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### Human:\nwhat is the right age for children to get braces?\n\n### Assistant: age 7 or 8 is a good time to have an orthodontic screening exam. frequently younger children can wear retainer-type appliances which will mold the jaws properly and make it possible for braces to be worn for a shorter amount of time.

### Human:\ni have a son who is 10 years old and 5 ft tall and he is on adhd medicene but cannot gain weight he is only 67 lbs. right now i know it probably has to do with the adhd med but he cannot go off it is their a protein diet he go on so it will not hurt him?\n\n### Assistant: protein diets do not cause weight gain and may even cause weight loss. most important is following your son's appetite. kids on adhd meds tend to be hungriest in the morning and dinnertime when the effects of mediation have worn off -- take advantage of these times. your best bet is to see a pediatric dietitian. they will track your son's growth and can provide diet recommendations to keep his weight and growth on track. they understand the effects of different medications. don't delay getting help! see adhd drugs and growth

### Human:\nare there lifestyle and dietary factors that can decrease the risk of breast cancer?\n\n### Assistant: weight is a really important factor to the postmenopausal woman. higher body mass index and postmenopausal weight gain increase a woman’s risk for breast cancer. a woman who has a bmi of more than 33 is 27% more likely to get breast cancer than a woman with a bmi of less than 21. losing about 22 pounds will lower your risk regular physical activity can help women protect themselves from breast cancer. engaging in say fast walking for 10 hours or more per week can benefit women immensely. drinking alcohol has definitely been shown to be a risk factor and the more one drinks the higher the risk. i always say “one drink is good for the heart but two drinks are bad for your breasts”. other factors that seem to help decrease the risk: eating olive oil sticking to a low-fat diet that includes monounsaturated and polyunsaturated fats complex carbohydrates and minimal red meat. taking vitamin d and coq10 may also help lower your risk. soy is still controversial so i advise eating no more than what is in a standard asian diet — 20 grams per day. breastfeeding for a least six months may decrease breast cancer risk. with every 12 months of breastfeeding a reduction of 4. 3% was seen for breast cancer risk. finally if a woman can control for this she should try to have a baby at a younger age. having a first baby before age 25 will decrease a woman’s risk by 10% and having a baby before 35 decreases her risk by 5%. unfortunately having a first baby later in life puts a woman at greater risk for breast cancer because of perimenopausal breast changes from hormones of pregnancy. yes

### Human:\nwhen signing up for health insurance in the exchange what happens to families with mixed eligibility?\n\n### Assistant: one of the most important aspects of the state insurance exchange is that there is “no wrong door” to find appropriate coverage. when you apply your application will determine your family’s eligibility for medicaid chip and exchange subsidies. states determine eligibility for medicaid based on household income. if you qualify for medicaid in your state you cannot qualify for a subsidy on the exchange. subsidy eligibility on the health insurance exchanges depends upon your household income and its relation to the federal poverty level (fpl). if your household earns between 100-400 percent of the fpl that corresponds to the size of your family you are eligible for subsidies on the exchange. for a single person in 2013 the 100-400 percent fpl income range is $11 490 to $45 960. in some cases for example children may qualify for chip whereas the parents qualify for exchange subsidies. in all cases your state health insurance exchange should lead you to the “right door” for coverage.

### Human:\ndo they make porcelain crowns for toddlers?\n\n### Assistant: porcelain crowns are a fairly expensive. the more permanent procedure they require is not indicated for toddlers. there are quicker more convenient procedures that can be performed in one visit for toddlers and children.

### Human:\nhow can i keep my hair and skin oil-free in the summer?\n\n### Assistant: oily hair is a natural production. if you wash your hair frequently it causes your body to produce more oil. the less you wash it the more the production slows down. ways to absorb body oil is to use baby powder. just use a small amount at the roots and pat the white color out. some hair salons have colored hair powder that can be used if you do not like the white powder. as for the face or skin a light lotion that is less greasy should be applied as a moisturizer. there are also face towelettes that can be used to blot the face and eliminate oil and perspiration.

### Human:\ni usually eat meat substitutes like tofu or seitan. do i need to eat meat instead while pregnant?\n\n### Assistant: your baby can receive nutrients for growth and develop while you follow a vegetarian meal plan. instead of meat you can continue to eat good sources of vegetable-based protein including beans peas nuts and seeds.

### Human:\nif a child is peanut-allergic can he have other nuts?\n\n### Assistant: yes. . peanuts are not really nuts. they are legumes. they grow in the soil. treenuts like walnuts pecans or cashews grow in trees -- hence the name. peanuts and treenuts are completely different types of allergies. but there are some food allergies that do go hand in hand. for instance a person who is allergic to cashews might also be allergic to mangos and pistachios.

### Human:\nour child in college is being treated for depression. we feel more support is needed but live far away. what can we do?\n\n### Assistant: i think it is tough in that you want to balance your child's autonomy and also make sure they get the care they need. i would ask your child to sign a release of information where their counselor at college is free to contact you and disclose information. then have a discussion with therapist that you would like to be notified of future appointments (so you can push your kid to attend) and also of missed appointments. some campuses may have a support group -- the student counseling service at college might be able to direct [you to] -- they may even run the groups.

### Human:\nhow can i get my 5-month-old to eat his cereal?\n\n### Assistant: feeding advice is sometimes hard to swallow and it is often easier (or at least tempting) for a parent to do something than nothing. i make these light-hearted comments because it is probably best to relax and give your son a little more time. you certainly should not worry about your son being behind -- especially since some do not recommend solid foods until 6 months. children will vary in every way and though your child may not be as quick to embrace spoon feeding the odds are high that he will be advanced in many other areas. assuming no difficulties with bottle feeding or other develeopmental delays i would not worry about this particular feeding milestone at all. you can write back to us all in 2-4 weeks when he is chowing down with enthusiasm.

### Human:\nreal ginger ale (without all the sugar) helps ease my nausea. but could the carbonation be harmful to me or my baby?\n\n### Assistant: carbonation does not present a health risk. in fact sparkling mineral water sometimes contains a little calcium and magnesium which are healthy minerals needed for the development of bones.

### Human:\nif a mother says to her 12 year old girl "i love u more if u were skinny" will it mentally scar the child? . will the child also develop abnormal behavior and think abnormally. i have a friend who is always depressed and she asked me why i would hang out with her. i said becuz u are nice and clean and a good person and u love god. she didn't believe me saying that she was too fat for that and explained to me that her mom didn't love her becuz she said "i love u more if u were skinny". she said she thinks her mom doesn't care if she was rude or disrespectful as long as she is skinny. .\n\n### Assistant: if a parents send their kids the message that they value appearance more than who they are as a person it will not have beneficial effects. that being said every person is different in how they react to such circumstances so it's hard to generalize. this article discusses the connection between weight and mothers and daughters. maybe your friend can get help with this issue so she can see how it is affecting her life today.

### Human:\ndoes drinking too much water and soda before a meal make you feel full that you do not want to eat? . my sons girlfriend allows her children to drink a lot of water and soda right before they eat and then they do not eat. doesn't drinking a lot before a meal fill you up and then you are not hungry?\n\n### Assistant: yes drinking fluids especially sugar-sweetened or calorie-containing beverages can cause feelings of fullness resulting in decreased food intake. young children with small stomachs are more likely to fill up than older children and adults. it's best to serve calorie-containing beverages with meals. for example juice and milk with lunch or dinner and soda only occasionally. water is the best in between meal beverage. good luck!

### Human:\nare baby carrots (pre-washed mini carrots you can get by the bag at the grocery store) bad for you?\n\n### Assistant: baby carrots are not at all bad for you! in fact they’re quite the contrary actually. there were concerns going around the internet that baby carrots were bad for you because they were rinsed in a solution that contains chlorine. it’s true that baby carrots as well as many other pre-cut vegetables on the market are cleansed using a solution that contains water and chlorine but this is to help prevent food borne bacteria like e. coli and salmonella. the baby carrots are rinsed again with potable water afterwards to reduce any trace of the chlorine. it’s important to know that the chlorine is used in amounts much lower than what the fda allows. also rinsing the baby carrots at home wouldn’t make a difference because even your tap water has chlorine in it too! there were also rumors around the internet that a white film that you may see develop on the baby carrot is chlorine rising to the surface but it’s merely just a result of dehydration. the bottom line is that baby carrots are safe to eat are low in calories and are a great source of nutrients like vitamin a and fiber so they can be part of an overall healthy eating plan. no. these are fine to eat. they taste pretty-good too.

### Human:\nmy 6-year-old has a black discoloration on his gums that is sensitive to touch. it won’t come off. what could this be?\n\n### Assistant: the possibilities include an infection trauma an erupting tooth or normal pigmentation. either way i would strongly suggest a visit to the pediatric dentist for an evaluation of the problem.

