Welcome to Michael's Website

INFORMATION ON MY CONDITIONS

• Autism

url to this info: http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=211

Although it was first identified in 1943, autism is still a relatively unknown disability. Yet autistic spectrum disorders are estimated to touch the lives of over 500,000 families throughout the UK.

What is autism?

Autism is a lifelong developmental disability that affects the way a person communicates and relates to people around them. Children and adults with autism have difficulties with everyday social interaction. Their ability to develop friendships is generally limited as is their capacity to understand other people's emotional expression.

People with autism can often have accompanying learning disabilities but everyone with the condition shares a difficulty in making sense of the world.

There is also a condition called Asperger syndrome, which is a form of autism used to describe people who are usually at the higher functioning end of the autistic spectrum.

"Reality to an autistic person is a confusing, interacting mass of events, people, places, sounds and sights. There seems to be no clear boundaries, order or meaning to anything. A large part of my life is spent just trying to work out the pattern behind everything."

                                                                 - A person with autism  

What are the characteristics of autism?

People with autism generally experience three main areas of difficulty; these are known as the triad of impairments.

• Social interaction (difficulty with social relationships, for example appearing aloof and indifferent to other people)
• Social communication (difficulty with verbal and non-verbal communication, for example not fully understanding the meaning of common gestures, facial expressions or tone of voice)
• Imagination (difficulty in the development of interpersonal play and imagination, for example having a limited range of imaginative activities, possibly copied and pursued rigidly and repetitively).

In addition to this triad, repetitive behaviour patterns and resistance to change in routine are often characteristic. 
 

What causes autism?

The exact cause or causes of autism is/are still not known but research shows that genetic factors are important. It is also evident from research that autism may be associated with a variety of conditions affecting brain development which occur before, during, or very soon after birth.

Diagnosis

The earlier a diagnosis of autism is made, the better the chances are of a person receiving appropriate help and support.

Can people with autism be helped?

Specialist education and structured support can really make a difference to the life of a person with autism, helping to maximise skills and achieve full potential in adulthood.

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• Bronchopulmonary Dysplasia

URL: http://asthma.about.com/library/weekly/aa110600a.htm

Bronchopulmonary Dysplasia (BPD)

Bronchopulmonary Dysplasia (BPD) is not a naturally occurring lung disease. BPD is a result of the efforts used to save premature infants and full term infants that require ventilatory support and high concentration oxygen at birth. In the United States, BPD ranks with cystic fibrosis and asthma as the most common types of chronic lung disease in infants.

BPD is caused by the pressure used to ventilate an infant's premature lungs and the oxygen used to maintain blood oxygen levels for the infant's survival. These two factors, along with infection, are the primary cause of BPD. Various ventilator and treatment modalities such as High Frequency Oscillatory Ventilation (HFOV), Continuous Positive Airway Pressure (CPAP), and Permissive Hypercarbia have been used to try to keep pressures and oxygen concentrations low.

An older definition of BPD defines it as any infant still dependent on ventilator support for oxygen at 28 days of age. A newer definition characterizes BPD as any infant requiring supplemental oxygen after 36 weeks of gestational age.

Most infants that develop BPD are premature. Ninety percent are premature infants weighing less than 1500 grams (3.5 pounds) at birth. Micro-preemies, those born before 24 weeks gestation and weighing under 1000 grams, BPD can develop even without an acute respiratory problem. As weight and gestational age decrease, the chances of an infant developing BPD increases.

Signs that an infant is developing BPD are rapid shallow breathing, retractions (sucking in of the skin between the ribs and the chest), cough, paradoxical or see-saw movement of the chest and abdomen, and wheezing. An infant is determined to have BPD if they have a history of lung injury within the first few days after birth, a continuous need for supplemental oxygen, and persistent signs of respiratory distress after 28 days of age.

Infants with BPD require a great deal of care and often develop more problems in the course of that care. In addition to needing ventilator support, they may develop complication involving the heart, brain, kidneys, eyes, and gastrointestinal tract. In some severe cases the infant will die.

Treatment of BPD infants include administrating surfactant to help the lungs function, mechanical ventilation, supplemental oxygen, strict control of fluid intake and output, treatment of (patent ductus arteriosus (PDA), bronchodilators, steroids, diuretics, antibiotics, intravenous feeds, and physical therapy. Most infants survive to be able to go home but may still need ventilatory support or supplemental oxygen.

