Bedwetting

Things that are cool to talk about with friends:

• your new computer games
• going to the movies
• what to do this weekend

Things that you probably don't talk about with friends:

• how you cry when you watch the movie Barbie
• the day you accidentally wore your underwear inside out
• how you wet the bed when you sleep

Millions of kids and teenagers from every part of the world wet the bed every single night. It's so common that there are probably other kids in your class who do it. Most kids don't tell their friends, so it's easy to feel kind of alone, like you might be the only one on the whole planet who wets the bed. But you are not alone.

The fancy name for bedwetting, or sleep wetting, is nocturnal (nighttime) enuresis (say: en-yoo-ree-sus). Enuresis runs in families. This means that if you urinate, or pee, while you are asleep, there's a good chance that a close relative also did it when he or she was a kid. Just like you may have inherited your mom's blue eyes or your uncle's long legs, you probably inherited bedwetting, too.

The most important thing to remember is that no one wets the bed on purpose. It doesn't mean that you're lazy or a slob. It's something you can't help doing. For some reason, kids who wet the bed are not able to feel that their bladders are full and don't wake up to pee in the toilet. Sometimes a kid who wets the bed will have a realistic dream that he or she is in the bathroom peeing - only to wake up later and discover he or she is all wet.

Many kids who wet the bed are very deep sleepers. Do your parents complain that it's hard to wake you up? Could you sleep through a marching band parading outside your bedroom door? Or a pack of dogs howling at the moon? Trying to wake up someone who wets the bed is often like trying to wake a log - they just stay asleep.

Some kids who wet the bed do it every single night. Others wet some nights and are dry on others. A lot of kids say that they seem to be drier when they sleep at a friend's or a relative's house. That's because kids who are anxious about wetting the bed may not sleep much or only very lightly. So the brain may be thinking, "Hey, you! Don't wet someone else's bed!" This can help you stay dry even if you're not aware of it.

Good News

The good news is that almost all kids who wet the bed eventually stop. So if you wet every night, don't be discouraged. And don't worry that you're not normal, either physically or emotionally. Sleep wetting is not usually caused by a problem with your body or your feelings.

It's likely that bedwetting will go away on its own. In fact, 15 out of 100 kids who wet the bed will stop every year without any treatment at all. But if you have this problem it's still a good idea for you and your parents to talk to your doctor about it.

Your doctor will ask you some questions, and it's important to answer them truthfully and not feel embarrassed. Remember, bedwetting is so common that your doctor probably treats a lot of kids who do it. The doctor will examine you and probably ask for a urine sample to test. Some kids who have other problems, like constipation (when you aren't pooping regularly), daytime wetting, or urinary infections, may need some extra tests.

More Good News

If you wet the bed, there are some things you can do to stay dry. Try not to drink anything after dinner and remember to go to the bathroom before going to bed. If you do wet the bed, help with the cleanup by pulling off the sheets and putting them in the laundry.

A lot of doctors think that the best treatment for enuresis is a program that retrains your brain to do one of two things:

1. wake you up so you can go to the bathroom
2. stay asleep and hold it until morning

This program includes doing bladder exercises, such as waiting a little longer to pee during the day, reading about and imagining staying dry, or even using a tiny alarm. The alarm is connected to a pad placed in your underwear at night. If you start to urinate, the pad senses the moisture and sets off the alarm. Different alarms buzz, vibrate, or do both, but they're all easy to use and can help wake even the deepest sleeper.

There are medicines that can help kids who wet the bed, including a nose spray or tablet that you take before going to bed. This may temporarily help you out, but it really isn't a cure. Medicines to treat enuresis work best when combined with the alarm or other training programs.

It may take some practice to retrain your brain, and you'll need to be patient. But eventually, you will stop wetting the bed.

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Blood

You know what blood is — it’s that red stuff that oozes out if you get a paper cut. The average person has about 1 to 1-½ gallons (4-6 liters) of it. But what is blood, really, and where does it come from?

How Does the Body Make Blood?

