Health
13 Cool Facts About Water which No One Tells You
Drink water?Why?How will water benefit you?Why should you drink water?How much water is enough?How to drink more water?13 Cool facts about water which no one tells you is the one post you must bookmark to remember why you need to drink more water.
What I must tell you at the beginning:
Water is a miracle fluid.Oxygen and water are essentials for life.If you think drinking tea, coffee, juices will take care of your water needs, stop kidding yourself.
About water, a lot of varied information will fly.I want to help you know the truth from the myths!
Content breakdown:
- 13 Cool Facts About Water which No One Tells You
- What are the factors which will determine your water needs
- How do you know you are drinking enough water?
- How to drink more water?
- How to make your child drink more water?
- Listen to the podcast
- Watch the video
13 Cool Facts About Water which No One Tells You
1)Drink 500 ml water half an hour before each meal.This will not only help you meet daily water goals but also help you lose excess weight.
2)Suffering from acidity and GERD?Drinking water helps in this too.
3)Water when replacing sugar-laden calorie-heavy drinks help you cut down on extra calories.With obesity a rising epidemic, you can’t afford to ignore this.
4)Physical activity and cognitive function are both improved with good hydration.Important especially in athletes and children to drink adequate water on a daily basis.
5)Older people . may experience delirium and dementia with dehydration.Since their thirst sensation is often altered It’s important for the elderly to drink adequate water.
6)The most obvious effect is on your gut health.If you don’t visit the loo regularly for your morning calls its something you need to think about.Constipation is not cool.A healthy bowel makes a healthy person.
7)Your kidney is crucial in managing your body’s water balance and blood pressure..Your kidney also needs water to filter the toxins from your blood which gets excreted in urine.
No water and this filtration system get strained and urine is decreased and is high-colored.
8)Drink water to prevent a headache and be happy.
Mood swings, irritability, and headache triggers are common signs of low water intake.Lack of adequate water may act as a trigger for migraines.
9)Water intake helps to increase concentration and cognition in children.
10)Adequate water intake reduces urinary tract infection.
11)Water intake has a strong preventive action against kidney and urinary stone formation.
12)It also reduces hypertension, fatal coronary heart diseases, venous thromboembolism.It keeps your cardiovascular system healthy.
13)Water has an effect on your gut health .If you don’t visit the loo regularly for your morning calls, its something you need to think about.Constipation is not cool.A healthy bowel makes a healthy person.This evidence needs more corroboration though.But I think you already know the truth about this.
What are the factors which will determine your water needs
Your general health status .how healthy you are.During fevers, disease states, water need may be increased.
- Environment
- In the hot climate you will need more water to meet your hydration needs.
- Exercise: High BMR states and increase in physical activity means you sweat more and your body needs more water.
- Pregnancy or breastfeeding status .Both these physiologic states need good hydration
Water has a lot of actions other than just hydration.Its range of goodness makes it the right thing to add to your new year health goals.
How do you know you are drinking enough water?
- You will not be thirsty
- You will have great energy.
- Your urine will be light colored.
- You will be making all your cells happy.
How to drink more water?
- Carry your own cool water bottle.Have fruit infusion water.Not fruit juice, or drinks.
- Eat plenty of fruits and veggies.They contain a lot of water and can help fulfill your water needs along with nutrition needs.
How to make your child drink more water?
- Drink water with them.The best way to teach them is by setting an example.
- Make drinking water fun using a sipper or a straw.
- Include plenty of fruits and veggies in their diet.
- Have a water drinking challenge every day, with the loser having to do whatever the winner says.
Listen to the podcast summarizing the main points.
Written as a part of #ChatterPrompts’
13 Cool Facts About Water which No One Tells YouReferences:
- Water-deprivation headache: a new headache with two variants.
Blau JN, Kell CA, Sperling JM
Headache. 2004 Jan; 44(1):79-83.Pubmed - Water, Hydration and Health
Barry M. Popkin, Kristen E. D’Anci, and Irwin H. Rosenberg Pubmed - Harrison Textbook of Internal Medicine
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NOSEBLEED in Kids: 3 THINGS YOU NEED TO KNOW(+A home care checklist download)
Nosebleed in children are worrying.Causes may be many and management of pediatric nose bleeds can be tricky .Read about nose bleed in adults here .
