Guillain-Barré Syndrome

Guillain-Barré syndrome (say: ghee-yan bah-ray sin-drome) is a rare medical condition that affects a person's immune system and nerves. The immune system, which usually keeps a person from getting sick, starts damaging the nerves that are outside of the brain and spinal cord.

Healthy nerves are able to transmit messages from the brain to different parts of the body. For instance, when you decide to throw a ball, your brain instructs your arm and hand to do it. And when you feel something with your fingertips, your skin sends signals your brain about the sensation. But when nerves have been damaged by Guillain-Barré syndrome (GBS), they can't transmit messages properly.

This is why someone with GBS may not be able to throw a ball, run, hold a pencil, or sometimes even breathe normally. The muscles don't work like they're supposed to, and in severe cases, the muscles may be paralyzed (say: par-uh-lyzed). This means they can't move at all. And sometimes a person with GBS feels funny sensations in their skin — this is because the nerves that transmit messages about sensation are not working properly.

People who get GBS usually spend time in the hospital. But most people with GBS recover and are able to return to normal lives and activities. GBS can affect almost anyone at any age, but it is extremely rare: Only one or two people in 100,000 will get it.

What Are the Symptoms of GBS?

The first symptoms include feelings of weakness or tingling in the legs. These sensations then spread to the arms and upper body. Sometimes people with GBS feel exhausted and can't seem to move. They may also have difficulty breathing.

What Causes GBS?

Doctors aren't sure what causes GBS, but they have some clues. For instance, doctors say many GBS cases seem to happen after a viral or bacterial infection, like a sore throat or diarrhea. This could be because the person's immune system is already working hard to get rid of the virus or infection and makes a mistake by attacking nerve cells. But doctors don't know why some people get GBS and other people recover normally.

How Is GBS Diagnosed?

Doctors may suspect GBS after looking at the problems a person is having, such as weakness or tingling in the legs. The doctor may perform a few tests, including a spinal tap. Two other tests — an electromyogram (EMG) and a nerve conduction velocity (NCV) test — can figure out how well the person's nerves are sending signals down to the arms and legs.

How Is GBS Treated?

Because GBS usually gets worse before it gets better, GBS is generally treated in the hospital, so the person can be near doctors, nurses, and medical equipment. Some GBS patients stay in the hospital's intensive care unit, called an ICU. In that part of a hospital, patients get extra special care. Someone who has GBS could be in the hospital for several days or several weeks. It depends on how sick GBS makes him or her feel.

Recovering From GBS

It may take a long time before people with GBS feel better, even after they come home from the hospital. Sometimes, someone with GBS may need to be in a wheelchair or use a walker until he or she regains strength and can walk easily again.

Physical therapy can help the person get stronger and learn to move around again. The physical therapist can create a training program of exercises that will help the person get better.

A kid recovering from GBS may feel sad, angry, frustrated — or all three. Sometimes seeing a counselor or therapist can help with the emotions and feelings that go along with having GBS. Family and friends can be a big help, too, by being supportive and cheering the person on to a full recovery.

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Blood Transfusions

What Is a Transfusion?

ay: trans-few-zyun) is a way of giving one person's blood to another person who needs it. When you need blood, you really need it because your body won't work right without enough healthy blood. Your heart pumps blood through blood vessels that reach every organ and tissue in the body. One of the blood's most important jobs is to deliver oxygen to each cell in the body. And without oxygen, the body can't stay alive.

Blood transfusions are possible because volunteers donate their blood. That makes it available at hospitals. It may sound creepy to donate blood, but it's safe and no big deal for a healthy person to donate a small amount - usually 1 pint (473 milliliters). Your mom or dad might have done this. Kids don't usually donate blood, but it's a good thing to do when you're older. A person usually must be 17 to donate blood.

Healthy, donated blood is very valuable stuff. They even call the place that collects it the blood bank. Get it? A bank is a safe place for money and other valuables.

People who have certain illnesses such as hepatitis or HIV infection aren't allowed to donate blood, because they could pass their sickness on to another person through a blood transfusion. After blood is collected, blood banks test it very carefully to make sure the blood is free of diseases and germs. The blood bank discards any blood that could make someone sick.

Blood banks are also very careful not to contaminate stuff like needles. People who collect the blood are sure to use a new needle and fresh collection equipment for every donor. That way, even if someone's blood was infected, it can't be spread to other people or contaminate other healthy blood at the blood bank. Blood is used just once and if there is any left over it is thrown away.

Why Are Transfusions Done?

Transfusions are often needed to save the lives of kids and adults who have life-threatening medical problems. A person might need blood if they've been in a bad accident, had surgery that caused blood loss, or have a certain disease, such as cancer or sickle cell anemia. Little babies that are born too early also might need transfusions to stay healthy while they grow.

In a transfusion, a person might get whole blood - meaning they receive blood just as it came out of the person who donated it. But usually the person needs only part of the blood. Blood has different parts, or components and each has a job to do. They include:

• Plasma is a yellowish, watery liquid that holds red blood cells, white blood cells, and platelets.
• Red blood cells pick up oxygen at your lungs and then move to your heart so that oxygen is pumped all over your body.
• White blood cells fight off germs that make your body sick.
• Platelets are cells that make your cuts stop bleeding. They stick together and plug up the cut blood vessel so that no more blood will flow out.

Red blood cells, plasma, and platelets are commonly used in transfusions. Red blood cells help people who have lost a lot of blood or are anemic. Doctors and nurses give people plasma if they are bleeding too much, and platelets help people with certain types of cancers or bleeding problems.

Not Just Any Blood Will Do

Hospitals have to be careful when they give a blood transfusion. People have different blood types - and not all blood will work in all people. Do you know your blood type? Your mom or dad might. But don't worry if no one knows.

If you ever need blood, the hospital would very quickly find out your blood type and may even do additional tests to make sure you get the right kind of blood. The blood will be tested against your blood before it is given to make sure it is compatible with your blood.

What Happens During a Transfusion?

Before a person gets blood, they need to give a little. Why? So the blood sample can be tested to determine its type and the best match from the blood bank. To get the sample, an IV - or intravenous (say: in-truh-vee-nus) - catheter (a tiny straw-like tube that goes into the vein) will be inserted into a vein in the person's hand or arm. It will feel like a small pinch. The blood will be drawn through this catheter, which is attached to a syringe with a test tube inside.

The IV will be taped carefully in place so that it can be used to give the blood when it is ready. A nurse will bring in a bag of the blood that has been specially selected for the person. The bag will hang on a pole near the hospital bed and a tube will be inserted into the bag. Then the blood can travel from the bag, through the IV, and into the person's blood vessels.

