often used to define obesity in teens. It has 2 categories:

  • BMIs at the 95th percentile or more for age and gender, or BMIs of more than 30, whichever is smaller. BMI findings in this category mean the child should have a full health checkup.
  • BMIs between the 85th and 95th percentile, or BMIs equal to 30, whichever is smaller. This result means the child should have a screening that looks at 5 areas of health risk:
    • Family history of cardiovascular disease, high cholesterol, diabetes, and obesity
    • High blood pressure
    • Total cholesterol level
    • Large gains in BMI from year to year
    • Concerns about weight, including the child’s own concerns about being overweight

Treatment depends on your teen’s symptoms, age, and health. It also depends on how severe the condition is.

Treatment for obesity may include:

  • Diet counseling
  • Changes to diet and amount of calories eaten
  • More physical activity or an exercise program
  • Behavior changes
  • Individual or group therapy that focuses on changing behaviors and facing feelings linked to weight and normal developmental issues
  • Support and encouragement for making changes and following recommended treatments

Treatment often involves the help of a nutritionist, mental health professionals, and an exercise specialist. Your teen’s treatment goals should be realistic. They should focus on a modest cutting back of calories, changing eating habits, and adding more physical activity.

Obesity can affect your teen’s health in a number of ways. These include:

  • High blood pressure and high cholesterol. These are risk factors for heart disease.
  • Diabetes. Obesity is the major cause of type 2 diabetes. It can cause resistance to insulin, the hormone that controls blood sugar. When obesity causes insulin resistance, blood sugar becomes higher than normal.
  • Joint problems, such as osteoarthritis. Obesity can affect the knees and hips because of the stress placed on the joints by extra weight.
  • Sleep apnea and breathing problems. Sleep apnea causes people to stop breathing for brief periods. It interrupts sleep throughout the night and causes sleepiness during the day. It also causes heavy snoring. The risk for other breathing problems such as asthma is higher in an obese child.
  • Psychosocial effects. Modern culture often sees overly thin people as the ideal in body size. Because of this, people who are overweight or obese often suffer disadvantages. They may be blamed for their condition. They may be seen as lazy or weak-willed. Obese children can have low self-esteem that affects their social life and emotional health.

Young people often become overweight or obese because they have poor eating habits and aren’t active enough. Genes also play a role.

Here are some tips to help your teen stay at a healthy weight:

  • Focus on the whole family. Slowly work to change your family’s eating habits and activity levels. Don’t focus on a child’s weight.
  • Be a role model. Parents who eat healthy foods and are physically active set an example. Their child is more likely to do the same.
  • Encourage physical activity. Children should get at least 60 minutes of physical activity each day.
  • Limit screen time. Cut your teen’s screen time to less than 2 hours a day in front of the TV and computer.
  • Have healthy snacks on hand. Keep the refrigerator stocked with fat-free or low-fat milk instead of soft drinks. Offer fresh fruit and vegetables instead of snacks high in sugar and fat.
  • Aim for 5 or more. Serve at least 5 servings of fruits and vegetables each day.
  • Drink more water. Encourage teens to have water instead of drinks with added sugar. Limit your child’s intake of soft drinks, sports drinks, and fruit juice drinks.
  • Get enough sleep. Encourage teens to get more sleep every night. Earlier bedtimes have been found to decrease rates of obesity.
  • Obesity is a long-term disease. It’s when a teen has too much body fat.
  • Many things can lead to childhood obesity. These include genes and lifestyle choices.
  • Body mass index (BMI) is used to diagnose obesity. It’s based on a child’s weight and height.
  • Treatment may include diet counseling, exercise, therapy, and support.
  • Obesity can lead to many other health problems. Some of these are heart disease, type 2 diabetes, and joint problems.
  • Obesity can be prevented with healthy lifestyle choices like being more physically active and eating more fruits and vegetables.

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

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.