As a parent, it’s heartbreaking and you feel terribly upset.
It’s actually very common.
And not as worrying as it looks.
As an ENT surgeon nosebleed are some of the most frequent emergencies we attend.
The most important advice in cases involving children is rarely medicine.
I felt a little info about first aid home care for nosebleed would be useful.
Why does it happen?
Most often it’s due to nose picking.
Nose picking is easily the most common reason for nosebleed in children.
Luckily nosebleed in children are hardly ever life threatening.
But just knowing the why is not good enough .
Parents need to be aware of danger signs.
The signs below show when you need to visit the emergency.
#IMPORTANT TIP 1
THE DANGER SIGNS WHICH YOU SHOULD KNOW
- Massive nosebleed which cause difficulty breathing
- Massive nosebleed , which doesn’t stop even after the home-care described below.
- You find nosebleed has made your child pale, tired or disoriented.
- Nosebleed occur repeatedly, often and in very large amount without any trauma
- Child has undergone a recent nasal surgery
- Child has some tumour in the nose
Doctors will focus more on the child’s breathing and hemodynamic stability ,than the nosebleed.
This means the child might need intravenous fluid support, blood transfusion, moist oxygen inhalation
Identification of the site and cause of nosebleed, is of importance only after making the child stable.
WHAT CAUSES NOSEBLEED
IN CHILDREN:
- Blowing the nose very hard
- Injury to your child’s nose during playing
- Broken bones
- Temperature and humidity changes make the inside of your child’s nose become dry.
- Juvenile nasopharyngeal angiofibroma
WHAT COULD BE THE CAUSE OF FREQUENT NOSEBLEED IN CHILDREN?
Mostly systemic causes
- Bleeding disorders,coagulopathies:Haemophilia A, B, Factor IX deficiency(Von Willebrand disease)
- Leukemia
- Hereditary Haemorrhagic telangiectasia(HHT)
A study had found at least 1 episode of nosebleed occur
- In 30% children less than 5 years
- 56% children aged 6 to 10 year
- Children younger than two years rarely have nosebleed.
Child abuse is another worrying cause of recurrent nosebleed in children.
That’s a potential red flag for healthcare providers.
50% Adults with nose bleeding has the history of nosebleed during childhood.
#IMPORTANT THING NO.2
WHAT IS THE BEST WAY TO STOP A NOSEBLEED AT HOME?
How to stop Nose bleed
Make your child sit down and bend forward and pinch the soft part of their nose.
- Make your child breathe gently through the mouth
- Do this for at least 5 minutes.Most nosebleed stop by a maximum of 10 minutes of pinching the nose this way
- Bending in front, helps to drain blood down the nose and prevents trickling to the back of the throat .Trickle to the back of throat can cause vomiting and more bleeding.
- You should pinch just above the nostrils
- Place an ice pack on the bridge of your child’s nose
- Avoid nose blowing
- You can apply antibiotic ointment, petroleum jelly,nasal drop.
ANTERIOR EPISTAXIS
Nosebleed in children most commonly occurs from the front part of the nose.
This is known as anterior epistaxis.If its not controlled at home you might need to visit, the emergency of your nearest hospital.
WHAT OTHER WAYS WILL THE DOCTOR STOP THE NASAL BLEEDING
CAUTERY
- Chemical cautery – silver nitrate, TCA
- Electric cautery
- Laser photocoagulation
- Indication – if bleeding site is identified by noting
- Active bleeding
- An eschar
- Prominent vessel
CHEMICAL CAUTERY
- Agent – silver nitrate commonly used
Anaesthesia – LA
- 4% lidocaine within adrenaline or 4% lidocaine with 0.5 phenylephrine or by 10% cocaine
TECHNIQUE
- Circumferentially around the bleeding site and then the real offending bleeding vessel
Disadvantage –
- Repeated cauterization required
- Ulceration or septal perforation
ELECTRIC CAUTERY
- Indication active arterial bleed not controlled by silver nitrate
- Bipolar cautery preferred over unipolar cautery
- If aggressively performed a hole may be formed in the septum
- For posterior bleeding , it has to be stopped using a 30° endoscope and cautery
- In children – cautery should be used under GA.