Most of the time, the person doesn't feel any discomfort when the blood goes in. But since the blood is refrigerated, it might feel a little cold. During the transfusion, nurses and others will make sure the person feels OK. A nurse keeps an eye on the person's temperature and blood pressure. The nurse also looks to make sure there's no rash or other signs of an allergic reaction.

Transfusions can be done very quickly, if necessary, like in an emergency situation. But when it's not an emergency, the transfusion can happen more slowly, taking a few hours to finish. When the transfusion's done, the person has taken a big step toward being healthy and feeling good again.

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Fungal Infections

What do you think of when you hear the word fungus? Do you think of mushrooms? A mushroom is one type of fungus, but fungus also refers to a type of germ that lives on all of us.

This germ is harmless most of the time, but sometimes it can cause a problem called a fungal infection (say: fung-gul in-fek-shun). It sounds gross, but don't worry or feel embarrassed. A lot of people get fungal infections, but they're usually easy to treat becuase a fungus rarely spreads below the skin. If you get one of these infections, before you know it, you'll be saying bye-bye to fungi (say: fung-guy).

What Is a Fungal Infection?

Fungi, the word for more than one fungus, can be found on different parts of the body. Here are some common types of fungal infections:

Tinea (say: tih-nee-uh) is a type of fungal infection of the hair, skin, or nails. When it's on the skin, tinea usually begins as a small red area the size of a pea. As it grows, it spreads out in a circle or ring. Tinea is often called ringworm because it may look like tiny worms are under the skin (but of course, they're not!). Because the fungi that cause tinea (ringworm) live on different parts of the body, they are named for the part of the body they infect. Scalp ringworm is found on the head, and body ringworm affects the arms, legs, or chest.

Athlete's foot is another type of fungal infection that usually appears between the toes but can also affect toenails and the bottom or sides of the feet.

Jock itch is a fungal infection of the groin and upper thighs. You might think only men and boys get it, but girls and women can get it, too.

Candida (say: kan-duh-duh) is a yeast, similar to a fungus. It most often affects the skin around the nails or the soft, moist areas around body openings. Diaper rash in babies can be from one type of candidal infection, as can thrush (white patches often found in the mouths of babies.) Older girls and women may develop another form of candidal infection in and around the vagina. This is called a yeast infection.

Why Do Kids Get Fungal Infections?

Lots of kids get fungal infections. Kids love to share and hang out together. Some of these infections are contagious (say: kon-tay-jus), which means they easily spread from person to person. Close contact or sharing a comb or hairbrush with someone who has tinea can spread the fungus from one person to another. Because fungi need a warm, dark, and humid place to grow, public showers, pools, locker rooms, and even the warmth of shoes and socks can give fungi the perfect opportunity to strike.

Taking antibiotics can cause some kids to get a yeast infection. Antibiotics get rid of germs that make us sick, but they can also kill many of the harmless bacteria in our body. These harmless bacteria normally fight with the yeast for a place to live, but when antibiotics kill them, the yeast is free to grow.

Sometimes, a fungus may infect kids if they have an immune system disorder (this means their bodies can't fight certain types of infections). This is rare, but it does happen.

How Do I Know If I Have a Fungal Infection?

There are many skin problems that look like a fungal infection so the best way to know for sure is to ask your doctor. Here are some signs you and a parent can look for:

• Athlete's foot causes symptoms that include red, dry, cracked, and itchy skin between the toes. Some people also have red, scaly bumps filled with pus on the bottoms and sides of their feet.
• Jock itch appears as a rash with elevated edges. It's itchy and often feels like it is burning. It's pretty common, especially if you play sports. Sweating and wearing athletic equipment can bring on this kind of rash.
• Ringworm of the head begins as a small pimple or scaly patch that looks like dandruff. The pimple or patch becomes larger and the hair in the infected area can become brittle and break off. This can create scaly patches of baldness, but the hair will grow back. If you have ringworm on your arms, legs, or chest, you may see small, red spots that grow into large rings.
• Candida, the yeast, causes the skin around the infected area to itch. The skin may also be red and swollen.

Farewell to Fungus!

Getting rid of a fungal infection is not that difficult. Your doctor may decide to scrape a small amount of the irritated skin or clip off a piece of hair or nail and look at it under a microscope. Once your doctor knows what kind of infection you have, there are special antifungal creams and shampoos that can help to get rid of it. Sometimes the doctor will prescribe a medicine to take. Make sure you take the medicine for as long as the doctor tells you.

Maybe fungal infections can't be avoided altogether, but there are some ways you can help yourself ward them off.

Walk away from athlete's foot by:

• Washing your feet every day.
• Drying your feet completely, especially between your toes.
• Wearing sandals or shower shoes when walking around in locker rooms, public pools, and public showers.
• Wearing clean socks. If they get wet or damp, be sure to change them as soon as you can.
• Using a medicated powder on your feet to help reduce perspiration. (Ask a parent first.)

You can ditch jock itch by:

• Wearing clean, cotton underwear and loose-fitting pants.
• Keeping your groin area clean and dry.

Prevent beastly yeast infections by:

• Changing out of wet swimsuits instead of lounging around in them.
• Wearing clean, cotton underpants.

There may always be a "fungus among us," but we can make it a lot tougher for them to invade and grow!

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Atrial Septal Defect

What Is an Atrial Septal Defect?

Atrial septal defect (say: ay-tree-ul sep-tul dee-fekt), or ASD for short, is a heart condition that can affect kids. To understand an ASD, it helps to know how the heart works. The heart has four chambers. The lower chambers of the heart are called the ventricles. There are two ventricles: a left ventricle and a right ventricle. The upper chambers are the atria and there are two of them — a left atrium and a right atrium. (Atrium is an old word that meant the main room in an ancient Roman house, so the atria are "rooms" in your heart!)

You may already know that your heart is a muscle that pumps blood throughout your body. In a person without a heart defect, blue blood that's low in oxygen flows first to the right atrium, then to the right ventricle, and is then pumped to the lungs to receive oxygen.

The red oxygen-rich blood then returns to the left atrium, flows from there into the left ventricle, and heads out to the body through the aorta, a large blood vessel that carries blood from the heart to the smaller blood vessels in the body.

Between the right and left atria, there is a wall called the septum that normally separates the blue and red blood. In a person with an atrial septal defect, there's an opening in that wall. This hole in the wall lets oxygen-rich blood from the left atrium mix with oxygen-poor blood on the other side. The extra blood that ends up crossing through the hole and flowing through the heart and out to the lungs creates a swishing sound, which is called a heart murmur. That sound may be the only clue that a kid may have an ASD.

any kids with an ASD don't have any problems or symptoms because of it. Occasionally, a kid with a very large ASD may have a poor appetite, may tire easily, may grow slowly, may experience shortness of breath, or have lung problems, like pneumonia.

