| Bulimia nervosa | Bulimia nervosa | Bulimia nervosa | B | English | Psychiatry | Teen (13-18 years) | NA | NA | Conditions and diseases | Teen (13-18 years) | NA | | 2023-03-13T04:00:00Z | | | | | | 10.1000000000000 | 54.1000000000000 | 723.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Bulimia nervosa is an eating disorder where a person overeats and feels out of control, called binge eating, and does things to make up for overeating to prevent weight gain, called purging. Learn about the signs and symptoms, diagnosis and treatments.</p> | <h2>What is bulimia nervosa? </h2><p>Bulimia nervosa is an eating disorder where a person struggles with eating a larger amount of food than most people would eat over a short time, once a week or more for at least three months. A person with bulimia nervosa worries about gaining weight, feels shameful about the binge eating and will engage in unhealthy or dangerous purging behaviours (e.g., vomiting, taking pills, dieting to extremes or doing too much exercise) to prevent weight gain.</p><p>People with bulimia nervosa may be thin, average weight, or overweight. In addition to bingeing and purging, someone with bulimia nervosa feels unhappy about their appearance and wants to lose weight. People with bulimia nervosa may not seek help on their own because they may be embarrassed by or ashamed of their eating patterns. However, with treatment, they can often get better.</p> | | <h2>Key points</h2><ul><li>Bulimia nervosa is an eating disorder where a person has a distorted body image and a fear of gaining weight. </li><li>The disorder involves both binge eating (eating much more than most people would in a short period of time and feeling guilty or ashamed) and purging (self-induced vomiting, taking laxatives, diuretics, weight loss pills, fasting, or exercising) to try to prevent weight gain. </li><li>It is important to see a health-care provider if you experience episodes of binge eating or purging, or you think you might have bulimia nervosa or another eating disorder. </li></ul> | | <h2>What are the signs and symptoms of bulimia nervosa?</h2><p>Bulimia nervosa has a range of signs and symptoms. </p><div class="symptoms-container" id="symp-bulimia">
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<span class="card-title">Eating quickly or large amounts of food in a short time</span>
<p>A person with bulimia may eat faster than expected in an effort to eat a lot of food in a short time.</p></div>
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<span class="card-title">Eating when nobody is around</span>
<p>Binge eating has links with guilt and shame. If someone has bulimia, they might eat in the middle of the night or when no one else around and may hide food wrappers around the home.</p>
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<span class="card-title">Disappearing immediately after a meal</span>
<p>Someone with bulimia tends to purge or otherwise compensate for their eating. Purging can include vomiting or taking pills such as laxatives to affect how the body responds to food.</p>
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<span class="card-title">Becoming more irritable</span>
<p>Because their brains are starved of nutrients, a person with bulimia might not think clearly. They may become irritable and have emotional outbursts and sudden mood swings.</p>
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<span class="card-title">Puffy face</span>
<p>Because of their repeated purging, someone with bulimia may develop swollen parotid glands (just in front of their ears). When these glands are swollen, they can make cheeks look puffy.</p></div>
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<span class="card-title">Calloused knuckles</span>
<p>If someone with bulimia engages in regular purging, their knuckles can get calloused. This is from repeatedly putting their fingers down their throat to induce vomiting. </p>
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<span class="card-title">Dramatic changes in weight</span>
<p>Someone with bulimia often has average weight, but this can rise and fall quickly due to bingeing and purging cycles.</p>
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<span class="card-title">Broken blood vessels in eyes or face</span>
<p>Repeated attempts to vomit puts pressure on the small blood vessels in the face and eyes. When someone retches regularly over a short time, these small blood vessels can start to burst.</p>
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<span class="card-title">Dizziness, confusion and weakness</span>
<p>Inappropriate intake of nutrition and fluids, along with purging, may interfere with a person’s electrolyte levels and cause them to feel dizzy, confused or weak.<br></p>
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<span class="symp-subtitle">Common Signs</span></h3></div><h3>Physical signs of bulimia nervosa</h3><ul><li>can be of any body weight, shape or size </li><li>puffiness of the face, especially around the cheeks</li><li>callouses or marks on the knuckles</li><li>broken blood vessels around the eyes and face</li><li>bad breath because of vomiting</li><li>dizziness</li><li>vomiting blood</li><li>digestive problems</li><li>confusion, weakness or fatigue due changes in important electrolytes such as potassium or sodium</li><li>thinning hair</li><li>tooth decay</li><li>potentially dangerous and sometimes fatal changes in heart rate</li></ul><h3>Behavioural signs of bulimia nervosa</h3><ul><li>hide their binging and purging behaviors </li><li>skipping meals </li><li>weight fluctuations (increases and decreases) because of bingeing and purging </li><li>eating large amounts in a short time </li><li>eating quickly </li><li>hiding food wrappers around the house </li><li>eating in the middle of the night </li><li>disappearing to the bathroom after eating </li><li>not wanting to eat with others </li><li>becoming more irritable or having mood swings and outbursts </li><li>judge themselves based on their body weight </li></ul> | | | | <h2>What if I think I may have bulimia nervosa? </h2><p>
