Health Care

Pregnancy -> Third Trimester

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 05:53:00 +0000

The third trimester of pregnancy spans from week 28 to the birth. Although your due date marks the end of your 40th week, a full-term pregnancy can deliver between the 38th and 42nd weeks of pregnancy. During this final trimester, your fetus grows larger and the body organs mature. The fetus moves frequently, especially between the 27th and 32nd weeks.

In the final 2 months of pregnancy, a fetus becomes too big to move around easily inside the uterus and may seem to move less. At the end of the third trimester, a fetus usually settles into a head-down position in the uterus. You will likely feel some discomfort as you get close to delivery.

Normal symptoms you may experience during the third trimester of pregnancy include:

Braxton Hicks contractions, which are "warm-up" contractions that do not thin and open the cervix (do not lead to labor).
Fatigue.
Back pain.
Pelvic ache and hip pain.
Hemorrhoids and constipation.
Heartburn (a symptom of gastroesophageal reflux disease, or GERD).
Hand pain, numbness, or weakness (carpal tunnel syndrome).
Breathing difficulty, since your uterus is now just below your rib cage, and your lungs have less room to expand.
Mild swelling of your feet and ankles (edema). Pregnancy causes more fluid to build up in your body. This, plus the extra pressure that your uterus places on your legs, can lead to swelling in your feet and ankles.
Difficulty sleeping and finding a comfortable position. Lying on your back interferes with blood circulation, and lying on your stomach isn't possible. Sleep on your side, using pillows to support your belly and between your knees. Later in your pregnancy, it is best to lie on your left side. When you lie on your right side or on your back, the increasing weight of your uterus can partly block the large blood vessel in front of your backbone.
Frequent urination, caused by your enlarged uterus and the pressure of the fetus's head on your bladder.

Signs that labor is not far off include the following:

The fetus settles into your pelvis. Although this is called dropping, or lightening, you may not feel it.
Your cervix begins to thin and open (cervical effacement and dilatation). Your health professional checks for this during your prenatal examinations.
Braxton Hicks contractions become more frequent and stronger, perhaps a little painful. You may also feel cramping in the groin or rectum or a persistent ache low in your back.
Your "water" may break (rupture of the membranes). In most cases, rupture of the membranes occurs after labor has already started. In some women, this happens before labor starts. Call your health professional immediately or go to the hospital if you think your membranes have ruptured.

Your Baby's Growth

Month 7

At the end of the seventh month, fat begins to be deposited on your baby. Your baby is about 14 inches long and weighs from 2 to 4 pounds. Your baby's hearing is fully developed and he or she changes position frequently and responds to stimuli, including sound, pain and light.

The amniotic fluid begins to diminish.

If born prematurely, your baby would likely survive after the seventh month.

Month 8

Your baby, who is now about 18 inches long and weighs as much as 5 pounds, will continue to mature and develop reserves of body fat. You may notice that your baby is kicking more. Baby's brain is developing rapidly at this time, and he or she can see and hear. Most internal systems are well developed, but the lungs may still be immature.

Month 9

Your baby continues to grow and mature: the lungs are nearly fully developed. Your baby's reflexes are coordinated so he or she can blink, close the eyes, turn the head, grasp firmly, and respond to sounds, light and touch.

You may notice that your baby moves less now since he or she is more confined in your uterus. Your baby's position changes to prepare itself for labor and delivery. The baby drops down in your pelvis, and usually his or her head is facing down toward the birth canal.

By the end of this month, your baby is about 18 to 20 inches long and weighs about 7 pounds.

(source: WebMD)

Pregnancy -> Second Trimester

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 05:27:00 +0000

The second trimester of pregnancy spans from week 13 to week 27 of your pregnancy. This is the time when most women start to look pregnant and may begin to wear maternity clothes. By 16 weeks, the top of your uterus, called the fundus, will be about halfway between your pubic bone and your navel. By 27 weeks, the fundus will be about 2 in. or more above your navel.

You may find that the second trimester is the easiest part of pregnancy. For some women, the breast tenderness, morning sickness, and fatigue of the first trimester ease up or disappear during the second trimester, while the physical discomforts of late pregnancy have yet to start. Pressure on your bladder may lessen as the uterus grows up out of the pelvis.

If this is your first pregnancy, you'll begin to feel your fetus move at about 18 to 22 weeks after your last menstrual period (LMP). Although your fetus has been moving for several weeks, the movements have not been strong enough for you to notice until now. At first, fetal movements can be so gentle that you may not be sure what you are feeling. If you've been pregnant before, you may notice movement earlier, sometime between weeks 16 and 18.

Normal symptoms you may experience during the second trimester of pregnancy include:

Breast changes.
Leg cramps.
Back pain.
Pelvic ache and hip pain.
Stretch marks and other skin changes.
Hemorrhoids and constipation.
Heartburn (also a symptom of gastroesophageal reflux disease, or GERD).
Nosebleeds and bleeding gums.
Hand pain, numbness, or weakness (carpal tunnel syndrome).

Common infections that require treatment during pregnancy include:

Vaginal yeast infections.
Bacterial vaginal infections.
Urinary tract infections.

Your Baby's Growth

Month 4

Your baby's fingers and toes are well-defined; eyelids, eyebrows, eyelashes, nails and hair are formed. Teeth and bones become denser. Your baby can even suck his or her thumb, yawn, stretch and make faces.

The nervous system is starting to function. The reproductive organs and genitalia are now fully developed, and your health care provider can see on ultrasound if you are having a boy or a girl. Your baby's heartbeat may now be audible through an instrument called a Doppler.

By the end of the fourth month, your baby is about 6 inches long and weighs about 4 ounces.

Month 5

Hair is beginning to grow on your baby's head and lanugo, a soft fine hair, covers his or her shoulders, back, and temples. This hair protects your baby and is usually shed at the end of the baby's first week of life.

Your baby's skin is covered with a whitish coating called vernix caseosa. This "cheesy" substance, thought to protect baby's skin from long exposure to the amniotic fluid, is shed just before birth.

You may begin to feel your baby move, since he or she is developing muscles and exercising them. This first movement is called quickening.

By the end of the fifth month, your baby is about 10 inches long and weighs from 1/2 to 1 pound.

Month 6

By the end of the sixth month, your baby is about 12 inches long and weighs about 2 pounds. His or her skin is reddish in color, wrinkled, and veins are visible through the baby's translucent skin. Baby's finger and toe prints are visible. The eyelids begin to part and the eyes open.

Your baby may respond to sounds by moving or increasing the pulse, and you may notice jerking motions if baby hiccups.

If born prematurely, your baby may survive after the 23^rdweek with intensive care.

(source: WebMD)

Pregnancy -> First Trimester

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 05:04:00 +0000

Pregnancy is measured in trimesters from the first day of your last menstrual period (LMP), totaling 40 weeks. The first trimester of pregnancy is week 1 through week 12, or about 3 months.

Early development

Your actual pregnancy begins at the time the egg is fertilized by a sperm cell. During the following week, the fertilized egg grows into a microscopic ball of cells (blastocyst), which implants on the wall of your uterus. This implantation triggers a series of hormonal and physical changes in your body.

The third through eighth weeks of growth are called the embryonic stage, during which the embryo develops most major body organs. During this process, the embryo is especially vulnerable to damaging substances, such as alcohol, radiation, and infectious diseases.

Having reached a little more than 1 in. in length by the ninth week of growth, the embryo is called a fetus. By now, the uterus has grown from about the size of a fist to about the size of a grapefruit.

Early signs of pregnancy

Your first sign of pregnancy may be a missed menstrual period. Other early signs of pregnancy, caused by hormonal changes, include:

Fatigue.
Breast tenderness.
Increased urination.
Fullness or mild aching in your lower abdomen.
Nausea with or without vomiting, also known as morning sickness.

Additional changes related to pregnancy

Throughout your pregnancy, you may notice a number of mild to severe effects, including:

Constipation, due to hormonal changes that slow down the normal function of your bowels. Iron in your prenatal vitamin can also cause constipation.
Mood swings, which can be caused by hormonal changes, extreme fatigue, or the stress of expecting a new baby.
Vaginal discharge changes. A thin, milky-white discharge (leukorrhea) is normal throughout pregnancy. Also, the tissues lining the vagina become thicker and less sensitive during pregnancy.
Vaginal yeast infections, which are more common in pregnancy because of the increased levels of hormones. Call your health professional if you have symptoms of a vaginal yeast infection or bacterial vaginal infection (bacterial vaginosis).
Vaginal bleeding. Spotting in early pregnancy may go away on its own, but it can be the start of a miscarriage. If you experience any vaginal bleeding during pregnancy, contact your health professional.

Your Baby Growth

Month 1

As the fertilized egg grows, a water-tight sac forms around it, gradually filling with fluid. This is called the amniotic sac, and it helps cushion the growing embryo.

The placenta also develops. The placenta is a round, flat organ that transfers nutrients from the mother to the baby, and transfers wastes from the baby.

A primitive face takes form with large dark circles for eyes. The mouth, lower jaw, and throat are developing. Blood cells are taking shape, and circulation will begin.

By the end of the first month, your baby is about 1/4 inch long - smaller than a grain of rice!

Month 2

Your baby's facial features continue to develop. Each ear begins as a little fold of skin at the side of the head. Tiny buds that eventually grow into arms and legs are forming. Fingers, toes and eyes are also forming.

The neural tube (brain, spinal cord and other neural tissue of the central nervous system) is well formed. The digestive tract and sensory organs begin to develop. Bone starts to replace cartilage. The embryo begins movement although the mother can not yet feel it.

By the end of the second month, your baby, now a fetus, is about 1 inch long, weighs about 1/3 ounce, and is virtually all head (1/3 of its body is head). At about 6 weeks, your baby's heartbeat can usually be detected.

Month 3

By the end of the third month, your baby is fully formed. Your baby has arms, hands, fingers, feet and toes and can open and close its fists and mouth. Fingernails and toenails are beginning to develop and the external ears are formed. The beginnings of teeth are forming. Your baby's reproductive organs also develop, but the baby's gender is difficult to distinguish on ultrasound. The circulatory and urinary systems are working and the liver produces bile.

At the end of the third month, your baby is about 3-4 inches long and weighs about 1 ounce.

(source: WebMD)

Pregnancy -> Planning -> Weight

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 05:01:00 +0000

Why is my weight a consideration for getting pregnant?

A healthy body weight promotes general health and reduces the likelihood of developing heart disease, some cancers, and diabetes. Achieving and maintaining a healthy weight is making an investment in your health, your pregnancy health, the health of your future baby, and the well-being of your growing family.

Weight can affect a woman's fertility. Studies have shown that a woman's ability to become pregnant may be severely compromised by two weight-related extremes: excessive thinness and excessive obesity.

Once you do get pregnant, your weight can affect the baby. Underweight women often have smaller babies. Infants with low birthweight (weigh 2500 grams/5-1/2 pounds or less) are at a greater risk of death within the first month of life, as well as increased risk for developmental disabilities and illness throughout their life.

Overweight women may suffer from medical problems, such as high blood pressure and diabetes, that can seriously complicate a pregnancy. If you are overweight, you have a higher risk of having a baby with certain birth defects (like neural tube defects), experiencing more difficulty during labor and delivery, delivering via cesarean section, and hemorrhaging.

While you are planning your pregnancy is the best time to try to reduce your risks through good nutrition and exercise. We strongly recommend that you take the time now, before you become pregnant, to assess your diet and eating patterns and begin to make changes that will help you achieve a healthy weight before you conceive. Once you become pregnant, you should not try to lose weight as it could harm your baby.

What's the best way to achieve and maintain a healthy weight?

The most reliable and safest way to achieve and maintain a healthy weight is to establish two essential good habits:

Good nutrition: Healthy eating is always a factor in good health, but it becomes even more important when you are planning to have a baby.
Regular exercise/physical activity: Establishing a regular exercise program or a pattern of moderate physical activity before pregnancy provides important benefits during pregnancy and birth.

What if I think I have an eating disorder?

What if I think I have an eating disorder?

If you have or think you might have an eating disorder such as anorexia nervosa (a psychological disorder in which a person's refusal to eat and/or an extreme loss of appetite leads to malnutrition, severe weight loss, and possibly death) or bulimia nervosa (episodic binge eating, often followed by forced vomiting or laxative abuse, and accompanied by a persistent preoccupation with body shape and weight) or if you are very overweight or underweight, we recommend that you see a health care provider as soon as possible. These conditions can seriously affect your own health, your ability to become pregnant, and the health of your baby.

(source: Childbirth Connection)

Pregnancy -> Planning -> Relationships

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:55:00 +0000

How do my partner and I know if we're emotionally ready to have a baby?

You're emotionally ready to have a baby if you're having it for the right reasons, with the right person, at the right time, and go into it with realistic expectations of yourself, each other, and your relationship.

The emotional demands of parenthood on each partner are enormous. Each must be prepared to commit to communicating and connecting to a new baby at all times and be able to accept the constant demands of a baby.

How much stress does a pregnancy put on a relationship? How will our life as a couple change when we get pregnant?

Changes that come with pregnancy will, to some degree, cause stress in any relationship, no matter how strong it is. Pregnancy is a major life-altering event with important physical, emotional, and financial effects that you need to deal with in advance.

Working together will make pregnancy preparation and the changes you will need to make in the future easier, and help you forge a strong, healthy family. You and your partner must be ready, willing, and able to withstand a range of degrees of stress. Your levels of stress may intensify, diminish, and vary constantly; it may be difficult to predict.

What kind of stress should we expect?

You must expect and be ready to endure feelings of stress, frustration, incompetence, vulnerability, and responsibility. You must be ready to act with total selflessness because that's what a new baby will require.

A key change is that you and your partner need to expect and be ready for interruptions of intimacy, obstacles to spontaneity, and limitations on your availability for each other.

Finally, relationship experts tell us that, ideally, any unresolved issues in the relationship should be worked out before pregnancy.

What should my partner and I talk about before getting pregnant?

Sit down with your partner and ask yourselves the questions below. There are no right or wrong answers; whatever your answers, they will increase your awareness of your readiness for parenthood.

Why do you want a baby?
- Family pressure?
- You're afraid your "biological clock is ticking"?
- Peer pressure?
- You think society demands it of you?
How strong is your relationship?
- Do you trust, respect, and love your partner?
- Do you share responsibilities?
Are you ready to deal with the major changes a baby will bring…
- In your relationship?
- In your social life?
- In your finances?
- In your living situation?
Do you share religious, moral, and ethical values?
Do you like children?
Did you enjoy your own childhood?
If you were left alone, could you cope?
Do you have a wide support network?

This will be a very important and powerful conversation. It may take some time and some soul-searching. Be prepared to have it once or twice or even three times to make sure you get to all the issues or to revisit issues that need more time. Be prepared to have insights into yourself, your partner, and your relationship that may necessitate additional consideration and conversation. Consider couples counseling to help resolve issues that are important to you and your partner.

What other issues should we talk about before getting pregnant?

If there are existing problems in your relationship, discuss them openly and honestly now because they might escalate after you become pregnant. If you are unable to work them out, consult a professional, someone trained in family therapy.

This is especially true if there is physical (hitting, pushing, kicking) and emotional (yelling, scaring) abuse in your relationship. Abuse is never ok. Becoming pregnant will not stop abuse, and sometimes the abuser's violence escalates when his partner becomes pregnant. Physical abuse is a risk not only to you but also to your baby. It can injure your baby or lead to miscarriage or preterm birth. It is psychologically harmful for children to witness domestic violence. Also, child abuse is more common in families where a parent is violent. Get help right away. Go to our resources to find assistance.