CARE AFTER CAUTERY
- Local antibiotic ointment x 10 days
- Avoid nose blowing/ picking
- To keep the mouth open while sneezing
ANTERIOR PACKING
INDICATION
- If cautery is not possible
- If obvious site can not be identified
- If bleeding not controlled by cautery.
- Mechanism
- Adequate pressure to the bleeding site
- Thrombosis of bleeding
- Anaesthesia LA/GA
MATERIAL USED
- Absorbable substance
- Oxidized cellulose
- Gelatin sponge
- Surgicel
INDICATION
- In bleeding disorders
- Hereditary telangiectasia
Mechanism of action:All the absorbable packs help the blood to clot .They give a matrix for the platelets and fibrin particles interlinks. This way the bleeding from the nasal cavity can be stopped
ADVANTAGE
- Dissolves spontaneously
- Trauma of pack removal eliminated
MEROCEL PACK: This is in between an Absorbable nasal pack and ribbon gauze.This is made of biocompatible , polyvinyl alcohol sponge material which helps to stop bleeding .It has a very high-capacity for absorption .
Provides a mild pressure and tamponade effect after insertion in the nasal cavity .This tamponade effect helps to stop the bleeding.
It may be kept for upto 5 days , but under antibiotic cover.
Advantage:
- Highly hydrophilic and can absorb blood upto 21 times its volume
- Soft , compressible, easy to insert
- Very little trauma during insertion and removal
- Easy to cut and shape according to size of nasal cavity
Disadvantage:
It’s expensive.
Nasal bleeding which needs high tamponade effect to stop , may not be controlled
RIBBON GAUGE PACK
- Impregnated with antibiotic and vaseline.
– Layered placement of the pack filling
COMPLICATION OF ANP
DURING PACKING
- Vasovagal attack
- Blind packing aggravates bleeding ,as the friable mucosa is traumatized.
- Pushed into throat
WHILE PACK IS PREVENTION IN THE NASAL CAVITY
- Epiphora, or watering of eye
- Secondary sinusitis.Infection of the sinuses.
- Anosmia, sleep apnea
- Toxic shock syndrome
DURING REMOVAL OF PACK
- Vasovagal attack
- Further bleeding
Posterior nosebleeds:
Originate toward the back of the nasal passage, near the throat.Occurs mostly in elderly as hypertensive epistaxis.
Posterior nosebleeds are less common than an anterior nosebleed. But they can be serious and can cause a lot of blood loss. Children do not usually get posterior nosebleeds.
But if it does occur, they can be serious .Posterior epistaxis can cause significant blood loss and collapse.
In children it can occur following trauma to nose.
This causes the nasal bone to break and injury to the sphenopalatine artery .This sphenopalatine artery at the back of the nose can cause profuse bleeding.Thus is a serious emergency and needs urgent medical intervention.
HOW CAN FREQUENT NOSEBLEED IN CHILDREN BE MANAGED?
Consultation with your doctor is important in case of frequent nosebleed.
Careful history: Generally there is the history of prolonged bleeding after minor trauma, teeth extraction etc.
The child may be having other signs of frequent bleeding:
- Pinpoint bleeding spots under the skin (purpura)
- Repeated bruising
- Swollen painful joints
- Bleeding from other places, blood in urine, blood in stool
Investigation:
- Complete haemogram
- BT, CT, platelet count
- Prothrombin time/Activated Partial Thrombosis tin Time
- Hess’s test, factor VIII and IX assay
Treatment:
- Treat the cause
- Stop bleeding
- Cautery is contraindicated
#IMPORTANT THING NO.3
NOSEBLEED PREVENTION
If your child gets nosebleeds frequently.After a full checkup if you find its due to nasal crusts and nosepicking.
There are a few things which you can do to help stop nasal crusting.
The less the crust, less will be the childs tendency to pick his/her nose.
Te following measures will help reduce drying and crusting.This in turn will significantly decrease the nose picking and the chances of getting a nosebleed:
- Use a humidifier in your bedroom while sleeping, especially when the air is very dry.
- Keep your child’s nose moist using a saline nasal spray.
- Teach your child to stop picking his/her nose, clip their fingernails to avoid injury.
- Explaining to your child about the possibility of a doctors visit ,with nose bleed may help them not to pick their nose.
I hope you found this post helpful.
Please share and help another parent.They will thank you for this.