<strong>Tell someone</strong>. Tell a trusted adult such as a parent, caregiver, teacher, coach or therapist. Explain your concerns and ask for their help. </p><p>
<strong>Don’t feel alone</strong>. It can be hard to tell someone about your eating disorder thoughts and behaviors. You might be concerned about how they will react. However, it can help to have an open and honest conversation about your eating disorder with those you trust. It will help you feel less alone. </p><p>
<strong>Get help early</strong>. It is important for you to see your health-care provider as soon as possible. Your health-care provider can help to determine whether you have an eating disorder and can also assess how serious the situation is. The sooner a diagnosis is made, the quicker you can start treatment, and the better chance for recovery. </p><p>It’s important to see your health-care provider if you: </p><ul><li>are worried you might have bulimia nervosa or another eating disorder </li><li>have out-of-control eating episodes or binges </li><li>are purging by making yourself throw up after you eat or taking pills to alter how food affects your body </li></ul><p>It is especially important to see a health-care provider if you experience pain in your body, especially chest or stomach pain, or you begin to vomit blood. </p><h2>What will a health-care provider do during an assessment for bulimia nervosa? </h2><p>A health-care provider will do a complete history (medical, nutritional and psychosocial history) and a thorough physical examination including: </p><ul><li>measuring your weight and height (plotting measurement on a growth curve) </li><li>taking your lying and standing blood pressure and heart rate </li><li>taking your temperature </li><li>assessing your pubertal growth development </li></ul><p>They may also do some initial tests including blood and urine tests to check if there are abnormalities and an electrocardiogram to check how the heart is functioning. </p><h2>How is bulimia nervosa treated? </h2><p>If the health-care provider determines that a person has bulimia nervosa, they will arrange for appropriate care. Eating disorder care is usually done with multiple health-care professionals including pediatrician or adolescent medicine doctor or family doctor or nurse practitioner, nurses, dietitians, psychologists, psychiatrists, and social workers who specialize in treating children and teens with eating disorders. </p><p>The health-care provider will decide if the patient can be managed as an outpatient (outside the hospital), either in the health-care provider’s office, or in a specialized eating disorder program. </p><p>The first treatment recommended for young people is an outpatient treatment is called family-based treatment, which focuses on recovery of the eating disorder. Parents/caregivers play an essential role in the treatment and recovery of their child. Family-based treatment includes 3 treatment phases. </p><ul><li>Phase 1 focuses on weight restoration. Parents, supported by the therapist, take responsibility for making sure that the adolescent is eating sufficiently and also takes on all meal planning and preparation. </li><li>Phase 2 is when substantial weight recovery has occurred and the adolescent gradually assumes responsibility for their own eating. </li><li>Phase 3 is when weight is restored and the focus is on general issues of adolescent development. </li></ul><p>If the health-care provider finds that the patient is too sick for outpatient treatment, they may refer the patient for urgent hospitalization. </p><p>The goals of treatment are to: </p><ul><li>ensure that the adolescent is medically safe </li><li>achieve a weight that guarantees healthy growth and development </li><li>stop the cycles of bingeing and purging </li><li>work on having all types of food in moderation, including foods the adolescent may have binged on </li><li>help manage any emotions about eating, including any worries about weight </li></ul><p>If you are experiencing depression or anxiety in addition to bulimia nervosa, your health-care team may suggest other treatments for those mental health disorders once the eating disorder is under control. </p><p>Sometimes your health-care team may also suggest medication. Antidepressants can help with depression or anxiety and can sometimes also help with urges to binge or purge. </p><p>Full recovery from bulimia nervosa is possible. It is important to remember that an early diagnosis and treatment and an early response to treatment may be associated with better outcomes. </p> | | | | | | | | | | | | | | | | | | | | <p>SickKids has an eating disorder program that treats children and teens who are struggling with symptoms of anorexia nervosa, bulimia nervosa and avoidant restrictive food intake disorder. For more information on our program visit:
<a href="https://www.sickkids.ca/en/care-services/clinical-departments/adolescent-medicine/">www.sickkids.ca/en/care-services/clinical-departments/adolescent-medicine/</a></p> | <p>
<a href="http://www.nedic.ca/">NEDIC – National Eating Disorder Information Centre</a> (Canada)</p><p>
<a href="https://www.nationaleatingdisorders.org/">NEDA – National Eating Disorder Association</a> (United States)</p><p>
<a href="https://www.beateatingdisorders.org.uk/">B-EAT – Beating Eating Disorders</a> (United Kingdom)</p><p>
<a href="https://keltyeatingdisorders.ca/">Kelty Eating Disorders</a> (Kelty Mental Health Resource Centre, BC Children's Hospital)</p><p>
<a href="https://anad.org/">ANAD - National Association of Anorexia Nervosa and Associated Disorders</a> (United States) </p> | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Bulimia-Interactive.png | | Learn about the common behavioural and physical signs and symptoms of bulimia nervosa with this interactive click through. | Teens | | |