Does my partner's lifestyle affect the pregnancy?

Yes, your partner's lifestyle can affect your pregnancy. Therefore, we recommend that you ask your partner to adopt the same healthy lifestyle as you. We know that's not always possible. However, if your partner can't or won't change a harmful behavior or lifestyle, you need to think about the implications of this for yourself, your relationship, your pregnancy, and your family.

We strongly recommend that before you try to get pregnant, you and your partner stop smoking, stop drinking alcohol, and stop recreational drug use. You should eat a healthy diet and avoid exposure to chemicals and pollutants that may harm you and your baby or in some way jeopardize or compromise a healthy pregnancy.

We also recommend paying serious attention to your work and home environment and that of the child's father. Studies have shown that a man's sperm can be affected by chemical exposure and that the effects on pregnancy are most likely to occur from exposures in the three months before conception. This is because sperm matures in the testes over a three month period. A father's exposure to chemicals, such as some pesticides, has been linked to miscarriage and premature babies.

Additionally, your partner's lifestyle can have an impact upon yours. For instance, the benefits of your decision to quit smoking can be compromised by the smoke from your partner's cigarette (sidestream and secondhand smoke). And, his drinking or smoking behavior can influence your behavior. Your partner has the opportunity to play a major role in helping you avoid alcohol use and smoking during pregnancy.

It is easier to make behavior changes when you work on them together. Working together this way can also help bring you closer and help you build a strong and healthy family unit.

Will we still be able to travel when I get pregnant?

A trip with your partner before your first pregnancy might be the last chance you and partner have to travel alone together for a long (long!) while. So, if you have any plans for a distant or foreign vacation, now – before you become pregnant - would be a good time to take that trip.

That said, there is no reason why you can't travel when you become pregnant; it largely depends on how you feel and how healthy you are. Long distance travel can be uncomfortable for some pregnant women.

Two important things you need to know are:

1. Most airlines won't accept women who are over 35 weeks pregnant.

2. Foreign travel can expose you to illnesses you might not encounter at home.

If you need to get immunizations for a trip, be sure to tell your health care provider that you are trying to get pregnant.
If you recently have taken a trip to a foreign country that has known health risks, ask your health care provider if you need to get a checkup and a clean bill of health before trying to conceive.

How can friends and family members help us prepare for pregnancy?

Friends and family members who have been pregnant can help you plan, tell you what you might expect, and ease many of your transitions through pregnancy and into parenthood.

If you don't already have a support network of friends, relatives, health care providers, health education professionals, clergy, etc., now is a good time to create and/or strengthen it.

(source: Childbirth Connection)

Pregnancy -> Planning -> Pre-Pregnancy Checkup

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:50:00 +0000

Should I have a pre-pregnancy checkup before I try to become pregnant?

A pre-pregnancy checkup is a smart idea. Your health care provider can help you minimize risks associated with pregnancy and any existing medical conditions that could affect and/or be affected by pregnancy. The more you can inform your caregiver before you conceive about your medical and family history, medications you take, any past pregnancies you've had, and your diet and lifestyle, the better advice he/she can give you to help you have a healthy pregnancy.

If you are taking any prescription medications, over-the-counter medicines, or alternative or herbal remedies, your caregiver can advise you about how and why you may need to change your practices. Some drugs, and even seemingly harmless ones like some acne medicines or certain vitamins, can actually have the opposite affect on you once you become pregnant and/or could affect your baby.

A pre-pregnancy checkup is good idea if you have an existing medical condition that could pose risks to you and/or your baby during pregnancy such as:

Asthma
Auto-immune disorders such as Lupus, Rheumatoid Arthritis, HIV, or AIDS
Blood Disorders such as Hemoglobinopathy or Hyperphenylalaninemia
Cancer
Deep Venous Thrombosis
Depression
Diabetes
Epilepsy
Heart Disease
Hemoblobinopathies
High Blood Pressure
Kidney Disease
Thyroid Disorders

It is possible to have a successful pregnancy if you have one of these chronic conditions, but it may be considered a high risk pregnancy and you will have to take some special precautions.

At your pre-pregnancy checkup, you should discuss the medications you are taking or should be taking for any of these conditions, as your health care provider will want to evaluate them in terms of their affect on you and the developing fetus.

Even if you think you are healthy and ready to get pregnant, a pre-pregnancy checkup is a good opportunity to start asking questions. Make a list of issues before your appointment and ask your caregiver for information.

What other health issues should I be concerned about when I’m thinking about having a baby?

You should definitely see a health care professional if you:

may have been exposed to a sexually transmitted disease
may have been exposed to certain childhood diseases
need any immunization booster shots

Exposure to a sexually transmitted disease can be harmful to you and your baby. Sexually transmitted diseases of greatest risk to women and their infants are:

AIDS/HIV: can be transmitted to the fetus
Hepatitis B: infected fetuses have a 25% chance of dying from a liver-related disease unless treated within days of birth
Chlamydia : can lead to ectopic (outside uterous) pregnancy
Gonorrhea: can lead to ectopic (outside uterous) pregnancy
Syphilis: can cause congenital anomalies and fetal/infant death
Herpes: prescribed abstinence during outbreaks increases the time it takes to conceive
Trichomoniasis: a vaginal inflammation which may lead to infertility
Human papillomavirus (HPV) (may lead to genital warts): is associated with cervical cancer, treatment of which can affect fertility
Herpes Simplex Viruses (HSV): can be passed onto the infant during vaginal delivery, may lead to brain damage, blindness, mental retardation and infant death

Most sexually transmitted diseases can be cured using drugs such as antibiotics; there is an immunization against Hepatitis B. But, some cannot and expose you and your baby to risks. Both you and your partner should be screened and, if necessary and if possible, treated before you try to become pregnant, since some can cause infertility, miscarriage, preterm birth, and infant death.

You should be aware that many of these diseases can have no symptoms. On general principle, if you are planning to get pregnant, have a pre-pregnancy checkup and ask your health care provider for the appropriate tests for sexually transmitted diseases.

Exposure to chickenpox, rubella (German measles), and the measles during pregnancy can cause birth defects in your baby. Before getting pregnant, you should make sure that you are immune to these common childhood diseases, either because you have had them already or because you've been vaccinated against them. If you don't have your childhood medical records you can find out through a simple blood test if you are immune to these conditions. Most women are immune. However, if it turns out you need an immunization shot, wait at least three months after having that shot before trying to get pregnant.

If you need booster shots for mumps, polio, or tetanus, the same caution should be taken; wait at least three months after having the last booster shot before trying to get pregnant.

Are there any special medical circumstances to think about?

If you are over 35 or have a family history of congenital (inherited) birth defects, you might want to consult with a genetic counselor.

(source: Childbirth Connection)

Pregnancy -> Planning -> Nutrition

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:43:00 +0000

There is so much advice out there; how do I choose what to eat?

Choosing what to eat should be based on a balanced diet and the amount of calories you need to carry out your daily activities. Avoid fad diets and those that over-emphasize or downplay any of the six main dietary nutrients: water, protein, carbohydrates, fat, vitamins, and minerals. Healthy eating will help you function at your best and achieve and maintain a healthy body weight.

Why are folic acid (or folate) and iron so important?

As part of the revised FDA national dietary guidelines for healthy eating, there are two specific recommendations for pre-pregnant women that relate to iron and folate (folic acid):

Consume adequate synthetic folic acid daily (from fortified foods or supplements) AND food forms of folic acid from a varied diet.

Whether you are planning to get pregnant or not, you must be sure to get enough folic acid (sometimes called folate).

Folic acid is a B vitamin that helps a baby's neural tube -- the part of the embryo that becomes the brain and spinal cord -- develop properly. It is critical to start taking it before conception and to continue taking it through the third month of pregnancy, when the baby's neural tube is developing, to prevent birth defects in the spine and skull.

You can get folic acid by taking a multivitamin with 400 micrograms (mcg) of it daily. You will also find it in fortified breakfast cereals; citrus fruits and juices; dried peas and beans; and green, leafy vegetables such as spinach, collard and turnip greens, and broccoli.

Eat foods high in heme-iron, iron-rich plant foods, iron-fortified foods, or foods that facilitate iron absorption, such as vitamin C-rich foods.

Iron is important during pregnancy as it prevents anemia, a condition in which the body isn't able to produce enough healthy red blood cells. Developing infants need a high level of red blood cells in order to receive enough oxygen. And, anemia in the mother can be passed on to her baby.

You can get heme-iron by eating food such as red meats, fish, and poultry (basically, food from animal sources). Iron-rich plant foods include cooked beans, lentils, and enriched pasta. Many breakfast cereals are also iron-fortified.

Foods that help iron absorption consist of fruits (oranges, orange juice, cantaloupe, strawberries, grapefruit) and vegetables (broccoli, brussels sprouts, tomato, tomato juice, potatoes, and green and red peppers), and are effective when eaten with iron-rich foods like meat, fish, and poultry.

What is considered healthy eating for women who are planning to become pregnant?

With two exceptions, healthy eating for pre-pregnant women is the same as healthy eating for most people of the same age, gender, and physical activity level. Those exceptions are iron and folate/folic acid.

New national dietary guidelines and a revised Food Pyramid were released April 2005 by the United States Department of Agriculture (USDA). Reviewed and revised as necessary every five years, the guidelines' purpose is to provide advice for healthy Americans about food choices that promote health and prevent disease.

Current national dietary guidelines are:

Focus on fruits. Eat a variety of fruits--whether fresh, frozen, canned, or dried--rather than fruit juice for most of your fruit choices. For a 2,000-calorie diet, you will need 2 cups of fruit each day (for example, 1 small banana, 1 large orange, and 1/4 cup of dried apricots or peaches).
Vary your veggies. Eat more dark green veggies, such as broccoli, kale, and other dark leafy greens; orange veggies, such as carrots, sweet potatoes, pumpkin, and winter squash; and beans and peas, such as pinto beans, kidney beans, black beans, garbanzo beans (chick peas), split peas, and lentils. Frozen produce is often as good for you as fresh since it's frozen immediately after harvest.
Get your calcium-rich foods. Get 3 cups of low-fat or fat-free milk--or an equivalent amount of low-fat yogurt and/or low-fat cheese (1-1/2 ounces of cheese equals 1 cup of milk)--every day. If you don't or can't consume milk, choose lactose-free milk products and/or calcium-fortified foods and beverages. The recommended daily allowance is 1,000mg.
Make half your grains whole. Eat at least 3 ounces of whole-grain cereals, breads, crackers, rice, or pasta every day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal, or 1/2 cup of cooked rice or pasta. Look to see that grains such as wheat, rice, oats, or corn are referred to as "whole" in the list of ingredients.
Go lean with protein. Choose lean meats and poultry. Bake it, broil it, or grill it. And vary your protein choices with more fish, beans, peas, nuts, and seeds.
Nosh on nuts. Five ounces a week of nuts is a healthy addition to any diet – unless you're allergic to them. Stick to almonds, walnuts, and hazelnuts as they have less fat and have more nutrients. Eat them raw and unsalted...you'll get used to the taste!
Know the limits on fats, salt, and sugars. Read the Nutrition Facts label on foods. Look for foods low in saturated fats and trans fats. Your body needs a certain amount of fat, so you should not eliminate it totally. Plant oils from nuts, nut butters, olives, and avocados are good for you. Choose and prepare foods and beverages with little salt (sodium) and/or added sugars (caloric sweeteners). Remove the skin and fat from meats and fish.
Understand your fats. Look for foods low in saturated fats, trans fats, and cholesterol to help reduce the risk of heart disease. Five percent of the daily value (DV) or less is low; 20% of the daily value (DV) or more is high. Most of the fats you eat should be polyunsaturated and monounsaturated fats. Keep total fat intake between 20% - 35% of all the calories you take in each day.
Reduce sodium (salt), increase potassium. Research shows that eating less than 2,300 milligrams of sodium (about 1 teaspoon of salt) per day may reduce the risk of high blood pressure. Most of the sodium people eat comes from processed foods, not from the saltshaker. Also, look for foods high in potassium (such as bananas), which counteracts some of sodium's effects on blood pressure.
Don't sugarcoat it. Since sugars contribute calories with few, if any, nutrients, look for foods and beverages low in added sugars. Read the ingredient list and make sure that added sugars are not among the first few ingredients. Some names for added sugars include sucrose, glucose, high fructose corn syrup, corn syrup, maple syrup, and fructose.
Check servings and calories. Look at the serving size and how many servings you are actually consuming. If you double the servings you eat, you double the calories and nutrients, including the percent of daily values.
Make your calories count. Look at the calories on the label and compare them with the nutrients you are also getting. Decide whether the food is worth eating. When one serving of a single food item has over 400 calories per serving, it is high in calories.

What is a serving size?

A serving size is usually described in terms of numbers of cups, teaspoons, tablespoons, ounces, or slices. A serving is not what you are served! Our tendency to severely misjudge serving size has been dubbed "portion distortion." Though the name is cute, the problem is not. In fact, it is cause for serious concern since it leads many of us to overeat.

Here are healthy one-portion servings for women:

Whole grains
- breads: 1 slice of bread, 1/2 English muffin, 1/2 hamburger bun, 1/2 bagel, 1 tortilla
- pasta: 1/2 cup cooked
- rice and other grains: 1/2 cup cooked
- cereal: 1 ounce ready-to-eat cereal, 1/2 cup cooked
Plant oils
- oils: 1 tablespoon
- fatty plant foods: about 15 nuts, 1 tablespoon nut butters, about 20 medium olives, 1/3 of an avocado
Vegetables and Fruit
- raw: 1 piece or 1 cup
- canned or cooked: 1/2 cup
- dried: 1 ounce
- juice: 6 ounces
Legumes
- 3/4 cup cooked
Nuts
- about 15
Poultry, fish and eggs
- poultry: 3 ounces
- fish: 3 ounces
- eggs: 1
Dairy
- milk: 1 cup
- cheese: 1 ounce
- yogurt: 1 cup
- soy milk: 1 cup
- calcium fortified orange juice: 1 cup
- tofu: 3 ounces
Red Meat
- 3 ounces
Sweets
- occasional treats

What foods should I be careful about eating?

Be careful about eating certain fish, including shark, swordfish, king mackerel and tilefish. Sometimes these fish have levels of methylmercury that can damage the nervous system of a fetus.

Although almost all fish and shellfish contain small amounts of mercury, you can enjoy some with lower mercury levels (shrimp, canned light tuna, salmon, pollock, and catfish) in moderation (no more than 12 ounces a week, according to the FDA and EPA). Because albacore (or white) tuna or tuna steaks are higher in mercury than canned light tuna, it's recommended that you eat no more than 6 ounces a week.

Do not eat raw or undercooked seafood, poultry and meat.

Thoroughly wash all fruits and vegetables.

As part of a healthy diet, what should I drink?

You should drink about 8 cups of non-alcoholic, noncaffeinated liquids each day.

Plain water is best, but you can also get the liquid you need from soups and juices (though, be careful…you'll add calories with these options!).

Drinks that have caffeine, and that includes many sodas, have a diuretic effect – meaning they will cause increased urine output. This is true of alcohol as well.

Is it ok to drink alcohol while I am planning to get pregnant?

It is best not to drink alcohol while you are planning to get pregnant. The first 8 weeks of your pregnancy are a particularly vulnerable time for your fetus as its vital organs are being developed. Because you may not know you are pregnant for a few weeks, or sometimes months, after conception, it is best to abstain from alcohol and avoid this serious risk. In addition, evidence shows alcohol may inhibit ovulation, perhaps making it more difficult to conceive.