### Human:\ni am five and a half months pregnant and take xanax. can this drug harm the fetus and how do i taper off my dosage?\n\n### Assistant: the u. s. food and drug administration (fda) assigns a category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. xanax and its generic (alprazolam) have been assigned pregnancy category d meaning this class of medication have shown clear evidence of risk to the fetus in studies. pregnancy category d is a stronger warning class than pregnancy categories c or b classifications. a pregnancy category d medicine may still be given to a pregnant woman if the health care provider believes that the benefits to the woman outweigh the possible risks to the unborn child. i would not just stop taking the medication if you are concerned that you may be causing harm to your baby. work with your health care provider to decide whether you should be taking the medication. if you reach a decision to not take the medication any longer work with your provider or pharmacist to taper (decrease gradually) the dose to take and to prevent withdrawal symptoms. common withdrawal symptoms consist of but are not limited to nausea vomiting diarrhea increased heart rate palpitations hallucinations memory loss confusion panic attacks seizures dizziness headaches depression and insomnia. it is important to work with your health care provider to make sure you are getting the best care possible. one side effect is clef lip to your unborn child

### Human:\nmy child wants to eat constanly and is on concerta for adha. dont know if symptom or eating disorder. she use to have curbed appetite being on the medicine but now eats non stop. gorges herself and thinks she is hungry non stop.\n\n### Assistant: most helpful answer although the medication she is on often decreases appetite it can increase appetite in some people. i would visit a pediatric dietitian for an evaluation to make sure nothing else is going on. you can find a dietitian near you at eatright. org. in the meantime here are some things you can do at home: structure meals and snacks at the table and don't allow grazing between meals. provide a variety of food groups at meals (2-3 at snack and 4-5 at meals) especially protein rich foods and fiber (fruits vegetables whole grains beans) that help increase feelings of fullness. allow treats but provide them less often. encourage her to listen to feeling so fullness and remind her she can have more food at the next meal etc. allow at least an hour of day for physical activity. good luck!

### Human:\nmy periods have always been weird – never normal. my latest period lasted three days and is very light. what is wrong? . i took a home pregnancy test and it was negative. i also had my tubes tied. could i possibly be pregnant despite the test?\n\n### Assistant: while it is uncommon to conceive after having had a tubal ligation it can happen. moreover there is an increased risk of it being a tubal or ectopic pregnancy. thus you were wise to do a reliable pregnancy test given your prior history of super light flows while actually pregnant. if you develop any pregnancy symptoms your should have the test repeated by a gyn or local family planning clinic as an ectopic pregnancy can delay the production of normal amounts of hcg (pregnancy hormone). a more likely explanation for the "too light flow" would be a missed ovulation. if the pregnancy test is negative then the next most common cause of a missed period is not having ovulated that cycle. in a normal cycle estrogen is produced all month. estrogen is responsible for building up the lining of your uterus so you have something to shed each month. in a normal cycle progesterone production increases following ovulation. progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. if you are not pregnant that month the levels of estrogen and progesterone fall triggering the release of the uterine lining—your period. so if you do not ovulate the estrogen build up of the lining continues but without the usual ovulation associated progesterone. thus the hormone levels don't decline and the lining stays up inside the uterus—as a missed/late period. alternatively just a small amount of the top of the lining can be shed which appears as a very scant flow. causes for not ovulating are many: thyroid problems pituitary problems ovarian cysts physical stressors (e. g. sudden increases in exercise crash dieting) emotional stressors (problems with partners children finances) increased body weight anorexia rotating shifts at work etc. you mentioned a prior history of "weird periods" that were "never normal. " that might also suggest alterations in your ovulations. there is a second less common cause for not having a period--or a too light flow. in some women the estrogen levels become very low. the levels are so low that no uterine lining is available to be shed. bottom line repeat the pregnancy test if you have pregnancy signs. if it is negative then you may want to keep a menstrual calendar. if your cycles become absent for three months (or are just minimal spotting) see your gyn or clinic for follow up. certainly if you develop other symptoms such as pelvic pain (e. g. ovarian cyst) get seen promptly. if your tubes are tied its almost if not completely impossible to get pregant. periods are wierd and not really predictable. just dont assume its over yet. wear something for the next few days just to make sure its completely over.

### Human:\nwhat is salmonella and how can i prevent getting it?\n\n### Assistant: salmonella (specifically salmonella enteritidis) is the most common form of bacterial food poisoning. within 12 hours to three days after an exposure people develop nasty diarrhea vomiting fever and stomach cramps. unlike the watery diarrhea one typically sees with a stomach virus salmonella usually causes diarrhea mixed with mucus and/or blood. and this infection lasts up to a week. . the good news is that most people fully recover without needing any special treatment or medication. some unlucky people can get dehydrated and end up being hospitalized. and a few very unlucky people can become seriously ill from this infection. that includes young infants people with weakened immune systems and the elderly. . so how do you avoid getting salmonella and other forms of food poisoning? make sure to thoroughly wash countertops sinks and cutting boards with soap and water when preparing foods with eggs raw meat or poultry. only prepare fully cooked eggs. make sure hamburger/ground beef is cooked completely until it is brown. yes pink makes a juicier burger but it also makes a germ-filled one. use pasteurized eggs in recipes that call for raw eggs (like caesar salad dressing). keep eggs meat and poultry properly refrigerated. keep all baby bottles pacifiers and breast pump supplies away from food preparation areas. keep pet iguanas or turtles out of the kitchen counter area. (you think i am joking… i had a patient get salmonella this way). make sure to wash hands thoroughly after handling. buy only pasteurized apple cider and other juice products. wash hands thoroughly after visiting a petting zoo. take-home tip: if you or a family member develops diarrhea that is bloody or mucousy it’s time to call your doctor.

### Human:\nmy son fell and one of his permanent front teeth fell out. the tooth was put back in its socket. what can we expect?\n\n### Assistant: the accidental loss of an adult tooth is a grave event and very tricky to treat. even the best techniques sometimes fail to permanently save the tooth. bear in mind that there is a distinct possibility that your child may lose the tooth even if every precaution is taken. root canal gum surgery and orthodontic care all may be necessary to ultimately save the tooth. and sometimes that may not work.

### Human:\nshould i wake my baby for feedings?\n\n### Assistant: i don’t recommend waking babies for nighttime feedings because you want them to sleep. however i would suggest you wake them for night feedings in their first couple of weeks if they haven’t yet gained back their birth weight; babies tend to lose 10% of their weight after they’re born. also if they’re sleeping more in the day than the night i do suggest waking them so they don’t go more than four hours without eating. overall i suggest not waking babies at night so they can find their own sleep schedule. and you generally don’t have to wake them in the day either because most will wake on their own. if you notice that the baby is sleeping for longer stretches during the day then i would start waking them in the day so they don’t get night and day mixed up.

### Human:\nhow can i find a good orthodontist or oral surgeon for my daughter?\n\n### Assistant: first i would ask your pediatric dentist for a referral. if that doesn’t work contact the local dental society in your area.

### Human:\ncan a child play sports with a perferated eardrum. my son perferated his ear drum diving into a swimming pool and was diagnosed in the er. can he play basketball and baseball while it heals?\n\n### Assistant: usually assuming he is not dizzy but patient-specific questions like this should be addressed by the medical provider who diagnosed him or his regular medical provider. someone who knows his history. ruptured eardrums (most) will quickly heal but that depends on the location on the eardrum and the severity. important bits of information that i do not have.

### Human:\nwhat do i do if my baby cries so hard he seems to stop breathing?\n\n### Assistant: crying is not dangerous to your baby. it’s not going to cause brain damage and they’re not going to stop breathing. there is however something called breath-holding spells where a baby may cry so hard that they stop breathing for a moment or two and then start breathing again. if this happens you do want to see your pediatrician to see if there’s something going on but a breath-holding spell is all it usually is. if they really seem to stop breathing or turn blue call your pediatrician but it could also be that the baby just cried so hard that mucus got stuck in the throat and he or she didn’t know how to clear it for a moment.

### Human:\nwhat causes milia? how can i avoid getting these?\n\n### Assistant: milia also known as whiteheads are very common white pimples that can occur in persons of all ages. they appear mostly on the upper cheeks nose and chin of infants. this occurs when dead skin cells and sebaceous matter gets trapped near the skin surface rather than exfoliating naturally. common causes of milia include the use of thick and heavy cosmetics or poor-quality products that are not suitable for the skin that prevent the sloughing-off of dead skin cells. excessive sun exposure makes the skin thick which leaves it unable to exfoliate naturally.

### Human:\nis it safe to take amoxicillin which should be refrigerated that has been left in a mildly warm car all weekend?\n\n### Assistant: i would need to know more information to answer this question for you. how long was the medication in the car? was it overnight and approximately what temperature was it? is it humid in the area? did the medication change color? all of these questions can help to determine whether the medication is still safe to administer to your child. most importantly check with your prescription health insurance to see if they cover a new prescription for damaged medications. if they do and the medication is affordable have your pharmacist call the health care professional for a new prescription.

### Human:\nhow can i prevent getting salmonella?\n\n### Assistant: foods of animal origin may be contaminated with salmonella. the following practices can help prevent food-borne illness: -cook poultry ground beef and eggs thoroughly and avoid raw milk or unpasteurized milk. -avoid raw eggs which may be found in homemade foods such as salad dressings ice cream and other desserts. -wash your hands surfaces and utensils that have been in contact with raw meat and always store it away from other items like produce and grains. -wash your hands after having contact with animals such as reptiles birds or baby chicks.