| Physical activity and mental health: Types of physical activity | Physical activity and mental health: Types of physical activity | Physical activity and mental health: Types of physical activity | P | English | Prevention | Teen (13-18 years) | NA | NA | Healthy living and prevention | Teen (13-18 years) | NA | https://assets.aboutkidshealth.ca/AKHAssets/Wellbeing-Interactive.png | 2019-03-22T04:00:00Z | | | | | | 9.00000000000000 | 56.4000000000000 | 468.000000000000 | | Flat Content | Health A-Z | <p>Find out how much physical activity you need every day and how you can add more exercise into your daily routine.</p> | <h2>How much physical activity do I need? </h2><p>Guidelines from the Canadian Society for Exercise Physiology (CSEP) divide a 24-hour day into four segments.</p><ul><li>Sweat</li><li>Step</li><li>Sleep</li><li>Sit</li></ul><p>For teens, it recommends:</p><ul><li>Sweat: At least 60 minutes (1 hour) of moderate-to-vigorous intensity physical activity every day. Vigorous intensity and bone and muscle strengthening activity at least three days a week.</li><li>Step: Several hours of structured and unstructured light intensity activities such as playing, walking to or from school, doing chores.</li><li><a href="https://teens.aboutkidshealth.ca/Article?contentid=3632&language=English">Sleep</a>: 8 to 10 hours of uninterrupted sleep.</li><li>Sit: No more than 2 hours of recreational <a href="https://teens.aboutkidshealth.ca/Article?contentid=3775&language=English">screen time</a> a day.<br></li></ul> | | | <h2>How can I tell if my activities are moderate or vigorous intensity?</h2><p>Vigorous-intensity activities make you sweat and feel "out of breath", leaving you able to speak only a few words between breaths. Examples include dancing, running, biking or swimming at a fast pace.</p><p>Moderate-intensity activities also make you sweat and breathe a little harder, but you can still talk while you move. Examples include rollerblading, bike-riding and moderate level yoga.</p><h2>What types of activities will strengthen my muscles and bones?</h2><p>Activities that strengthen muscles and bones force the body to bear weight. They include hiking, playing tennis or basketball or doing weight training with body weight or hand-held weights.</p><p>Cycling and swimming are good for building muscles and improving heart health, but they are not as effective as other activities for building strong bones. This is because the bones are not required to bear as much weight while the body is in a seated position or in water.</p><h2>I’m not very physically active. How do I start?</h2><p>If you don’t have a routine, spend time finding something you enjoy doing and take gradual steps from there. Getting outside, going for a swim or walking, running or bike riding with friends or family are all great ways to start.</p><p>The most important thing is to choose an activity that fits your interests. If you prefer doing physical activity on your own, consider running, biking or swimming. If you enjoy being part of a group while you’re active, then team-based sports like basketball or soccer might be a better option. </p><p>Also consider if you can access the activity pretty easily. Uniforms, equipment, lessons and travel to and from training or competitions can make some activities expensive. To reduce some costs, think of some activities that might be available through your school or your city’s or town’s recreation centres. </p><h2>I’m already physically active. Do I need to get some activity every single day?</h2><p>Even if you play an organized sport a few times a week, it’s a good idea to move on your off days as well. Think about walking or cycling to a friend’s house or going for a swim.<br></p>
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<iframe src="https://teens.aboutkidshealth.ca/Style%20Library/AKH/animations/AKH%20Excercise%20Quiz/quiz.html"></iframe> </div> | | | | | | | | | | | | | | | | | | | | | | | | | | <h3>Centre for Addiction and Mental Health (CAMH) –
<a href="http://www.camh.ca/">camh.ca</a></h3><p>CAMH is a mental health and addiction teaching and research hospital that provides a wide range of clinical care services for patients of all ages and families.</p><p>
<a href="https://youtu.be/qMnQFTy3t30">Mood Matters: How Food, Movement & Sleep Can Have an Impact on You</a></p> | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/types_of_physical_activity.jpg | What type of exercise is right for you? | Take this quiz to find out what type of exercise or activity is right for you based on your exercise preferences. | Teens | | |
| Consent and capacity in health care | Consent and capacity in health care | Consent and capacity in health care | C | English | Adolescent | Teen (13-18 years) | NA | NA | Healthy living and prevention | Teen (13-18 years) | NA | https://assets.aboutkidshealth.ca/AKHAssets/Consenr-Interactive.png | 2021-11-10T05:00:00Z | | | | | | 10.1000000000000 | 55.1000000000000 | 1071.00000000000 | | Flat Content | Health A-Z | <p>Discover the difference between consent and capacity, and learn how health-care providers determine that you are capable of making your own health-care decisions.</p> | <h2>Making your own decisions</h2><p>
<em>Consent</em> and
<em>capacity</em> are two concepts that relate to your ability to make decisions. When you are young, your parents or caregivers make most of the decisions for you. In general, as you get older, you are able to make more decisions by yourself. You can always ask your parents/caregivers for help or advice on making health-care decisions, regardless of your age. Some of the most important decisions that you make can involve giving permission to other people.</p><p>There are specific rules around two of the most important types of decisions that can be made: decisions related to health and decisions related to being sexually active.</p> | | <h2>Key points</h2><ul><li>Consent means giving permission for something to happen, or agreeing that someone will do something for you on your behalf.</li><li>Capacity is your ability to make a decision for yourself.</li><li>To be able to make your own decisions about your health, your health-care provider needs to know that you are <em>capable</em> to make those decisions.</li><li>You are considered capable when you demonstrate that you understand the information about the decision you are going to make and can appreciate the consequences of that decision.</li><li>If you are not capable of making your own health-care decision, a substitute decision maker will make the decision on your behalf.</li></ul> | <h2>What are consent and capacity?</h2><p>