(source: Childbirth Connection)

Pregnancy -> Planning -> Medications

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:38:00 +0000

Are there any prescription medicines I should worry about taking now?

Prescription medications such as Accutane, Thalomid, Paxil, and anything labeled a teratogen (anything that causes malformation of an embryo or fetus) should not be used by women planning to get pregnant or after conception. These medicines can cause serious birth defects and miscarriage.

Accutane is prescribed for severe acne and if taken during pregnancy can cause serious birth defects in the central nervous system, bone and heart defects, impeded fetal growth, increased likelihood of miscarriage, and mental retardation.
Thalomid, once known as Thalidomide, was used to treat leprosy and some arthritic disorders, and is now prescribed for ulcers and AIDS. This, too, if taken during pregnancy, can cause serious birth defects such as fetal limb deformities and kidney and heart defects.
Paxil, (also available as Paxil CR, Pexeva, and generic paroxetine hydrochloride) is a drug used to treat depression. The Food and Drug Administration (FDA) has recently advised that women taking it in their first trimester of pregnancy may have an increased risk for heart defects in their baby.
Lamictal is prescribed to treat seizures and bipolar disorder. This drug, taken during the first trimester, may increase your risk of having a baby with a cleft lip or cleft palate (a gap in the upper lip or roof of the mouth).

If you are taking any of these, talk to your health care provider about the best way to stop, or gradually stop, taking them at least one month before trying to get pregnant. You should not simply stop taking them on your own.

Medicines used to treat infections, epilepsy, blood clots, and some cancers can be risky. If you are prescribed any medications, be sure to tell your health care provider that you are planning to get pregnant. Ask specifically if this medication might have any negative affects on you or a fetus.
Avoid new drugs. Many have not been tested for their impact on pregnant women and a fetus.

Remember, different prescription medications have different degrees of risk in terms of their affect on you and a growing fetus. Some are completely safe while others may be very harmful.

Why should I talk to my health care provider about over-the-counter medicines I'm taking?

Even cold or headache remedies sold without a prescription (over-the-counter) at a pharmacy or drug store are strong medicine. Tell your health care provider what you are taking in case they might affect your ability to get pregnant or in case they can have an effect on a growing fetus. This site also has resources for finding out more about non-prescription medicines.

Are alternative or "natural" remedies safe?

Most "natural" remedies and herbal dietary supplements have not been tested to determine their effects during pregnancy. Many have active ingredients that have strong biological effects and their safety is not always assured. Also, some interact dangerously with some prescription medicines. You could be putting yourself and your baby at risk if you don't discuss all the possible consequences with your caregiver. You might need to stop taking some of these remedies before becoming pregnant.

(source: Childbirth Connection)

Pregnancy -> Planning -> Healthy Lifestyle Habits

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:35:00 +0000

How can I successfully develop new, healthy lifestyle habits before I get pregnant?

It can take time to establish new healthy behavior patterns and break harmful habits, especially those bad habits that have been repeated for years.

Don't try to change everything at once. An ambitious plan to quit smoking and drinking, start eating better, and exercising all at the same time could lead you to become discouraged and give up. Start with changing a habit that will give you the most confidence to go on. For example, identify the toughest habit to break and work on that first.
Start with something do-able. Pick one thing you want to change and believe you can change. Make a promise to yourself to achieve a particular goal by a particular time. Break it down from a large behavior (quit smoking) into smaller ones (not buying cigarettes, smoking fewer and fewer each day, eliminating the after dinner cigarette, etc.). Your track record of initial small successes will provide the momentum you need for the really big challenges ahead. Imagine the "new you." Confront any fears of what life will be like without the support of the harmful behavior until they no longer scare you.
Arrange for reinforcement and encouragement. Organize ways to be supported by friends, colleagues, and relatives until your own pride in your accomplishment is enough to keep you going. Talk positively to yourself – be your own greatest fan and cheerleader. Find role models whose success inspires you. When the new healthy routine is well-established, start on the next one.
Be specific. Instead of saying you'll exercise more, arrange to walk a mile every other day with a friend. Writing down your goals can help, too. Read them whenever you feel you might slip. Put a note to remind yourself -- where you'll see it!
Get temptation out of the way. Re-arrange your surroundings to support your new behavior and not perpetuate the old one. If you are trying to quit drinking in preparation for getting pregnant, don't keep wine in the house. Ask your partner to support you by joining you in the new behavior.
Give yourself healthful rewards. Acknowledge small victories by having lunch with friends, taking a relaxing bath, getting a new haircut, or buying a CD of music you love. You'll only need to do this for a short time. It's amazing, but pretty soon, just the fact that you're still doing the new behavior or that you haven't done the old behavior for a long time will be a sufficient reward.
Make no exceptions for the first month. Studies have shown it takes 30 days to establish a new behavior. Don't fool yourself into thinking that just one cigarette, or one extra cookie, or one skipped exercise session won't hurt. "Just one" is like "just dropping" a ball of string you are trying to wind: It unravels and runs out of control. Let yourself and your body develop new behavior rhythms.
Accept the loss and grieve. Yes, behavior change can be uncomfortable; in fact, sometimes it can actually hurt. The fact is, giving up an established behavior is a loss and it's natural to grieve. That's fine. But grieving does not mean going back into the old behavior. Talk about the change to a health professional, a friend, a colleague, or a family member. Be as upset with the change as you have to be and then focus on the benefits you want that led you to make this change. Hang on tight – you'll make it!
Make substitutions. Eat fresh fruit rather than cake, but don't deny yourself dessert altogether. Sometimes habits are attached to other activities, like snacking while watching television. You might be most inclined to slip when you feel deprived, so instead of mindlessly eating high fat, sugary foods, eat healthier snacks instead.
Join a support group. People who share your concerns can help you reach your goals. There are groups for just about every concern. You will find resources for finding such groups, as well as other resources for changing habits on this website.
Be motivated by why you are doing it. Sometimes it's easier to make changes for someone you love than for yourself. Think about the baby you are planning for. Don't indulge in any habits you wouldn't want your child to have.

(source: Childbirth Connection)

Pregnancy -> Planning -> Genetic Counseling and Testing

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:29:00 +0000

What is a genetic counselor?

A genetic counselor is a health professional specially trained to understand and interpret your genetic information and the likely genetic consequences of a pregnancy between you and your partner. Genetic counselors can help you determine if you want to pursue any genetic testing, screening, or preventative measures. A genetic counselor can help you examine and make decisions about genetic factors that might place you at higher risk for having a baby with hereditary diseases or birth defects. Genetic counselors also provide emotional support and can refer you and your family to community or state support services, if needed.

Medical conditions that occur or have occurred at some time in your family can be passed on through you. Talking with a genetic counselor is often the first step toward understanding and dealing with your inherited risks. Getting this information while you are planning to get pregnant can help you prepare and make informed decisions throughout your pregnancy.

Why would I want to see a genetic counselor?

You may want to consider genetic counseling if you and/or your partner:

are concerned about inherited diseases or traits
belong to certain ethnic groups that have a higher than usual incidence of a particular genetic disease
have had 3 or more miscarriages or a baby who died in infancy
already have a child with mental retardation, an inherited disorder, or a birth defect
are over 35
are concerned that your lifestyle, job, or environment may pose a risk to pregnancy

What inherited conditions suggest a consultation with a genetic counselor?

You might want to talk to a genetic counselor if any of the following conditions are present on either side of your families:

Achondroplasia (a form of dwarfism)**
Canavan Disease*
Cleft Palate
Club Foot
Congenital (inherited) Heart Disease
Cystic Fibrosis*
Diabetes
Dwarfism
Gaucher's Disease*
Hemophilia
Huntington's Chorea (a debilitating neurological condition)
Mental Retardation (Fragile X Syndrome, some forms of Down Syndrome)
Hydrocephalus ("water on the brain")
Muscular Dystrophy
Phenylketonuria
Polydactylism (extra toes or fingers)**
Sickle Cell disease or trait*
Thalassemia*
Tay-Sachs trait or disease*

** Autosomal dominant inherited pattern- only one parent has to carry the gene; the parent usually has the disease, and each child has a 50:50 chance of inheriting it

*Autosomal recessive diseases- diseases that both parents carry in their genetic make-up; the child has to inherit one copy of the gene from each parent in order to get it. If a woman and her partner share an ethnic background that is high risk of a specific autosomal recessive disease, there is a 25% chance with each pregnancy that the baby will have that disease.

What inherited diseases are most common in certain ethnic groups?

Among the most common inherited diseases by ethnic group are:

Sickle Cell Anemia, a blood disorder that mainly affects people of African descent
Tay-Sachs Disease, a central nervous system disease that primarily affects Jewish people of Eastern European ancestry
Thalassemia, a group of blood disorders that mainly affect people of Mediterranean, African, and Southern Asian descent
Cystic Fibrosis, a disorder of the lungs and digestive system that mainly affects Caucasians

What happens during a visit to a genetic counselor?

Typically, when you go to see a genetic counselor, you will discuss background medical information about you and your partner. This may include information about your family history, your own medical history, and any previous pregnancies. Before the meeting, you can help by preparing a health family tree going back three generations. You may also be asked to bring your medical records as well as photos of any members of your family with possible genetic disorders.

In some cases, the counselor may offer carrier testing, usually a blood test, to help determine if you or your partner has genes that increase the chances that you will have a child with a certain inherited disease or birth defect. After you become pregnant, there will be further genetic tests you can take to determine if your fetus has a genetic disorder.

The cost of genetic counseling and testing can range from under $100 to over $2,000, depending on what tests are required, but average between $175 and $300. Some health insurance plans cover these costs, especially if your doctor recommends it.

What if tests show that there is a risk that we might pass on an inherited disorder?

The genetic counselor should ask about your concerns and guide you toward information on specific birth defects that will help you make informed decisions. This is a totally personal choice. Counseling enables you and your partner to educate yourselves about potential challenges and to talk through some difficult questions before a baby is even part of the equation. Counseling can also help you and your partner prepare for any medical or social needs for your baby before it is born.

Where can I find a genetic counselor?

Many large medical centers offer genetic counseling. Your primary health care provider can probably refer you to one. Also, this website resources to help you find a genetic counselor. Many genetic counselors become certified by the American Board of Genetic Counseling as a way to attest to their acquired knowledge and skills.

What effect will all this new genetic research have on my pregnancy?

The field of human genetics has seen enormous breakthroughs recently. In coming years, gene therapy -- the manipulation of genes to fight or prevent diseases -- will undoubtedly have a significant impact on the incidence (new cases) and prevalence (total cases) of genetic diseases and birth defects. The treatment or elimination of inherited diseases or birth defects could one day become a reality, but right now the field is still young.

(source: Childbirth Connection)

Pregnancy -> Planning -> Finances and Insurance

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:20:00 +0000

How can my partner and I be sure we can afford to have a baby?

You should think about whether you can afford to support a child from birth through adulthood rather than simply the cost of having a baby. It is not just the expense of pregnancy and childbirth you need to plan for, as that is only the first step in the financial commitment that may last decades.

The U.S. Department of Agriculture (USDA) estimates that a middle-income family spends about $250,000 (not counting college tuition) to raise a child to adulthood (18 years old).

So, financial planning and preparation before you become pregnant is a very good, practical idea.

What should we do to prepare financially for a baby?

Regardless of your lifestyle and circumstances, it's almost impossible to predict how parenthood and other events will affect your life. But, here are seven steps you can take to prepare financially for a baby.

1. Assess your expenses. Figure out how much you currently have in your budget for the extra costs of having a baby and raising a child.

A baby budget includes the costs of diapers, formula (unless you are breastfeeding â€“ it's free!), insurance co-payments, day care, furniture, equipment (strollers, car seats, etc.), clothing, education savings, and other needs. Build in a cushion in case you have unexpected medical bills.

Should there be no allowance in your budget for these expenses, you might have to cut back on your personal spending.

Almost every expectant parent, especially those expecting their first child, worries about money. But the good news is that most discover after the baby is born that adjusting isn't as hard as they thought.

2. Examine your income. Think about if you'll be living on one income rather than two after the baby comes, and, if so, for how long. Are you going back to work? Will your partner be the care provider and stop working? If you will be shifting from being a two income couple to a one paycheck family (even for a short period of time), now is a good time to start saving money, while you still have the two pay checks. Since it is hard to predict how much time you or your partner might want to take off work after the baby is born, plan to save as much as possible before becoming pregnant.

3. Pay off any large credit card debts. If you are in over your head and need assistance, now would be the best time to contact a credit counseling service. There are non-profit organizations in every state that counsel people in debt for no or little cost. They will help you with repayment plans and help you set up a realistic budget. Our resources section for Finances and Insurance has some places for you to start.

4. Buy life insurance. It seems way too early to think about this, but you need to plan, right now, for your child if something were to happen to you. Term life insurance insures you for a fixed amount for a given premium. It is generally the least expensive life insurance option and you can change the coverage, as your family's needs change. Also remember to buy life insurance for the stay-at-home parent - if something happens to that parent, the working parent will more than likely need to purchase child care and other services.

5. Get long-term disability insurance. Get long-term disability insurance. Yes, this is something else you might resist thinking about, but the fact is, people 35 - 65 are more likely to become disabled than to die. Therefore, it's very important that the primary wage earner in the family has disability insurance. It will provide for your family if you're disabled and can't work. Check with the Personnel Department at work to see if you're covered and, if so, what the terms of the coverage are; if you don't think it's enough, you may be able to get more.

6. Make a will and update your beneficiaries. It's a major consolation to know that your child will be raised and provided for in the way you intend if something happens to you. One way to insure this is to make a will that states who should take care of your child and his or her finances (it doesn't have to be the same person, and often shouldn't be). Also check your retirement accounts. Usually you name the beneficiaries of retirement accounts like IRAs and 401(k)s when you open them. You'll want to be sure these are updated to reflect your current intentions.

7. Study your employer's maternity and paternity leave policies. It's important to know what benefits your company offers new parents. If you work full time and plan to return to your job after your baby is born, find out about your company's maternity leave policy. Thanks to the Family and Medical Leave Act, mothers and fathers who have worked at least one year for a company with 50 or more employees are entitled to up to 12 weeks of unpaid time off. You are also guaranteed to get your job back at the end of your leave. If you work for a smaller company, be sure to check into whether any maternity benefits are offered.

I work outside the home. What employee benefit information should I look at before getting pregnant?

If you intend to return to your place of employment after the birth, you need to find out about your employer's policies on maternity or paternity leave before you get pregnant. Some policies are dictated by the Family Medical Leave Act (FMLA); others are at the discretion of the employer.

Look into paid maternity leave, short-term disability, flexible spending accounts, sick leave, vacation time, flex time, new mom benefits, and paternity leave.

Paid maternity leave: If you have worked at a company with 50-plus employees for at least one year, you are entitled to 12 weeks of unpaid maternity leave and are guaranteed your job back. Find out if your employer offers any paid leave.
Short-term disability: If your employer has such a policy, typically it will pay 60%-70% of your gross income for approximately six weeks following the birth of your child.
Flexible spending account: If your employer offers one of these accounts, you can put aside pre-tax money toward deductibles and uncovered medical expenses.
Sick leave: If your employer allows you to substitute accrued paid sick leave for unpaid maternity leave, take advantage of this. Federal law does not require it, but your employer may do so.
Vacation time: If you have accrued paid vacation or personal time, federal law says that you may substitute it for your unpaid maternity leave.
Flex time: If your employer offers flex time, you may have the option of a gradual-return-to-work schedule, flexible hours, job sharing, compressed work weeks, or the chance to work from your home after the baby is born.
New-mom benefits: Some companies offer lactation stations, visiting-nurse services, and day care.
Paternity leave: New dads may also be covered by the Family Medical Leave Act (FMLA), and so may also take 12 weeks of unpaid leave under the same circumstances, regardless of whether or not mom takes her leave (unless you both work for the same company, in which case, you get a combined 12 weeks).

