This is the first part of this series on Autism. Today we are going to talk about What Autism is.  Since it is such a broad category and the symptoms are very important to understand. This is where we will spend our time today.  In Part Two we will look at the causes, the diagnosis, and the management of Autism.

Autism has been a word that has been used in the media so much over the past several years. But do you really know what Autism is?  Are your children at risk of getting Autism and is Autism on the rise?  These are great questions.  Now let’s take a look.

Autism is a Development Disorder

Really this is means a neurodevelopment disorder.

On a basic level, autism is a behavioral issue.  You will notice that children with this condition have difficulty functioning with other children. The problem is that there is a large range of symptoms. You may not even know that someone has Autism because their symptoms may be very mild.

It often deals with the repetitive movements or restricted social behaviors. Both can be seen in some degree.

It can become seen in children during infancy or during childhood.  Often, changes are seen between six months of age and three years. Though changes can really be seen at any age.

There is not one symptom that defines this disease. It is more of a collection of symptoms or evaluations.

Main Symptoms

1.)     Problems with Social Interactions

This may mean that the child doesn’t react in a social setting as other children do. They may have less stimuli with other children.

They may smile less often than expected and they may avoid eye contact or have limited eye contact.  In some cases, pointing at things may be a problem.

They may avoid talking with other children or a normal quizzical behavior. They prefer to be left alone, but not always.

Speech is often affected. Sentence structure or communication is a problem.

Babbling, slow speech, confused speech, unrecognizable gestures, voice pattern changes, screaming, and other speech problems can be seen.

2.)     Repetitive Behavior

Several types of repetitive behaviors can be seen.  No one child may have all the repetitive behavior or the exact behavior seen. But often, a similar or exact behavior can be identified.

Hand flapping or banging occurs often.  Head rolling to one side or the other. This happens over and over again as if a game.  A large percentage of the time, the child will rock their body back and forth. It could be torso, head, arms, or legs. Often though, it is the entire body.

They may arrange items according to size, color, lines,

Also seen is a desire to have a pattern in their day.  This means that they prefer the same chores, processes to get ready for the day and more.

An aspect of Repetitive behavior that can become a real problem is self-injury.  This happens repetitively.  They will start biting their hand over and over again. They can also bang their head again and again.

This can also be seen with picking of skin, poking an eye, kicking a foot.

These self-injuries behaviors seem to affect just under fifty percent of those with Autism.

3.)     Restricted Interests

There is a sense of sameness. This means that there is a huge resistance to change. This can be seen in changing schools, vacations, moving, or even day to day things like where furniture is positioned in the room and other more basic things.

Preoccupation is another thing that is seen. This means that their attention gets grabbed by a certain object, toy, game, or television program.  They become so preoccupied that they only want that toy or object. They lose focus or interest in other things for a period.

4.)     Others

This area is far more difficult.  Often it is difficult to say that a particular behavior is or isn’t an aspect of Autism. It could be just something they are going through at the time, or something unique to the child.

Abilities – this area is not a given. Some children with less affecting autism may have some ability. It is estimated to affect somewhere between 1 percent and 10 percent of those with Autism.  A sub category of Autism is Asperger’s. Abilities are found liked with this diagnosis in some cases.

An ability could be memorization, math extraordinaire,  musical instrument, and many other rare talents. In many cases these individuals are called Savants.

Other symptoms may include: muscle loss, difficulty walking, unusual eating patterns, stomach problems, and others.

Classification

Autism falls under the category of Pervasive Developmental Disorders or PDD.

There are five disorders

1.)     Autism
2.)     Asperger Syndrome
3.)     Rett Syndrome
4.)     Childhood Disintegrative Disorder
5.)     PDD not otherwise specified

Stay tune to Part Two to look at:  the causes, the diagnosis, and the management of Autism.

We’ve all heard something similar to, “My chest is on Fire!”

Though really, this could mean a ton of different things. Heartburn is one of the options and it can literally feel like your chest is on fire. Of course, other options may be heart attack, angina, muscle pains, anxiety and much more.

Today I am going to look at Heartburn

Heartburn is also known as acid indigestion, acid reflux, and much more.

The pain arises in the chest, but can also occur in the stomach, throat and back.

It occurs when acid from the stomach becomes to much of a problem. This could happen in the stomach itself or when acid is regurgitated into the esophagus.

This condition is often seen during pregnancy.

GERD

This is another name for acid reflux.  This is when the cells of the esophagus are damaged because of the acid.  Often an area on the lower end of the esophagus holds the stomach opening closed until food comes into play.

If this area is damaged or impaired, the acid can become a problem.

Functional Heartburn

This occurs when the heartburn occurs without a known cause.   It can be from other medical disorders like irritable bowel syndrome, gastrointestinal disorders, as well as other causes.

Cardiac

Sometimes, heartburn can follow angina or a heart attack.  Ischemic heart disease may also precede heartburn.

In these cases, treatment of the underlying condition is vitally important.