About 1 in every 100 babies is born with some type of heart defect. Atrial septal defects are one of the more common types of these heart defects. A person could be diagnosed with an ASD in infancy, childhood, during their teen years, or even as an adult.

In some kids with small-sized atrial septal defects (small-size holes), the hole can close up on its own. Most kids with a medium-sized or large-sized ASD will need some kind of procedure (such as surgery) to close the hole. If the hole is left open, later in life that person may develop other kinds of heart problems, such as an abnormal heartbeat. The person also could develop serious damage to the lung blood vessels. The risk of having a stroke, a problem where a clot or air bubble clogs up a blood vessel in the brain, is also increased in someone with ASD. To prevent these problems, doctors often recommend closing the hole while the kid is still young.

What Causes an Atrial Septal Defect?

Atrial septal defects develop when a baby is still growing inside its mother. Before birth, the heart begins as a large tube that folds and divides into sections that will eventually become the walls and chambers of the baby's heart. If a problem occurs during this process, a hole may develop in the wall between the left atrium and right atrium.

In some cases, the tendency to develop an ASD may be inherited, or genetic. In other cases, an ASD may happen if the pregnant woman was exposed to chemicals or drugs while the baby was growing in her uterus. For most kids with ASDs, no one knows why they developed this problem.

What Do Doctors Do?

Kids who have ASDs may first find out that they have a heart murmur in the doctor's office. The next stop is usually to a pediatric cardiologist (say: pee-dee-ah-trik car-dee-ah-lo-jist), a doctor who specializes in diagnosing and treating heart disease in kids and teens.

The pediatric cardiologist will ask about the kid's medical history (the mother's health during pregnancy and illnesses the kid has had). The cardiologist also will do an exam and listen to the kid's heart. If a doctor thinks a kid may have an ASD, these tests might be done:

• chest X-ray, which produces a picture of the heart and surrounding organs
• electrocardiogram (EKG), which records the electrical activity of the heart
• echocardiogram (echo), which uses sound waves to create a picture of the heart

In some kids, the doctor may recommend regular follow-up visits to see if a small defect will close on its own. A kid with a small ASD usually can participate in sports and other regular activities without restrictions.

What If The Hole Doesn't Close on Its Own?

If the hole needs to be closed, the doctor will decide whether the kid needs surgery or a cardiac catheterization (say: kar-dee-ak ka-thuh-tur-uh-zay-shun). With either one, the kid will get special medicine called anesthesia that causes sleepiness and prevents pain during the operation.

In ASD surgery, the doctor repairs the hole with stitches or a patch made out of either surgical material or the body's own tissue. A kid may have to spend a few days in the hospital after surgery. Within about 6 months, the tissue of the heart heals over the patch or stitches.

Another way to fix the hole is cardiac catheterization. This method uses a thin, flexible tube called a catheter. The cardiologist inserts the catheter into a blood vessel in the leg that leads to the heart. The cardiologist then guides the tube into the heart and inserts a device that covers the hole in the heart. The device is made out of metal mesh and is springy and flexible. The kid usually will spend a night at the hospital after the procedure. As with surgery, over time, the heart's natural tissue will grow to completely cover the device.

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Epilepsy

What Is Epilepsy?

It's a strange word, isn't it? Epilepsy comes from a Greek word meaning "to hold or seize," and people who have epilepsy have seizures. You might also hear a seizure called a convulsion, fit, or spell.

Seizures happen when there is unusual electrical activity in the brain. Your brain cells are constantly sending out electrical signals that travel along nerves to the rest of the body.

These signals tell the muscles to move. During a seizure, a person's muscles tighten and relax rapidly or stop moving completely. Seizures come on suddenly, and people who have them cannot control their muscles while they are having a seizure. If too many brain cells are sending signals at the same time, it causes an overload and a person may pass out and shake all over. People who have epilepsy may have seizures only once in a while or as frequently as every day.

What's a Seizure?

Most seizures occur without warning, although some people have a funny feeling, an upset stomach, or a weird smell or taste right before a seizure. This is called an aura. Others find that certain things may bring on a seizure, like not getting enough sleep or playing video games.

Even though a seizure may look scary, it's not painful. During a seizure, the person may fall down, shake, stiffen, throw up, drool, urinate (pee), or lose control of their bowels. Other seizures are less dramatic. The person may just stare into space or have jerking movements in one part of the body. When the seizure is over, the person may feel sleepy and won't remember what happened.

Who Has Epilepsy?

About 2 million Americans have epilepsy, including boys and girls and people of all races and ages. Seizures can start at any age, but often they begin before age 15 or after age 65. Doctors often cannot explain why a person has epilepsy. They do know that epilepsy is not contagious - you can't catch it from somebody. Epilepsy is not passed down through families (inherited) in the same way that blue eyes or brown hair are. But if somebody's mom or dad or brother or sister has epilepsy, then he or she has a slightly higher risk for epilepsy than somebody whose family has no history of seizures.

How Can Doctors Help?

If a person has a seizure, doctors may do some tests, such as a CAT scan, an MRI, or an electroencephalogram (EEG). A CAT scan or MRI help a doctor look at a person's brain and an EEG records brain waves. Don't worry - these tests don't hurt at all. Blood tests may also be done.

All of these tests can help doctors try to find out what caused the seizure and if a person might have more seizures. But sometimes seizures are a one-time thing for a kid. Half of the kids who have one seizure never have another one.

For people who are diagnosed with epilepsy, most of them can control their seizures by taking medicines. As they get older, many kids with epilepsy get better and can stop taking medicine. For some kids, it may be difficult to get the seizures under control. A special diet or surgery may be needed.

Are Kids With Epilepsy Different?

People who have epilepsy may need to be careful in places where they could get hurt if they have a seizure, like a high place or in the bathtub. And they may not be able to do certain sports, such as boxing or scuba diving.

But other than that, people with epilepsy can live normal lives and do what everyone else does. They can go to school, attend college, and get jobs. They can get married and have children. Epilepsy does not limit a person's ability, but it may make a person feel different. So, if you know someone who has it, you can help a lot by just being a good friend.

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Chronic Kidney Disease

When you're hungry, your stomach lets out a growl or two. When you run around, your heart lets you know it's really working by boom, boom, booming! But some important body parts are quiet as a whisper. Psst - we're talking about your kidneys.

What Are the Kidneys?

Your kidneys are tucked under your lower ribs on either side of your spine. Each one is about the size of your fist and shaped like a bean. Most people have two kidneys, but they work so effectively that a person can be happy and healthy with only one.

