Ok, ok, ok! I’ve been informed more than once this week that two other bugs have an affinity for human flesh and are seen just as often, at least in the warmer climes. I admit I had forgotten about the more, let’s say: “winter challenged” (equatorially inclined) portions and desert areas of this great world where both ticks and fleas flourish.
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There are lots and lots of things that cause rashes in children and we’ve spoken about them several times before. There are fewer problems that cause rashes that itch and less caused by things that bite— although that’s still more than in a world I would create… if it were me.
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It’s incredible how popular the posts that I do with a “guess the answer” format have been. I usually try to make them about topics which train young parents in diagnostic or treatment skills that will help them keep their children healthy and safe.
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Astin, the 17-year-old who suffered cardiac arrest when he was hit in the chest by an elbow playing baseball, is back for his 2nd follow-up. Remember, last visit he was depressed with worry over all the junk he had read on the internet and you (well I) assigned him some homework.
For the third article in the series we’ll talk about what we can do to “prevent” Commotio Cordis (CC, his final diagnosis) and help him decide about going back to play baseball in competition.
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Ok, it’s been over a week and your 17-year-old Commotio Cordis patient who suffered a cardiac arrest on the baseball field is back for his follow-up and an answer to his question: “When can I go back to playing baseball?”
You knew he was coming and you’ve had a week to prepare what to tell him… so, go ahead, I’d like to hear this too…
Sudden Cardiac Death is, by definition, both sudden and unexpected – especially in a child whose life is supposed to revolve around “play” and “fun.” Unfortunately, it is also increasing.
Just as unfortunate, children’s “play” is often “industrialized” into major competitions with adult methods, standards and expectations leading to unintended consequences.
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This was a fun series of articles to write, but about an almost terrible experience on a 17-year-old boy athlete. It made the papers when he ostensibly had a “heart attack” on the baseball field.
The reader gets to “see the patient” and make a diagnosis (and see my humorous side) while learning about the four causes of sudden cardiac arrest in a child.
In follow-up we see some of the emotional side-effects of the near-death experience, exacerbated by viewing social media; and learn methods of problem-solving the correct way.
“That gunky, smelly, puss draining out of your son’s ear is an infection called ‘Otitis Externa‘ – or possibly Otitis Media that has ruptured and is draining.
With the history you gave I’m guessing it’s ‘externa’ – you can call it ‘Swimmer’s Ear‘ but I don’t, cause it’s certainly caused by a lot more things than merely swimming.”
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For the first time in a long time that I can remember, the dislike of mosquitos has taken on an entirely new life this summer. Most certainly due to all the medical news about the mosquito illnesses and Zika; but, there are other diseases mosquitos harbor too that we can’t just rely on “citrus smells” and “bug zappers” to defeat.
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The Lachman test is pretty easy to explain to someone but difficult to understand without some kind of example.
A plastic model of the knee helps in understanding but an actual patient is better. Unfortunately, there isn’t always one available during your “teaching moment.”
A great alternative is a good teacher and a cooperative patient on a video – like this one.
The anterior cruciate ligament (ACL) is hidden inside the knee joint and is diagnosed by performing the Lachman Test during a thorough physical exam – like this one by a pediatric orthopedist.
As you watch him explain the terms: “medial” means “inside or middle“; “lateral” means “outside“; “anterior” means “to the front” and “posterior” means “to the rear.”
There are two “collateral” ligments – one on each of the medial and lateral sides of the knee which prevent right and left scissoring of the lower leg outward and inward.
And there are two “cruciate” ligments – the anterior and posterior, in the middle of the joint which prevent the lower leg from slipping forward or backward out of the joint.
There are other tests which diagnose tears in the remaining three knee ligaments that are not described here. An ACL tear is the most common injury of this type.
Thirty-six million kids participating in organized sports across the US means that 2.6 million of them will be treated in ERs this year with sport’s injuries – and that’s not counting informal recreational activities or kids over 19.
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We’ve written about common summer problems in previous posts. But we’ve got a new crop of kids going out the front door now this season and a new crop of parents worrying about their bumps, bruises and fractures.
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