What should I look for in my health insurance policy?

It is a good idea to check out policy options or reread your current insurance policy. Often, with enough notice, you can change plans, and, based on the benefits or lack of benefits in your current policy, you may wish to do so before becoming pregnant.

Find out if your insurance policy covers:

A pre-pregnancy checkup
Prenatal tests and prenatal care visits
Postpartum checkup
Your chosen maternity caregiver
Different birth settings and labor support options
Baby's hospital costs, including nursery costs
Sick and well baby visits

You should find out if your insurance plan has a deductible, and if so, how much it is. Determine if you are responsible for a co-payment and estimate your total out-of-pocket expenses.

Can I change health insurance plans to increase pregnancy benefits?

When your policy is limited in benefits or you are afraid that your out-of-pocket expenses will be excessively high, you might want to investigate the possibility of changing plans. Sometimes you can only change once a year, so this may take some forethought.

Many insurance policies say they will not cover "pre-existing conditions". Pregnancy is not a pre-existing condition. Under The Health Insurance Portability and Accountability Act (HIPAA), federal law says that if you change group health plans while you're pregnant, your new group health insurer can't deny claims related to your pregnancy as long as the plan covers maternity. However, this only applies to group plans; if you pay for an individual insurance policy, you may not get coverage at all if you are pregnant.

I am not married. Will my partner's insurance cover my pregnancy?

Right now companies are not legally required to offer coverage to domestic partners. Some may do so at their own discretion.

However, once the baby is born, the father can add the baby to his policy as a dependent.

What help is available to families with limited incomes

Resources available to eligible low-income pregnant women and families are:

Women, Infants and Children (WIC), a federally funded program, provides coupons for free food for pregnant women.
Government sponsored health insurance programs, called Medicaid, MediCal, etc. (depending on which state you live in), are joint federal and state medical assistance programs for individuals and families that meet specific standards for low income and limited assets.
Most cities or counties have public free clinics providing prenatal care for low-income women. Check your Yellow Pages or call your county Health Department. Some hospitals will also run free or low cost clinics.
Many communities have privately funded facilities, such as charitable organizations and foundations, for low-income pregnant women. Ask at your local hospital or church.
Toll-free Maternal and Child Health Helplines in every state can help you link up with needed services.

(source: Childbirth Connection)

Pregnancy -> Planning -> Exercise and Fitness

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:15:00 +0000

What is the connection between physical activity, exercise, fitness, and pregnancy?

Physical activity is about moving around and being less sedentary. Exercise is a more systematic, routine form of physical activity. Both or either can lead to all-around improved health and fitness, and by extension, to a healthier pregnancy.

Specifically, physical activity, in appropriate amounts can decrease the risk of developing conditions and their complications such as heart disease, high blood pressure, diabetes, some forms of cancer, and osteoporosis.

Physical activity and exercise can help to:

relieve stress, anxiety, and depression
help you maintain a healthy weight
help you sleep better
boost your energy
help fight off colds and flu by boosting your immune system (your body's defense system against bacteria, viruses, fungi, and parasites)
give you strength and endurance to carry your baby both before and after it's born
build the stamina you might need during labor
improve the quality of your life in general

Getting into the habit of being as active as you can be now, as you are planning to become pregnant, should make it easy to continue to be physically active during your pregnancy.

What kind(s) of physical activity/exercise should I do?

Current research suggests all-around fitness requires three types of activities:

Cardiovascular exercise (walking, running, cycling, swimming, aerobic dancing):
- for health - to strengthen your heart and lungs - 30 minutes a day is best, but at least 20 minutes a day three to five times a week. Studies show that three 10-minute sessions a day are as good as one 30-minute workout.
- to lose weight, do at least 30 to 60 minutes of continuous exercise three or more times a week.
- for endurance, to prepare for labor and birth and keeping up after the baby is born
Strength training (lifting free weights, using resistance machines, doing isometrics): work all your major muscle groups twice a week. These activities strengthen your bones and muscles, and they boost your metabolism (increase the number of calories you burn). Thus, they also help prevent osteoporosis.
Flexibility training (stretching, doing yoga or tai chi): every day for 10 minutes. These exercises keep you flexible, reduce your risk of injuries, and improve how you feel in general.

What we recommend is increased physical activity - you can do it on your own or through a gym.

The good news is you can get many of the health benefits of exercise simply by adopting a more active lifestyle. An active lifestyle includes a total of 30 minutes or more a day of moderately strenuous activities such as walking the dog, gardening, or doing housework.

Some more ideas for staying active are:

Take the stairs instead of the elevator
Walk upstairs to the other restroom
Walk to a co-worker's office instead of using the phone or email
Park further away when going to the store, visiting a friend, or going to work
Walk to the next bus stop before getting on
Don't use any drive-through services - get up, get out, and walk
Do stretching or isometric exercises while you watch television
Go dancing
Work in the garden
Take active vacations
Play a team sport or take lessons

(source: Childbirth Connection)

Pregnancy -> Planning -> Environment: Home and Work

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:08:00 +0000

Why should I worry about environmental hazards at work?

Some substances found in the workplace may affect fertility.
Additionally, if you don't realize you are pregnant, you could unintentionally expose your unborn baby to potentially dangerous substances during its vulnerable first few weeks of growth and development. This could increase your risk of miscarriage, birth defects, low birthweight, or premature birth.

What substances should I be aware of at work or while enjoying my hobbies?

Some substances can be harmful to you once you become pregnant (and to your baby), so it is good to become informed about these potential risks while you are planning your pregnancy. You should be aware if at work, or when enjoying one of your hobbies, you are exposed to:

Toxic substances such as lead, mercury, pesticides, paint and paint thinners, or dry-cleaning fluids
Ionizing radiation as found around X-ray machines or in nuclear medicine procedures
Anesthetic gases used for medical and dental procedures
Childhood viruses encountered by teachers and health care workers
Excessive secondhand smoke or side-stream smoke from others' cigarettes, cigars, or pipes
Strenuous work, including prolonged standing or heavy lifting

How do I know if I'm being exposed to dangerous levels of these substances?

Raise the subject with your health care provider and check our resources section for Enviornment: Home and Work to find out where you can get further information on specific environmental hazards.

Are there any environmental factors I should be aware of at home?

While you are planning your pregnancy, it is helpful to know what things within your environment you will need to avoid as soon as you become pregnant. Although these environmental factors should not affect your health pre-pregnancy or your ability to conceive, domestic health hazards you'll want to avoid as soon as you are pregnant include:

Household cleaners with strong odors, paint, and hobby glue
Childhood viruses contracted from school-age children
Raw fish or meat and unpasteurized milk as they can contain bacterial contaminants such as listeria
Cat litter boxes as they can expose you to toxoplasmosis
Heat from hot tubs or saunas

What is listeriosis?

Listeriosis is a disease carried by the bacterium listeria. The possible consequences are severe and include miscarriage. You can get listeriosis from eating some soft cheeses, undercooked meat and fish, and prepared meat products such as cold cuts and sausages. It is not particularly common, but about one-third of the cases in the United States occur in pregnant women.

How can I avoid getting listeriosis?

To stay clear of listeriosis, you should:

Thoroughly cook raw food from animal sources.
Thoroughly cook leftover or ready-to-eat foods, such as hot dogs.
Heat all meals to steaming.
Strictly observe expiration dates on prepared food.
Avoid unpasteurized milk and milk products.
Avoid unpasteurized cider and apple juice.
Avoid soft cheeses such as Feta, Brie, Camembert, blue-veined, and Mexican-style.
Wash all raw fruit and vegetables.
Store uncooked meats separately from all other foods.
Use hot water and soap to wash your hands, knives, and cutting boards after handling uncooked foods.
Clean kitchen sponges by washing them in the dishwasher.

What is toxoplasmosis?

Toxoplasmosis is a common parasite that can seriously harm an unborn baby. The parasite is most often spread through exposure to cat droppings or eating contaminated raw and undercooked meat. If you have always been around indoor/outdoor cats, it is likely you already have antibodies against contracting toxoplasmosis.

Many people who have it don't know it; symptoms are mild and flu-like. If you've had it in the past you may now be immune. Pre-pregnancy testing for toxoplasmosis is not routine, so if you think you may have been exposed, ask your health care provider for a test.

How can I avoid getting toxoplasmosis?

There are a number of ways you can avoid getting toxoplasmosis if you think you may be pregnant:

Have someone else empty the cat's litter box. If you have to do it yourself, wear rubber gloves and a protective breathing mask and wash your hands thoroughly afterwards.
Take glove and mask precautions when gardening since the soil may be contaminated.
Don't feed your cat raw or undercooked meat.
Keep the cat indoors as it can be infected by eating birds or mice.
Thoroughly cook raw food from animal sources.
Thoroughly cook left-over or ready-to-eat foods, such as hot dogs.
Avoid unpasteurized milk and milk products.
Avoid soft cheeses such as Feta, Brie, Camembert, blue-veined and Mexican-style.
Store uncooked meats separately from all other foods.
Use hot water and soap to wash your hands, knives, and cutting boards after handling uncooked foods.

Can I relax in a hot tub or sauna?

If you are in the early stages of pregnancy, prolonged exposure to high temperatures can lead to neural tube defects in the baby.

You can, however, enjoy a calming soak in a bathtub with water no warmer than 100 degrees Fahrenheit.

Avoid, or at least limit your time to ten minutes, in saunas, steam baths, and hot tubs.

(source: Childbirth Connection)

Pregnancy -> Planning -> Emotions and Stress

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 04:02:00 +0000

Why can trying to become pregnant be stressful?

Worrying about whether or when you will conceive, what being pregnant will mean to you and your relationship, and all the steps you will want to take to increase the chance of a healthy pregnancy and healthy baby, can sometimes create stress and anxiety.

Why should I avoid stress when I'm trying to get pregnant?

There is no hard evidence to suggest that stress can prevent you from becoming pregnant. However, stress can depress your immune system, raise your blood pressure and alter your hormonal function. Also, it can prevent you and your partner from enjoying this time of anticipation and pleasure.

How can I learn to reduce stress while I'm trying to get pregnant?

To learn to relax, we recommend that you first try to:

Identify the causes of stress in your life: your long commute, your finances, family relationships
Simplify your life: reduce contact with people and cut out activities that sap your energy and time
Clarify your priorities: learn to say "no", decide what is really important and what can be addressed later
Ask for help: turn to family, friends, or a counselor

To help you cope with the stresses in your life that you can't avoid, we recommend:

Exercising has been proven to be a true reliever of stress. It helps to release tension and lift your mood. Physical activities such as nature walks or yoga can calm and relax you.
Meditating triggers a relaxation response as it decreases your respiratory rate, heart rate, and blood pressure, and relieves muscle tension. It has also been shown to cause a drop in the stress hormones in your blood. Some women feel that meditation is as restful as a nap.
Journaling, the act of writing out your thoughts and concerns, can help prevent you from dwelling on anxieties.
Creating a calm atmosphere by using essential oils for aromatherapy, listening to quiet music, and dimming the lights can help you feel very peaceful.
Getting adequate sleep keeps you from becoming tired and less able to deal with the fast-pace of modern life. Try to avoid turning to food or caffeine to fight fatigue. You will need your rest more than ever when you are pregnant and after the baby comes, so now is the time to develop good sleep patterns.

(source: Childbirth Connection)

Pregnancy -> Planning -> Drugs, Alcohols and Tobacco

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 03:53:00 +0000

What should I do about drugs, alcohol, or tobacco? Why should I quit before I even get pregnant?

If you are thinking about getting pregnant, it is important to stop drinking and smoking before you try to conceive. It is also important to stop using illegal drugs such as marijuana, cocaine, Ecstasy and other amphetamines, and heroin. All of these substances can be harmful to your health and can interfere with your chances of becoming pregnant. Your physical health before pregnancy affects the health of your future baby, so we recommend that you stop drinking and smoking, and using illegal drugs before trying to conceive. A baby's organs begin to form in the early weeks of pregnancy before you even know you are pregnant. Fetal exposure to drugs, alcohol and tobacco can put your baby at risk for serious health problems, so stop using them before you get pregnant.

Why should I stop drinking before I become pregnant?

While some experts have found that moderate drinking (one drink a day for women) can have some health benefits for the heart, no level of alcohol has been proven safe for women trying to get pregnant; and, it can reduce your chances of conceiving. It is well established that drinking alcohol can cause birth defects, particularly during the first weeks of pregnancy (perhaps before you know you're pregnant) when the vital organs of the fetus are developing. There are also the risks of mental retardation, miscarriage, and low birthweight which have been linked to alcohol consumption during pregnancy.

Why should I stop smoking before I get pregnant?

Because of the damage that might be done to the developing fetus in the first few weeks of pregnancy - often before a woman realizes she's pregnant - experts strongly recommend that women and their partners stop smoking before trying to conceive.

Smoking may make it more difficult for you to conceive. If you can't stop smoking before you become pregnant, we strongly urge you to stop as soon as you learn you are pregnant. The more you smoke, the greater the risk is to your baby. As soon as you stop smoking, even if you are already pregnant, the risks to your baby decrease. If you cannot quit, reducing the amount you smoke and the exposure to secondhand smoke may lower your risks.

The smoke you inhale when you smoke, and the secondhand (or sidestream) smoke you inhale when your partner or others smoke, can harm your developing baby and result in:

premature birth
a low birthweight baby
premature rupture of membranes
problems with the placenta
miscarriage
stillbirth

There is also an increased risk of the baby dying from Sudden Infant Death Syndrome (SIDS). Children who have been exposed to cigarette smoke before birth may get asthma and have learning and behavioral problems. They might also be more prone to ear infections.

There are many resources available to help you stop smoking, and techniques you can use to break the smoking habit by yourself or with help from your health care provider.

What drugs should I avoid if I'm planning to become pregnant?

It's best to stop using all drugs before trying to get pregnant.