Think that's cool? Check out their job: each day your kidneys act like high-powered filters for about 200 quarts (189 liters) of fluid in your flowing blood. That's enough fluid to fill 100 of those big soda bottles that hold 2 liters each!

Your kidneys remove waste and excess fluid that naturally builds up in your blood after your body breaks down food. The kidneys collect that stuff and send it on to the bladder as urine (pee), so you can get rid of it when you go to the bathroom.

Besides taking out your body's "trash," your kidneys help balance your body's vitamin and mineral levels so your other organs and bones can do their best work. They help in the production of red blood cells and produce a form of vitamin D, which promotes healthy bones. If that's not enough, they help keep your blood pressure at a healthy level.

Kinds of Kidney Diseases

Like any complicated machine, not all kidneys work perfectly. When someone's kidneys have problems for a long time, doctors call it a chronic kidney disease. Children's kidney problems are either congenital (say: kun-jeh-nuh-tul) or acquired (say: a-kwired).

The difference is that a congenital problem exists from the day someone is born. An acquired kidney problem develops over time, often due to an injury, kidney infection, or other illness. Many congenital kidney problems are hereditary, which means it's something that is passed down through your genes. Acquired kidney problems are not hereditary.

The two most common kidney problems are congenital. A common congenital kidney problem is obstructive uropathy (say: ub-strukt-iv yur-ah-pah-thee). This means something is blocking urine flow and keeping the kidneys from doing their waste-removing job properly. Another congenital problem is renal dysplasia (say: ree-nul dis-play-zhuh). A person with renal dysplasia was born with kidneys that are smaller than they should be or that didn't form correctly. This makes it difficult for the kidneys to work the way they should.

How Are Kidney Diseases Diagnosed?

Kidney problems are often not noticed at an early stage. As the illness progresses, a person with a kidney disease may feel tired, nauseated, itchy, or dizzy. The person also might have puffy eyes, ankles, or feet because the person's body has trouble getting rid of extra fluid. Someone who has these problems needs to go to the doctor.

At a doctor visit, the doctor would examine the person and ask questions about past and current health problems. There are also many special tests a doctor can do to find out if someone's kidneys are working properly. Blood pressure can be measured, and if it's high, it may indicate a kidney problem. Because the kidneys produce urine, the doctor can check a person's pee for blood or protein. Normal urine usually doesn't contain much of either one.

The doctor also might take a little bit of the person's blood to check the amount of something called creatinine (say: kree-ah-tin-een), a natural waste product that muscles release into the blood. The level of creatinine can go up too high if the kidneys aren't working well.

Some doctors check for growths or blockages by using machines that take special pictures, like X-rays, ultrasound scans, or CAT scans. To pinpoint the problem, a doctor may also do a biopsy (say: by-op-see). In this test, the doctor takes out a tiny piece of kidney tissue with a needle and looks at it under a microscope. Doctors and nurses will give medicine called anesthesia to keep the person comfortable during the biopsy.

How Do Doctors Treat Kidney Problems?

The treatment for chronic kidney problems depends on how well the kidneys are working. It may include vitamins, minerals, and medications to help with growth and to prevent bone disease. Sometimes unhealthy kidneys have problems producing a hormone that helps make red blood cells, the cells that carry oxygen to your body's tissues.

When a person doesn't have enough red blood cells, that's called anemia, which can make a person feel worn out. If this is a problem, the doctor may prescribe blood transfusions or medicine that helps the body make red blood cells.

Kids with kidney problems are more likely to get high blood pressure, which can be harmful if it isn't controlled. In those cases, the person may have to take blood pressure medicine. For kidneys that need even more help, doctors might suggest dialysis (say: dy-ah-luh-sis), a process that cleans the blood artificially. A kidney transplant is another possibility. In this operation, doctors replace a kidney that doesn't work with a healthy kidney from another person.

What's Life Like for Kids With Kidney Problems?

Kids who have kidney problems are just like other kids, but they may have to take special medicine or go to the hospital for treatments, such as dialysis. They also will need to talk with their doctors about participating in sports, but often they can join in the fun. Some kids may need to avoid contact sports, such as football, soccer, or basketball.

Kids with kidney illnesses also may need to talk with a doctor or dietitian about the foods they eat. Some kids won't have to follow any special diet, but others may need to avoid salty foods and limit the amount of fluid they drink. Potassium and protein also may be a concern for someone with a kidney disorder.

It's no fun to be sick, no matter the cause. But the good news for kids with kidney problems is that they can take steps to stay healthier and feel better, with a little help from their families and doctors.

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Inhaler

Inhalers (say: in-hay-lurz) work to get medicine right into your lungs, where it can help stop breathing problems related to asthma. Inhalers are small and easily fit into your pocket or backpack. Research shows that even young kids can use inhalers, especially when they're used with a spacer.

There are two types of inhalers:

Metered dose (say: mee-turd dohs) inhalers are the most common. They spray out a mist of liquid medicine that you breathe in. They work in much the same way that a can of hair spray does.

Dry powder inhalers deliver medicine in a powder form. You inhale and pull the medicine into your lungs. They are a little easier to use than metered dose inhalers, but you have to breathe in a bit harder.

Any kid, even a baby, can use a metered dose inhaler with a spacer and a mask. Once a kid is 5 or 6 years old, he or she can learn to use a metered dose inhaler with just a spacer. Most kids who are older than 5 or 6 are also able to use a dry powder inhaler. Your doctor will help you decide what type of inhaler you should use. You may try several different kinds before you find the right one.

If your doctor has given you an inhaler, it's important that you learn how to use it the right way. You may need to practice at home. Sometimes, during a visit to the doctor, the doctor or nurse will ask you to show them how you use your inhaler. This helps him or her see if you're doing it correctly. If not, don't worry, practice makes perfect!

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Snooze

There's nothing worse than the sound of someone snoring if you're trying to fall asleep. Or maybe it's you who snores, and people tease you about the noise you make in your sleep. Snoring isn't just noisy. Sometimes it's a sign of a serious medical problem that should be treated by a doctor. Read on to find out more about the snore!

Snoozing or Snoring?

Snoring is a fairly common problem that can happen to anyone - young or old. Snoring happens when a person can't move air freely through his or her nose and mouth during sleep. That annoying sound is caused by certain structures in the mouth and throat - the tongue, upper throat, soft palate (say: pa-lut), uvula (say: yoo-vyuh-luh), as well as big tonsils and adenoids - vibrating against each other.

People usually find out they snore from the people who live with them. Kids may find out they snore from a brother or sister or from a friend who sleeps over. Snoring keeps other people awake and probably doesn't let the snoring person get top quality rest, either.

What Makes You Snore?

