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Pediatric progress report(1)


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Pediatric progress report(1)

  1. 1. Dr. Thomas Gregson’sThe information provided in this presentation is not intended as a substitute for medical consultation and doesnot imply or suggest that a Doctor of Chiropractic treats, cures or prevents any disease. There are noguarantees that any chiropractic care will provide a cure for your specific health problem.© 2005 Peter Pan Potential 559.291.5585
  2. 2. Nocturnal Enuresis
  3. 3. A Common ProblemTwo to three million children in the U.S. suffer fromnocturnal enuresis, including 10% to 15% of 5-year-olds and5% of 10-year-olds.
  4. 4. What is Nocturnal Enuresis?Nocturnal enuresis is the medical termfor nighttime bedwetting.It can be described as involuntaryurination during sleep in the absence ofa urological or neurological disorder.
  5. 5. The cause of nocturnal enuresis, orbedwetting, is not clearly known.Heredity seems to be a factor, sincechildren with the disorder are three tofour times more likely to have a parentwho also had the problem as a child.
  6. 6. Don’t children just grow out of it?For the most part, children do grow outof it, but many do not.Some children continue to struggle withbedwetting well after their tenth year.This situation presents many challengesfor both the child and their family.
  7. 7. Children with bedwetting problemsoften become frustrated with theirinability to control the disorder.This may be compounded by a parent’sfeelings of annoyance or frustrations.
  8. 8. The condition is an embarrassing anduncomfortable one.Furthermore, it may interfere with thechild’s desire and ability to participatein some of the priceless activities ofyouth – camp-outs, sleepovers, orweekends with grandparents.
  9. 9. One important factor to consider iswhether the child’s episodes ofbedwetting may be related topsychological or emotional issues.Further, it is important that systemicdisorders like diabetes be ruled out aspart of a medical evaluation.
  10. 10. What is the medical approach?Many children who experiencebedwetting problems have achievedfavorable results with behaviormodification training.One study found that over half of theparticipating children over the age ofseven achieved success with aregimen of dry bed training and a“wetness alarm”.
  11. 11. However, drugs tend to be a morefrequent treatment prescribed byphysicians.Unfortunately, prolonged effectivenessof these drugs (usually imipramine ordesmopressin) is less encouraging.
  12. 12. After the termination of the drugtreatment, only a fraction of thepatients continued to enjoy thebenefits.Furthermore, as with all drugs, sideeffects such as seizures, allergicreactions, and increased bloodpressure may occur.
  13. 13. Can chiropractic care help?Many parents report an improvement,often quite significant, afterimplementing a schedule of regularchiropractic visits for their child.In addition, numerous case studieshave demonstrated that chiropracticcare has quickly improved or evenresolved the problem.
  14. 14. While there is no guarantee thatchiropractic care will help, it doesprovide a sensible, non-invasiveapproach to managing the condition.Consider talking with a qualified doctorof chiropractic about how your childmight benefit from regular visits.
  15. 15. Otitis Media
  16. 16. Heard the Latest onChildhood Ear Infections?
  17. 17. The #1 reason why patients take theirchildren to the pediatrician’s office is toinvestigate an earache.Many of these visits result in a diagnosisof Otitis Media (OM).
  18. 18. From 1975 to 1990, office visits forOtitis Media increased by 150 percent –that’s nearly 24.5 million doctor visits.The leading age group of Otitis Mediasufferers is children under the age oftwo. So, if you are the parent of aninfant or toddler, it is important thatyou educate yourself about thiscondition.
  19. 19. What is Otitis Media?Otitis Media (OM) is the general namefor several conditions that can affect themiddle ear. This includes inflammationof the middle ear, ranging from acute tochronic.
  20. 20. Outward symptoms may be present, butnot always. For example, Acute OtitisMedia (AOM) is characterized bysymptoms of pain and fever.However Otitis Media with Effusion(OME) may or may not produce visiblesymptoms. “Effusion” simply meansthat there is fluid in the middle ear.
  21. 21. What are the Symptoms?The most obvious symptom of OtitisMedia is earache and the feeling ofpressure and blockagein the ear.If there is fluid in the middle ear, theremay be a temporary loss of hearing.
  22. 22. Due to their age, children may not be ableto verbally describe what they are feeling.However, you may notice them rubbing ortugging on the affected ear.Of course, this may be accompanied byfrequent crying.
  23. 23. Often parents are quick to assume thatthese symptoms point to an earinfection.However, teething often produces similarsymptoms, and even physicians mayjump to the conclusion that Otitis Mediais the cause.But, before you overreact, closelyobserve your child’s symptoms and, ofcourse, don’t delay seeking qualifiedcare.
  24. 24. Some Children are at Higher RiskThe Clinical Practice Guidelines, whichhave been established by the U.S.Government to give standard proceduresfor common ailments, concluded thatbottle-feeding, secondhand smoke andchildcare facilities can expose your childto a higher risk for Otitis Media withEffusion.
  25. 25. Other factors that may contribute areallergies and sensitivity to airbornesubstances.Even certain foods, such as dairyproducts, wheat, soy, corn and peanutsmay put your child at risk.
  26. 26. What does the U.S. Department ofHealth and Human Servicesrecommend?For Otitis Media with Effusion, the ClinicalPractice Guidelines suggest observation ofthe condition for a period of three to sixmonths.
  27. 27. After this initial observation period, drugtherapy may be indicated.The standard treatment for OM is a ten-day regimen of the antibiotic, amoxicillin.However, this may not be the best courseof action.