### Human:\nif my baby sucks her thumb will she need braces?\n\n### Assistant: not necessarily. frequently when thumb-sucking stops any teeth that have shifted will go back nto their proper place. i would see the pediatric dentist for an evaluation and for help with stopping the habit.

### Human:\nis it safe to take diflucan during pregnancy? . fluconazole (diflucan) at a single low dose is pregnancy class c which means risk to the developing baby cannot be ruled out.\n\n### Assistant: fluconazole (diflucan) at a single low dose is pregnancy class c which means risk to the developing baby cannot be ruled out. in studies on animals and people when pregnant mothers took fluconazole in high doses (400 mg/day) for weeks or months birth defects in the newborn children and animals were sometimes seen. at these doses fluconazole is considered pregnancy class d – meaning it should absolutely not be taken by a mom-to-be. fluconazole is most often taken in a single smaller dose (150 mg once) as treatment for a vaginal yeast infection. there does not seem to be a significant risk to the developing baby from such a low dose of fluconazole. talking with your ob/gyn doctor is the best way to decide if fluconazole is safe for you and your baby.

### Human:\nis there a cure for a child with a severe under bite?\n\n### Assistant: orthodontics can help. i would schedule your child for a consultation with your orthodontist as soon as possible.

### Human:\ncan i breastfeed while taking trileptal?\n\n### Assistant: your question is an important one for women with epilepsy who wish to have a family. there is little scientific information on this subject and most of what we know if based on clinical experience of doctors taking care of women with epilepsy. the bottom line is that most physicians with expertise in managing epilepsy encourage their patients to breastfeed even if they are taking anti-seizure medicine. the baby has developed for nine months in the presence of the anti-seizure medicine and as such for the baby to continue to be exposed to it after delivery usually does not create problems. i am unaware of any [known] descriptions of problems with breastfeeding while on trileptal (oxcarbazepine). if blood levels are done in mom and her baby while breastfeeding the baby's level will be around half of the mother's. so the baby is definitely getting some of the drug but it usually does not create problems as best we tell. so if breastfeeding is important to you (as it is for most women) most experts in the field would encourage you to breastfeed.

### Human:\nshould toddlers take vitamins with omega 3 and vitamin d3\n\n### Assistant: that depends on their diet. most kids need supplemental vitamin d because it not found naturally in many foods and the sun is not reliable. the american academy of pediatrics recommends supplementing with d for children not receiving enough through diet. it would take 6 cups of milk to get the 600iu recommended -- and that would be too much milk for kids anyway. as for omega-3 fatty acids i assume your referring to dha which is important for health and brain development in babies and young toddlers. if a toddler eats fish about twice a week (small portions) than it's not needed. if he doesn't eat any fish you may want to consider supplementing. fortified foods have some but not as much as in fish.

### Human:\nwhat are the negative side effects of fluoride?\n\n### Assistant: the proper amount of fluoride helps prevent and control tooth decay in children and adults. fluoride works both while the teeth are developing and every day after the teeth have emerged through the gums. fluoride consumed during tooth development can also result in a range of visible changes to the enamel surface of the tooth. these changes have been broadly termed dental fluorosis. that is probably fluoride's no. 1 negative aspect.

### Human:\nmy daughter's new adult teeth are all coming in yellow. will they always remain this color? is it from supplements?\n\n### Assistant: when a child begins to lose their baby teeth and permanent teeth begin to erupt the permanent teeth appear more yellow than the baby teeth. this is a natural occurrence because of the different makeup of baby teeth and permanent teeth. baby teeth reflect light differently than adult teeth making the adult teeth appear more yellow. when they are right next to each other the difference in color is more dramatic. it is probably not the supplements so go easy on yourself. also check with your child’s pediatrician to see what they recommend about giving. supplements

### Human:\nare there any foods or drinks you should avoid giving children so their adult teeth don't come in discolored?\n\n### Assistant: food and drinks like coffee red wine and tea can discolor the teeth on the outside. but those drinks aren't for children. sodas are the worst possible drinks due to the high acid content. acid in the saliva allows cavities to form and grow on your teeth.

### Human:\nwhat are symptoms of teething in a baby?\n\n### Assistant: symptoms of teething in a baby can include: increased irritability placing objects or fingers in the mouth and biting down on them increased saliva or drooling loss of appetite or becoming choosy about foods tender and swollen gums rash on cheeks or redness in the area of the cheeks near the affected gums restlessness ear pulling which may be a sign of teething or possibly an ear infection (make an appointment to have your child seen by your doctor or pediatrician) teething does not result in fever vomiting or diarrhea. if your child experiences these problems contact your doctor. here's a list of teething symptoms: drooling. irritability. a tooth visible below the gum. swollen bulging gums. trying to bite chew and suck on everything she can get her hands on. rubbing her face. difficulty sleeping. turning away food. also it is important that you start maintaining the oral health of your infant as soon you see the symptoms of teething to avoid future dental problems. there are dental clinics which consists of skilled and experienced pediatricians.

### Human:\nwill baby have type i diabetes if i have gestational diabetes. i have just been diagnosed with gestational diabetes. the doctor said i will need to take insulin. i am worried my baby will be born with type i diabetes. what are the risks to my baby? i am 43 weeks along.\n\n### Assistant: children born to mothers with gestational diabetes mellitus (gdm) are at a higher risk for obesity type 2 diabetes and metabolic syndrome; but your child will not be at a higher risk for type 1 diabetes. it’s important to follow your doctor’s recommended course of action for managing gestational diabetes to help minimize the potential risks which may include: • maintaining appropriate weight gain • following specific dietary guidelines • following your doctor’s recommendations for an appropriate exercise routine • monitoring your blood sugar levels frequently • taking insulin as directed blood sugar levels will typically return to normal for you after 6 to 8 weeks after delivery but you will be more likely to develop gestational diabetes again during subsequent pregnancies. please refer to the following for more information: <link> <link> no

### Human:\nwhich toothpastes are good for a 2-year-old?\n\n### Assistant: it takes many years before children develop the fine motor coordination they need to do a good tooth brushing job. some dentists advise that parents brush their children's teeth until the child can neatly write his or her own name. other dentists suggest parents use their own judgment but to consider between ages 6 and 8 as the time for kids to take on the job of keeping their teeth clean and healthy. general rule: a smear or pea sized drop of fluoridated toothpaste can be used when the child can spit effectively.

### Human:\ninfant runny bowel movements. my 2 month old son has had very runny bowel movements since birth. we have checked with his doctor changed his formula and still have had no changes. his bm's most often happen before he has even finished a. 5-6 oz. bottle. he also grunts a lot as if constipated. wehave gotten no answers from out dr and are very concerned.\n\n### Assistant: two important things to note here are growth and hydration. if your child is growing steadily as shown on his growth chart and is having plenty of wet diapers than that is a good sign. diarrhea that results in dehydration or slowed growth is problematic. you also might want to try a formula with probiotics (good bacteria for the gut) to see if that helps. if you are still concerned ask to be referred to a pediatric gastroenterologist. they can perform some tests and have the appropriate experience to troubleshoot potential solutions or let you know everything is fine. trust your instincts and get the help you need!

### Human:\ni read that pregnant women are at greater risk for food-borne illness. what can i do to protect myself and my baby?\n\n### Assistant: everyone's at risk but those at greater risk are infants young children pregnant women and their unborn babies older adults and people with weakened immune systems (for example those with hiv/aids cancer diabetes kidney disease and transplant patients). some people may become ill after ingesting only a few harmful bacteria. others may remain symptom-free after ingesting thousands. to prevent food-borne illness keep these key actions in mind: wash your hands. keep raw meats and ready-to-eat foods -- like salads -- separated during preparation. cook foods to the proper temperature by using a food thermometer. refrigerate foods promptly and reheat leftovers to 165 degrees fahrenheit.

### Human:\ni'm 34 have hot flashes night sweats high fsh levels and no period for two months. do i have ovarian failure? . after a progesterone withdrawal test my period started in two days.\n\n### Assistant: what the progesterone withdrawal tells you is that there is definitely some stimulation of the lining of the uterus by estrogen -- estrogen can come from the ovary and it also can be made in other parts of the body too. if the fsh is high it does mean that most likely you are heading toward menopause. the major question i would ask you is "are you hoping to have children beyond this point? " if you are i would encourage you to consult with a gynecologist who specializes in what is called reproductive endocrinology as soon as you can. (the american society of reproductive medicine or asrm could help you find someone near you if you don't know of anyone locally). if you are not planning for children at this point there is no race toward intervention. if you are indeed heading toward menopause and are having symptoms you would be a good candidate for a low-dose birth control pill that would take care of your symptoms well. as i have mentioned before for women who do experience premature ovarian failure taking hormones is usually a good idea -- so do not be afraid of hormonal intervention.

### Human:\nshould i give my 3 year old omega 3 supplement on top of her pediatrician prescribed vitamin?\n\n### Assistant: it depends on if your child is getting some through her diet. if she is eating fish at least twice a week she doesn't need to supplement with omega 3s. but if she eats no fish then it is unlikely she is getting enough docosahexaenoic acid (dha) and eicosapentaenoic acid (epa) which plays an important role in brain development. when looking at supplements check the specific amount (milligrams) of dha and epa in the product. the world health organization recommends 2-4 year old's get 100-150 milligrams of dha and epa (combined) daily. studies show most children only get 45 milligrams. always check with your healthcare provider.

