Lifestyles
Tuesday August 21, 2018

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  • For the Children: History…

    By Oklahoma Institute for Child Advocacy CEO Joe Dorman

    As we at the Oklahoma Institute for Child Advocacy (OICA)…

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  • Free Breakfast and Lunch…

    Howe Public Schools is participating in a free breakfast and/or lunch program for the 2018-2019 school year.

    By…

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  • EOMC offers Telemed services…

    Eastern Oklahoma Medical Center is proud to offer Telemedicine to students, faculty & staff of both Howe and Poteau…

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  • Decorating Wisely: All about…

    By Glenda Wise

    I hope you have enjoyed Grayson’s columns the last few weeks. By the time you are reading this, she…

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  • Teen Drivers Can Pledge to…

    Press release

    OKLAHOMA CITY – As students head back to school this month, the Oklahoma Insurance Department (OID) is…

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  • Decorating Wisely : Movin on…

    By Grayson Wise

    Hello, my dear readers, it’s Grayson! We are talking about my dorm again since I have less than a week…

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  • World Breastfeeding Week…

    Press release

    The Oklahoma State Department of Health (OSDH) is promoting World Breastfeeding Week Aug.1-7 with the…

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  • Decorating Wisely: PASTA

    By Grayson Wise

    Bonjour... again! I’m becoming quite the frequent guest writer, aren’t I? This week I wanted to…

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  • Application Information and…

    Press release

    As required by SQ 788, the Oklahoma Medical Marijuana Authority has posted application information and…

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  • New Rule Protects 23K…

    Press release

    OKLAHOMA CITY - Oklahoma public housing residents will be protected from the dangers of secondhand…

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  • EOMC opens Walk In Clinic

    Press release

    When you have a medical issue, the last thing you need is a long wait at the doctor’s office or emergency…

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  • Dorm Sweet Dorm

    By Grayson Wise

    Bonjour, it’s me, Grayson! I’ve been given the honor of writing my mom’s article again, so let’s hope I…

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  • Software Vendor Selected for…

    Press release

    The Oklahoma Medical Marijuana Authority (OMMA), with assistance from the Office of Management and…

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  • For the Children: Reducing…

    By Oklahoma Institute for Child Advocacy CEO Joe Dorman

    With the upcoming task force formed by Senate Bill 1517, I am…

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  • Cornflake Cookies

    These easy no-bake cookies are the perfect combination of creamy, sweet peanut butter and crunchy cereal.

    Ingredients1…

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Health & Wellness
Monday, 03 August 2015 11:19

It's Now Or Never

Pervasive Parenting

 

This week I want to talk about something a little different. While it's not necessarily parenting advice, I feel it's important for those of us with family members on the spectrum.

 


A recent article I read talked about the price of caring for Americans with autism. The data presented by the Center for Disease Control stated that the cost this year alone will be a conservative $268 billion.

 


In the next 10 years that number is projected to reach $461 billion, according to findings published online in the Journal of Autism and Developmental Disorders. This is due in part by the rising number people diagnosed with autism.

 


I understand that the budgets are very tight, and are becoming tighter all the time. However, I want to encourage legislators to put whatever they can into something I feel could help in the long run. Before I say this I would like to preface it with a warning. I'm not a politician. I don't pretend to know the way that the world of civics work beyond a basic high school class.

 


That being said, I feel that as much as possible should be put into helping with early intervention and assisting with community inclusion. That is, we should help families get the services they need in therapies, special education, transition skills, and insurance assistance. If we can help children when they are younger to receive the assistance they need to live a better life, to become productive in society, and eventually give back by having a job, paying taxes and helping others, then we can save funding in the long run to assistive living costs, caregiver costs, and long term Medicaid and other medical funding.

 


We have families, especially in the rural areas, that need assistance with finding resources and obtaining the tools they will need to have an impact on society; to be productive.

 


Due to high divorce rates in families coping with disabilities, we have many single mothers, and fathers, raising children with little help financially. Many have to sacrifice their personal lives and even their careers in order to help care for their children.

 


We also have families like mine where both parents work full time and make just enough money to be out of reach for any assistance with the many therapies necessary to help our children.

 


We need better assistance for these families to help with divorce rates, insurance, respite care, and child care.

 


This doesn't mean that I think other areas should suffer. We still need research and other assistance, I just feel if we concentrate on these areas it will help relieve the long-term funding.