There are many reasons why people snore. Here are some of the most common:

• Seasonal allergies can make some people's noses stuffy and cause them to snore.
• Blocked nasal passages or airways (due to a cold or sinus infection) can cause a rattling snore.
• A deviated septum (say: dee-vee-ate-ed sep-tum), which is the tissue and cartilage that separates the two nostrils in your nose, may be crooked. Some people with a very deviated septum have surgery to straighten it out. This also helps them breathe better - not just stop snoring.
• Enlarged or swollen tonsils or adenoids may cause a person to snore. Tonsils and adenoids (adenoids are glands located inside of your head, near the inner parts of your nasal passages) help trap harmful bacteria, but they can become very big and swollen all of the time. Many kids who snore have this problem.
• Drinking alcohol can relax the tongue and throat muscles too much, which partially blocks air movement as someone is breathing and can contribute to snoring noises.
• Being overweight can cause narrowing of the air passages. Many people who are very overweight snore.

Snoring is also one symptom of a serious sleep disorder known as sleep apnea. When a person has sleep apnea, his or her breathing is irregular during sleep. Typically, a person with sleep apnea will actually stop breathing for short amounts of time 30 to 300 times a night! It can be a big problem if the person doesn't get enough oxygen.

People with this disorder often wake up with bad headaches and feel exhausted all day long. They may be very drowsy and have difficulty staying awake while having a conversation or even while driving. Kids affected by sleep apnea may be irritable and have difficulty concentrating, particularly in school and with homework.

Snoring Solutions

According to the government's patent office (this is where you go to register an idea or invention), there are hundreds of anti-snoring devices on the market. Some of them startle you awake when they sense you are snoring. Unfortunately, they may only work because they keep you awake!

Those small, white strips some football players wear across their noses that kind of look like a bandage are another anti-snoring device. Football players wear them during the game to breathe easier while running a play or making a tackle. People also wear these breathing strips to try to stop snoring.

Other snoring solutions include tilting the top of a bed upward a few inches, changing sleeping positions (from the back to a side), and not eating a heavy meal (or for an adult, not drinking alcohol) before bedtime. These kinds of "cures" may work only for someone who snores occasionally and lightly - or they may not work at all.

If you can't stop snoring or the snoring becomes heavy, it's a good idea to see a doctor. He or she might tell you how to keep your nasal passages clear and will check your tonsils and adenoids to be sure they aren't enlarged and don't have to be removed.

Some people need to lose weight, change their diets, or develop regular sleeping patterns to stop snoring. It may be helpful to remove allergy triggers (stuffed animals, pets, and feather/down pillows and comforters) from the person's bedroom. The doctor might also suggest medications for allergies or congestion due to a cold.

If a doctor suspects a person has sleep apnea, he or she will order a test to monitor the patient while they sleep. This is usually done in a sleep center (a medical building that has equipment to monitor breathing during sleep). A patient is attached to machines that check heart rate, oxygen and carbon dioxide levels, eye movement, chest wall movement, and the flow of air through the nose.

The doctor can then tell if a patient has a disorder like sleep apnea. The best thing about the test is that it doesn't hurt at all. After all, you sleep right through it! Once doctors know what's wrong, you can be treated for it, usually with lifestyle changes, sometimes medicines, or even surgery, if necessary.

Solving a snoring problem lets everyone breathe and sleep a little easier!

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Anthrax

What is Anthrax

You may have heard about anthrax and wondered what it is. Some people are worried that the germ that causes anthrax could be spread by people who want to use the disease as a weapon. Although this is a frightening thought, the government and police are working on ways to protect us.

In the meantime, it's important not to panic over anthrax - the chance that you or someone in your family could ever get it is very small. One of the ways you can feel better is to learn about the disease. When you know what it is and how you can get it, it doesn't seem quite as scary. So here are answers to some questions you might have about anthrax:

• What is anthrax?
  Anthrax is an infection caused by bacteria (a type of germ) called Bacillus anthracis (say: buh-sil-us an-thray-sus). These bacteria make spores, a form of the germ covered by a protective shell. The spores can live for years in the soil, and they cause anthrax when they enter the body. Although the disease is most common in farm animals - like sheep, cows, and goats - there's a small chance that people can get it as well, usually from some type of contact with an animal or part of an animal that had anthrax.
• How do people get anthrax?
  People may get anthrax if they are exposed to the spores. (Exposed means that a germ that can cause disease is found in the same place that you are - like in the same room - where it could come into direct contact with your body.) But here's the important part: Just being exposed to these spores doesn't mean that people will get sick.
  
  To get sick, people would have to have contact with the spores in one of three very specific ways: They would have to breathe thousands of these spores all the way into their lungs. Or they would have to eat meat that had spores in it. (Meat that spreads anthrax comes from animals that were infected with the bacteria and usually is not cooked fully.) Or they would have to handle something with spores on it and get spores in cuts on their skin. This may sound scary, but even when people come into contact with the spores it's unlikely that they will get sick. If the bacteria do not get into the skin, digestive tract, or lungs, the disease will not develop.
• Is anthrax contagious?
  Anthrax is not contagious, which means it does not spread from person to person the way the flu can spread between family members or classmates.
  
  
• How is anthrax treated?
  Anthrax can often be successfully treated with antibiotics (medicine that kills bacteria).
  
  
• Should I worry about anthrax?
  Anthrax is very rare. In the fall of 2001, a few people became infected with anthrax after someone used letters in the mail to spread the spores that cause the disease. Although this was scary, only a few people became sick and the police have been working hard to stop anything like that from happening again. A person's chance of getting anthrax from spores that someone spreads or from any type of contact with an infected animal is very, very low.

If you're still worried about anthrax, remember that you, your family, and your friends will probably never be exposed to anthrax spores. Talking to your teacher or parent may make you feel better, and he or she can help you find the answers to any other questions you may have about anthrax.

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Celiac

Have you ever eaten gluten? No, not glue - gluten! If you've ever eaten a piece of bread, a slice of pizza, or a bowl of cereal, chances are you have. Gluten (say: gloo-tin) is a protein found in wheat, rye, and barley - grains that are in many everyday foods.

Most people can eat food containing gluten with no trouble. But for some people, eating gluten can cause a reaction in their bodies. Someone who has this problem has celiac (say: see-lee-ak) disease.

After you eat food, it goes to your stomach, which is part of a group of organs that make up your digestive system. An important part of the digestive system is the small intestine, which is lined with villi (say: vih-lie). Villi are usually described as microscopic, finger-like projections. Weird, huh? Fingers in your intestines! But don't forget that they're microscopic, meaning they are extremely small - so small you can't see them without a microscope. The villi are important because they absorb nutrients into the body.