Symptoms

1.)     Feeling of acid in throat, chest, or stomach
2.)     Regurgitation of food.
3.)     Difficulty sleeping
4.)     Symptoms worsen after spicy foods
5.)     Symptoms worsen after acidic foods
6.)     Symptoms worsen after other foods
7.)     Symptoms worsen after eating
8.)     Symptoms worsen when laying down
9.)     Nausea
10.)     Diarrhea
11.)    Chest pain  (In some cases – traditional heart burn is not felt. Instead, a chest discomfort or pain is seen.)
12.)    Chronic cough
13.)    Breathing difficulties
14.)    Change in voice
15.)    Need to clear throat
16.)    Burping or gas
17.)    Others

Diagnosis

Since the cause and symptoms are so overwhelming, symptoms are often treated with Tums, Pepto, or over the counter medications before an actual diagnosis can be seen.

Diagnosis is primarily done by signs and symptoms.  Pregnancy is another place where symptoms can be seen.

A normal X-ray is usually unhelpful.

Another specific X-ray can be done called an Upper GI series. It will find ulcers in some cases. A fasting is done.  A drink is given that will help enhance the X-ray.  Can also be called a barium swallow.

Endoscopy

This is another diagnostic approach.  It is done with a camera that enters the mouth and continues into the stomach. It can evaluate tissue, damage, ulcers, and much more. Biopsies can be taken to examine tissue, ulcers, or blockage.

The endoscopy is a scope that is highly used for chronic heartburn.

In some cases hiatal hernia can be seen.  In these cases, an out pocketing of the stomach results in a larger chance for heartburn.

Ulcers are often seen through endoscopy

pH monitoring –

A probe is placed through the nose that can record the acidity of the esophagus.  The stomach has a specific acid level.   When the acidity ph changes – a larger amount of heartburn can be seen.

Prevention

1.)     Lose weight
2.)     Sleep on left side of body
3.)     Sleep with upper body raised
4.)     Avoid spicy foods
5.)     Avoid acid foods
6.)     Exercise
7.)     Eat smaller meals

Treatment

Often treatment consists of starting with over-the-counter medications including TUMs or Antacids.  Fiber tabs may be beneficial in some cases

If symptoms don’t improve, prescription medications to treat acid production can be given. In some cases, these medications are becoming over-the-counter.  But continued heartburn should be discussed with a medical provider.

Surgery – when the cause is a hiatal hernia, which can increase the acid in the esophagus, surgery is a great choice. Not something that everyone with a hiatial hernia needs, but it should be considered.

A reader of our blog recently wanted emailed and asked for  help on an issue that she was having. She indicated she was suffering from an overactive bladder.

This is a common and very frustrating occurrence in women after live births, as they age, and even can be found in men.   Imagine that every time you go into a building, your office, or your own home, the first thing that you do is find the restroom.

Overactive bladder can be such a problem that for several days of the month, you fear leaving your own home.   When you have overactive bladder, you have sudden and frequent sensations to urinate. But even worse than that, you have accidental urination and sometimes painful urination.

Overactive Bladder

This is a urological condition that can also be called urge incontinence.  Many times the symptoms can be seen during the day as well as night.

It is believed that somewhere between 10 and 30 percent of Americans experience frequent urination.

It is defined when you urinate more than 8 times a day.

The problem with this definition is that there are other causes of urinating over 8 times per day including bladder infections, bladder tumors, cystitis, and others. Therefore, these other conditions often need to be rule out as something more serious.

Cause of Overactive Bladder

This is the unknown aspect of this condition.   Often the first place to look is a group of muscles that help with urination – They are called Detrusor urinae muscle.

This muscle contracts with urination occurs.  When it is relaxed, it allows the bladder to fill.  When the muscle contracts, then urination can occur.

Overactive bladder does increase or becomes more prevalent as age increases.

Caffeine – this causes an increased urinary output. Often this only makes things worse and isn’t a direct cause of the problem.

Diagnosis

This is often done after ruling out everything else that could potential be the main problem.

Once this is done, the next step is to get tested or a Urodynamic Testing.   This is a study the assesses how the bladder and urethra are performing.

The goal of the bladder and urethra is to store and release urine in a timely manner.

This diagnostic test is done in Urology, Gynecology, and other offices.

It also looks at the prostate of men who have enlarged prostates.  In this case, an enlarged prostate can cause a man to void several times a day and at night.

The test itself is initially about how you urinate. The strength and stream of the urination. They measure the volume of your urine after you finish urinating.

They will check the urine under a microscope. They also check to see how fast you can empty your bladder.   This can look specifically into why you may or may not be completely voiding.

X-rays can also be done as you are urinating. This is a more specialized look at the voiding process.

Treatment for Overactive Bladder

1.)     Retraining your muscles.

-          This is a reminder that your body has gotten used to frequent urination
-          Bladder training will lengthen the time between voiding process.
-          An active attempt to hold your urination
-          This is a very slow process – extending time between voiding by 5 minutes and not 60 minutes initially.

2.)     Fluid restriction

3.)     Caffeine restriction

4.)     Medications

5.)     Botulinum toxin in some cases

6.)     Urinary devices

7.)     Other

Overview

Overactive bladder is a difficult thing and you’d be surprised at how hard and demoralizing it can be for those who are affected. Treatment is often only a partial improvement. Much of what happens is because of the fear we have inside our heads.

By beginning treatment, that fear is replaced by a goal and a realization that improvement is possible.

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