<strong>Consent</strong> means giving permission for something to happen, or agreeing that someone will do something for you on your behalf. You give consent for different things every day. For example, if you make a new friend and decide to share your phone number, you are giving them consent or permission to contact you. Another example is when you install a new app on your phone; it may ask you for your consent or permission to know your location.</p><p>
<strong>Capacity</strong> relates to your ability to make decisions. When you are a baby, you do not have very much capacity, that is, you cannot make many decisions for yourself. As you get older and become more mature, you have the capacity to make more and more decisions for yourself. Your capacity to make some decisions is often related to your age. For example, you have to be 18 years old in order to vote in an election. However, your capacity is also determined by how much you understand. For example, you have to be 16 years old in Ontario before you are able to write your driver’s test, but you cannot obtain your full licence until you have passed two driving tests.<br></p><p></p><div class="asset-video">
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<h2>Making decisions about your health</h2><p>The decisions you make about your health and health care are very important. They are so important that they are governed by a set of laws. To be able to make your own decisions about your health, your health-care provider (doctor, nurse, physiotherapist, etc.) needs to know that you are
<em>capable</em> to make those decisions. In health care,
<em>capacity</em> has a special definition with two parts:</p><ol><li>
<em>Understanding:</em> your health-care provider needs to know that you understand the information about the decision you are going to make.</li><li>
<em>Appreciation:</em> your health-care provider needs to know that you appreciate what the decision and the consequences of the decision mean to you as a person.</li></ol><p>Let’s use an example of having an ear infection caused by bacteria. Your doctor may recommend that you take antibiotics to treat the infection. To make sure that you are
<em>capable</em> of making the decision to take antibiotics to treat the infection, your doctor has to confirm that you
<em>understand</em> that ear infections may not go away on their own; ear infections can be cured with antibiotics; if the ear infection is not treated, it may cause hearing loss; and the treatment the doctor recommends, antibiotics, may have side effects. The doctor will also have to make sure that you
<em>appreciate</em> what this decision means for you and your life. If you choose to take the antibiotics, you
<em>appreciate</em> that you want the infection to be cured so you do not lose your hearing. You also
<em>appreciate</em> that, while you may not like the side effects of antibiotics, it is still better for you to take the medicine to get rid of the infection than to refuse treatment.</p><p>In the province of Ontario, unlike driving and voting, there is no minimum age to consent to medical treatment. Every person, regardless of their age, is assumed to be
<em>capable</em> to make decisions about their health unless a health-care provider determines they are not capable.
<em>Capacity</em> is not a “blanket concept,” meaning just because you are capable of making one decision, does not mean you are always capable of making every decision. When you are younger, you may be capable of making some small-scale decisions, but you may still need help from your parents/caregivers to make more important decisions.</p><h2>What happens if I am not capable of making a decision about my health?</h2><p>Sometimes, it is obvious when a person is not capable of making a decision about their health. For example, it is obvious that babies cannot make their own decisions about their health. Another example is if you are in an accident and unconscious; it is clear you cannot make decisions when you are unconscious. In those situations, a substitute decision maker will make decisions on your behalf. For children and teens, their parents/caregivers are most often their
<em>substitute decision makers</em>. Substitute decision makers are required, by law, to make the best decision for you, which means they must make the decision that is in your
<em>best interests</em>.</p><p>There are other situations where it is not so clear if a person is capable of making their own health decisions. This might be because the person is suffering from a physical or mental illness, or they are a young teen who is still maturing. For very important decisions, health-care providers may do a
<em>capacity assessment</em> to ensure you are capable of making the health-care decision. The capacity assessment must be performed by the health-care provider who is suggesting the treatment, such as your doctor, nurse, or therapist.</p></div> | | | | | | | | | | | | | | | | | | | | | | | | | | <p>Relevant laws for Ontario can be found at
<a href="http://www.ontario.ca/">www.ontario.ca</a>:</p><ul><li>
<a href="https://www.ontario.ca/laws/statute/96h02">Health Care Consent Act (1996)</a></li><li>
<a href="https://www.ontario.ca/laws/statute/90m07">Mental Health Act (1990)</a></li><li>
<a href="https://www.ontario.ca/laws/statute/04p03">Personal Health Information Protection Act (2004)</a></li><li>