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Tracheostomy Care in Children:What you need to know(+A handy guide for download)
Tracheostomy Care in children
A distinctly serious topic.But a necessary one.
I realized this when working as a resident in Safdarjung Hospital New Delhi, many caregivers would often ask persistent questions regarding home care.
All children may not be fit for home care.
But for those who are otherwise alright, home environment often speeds up their recovery to a tube free life.
What is tracheostomy?
Tracheostomy is an opening made in the anterior wall of the breathing tube or trachea.
For children the opening is generally a slit in the tracheal cartilage and the cartilage itself is never removed.
It’s a life-saving procedure.
What are the indications of tracheostomy in children?
Indication for Pediatric tracheostomy
- To relieve upper airway obstruction(most common)
- To prevent complication of prolonged ventilation
- To reduce anatomical dead space
- Allow suction toilet of trachea
Indication of upper airway obstruction potentially requiring tracheostomy
Nose, Nasopharynx, oropharynx, base of tongue:
- Choanel atresia
- Macroglossia
- Treacher Collins/Goldenhar Syndrome
- Cystic hygroma
Supraglottis and glottis:
- Supraglottic cyst
- Vocal cord palsy
- Physical trauma
Subglottis trachea:
- Tracheomalacia
- High tracheal stenosis
Conditions which may require prolonged ventilation
- Failure of control over breathing
- Chest wall dysfunction
- Disorders of Lung parenchyma
- Large Airway disease
- Central sleep apnea (Ondine’s curse)
- Thoracic dystrophy
- Bronchopulmonary dysplasia
- Tracheobronchomalacia.
The serious nature of the conditions which require tracheostomy will give you an idea, about why this procedure helps to save lives. is only done when all other conservative options fail.
Itis only done when all other conservative options fail.
[wysija_form id=”16″]
So what should parents and caregivers of children living with tracheostomy know?
1)Acceptance
I know it’s difficult to watch a child breathing through a tube.
You wonder why innocent children have to suffer.
But that tube will help the child live healthier.
Always remember when condition improves , tracheostomy is a totally reversible procedure , with little morbidity.
[Tweet theme=”basic-white”]Having faith and hope is must[/Tweet]
Acceptance of a tracheostomized child is important. As your child breathes and feeds better , your unconditional love and support will help him/her accept the tube and live healthier.
As your child breathes and feeds better , your unconditional love and support will help him/her accept the tube and live healthier.
2)Suctioning the tracheostomy Tube
The suction catheter should not be passed more than 1cm beyond tube tip to avoid tracheal damage.
With time , secretions become less.
Then you need to suction less frequently.
Humidification of inspired air by using nebulizer & tracheostomy mask helps to prevent excessive drying and irritation of trachea.
The suction should be made to suck some clean water after every tracheostomy Tube suction and kept clean.
The suction tube should be changed regularly.
The frequency of change ideally should be every 2 to 3 days , but will depend on the condition of child.
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3)Supervision and sleeping
Baby with a new tracheostomy should be sleeping near parent.
This helps in becoming familiar with the sounds she makes and to determine the frequency of suctioning.
It’s good to keep a child monitor next to the child at all times.
4)Change of tube
First change of tube is always done by a doctor.
Then after you can learn to change tube under supervision by a trained healthcare worker.
This makes you confident and keeps you aware about potential hazards.
- When you come home the tube may be changed weekly if no cheat infection present.
- If the child has Chest infection then it’s better you change tube, every 2-3 days
- Never change tube at home alone.Always 2 caregivers should be present during the change of tracheostomy Tube.
- In hot humid climate, it’s better to change the Tracheostomy Tube tape daily.One side at a time should be changed by 1 caregiver while the other caregiver holds the tube in place
- Always wash your hand with soap and water before touching the tube.
- Before insertion of fresh tracheostomy tube, lubrication with xylocaine jelly helps to lessen the irritation.
5)Bathing
Swimming is not allowed.
The bath should always be supervised even for older children.
Better not to use an overhead shower.
A handheld shower or bucket -mug technique works best.
6)School
If the child has no other problem, regular schooling should be continued.
But it’s important for the teachers, healthcare workers, and school authorities to be aware of the condition, potential hazard, and emergency management procedure.
7)Discipline
When we are ill we are pampered.