### Human:\nhow can i get control back in my life after a cancer diagnosis?\n\n### Assistant: once you have dealt with the shock of a cancer diagnosis you will need to be as organized as possible in order to make your cancer journey as livable as possible. your treatment: choose caregivers whom you like and trust. choose one oncologist to be your most trusted adviser and ally to help you make the best decisions at every juncture of your cancer journey. your loved ones: although there is only one person going under the surgical knife or receiving chemotherapy cancer still affects an entire family and more. seek the help of professional counselors who will help you cope with cancer as well as provide guidance on how to communicate effectively with your loved ones about your situation. your support system: family and friends will want to help you cope with cancer but they will need guidance on how best to do so. let them help you with chores children and transportation to and from treatment. your mind: the diagnosis and treatment of cancer no matter how successful the result frequently causes depression and anxiety and nearly always uncertainty. learning how best to cope with these is vitally important to getting through the treatment phase and especially during long-term survivorship. your work: you and your employer will want to know how much time you will need to deal with cancer. do not try to maintain a full work schedule during arduous treatments. consider short or long-term disability depending on the rigors and after-effects of treatment. your finances: even if you are highly likely to survive your cancer the diagnosis is a good reason to get your financial situation in order for the sake of you and your loved ones. your time: the ultimate goal is for you to have your life so organized that you can deal with cancer treatment almost on autopilot. this will also enable you to have time for yourself which is an essential component of the recovery process.

### Human:\nhow can i know if my children are brushing their teeth enough? how long should they brush?\n\n### Assistant: brushing for two minutes is best -- a bit on every tooth. there are some fun brushing timers available to use for kids to help encourage these habits.

### Human:\nwhat can i do to prevent my kids from getting head lice?\n\n### Assistant: the best prevention of head lice is avoidance of other kids who have lice. however this can be difficult with school-age children who frequently have sleepovers and spend time in close contact. encourage your children not to share their combs hair brushes hats and the like with other kids unless you are certain no lice are present. new prescription items such as natroba (topical spinosad) will also make the treatment of lice easier with no nit combing required and no risk of systemic toxicity.

### Human:\ncan a male alcoholic pass on the disease to fetus\n\n### Assistant: some people feel that genes related to addiction can be transmitted to the offspring since alcoholism can run in families. it can be very difficult to say what human characteristics are genetic versus environmental factors. growing up in a family that has more than their share of alcoholism i can certainly say that it never surfaced in me. i actually detest alcohol. alcoholism is classified as a disease and certain characteristics in our personality can be genetically transmitted but to worry that a male alcoholic would create an alcoholic child would be a stretch at this point. an alcoholic. one who continues to drink. would not make a good father/husband for lots of reasons.

### Human:\nwhat health insurance plan is best for a pregnant woman? . of course premiums go up or down but how does one decide if the 90% the insurance company pays/ 10% i pay the 80/20 or 70/30 is right for a first time pregnant woman?\n\n### Assistant: it has been awhile since my wife gave birth but the costs of even a routine childbirth can be substantial like $15 000 (this includes the insurers' cost). it depends on the tradeoff between premiums and your expected out-of-pocket cost but i would strongly consider paying more for a "gold" or "platinum" plan if you know you are going to give birth next year.

### Human:\nwhat is the critical difference between a sterol and a stanol?\n\n### Assistant: we hear in the news and in commercials that plant sterols are good for us and lower cholesterol levels. we are even fortifying certain foods and some baby aspirin with these phytosterols. yet these phytosterols may be more atherogenic (have the ability to initiate or accelerate atherogenesis — formation of fat deposits on the inner lining of blood vessels) than cholesterol in certain groups of people. stanols on the other hand are good for everyone and do lower cholesterol levels. let’s start with some definitions: * cholesterol is a sterol. a sterol is a steroid with an alcohol group attached to it. * stanols are saturated or reduced sterols that are similar to cholesterol but have a methyl or an ethyl group attached to them. this difference minimizes stanol absorption in the intestines. * cholestanol is a stanol. cholesterol can be broken down by the liver into cholestanol and thus is a by-product of cholesterol metabolism. if sterols or stanols are esterified (combined with fatty acids) then they can be incorporated into margarine. we consume many sterols from plant sources (sitosterol campesterol and stigmasterol) shellfish (desmosterol and fucosterol) and animal sources (cholesterol). all of these sterols with the exception of cholesterol are collectively referred to as noncholesterol sterols. collectively these sterols can be called phytosterols. sitosterol represents about 80% of all noncholesterol sterols in the diet and is the most well known noncholesterol sterol in the diet. when fats (triglycerides) enter the intestine in our food they are broken down into their basic building blocks. the main breakdown products are called fatty acids. these fatty acids and sterols from dietary sources are packaged into what is called a micelle. these micelles “ferry” these fatty acids and sterols to the intestinal lining (epithelium). they are then absorbed by passive diffusion into the intestinal cells. passive diffusion is a biological principle that substances flow through a semi-permeable tissue from an area of higher concentration to an area of lesser concentration. there is no pump required to get them out of the intestine and ultimately into the bloodstream. most humans absorb about 50% of sterols in the intestines. however there are some people who are what is termed” hyperabsorbers” (they absorb 60-80%) and some are “hypoabsorbers” (they absorb less than 50%). noncholesterol sterols are not esterified as humans do not have the enzymes necessary for that. when these unesterified sterols get into an arterial wall they are more atherogenic than cholesterol (an esterified sterol). this means they have a greater artery clogging potential than does cholesterol. if one lacks these transporters (homozygote) all sterols are absorbed and none are pumped back out: this is a very rare homozygous condition leading to the disease called sitosterolemia or phytosterolemia. it is associated with severe atherosclerosis as noncholesterol sterols (which cannot be esterified) are more atherogenic than cholesterol. heterozygotes people who have some transporter function eliminate some but not all of these phytosterols. stanols do not require these transporters to get back into these intestines. this is the reason that they are safe and effective to reduce cholesterol. stanols are commercially available in the supermarket in a product called benecol. in summary noncholesterol sterols serve no physiologic function in man. all sterols are atherogenic if they accumulate in the arterial wall. stanols are saturated sterols. they are not absorbed and can be used therapeutically to reduce cholesterol absorption from the intestine.

### Human:\nif i have some miralax that is expired would it be a safe to give it to anyone?\n\n### Assistant: expiration dates are printed on the medication container for a reason. i would advise you not to use this medication since the expiration date has passed. medications can change effectiveness. and you wouldn’t know how to supplement the dose to make it accurate. some medications can become “sour” after they expire. and you wouldn’t want to become sick from taking an expired medication. i would dispose of expired medication with a local pharmacy through a local drug take-back program (check with your local police department) or through proper disposal at home. to dispose of medication at home mix drugs (crush first if in tablet form) with an undesirable substance such as cat litter or used coffee grounds and place in a plastic sandwich bag. seal the bag and double bag to prevent leakage. throw the bag in the trash keeping it out of reach of children and animals. do not flush medication down the toilet or pour it into a drain.

### Human:\nmy 11month old keeps vomiting after eating formula but nothingelse could this mean its time to stop feeding him formula? . the vomiting is occasional but has been occurring about once a day for almost a week mostly at night.\n\n### Assistant: while it's hard to tell for sure it could be that child your child is getting overfed at times. if the formula is given after a big meal which may occur at night that could cause him to throw up. once children turn one it's recommended parents switch them to whole milk. if his birthday is soon go ahead and switch him. either way i would try giving the formula in a sippy cup instead of the bottle and do it between meals and not right after eating. it's important to remember that babies have small tummies and if they get filled to the brim some of that food may come back up. if these changes don't work and he continues to vomit see your healthcare provider. having had 6 children my pediatrician advised me that some babies have allergies to certain formulas (like soy). his pediatrician will recommend another formula. since he is 11 months old i would discontinue the formula and try pediasure (spelled wrong). don't invest in too much of that because he may not be able to tolerate that either. he could also be lactose intolorant. in that case you may have to try a lactose free milk.

### Human:\nhi um 21 years old and i have been trying to get pregnant for almolst 2 years\n\n### Assistant: most couples are able to become pregnant within the first 12 months of having regular unprotected sex. if after a year of trying a woman under 35 is still not pregnant then a checkup is in order to see if there is a problem. there are many reasons why a couple may have a problem getting pregnant. sometimes it is a health issue for the man and sometimes it is a health issue for the woman. a woman can have a problem with her hormones or with her womb or fallopian tubes. a man may not have enough healthy sperm. sometimes both the man and woman can have an infertility problem. just because you are not pregnant yet does not mean that you can’t have a healthy baby. you should make an appointment with your gynecologist and have your partner see his doctor or urologist to see what may be the cause. your doctor will most likely give you a prenatal vitamin to be sure that your pregnancy gets a healthy start. in the meantime make sure you are eating a healthy diet. get enough exercise. and avoid tobacco alcohol and any drugs that have not been prescribed by your doctor. for more information check out this link to webmd’s infertility and reproduction health center. <link> i had this same problem. my fiance and i have been together a little over 2 years now and havent used any kind of protection. i have 2 kids already with my ex but he doesnt have any. so we started thinking maybe he wasnt able to have kids! but about 2 weeks ago i started having symptoms and took 3 tests and i am now 6 weeks pregnant! so just give it a little time! i know its frustrating especially because you have been trying but it will happen when the time is right!