  28. 28. Does Drug Therapy Work?The purpose of antibiotics in treating earproblems in children is unclear.
  29. 29. George Washington University and theUniversity of Minnesota recentlyreviewed 33 studies evaluating the effectof various antibiotics for the treatment ofAcute Otitis Media.The review discovered that drugs onlyhave a slight advantage over the body’sown immune system.
  30. 30. A study published in the Journal of theAmerican Medical Association (JAMA)found that children with chronic earachesreceiving amoxicillin experienced 2 to 6times the rate of recurrence whencompared with those taking a placebo.
  31. 31. A review of antibiotic therapy for acuteOM revealed that there was poorevidence to support the usage ofantibiotics for children under two yearsof age.
  32. 32. There are a few circumstances whenantibiotics are called for or recommended,but those occur only when culture andsensitivity tests are done.Also important to consider is the fact thatdrug therapy may not eliminate the fluidpresent in the ear.
  33. 33. In fact, the drugs may cause side effectssuch as diarrhea, gastric intestinaldisturbances, nausea and vomiting.Drug-resistant strains of bacteria mayalso develop.Finally, in approximately 60 percent ofaffected children, middle ear fluid simplygoes away without treatment withinthree months.
  34. 34. A Common Sense Approach toOtitis MediaBefore you begin a regimen of drugtherapy for your child, you shouldcarefully consider chiropractic care.
  35. 35. A recent study was published in theJournal of Clinical Chiropractic Pediatricsregarding the role of chiropractic care forchildren with Otitis Media.The results were very interesting.
  36. 36. Of the 332 children that participated, thestudy revealed that Otitis Media wasresolved in an average of only 4 visits inacute cases and an average of only 5visits in chronic cases.This data suggests the possibility thatchiropractic care may be more effectivethan drug therapy in addressing yourchild’s health.
  37. 37. While there is no guarantee thatchiropractic care will help your child, itdoes provide a sensible, non-invasiveapproach to managing your child’shealth.Talk to your qualified doctor ofchiropractic about how your child mightbenefit from regular visits.
  38. 38. Normal Tympanic Membrane
  39. 39. Red Reflex
  40. 40. Acute Otitis Media with Infection
  41. 41. Otitis Media With Effusion
  42. 42. Tympanostomy
  43. 43. Asthma
  44. 44. Want to Breath a Little Easierabout Your Child’s Asthma?
  45. 45. Missed School DaysDid you know that childhood asthmacauses more school absences than anyother single pediatric disorder?And the problem seems to be growing.Between 1982 and 1992, there was a56.7% increase in newly diagnosedasthma cases in the U.S.
  46. 46. What is Asthma?Asthma is the obstruction of the lungs’airflow, and extreme sensitivity in theairway to environmental conditions.Asthma is the most common of all chronicchildhood illnesses and one of the leadingcauses of hospitalization for acute care ofchildren.In the U.S., asthma affects nearly 5 millionchildren under the age of 18.
  47. 47. What are the Symptoms?An acute attack typically includes anxiety,along with wheezing and painful and/orlabored breathing.This is a result of the rib cage puttingpressure on the lungs, causingcompression of the soft tissues (alveoli andsmall bronchi).The resulting reduced airflow, combinedwith the presence of mucus, results inwheezing during exhalation.
  48. 48. What Triggers Asthma?It can’t be accurately predicted who willdevelop asthma, but some children maybe at higher risk.Triggering mechanisms can includepollens, house dust and animals,exposure to cold, and psychologicalstress factors.Physical exertion may also cause oraggravate the condition. Asthma mayalso be associated with the increasedlevel of pollution.
  49. 49. How is Asthma Treated?There is no “cure” for asthma.The only treatment is to control itssymptoms. The primary medicalapproach is drug therapy.For those types of asthma that aretriggered by allergies, avoidance of thosesubstances that produce the allergicreaction is also important.
  50. 50. Drugs in the steroid family are a typicaltreatment for acute asthmatic episodes.Inhalers are often used in early stages ofthe disease, or for minor attacks. Theseinhalers, or “bronchodilators,” are usedto help ease the restriction to the airway.Unfortunately, many patients find itnecessary to continue using inhalersthroughout their lives.
  51. 51. Are there Side Effects?If you and your physician are consideringthe use of drugs to manage your child’sasthma, it is important to weigh thepotential benefits against the risks.Although the treatment of asthma bymedication is common and for many, lifesustaining, there may be other healthcomplications associated with thisapproach.
  52. 52. Frequent side effects of drugs• increased vulnerability to infection• headache• nausea• diarrhea• indigestion• nervousness• appetite changes• throat, nasal and eye irritations• insomnia
  53. 53. Less common side effects• allergic reactions• heart problems• diabetes• increased blood pressure• stomach pain
  54. 54. Can Chiropractic Care Help?A positive correlation has been notedbetween chiropractic care and thepatient’s perception of relief from theirasthma symptoms.Perhaps more compelling are thepersonal stories of parents and childrenwho have experienced the benefitsfirsthand. Many have observed adecrease in the severity of asthmasymptoms after implementing a scheduleof regular chiropractic visits.
  55. 55. Chiropractic care represents a safe, drug-free approach that could reduce oreliminate the need for medication.Consider talking to a qualified doctor ofchiropractic to learn more about howregular chiropractic care may benefityour child.
  56. 56. What are your next steps?• Fill out the Family Health Survey,• Pick up available literature,• Discuss this information with yourspouse, and• Make an appointment for yourwellness consultation.
  57. 57. How to Contact Us…Gregson Health Chiropractic425 Winter StreetMadawaska, ME 04756P: (207)