 


We can either pay now to help them become productive, or pay to assist them for the rest of their lives.


People today know the importance of breastfeeding. While most new mothers start out breastfeeding, many Oklahoma mothers are not able to exclusively breastfeed for six months nor continue for up to 2 years of age as recommended by the World Health Organization (WHO) and United Nations Children's Fund (UNICEF). One of the challenges they face is continuing to breastfeed after they return to work.


The Oklahoma State Department of Health (OSDH) is promoting World Breastfeeding Week, August 1-7, with the theme Breastfeeding and Work: Let's Make it Work. The goal is to empower and support all women, working in both the formal and informal sectors, to adequately combine work with child-rearing, particularly breastfeeding.


Data provided in the 2012 Pregnancy Risk Assessment Monitoring System (PRAMS) and The Oklahoma Toddler Survey (TOTS, 2013) compiled by OSDH indicates that 85.6 percent of Oklahoma mothers initiated breastfeeding. However, only 34.8 percent of Oklahoma mothers breastfed for six or more months. Oklahoma initiation rates have met the national benchmark of 81.9 percent of mothers breastfeeding as established by Healthy People 2020 (HP 2020). However, more improvement is needed to meet the HP 2020 goal for 60.6 percent of mothers to breastfeed for at least six months.


Major medical organizations such as the American Academy of Pediatrics and the American Association of Family Physicians recommend babies receive nothing but mother's milk during the first six months of life, and continue breastfeeding for at least the first year and beyond. Like any aspect of raising a child, breastfeeding requires the encouragement and support from a community of people. Support from hospitals, workplaces and family members go a long way in helping mothers and babies breastfeed for maximum benefit.


According to national and state surveys, mothers say breastfeeding is easier when they have support at home as well as at work. It is important that family members, clinicians, friends, co-workers and employers know how they can help make breastfeeding easier. Family members can help with household chores and other children, allowing the mother to have time to spend caring for her new baby. Employers can support mothers by being recognized as breastfeeding friendly worksites.


During World Breastfeeding Week, OSDH WIC clinics will be encouraging breastfeeding in Oklahoma by presenting award certificates to mothers who choose to breastfeed. Clinics may also hold receptions for breastfeeding mothers as well as display information that promotes the World Breastfeeding Week Theme.
OSDH and the Coalition of Oklahoma Breastfeeding Advocates (COBA) recognize worksites that meet the following criteria for becoming breastfeeding friendly:
· Flexible break times and a private location are provided for mothers to express milk.
· A water source is accessible for washing hands and breast pump equipment.
· A written breastfeeding policy.


For information about becoming a Breastfeeding Friendly Worksite, and a list of current recognized sites, visit the Oklahoma breastfeeding website at http://bis.health.ok.gov.


For breastfeeding support and information, call the Oklahoma Breastfeeding Hotline toll free at 1-877-271-MILK (6455).

Wednesday, 29 July 2015 16:57

Physical therapy helps injured Airmen

ANDERSEN AIR FORCE BASE, Guam -- At times the fast paced military lifestyle can take a toll on Airmen, and can lead to injuries affecting their ability to accomplish the mission.

 

Airmen assigned to the 36th Medical Operations Squadron Physical Therapy Clinic offer their assistance by helping patients recover from chronic or acute injuries so they can return to their duties as soon as possible.

 

"We focus on active duty members, especially acute patients, meaning those with a new onset of injury," said Maj. Michael Curtin, 36th MDOS Health Promotion Flight commander. "We are musculoskeletal specialists so we focus on the musculoskeletal side of rehab. Physical therapy in the Air Force is primarily manual therapy, so we do a lot of hands on."

 

A team of three Airmen treat an average of 36 patients a day for musculoskeletal pain and a variety of injuries. The most common injuries include knee and lower back pain.

 

There are different ways a patient can begin treatment at the clinic. They can visit their primary care provider to get a referral to see a physical therapist for an evaluation. Another option is to call the appointment line and be directed to the clinic. This is mainly for those with acute injuries, which are injuries that have happened in the past couple weeks. If there is space available, then the patient can see the physical therapist for an initial evaluation.

 

"Once they come in, I do an evaluation to diagnose their ailment and then try a treatment to fix some or all of it and then start them on a home exercise program," Curtin said. "It varies from there. Sometimes patients would do exercises with the technicians, or they would come back and see me for a couple treatments."

An initial evaluation is typically 40 minutes while follow-up sessions last 20 minutes with the physical therapist.