Recreational street drugs have the potential to harm you and your baby:
- Cocaine use in early pregnancy may increase your risk of miscarriage. Cocaine-exposed babies are more likely than unexposed babies to be born with low birthweight and are at increased risk of certain birth defects including urinary-tract defects and heart defects. Babies exposed to cocaine are more likely to have a stroke, be born prematurely and have smaller heads. They may be also have feeding and sleep difficulties.
- Heroin and other narcotics can cause miscarriages, premature births, and low birthweight in exposed babies. Most babies exposed to heroin before birth suffer from withdrawal symptoms after they are born and are at higher risk of sudden infant death syndrome (SIDS).
- PCP ("angel dust") can lead to small babies and babies with poor control of their movements.
- LSD may lead to birth defects.
- Glue and solvent sniffing may cause birth defects similar to those caused by alcohol.
- Amphetamines (including methylamphetamine, also known as speed, ice, crank and crystal meth) are powerful stimulants that may cause birth defects including cleft palate and heart and limb defects. Women who take amphetamines may be too malnourished to properly support her pregnancy and growing fetus. Amphetamine use during pregnancy can contribute to serious pregnancy complications such as maternal high blood pressure, premature delivery and excess maternal bleeding following delivery.
- Marijuana can lead to low birthweight newborns, babies having withdrawal-like symptoms including excessive crying, and tremors (shaking), and children with an increased risk of attention disorders and learning problems. Use of marijuana during the first month of breastfeeding can impair infant motor skills development.
Medical prescription drugs sold illegally for recreational use can be potentially dangerous to the user. The most commonly misused prescribed drugs are:
- OxyContin, a time-release pain medication, is addicting and has powerful withdrawal symptoms. An overdose can cause respiratory failure and death.
- Ketamine ("Special K"), a tranquilizer used on humans and animals, causes delirium, amnesia, depression, and long-term memory problems.
- Rohypnol, a powerful tranquilizer, is not prescribed in the United States but is illegally imported from other countries. It is often called "the date rape drug."
"Designer" drugs are now among the most popular recreational drugs. There have not been any long-term studies of these chemically manufactured substances, but short-term studies and anecdotal data suggest they are dangerous and not something with which you should experiment if you are considering getting pregnant. Designer drugs include:
- Ecstasy (MDMA), is a stimulant. A small study on its use during pregnancy found a possible increase in the risk of congenital heart defects and in females, a birth defect called clubfoot.
- GHB, a "date rape drug," causes unconsciousness, seizures, severe respiratory depression, and coma in women exposed to high dosages of the drug.
- GBL, a compound used to make GHB, can be used by itself, and has effects similar to GHB.

Should my partner/the prospective father of my child quit, too?

The amount of data available on the effect of drugs on men varies depending on the type of drug. It is well established that heavy drinking impairs sexual performance. There is limited but compelling evidence that the sperm of men who have three to four drinks a day may become damaged and that their children may be born with low birthweight - a factor that will influence their overall health in infancy. Your partner's smoking can lower his fertility, damage his sperm, and make it more difficult for you to conceive. There is also some research that suggests that more than 700mg of caffeine a day (about 5 cups of regular coffee) may affect the health and/or survival rate of offspring.

Men who wish to become fathers and live a long and healthy life with their children will enjoy the same health benefits (reduced likelihood of premature death and disability) as women who stop using drugs, alcohol and tobacco. The best way to protect a future baby from the dangers of illicit drugs, alcohol and tobacco is to stop using these substances before getting pregnant.

(source: Childbirth Connection)

Pregnancy -> Planning -> Dental Care

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 03:50:00 +0000

Why is dental care before pregnancy important?

The health of your teeth and gums, also called dental care or oral health, may possibly affect the growth and development of your fetus.

It is important to brush and floss your teeth to prevent gingivitis. Gingivitis, a gum disease, and other oral infections can lead to poorer maternal nutrition due to pain or discomfort while eating. More importantly, studies show that gum disease and oral infections can increase your risk for premature birth and low birthweight babies from either preterm labor or premature rupture of the membranes (meaning your water breaks early).

If you think you might be pregnant and have an appointment with your dentist or if a dental emergency arises, be sure to tell your dentist that you might be pregnant or that you're planning to get pregnant.

It's a smart idea to tell your dentist about your plans to become pregnant so you can schedule any special work, treatments, or X-rays before you conceive. As a rule of thumb, dentists prefer to do only emergency and routine hygiene/cleaning procedures on pregnant women. But, some dentists may fill cavities as well.

You will want to avoid X-rays if you think you might be pregnant even though dental X-rays (especially those taken with newer machines) don't send out large amounts of radiation. If X-rays are necessary, be sure your dentist always covers you with a lead apron for protection.

Should I be drinking fluoridated or unfluoridated water?

Fluoride helps prevent cavities. Therefore, to reduce the likelihood that you'll have to be treated for cavities or gum disease during your pregnancy, it's a smart idea to get some fluoride into your system on a regular basis before you become pregnant.

You have a number of choices of fluoride sources. You can get your fluoride through your tap water (depending where you live -- it varies by state), fluoridated bottled water, or by using a fluoride rinse or fluoridated toothpaste (twice a day).

Your dentist can tell you if you're getting enough fluoride.

(source: Childbirth Connection)

Pregnancy -> Planning -> Caregivers and Birth Settings

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 03:47:00 +0000

Why do I need to think about choosing a maternity caregiver and birth setting before I get pregnant?

Most women will make these important decisions early in their pregnancy, but you might want to consider what care options are available to you before you get pregnant. The caregiver you choose will affect many things -- from the quality of care you receive and the amount of information that is shared with you, to your options during labor and birth and your involvement with these decisions. An established relationship with your caregiver during pregnancy planning can be an important part of your support system and a trusted source of information throughout your pregnancy.

If you have a chronic medical condition, are on certain medications, or have a disease that could cause birth complications, you will need to choose a maternity caregiver and birth setting which can accommodate these needs. In your situation, you will probably want to plan to give birth in a hospital and be in the care of a doctor who is board-certified in obstetrics.

If you are healthy, as most pregnant women in the U.S. are, you have decisions to make as well, including whether to have a doctor or a midwife provide your maternity care. You will want to begin reviewing the points that go into making educated decisions about a maternity caregiver and birth setting during this planning pregnancy stage. This website has detailed Pregnancy Topics covering both Caregivers and Birth Settings to help you make an informed decision.

(source: Childbirth Connection)

Pregnancy -> Planning -> Body Awareness

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 03:36:00 +0000

What do I need to know about my body before I get pregnant, and why?

The more you know about how your body works, the better you will understand what to expect when you become pregnant and as the pregnancy progresses. If you have any health issues, the best time to identify and address them is before trying to or actually becoming pregnant.

Before you become pregnant, you'll want to know:

If you have any existing medical conditions that might affect your ability to conceive, have a healthy pregnancy, and/or give birth to a healthy baby
The health of your reproductive organs and breasts
Your fertility status
Your genetic history/heritage
Your metabolism rate
The condition of your heart, blood, lungs, urine, and hormones
If you need any adult immunizations/vaccinations
How current lifestyle choices could affect your pregnancy or your baby

To make sure you get the most accurate assessment of your health, you'll want to tell your pre-pregnancy care provider as much as you know about your genetic history, reproductive health history, lifestyle (home, work, leisure activities, and settings), and family medical history.

It's also very helpful to learn more about the body systems involved in pregnancy and how they relate to each another.

When should I go off birth control when I want to get pregnant?

When to go off your birth control method to get pregnant depends on the kind of birth control you've been using.

If you have been using barrier methods of contraception such as condoms and diaphragms, theoretically, you can get pregnant as soon as you stop using them.
If you have been using hormone-based methods such as the Pill, implants, or injections, it may take a few months before your periods become regular and you can plan your pregnancy. For example, for women using Depo-Provera, the average length of time from going off the drug to conception is 9 months.
If you have been using an IUD, you will need to have it removed before trying to get pregnant.
If you have been using natural family planning, theoretically, you can get pregnant as soon as you change the timing of your sexual activity.

It is important to remember that you may not get pregnant immediately after going off birth control. In fact, only about 20% of women who wanted to become pregnant in a given month, actually conceive.

What if I'm having trouble getting pregnant?

If a couple is having sex regularly, most women will conceive within 6 months and almost all women will become pregnant in one year. If you do not become pregnant after a year, then it may be time to consult your caregiver. Only after a year of trying to conceive would a medical doctor consider your situation as having trouble getting pregnant.

Having trouble getting pregnant may be due to timing, stress, age, premature withdrawal or pulling out by the partner, reduced vaginal lubrication, or more complicated medical factors, such as male and/or female infertility issues.

A pre-pregnancy checkup can help you identify which, if any, of these factors might influence your ability to get pregnant. This could save you and your partner a great deal of unnecessary stress.

Timing: Knowing your body, particularly when you ovulate, helps you plan conception. Are you making love immediately before, during, or immediately after ovulation? These are the best times to conceive. Once you know you're ovulating, you have a 24-48 hour window of opportunity to become pregnant. Remember, sperm can live 24-72 hours in the woman's reproductive system, so conception can happen if you make love a day or two before or after ovulation.

There are four ways to tell when you're ovulating - when your hormones and your egg are ready for fertilization. Some you'll feel comfortable with and some may not appeal to you at all.

Some women feel mittleschmertz - a slight mid cycle cramping - usually midway between their periods.
Some women track their basal body temperature (BBT) by taking their temperature every morning when they wake up - even before they get out of bed; charting your BBT will reveal your temperature patterns, and in particular, the sudden rise at ovulation.
Some women monitor the consistency of their vaginal cervical mucus; usually minimal and clear, the closer to ovulation, the stickier and waterier it becomes. Ultimately it resembles uncooked egg whites. The further you can stretch it between you thumb and your index finger, the closer you are to ovulation.
Some women buy ovulation predictor kits which measure how much luteinizing hormone is in your urine; there is a surge right before ovulation.

How will I know I'm pregnant? What are the most common symptoms or signs of pregnancy?

A late period or missed period may or may not mean you are pregnant.

About three weeks after conceiving, you will begin to notice these other signs:

tender, swollen breasts
fatigue
the urge to urinate more often than usual
nausea, sometimes made worse by certain smells and tastes
becoming emotional, even teary
increased vaginal discharge

How soon can I know for sure that I'm pregnant?

Pregnancy tests include:

A blood test at a doctor's office, 5-7days after conception.
A home pregnancy test, 10 days after you think you may have become pregnant.

Home pregnancy kits detect a hormone - human chorionic gonadotropin (hCG) - that is produced by the primitive but functional placenta along the uterine wall. It can be detected as early as the second or third week after fertilization. Home pregnancy kits are not 100% accurate. To increase their accuracy, use the first urine of the day (hCG is most easily detected then), follow the instructions carefully, and recheck your test results the next morning and again in a week (unless your period has started).

The more sensitive the kit, the lower the amount of hCG it can detect. Waiting the full ten minutes for the results also increases the accuracy of the result. You may want to look at the Consumer Search article that compared 25 brands. Some tests, however, don't detect the hCG and can mislead you into believing you are not pregnant when, in fact, you are. If you tested negative and your next period is late, retest. Your hCG levels double every two or three days and some women won't have a positive result until the first day of a missed period.

If you have been taking a fertility medication that contains hCG such as Novarel, Profasi or Pregnyl, be sure to ask your health care provider when you should test for pregnancy. You may need to wait 10-14 days after last taking your medication, since, otherwise, it might give a positive result when you're not pregnant.

Once you think you're pregnant, schedule an appointment with your health care provider as soon as possible.

As a woman over 35, are there any special issues I need to consider?

Most women over 35 have successful pregnancies, minimal pregnancy complications, and healthy babies. However, there are some changes and risks of which you should be aware:

Fertility (the ability to conceive) - naturally changes with age but at what age and at what rate varies. As you approach age 35 and more decidedly after age 40, the number of eggs in your ovaries and those eggs' ability to become fertilized and grow into embryos declines.
The older you are when you become pregnant, the greater your risk of having a miscarriage (pregnancy ends during the first five months), complications during pregnancy such as gestational diabetes, high blood pressure, and placenta abruption (when the placenta detaches from the uterine wall), or a baby with chromosomal problems resulting in birth defects.

If you are concerned about these or other possible pregnancy complications, see your health care provider as soon as possible. There are increased risks if you are in your mid-30s or older, but age doesn't have to prevent you from trying to get pregnant.

(source: Childbirth Connection)

Pregnancy: Planning

noreply@blogger.com (Fureichi-Beru) — Mon, 10 Sep 2007 02:57:00 +0000

Planning before you get pregnant is very important. Simply put, the healthier you are as you are planning your pregnancy, the more likely you are to have a healthy baby. We hope you'll start planning for pregnancy as soon as you begin to have thoughts about having a baby.

A baby's organs begin to form in the first few weeks of pregnancy, before you may know that you are pregnant. As this is a critical phase of development, the more planning you do, the greater the pay off can be in terms of the health of your baby. Unfortunately, there are no foolproof methods for having a healthy baby, but there are many things you can do that may improve your chances of a good outcome.

Planning your pregnancy may help you to:

conceive more easily
have a healthier pregnancy
avoid or minimize pregnancy complications
give birth to a healthier baby
recover more quickly and easily after giving birth
have a more pleasant postpartum (post birthing) experience
minimize your child's risk of future adult health problems.

By planning your pregnancy, you will know that during this important early stage you were taking the best possible care of yourself and your baby.

Inside Planning Pregnancy

Heart Disease Treatments

noreply@blogger.com (Fureichi-Beru) — Sat, 08 Sep 2007 21:58:00 +0000

Medical treatment may be started immediately, before a definite diagnosis of a heart problem is made.

General treatment measures include the following:

Oxygen through a tube in the nose or face mask
Nitroglycerin under the tongue
Pain medicines (morphine or meperidine)
Aspirin: Those with allergy to aspirin may be given clopidogrel (Plavix).

Clot-dissolving medicines: The tissue plasminogen activators (tPAs) can actually dissolve clots in some circumstances.

The earlier these drugs are given, the better the chance of opening the blocked artery and of protecting the cardiac muscle from further injury.
If more than 6 hours has passed since the onset of chest pain, these drugs are less helpful.
Potential risks of this therapy include bleeding.
The most serious risk is a stroke (bleeding into the brain).

Angioplasty: Emergency coronary angiography and coronary balloon angioplasty (percutaneous transluminal coronary angioplasty, or PTCA) are available in hospitals equipped with a full-service cardiac catheterization laboratory. This is the most direct method of relieving blockage in a coronary artery.

Coronary balloon angioplasty is an extension of coronary angiography.
A long, thin tube (catheter) is inserted in an artery in the groin or arm.
At the tip of the catheter is a tiny, elongated balloon, which is threaded over a hair-thin guidewire into the narrowed coronary artery.
Once the balloon is positioned at the blockage in the coronary artery, it is inflated.
The balloon pushes aside the plaque and clot that are blocking the artery, allowing blood to flow more freely.
The balloon is then deflated and removed with the catheter.

Stenting: A stent is a small, springlike device that may be inserted into a coronary artery after balloon angioplasty. After the catheter and balloon are removed, the stent stays in place, holding the artery open. A stent is better than angioplasty alone at keeping the artery from narrowing again.

Atherectomy: Sometimes the plaques are too rigid, bulky, or calcified to be treated by balloon angioplasty. In these cases, the plaque often can be removed by cutting it out with a drill-like rotary blade or a laser or other tool.

Medications

If you are having a heart attack, you will almost certainly be given some or all of these medications while you are in the hospital. Some you will continue taking at home.

Intravenous (IV) nitroglycerin has been shown to improve blood flow to the heart muscle by relaxing (dilating) the coronary arteries and increasing blood flow. It is usually given for 24-48 hours continuously.
Heparin is a "blood thinner," or anticoagulant, which may be given after a heart attack. Heparin does not remove an existing clot, but it reduces the tendency of blood to clot in the coronary arteries. Some newer forms of heparin have recently been introduced that can be given as a shot instead of through an IV line.
Beta-blockers are medications that decrease the heart rate and blood pressure. This reduces the heart's workload and thus the amount of oxygen it needs. Beta-blockers may provide immediate as well as long-term benefit for people who have a heart attack.
Angiotensin-converting enzyme (ACE) inhibitors may prevent repeat heart attacks and other problems when started early during a heart attack. They are especially useful in people with diabetes and those with a weakened heart muscle congestive heart failure).

Surgery

Sometimes cardiac catheterization reveals extensive coronary artery disease. In such cases, you will need to undergo coronary bypass surgery.