Children that survive BPD often have slowed growth and some residual decrease in lung function. Outcome depends greatly on severity, the most severe may have long term problems with muscle tone, exercise tolerance, vision and hearing problems, and learning disabilities.

The advances made in the care of infants weighing as little as 500 grams has made it possible for a majority of these infants to survive. But there has been a price, BPD is only one of many. The only practical way to help prevent BPD is better prenatal care especially for high risk mothers that have the highest rate of premature and low birth weight infants.

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• DEVELOPMENTAL DELAY

Doctors will look at the following factors when investigating concerns about developmental delays:

The best predictors of development are skills relating to brain functioning, rather than reaching specific movement milestones within the expected timeframe.

Language and problem solving milestones in infancy provide the best insights into intellectual potential, and their evolution is independent of motor skills which may be obscured by physical disability.

Psychosocial abilities are critical to understand the whole child and in making a meaningful assessment about behaviour, but they do little in assessing motor and intellectual skills.

A developmental delay is defined as absence of age specific developmental behaviours.

The following is a guideline by age and months of delay:

A delay in learning increases the risk for diagnosis of a specific mental disability or medical condition. These may include:

A developmental delay becomes Mental Retardation after the age 3 years due to ability to provide more accurate tests; however, a diagnosis may be made earlier where there is a significant degree of impairment. (Moderate mental retardation suspected at 12 months, established by 2 years; mild mental retardation suspected at 2 years, established at 3 years). However, parents need to maintain hope, therefore continue to use delay, where there is potential for catch up.

Risk factors

Prenatal maternal factors:

Developmental evaluation

Various screening techniques are used to assess the level of intellectual functioning for babies and children. Some of these include:

Risk factors for developmental delay identified on developmental assessment:

Clinical evaluation by doctors only identifies about half the children in need due to some of the following factors:

Early intervention and treatment

What works?

There are several recognised factors which may help limit problems linked to slow development. These include:

The Medic8® Family Health Guide

• Dysphagia

This information taken from :  http://www.nidcd.nih.gov/health/voice/dysph.asp

What Is Dysphagia?

People with dysphagia have difficulty swallowing and may also experience pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Eating then becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body.

How Do We Swallow?

Swallowing is a complex process. Some 50 pairs of muscles and many nerves work to move food from the mouth to the stomach. This happens in three stages. First, the tongue moves the food around in the mouth for chewing. Chewing makes the food the right size to swallow and helps mix the food with saliva. Saliva softens and moistens the food to make swallowing easier. During this first stage, the tongue collects the prepared food or liquid, making it ready for swallowing.

The second stage begins when the tongue pushes the food or liquid to the back of the mouth, which triggers a swallowing reflex that passes the food through the pharynx (the canal that connects the mouth with the esophagus). During this stage, the larynx (voice box) closes tightly and breathing stops to prevent food or liquid from entering the lungs.

The third stage begins when food or liquid enters the esophagus, the canal that carries food and liquid to the stomach. This passage through the esophagus usually occurs in about 3 seconds, depending on the texture or consistency of the food.

How Does Dysphagia Occur?

Dysphagia occurs when there is a problem with any part of the swallowing process. Weak tongue or cheek muscles may make it hard to move food around in the mouth for chewing. Food pieces that are too large for swallowing may enter the throat and block the passage of air.

Other problems include not being able to start the swallowing reflex (a stimulus that allows food and liquids to move safely through the pharynx) because of a stroke or other nervous system disorder. People with these kinds of problems are unable to begin the muscle movements that allow food to move from the mouth to the stomach. Another difficulty can occur when weak throat muscles cannot move all of the food toward the stomach. Bits of food can fall or be pulled into the windpipe (trachea), which may result in lung infection.

What Are Some Problems Caused by Dysphagia?

Dysphagia can be serious. Someone who cannot swallow well may not be able to eat enough of the right foods to stay healthy or maintain an ideal weight.

Sometimes, when foods or liquids enter the windpipe of a person who has dysphagia, coughing or throat clearing cannot remove it. Food or liquid that stays in the windpipe may enter the lungs and create a chance for harmful bacteria to grow. A serious infection (aspiration pneumonia) can result.