### Human:\nwhat is the treatment for a tooth growing out of the roof of a child’s mouth?\n\n### Assistant: sometimes teeth do not have enough room to erupt into the mouth and can be impacted in the palate. the best way to deal them it is to get treatment with an orthodontist and an oral surgeon to uncover the tooth and to guide eruption into the mouth.

### Human:\nis creatine safe for a 9 year old child?\n\n### Assistant: i would not recommend or encourage using creatine in anyone especially a prepubescent child.

### Human:\nmy son has add and mild autism. he has been successfully on concerta for 6+ years. can you help with his weight loss?\n\n### Assistant: stimulants in general tend to decrease appetite in certain not all children. over time this side effect seems to lessen but as in the case of your son for some children it may persist. weight loss is the result of this appetite decrease and not consuming enough calories during the day. therefore since the medication is effective and at "the perfect dose for him " right now i would suggest that you work on increasing your son's calorie intake. this however is often not an easy task! some suggestions include offering your son his preferred foods whenever he seems hungry; starting the day with a large calorie-laden breakfast early in the morning before the medication takes effect; increasing the calories in snacks during the day and at bedtime; and adding a high calorie supplement like ensure or shakes with ice cream etc. during the day. consult your pediatrician or a nutrionist to determine how many calories a day your son should be consuming and try to make sure this is the minimum he consumes to prevent weight loss. if you find this remains a problem i suggest you consult a pediatric nutritionist for additional suggestions. if the problems persists despite you and your son's best efforts you may want to discuss changing to a non-stimulant medication with your son's prescribing physician.

### Human:\ni'm 24 but laugh lines and forehead wrinkles are already apparent on my face. can i slow them down?\n\n### Assistant: sun damage and smoking are the no. 1 reasons for premature aging or wrinkling of the skin. therefore you should incorporate the use of sunblock in your daily skin-care regimen. next utilize a daily skin regimen that exfoliates your skin which will help remove dead skin cells. this should be followed by a non-comedogenic moisturizer that contains vitamins (c & e) and rebuilds peptides for your skin. use a very dramatic moisturizer! i use multiple moisturizers and it seriously takes away my laugh lines and wrinkles. and i smile all the time. try using moisturizers that are for dry skin. i use several natural oatmeal moistorizers that work and i use a heavy body butter around the area that i have most trouble with and a gentle baby lotion for the areas i dont have trouble with. you can also use natural exfoliators i have noticed they work so much better than commercial ones! try baking soda and water apply to face keep it on for a minute or two (never longer than 3 min because of the result of skin irritation) grab a rag and put cool water on it and gently wipe it off. sometimes if it doesn't all come off and you can still feel the particles on your face then i put my face under the faucet. you can do it however you want though but you can instantly tell the difference between your first try! don't stop smiling! our body is like a computer. garbage in garbage out. i highly recommend that you look at your diet. are you eating a lot of processed foods? there is not much nutrition in processed foods if any. in my opinion even organic processed food is garbage. once something has been processed it is dead food. are you eating fresh fruits and vegetables (preferably organic so your immune system can heal your skin and does not have to fight all the chemicals in conventional foods)? raw unprocessed nuts? eggs (yes they are really good for you! ) stay away from conventional meats and dairy? it is truly true. you are what you eat! make it an adventure to discover real food not stuff that comes from a box. you will see your skin become as it should be at your age luminous and supple. granted it takes a little effort but once you see the results in your skin (and you will) you gladly eat at home and make it a home cooked meal. highly recommend you study up on healthy nutrition maybe take a cooking course. i am 64 and almost wrinkle free my weight is normal and i can pass for 50. that is what good nutrition can do for you. my best wishes to you r. d. externally there are topical line relaxers the most effective target just the line you want to treat. the line fillers are meant to "fill in" your lines but don't seem to work too well for me. i think regular consistent care of the skin is the most important thing you can do. routinely moisturize your skin twice a day face and neck. shower and then follow with a good thick moisturizer that has vitamins c e a with hyaluronic acid and sunscreen. avoid products with alcohol as an ingredient as this will dry and damage new skin. clean skin at night and use a good night cream. personally i love the olay refinishing night cream makes skin so soft and smells great. internally drink water and eat your berries & veggies. take a b vitamin complex with biotin fish oil and a multivitamin. if your lines don't respond to a line relaxer and twice daily tlc a precription for retinol may do the trick. i personally find these creams effective: strivectin lift cream really lifts! the newest neutrogena tone improving moisturizer is a nice effective cream that brightens skin well the olay refinishing line helps with surface problems such as large pores. i also use vitamin e oil and collagen(absorbed through skin) about once a week after a shower on wet skin. allover. then of course there's always botox.

### Human:\nif my 7 month old is teething what can we do to make her more comfortable?\n\n### Assistant: the first teeth usually come in between 6 and 8 months of age so this is perfect timing for your daughter to be teething. it may be helpful to give her something to gnaw on such as a washcloth or teething toy. your doctor may recommend over-the-counter remedies such as acetaminophen ibuprofen or a numbing gel. . it's helpful to double check the doses with your doctor since they depend on how much baby weighs. . if your teething baby seems uncomfortable consider these simple tips: rub your baby's gums. use a clean finger or moistened gauze pad to rub your baby's gums. . keep it cool. a cold washcloth spoon or chilled teething ring can be soothing on a baby's gums. . try hard foods. dry the drool. try an over-the-counter remedy.

### Human:\nhow do i care for my daughter whose ear and face are covered in poison oak?\n\n### Assistant: with poison oak involving the face the child should be seen by a doctor and evaluated for the possible need for prescription medications. poison oak is a reaction from the oil found in the plant. the more contact you have with the oil the more severe the rash. it is important to make sure you wash all clothing in hot water to eliminate all the oil from the plants and to prevent further contact or spreading to other people. once the oil is off the clothing and the body it is no longer contagious. if it doesn’t involve the face the first part of treatment for poison oak is to wash the body thoroughly with wet compresses or cool water. the sores or the rash can be treated with many different over-the-counter products. antihistamines can help to decrease the swelling itching and redness. the corticosteroid cream is also great to use to treat the rash.

### Human:\nwhat causes diaper rash and how is it treated?\n\n### Assistant: any irritation of the skin in the diaper area can be considered a diaper rash. they are extremely common in babies especially those who have loose stools or who have very wet diapers (such as infants over 9 months). changes in a child's diet can also cause the stool to irritate a baby's skin even if she is changed right away. if the baby is not fussy it is likely not a serious rash and will probably go away after a few days of using a diaper cream or ointment. if a baby has a fever develops sores in the diaper area has bleeding or pus from the skin has a rash for longer than a few days or seems very uncomfortable it's important to have her checked out by the pediatrician.

### Human:\nmy nine month old wont sleep can i give him water to deter him from wanting to night feed. my son is 9 months old and wakes 5-6 times a night to feed still his doctor insists this is normal but to me 5-6 feedings and 3-4 diaper changes per night for a nine month old 25pound baby seems way too much i dont like the night formula feedings as he has 8 perfect little teeth i would like to not have rot out of his mouth. he is eating baby foods fingerfoods and some tablefoods but he does not sleep at night ive tried every sleeptraining method to no sucess.\n\n### Assistant: no i would not advise giving water at night. at nine months water should only be given as sips during the day. the bulk of fluid at this age should be formula or breast milk. instead of feeding right away try soothing or rocking your baby first before going to feeding him. i would work on getting the sleep straightened out. regular naps and early bedtime works great. one of my favorite books is healthy sleep habits happy child. for more on the subject see expert q&a: baby's sleep

### Human:\nhow many ear infections are too many?\n\n### Assistant: here's what i suggest: four infections in peak cold and flu season (winter=october through april). three infections in non-peak season (summer). three months of persistent residual fluid behind the eardrum. three back-to-back courses of antibiotics for the same ear infection. if your child fits into one of these categories ask your child's doctor about a specialist referral.

### Human:\nwhy does my son have white spots on his teeth?\n\n### Assistant: white spots can be caused by the presence of fluoride in the water known as dental fluorosis. white spots are not necessarily a bad thing. white spots can also be caused by a child having a high fever while their teeth are still developing. if the spots are a cosmetic concern they can be removed. be sure to also have the spots checked to make sure they aren't cavities that are forming.