For someone with celiac disease, eating gluten - in a piece of bread, for instance - causes an immune system reaction. Your immune system ordinarily keeps you from getting sick, but in someone with celiac disease, the body starts damaging and destroying the villi. Without villi, a person's body can't absorb vitamins and nutrients from food. Without enough nutrients, a kid's body has a tough time staying healthy and growing properly. Even if the person is eating a lot, he or she might still lose weight and might develop anemia (say: uh-nee-me-uh) from not absorbing enough iron.

Why Do Kids Get Celiac Disease?

No one is sure why celiac disease happens, but it appears to run in families. You have a 5-10% chance of getting celiac disease if someone in your family has it. It's common in people from the northern European countries and the United States. How common? We think that about one in every 133 people has celiac disease in the United States. Obviously, many people who have celiac disease do not know it. If all these people were diagnosed, celiac disease would be more common than Type 1 diabetes. Fortunately, awareness is growing about the problem, and there are better ways of testing people for it.

Signs and Symptoms

Some common symptoms of celiac disease are diarrhea, decreased appetite, stomachache and bloating, poor growth, and weight loss. Many kids are diagnosed with the problem between 6 months and 2 years of age. It makes sense because, at this time, kids are getting their first taste of gluten in foods. For some people, the problems occur gradually and the symptoms may be terrible one week and not as bad the next. Because of this, some people aren't diagnosed with the celiac disease until they are older. The problem is chronic, which means that the symptoms may go away and come back over and over again.

A person with celiac disease may feel tired, and he or she could be irritable. Some people with the disease also have skin rashes and mouth sores. The problem is sometimes mistaken for other digestive problems called inflammatory bowel disease or lactose intolerance. And in some cases, a kid won't have any symptoms and then will all of a sudden start having problems during a time of stress, such as after an injury.

How Do People Know If They Have It?

Someone who has a lot of stomachaches, diarrhea, weight loss, or any of the other symptoms mentioned above should talk to the doctor. It may or may not be celiac disease, but a doctor can help sort this out. The doctor will usually order a screening blood test.

If the screening tests show a person might have celiac disease, the next stop is usually a gastroenterologist, a doctor who specializes in digestive problems. This specialist may decide to take a sample of the person's small intestine to look at under the microscope. This small sample is called a biopsy. If a biopsy is done, the doctor will give the person some special medicine to keep him or her comfortable during the procedure.

How Is It Treated?

Celiac disease is treated by not eating gluten. This can be difficult because gluten is in many foods, but a dietitian can help adjust a person's diet to cut out gluten. It is important not to start a gluten-free diet unless you are truly diagnosed with celiac disease. Following a gluten-free diet allows the small intestine to heal. But that doesn't mean the person can start eating gluten again. For someone with celiac disease, gluten will always irritate their intestines and, if this happens, the diarrhea, stomachaches, and other problems will return.

If you're diagnosed with celiac disease, it can be a challenge to learn which foods contain gluten. You may not be able to remember them all, but you can keep a list with you, and ask about menu items at restaurants before digging in. Before you know it, you'll be a pro at knowing which foods are safe and which are not. Here's a quick quiz:

Which of these foods contain gluten?

• pizza
• fried chicken
• pasta

If you said all three, you're right! Pizza was the easiest choice because you know the crust is bread. But did you know that battered foods like fried chicken and even some French fries contain gluten? Pasta also contains gluten because it is made from wheat. Luckily, you can make or buy gluten-free pizza crust, make fried chicken with a gluten-free batter, and find gluten-free pasta and French fries. In fact, nearly all of the foods we eat can be made gluten-free.

In addition to foods that contain gluten, you'll need to watch out for foods that may have been contaminated with gluten. That means a food that doesn't contain gluten as an ingredient, but came into contact with gluten-containing foods. This is most likely to occur at home in your own kitchen. For instance, wheat bread crumbs in the toaster, the butter, or peanut butter.

If you have celiac disease you will need your own toaster and you should also have separate spreads and condiments to avoid this cross-contamination. Some foods are contaminated during processing, so your mom or dad can help you by finding foods that are certified as gluten-free. For instance, gluten-free oats are now available for people with celiac disease.

The best approach is to read labels, but here are a few foods to steer clear of until you can verify that they are gluten-free:

• packaged rice mixes
• lunch meats
• sausages
• instant cocoa
• canned soups

A diagnosis of celiac disease does not mean giving up all your favorite foods. It just means adapting them to be gluten-free. There are many different gluten-free products, baking mixes and recipes available to help. A support group is a great resource for finding out which recipes and products are best.

A support group can help keep you up to date as well. For instance, a few years ago it was recommended that distilled vinegar be completely avoided on a gluten-free diet. Now we know that the gluten molecules do not appear in the distillate. Huh? What it means is that distilled vinegar is now an OK ingredient. That made a big change in the allowed foods someone with celiac disease could eat.

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Mosquito Bite

a Mosquito

A mosquito (say: mus-kee-toe) is an insect that is found all over the world. There are thousands of different kinds of mosquitoes in many different sizes and colors. The female mosquito needs blood from vertebrates (animals that have a spine) to lay eggs and produce more mosquitoes. She has a special part of her mouth that she uses to suck blood, and her saliva (spit) thins the blood so she can drink it. In fact, it's the mosquito's saliva that makes the bites itch!

Mosquito Bite Looks and Feels Like

A person who gets bitten by a mosquito will notice a round pink or red bump that itches a lot.

You Should Do

If you think you've been bitten by a mosquito, wash the bite with soap and water. Put on some calamine lotion to help stop the itching, or an adult can find an anti-itch cream at the drugstore for you. Placing an ice pack on the bite may also help. Tell an adult you've been bitten by a mosquito, especially if you live in the eastern United States.

a Doctor Will Do

It's very unusual for someone to have an allergic reaction to a mosquito bite. But if you develop an allergic reaction and feel dizzy or sick, tell an adult immediately. A doctor can treat allergic reactions with medicines.

Avoid Getting Bitten

The best way to avoid mosquito bites is to wear an insect repellent. Repellents that include one of these ingredients are best: DEET, lemon eucalyptus, or picaridin. Ask a parent to help you apply them.

Since mosquitoes lay their eggs in water, it's also a good idea to empty out buckets, flower pots, toys, and other things in your yard that may have collected water during a rainstorm. And when it's possible, wear long-sleeved shirts and long pants to keep mosquitoes away from your skin.

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Avian (Bird) Flu

You might have heard about avian flu in the news, but what is it? "Avian" (say: ay-vee-yan) means related to birds. Avian flu is an influenza virus that affects mostly birds and sometimes pigs. This isn't the same flu that people normally get.

The main difference between the regular flu and avian flu is the way it has spread. Regular flu spreads from person to person by coughing, sneezing, or picking up the germs other people have left behind. That's why people are always telling you to wash your hands during flu season.