It’s not made in a kitchen, but blood has ingredients, just like a recipe. To make blood, your body needs to mix:

• red blood cells, which carry oxygen throughout the body
• white blood cells, which fight infections
• platelets, which are cells that help you stop bleeding if you get a cut
• plasma, a yellowish liquid that carries nutrients, hormones, and proteins throughout the body

Your body doesn’t go to the store to buy those ingredients. It makes them. Bone marrow — that goopy stuff inside your bones — makes the red blood cells, the white blood cells, and the platelets. Plasma is mostly water, which is absorbed from the intestines from what you drink and eat, with the liver supplying important proteins.

Put all these ingredients together and you have blood — an essential part of the circulatory system. Thanks to your heart (which pumps blood) and your blood vessels (which carry it), blood travels throughout your body from your head to your toes.

Let’s find out more about each ingredient.

Red Blood Cells

Red blood cells (also called erythrocytes, say: ih-rith-ruh-sytes) look like flattened basketballs. Most of the cells in the blood are red blood cells. They carry around an important chemical called hemoglobin (say: hee-muh-glow-bin) that gives blood its red color.

Blood and breathing go hand in hand. How? The hemoglobin in blood delivers oxygen, which you get from the air you breathe, to all parts of your body. Without oxygen, your body couldn’t keep working and stay alive.

White Blood Cells

White blood cells (also called leukocytes, say: loo-kuh-sytes) are bigger than red blood cells. There are usually not a whole lot of white blood cells floating around in your blood when you’re healthy. Once you get sick, though, your body makes some more to protect you.

There are a couple types of white blood cells that do different things to keep you well:

Granulocytes

You know how your skin gets a little red and swollen around a cut or scrape? That means the granulocytes are doing their jobs. They have a lot to do with how your body cleans things up and helps wounds heal after an injury. Granulocytes also help prevent infection by surrounding and destroying things that aren’t supposed to be in your body and by killing germs.

Lymphocytes

There are two types of lymphocytes, B cells and T cells. B cells help make special proteins called antibodies that recognize stuff that shouldn’t be in your body, like bacteria or a virus you get from a sick friend. Antibodies are very specific, and can recognize only a certain type of germ. Once the antibody finds it, it gets rid of the germ so it can’t hurt you.

The really cool part is that even after you are better, B cells can become memory cells that remember how to make the special antibody so that if the same germ infects you again, it can kill the germ even faster! T cells also battle germs that invade the body, but instead of making antibodies, they work by making special chemicals that help fight the infection.

Monocytes

Monocytes are white blood cells that fight infection by surrounding and destroying bacteria and viruses.

Platelets

Platelets, also called thrombocytes (say: throm-buh-sytes) are tiny round cells that help to make sure you don’t bleed too much once you get a cut or scrape. Cuts and scrapes break blood vessels. If a platelet reaches a blood vessel that’s been broken open, it sends out a chemical signal that makes other nearby platelets start to stick together inside the vessel.

After the platelets form this plug, they send out more chemical signals that attract clotting factors. These clotting factors work together to make a web of tiny protein threads. The platelets and this web of protein come together to make a blood clot. The clot keeps your blood inside the vessel while the break in the blood vessel heals up. Without platelets, you’d need more than a bandage to catch the blood when you scrape your knee!

Plasma

Plasma is a yellowish liquid that is mostly water. But it also carries important nutrients, hormones, and proteins throughout the body. Nutrients are chemicals from the food you eat that give your body energy and other things your body’s cells need to do their work and keep you healthy.

Hormones carry messages throughout your body, telling it what to do and when. An example of a hormone is growth hormone. It gets your bones and muscles to grow. Many proteins in plasma are really important to your body, like the clotting factors that help you stop bleeding if you get a cut or a scrape.

Plasma also carries away cell waste — chemicals that the cell doesn’t want anymore. Nutrients, hormones, proteins, and waste are dissolved in the plasma — kind of like the cocoa mix that dissolves in a cup of hot water. What are the marshmallows? The blood cells — they float in the plasma.