<a href="https://www.ontario.ca/laws/statute/92s30">Substitute Decisions Act (1992)</a></li><li>
<a href="https://www.ontario.ca/laws/statute/90h08">Highway Traffic Act (1990)</a></li><li>
<a href="https://www.ontario.ca/laws/statute/17c14">Child, Youth, Family Services Act (2017)</a></li></ul> | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Consent_and_capacity_in_health_care.jpg | | Watch this video to learn about the importance of consent, capacity and confidentiality in health care and what your rights are as a patient. | Teens | https://youtu.be/ceguD3F4tmA | |
| Celiac disease: eLearning modules | Celiac disease: eLearning modules | Celiac disease: eLearning modules | C | English | Adolescent;Gastrointestinal;Nutrition | Pre-teen (9-12 years);Teen (13-18 years) | Small Intestine;Stomach | Digestive system | Conditions and diseases | Pre-teen (9-12 years)
Teen (13-18 years) | Abdominal pain;Pain | https://assets.aboutkidshealth.ca/AKHAssets/Celiac-Disease-and-Type1-Diabetes-Module.jpg | 2021-05-03T04:00:00Z | | | | | | | | | | Flat Content | Health A-Z | <p>Celiac disease is a lifelong condition. These eLearning modules will help you learn about the symptoms of celiac disease, how celiac disease is diagnosed, how it is treated and how gluten affects people with celiac disease. Also learn about special considerations for people who have both celiac disease and type 1 diabetes.</p> | <p>Celiac disease is an autoimmune disease that can affect people of all ages anywhere in the world. The first two interactive modules below will teach you what celiac disease is, how it is diagnosed and managed, and how gluten affects people with celiac disease. The next two modules are intended for those who have both celiac disease and type 1 diabetes (T1D).</p><p>To get started, click the "<strong>play</strong>" button on the module below. The module will open in a new browser window.</p> | | <h2>Key points</h2><ul><li>Celiac disease is a lifelong condition that must be carefully managed through a strict gluten-free diet.</li><li>People with type 1 diabetes have a greater chance of developing celiac disease than the general population.</li><li>Press the play button and then click through each of the interactive modules to learn about celiac disease, the gluten-free diet and special considerations for those with celiac and type 1 diabetes.</li></ul> | <h2>Celiac disease</h2><p>In this module, you will learn:</p><ul><li>About the symptoms of celiac disease</li><li>How celiac disease is diagnosed</li><li>How celiac disease is treated</li><li>How gluten affects people with celiac disease</li></ul>
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<h2>The gluten-free diet</h2><p>In this module, you will learn:</p><ul><li>How to start the gluten-free diet</li><li>Which foods are allowed, not allowed and need to be questioned</li><li>How to read ingredient labels</li><li>All about cross-contamination</li></ul>
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<h2>Celiac disease and type 1 diabetes</h2><p>In this module, you will learn:</p><ul><li>About the symptoms of celiac disease</li><li>How celiac disease is diagnosed</li><li>About the connection between celiac disease and type 1 diabetes (T1D)</li><li>How celiac disease is treated</li><li>How gluten affects people with celiac disease</li></ul>
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<img src="https://assets.aboutkidshealth.ca/AKHAssets/Celiac-Disease-and-Type1-Diabetes-Module.jpg" alt="open celiac module" /></figure></a>
<h2>Celiac disease, type 1 diabetes and the gluten-free diet</h2><p>In this module, you will learn:</p><ul><li>How to start the gluten-free diet</li><li>Which foods are allowed, not allowed and need to be questioned</li><li>How to read ingredient labels</li><li>All about cross-contamination</li><li>Special considerations for celiac disease and type 1 diabetes</li>
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<a href="https://www.aboutkidshealth.ca/Style%20Library/akh/animation/Diabetes%20-%20CD%20T1D%20Module%202%20-%20Gluten-free%20diet%20-%20Storyline%20output/story.html" target="_blank">
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<img src="https://assets.aboutkidshealth.ca/AKHAssets/Celiac-Disease-and-Type1-Diabetes-and-the-Gluten-Free-Diet-Module.jpg" alt="open celiac module" /></figure></a> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | celiacdiseaseonlinelearning | celiacdiseaseonlinelearning | | Celiac disease and the gluten-free diet | This e-learning module will teach you about the symptoms of celiac disease, diagnosis, treatment and how gluten affects people with celiac disease. | Teens | https://www.aboutkidshealth.ca/Style%20Library/akh/animation/Module%201%20-%20Celiac%20Disease%20%20-%20Storyline%20output/story.html?hub=celiacdisease | |
| Hemophilia: Understanding inhibitors | Hemophilia: Understanding inhibitors | Hemophilia: Understanding inhibitors | H | English | Haematology | Child (0-12 years);Teen (13-18 years) | NA | Arteries;Veins | Conditions and diseases | Teen (13-18 years) | NA | https://assets.aboutkidshealth.ca/AKHAssets/Hemophilia-Interactive.png | 2019-03-13T04:00:00Z | | | | | | 8.80000000000000 | 58.4000000000000 | 810.000000000000 | | Flat Content | Health A-Z | <p>Teens living with hemophilia can learn about inhibitors, what they are and how they affect treatment.</p> | <p>Trying to wrap your head around inhibitors and how they work may seem tricky. But inhibitors can be an easy concept to grasp, especially if you’re a football fan. Click on the animation to learn how inhibitors affect hemophilia treatment and how different types of therapy can help.