So far, the bird flu has spread only from bird to bird and bird to person — not person to person. Avian flu has mostly infected birds in Asia. When birds get it, they get sick and often die. Some people who handle the birds, such as farmers, have caught avian flu from the animals. This illness has been very serious for about 100 people who have been infected. More than half died from it. That makes it tougher than the regular flu. With the regular flu, most healthy people will recover after a week or two of feeling sick. They usually don't even need special medicine.

Who's at Risk?

Right now, you're not at risk for getting bird flu unless you're a bird or you're a farmer or someone who handles chickens and other birds. And so far, the United States hasn't had any cases of this serious bird flu, called H5N1.

But there's good reason why people everywhere are concerned about bird flu:

• The virus appears to be spreading from birds in Asia to birds in other countries.
• Unlike the regular flu, there's no vaccine yet to protect people from catching it.
• It's possible the virus could change (mutate) and become a kind of germ that could be easily passed from person to person.

Without a vaccine or effective medicine, a lot of people could get sick if the virus changes and starts spreading from person to person. When a lot of people around the world get sick from a fast-spreading illness, it's called a pandemic (say: pan-deh-mik).

What's Being Done?

A lot of people are working to protect people from avian flu. Millions of birds have been destroyed in countries where the infection has struck. That's one way of keeping the virus from spreading. Lots of groups — from the World Health Organization down to local governments — are also talking about how they would handle it if there were an outbreak of bird flu.

But maybe most important, medical researchers are working on a vaccine that would protect people from catching bird flu, even if it started to spread among humans. Those researchers are also figuring out the most helpful medicines to give someone who does catch bird flu.

What Can You Do?

In most places, there's no immediate threat to humans from bird flu. And the best precaution to take is an easy one: Wash your hands. By keeping your hands clean you also protect yourself from other, far more common illnesses, like colds and the regular flu. Be sure to wash them thoroughly with soap and water, especially after going to the bathroom, before eating, or after being around someone who's sick.

Some kids might live in or visit a country that has had an outbreak of bird flu. Those countries include Cambodia, China, Croatia, Indonesia, Japan, Kazakhstan, Korea, Malaysia, Mongolia, Romania, Russia, Thailand, Turkey, and Vietnam. If you're in one of those places, avoid any contact with chickens, ducks, geese, pigeons, turkeys, quail, or any wild birds. Stay away from live bird markets, local poultry farms, or any other settings where there might be infected poultry. Avoid touching surfaces that could have been contaminated by bird saliva (spit), feces (poop), or urine (pee).

No matter where you live, kids might be worried about bird flu. Often, what you hear on TV or read in the newspapers focuses on the very worst thing that could happen. Remember that bird flu is not spreading quickly to humans right now and many people are getting prepared in case something changes.

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Rabies

Rabies is a serious infection of the nervous system, which controls everything you do - from breathing to walking. A person can get rabies if he or she is bitten or scratched by an animal that carries the rabies virus. Fortunately, very few people get rabies and most cases today are found in wild animals. If someone gets bitten by an animal that has rabies, quick treatment can prevent the illness.

Animal Bites

Rabies is very serious and can make a person very sick. The person's brain may swell and the person can die.

That's why it's so important to see a doctor if a person gets bitten by an animal. This is especially important if bitten by a wild animal, such as a squirrel or a bat. But any mammal can get rabies, including household pets, such as dogs, cats, and even ferrets. Household pets can get a rabies vaccine to protect them and their owners. Animals who are not mammals, such as birds, fish, turtles, and snakes, cannot carry rabies.

An animal infected with rabies carries the virus in its saliva, so if it bites a person, the virus has a way into the person's body. It's possible to get rabies from an animal scratch, too. People sometimes describe animals that have rabies as "foaming at the mouth." This happens because the animal's nerves no longer work properly and it can't swallow its own saliva.

What Should You Do If You're Bitten?
If an animal ever bites or scratches you, tell an adult exactly what happened and ask the adult to help you take these steps to protect yourself:

• Wash the wound with soap and water for 10 minutes.
• Call your doctor or the hospital emergency department.
• Give a description of the animal that bit you to your local animal control office so they can try to find the animal and test it for rabies. Your mom or dad can help you do this.

What Will the Doctor Do?
If someone goes to the doctor for an animal bite, the doctor will want to know:

• What kind of animal bit you?
• How did the animal act? (Rabid animals may look and act strangely.)
• How do you feel now?

If a rabid animal bites someone, the disease will not develop right away. That's because there's an incubation period (say: in-kyuh-bay-shun) with rabies. That means there's a period of time between getting bitten and experiencing symptoms of rabies. With rabies, the incubation period may be a few days to several weeks or even a lot longer.

But doctors don't wait around when it comes to rabies. If there's a chance the person was bitten by a rabid animal, the doctor can give the person several shots to prevent the disease. Every year, about 40,000 people in the United States get these injections as a precaution. Shots are never fun, but they're much better than getting a deadly disease.

Protect Yourself From Rabies
The best way to protect yourself from getting infected with rabies is to never approach any stray or wild animals. Don't feed them or touch them, even if they look cute and friendly. A rabid animal may sometimes look tired or sick or even very angry. That's a sure sign to stay away!

Another important step is to have your pets vaccinated (say: vak-suh-nay-ted) by your veterinarian. The vet will give them shots so they can't catch rabies or give it to you or any other people or animals. Because of these vaccinations, almost no domesticated pets have rabies.

Also, keep outdoor trash cans carefully sealed, so they don't attract raccoons and other wild animals known to carry rabies. By closing your trash can, you'll be shutting the lid on rabies, too!

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Flu

Influenza (say: in-floo-en-zah) is also called the flu. It's an infection that causes fever, chills, cough, body aches, headaches, and sometimes earaches or sinus problems. The flu is caused by the influenza virus (say: vy-rus). A virus is a microorganism (say: my-croh-or-gah-nih-zum), which means it's so small that you can't see it without a strong microscope.

For most people, the flu is a drag, but it goes away in a week or two. But for some people, the flu can make them very sick. Those groups include:

• babies and kids under age 5
• people older than 50
• adults and kids who have health problems, such as diabetes and asthma

Anyone who's at risk of getting really sick needs to get a flu shot, or vaccine (say: vak-seen). People such as doctors and nurses also need the shot because they take care of sick people. It’s good for kids who are around older people and younger kids (like little brothers and sisters) to get the vaccine too.

Healthy kids and adults can also get a flu shot, so they are less likely to get the flu. Flu vaccines are usually given in the fall, before flu season starts. Flu season means the months of the year when a lot of people have the flu and it's easy to catch it. It starts in November and usually ends in April.