Hey, What’s Your Type?

Everybody’s blood is red, but it’s not all the same. There are eight blood types, described using the letters A, B, and O. Those letters stand for certain proteins found on the red blood cells. Not everyone has the same proteins.

In addition to getting a letter or two, a person’s blood is either "positive" or "negative." That doesn’t mean one person’s blood is good and another person’s blood is bad. It’s a way of keeping track of whether someone’s blood has a certain protein called Rh protein. This protein is called "Rh" because scientists found it while studying Rhesus monkeys. If your blood is positive, you have this protein. If it’s negative, you don’t. Either way is totally fine.

People have one of these eight different blood types:

1. A negative
2. A positive
3. B negative
4. B positive
5. O negative
6. O positive
7. AB negative
8. AB positive

Blood types are important if a person ever wants to donate blood or needs a blood transfusion. Getting blood of the wrong type can make a person sick. That’s why hospitals and blood banks are very careful with donated blood and make sure the person gets the right type.

Someone might need a blood transfusion when they’re sick or if they lose blood. Without enough healthy blood, the body won’t get the oxygen and energy it needs. Healthy blood also protects you from germs and other invaders.

Now that you know how important blood is, what can you do? Kids generally aren’t allowed to donate blood, but when you’re older consider giving the gift of life!

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Anemia

To understand anemia (say: uh-nee-mee-uh), it helps to know a little bit about breathing. Have you ever tried to hold your breath? At first, you feel fine. After a short time, though, you need to take a breath. That's because when we breathe, our lungs take in oxygen (say: ahk-sih-jun) from the air. We need oxygen to live.

We also need a way to get the oxygen from the lungs to the rest of the body. Blood flows like a river through every part of the body. The blood carries the oxygen, but the oxygen needs something to hang on to. It needs a boat - and the boats that carry oxygen are red blood cells.

Red blood cells are made inside the bones in the soft, spongy area called the bone marrow (say: mar-o). So every time you take a breath, you breathe in oxygen. And your red blood cells carry oxygen to every cell in your body.

What Is Anemia?

Anemia occurs when a person doesn't have the normal amount of red blood cells or if the person is low on hemoglobin. What's hemoglobin (say: hee-muh-glow-bin)? Hemoglobin, a protein, is an important part of red blood cells because it gives the oxygen something to stick to.

A kid who has anemia may not know it because he or she may not have any symptoms. Looking pale can be a sign of anemia because there is less blood flowing through the blood vessels in the skin. A fast heartbeat can be another sign of anemia, because when you don't have as many red blood cells, the heart has to work harder to get the same amount of blood and oxygen to the body. If anemia worsens, a kid who was once very active may become worn out quickly. He or she may feel weak or tired.

Why Do Kids Get Anemia?

The bone marrow in a person's body makes new red blood cells to replace the old ones that die off after about 120 days. A person may get anemia if:

• not enough red blood cells are made
• too many red blood cells are destroyed
• too many red blood cells are lost (bleeding)

Not enough being made: There are several reasons why a person might not make enough red blood cells, but often it's because the person isn't getting enough iron. Iron is a nutrient found in meat, dried beans, and green leafy vegetables. Without iron, the body can't make hemoglobin, the oxygen-carrying part of a red blood cell.

Besides iron, your body needs the vitamins B12 and folic acid to make red blood cells. You get these vitamins in the foods you eat. Vitamin B12 is found in animal products, so vegetarians who don't eat meat, eggs, or dairy products have to look for other ways to get enough of this important vitamin. Folic acid is found in a variety of foods, such as citrus fruits, green vegetables, and fortified cereals.

Anemia also can develop if the bone marrow is not working properly. This may be because of an infection or a chronic illness, such as arthritis or kidney disease. In rare cases, someone might be born without the ability to make enough red blood cells.