 

Once the physical therapist examines a patient and has a treatment program in place, the clinic technicians can provide treatment and help Airmen recover through numerous exercises to do at the clinic as well as at home.

 

"The duration of appointments varies depending on the injury," said Staff Sgt. David Pienta, 36th Medical Operations physical medicine technician. "I can treat multiple patients at a time. If I have someone on a table doing leg lifts, I can also have someone on another table doing hamstring curls. For the technician appointments, the sessions generally last 30 minutes, but some patients may need up to an hour."

 

The team utilizes a number of methods and equipment for treatment. This includes ultrasound units, cardio equipment, traction machines and slide boards. One of the most important tools is a motion analysis machine, which analyzes any kind of motion to decipher what might be wrong and find the cause of the problem. Curtin also offers dry needling, which is the use of acupuncture needles to find trigger points or knots in the muscles.

 

The Airmen in the clinic always seek ways to improve treatment options and offer programs that are of great service to our patients Curtin said.

 

Twice a month the clinic offers lower back and knee treatment programs, especially since it is a common injury. Also offered is a group aquatic class instructed by Curtin on Tuesday and Friday at the base pool. It is especially useful for post-operation patients who need a lower impact exercise.

 

While results are not always immediate, Pienta said observing steady improvement in their patients is a rewarding part of the job.

 

"Many people, especially the surgery patients, are down on themselves and think they won't get better," said Pienta. "Toward the end, when they see improvement and are able to move and run again, I can see how this makes them feel which brings me joy in what I do."

 

swim therapy

Maj. Michael Curtin, 36th Medical Operations Squadron Health Promotion Flight commander, instructs a group aquatic class July 7, 2015, at Andersen Air Force Base, Guam. The class is designed for post-operation patients who need a lower impact exercise. (U.S. Air Force photo by Airman 1st Class Arielle Vasquez/Released)

Tuesday, 28 July 2015 07:04

Ticks, mosquitoes and fleas, oh my...


A Service of Military Health System <This email address is being protected from spambots. You need JavaScript enabled to view it.>

 

Mosquitoes, ticks, fleas and numerous other pests form a family of creatures known as arthropods. They are with us year-round, and make themselves known in the hot months of the year, mainly June, July and August, when families, and especially children, stand the risk of being bitten.

 

"Exposure is a factor," said Maj. Chelsea B. Payne, a physician in the United States Air Force and a chief resident of the Preventative Medicine program at the Uniformed Services University of Health Sciences. "In the summer, people will go camping and spend more time outside, but insect-borne illnesses—including Lyme disease and bites from fleas and mosquitoes—are preventable."

 

"People don't necessarily take the right precautions every time they go outside," Payne explained. "Precautions include wearing protective clothing so the skin isn't exposed, using insect repellants and avoiding walking through wooded areas. If they are sleeping where there is not a screened-in area, or if they are letting a lot of habitat overrun their yards, that might bring in more insects. Finally, avoid allowing water to collect around the home, like in bird baths or on a pool cover. Standing water is a place where mosquitoes breed."

 

While insect-borne diseases differ depending upon the carrier, said Payne, mosquitoes, tick and fleas are among the most common pests known in the continental U.S., and are largely responsible for transmitting organisms to humans that can cause a range of mild symptoms or more severe illness.

 

"There are lots of interesting organisms that are transmitted around the U.S., some that we don't even necessarily think about," Payne said. "We still have cases [though few] of plague from the bacteria Yersinia Pestis, which is transmitted by the fleas of rodents.

 

People don't think about that—it is a very old organism."

 

Payne said homeowners want to avoid a flea infestation because fleas are difficult to get rid of, not to mention carriers of potentially serious infections to pets and humans. Applying topical solutions, seeing a veterinarian regularly and ensuring the cleanliness of kennels and pet boarding facilities in the event of travel are methods for keeping a home flea-free."I think people underestimate fleas, but you don't want to get them," she added.

 

Symptoms of an insect bite might include pain and swelling surrounding the affected area. If a person acquires Lyme disease, caused by organisms transmitted by the diminutive deer tick, he or she may develop a rash that looks like a "bull's-eye." Other symptoms of Lyme disease include headache, fever, chills, muscle aches and in severe cases, long-term illness. Confirmed cases of Lyme disease have been on the rise between 1995 and 2009, according to the Centers for Disease Control and Prevention (CDC).