Getting the Flu Vaccine

If you get the flu vaccine, or shot, it will protect you from getting a bad case of the flu. You either won't get the flu at all or, if you do get it, you will have only mild symptoms and you should get better pretty quickly. Like other shots, a flu shot is given using a needle. There's also a nasal mist flu vaccine, which is a spray that's squirted up your nose.

Whichever one you get, you need to get a new vaccine every year. Why? Because the flu virus changes every year and the vaccine is specially created to fight the viruses that are going to be a problem that year.

How Does the Flu Spread?

This virus gets around in little drops that spray out of an infected person's mouth and nose when he or she sneezes, coughs, or even laughs. You can catch the flu from someone who has it if you breathe in some of those tiny flu-infected drops. You can also catch the flu if those drops get on your hands and you touch your mouth or nose. No wonder people are always saying to cover your mouth when you sneeze!

What If You Get the Flu?

But even if you steer clear of sneezers and you wash your hands regularly, you still might get the flu. At the doctor's office, the doctor will ask you how you've been feeling and examine you. He or she might use a long cotton swab to get a sample of the gunk in your nose or throat. Testing this sample in a lab can determine, for sure, that you have the flu. But usually this isn't necessary. Based on your symptoms, your doctor can usually tell if you have the flu, especially during times when a lot of flu is going around your town.

Once your doctor says you have the flu, you can start taking these steps to feel better:

• Rest in bed or on the couch.
• Drink lots of liquids, like water, chicken broth, and other fluids.
• Take the medicine your mom or dad gives you to ease your fever, aches, and pains.
• Tell your mom or dad if you have trouble breathing, your muscles really hurt, or if you feel confused. These are signs you may need to see the doctor again.

Most of the time, you'll feel better in a week or two. Until then, you'll have to stay home from school and take it easy. We hope you're flu-free this year, but if you do get the flu, now you know what to do!

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Hair Loss

Every day, you lose about 50 to 100 hairs. You've seen them. They swirl down the drain in the tub or get stuck on the back of your sweater. Or, worst of all, one might get in your mouth. Gross.

Normally, when hair falls out, new hairs start forming in the same place as the old ones. But when someone has hair loss, the hairs don't grow back. Or they do grow, but there aren't enough of them to take the place of what's already fallen out. This often happens to men, who start to go bald as they get older.

But anyone can have hair loss, even kids. The medical name for hair loss is alopecia (say: ah-luh-pee-shuh).

The Hair-y Story

Every hair on your head is made of keratin (say: kair-uh-tin), the same protein that makes up your nails. Hairs grow from follicles (say: fah-lih-kulz), which are very tiny holes deep in your skin. Each follicle contains a hair root, the part of the hair that is alive and growing. The part of the hair you can see, the part above the skin, is dead. (That's why it doesn't hurt to get a haircut!)

This part is called the hair shaft, and it's the part of your hair that can get long. Most kids' hair grows about half an inch (2 centimeters) a month. About 85 out of 100 hairs on your head are growing (the anagen phase) at any time. When a hair is done growing it goes into its resting (telogen) phase and eventually falls out. Usually, 15 out of 100 hairs on your head are in the resting phase.

What Causes Hair Loss?

Men, especially older men, are the ones who are most likely to lose their hair. This kind of hair loss is called androgenetic (say: an-dro-jeh-neh-tik) alopecia, also known as male-pattern baldness. It's the most common type of hair loss and it doesn't affect kids. This type of baldness runs in families and happens when people get older.

So why do some kids lose their hair? A kid's hair may fall out if he or she uses harsh chemicals to dye, bleach, straighten, or perm their hair. Even drying hair with very high heat can hurt it and cause it to fall out. Too-tight braids, ponytails, and barrettes can also make hair hit the road. Hair also can be lost if a person combs or brushes the hair too hard, especially when it's wet.

Here are some other causes of hair loss:

• Telogen effluvium (say: teh-luh-jen eh-flu-vee-um). This means that more hairs than usual are in the resting phase and fall out more easily. As a result, you lose more hair than usual. You might notice more hair on your brush or a big clump of hair in the drain after you shower. A fever, stress, or surgery can cause this change in your hair. The good news is that you are not going bald and your hair will be back to normal within 6 months.
• Ringworm. Kids who have a fungus called ringworm on their scalp might lose their hair. This infection causes the hairs to break close to the scalp.
• Alopecia areata (say: ar-ee-at-uh). In this condition, round patches of hair completely fall out. No one knows exactly what causes alopecia areata, but it looks like the body's own immune system attacks the hair follicles. It also runs in some families. In 95 out of 100 cases of alopecia areata, the hair grows back completely.
• Trichotillomania (say: trik-oh-til-oh-may-nee-uh). This is the fancy name for the habit of pulling and twisting your own hair. Some kids may pull their hair because they are stressed out or anxious about something. Hair will grow back when it's not being pulled, but some kids find it hard to stop. For these kids, the doctor can recommend treatment.
• Hormone problems. If your thyroid gland isn't working right, it can also cause hair loss. (The thyroid gland sits in the front of the lower neck and makes important hormones that keep the body healthy.) Severe problems with nutrition also can result in unhealthy hair that falls out or breaks easily.
• Cancer treatment. Most people think about cancer when they see a kid who is bald. Cancer does not cause hair to fall out, but the powerful drugs and treatments used to kill cancer cells (chemotherapy and radiation) kill the cells that make hair grow, too. A kid getting chemotherapy may lose a lot of hair quickly, but the hair will grow back when the treatment is stopped.

What Will the Doctor Do?

If you think you're having some hair loss, talk with your doctor. Your doctor might look at a few strands of your hair under a microscope. This will give the doctor a better look at what's going on to help decide what to do next.

For a fungal infection (ringworm), the doctor will probably prescribe some medicine to treat it. Or if you are taking a medication that can cause hair loss, the doctor might stop it or prescribe something different. If the doctor thinks that an illness is causing the hair loss, you might need more tests.

Coping With Hair Loss

In some cases, it can take a while for hair to grow back on its own - especially if a kid has alopecia areata or is getting chemotherapy. Being bald can be upsetting and scary. Some kids wear wigs or hair extensions while they wait for their own hair to return. Others feel more comfortable just wearing a baseball cap, bandanna, or scarf.

It's always tough to be different, especially in a way that's easy for people to notice. Friends and classmates can make all the difference to someone who's dealing with hair loss. They can tease the person and make him or her feel even worse. Or they can support the person, be kind, and remember that a person is more than just his or her hair.

Some kids have really gone the extra mile for a friend who had hair loss due to cancer treatment. How? They decided to shave their heads, too, so their friend wouldn't be the only one. What a bald and beautiful thing to do!

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