</p> | | | <h2>How inhibitors work</h2><p>Let’s use a football game to understand what happens inside your bloodstream when you treat a bleed. During a game, the goal is to try to get the football past defense and into the ‘end zone’ – the area at the other end of the field. Think of the football as factor; the football field is your bloodstream; and the end zone is the location of your bleed. During a football game, the defensive players try to prevent the football from getting into the end zone. Think of these defensive players as inhibitors. As you will learn, inhibitors can vary in strength. </p><p>A football team without a defense is just like a person with hemophilia who does not have any inhibitors. It is easy for factor to get into the end zone and stop the bleed because there are no defenders to “inhibit” the play.</p><p>Some inhibitors do not completely prevent factor from working. They just slow down factor, so that it is less effective. These are called low-titre inhibitors. This is similar to having only one defense player on the field. Sometimes these low-titre inhibitors resolve over time. If bleeding occurs, a person with a low-titre inhibitor may need more factor than usual to treat a bleed.</p><p>As more defensive players move into the field, it is going to be even harder to get the football into the end zone. This is similar to developing a strong inhibitor, which tackles factor, preventing it from reaching the bleeding joint. Stronger inhibitors are called high-titre inhibitors. In this case, doctors will have to adjust the treatment plan. The strongest inhibitors are the most difficult ones to treat. Increases in factor dosing may not work.</p>
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<p class="sr-only">This is a click-through animation of the concept described above. The animation is supplemental and repeats information from the body text.</p>
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<h2>Bypassing agents</h2><p>One option to get around the strong inhibitor defense is to use special factors called bypassing agents. These agents can avoid the high-titre inhibitors completely, much like a lateral pass in football that is thrown over and past the defense players. Bypassing agents are an effective strategy to treat people with inhibitors.</p><h2>Immune tolerance therapy (ITT)</h2><p>If you develop a high-titre inhibitor, doctors may put you on a treatment plan called immune tolerance therapy or ITT. </p><p>In ITT, doctors give you strategic doses of the product that you are missing. By giving you doses of factor at regular intervals over the course of several months or years, your body gets used to it. ITT helps your body build a ‘tolerance’ to product; it trains the body to recognize factor without reacting to it. The goal of ITT is to stop your body from making “defense players", thus resolving the inhibitors.</p><p>ITT is usually effective: studies show that ITT works about 80% of the time. Some people with hemophilia who have inhibitors may be on ITT for six months; others may be on it for up to two years or longer. </p><p>Once your body develops a good tolerance to the product, you still need to follow the advice of your comprehensive care team (CCT). In rare cases, the inhibitor can come back. </p><h2>Diagnosing inhibitors</h2><p>To determine the presence and amount of inhibitors in your blood, doctors need to run a blood test. If we think back to the football analogy, the test is like the Football Scouting Combine. In the Scouting Combine, university or college football players perform various mental and physical tests so scouts can determine their level of fitness. For a person with hemophilia, doctors will look for the number of inhibitors (defense players) and check to see how strong these inhibitors are. </p><p>The testing helps doctors distinguish between low and high-titre inhibitors. If the number ends up being high then your team knows that they are up against a high-titre inhibitor; low counts are low-titre inhibitors. Depending on which one it is, your CCT will come up with different “plays” to get your factor into scoring range and hopefully the end zone.</p><h2>Living with an inhibitor</h2><p>About 30% of people living with severe hemophilia will have inhibitors to factor. Living with an inhibitor is a very different story today than it used to be. A lot of research in hemophilia is focused on making products and treatment safer for you to use. Treating inhibitors with the bypassing agents and immune tolerance therapy (ITT) are now readily available even for home care. These treatment options are effective and can give you a similar quality of life to a person who has severe hemophilia without inhibitors.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | <h2>References<br></h2><p>Hemophilia Federation of America. <em>Inhibitors</em>. Retrieved from <a href="https://www.hemophiliafed.org/understanding-bleeding-disorders/complications/inhibitors/">https://www.hemophiliafed.org/understanding-bleeding-disorders/complications/inhibitors/</a>.</p> | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/hemophilia_understanding_inhibitors.jpg | Understanding inhibitors | Inhibitors are a type of immune complication that some people with hemophilia may develop. This interactive shows you how inhibitors work. | Teens | | |
| How does chemotherapy work? | How does chemotherapy work? | How does chemotherapy work? | H | English | Oncology | Pre-teen (9-12 years);Teen (13-15 years);Late Teen (16-18 years) | Body | NA | Drug treatment | Pre-teen (9-12 years)
Teen (13-15 years)
Late Teen (16-18 years) | NA | https://assets.aboutkidshealth.ca/AKHAssets/Chemo-Interactive.png | 2019-09-03T04:00:00Z | | | | | | 12.2000000000000 | 33.6000000000000 | 328.000000000000 | | Flat Content | Health A-Z | <p>Chemotherapy works by damaging cells as they are dividing. Find out how chemotherapy reaches the cancer cells, why there are so many different chemotherapy medications and what 'protocol' means in terms of treatment.</p> | <h2>How does chemotherapy work?</h2><p>Cells reproduce by dividing so that one cell becomes two, and then two cells become four, and then eight, and so on. Normal cells only reproduce when our bodies need new cells, for example to allow us to grow or replace cells that die. </p><p></p><div class="asset-animation">