 

Payne said getting bitten by a Lyme tick is more common in the summer months. According to CDC data, Lyme tick bites are most common in children under 10 and adults in their mid-40s, especially men. Safety precautions against ticks are much the same as those for mosquitoes, which transmit a variety of organisms, some more dangerous than others. Ticks are most common in the Northeast, but can be found in nearly every region of the continental United States. It is important to do a "tick check" on children since they are especially susceptible to bites. This check includes scanning arms and legs and looking through the hair and around the neck.

 

"If you ever find a tick, and certainly if you think it has been there for more than 36 hours, you would want to go in and be seen [by a medical professional]," advised Payne. "Most mosquitoes bite people for a meal and they can transmit an organism in the process. There isn't necessarily a vaccine against a lot of those illnesses, so most of the time prevention is essential, like using insect repellent sprays."

 

Payne said products containing the chemical DEET (diethyltoluamide) work well for people who plan to be outside for long periods of time. For those who prefer natural remedies, Payne said repellents containing lemon eucalyptus oil, which can last two to five hours, are a good option for adults and recommended by the Federal Drug Administration for children 3 years of age and older.

Monday, 27 July 2015 16:11

It's Getting Better All The Time

Pervasive Parenting

 

Sunday morning I woke up early, after several episodes with the snooze button, and along with the family, made the three-hour drive to Oklahoma City to celebrate the 25th Anniversary of the Americans with Disabilities Act (ADA). I'm extremely glad that I did. Besides the fact that I got to see many friends I also got to see the true spirit behind the ADA. That is the hard working advocates that make the ADA worthwhile.

 


Among the more than 100 volunteers and walkers there were family members, lawyers, social workers, friends, and self-advocates. These are the people that work tirelessly to make sure that themselves and others are protected by this act.

 


You see, this is nothing more than words on paper if we don't do our share to make sure that others are following the laws and rules set forth on that day 25 years ago when President George H.W. Bush signed it into law.

 


This has been a tremendous help to those of us coping with disabilities. It has given us some ground to stand on when trying to get equality in schools, work, and home. We have come a long way, but we still have a long way to go.

 


We still have employers who do not believe in giving a chance to those with disabilities. We have store owners and operators who don't feel they need to do what is right to accommodate those with disabilities. And, we still have educators and administrators who feel they don't need to make accommodations and changes for inclusion.

 


While this walk was as much a celebration of a great act put into place a quarter century ago, it is just as much a celebration of those who fight every day to make sure others are keeping up their end of things. The light keepers if you will of a beacon that started well over those 25 years ago.

 


It's also a reminder that we have more work to do, but as long as we have great people like those who organized and participated in this near triple-digit heat then I am satisfied that everything will continue to get better.


WASHINGTON, July 24, 2015 - The San Antonio Military Medical Center here ranks among the top hospitals in the nation for surgical care, according to a recent report from the American College of Surgeons.

 

SAMMC earned an exemplary or average rating in 180 different surgical quality variables, placing the facility in the upper half of hundreds of esteemed hospitals throughout the nation.


The report is issued by ACS' National Surgical Quality Improvement Program, or NSQIP, a voluntary program that gauges the quality of surgical programs across the nation. The aim is to help surgeons better understand their quality of care compared to similar hospitals with similar patients, according to the program's website.
"The largest and best hospitals in the U.S. are part of this program, and our percentages place us in the top half of those hospitals," said Air Force Col. Joseph Brennan, chief of SAMMC's Department of Surgery. "We are very proud of that."


Data Collection is Key
Data collection is key to the program's success, Brennan noted. At SAMMC, a surgeon oversees the program and two nurses are dedicated to inputting preoperative through 30-day postoperative data into a secure, web-based platform. ACS analyzes rates of mortality and morbidity, such as pneumonia, surgical site infections, urinary tract infections, sepsis and readmissions.


"Blinded" information is then shared with all participating hospitals, offering a snapshot of how hospitals rank according to surgical outcomes.
This data offers priceless insight, noted Army Maj. (Dr.) George Kallingal, surgeon champion for NSQIP at SAMMC.


"NSQIP foremost offers us an internal metric to ensure our surgical quality outcomes continue to progress at SAMMC and sets in motion the process of continual analysis and improvement," he said.


SAMMC's surgical outcome data has been increasingly positive over the past three years, Brennan noted, an uptick he attributes to SAMMC's care providers and infection control, quality and process improvement teams.