Too many being destroyed: If the life of a red blood cell is cut short for any reason, the bone marrow may not be able to keep up with the increased demand for new ones. One reason red blood cells get destroyed is because their shape changes. If you looked at red blood cells through a microscope, you would see that they are round and flattened. That's a good shape for moving through tight spaces as blood circulates around the body.

If the shape changes, as is the case in sickle cell anemia, the red blood cells get stuck and are destroyed. Sickle cells are curved like crescent moons. This shape makes it hard for them to move throughout the body. Sickle cell anemia is one of several genetic conditions that can affect the life span of red blood cells. Certain medications, infections, and chronic diseases also may cause this type of anemia.

Too much lost: When you lose a little blood, like when you cut yourself or have a nosebleed, your bone marrow is able to make more blood so you don't develop anemia. But if you lose a lot of blood, which may happen in a serious accident, your bone marrow may not be able to replace the red blood cells quickly enough.

If someone loses a little blood over a long period of time, it can also lead to anemia. This can happen in girls who have heavy menstrual periods, especially if they don't get enough iron in their diets, or in people who have inflammatory bowel disease.

What Do Doctors Do?

When you see the doctor, he or she will examine you and ask questions about how you have been feeling, what you eat, and if you are taking any medicines. If a doctor thinks a kid has anemia, he or she can order a simple blood test called a hematocrit (say: hih-mah-tuh-krut).

The blood sample then can be studied in the laboratory where the number of red blood cells can be counted, the amount of hemoglobin can be measured, and the size and shape of the cells can be examined. A doctor may order additional tests, depending on what he or she suspects is the problem.

How Is Anemia Treated?

The treatment of anemia depends on the cause. In kids, the most common cause of anemia is not getting enough iron in their diets. Some kids may need to take medicine containing iron to help their bodies make more red blood cells. It is also important to eat more foods that are rich in iron, like meat, enriched grains and cereals, dried beans, and tofu.

If the anemia is caused by an infection, usually the anemia will go away when the infection is treated and the body gets healthy again. For some other types of anemia, the kid may need to see a specialist and have additional tests before treatment can start.

Whatever the cause, a person with severe anemia may need a blood transfusion. A transfusion means that donated blood, which is stored at a place called a blood bank, is given through tube in a vein. This may sound a little scary, but millions of kids and adults have blood transfusions every year. Except for inserting the tube, they don't hurt. And getting a blood transfusion is the fastest way to get blood to deliver oxygen to all the cells in the body.

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Smoking Can Causes Asthma

Smoking is bad news for everyone, but especially for kids who have asthma. Smoking causes coughing and wheezing and makes it hard to breathe - the same problems that happen during an asthma flare-up. So if you add smoke to lungs that are already irritated, you have big-time breathing trouble.

If people have asthma and they smoke, they will probably:

• have more asthma flare-ups, including coughing and wheezing
• need more asthma medicine because it won't work as well
• visit the doctor and emergency room more often
• miss fun stuff they want to do because of asthma flare-ups

Why Do People Smoke?

You might wonder why people smoke at all. Many people start smoking when they are kids or teens and they try it for many reasons. Maybe all of their friends were doing it or they grew up in a house where all the grown-ups smoked.

But no matter why they started, many smokers wish they could quit. Smoking doesn't just cause problems for people who have asthma. Over time, smoking can lead to serious health problems, such as cancer and heart disease.

Quitting smoking is hard, though, because the tobacco (say: tuh-bah-ko) in cigarettes, pipes, and cigars contains a substance called nicotine (say: nih-kuh-teen). Nicotine is addictive (say: uh-dik-tiv). When something is addictive, your body and mind will tell you that you need it to feel OK. If you don't get it, you might feel sick, stressed out, or crabby.

Don't Breathe Secondhand Smoke

We hope you're not smoking! But even if you don't smoke, tobacco smoke can still cause you problems. How? If you're around other people who smoke, just breathing that secondhand smoke can cause an asthma flare-up. You can ask to sit in the no-smoking section at restaurants and other places, such as ballparks. But that might not be enough to protect you from nearby smoke.