But as the child gets better it’s best to treat him /her as you would any other child.
Discipline and all other activities should be like a normal child.
You should encourage him /her to participate in activities as far as possible (discuss with your doctor if your child’s special condition has any restrictions ).
Dress the tracheostomy Tube with a nice scarf to avoid unpleasant curiosity and help your child feel like the other little ones.
8)Speech and Language development
An assessment by a speech therapist early helps you plan better.
- Tracheostomy tube with a speaking valve is a must.
- Encourage both verbal and nonverbal means of communication with your child.
9)Travel
Wherever child goes, a suction pump must go.
- Suction pump
- Spare tracheostomy Tube
- Tape
- Xylocaine jelly
- Suction catheter
- Syringe
- Saline
- Scissors
10)Equipment needed for Home care of Tracheostomy tube
- Tracheostomy Tube
- Suction catheter
- Suction pump 3
a)Permanent at home
b)portable suction pump for travel
c)Manual: in case of power disruption, malfunction, regular cleaning and service of pump
11)Skin Care:
- Keep the tape clean and dry at all times
- Every day put a clean soft piece of gauze tucked between the skin of the neck and the side flanges of the tube.
- This gauze should be changed as soon as it gets wet
- Clean the skin around the tracheostomy opening with a gauze soaked (and rinsed dry) in mild antiseptic solution, keeping in mind to make the skin dry afterward.
12 )Requirement for children at home with tracheostomy
- Caregiver : At least 2 responsible adults
- The environment at home: Adequate space, heating, cooling, humidifying facility.Having a telephone and access to transportation.
- Healthcare Support system:
District Nurse
Community pediatrician
General Physician
Hospital nearby
Community support
Having a child with a tracheostomy is a big challenge.
But if your child is otherwise healthy and you are willing to learn .
You can take care of a tracheostomy at home.
But every case is unique and the best guide to your child’s conditions is your doctor.
Stay informed and stay healthy.
Sign up below and get a handy guide for home care of tracheostomy tube.
Disclaimer :
The information provided here is strictly for the purpose of helping you live better and not to be confused with professional medical advice which is only given after professional consultation.
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EAR PIERCING : DON’T DO IT WITHOUT READING THIS!
Ear Piercing has been popular from time immemorial. Piercings, at all levels of the pinna, is popular even now. Sometimes even the tragus is pierced. I am an ENT surgeon and this is a public service post.
Previously seen in rural, but now more among the urban population than before. So what’s the worry?
Traditionally single piercing of the ear lobule’s fleshy part caused little problem.P roper aseptic precautions in the right setup were all that was needed!
But piercing of the cartilaginous part often brings with it multiple problems.
Problems of Piercing in cartilaginous part
- perichondritis (inflammation of cartilage )
- hypertrophic scar
- keloids
- sometimes even necrosis of the cartilage
- the collapse of the pinna.
The problems of inflammation, infection hypertrophic scar, keloid can occur also in the lobular part.
Signs of infection of Pinna after piercing
Pain, redness, swelling, discharge.
If piercing can cause these problems both in the ear lobules and cartilaginous part, then why the precaution for cartilage piercing?
The deformity produced in the cartilaginous part is greater and often more severe. Add to it the sensitive nature of cartilage and the prominent site of your ear.This piercing may give you the kind of “look” which is more than what you bargained for!
So what should you know before you go for an Ear Piercing?
1) Avoid piercing of the cartilage of your ear.
2)Go for Ear Piercing in the fleshy lower part(lobe)
3)Ensure Aseptic measures are being taken care of.
The doctor or the piercing clinic representative should be using sterile gloves.
Sterile instruments should be used. Cleaning the ear lobules with betadine solution,
Cleaning the ear lobules with betadine solution, spirit is recommended.
4)If you have a history of a thick raised scar forming in regions with cuts and scars…
AVOID EAR PIERCING especially if you are still in your growing years!
What material should you use while choosing earrings?
Gold, Silver, Platinum, Titanium, stainless steel non-reacting, neutral pure metal.Ring or stud with no ridging. This is important because imitation alloys and even white gold (it contains nickel along with gold )can cause a foreign body reaction.
Inflammation, infections, and allergic reaction predisposes to hypertrophic scar and keloid formation.
Can pain during piercing be reduced?