Standard coronary artery bypass grafting (CABG) is performed if many coronary arteries are narrowed or blocked. This is especially recommended when the left main coronary artery shows significant blockage. This is "open heart surgery," meaning that the chest wall is opened. When performing a bypass, heart surgeons use sections of the mammary artery from the chest or veins from the legs to create detours around the blocked arteries. For this surgery, you will be connected to a bypass pump, which does the work of the heart during the operation. Although this sounds dangerous, this surgery is considered very safe and has a very low rate of complications.
Off-pump bypass surgery: Sometimes the surgeon can perform open heart surgery without using a bypass pump. The heart continues to beat during surgery. This type of surgery has even fewer complications than the standard procedure but is not always feasible.
Minimally invasive coronary bypass: If just the front or the right coronary artery needs bypass, the bypass may be performed via a small keyhole-type incision without a large incision in the chest. The internal mammary artery is used for the bypass.

(source: Los Angeles Chinese Learning Center)

Cancer Treatments

noreply@blogger.com (Fureichi-Beru) — Sat, 08 Sep 2007 21:30:00 +0000

Once the diagnosis confirms the type and other characteristics of the cancer, the next step is to develop a program of treatment that is best suited to the particular type of cancer and to its stage of development.

At the present time there are still three primary types of treatments that are being used alone or in combination. The three major medical treatments for cancer are surgery, radiation therapy and chemotherapy. Treatment options depend on a variety of factors such as the type and location of the cancer, the degree to which the cancer has spread, and the patient's age and general health.

Whether or not a cancer has remained in the area of the body where it began, or has spread to other areas, one of the most important factors leading to successful treatments is:

The earlier a cancer is discovered and diagnosed, and the sooner treatment gets underway, the better a person's chances are for a successful treatment.

Surgery

Surgery plays two important roles in cancer. It is used in 90% of all cancers for diagnosis, the biopsy, and for estimating the size, position and condition of the cancerous tissue. Once it is established that the tumor is cancerous, it is used as the primary treatment in 60% of all cancers.

This treatment is the removal of the tumor through surgery and it has probably been the most widely used treatment. The objective of the surgical treatment of a cancerous tumor is to completely eradicate the primary tumour and any surrounding tissue that may contain cancer cells in order to achieve a total removal of the cancer. For the most part, cancer surgery is carried out by surgeons who specialize in this particular type of surgery.

Although all surgery involves cutting into the body, the actual procedures and type of surgery depends on the type, location and development stage of the tumor. Part of the diagnostic process may involve what is called exploratory surgery. In this procedure surgery will be used to determine if the cancer can in fact be operated on or if it has reached the stage where it is too advanced for surgical removal.

To remove a tumor surgically, the patient is put under general anesthetic in the hospital. The doctor makes an incision in the patient and removes the tumor. Often, as a precaution, some of the tissue around the tumor, and near-by lymph nodes, are also removed, in case the cancer has already begun to spread. As with all surgical operations requiring general anesthetic, the patient will have side effects such as tiredness and weakness. The time the patient must stay in the hospital varies for each patient, depending on the location of the tumor, the amount of neighboring tissue removed and the patient's general health.

Although surgery continues to be one of the most widely used treatments for cancer, it is almost always linked to follow-up treatment with radiation and or chemotherapy.

Radiation

In radiation therapy, high-energy rays called ionizing radiation are used to disrupt the out of control growth of cancer cells so that they cannot continue to grow and multiply. This is done in the localized area of the tumor and great care is taken to ensure that surrounding tissue is not damaged. The goal of radiation is to maximize the destruction of cancerous cells with minimum damage to the surrounding non cancerous parts of the body.

There are two kinds of radiation therapy:

External Radiation Therapy is done by precisely designed x-ray machine. No hospital stay is usually required: the patient comes to the hospital or clinic each day for a period of several weeks. Although patients are not actually radioactive during or after the treatment, individuals undergoing intensive radiation are advised not to have close contact with small children.

Internal Radiation Therapy requires a hospital stay of several days. A tiny piece of radioactive material is surgically placed into or near the tumor, that then releases a very high but specially targeted and confined level of radiation for the cancerous area. Radiation therapy is often used on patients who have had malignant tumors removed, as an added insurance that all cancer cells have been destroyed. Some patients receive both kinds of radiation therapy.

The side effects of radiation therapy include tiredness, skin rashes and loss of appetite and the degree that a patient suffers from any of these reactions depends on the treatment dose and the area that has been treated. These side effects can be very unpleasant, but they are not permanent, and the doctor can usually control them.

Radiation therapy can cause a temporary decrease in the number of white blood cells in the body. Since white blood cells help protect us against infections, patients who have received radiation therapy may be more subject to infections until the number of white blood cells in their bodies return to normal levels. In some extreme cases such as cancers of the bone where very high doses of radiation are used, the patient will be totally isolated from any contact with people until the treatment is over and the level of white blood cells has returned to a more normal level.

Chemotherapy

Treatment with drugs and other chemical substances that have been specifically developed to kill cancer cells is called chemotherapy. These drugs have the same mission as radiation since they are intended to disrupt the cancer cells ability to reproduce.

Chemotherapy is usually delivered to the patient through injections into a vein but some are taken by mouth. Once taken, these drugs flow through the bloodstream to nearly every part of the body, but they are designed to only attack and kill the cancer cells.

Usually, chemotherapy is given in cycles which is a series of treatments with recovery periods in between. Treatments are given at the hospital or clinic, the doctor's office, or even at home. While hospital stays are usually not necessary, the specific type of cancer-killing drug used, and the patient's general level of health may require a short hospital stay.

Alternative Cancer Therapy

In treating cancer (as well as other medical conditions) two types of therapies can be used. The first is conventional medical therapy and includes all of the different uses of surgery, chemotherapy and radiation. The second type of treatment for cancer is referred to as alternative therapy and it includes a wide range of treatments including diet and nutrition, the detoxification of the body, vitamin supplements, control of stress and changes in life style. It also includes a range of therapies based on spiritual and social healing that is needed to connect a cancer patient to their own purpose for being alive and to strengthen the will to beat cancer. This can include religious services or other forms of aboriginal healing practices.

Although alternative therapies, especially when combined with traditional therapy may be an important choice for cancer patients to consider, it is, however, extremely important to investigate whether an alternative therapy is more than just wishing.

(source: ITK

Blood Disorders Treatments

noreply@blogger.com (Fureichi-Beru) — Sat, 08 Sep 2007 20:34:00 +0000

Hematologists at Rush treat patients with a variety of nonmalignant (i.e., benign or noncancerous) blood disorders. Benign blood disorders include the following:

Anemia
Neutropenia (too few bacteria-fighting white cells)
Neutrophilia (too many bacteria-fighting white blood cells)
Thrombocytopenia (too few platelets)
Aplastic anemia (generalized bone marrow failure)
Myeloproliferative disorders

Anemias

There are dozens of causes of anemia. Some can be diagnosed readily by taking a history and looking at the blood count results. Others may take a long time and many tests, including a bone marrow study, to diagnose. Some are never definitively diagnosed. Briefly, the anemias fall into a few major categories.

Those due to vitamin and mineral deficiencies such as iron, folic acid or B12 deficiency.
Those due to blood loss¿for example, gastrointestinal or excessive menstrual bleeding.
Those resulting from primary bone marrow failure ¿ for example, aplastic anemia.
Those caused by excessive blood cell destruction because of:
- Abnormal red blood cell enzymes (for instance, G6PD deficiency, especially common in African Americans)
- Abnormalities of the globin molecule (the protein part of the molecule that carries oxygen in the red blood cell)
- Abnormalities of production of the protein portion of the hemoglobin molecule (the molecular of the red cells that carries oxygen) ¿ e.g., thalassemia
- Abnormalities of the immune system, e.g., immune hemolytic anemia
Physical stress to the red cells, which may occur with artificial heart valves, or trauma to the feet, caused by such things as running with poorly padded shoes
Those related to an enlarged spleen
Those related to chronic infections or inflammation
Those related to kidney disease
Those caused by toxins, certain medications and radiation

White Blood Cell Disorders

Neutropenia (too few bacteria-fighting white cells) if mild, may be constitutional. Other causes for neutropenia include:

Primary bone marrow diseases such as cyclic neutropenia, aplastic anemia or replacement of the bone marrow by foreign cells
Medications
Enlarged spleen
Immune disorders
Viral infections
Radiation

Neutrophilia (too many bacteria-fighting white blood cells) is usually due to an infection or inflammation but may result from not having a spleen or from having a myeloproliferative disorder (see below).

Platelet Disorders

Thrombocytopenia is the label given to a condition in which there are too few platelets. Platelets are small particles in the blood that help initiate the process of blood coagulation. Thrombocytopenia may be caused by immune problems, primary bone marrow disorders (e.g., aplastic anemia), disorders that consume platelets (such as big spleens and certain coagulation disorders), medications and radiation.

Thrombocytosis (too many platelets) may result from infections or inflammation or from a myeloproliferative disorder. High platelet counts may also be a reaction to a nonhematologic malignancy.

Treatment

Treatment of the above disorders varies with the cause. Whenever a drug or toxin is implicated as the cause of anemia, low white blood cell or low platelet counts, the offending agent must be removed. When an infection, inflammatory disease or other disorder, such as cancer, causes anemia, the underlying disease must be treated. Often, erythropoietin (a red cell growth factor, commercially available as Procrit, Epogen and Aranesp) may help restore red cell production. For vitamin or mineral deficiencies, the appropriate factor must be replaced and the reason for the deficiency identified. Iron deficiency is often due to bleeding; if so, the source of the bleeding must be found and remedied. Big spleens sometimes have to be removed. Other times medical treatment of the underlying problem may help. Immune disorders may be treated with immune suppressants, such as prednisone (a corticosteroid), or other biological agents, such as immunoglobulins or Rituxan. For inherited diseases, such as sickle cell anemia and thalassemia, appropriate supportive care must be instituted; sometimes patients have to go on an iron chelation program (if they are iron overloaded as may occur after many transfusions) and sometimes a marrow transplant is performed. For hereditary spherocytosis, splenectomy may be required. Patients with aplastic anemia¿depending on their age, severity and availability of a marrow donor¿may be treated either with a bone marrow transplant or with immunotherapy. For certain anemias, treatment with erythropoietin (red blood cell growth factor) may be very beneficial; this is especially the case for patients with kidney disease or anemia related to cancer or inflammatory diseases such as arthritis. Neutrophil growth factors are also available, but they are usually not indicated as long-term treatment, except in some rare disorders.

Myeloproliferative Disease

The myeloproliferative disorders are a group of marrow stem cell diseases in which the growth of cells in one or more blood cell lines is abnormal and uncontrolled. This often leads to too many blood cells of one type or another, with a very overcrowded bone marrow. Often the spleens of these patients are enlarged. In a small percentage of patients, the disease may become leukemic. Aside from chronic myeloid leukemia, there are three disorders that fall in this category: polycythemia vera, essential thrombosis and idiopathic myelofibrosis (myeloid metaplasia with myelofibrosis, MMM).

In polycythemia vera, the primary problem is an overabundance of red blood. The patient must be fully evaluated to make sure that the increase in the red blood cell volume is not due to some other underlying problem. The abundance of red blood cells leads to an increase in blood viscosity (thickness), which may cause thrombosis (blood clots) in the legs, heart, brain or other parts of the body. Removal of blood (phlebotomy) is the primary way to treat this problem. Often patients have too many platelets (small particles in the blood that help in blood clotting) as well, and sometimes the platelet count has to be reduced. Medications such as anagrelide, hydroxyurea or interferon may be used to reduce the platelet count. These drugs may also decrease the need for phlebotomies. In some patients, spleen size may have to be reduced with medications (e.g., hydroxyurea or interferon); occasionally the spleen may have to be removed.

In essential thrombocytosis, the patient¿s bone marrow produces an excess of platelets. Too many platelets may lead to thrombotic complications. In some patients, treatment need not be instituted immediately, but in others treatment may be urgent. Anagrelide, hydroxyurea or interferon can be used to lower platelet counts. In this condition, as in polycythemia vera, some patients may have poorly functioning platelets resulting in abnormal bleeding.

In idiopathic myelofibrosis, the blood-forming cells are abnormal. As a result, their progeny are also abnormal. Some of the abnormal cells (especially megakaryocytes and their progeny, the platelets) may produce cell products that cause scar tissue (fibrosis) in the marrow. The blood-forming cells may also migrate to and reproduce in other organs, such as the liver and spleen. This leads to enlargement of those organs. The spleen may become massively enlarged. Patients usually are anemic and may have abnormal platelet counts (high or low). Treatment depends on the individual patient¿s condition. It may include medications to shrink the spleen and lower platelet counts and medications to boost red blood cell production; in some cases, stem cell transplantation may be indicated. Removal of the spleen may be beneficial in those patients who have major symptoms related to the enlarged spleen or who have low blood counts because of a big spleen.

(source: Rush University Medical Center)

Birth Defects Treatments

noreply@blogger.com (Fureichi-Beru) — Sat, 08 Sep 2007 19:04:00 +0000

There are many screening tests that can be performed during pregnancy to diagnose birth defects. These tests are routinely performed if the mother is over 35 years old or if there is a family history of birth defects. An ultrasound exam can be done during any stage of the pregnancy. This test uses sound waves to produce a picture of the fetus, and can detect spina bifida, limb defects, and heart and kidney problems. During the 16th to 18th week of pregnancy, a blood test that measures levels of alpha-fetoprotein (AFP) can identify neural tube defects in the fetus. During the 16th to 20th weeks of pregnancy, a small amount of amniotic fluid can be withdrawn from the mother's womb and tested for a number of genetic defects, including Down syndrome. Chromosome and some genetic disorders can be diagnosed as early as the ninth week of pregnancy through chorionic villus sampling (CVS). With this test, a fine needle is inserted through the abdomen or a flexible tube is inserted through the vagina. Both methods remove a small sample of the placenta. Keep in mind that most screening tests identify the possibility of a defect. These tests are not fail-safe, so it's important to discuss all options and further testing with your doctor to ensure your baby's health. Babies are also routinely screened after birth for birth defects that require immediate treatment.

What is the treatment?

Treatment of birth defects depends upon the type of birth defect and how severe it is. Some require surgery to correct the defect at some point in the child's life. Others require a combination of medical and educational therapy as the child grows. Your doctor will help you understand your child's birth defect and the best course of treatment.

Self-care tips

A healthy pregnancy goes a long way in preventing birth defects, and it all starts before you even become pregnant. If you are thinking about becoming pregnant, make sure you are aware of any family history of birth defects, on both your and your partner's side. Some birth defects cannot be prevented. However, if there is a history of birth defects, or you are considered high risk because of age, ethnic background, or health problems, you can receive genetic counseling and testing to help you in your planning. It's also important to make sure you have had all your immunizations; to avoid cigarette smoking, drugs, and alcohol; and to make sure neither you nor your partner has a sexually transmitted disease. Your diet is also important before and during pregnancy. It has been proven that taking a recommended daily dose of folic acid, found in foods such as leafy green vegetables, beans, and orange juice, actually reduces your risk of having a baby with neural tube defects. Neural tube defects are conditions involving the brain and spinal cord, such as spina bifida. Doctors recommend that all women of childbearing age receive 400 micrograms of folic acid per day. While many foods are now fortified with folic acid, many women still do not get enough folic acid in their diet. That's why your doctor will prescribe special prenatal vitamins to ensure you and your developing baby get the correct amount of important vitamins and minerals. If you must take any medications on a daily basis, check with your doctor to be sure they are okay to take during pregnancy. However, never stop taking any medication without checking with your doctor first. Regular exercise and plenty of rest also contribute to a healthy pregnancy.