Swallowing disorders may also include the development of a pocket outside the esophagus caused by weakness in the esophageal wall. This abnormal pocket traps some food being swallowed. While lying down or sleeping, a person with this problem may draw undigested food into the pharynx. The esophagus may be too narrow, causing food to stick. This food may prevent other food or even liquids from entering the stomach.

What Causes Dysphagia?

Dysphagia has many causes. Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. For example, people with diseases of the nervous system, such as cerebral palsy or Parkinson's disease, often have problems swallowing. Additionally, stroke or head injury may affect the coordination of the swallowing muscles or limit sensation in the mouth and throat. An infection or irritation can cause narrowing of the esophagus. People born with abnormalities of the swallowing mechanism may not be able to swallow normally. Infants who are born with a hole in the roof of the mouth (cleft palate) are unable to suck properly, which complicates nursing and drinking from a regular baby bottle.

In addition, cancer of the head, neck, or esophagus may cause swallowing problems. Sometimes the treatment for these types of cancers can cause dysphagia. Injuries of the head, neck, and chest may also create swallowing problems.

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• Hypotonia

Hypotonia literally means low muscle tone. Therefore, this is not a diagnosis of a particular condition but simply refers to low muscle tone that can be caused by a variety of conditions. In addition, its severity can vary significantly from mild to severe hypotonia depending on the underlying cause.

Hypotonic infants appear floppy. Head control may be poor causing the head to fall forwards, backwards and/or sideways in the sitting position. This is also reflected in head lag when pulling the child to sitting from lying down. Often children with hypotonia have good arm and leg movements but the range of movements at the hips, elbows and knees is excessive. Poor sucking and chewing may also be present in some hypotonic children depending on the underlying condition.

In a significant number of cases hypotonia is merely a reflection of increased joint laxity and the term 'benign hypermobility syndrome' is often used in these cases. The joint laxity and associated hypotonia tends to improve with time in the majority of children.

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• Pectus Carinatum

Medical Encyclopedia: Pectus carinatum

URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/003321.htm

Alternative names   

Pigeon breast

Definition   

Pectus carinatum describes a protrusion of the chest over the sternum, often described as giving the person a bird-like appearance.

Considerations   

url of this page:- http://tiscali.medicdirect.co.uk/videos/?step=4&pid=2342

Respiratory

A number of different pathologies can cause respiratory distress in the newborn. Features of this distress include:

• tachypnoea (>60 breaths/minute)
• subcostal and sternal recession (the soft bones of the newborn's ribcage are deformed with increased work of breathing) and tracheal tug
• grunting (attempt to maintain Positive End Expiratory Pressure [PEEP] and thereby prevent lung collapse at expiration)
• nasal flaring
• low saturations
• apnoea (immature brain control of respiration)

Hyaline Membrane Disease (HMD) is the pathological finding in the lungs of newborn premature babies. The clinical picture it produces is called 'Respiratory Distress Syndrome' (RDS).

The condition is caused by immaturity of the lungs, especially lack of surfactant production. The absence of surfactant, which normally reduces the surface tension in the lungs, leads to collapse. It can occur in term infants, especially infants of diabetic mothers, though this is rare. As well as lacking surfactant the lungs of premature babies are underdeveloped. Alveoli only start to form at about 24 weeks' gestation and at this stage are thick walled and poorly adapted for gas exchange. As the baby matures so do the lungs with increased numbers and maturity of the alveoli. (This development actually continues until the child is about seven years old).

It is lung maturity that usually limits resuscitation of very premature infants. Steroids given to mother up to 48 hours before delivery help to mature the lungs by 'switching on' surfactant production. After delivery surfactant can be given to babies with RDS.

Bronchopulmonary Dysplasia (BPD) is the sequel of hyaline membrane disease. It is defined as an oxygen requirement beyond 36 weeks gestation (previously an oxygen requirement at 28 days of age). It results from damage to the developing lung caused by HMD and ventilation. Babies with BPD can require oxygen for well over a year after delivery. Failure to provide adequate oxygen can lead to pulmonary hypertension and death. Steroids are sometimes used to ameliorate the condition.

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