### Human:\nwhat precautions can i take against sudden infant death syndrome?\n\n### Assistant: co-sleeping isn’t recommended because of what we know about sleep safety. there’s more of a risk of smothering sudden infant death syndrome and of falls off the adult bed when there’s bedsharing. . always put your baby on his back to sleep never on his side or tummy. there’s a higher risk of sids if they’re on their tummy or their side; they can roll onto their stomach if they’re lying on their side. and be sure that childcare providers grandparents and so on know to put the baby on his back because there’s also a higher risk of sids if a baby is usually put to sleep on his back but suddenly gets put to sleep on his tummy. finally be sure to give your baby a lot of tummy time when he’s awake. tummy time helps promote physical development; generally babies don’t roll or crawl as soon if they don’t get tummy time for example. and if you’re worried about sids you want them to have a stronger head and neck so they can [lift] their face up if it gets covered.

### Human:\n18 years old already have 2 kids can i get a hysterectomy? . i'm 18 years old i already have 2 kids and i don't want anymore my period is extremely painful and heavy will a doctor give me a hysterectomy or am i to young?\n\n### Assistant: it would be highly unlikely for any surgeon (or an insurance company that would pay for this elective procedure) to agree that a hysterectomy is the way to go at this point. it is not just your age that is a contributing factor but a hysterectomy is not medically-indicated in most cases just because you have two kids and your periods are heavy/painful. see your gynecologist and i am sure there are other solutions to answer your concerns that are considerably less riskier than removing your uterus. thank you for asking with the age of just 18 i am afraid going for hysterectomy is unwise although possible. procedures like hysterectomy are permanent and there is no coming back and depression and other psychological accidents are common in such women as well. also there is a long life ahead for you you may wanna change your mind to have another child due to any reason and then you will need a uterus to conceive. so my suggestion is don't opt for it unless you have some severe problem with uterus like heavy periods etc. hysterectomy can wait till 35 years or older age. i hope it helps. regards dr s khan ehealthdesk

### Human:\ndoes microwaving infant formula destroy all the nutrients? . my boyfriend and i have been microwaving the formula for a few seconds just enough to make it warm. i mostly breast feed but i have had problems producing enough milk so when we supplement with formula we microwave it. my mom says it kills all the nutrients i say i don't think it does but im not a doctor! please help. i want to know so that if it does kill the nutrients i can stop doing that and do it a different way that will benefit my child.\n\n### Assistant: most helpful answer heating formula in the microwave will not destroy the nutrients but it is not recommended. the reason is it does not heat the milk evenly potentially resulting in milk that is hot in some areas and cold in others. a better way to warm up formula is by running it under warm water or placing it in a bowl of hot water for a few minutes. just make sure the bottle is not to hot when you give it to your baby. congratulations on your baby

### Human:\nwhat can i do to help my 9 year old son who falls aleep easily but then wakes up several times a night?\n\n### Assistant: insomnia in children is quite common. it can become very problematic for parents as this disturbs their sleep as well. often the children do not seem too bothered by their insomnia. there can be many causes for this type of insomnia. use of caffeine refined sugars and heavy meals particularly at night can cause this problem. another common reason for insomnia in kids is sleep association disorder. in this disorder children learn to fall asleep with a particular object or activity (such as rocking or patting). when they wake up periodically at night (as all of us do normally) they are unable to fall back asleep until they again have the same object or activity. sleep apnea can also occur in children and can cause insomnia. these are only a few of the reasons a child can have sleep maintenance insomnia. i would suggest talking first with your pediatrician. often it is a problem that they can easily address. if not they may recommend further consultation depending on what they think is going on.

### Human:\nwhen should my child's sickness keep her home and when can i send her to school?\n\n### Assistant: generally speaking she can be around other kids once her fever has been gone for 24 hours and she is feeling better. if your child has been placed on an antibiotic for any reason she should receive the medication for at least 24 hours before being around other children. if you kept your child home every time he had the sniffles he'd never be in school. and the older he gets the harder it is to make up missed schoolwork. so if he feels okay and doesn't have a fever he should be in school. but if your child has a fever (temperature over 100. 3) is vomiting having bad diarrhea coughing up a storm has pain interfering with activity or really isn't feeling well keep him at home until these symptoms are under control. often it's the milder symptoms (such as slight runny nose and cough) that leave parents wondering what to do. only you can make that game-day decision but be considerate of others. before you take him out think to yourself would i want another child with the same symptoms around my son? you can always check with your child care or preschool. they may have specific guidelines for when previously sick children can return. you know your child best so if you think something is wrong don't send him to school. if you're concerned call your pediatrician.

### Human:\nwhen should i introduce my baby to solid foods?\n\n### Assistant: the pendulum has swung back and forth a lot on when to start solids. we now know that 4 to 6 months seems to be the best time -- when the baby’s digestive system can handle solids and they don’t impact allergies for the worse. if you wait until your baby’s much older than 6 months she may reject the texture.

### Human:\ni gave birth last week and am excessively anxious about going back to work. it doesn't seem like baby blues. what is it? . i’m worried about giving my eldest child attention. i have bipolar disorder but this isn't it.\n\n### Assistant: as you said you have a pre-existing condition and you have recently given birth to a child. only one of these giving birth would be enough to cause this type of depression and anxiety. you however have an additional component of bipolar disorder and together this can be a very difficult time for you as i see it is. please be sure that your husband and your ob know the extent of your current anxiety and possible depression so that they can quickly help you. if you had been receiving some treatment from a psychiatrist prior to your pregnancy consider putting a call immediately in to that person. your body is experiencing a change in hormones because of the birth and we know that this will upset anyone's normal mood and anxiety levels. so it is biological and you do need some help now.

### Human:\ni eat a lot of celery daily. i'm about to have surgery on my caroid artery. should i stop eating celery if so when?\n\n### Assistant: other than not eating (or drinking) anything 12 hours or so before your surgery (your doctor will give you explicit instructions) i know of no specific contraindications for eating celery when you have carotid artery problems. unless your surgeon specifically tells you not to eat it for some reason (i don't know your medical history) i think you can crunch away.

### Human:\nhow to reduce swelling in the legs after open heart surgery?\n\n### Assistant: your post-surgical instruction should only come from your treating medical providers. not knowing your medical history the type of surgery you are having medications etc. it would be impossible to offer you any specific suggestions. your doctor(s) may certainly recommend the elevation of your legs range of motion activity special medications or even compression stockings but this advice should only come from someone familiar with your particular case. hi this is form columbia university. your legs may swell a little especially if you had veins removed from your legs during your heart surgery. this occurs because excess fluid collects in the tissue when you are not moving around as much. to control the swelling: get up once an hour and walk around for a few minutes. when sitting or sleeping keep your legs elevated. to help with circulation avoid crossing your legs. but like all things the more you do get around the better it will be for you if your allowed do get in swimming its a great all over exercise. good luck your consulting doctor is the best person to guide you for the post surgery swelling. without overall medical history it will be incorrect to guide you online for this.

### Human:\ndoes lemon juice lower blood pressure\n\n### Assistant: try it if you want but lemon juice has not been clinical proven as a method of treating hypertension (high blood pressure). you would be best to have your elevated blood pressure treated by your medical provider since treatment is so individualized and more complex than you might imagine.

### Human:\nnormal for hemorrhoids to bleed without bowel movement? . been seeing some bleeding not alot but even without a bm. started about 5 days ago i wiped after a bm and it hurt thought maybe i cut myself or something. later noticed a pea size bump near anus that hurt for acouple days. it has not been painful in a few days now but yesterday noticed small blood on my night shorts and when i would pad just to see there would be alittle blood on there even though it really is not painful. the bump seems it may be getting smaller.\n\n### Assistant: most helpful answer sure. hemorrhoids are veins and they can just bleed from time to time even if you are not having a bowel movement.

### Human:\nwhy cant they see my dad's heart on an mri. my dad had an mri and they said they cant see his heart. what does that mean.\n\n### Assistant: the mri is usually not a whole-body scan but directed to certain areas. i don't know the reason your father was getting an mri but this could be the logical reason. while some fathers my be considered heartless i suspect your father is not one of them. we know he has a heart and a daughter that cares about him.

### Human:\nis a heart attack or cardia arrest ultimately more life threatening?\n\n### Assistant: obviously a completely stopped heart (cardiac arrest) is more life-threating since you only have a few precious minutes to get it ticking again or death will occur. a "heart attack" is lay term that refers to dozens of different serious cardiac conditions some that are life-threating and some not-so-much.

### Human:\nwhat if a man never in the moon to have sex\n\n### Assistant: i tend to make a few typos as well but i think you mean "mood" not moon. (the man in the moon should not be having sex at all. ). sexual desire is very very complex and can involve a variety of cultural emotional psychological and even biological factors. unfortunately since i do not know anything about this man or have the ability to examine him i cannot be of much help. as someone who cares you should encourage him to see his medical provider to start the evaluation process. hi you need something to lift your libido have you had your testosterone levels checked its just a blood test that would give you one idea on how your doing. google these two title's its a lists i put together for ed. nohards herb list with links nohards herbs for ed part 2 there some libido boosters amongst them just read the links some of may just help. one last thing are you on any meds some side effects of antidepressants statins for high cholesterol diabetes drugs and a whole host of other things that can kill our sex lives alcohol stress smoking self image being over weight low testosterone as well as high testosterone this gives overkill anger and your general health. do hope something here helps. good luck i am getting a feeling that he must not be into women. that or he is just not physically attracted to you. find another fish in the sea. then you need to make yourself more sexually attractive. you could also consider introducing another woman into the mix. seek someone else

### Human:\ncan heart attack symptons mimick carpal tunnel symptons or vice versa? . mother was diagnosed with carpal tunnel and had surgery on her non dominate hand. two weeks later she was dead from a massive heart attack. could the pain in her hand and shoulder been misdiagnosed as carpal tunnel when in reality it was a heart issue?\n\n### Assistant: cardiac pain can be referred to the left arm and shoulder area jaw and sub-sternal area. but not the wrist. a clinician would not relate the pain of carpal tunnel syndrome to something related to the heart.