(source: PennState)

Anemia Treatments

noreply@blogger.com (Fureichi-Beru) — Sat, 08 Sep 2007 16:59:00 +0000

What Are the Treatments?

Your doctor will not treat your anemia until the underlying cause has been established. The treatment for one type of anemia may be both inappropriate and dangerous for another type of anemia.

Anemia caused by blood loss. If you suddenly lose a large volume of blood, you may be treated with fluids, blood transfusion, oxygen, and possibly iron to help your body build new red blood cells. Chronic blood loss is treated by identifying the source of bleeding, stopping the bleeding, and, if necessary, giving treatment for iron-deficiency anemia.

Anemia caused by decreased red blood cell production. With iron deficiency anemia your doctor will probably recommend iron supplements that contain the ferrous form of iron, which your body can absorb easily. Timed-release iron supplements are not a good choice for most people because iron is primarily absorbed in the upper part of the digestive tract.

CAUTION: Always consult with your doctor before taking iron supplements. Excess iron intake can be harmful. Symptoms of iron overload include fatigue, vomiting, diarrhea, headache, irritability and joint problems.

CAUTION: Iron supplements -- like all supplements and any medication -- should be kept out of the reach of children. Iron poisoning is the most common cause of accidental poisoning in young children. Very few tablets can prove fatal in a matter of hours. Symptoms of poisoning in a child include dizziness, confusion, nausea, vomiting, and diarrhea. Seek medical help immediately.

Side Effects: You may need to continue taking iron supplements for up to one year. Taking iron supplements with food can help prevent common side effects, which may include nausea, diarrhea, constipation and stomach pain. Let your doctor know if you continue to have side effects. Different formulations are available.

Iron supplements can also interact with other medications you may take, so be certain to tell your doctor if you are being treated for another condition. Calcium supplements interfere with iron absorption so it is best to take them at different times of the day.

Your doctor may also recommend that you increase the amount of iron in your diet. Good dietary sources of iron include red meat, beans, egg yolk, whole-grain products, nuts and seafood.

Your doctor will monitor your red blood cell counts including hematocrit, hemoglobin, and ferritin levels during treatment. If your anemia doesn't improve with iron supplements, your doctor will look for some other underlying cause. In rare cases, your doctor may prescribe iron injections or give you iron intravenously (through a needle in the vein). In extremely rare cases of life-threatening iron-deficiency anemia, treatment may involve blood transfusion.

Vitamin B-12 and folate deficiency anemia. If your body stores are depleted of vitamin B-12, your doctor will most likely prescribe vitamin B-12 injections and may also recommend high doses of B-12 supplements or a B-12 nasal spray. There is a good chance that many of the symptoms of deficiency will improve once the body is provided with the needed B-12.

Most people with vitamin B-12 deficiency have a permanent inability to absorb vitamin B-12 and will need injections every one to three months or pills daily for the rest of their lives.

Your doctor may also recommend that you increase the amount of vitamin B-12 in your diet. Good dietary sources of vitamin B-12 are meat, liver, and kidney; fish, oyster, and clams; and milk, cheese and eggs.

If you have a folate deficiency, your doctor will prescribe folate supplements and may recommend you increase the amount of folate in your diet. Good dietary sources of folate include fresh fruits, green leafy vegetables, cruciferous vegetables (cauliflower, broccoli and brussel sprouts), liver and kidney, dairy products, and whole grain cereals. Vegetables should be eaten raw or lightly cooked.

Anemia caused by problems of the bone marrow and stem cells. Anemia that originates in the bone marrow and stem cells tend to be more persistent and difficult to treat. The treatments for hereditary anemias, such as thalassemia, vary widely and depend on the specific condition and the severity of symptoms. Some anemias will not require any treatment while others may require repeated transfusion and other aggressive measures. Although aplastic anemia will occasionally go into spontaneous remission, people with this disorder generally require bone marrow transplantation.

Lead poisoning is treated by discontinuing exposure to lead and administering a drug that binds and draws lead out of the body.

For people with anemia as a result of chronic disease, the best way to alleviate the anemia is often to treat the underlying condition. Shots of Epogen, a hormone that stimulates the production of red blood cells, may also help in some instances. People who have anemia as a result of kidney failure will require adequate dialysis, take Epogen, and possibly have a kidney transplant.

Anemia caused by increased red blood cell destruction. The treatment of hemolytic anemia will be tailored to the underlying cause. Mild cases of hemolytic anemia may not require any treatment at all. If an offending environmental agent can be identified -- a chemical, for example -- exposure to this agent should stop immediately. People with hemolytic anemia may need surgery to replace faulty heart valves, remove a tumor, or repair abnormal blood vessels.

Supportive treatment -- like intravenous fluids and pain medication -- will often be administered. Blood transfusion may be necessary in some cases. Steroids can halt the body's immune attack on its own red blood cells. Certain damaging factors can be removed from the blood by a treatment called plasmapheresis.

If hemolytic anemia persists despite treatment, your doctor may recommend splenectomy --surgical removal of the spleen -- as a last resort. Most people can lead a normal life without their spleen.

Gallbladder surgery may also be required if you have longstanding hemolytic anemia and symptoms of gallstones. Hemolytic anemia that damages the kidneys may make dialysis necessary. In extremely rare cases, bone marrow transplantation may be the only solution for certain types of hemolytic anemia.

While there is no cure for sickle cell anemia, drugs can help ease the pain. And a drug called hydroxyurea appears to stimulate the formation of an alternate form of hemoglobin that isn't susceptible to the sickling.

How Can I Prevent It?

You can prevent iron-deficiency anemia by eating a well-balanced diet that includes good sources of iron, vitamin B-12 and folate.

If you are a vegetarian, talk to your doctor or a nutritionist about your diet and any possible need for supplements.
Ask your doctor or nutritionist if you should take vitamin C. Vitamin C makes the stomach more acidic and can improve the absorption of iron in your diet.
Decrease your consumption of caffeinated products and tea. These substances can decrease iron absorption. Other offenders include the preservative EDTA, fiber, large amounts of calcium, and the phytates found in some vegetables.
Select iron-fortified cereals and breads.
Carefully follow safety guidelines if your occupation involves work with lead-containing materials such as batteries, petroleum, and paint.
Ask your doctor or local public-health authorities about lead-testing the pottery you use for food or beverage preparation.

(source: WebMD)

Allergies Treatments

noreply@blogger.com (Fureichi-Beru) — Sat, 08 Sep 2007 16:20:00 +0000

Treatment list for Allergies:

The list of treatments mentioned in various sources for Allergies includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Antihistamine drugs
Hospitalization - for an asthma attack
Emergency treatment - for a severe asthma attack or anaphylactic shock

Treatments of Allergies: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review the full text of medical books online, free, without registration, for more information about the treatments of Allergies.

Urticaria: Treatment
(In a Page: Signs and Symptoms)

Identify and avoid physical or drug triggers
Systemic antihistamines (e.g., hydroxyzine, doxepin, cimetidine) are helpful and may be used alone or in combination with each other or with nonsedating antihistamines (e.g., loratidine, cetirizine, fexofenadine)
Severe attacks with associated angioedema may require administration of prednisone and epinephrine (consider pen-type epinephrine injector such as Epi-Pen_^R)
Danazol is used to treat only the rare, hereditary subset of angioedema (without urticaria); it stimulates hepatic production of the dysfunctional or absent C1 esterase inhibitor, thereby normalizing the complement cascade
Treat yeast, tinea, or bacterial infections of the skin, mucosa, sinuses, or other locations with appropriate antifungal or antibacterial preparations
Treat thyroid disease if found

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Urticaria: Treatment
(In A Page: Pediatric Signs and Symptoms)

Urticaria: Antihistamine; if nonresponsive to antihistamine or chronic uritcaria, then use corticosteroids

Severe angioedema/anaphylaxis: ABCs of resuscitation
–Epinephrine: 1:1,000, 0.01 mg/kg SC (1:10,000 IV/IO if in shock), every 15 minutes up to three doses, maximum cumulative dose: 0.3 mg (child), 0.5 mg (adult)
–IV fluids if hypotension
–Nebulized Albuterol; antihistamine; corticosteroid (for late phase)
–Observation: Mild, 2–4 hrs; severe, 12–24 hours
–Consult pediatric allergist
–Give patient EpiPen for self-administration

Hereditary angioedema
–C1 esterase inhibitor concentrate; adults, danazol
Avoid exposure to causative agents
Desensitization to insect venoms
Treat underlying disorders

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Urticaria [Hives]: Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))

In an acute case of urticaria, quickly evaluate respiratory status, and take vital signs. Ensure patent I.V. access if you note any respiratory difficulty or signs of impending anaphylactic shock. Also, as appropriate, give local epinephrine or apply ice to the affected site to decrease absorption through vasoconstriction. Clear and maintain the airway, give oxygen as needed, and institute cardiac monitoring. Have resuscitation equipment at hand, and be prepared to begin cardiopulmonary resuscitation. Intubation or a tracheostomy may be required.

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Anaphylaxis: Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))

Epinephrine, establishment of airway, I.V. volume expanders, steroids, diphenhydramine, CPR if cardiac arrest occurs

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Allergic purpuras: Treatment
(Professional Guide to Diseases (Eighth Edition))

Treatment is generally symptomatic; for example, severe allergic purpura may require steroids to relieve edema and analgesics to relieve joint and abdominal pain. Some patients with chronic renal disease may benefit from immunosuppressive therapy with azathioprine along with identification of the provocative allergen. An accurate allergy history is essential.

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Allergic rhinitis: Treatment
(Professional Guide to Diseases (Eighth Edition))

Treatment aims to control symptoms by eliminating the environmental antigen, if possible, and providing drug therapy and immunotherapy.

Antihistamines block histamine effects but commonly produce anticholinergic adverse effects (sedation, dry mouth, nausea, dizziness, blurred vision, and nervousness). Antihistamines, such as cetirizine, loratadine, and fexofenadine, produce fewer adverse effects and are less likely to cause sedation.

Inhaled intranasal steroids produce local anti-inflammatory effects with minimal systemic adverse effects. The most commonly used intranasal steroids are fluticasone, mometasone, and triamcinolone. These drugs are effective when symptoms aren’t relieved by antihistamines alone.

Advise the patient to use intranasal steroids regularly as prescribed for optimal effectiveness. Cromolyn may be helpful in treating hay fever, but this drug may take up to 4 weeks to produce a satisfactory effect and must be taken regularly during allergy season. Eye drop versions of cromolyn and antihistamines are available for itchy, bloodshot eyes.

Long-term management includes immunotherapy, or desensitization with injections of extracted allergens, administered before or during allergy season or perennially. Seasonal allergies require particularly close dosage regulation.

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Latex allergy: Treatment
(Professional Guide to Diseases (Eighth Edition))

The best treatment of latex allergy is prevention; the more a latex-sensitive person is exposed to latex, the worse his symptoms will become. To avoid exposure, advise the patient to substitute products made of silicone and vinyl for those made of latex.

When a latex allergy is suspected or known, the patient may receive medications before and after surgery or other invasive procedures. Premedications may include prednisone, diphenhydramine, and cimetidine. Postmedications may include hydrocortisone, diphenhydramine, and famotidine.

There’s no known treatment for an allergic reaction to latex. Care is supportive in nature. The patient’s airway, breathing, and circulation must be monitored. An artificial airway, oxygen therapy, cardiopulmonary resuscitation, and fluid management may be necessary. During an acute reaction, epinephrine, diphenhydramine, and hydrocortisone are commonly administered by I.V. infusion.

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Urticaria and angioedema: Treatment
(Professional Guide to Diseases (Eighth Edition))

Treatment aims to prevent or limit contact with triggering factors or, if this is impossible, to desensitize the patient to them and to relieve symptoms. During desensitization, progressively larger doses of specific antigens (determined by skin testing) are injected intradermally. After the triggering stimulus has been removed, urticaria usually subsides in a few days — except for drug reactions, which may persist as long as the drug is in the bloodstream.

Diphenhydramine, hydroxyzine, or another antihistamine can ease itching and swelling in every kind of urticaria. Corticosteroid therapy may be necessary for some patients.

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Urticaria [Hives]: Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))

In a patient with acute urticaria, quickly evaluate his respiratory status and take his vital signs. Ensure patent I.V. access if you note respiratory difficulty or signs of impending anaphylactic shock. Also, as appropriate, give local epinephrine or apply ice to the affected site to decrease absorption of the irritating agent through vasoconstriction. Clear and maintain the airway, give oxygen as needed, and institute cardiac monitoring. Have resuscitation equipment at hand, and be prepared to begin cardiopulmonary resuscitation. Intubation or a tracheostomy may be required.

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anaphylaxis: Treatment and special considerations
(Handbook of Diseases)

Anaphylaxis is always an emergency. It requires an immediate injection of 0.1 to 0.5 ml of epinephrine 1:1,000 aqueous solution, repeated every 5 to 20 minutes as necessary.

If the patient is in the early stages of anaphylaxis and hasn’t yet lost consciousness and is still normotensive, give epinephrine I.M. or subcutaneously (S.C.), helping it move into the circulation faster by massaging the injection site. For severe reactions, when the patient has lost consciousness and is hypotensive, give epinephrine I.V.

Maintain airway patency. Observe the patient for early signs and symptoms of laryngeal edema (stridor, hoarseness, and dyspnea), which will probably necessitate endotracheal tube insertion or a tracheotomy and oxygen therapy.

If the patient is experiencing cardiac arrest, begin cardiopulmonary resuscitation, including closed-chest heart massage, assisted ventilation, and sodium bicarbonate; further therapy depends on the patient’s response.

Watch for hypotension and shock, and maintain circulatory volume with a volume expander (plasma, a plasma expander, saline solution, or albumin) as needed. Stabilize blood pressure with the I.V. vasopressors norepinephrine and dopamine. Monitor blood pressure, central venous pressure, and urine output as a response index.

After the initial emergency, administer such medications as S.C. epinephrine, a longer-acting epinephrine, a corticosteroid, and I.V. diphenhydramine for long-term management and aminophylline I.V. over 10 to 20 minutes for bronchospasm.

Caution: Rapid infusion of aminophylline may cause or aggravate severe hypotension.

CLINICAL TIP: Even after the acute anaphylactic event has been controlled, patients must be counseled about the risks of delayed signs and symptoms. Any recurrence of shortness of breath, chest tightness, sweating, angioedema, or other signs and symptoms must be reported immediately.

To prevent anaphylaxis, teach the patient to avoid exposure to known allergens. If the patient has a food or drug allergy, he must learn to avoid the offender in all forms. If the patient has an allergy to insect stings, he should avoid open fields and wooded areas during the insect season and should carry an anaphylaxis kit whenever he goes outdoors. Show him how to use the kit. (See Showing patients how to use an anaphylaxis kit.) What’s more, if the patient is prone to anaphylaxis, he should wear a medical identification bracelet identifying his allergies.

If a patient must receive a drug to which he’s allergic, prevent a severe reaction by making sure he receives careful desensitization with gradually increasing doses of the antigen or advance administration of steroids.

A patient with history of allergies should receive a drug with a high anaphylactic potential only after cautious pretesting for sensitivity. Closely monitor the patient during testing, and make sure you have resuscitative equipment and epinephrine ready.

If any patient needs a drug with high anaphylactic potential (particularly a parenteral drug), make sure he receives each dose under close medical observation.

Closely monitor a patient undergoing diagnostic tests that use radiographic contrast dyes, such as cardiac catheterization, excretory urography, and angiography.