<iframe src="https://teens.aboutkidshealth.ca/Style%20Library/AKH/animations/TTCCancer_Chemotherapy_CanvasVersion/TTC_Cancer_Chemotherapy_Canvas_AMD_EN.html"></iframe> </div><p>Some chemotherapy drugs work by damaging cells as they are dividing and reproducing. Cancer cells behave differently than normal cells and often divide more frequently. This means they are sensitive to the chemotherapy drugs that interfere with cell division or reproduction. Although chemotherapy can damage normal or healthy cells too, non-cancerous cells are usually able to repair themselves. </p> | | <h2>Key points</h2><ul><li>Cells reproduce by dividing when our body needs to make new cells.</li><li>Some chemotherapy drugs work by damaging cells as they are dividing.</li><li>Chemotherapy medications travel through the blood to reach different parts of the body.</li><li>Different chemotherapy medications work in different ways. The type of chemotherapy given will depend on the type of cancer.</li></ul> | <h2>How does chemotherapy reach the cancer cells?</h2><p>Chemotherapy medications travel through blood and can usually reach most of the different parts of the body. The blood carries the medication to the site of the cancer and to any cancer cells that have spread to other parts of the body. </p><h2>Why are there so many different chemotherapy drugs?</h2><p>Each chemotherapy drug damages cancer cells in a different way. For example, one chemotherapy drug might damage different parts of the cells than another one does, or it might damage the cells at different points in the process of dividing. This is why different chemotherapy drugs are used to treat different types of cancer. It is also why treatment might involve more than one type of medication. </p><p>You might sometimes hear your health-care team talk about a chemotherapy "protocol". This is a chemotherapy treatment plan designed to treat your type of cancer. You will learn a lot more about your chemotherapy when you start your protocol. The
<a href="/Article?contentid=3470&language=English">assent forms</a> contain information about how the medication works and any side effects you may expect. </p><h2>Useful resources</h2><p>AboutKidsHealth -
<a href="https://www.aboutkidshealth.ca/Article?contentid=999&language=English" target="_blank">Chemotherapy at home: Safely handling and giving medications</a> </p><p>Canadian Cancer Society -
<a href="http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/chemotherapy-and-other-drug-therapies/chemotherapy/?region=on" target="_blank">Chemotherapy</a></p><p>American Cancer Society -
<a href="https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy.html" target="_blank">Chemo – What it is, How it helps </a></p><p>Cancer Research UK -
<a href="https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/chemotherapy/how-chemotherapy-works" target="_blank">How chemotherapy works</a></p><p>Macmillan Cancer Support (from the United Kingdom) -
<a href="https://www.macmillan.org.uk/information-and-support/treating/chemotherapy/chemotherapy-explained" target="_blank">Chemotherapy explained</a></p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Learn how chemotherapy works with this click-through animation that shows how chemotherapy affects cells in the body. | Teens | | |
| Sleep and your mental health: Overview | Sleep and your mental health: Overview | Sleep and your mental health: Overview | S | English | Adolescent;Psychiatry | Teen (13-18 years) | NA | NA | Healthy living and prevention | Teen (13-18 years) | NA | | 2019-01-04T05:00:00Z | | | | | | 7.80000000000000 | 70.9000000000000 | 499.000000000000 | | Flat Content | Health A-Z | <p>Sleep is a very important part of your mental and physical health. Find out how a good night's sleep impacts your daily routine.</p> | <h2>Why is sleep important?</h2><p>Sleep is a very important part of your mental and physical health. When you consistently get a good night’s sleep, you can think more clearly, have more energy, are more patient and are better able to get along with others. According to the National Sleep Foundation in the US, teens should get eight to 10 hours sleep a night.</p> | | | <h2>What are the signs and symptoms of lack of sleep?</h2><p>Over time, not getting enough quality sleep each night can lead to a range of symptoms.</p><h3>Physical symptoms</h3><p>You might find it difficult to wake up in the morning or need someone to wake you repeatedly. During the day, you might feel drowsy, want to nap or even fall asleep at school or at home when doing homework. You might also want to consume stimulants, such as caffeine or sugary food and drinks, regularly.</p><h3>Cognitive (mental) symptoms</h3><p>Ongoing lack of sleep can make you lose interest and motivation for everyday tasks. It can also make you forgetful and make it harder for you learn and remember new information and to problem-solve.</p><h3>Emotional symptoms</h3><p>When you don’t get enough sleep, you’ll likely be moody and irritable during the day. You might also feel impulsive or more stressed, as your mind isn’t rested enough to cope with the demands of everyday life.</p><p>When you do not get enough sleep each night, you owe your mind and body a “sleep debt”. A large sleep debt (not getting enough sleep for many nights in a row) can make you feel mentally exhausted. It can also worsen the symptoms of any anxiety, depression or bipolar disorder and any chronic (long-term) pain. You cannot repay a sleep debt by simply sleeping in late one day a week.<br></p><h2>Thinking differently about sleep</h2><p>Your circadian rhythm (your “body clock”) is a 24-hour cycle that tells your body when to sleep. During your teen years, it is normal for your body clock to make you fall asleep later at night and wake up later in the day.</p><p>Because of this, you might be in the habit of going to bed late, especially if you spend time with friends then (in person or online).