### Human:\ncould my child's shortness of breath be related to him being over weight somewhat? . my child is 9 years old and somewhat overweight. he has shortness of breath all the time not just during activity. he goes around taking in deep breaths a lot and i can tell he isn't getting proper air. he uses his inhaler daily. my husband thinks its because he is overweight but i am concerned. he was put on inhaler because he may have exercised induced asthma the doctor said but that was when he was 7 years old. could this type of shortness of breath be caused by overweight? .\n\n### Assistant: i have to say that being overweight is definitely a factor but there are soooo many reasons for shortness of breath in children that it would be wrong to just attribute it to his weight. his doctor needs to do some pulmonary function tests or refer him to someone who can do this. shortness of breath due to exercise can be cardiac (heart) as well as an example. he may need more than just a rescue inhaler like albuterol to manage this problem but you would be wise to take his medical evaluation up a notch. i do agree with what rod moser has said but i do like to add few more things to this that inhalers are just not the available solution for every problem. keeping in consideration the age of your child i will suggest him some deep breath exercise like :- the stimulating breath (also called the bellows breath) the 4-7-8 (or relaxing breath) exercise breath counting. once he will be fine with these he push himself further more with some more deep breath exercise. for more information you can visit pharmacysell

### Human:\ndoes too much iron harden arteries. i had blood work done and was told that my red blood cell count is high but my dr wants me to take iron pills and i don't understand\n\n### Assistant: iron pills will not "harden your arteries". i don't know the underlying reason why your doctor is suggesting iron pills so i would suggest that you ask for an explanation. since i do not know you your medical history or the results of your lab tests it would not be prudent for me to make a blind guess as to his/her rationale. hi have a read through this link it may throw some light to why. <link> just copy link to the www. to open and read. to much iron and this is from injections can constrict blood vessels but not harden then your find harden arteries tends to come from plaque which also gives you high cholesterol. hope this helps you. good luck

### Human:\nhigh bp 220/100 its constant. no need in change of number since last week. my brother in law's bp reached from 180/90 to 220/100 in ten days of period. after he reached 220/100 tests were performed for him. his sugar and cholesterol levels are normal. but no change in his bp number 220/100. what should we do?\n\n### Assistant: your brother-in-law needs pharmacological management of his hypertension without delay.

### Human:\nmy heart races for no reason & it scares me to death! what do i do when this happens? . a heart doc said to 'walk it off' but this sure doesn't seem reasonable! please advise asap.\n\n### Assistant: you did the right thing. you saw a heart doctor. unfortunately it appears that the heart doctor did not reassure you that everything is fine so you may need to get a second opinion from another cardiologist that is a bit more reassuring. your heart can be monitored several different ways like wearing a device that records your heart for 24 hours (holter monitor). assuming your heart was fine on a treadmill test you may be just experiencing palpitations -- a feeling that your heart is racing but it is not. or your heart is actually racing at times. this is why your doctor should consider taking your evaluation to a higher level. if you pass all of these tests then you may be less frightened when you have palpitations.

### Human:\nherpes cold sore or angular chelitis? . this thing appeared on the side of my lip that looks like a blister but is split in the middle. on either side of the split there is excess skin and it hurts when i open my mouth. when it was closer to healing there seemed to be a yellow crust around it. i have never had a herpes cold sore before so it's going to break my heart if i have just gotten the virus. it's taken about 2 weeks to heal probably because i messed with it in the beginning. never noticed and small blisters though.\n\n### Assistant: don't sound like herpes simplex to me but then again i didn't examine you. you are correct about angular chelitis as being the most likely explanation but next time show this lesion to a medical professional. herpes tends to have a cluster of small and painful blisters and may be recurrent; showing up again in the same place.

### Human:\nis sea salt better than table salt?\n\n### Assistant: table salt is getting a lot of competition from the new guy on the block--- sea salt. the hype about sea salt is that they claim it contains trace minerals that table salt doesn't have. truth is those minerals are in such a low quantity that they don't make a difference to your health. the interesting news is that because sea salt has a much more intense flavor you end up using less of it. that's great for the prevention of high blood pressure and heart disease.

### Human:\nwhy would a person be prescribed hydrochlorothiazide and metoprolol? . is it appropriate that a doc prescribed hydrochlorothiazide and metoprolol (hydrochloro 25 mg & metoprolol 50mg)?\n\n### Assistant: this is a common and appropriate treatment for hypertension (elevated blood pressure).

### Human:\nwhat does it mean if my blood glucose is 81 but my hemoglobin a1c is 5. 7? i am 5'7. 5" 140lb. i have never been diagnosed with diabetes but a maternal uncle died from complications of diabetes.\n\n### Assistant: based on a set of criteria a hga1c level between 5. 7-6. 4% is prediabetes. this means that there's an increased risk for developing overt diabetes. a person with prediabetes may have a normal blood sugar but only because their body has compensated for this with an increase in the amount of insulin produced. as prediabetes progresses the overproduction of insulin just won't be enough to compensate for high sugars and they become overtly abnormal and elevated. people with type 2 diabetes can have normal blood sugars but the metabolic abnormalities that occur will continue: insulin will continue to be produced in excess amounts. at some point it fails. and having either prediabetes or diabetes means your risk of heart disease is significantly above normal. you should modify the risks that you have: improved nutrition with calorie restriction and more fruits and veggies manage excess weight look for stress reduction methods and make good sleep a priority. seek help from a diabetes team. there are tons of information online and numerous organizations that help.

### Human:\ncan a pap smear cause a miscarriage. i find out by a home preg test that i was preg. and went to doctors and confirm i was and doc did my yearly pap at same time 5 days later had miscg. i'm just confuse and want to know more about miscarriages\n\n### Assistant: a pap smear will not cause a miscarriage but sadly miscarriages do spontaneously happen. my heart goes out to you. some pregnancies are no viable and your body simply will not let it continue. i don't have any way of knowing the reason(s) in your case but a discussion with your ob/gyn will be helpful.

### Human:\ninnocent' heart murmur has started to give symptoms. about 8 years ago i went to the gp with breathlessness. following ecg's it was diagnosed as an innocent heart murmur. i went back about 4 years ago with increased symptoms but they said that it was nothing. over the last few years i've been having episodes of palpitations at least a few times a week. until recently i had never fainted before but i've fainted 3 or 4 times alongside these palpitations. is it worth going back to the gp? i feel like i'm going to be told its nothing again.\n\n### Assistant: go see a cardiologist and have a highly-level heart examination by this specialist. an ecg does not diagnose "innocent murmurs". a murmur is heard by a stethoscope and the determination of it being innocent is one made by the medical professional who is hearing it.

### Human:\nare bananas bad for the heart?\n\n### Assistant: no. bananas are good and will not harm your heart.

### Human:\ndoes chlorophyl help hair loss and fertility\n\n### Assistant: in my opinion. no. there could be a link between chlorophyll usage and hair loss / fertility issues. but the bottom line is that there is no scientific evidence through verifable studies proving that chlorophyll will cause hair growth or impact conception odds. with that said chlorophyll seems to have many possible beneficial properties. it may be a worthwhile time investment to discuss chlorophyll usage with your physician before its purchase and consumption. chlorophyll is found in green leafy vegetables and may be located in liquid form throughout health food stores. many natural medicine proponents claim that chlorophyll is a detox agent effective in heart health and protects against cancer. other claims include improvements in digestion bad breath body odor and gas conditions. specifically mentioned as effective in hormonal balancing according to the encyclopedia of natural medicine women taking chlorophyll experienced correction in conditions such as delayed menstruation and p. m. s. additionally menopause symptoms such as dry skin irritability depression and hair loss also showed improvement. in summary it’s worth some additional research and talking with your doctor about chlorophyll claims. although there is no scientific evidence of chlorophyll causing hair growth or stimulating conception some natural medicine experts cite menstruation improvement and a reduction of hair loss.

### Human:\ncan a former heart attack (19 yrs. ago) cause an abnormally on ekg when taking a stress test?\n\n### Assistant: yes an old heart attack may still show up on an electrocardiogram especially when having a stress test. have your doctor go over this test result (since i have no way of seeing it of course).

### Human:\nwhy do i get a normal bp reading with my arm resting on my head? . if i take my bp in the recommended position it is always high. if i rest my arm on top of my head my bp is normal. can you tell me why and would this be a true reading?\n\n### Assistant: it is simple gravity. the most accurate bp reading is with your arm at heart level. when you raise it above your head you will get a falsely low reading because your heart has to pump the blood higher.