If a friend or family member smokes around you, let him or her know that it makes your asthma worse. Ask the person not to smoke in your house or car. This can really help with your asthma symptoms. If you can't get the person to stop smoking around you, talk with your mom, dad, or another trusted adult, such as a school counselor.

Even if you try your best, you still might find yourself in a smoky situation. That's why you should always have your rescue medication with you!

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Bedbug bite

What a Bedbug Is

A bedbug is a small (about the size of a pencil eraser), flat, reddish-brown bug that can be found in homes all over the world. It hides during the day and comes out during the night to look for blood. A bedbug has a special ingredient in its saliva (spit) that keeps blood from clotting while it's eating.

What a Bedbug Bite Looks and Feels Like

If a person gets bitten by a bedbug, the bite will feel itchy. Bedbug bites look like little red bumps (similar to mosquito bites) and they can sometimes occur in a line on the body.

What You Should Do

If you think you've been bitten by a bedbug, wash the bites with soap and water. Put on some calamine lotion to help with the itching. An adult can find an anti-itch cream at the drugstore for you. Try not to scratch the bites too much because this can make them become infected.

What a Doctor Will Do

If you get an infection from scratching bedbug bites, a doctor will need to prescribe medication to clear up the infection.

How to Avoid Getting Bitten

The best way to avoid getting bitten by bedbugs is to keep your room uncluttered so bedbugs won't have places to hide. Changing your sheets once a week and vacuuming the floor often are also important things to do. If you think you have bedbugs, ask an adult about the best way to get rid of the bugs.

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Osteoporosis

"Drink your milk!" Why do grown-ups say this? One big reason is that milk contains calcium, an important ingredient in building strong bones. And if you start out with strong bones when you're a kid, those bones will serve you well your whole life.

You want bones that are dense, which means they're strong all the way through. Why? Because as people age, bones naturally become less dense. In other words, everyone's going to lose some bone density as he or she ages, so you want to start out with as much as possible. Your big chance to build bones is when you're young. The process is pretty much over by the time you're 19.

If someone has osteoporosis (say: oss-tee-oh-puh-ro-sis), the person's bones are now weakened because of this loss of bone density. Weak bones can break easier and the person may have other problems such as a stooped-over posture. Maybe you've seen an older woman who's a little hunched over. Older people — especially women, who are generally smaller and have bones that are lighter and less dense — are more likely to develop osteoporosis.

Types of Osteoporosis

The most common cause of osteoporosis is age. The older you get, the more bone loss you are likely to have, especially if you don't take in enough calcium.

Osteoporosis also can be caused by diseases or other factors, such as:

• hormone problems
• poor diet
• certain medications
• too much smoking or drinking

Signs and Symptoms

Many people don't realize they have osteoporosis until they fracture a bone. There are usually no other symptoms — although some older people may notice they are getting slightly shorter or have a hunched-over posture. Older people with osteoporosis are especially at risk of breaking a hip if they fall down.

What Does the Doctor Do?

If the doctor suspects osteoporosis, he or she will talk to the person and do an examination. The doctor will order X-rays of the patient's bones as well as a bone density test.

Once the doctor is sure of osteoporosis, he or she will treat the patient to prevent more bone loss. Usually, someone with osteoporosis is placed on medications that help slow down bone loss and is also advised to take calcium supplements.

Diet and exercise are important parts of osteoporosis treatment. People need a variety of healthy, calcium-rich foods and regular exercise, such as walking or running, to strengthen bones. Weight training or special exercises may be recommended. The person also will need to be careful to avoid falls, so avoiding icy sidewalks and other hazards is a good idea.

Can Kids Get Osteoporosis?

Kids don't usually get osteoporosis, but they can do something to prevent it later in life.

• Eat a well-balanced diet, especially with foods rich in calcium (like milk, cheese, yogurt, green leafy vegetables, and citrus fruit).
• Be active. In other words, play a lot! Playing sports, running, jumping, dancing — whatever you like to do.
• Don't smoke.

Take these steps and your skeleton will thank you later!

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