<a href="https://teens.aboutkidshealth.ca/Article?contentid=3633&language=English">Choosing sleep over social time</a> might make you feel like you’re missing out, but your brain and body will thank you for it.</p><p>If you hear your friends talking about their "all nighters", remember how good you feel after you get enough sleep. Staying up late to study will usually leave you too tired to concentrate the next day. Sleep allows your brain to process and reinforce what you have learned, something that is especially important after studying for a test.</p><p>Remember too that you can’t repay a sleep debt with anything other than sleep. If you’re sleep-deprived, the best thing you can do is get some good quality sleep as soon as you can. Don’t resort to supplements or energy drinks to get you through energy dips. No pills, vitamins or drinks can replace good sleep!</p><h2>Guided meditations</h2><p>The following guided meditations will help you relax. Try listening to them before you go to sleep.</p><div class="call-out"><div class="asset-video vid-small">
<iframe src="https://www.youtube.com/embed/EL_fvAepwv8?rel=0" frameborder="0"></iframe><span class="vid-title">Equal </span><span class="vid-title">breathing</span><span class="vid-type">audio</span><span class="vid-type"></span> </div><p>
<strong>How to use: </strong>This audio meditation helps you balance your in-breath and your out-breath. Use this meditation when you’d like to refocus or bring yourself back to the present moment. Follow along with the meditation to match your in-breath to your out-breath and slowly increase the length of each. If you feel out of breath or dizzy during this meditation, pause and breathe comfortably until you feel better.</p></div><div class="call-out"><div class="asset-video vid-small">
<iframe src="https://www.youtube.com/embed/Jqu3SOEKtvE?rel=0" frameborder="0"></iframe><span class="vid-title">Progressive muscle relaxation with </span><span class="vid-title">tension</span><span class="vid-type">audio</span><span class="vid-type"></span> </div><p>
<strong>How to use: </strong>Stress and pain can cause tension in different parts of your body. This audio meditation will guide you through tensing and relaxing different parts of your body. You can listen to this meditation before going to sleep to help your muscles relax. </p></div><div class="call-out"><div class="asset-video vid-small">
<iframe src="https://www.youtube.com/embed/4ilNITE3-fE?rel=0" frameborder="0"></iframe><span class="vid-title">Relaxation with </span><span class="vid-title">imagery</span><span class="vid-type">audio</span><span class="vid-type"></span> </div><p>
<strong>How to use: </strong>This audio meditation can help you if you are experiencing muscle soreness, tension or stress. Use this when you need to relax or find a moment of calm throughout your day. You can practice relaxation with imagery throughout your day.</p></div> | | | | | | | | | | | | | | | | | | | | | | | | | | <h3>Kids Help Phone –
<a href="https://kidshelpphone.ca/">kidshelpphone.ca</a></h3><p>Kids Help Phone is a 24/7 e-mental health service offering free, confidential support to young people.</p><p>
<a href="https://kidshelpphone.ca/get-info/sleep-diary/">Sleep Diary</a></p><p>
<a href="https://kidshelpphone.ca/get-info/all-night-get-better-sleep-these-tips/">Up all night? Get a better sleep with these tips.</a></p><h3>Centre for Addiction and Mental Health (CAMH) –
<a href="http://www.camh.ca/">camh.ca</a></h3><p>CAMH is a mental health and addiction teaching and research hospital that provides a wide range of clinical care services for patients of all ages and families.</p><p>
<a href="https://youtu.be/qMnQFTy3t30">Mood Matters: How Food, Movement & Sleep Can Have an Impact on You</a></p> | | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/iCanCopeSCD/how_much_sleep_are_you_getting_SCD_J4T.jpg | Sleep and your mental health | Sleep is a very important part of your mental and physical health. Check out the guided meditations on this page to help you fall asleep. | Teens | | |