### Human:\ndoes excedrin lower blood pressure?\n\n### Assistant: not really. excedrin has aspirin and low-dose aspirin is recommended as an adjunct for older folks who may be at risk for cardiovascular disease or heart attack. the aspirin part is good. excedrin (some forms) have caffeine and caffeine can actually raise blood pressure (temporarily) in someone who is sensitive.

### Human:\ncan cocoa butter on skin raise cholesterol\n\n### Assistant: cocoa butter is not absorbed through the skin into the systemic circulation so it should not have any adverse effects on your cholesterol.

### Human:\nhow how long after heart surgery can you resume your normal workout routine? . my mom had bypass surgery 10 weeks ago and has only been walking. used to do spin yoga kickboxing etc. when will she be able to workout like this again?\n\n### Assistant: that is up to her cardiologist. there is no set time since every person is different when it comes to recovery. before starting any strenuous exercise regime especially after having a bypass your mother will need to be cleared to do so. often an echocardiogram and a treadmill test is needed. the resume should be created for very well and it must be clear and effective. the resume should be created at more volume for related jobs. the name and your educational qualification are important in resume. the thesis writing guide is more support to prepare that effective. the resume should be prepared at clear to understand by another quickly. the thesis writing guide should be explain for preparing the resume.

### Human:\nwhat organ controls blood pressure. what organ regulates our blood pressure causing it to rise or lower?\n\n### Assistant: the brain. there really is no one organ that controls blood pressure. blood pressure is controlled through how much blood goes through your heart and a delicate body balance achieved through the cardiovascular central nervous and urinary systems. neurotransmitters in the brain signal the heart to beat quicker and increase blood pressure when it becomes too low. the change in your heart beating then changes the volume and force of blood going through the kidneys and the sodium balance. this action further impacts the fluid in your blood vessels and either lowers or increases your blood pressure.

### Human:\nmy blood pressure is 222/186 heartbeat 128. i'm 32 female. i know this is really high. how concern should i be?\n\n### Assistant: if this is truly your blood pressure (this actual reading would be very unusual since the top number (systolic) and bottom number (diastolic) is quite close together) yes i would be concerned. many blood pressure recording devices can give inaccurate readings so please take your blood pressure more often or better yet see a medical provider so that you can be properly evaluated.

### Human:\nis it possible to have an md in psychiatry and a phd in psychology with a md/phd program? . i am a senior in high school and i have always wanted to either be a psychiatrist or psychologist. i love the idea of both but i have heard that most psychiatrists don't practice psychotherapy. my real question is if i need another degree to practice psychotherapy as well as being a psychiatrist. also is it possible to be an md in psychiatry but also have a phd in psychology? or is it possible to just be a therapeutic psychiatrist?\n\n### Assistant: an md prescribes medications as part of their practice; a psychologist does not. both are skilled and licensed to provide psychotherapy. while it is possible to have both (there are combined phd and md programs) you may want to choose a discipline that best suits your career goals. to be a physician you are looking at four years of college four years of medical school followed by three or four years of a psychiatry residency. after you complete your residency and take your specialty board exams you can design your practice anyway that you like. you can prescribe medications if the patient needs them and provide the psychotherapy. it’s smart to plot your course of action for college success while still in high school. once your start driving down the college highway it’s not always easy or practical to change your destination and route. undergraduate coursework focuses on a different set of emphasized study for your desired type of graduate degree. (see bolded text below). let’s look at your potential career choices and the educational/training requirements as follows: licensed clinical psychologist (ph. d. ) – with this choice your hold a doctorate degree and the title of “doctor”. unlike a medical doctor you will not be able to write-out prescriptions for medication. typically ph. d. students complete 4-5 years of undergraduate study in a related field such as psychology social work mental health counseling sociology or anthropology. you can then expect to enroll in a graduate program and spend 4-7 years working on your doctorate degree. to be a licensed clinical psychologist most people will spend between 9 to 12 years in a higher education setting. the amount of time that it will take you to complete those educational requirements depends on your level of motivation and area specialty interest (such as forensics childhood adolescent or marriage counseling). medical doctor- you will be accorded the title of medical doctor (m. d. ) or osteopathic physician (d. o. ) along with all of the rights privileges and responsibilities of the designation. educational requirements are lengthily. you’ll need 4 years at a college or university to earn a bs or ba degree usually with a strong emphasis on the sciences such as biology physics chemistry and anatomy and physiology. advanced studies in mathematics will also prove to be helpful. other areas of emphasis may be acceptable for some students. you’ll then need undergraduate medical education (medical school) which includes 4 years of study at a u. s. medical school accredited by the liaison committee on medical education. your 4 years of medical school will include preclinical and clinical components. newly graduated md’s enter into a residency program that can be 3-7 years in length of vigorous training under the guidance of senior medical educators. the length of residency training depends on your choice of specialties such as cardiology family medicine psychiatry pediatrics or others. this can be followed by fellowship training of 1-3 years in a subspecialty when doctors want to become highly specialized. for example some doctors may want to focus on the area of adolescent psychiatry a subspecialty of psychiatry. after completing undergraduate school medical school and graduate medical education a physician must still obtain a license to practice medicine from a state or jurisdiction in which they are planning on practicing. you can then apply for a permanent license after successfully completing a number of examinations. the majority of physicians also choose to become board certified. some states and jurisdictions require a certain number of continuing education credits be earned in order to maintain their level of competency in the medical field. please note: a psychiatrist is a medical doctor who specializes in the field of psychiatry. although it is not against the law for psychiatrists to engage in therapy treatment sessions most psychiatrists are content with specializing in prescribing psychotropic medications and in leaving the “talk therapy sessions” to other professionals. therapist- other options in psychology do exist that require fewer years of college. for example you might find it rewarding to become a licensed marriage counselor or family therapist. this pursuit may require 4 years of undergraduate study followed by 2- 3 years of graduate school study. best wishes for your success.

### Human:\nmy a1c was 5. 9 should my dr have talked about prediabetes with me?\n\n### Assistant: based on a set of criteria a hga1c level between 5. 7 and 6. 4% is prediabetes. this means that there is an increased risk for developing diabetes. essentially prediabetes describes a group of people with blood sugar levels between normal and the level used to diagnose someone with overt diabetes. it's important to discuss this with your health care provider since this category carries an increased risk of both diabetes and heart disease. most people in this category are overweight and have developed resistance to the actions of insulin. to help reduce your risk of developing overt diabetes and to reduce your risk of heart disease requires simple actions: routine exercise and weight management through reduce calories and nutritional knowledge. muscles are the primary site of action for insulin so get moving find an activity you enjoy and commit to a change in your priorities and lifestyle. these actions help utilize sugars burn fat and improve insulin's function. all of which reduce your risks of both diseases.

### Human:\nwhy no herbs prior to open heart surgery. my sister-in-laws surgeon told her not to consume herbs prior to her heart surgery. what is the dangers to taking or eating herbs?\n\n### Assistant: depends on the herbs. just because certain herbs are not considered medications per se and do not require prescriptions does not mean they do not cause unintentional medical effects drug interactions anesthesia interactions etc. she is having heart surgery. rather than question the reason for "no herbs" it is best to follow the specific instruction given by the surgeon who has her best interests at heart.

### Human:\nbp is 199/119 but still no meds prescribed. i have been suffering high blood pressure for three years - since college. i wore a monitor for 24 hours at the start of this year and have been deemed hypertensive. i feel unwell and have recently had crippling chest pain. my gp says these are not a cause for concern. my bp is 140/110 usually but is now 199/119. all readings have been in gp office. do i need meds? should i seek a second opinon? . thank you for your time.\n\n### Assistant: yes and yes. based on the information you shared you most definitely need blood pressure treatment and this usually includes medication with the high readings you are having as well as a complete hypertension work-up. i have no explanation as to why your doctor is not concerned so you do need to see someone else line a specialist in internal medicine. yes definitely. you should take second opinion and start with the anti-hypertensive medications. we advice to start with plain arjuna powder (terminalia arjuna) at dose of 3 gms daily after meals with lukewarm water. thank you for your contributions. i am the mother of the girl who posted the question. she thought i was being over anxious as our gp had been rather blasé about it. i took her to a gp in a different town for a second opinion. she was sent to hospital the following day and started on meds. she has had a number of tests so far and as of today she is still 174/111 after a week on meds. however she has had lots of tests scans echoes and ultrasounds! she is only 24 so i hope that we get to the bottom of it soon and see her right again. i appreciate you taking the time to answer her question. regards - mum of marble arch

### Human:\ncan having sex with someone who has a vaginal infection give you ingrown hairs? . my girlfriend has a vaginal infection but we still had sex because she decided the pleasure outweighed the pain. later the next day i had a couple ingrown hairs among my pubic hairs. i do shave that area but this time i had shaved it into a heart and the ingrown hairs were among the already grown hairs rather than the shaved and none were outside of the previously grown area. there are five in total and i've never had more than one or two from shaving. so this time stood out to me.\n\n### Assistant: your ingrown hairs were most likely caused by your pubic shaving (called folliculitis barbae) not an occult vaginal infection from your partner. while skin bacteria can be spread in this way she would most likely have a similar skin infection no a vaginal infection that may be contributory.