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Allergic purpura: Treatment
(Handbook of Diseases)

Most patients with Henoch-Schönlein syndrome recover completely. When therapy is required, the glucocorticoid prednisone is given in doses of 1 mg/kg, and tapered to response, to relieve edema. An analgesic may be given to relieve joint and abdominal pain. Some patients with chronic renal disease may benefit from intensive plasma exchange combined with an immunosuppressant, along with identification of the provocative allergen. An accurate allergy history is essential.

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Allergic rhinitis: Treatment
(Handbook of Diseases)

Symptoms may be prevented by eliminating the environmental antigen, if possible, and by obtaining drug therapy and immunotherapy.

Antihistamines and nasal decongestants are useful for treating acute symptoms. Although these drugs block histamine effects, they do have some adverse anticholinergic effects (sedation, dry mouth, nausea, dizziness, blurred vision, and nervousness).

Newer antihistamines, such as cetirizine and loratadine, have proved effective in clinical trials. Fexofenadine may be effective but with less sedation and a lower risk of cardiac arrhythmias.

Inhaled intranasal steroids produce local anti-inflammatory effects with minimal adverse systemic effects. The most commonly used intranasal steroids are flunisolide and beclomethasone. These drugs usually aren’t effective for acute exacerbations, but they can help control chronic symptoms.

Advise the patient to use intranasal steroids regularly, as prescribed, for optimal effectiveness. Cromolyn sodium may be helpful in preventing allergic rhinitis; however, this drug may take up to 4 weeks to produce a satisfactory effect and must be taken regularly during allergy season.

Long-term management includes immunotherapy or desensitization with injections of extracted allergens administered before or during allergy season or perennially. Seasonal allergies require particularly close dosage regulation. Local nasal immunotherapy is also being studied.

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Urticaria and angioedema: Treatment
(Handbook of Diseases)

Treatment aims to prevent or limit contact with triggering factors or, if this is impossible, to desensitize the patient to them and relieve symptoms. Once the triggering stimulus has been removed, urticaria usually subsides in a few days. (Drug reactions may persist until the drug is no longer in the bloodstream.)

During desensitization, progressively larger doses of specific antigens (determined by skin testing) are injected intradermally. Antihistamines such as hydroxyzine can ease itching and swelling in every kind of urticaria, although they may induce drowsiness.

Corticosteroid therapy may be necessary for some patients.

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Urticaria: Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

To help relieve the patient’s discomfort, apply a bland skin emollient or one containing menthol and phenol. Expect to give an antihistamine, a systemic corticosteroid or, if stress is a suspected contributing factor, a tranquilizer. Tepid baths and cool compresses may also enhance vasoconstriction and decrease pruritus.

Patient teaching

Teach the patient to avoid the causative stimulus, if appropriate. Emphasize the importance of wearing a medical alert bracelet that identifies his allergies. Explain the risks of delayed symptoms and which signs and symptoms to report. Discuss methods and techniques to prevent anaphylaxis. Instruct the patient on the proper use of an anaphylaxis kit and epinephrine administration.

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Urticaria: Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

In an acute case of urticaria, quickly evaluate respiratory status and take vital signs. Ensure patent I.V. access if you note any respiratory difficulty or signs of impending anaphylactic shock. Also, as appropriate, give local epinephrine or apply ice to the affected site to decrease absorption through vasoconstriction. Maintain a patent airway, give oxygen as needed, and institute cardiac monitoring. Have resuscitation equipment at hand, and be prepared to begin cardiopulmonary resuscitation. Intubation or a tracheostomy may be required.

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Urticaria [Hives]: Nursing considerations
(Nursing: Interpreting Signs and Symptoms)

▪ Apply a bland skin emollient or one containing menthol and phenol to the patient's skin.

▪ Administer an antihistamine, a systemic corticosteroid or, if stress is a suspected contributing factor, a tranquilizer, as ordered.

▪ Provide tepid baths and cool compresses to enhance vasoconstriction and decrease pruritus.

▪ Administer oxygen and monitor respiratory status.

Patient teaching

▪ Explain the underlying disorder and treatment plan.

▪ Teach the patient to avoid the causative stimulus, if identified.

▪ Emphasize the importance of wearing medical identification for allergies.

▪ Explain signs and symptoms that require prompt medical attention.

▪ Stress ways to avoid anaphylaxis.

▪ Teach the patient and his family how to use an anaphylaxis kit.

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Medications used to treat Allergies:

Note:You must always seek professional medical advice about any treatment or change in treatment plans.

Some of the different medications used in the treatment of Allergies include:

Brompheniramine, Pseudoephedrine and Dextromethorphan
AccuHist DM Pediatric Drops
AccuHist PDX Drops
Anaplax DM
Andehist DM NR
Bromaline DM
Bromaxefed DM RF
Bromhist-DM
Brotapp-DM
Carbofed DM
Dimaphen DM
Dimetapp DM Children's Cold and Cough
EndaCof-DM
EndaCof-PD
PediaHist DM
Rondec-DM Syrup
Carbinoxamine, Pseudoephedrine and Dextromethorphan
Andehist DM NR Drops
Carbaxefed DM RF
Decahist-DM
Pediatex-DM
Rondec-DM Drops
Slidec-DM
Tussafed
Chlorpheniramine, Phenylephrine and Dextromethorphan
Alka-Seltzer Plus Cold and Cough
Coldtuss DR
Corfen DM
De-Chlor DM
De-Chlor DR
Dex PC
Tri-Vent DPC
Chlorpheniramine, Phenylephrine and Phenyltoloxamine
Comhist
Nalex-A
Pediacof
Chlorpheniramine, Phenylephrine, Codeine and Potassium Iodide
Adrecort
Alin
Alin Depot
Decadronal
Dexagrin
Dibasona
Indarzona
Dexamethasone Intensol
DexPak
Taper-Pak
Promethazine
Phenadoz
Phenergan

Medical news summaries about treatments for Allergies:

The following medical news items are relevant to treatment of Allergies:

Discussion of treatments for Allergies:

Something in the Air Airborne Allergens: NIAID (Excerpt)

Doctors use three general approaches to helping people with allergies: advise them on ways to avoid the allergen as much as possible, prescribe medication to relieve symptoms, and give a series of allergy shots. Although there is no cure for allergies, one of these strategies or a combination of them can provide varying degrees of relief from allergy symptoms.

Avoidance

Complete avoidance of allergenic pollen or mold means moving to a place where the offending substance does not grow and where it is not present in the air. But even this extreme solution may offer only temporary relief since a person who is sensitive to a specific pollen or mold may subsequently develop allergies to new allergens after repeated exposure. For example, people allergic to ragweed may leave their ragweed-ridden communities and relocate to areas where ragweed does not grow, only to develop allergies to other weeds or even to grasses or trees in their new surroundings. Because relocating is not a reliable solution, allergy specialists do not encourage this approach.

There are other ways to evade the offending pollen: remaining indoors in the morning, for example, when the outdoor pollen levels are highest. Sunny, windy days can be especially troublesome. If individuals with pollen allergy must work outdoors, they can wear face masks designed to filter pollen out of the air and keep it from reaching their nasal passages. As another approach, some people take their vacations at the height of the expected pollinating period and choose a location where such exposure would be minimal. The seashore, for example, may be an effective retreat for many with pollen allergies.

Mold allergens can be difficult to avoid, but some steps can be taken to at least reduce exposure to them. First, the allergy sufferer should avoid those hot spots mentioned earlier where molds tend to be concentrated. The lawn should be mowed and leaves should be raked up, but someone other than the allergic person should do these chores. If such work cannot be delegated, wearing a tightly fitting dust mask can greatly reduce exposure and resulting symptoms. Travel in the country, especially on dry, windy days or while crops are being harvested, should be avoided as should walks through tall vegetation. A summer cabin closed up all winter is probably full of molds and should be aired out and cleaned before a mold-sensitive person stays there.

Around the home, a dehumidifier will help dry out the basement, but the water extracted from the air must be removed frequently to prevent mold growth in the machine.

Those with dust mite allergy should pay careful attention to dust-proofing their bedrooms. The worst things to have in the bedroom are wall-to-wall carpets, venetian blinds, down-filled blankets, feather pillows, heating vents with forced hot air, dogs, cats, and closets full of clothing. Shades are preferred over venetian blinds because they do not trap dust. Curtains can be used if they are washed periodically in hot water to kill the dust mites. Most important, bedding should be encased in a zippered, plastic, airtight, and dust-proof cover.

Although shag carpets are the worst type for the dust mite-sensitive person, all carpets trap dust and make dust control impossible. In addition, vacuuming can contribute to the amount of dust, unless the vacuum is equipped with a special high-efficiency particulate air (HEPA) filter. Wall-to-wall carpets should be replaced with washable throw rugs over hardwood, tile, or linoleum floors. Rugs on concrete floors encourage dust mite growth and should be avoided.

Reducing the amount of dust mites in a home may require new cleaning techniques as well as some changes in furnishings to eliminate dust collectors. Water is often the secret to effective dust removal. Washable items should be washed often using water hotter then 130 (degrees) Fahrenheit. Lower temperatures will not kill dust mites. If the water temperature must be set at a lower value, items can be washed at a commercial establishment that uses high wash temperatures. Dusting with a damp cloth or oiled mop should be done frequently.

The best way for a person allergic to pets, especially cats, to avoid allergic reactions is to find another home for the animal. There are, however, some suggestions that help lower the levels of cat allergens in the air: bathe the cat weekly and brush it more frequently (ideally, this should be done by someone other than the allergic person), remove carpets and soft furnishings, and use a vacuum cleaner with a high-efficiency filter and a room air cleaner (see section below). Wearing a face mask while house and cat cleaning and keeping the cat out of the bedroom are other methods that allow many people to live more happily with their pets.

Irritants such as chemicals can worsen airborne allergy symptoms and should be avoided as much as possible. For example, during periods of high pollen levels, people with pollen allergy should try to avoid unnecessary exposure to irritants such as insect sprays, tobacco smoke, air pollution, and fresh tar or paint.

Air conditioners and filters

When possible, an allergic person should use air conditioners inside the home or in a car to help prevent pollen and mold allergens from entering. Various types of air-filtering devices made with fiberglass or electrically charged plates may help reduce allergens produced in the home. These can be added to the heating and cooling systems. In addition, portable devices that can be used in individual rooms are especially helpful in reducing animal allergens.

An allergy specialist can suggest which kind of filter is best for the home of a particular patient. Before buying a filtering device, the patient should rent one and use it in a closed room (the bedroom, for instance) for a month or two to see whether allergy symptoms diminish. The airflow should be sufficient to exchange the air in the room five or six times per hour; therefore, the size and efficiency of the filtering device should be determined in part by the size of the room.

Persons with allergies should be wary of exaggerated claims for appliances that cannot really clean the air. Very small air cleaners cannot remove dust and pollen--and no air purifier can prevent viral or bacterial diseases such as influenza, pneumonia, or tuberculosis. Buyers of electrostatic precipitators should compare the machine's ozone output with Federal standards. Ozone can irritate the nose and airways of persons with allergies, especially those with asthma, and can increase the allergy symptoms. Other kinds of air filters such as HEPA filters do not release ozone into the air. HEPA filters, however, require adequate air flow to force air through them.

Medications

For people who find they cannot adequately avoid airborne allergens, the symptoms often can be controlled with medications. Effective medications that can be prescribed by a physician include antihistamines and topical nasal steroids--either of which can be used alone or in combination. Many effective antihistamines and decongestants also are available without a prescription.

Antihistamines. As the name indicates, an antihistamine counters the effects of histamine, which is released by the mast cells in the body's tissues and contributes to allergy symptoms. For many years, antihistamines have proven useful in relieving sneezing and itching in the nose, throat, and eyes, and in reducing nasal swelling and drainage.

Many people who take antihistamines experience some distressing side effects: drowsiness and loss of alertness and coordination. In children, such reactions can be misinterpreted as behavior problems. During the last few years, however, antihistamines that cause fewer of these side effects have become available by prescription. These non-sedating antihistamines are as effective as other antihistamines in preventing histamine-induced symptoms, but do so without causing sleepiness. Some of these non-sedating antihistamines, however, can have serious side effects, particularly if they are taken with certain other drugs. A patient should always let the doctor know what other medications he/she is taking.

Topical nasal steroids. This medication should not be confused with anabolic steroids, which are sometimes used by athletes to enlarge muscle mass and can have serious side effects. Topical nasal steroids are anti-inflammatory drugs that stop the allergic reaction. In addition to other beneficial actions, they reduce the number of mast cells in the nose and reduce mucus secretion and nasal swelling. The combination of antihistamines and nasal steroids is a very effective way to treat allergic rhinitis, especially in people with moderate or severe allergic rhinitis. Although topical nasal steroids can have side effects, they are safe when used at recommended doses. Some of the newer agents are even safer than older ones.

Cromolyn sodium. Cromolyn sodium for allergic rhinitis is a nasal spray that in some people helps to prevent allergic reactions from starting. When administered as a nasal spray, it can safely inhibit the release of chemicals like histamine from the mast cell. It has few side effects when used as directed, and significantly helps some patients with allergies.

Decongestants. Sometimes re-establishing drainage of the nasal passages will help to relieve symptoms such as congestion, swelling, excess secretions, and discomfort in the sinus areas that can be caused by nasal allergies. (These sinus areas are hollow air spaces located within the bones of the skull surrounding the nose.) The doctor may recommend using oral or nasal decongestants to reduce congestion along with an antihistamine to control allerigic symptoms. Over-the-counter and prescription decongestant nose drops and sprays, however, should not be used for more than a few days. When used for longer periods, these drugs can lead to even more congestion and swelling of the nasal passages.

Immunotherapy

Immunotherapy, or a series of allergy shots, is the only available treatment that has a chance of reducing the allergy symptoms over a longer period of time. Patients receive subcutaneous (under the skin) injections of increasing concentrations of the allergen(s) to which they are sensitive. These injections reduce the amount of IgE antibodies in the blood and cause the body to make a protective antibody called IgG. Many patients with allergic rhinitis will have a significant reduction in their hay fever symptoms and in their need for medication within 12 months of starting immunotherapy. Patients who benefit from immunotherapy may continue it for three years and then consider stopping. Although many patients are able to stop the injections with good, long-term results, some do get worse after immunotherapy is stopped. As better allergens for immunotherapy are produced, this technique will become an even more effective treatment. (Source: excerpt from Something in the Air Airborne Allergens: NIAID)

Allergies: NWHIC (Excerpt)

Allergies are usually treated in three possible ways. Some of these methods can be used alone or in combination.

Avoidance: This is most effective for food allergies. Once the allergen is identified, it can be avoided simply by removing it from the diet. Avoidance is more difficult for airborne allergens, however, which are often associated with a particular climate and environment.
Medications: Several oral antihistamine medications are available over-the-counter or by a doctor's prescription. A combination of antihistamines and nasal steroids can effectively treat allergic symptoms, especially in people with moderate or severe allergic symptoms. Oral and nasal decongestants reduce congestion sometimes caused by the allergic reaction. However, most medications are for short-term relief only. Nose drops and sprays should not be used for more than a few days at a time because they can lead to even more congestion and swelling of the nasal passages. If you find you "can’t get through the day" without regular use of nasal sprays - see your doctor, and if you can, an allergy specialist. (For example, an ear, nose, and throat doctor.)
Immunotherapy: This is series of allergy shots, and is the only available treatment that has a chance of reducing allergy symptoms over the long term. About 80 percent of people with hay fever will have a significant reduction in their symptoms and in their need for medication within 12 months of starting allergy shots.

(Source: excerpt from Allergies: NWHIC)