Yes, it’s possible by topical application of a local anesthetic agent preferably 15 to 20 min before the procedure.
Who can do ear piercing?
ENT surgeon and dermatologist can both pierce the ear aseptically with due precautions. But all of them may not be doing it. Often piercing clinics are the only option and, in that case, you have to use your sensibility to choose the best option!
What is the care required after Ear piercing?
1)Keep the ear-piercing clean.
After washing hand with soap and water clean the ear lobules with cotton wool dipped in antiseptic solution, twice a day.
2)Rotate the earring in its hole slowly to avoid the build-up of debris.
3)Keep the region dry.
4)Look out for signs of infection. Infection and allergic reactions make the chance of hypertrophic scar, and keloid formation more likely.
5)Don’t try to change the ear-ring/stud before 6 weeks after Ear piercing.
6)Continue wearing ear-ring continuously for 6 months as otherwise the tract will not form and the piercing may close.
What to do for foreign body reaction to ear-ring?
A granulomatous inflammation due to foreign body reaction may manifest as an itchy, reddish, nodular lesion at the site of the piercing. Taking out the offending object followed by steroid ointment application in proper concentration helps cure the condition in most cases
More aggressive lesions may need intralesional (within the swelling) steroid injections and sometimes even excision. Keep in mind to avoid further piercing at least 6 months after this event and ideally till the growing age of the person is over.
What is Keloid and why you should be careful?
Some people may have an aggressive response of skin repair after surgical nonsurgical trauma to the skin.
It’s characterized by elevated itchy scars after even minor skin lacerations. This occurs due to an over-enthusiastic, poorly regulated proliferation of the cells responsible for skin repair and is mediated by the individual immune system.
The problem with people with this problem going for Ear Piercing is they will develop unsightly nodular lesions on the pinna which are often very difficult to get rid of completely.
Best treatment options for Keloid
Steroid treatment
Steroid-containing creams and ointment. May work for small lesions. Helps to flatten the lesion and decreases itchiness. Often regains to original size after stoppage of cream.
For both hypertrophic scar and keloid:
The serial weekly course of intralesional steroid injection helps decrease the itching, and redness and decreases the size of the lesion. The main reason steroids work is they decrease the hyper-reactivity of the scar-forming tissues. A prolonged treatment up to 6 to 7 weeks may be needed in some cases.
Pros of this treatment:
- Maybe done in an outpatient setting.
- Not expensive
- Less morbidity
Cons of this treatment:
A high level of patient motivation and compliance is needed for weekly pricking with a needle.
There’s often loose extra skin left at the site of lesion, which looks unsightly.
Smaller lesions respond better.
Surgical excision followed by steroid injection at the base of the lesion location.
This mode of treatment actually gives good results in most cases, especially for large keloids.
The principle of surgical excision for best result in keloid is to give the surgical incision within 1cm of the external border of the lesion. This avoids the involvement of further area of skin.
After excision of the bulk of the keloid intralesional steroid injection is given at the base of the lesion to inhibit further proliferation of fibroblasts. This steroid injection is again repeated weekly till about 6 to 7 weeks for best results.
Laser surgery is also another method of excision. But not much difference in results has been seen compared to regular surgery.
The results for surgery alone are not very good. But surgery along with steroid injection gives quite a good result in the majority of small to medium-sized keloid. Results may, however, vary according to the size of the Keloid and patient profile.
Radiotherapy along with Surgery
Radiotherapy is a definite a last resort.
It’s used only in case of highly disfiguring keloids resistant to other types if treatment.
An important thing to remember is if you have a tendency to keloid formation, you should definitely avoid repeat piercings and all nonsurgical types of skin trauma.You should also tell your doctor about this before all surgical treatment.
What’s the Ideal age for skin piercing in Children?
This is a somewhat controversial area. Though there’s no set age for Ear Piercing. It’s better to get it done when the child is able to actively help take care of the ear-piercing site and ear-ring. About 6 to 10 years is a good age when the child is able to understand the process and will be actively interested.
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So pierce your ear or your child’s ear, do it with due precautions. Did you get your ears pierced? Do you plan to get your ears pierced?
Comment below to let me know what problems(if any ) you have faced when you got your ears pierced when you got your ears pierced.
Ear piercing image by Stuart Miles at freedigitalphotos.net
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