Improvements to Surgical Processes
"As a result of the data, we've made multiple improvements to our surgical processes," he said, citing efforts to improve operating room preparations and catheter use. "And our exceptional staff did a great job pushing initiatives focused on better patient care."


While NSQIP provided the framework for analysis, "the dedication of SAMMC personnel and their commitment to quality improvement is what fostered meaningful change," Kallingal said. "It will continue to be an important tool to provide the framework for improving surgical quality outcomes in the future."
The program is an easy sell at SAMMC, added Mariea Shelton, process improvement coordinator. The aim, she said, is to always strive for "great outcomes in surgical procedures."


With an eye on further improvements, Brennan hopes to add a third NSQIP surgical clinical reviewer soon to enable more data to be inputted and more feedback to be gained. "The more numbers we can track, the better off we'll be when it comes to gauging our strengths and weaknesses," he said.
While the program is voluntary, the Defense Department requires all military hospitals to participate in NSQIP. SAMMC has been a voluntary member of the program since 2009.


"Participation in NSQIP means there is a total commitment to deliver the highest quality surgical patient care," said Marilyn McFarland, a NSQIP surgical clinical reviewer.


Multiple Recent Successes
"Quality patient care is [the] priority here and it shows," added Laura Van Dyk, surgical clinical reviewer.


Brennan praised the hospital's exceptional care, citing recent successes on The Joint Commission reaccreditation survey, Level I trauma center reverification, and a Commission on Cancer silver designation for SAMMC's cancer program.


"Our focus has always been on providing the best patient care," the colonel said. "That emphasis has never wavered. This is just a great organization, from the leadership on down."

Sunday, 19 July 2015 21:53

Celebrate Good Times

 

My classmates and I just started talking today about our 20-year class reunion coming up next spring. That made me think about what a great group of friends I had in school.

 

I also started thinking about what a great group of people I work with now who are my friends, and what a great family I have. I wondered what it would be like if I didn't have those friends in high school. What would work be like if I didn't have those friends and coworkers, and what would life be like if I didn't see my family every day?

 


This also sparked me to think what life would be like for Konner if it weren't for his friends in school. He has such a great support system with his fellow classmates.
What will his life be like later when hopefully he gets a job?

 


What would life be like for any of us if he were placed in a home and we could only visit him?

 


These may seem strange, but a little over five years prior to my graduating high school an act was signed that helped make sure that the same life that has made me happy is readily available for my child on the spectrum.

 


There were many other things leading up to the Americans with Disabilities Act that was signed July 26, 1990. As we come upon the 25th anniversary on Sunday I would like to share a brief history.

 


The Americans with Disabilities Act (ADA) actually got its start in 1973 with section 504 of the Rehabilitation Act. However, it opened the door to many other great laws and regulations to help our children with special needs. One of these of course is the Individuals with Disabilities Education Act (IDEA), which states that my son, and others with disabilities, are entitled to a free and appropriate public education (FAPE) in the least restrictive environment (LRE).

 


This means that Konner can, and will, get a public education in a classroom with his peers. He will also have the opportunity to live in the world at his will, and have a job if he wants.

 


Now, it's a little more complicated than that, but honestly not much.

 


A walk to celebrate the 25th anniversary of ADA is planned for Sunday at the Capitol in Oklahoma City. This is a great way for families to show their appreciation for the freedoms and rights that the act has allowed for everyone coping with disabilities.

 


For more information contact Ellyn Hefner at 405-640-9408, or me at This email address is being protected from spambots. You need JavaScript enabled to view it..

Wednesday, 15 July 2015 17:24

West Nile Virus Information

From the Oklahoma Department of Health

 

 

CDD - MosquitoWest Nile virus (WNV) is a reportable disease in Oklahoma.

 

The first cases for 2015 have been confirmed in Ellis, Okfuskee, Oklahoma and McIntosh county residents.

 

There have been no deaths.

 

Persons are at greatest risk of exposure to infected mosquitoes from July through October in our state.

 

Persons of any age can become ill after being bitten by an infected mosquito, but those over the age of 50 are at greater risk of developing serious illness involving the nervous system. Over 80% of people infected with the virus never become ill.

 

If people do become ill, most cases are mild with symptoms such as a fever, headache, tiredness and body aches that go away on their own. Some people may develop a rash on the trunk of the body. In more severe cases, persons can develop meningitis or other neurologic disease.

 

 

The mosquito population boom that has resulted from the excessive recent rainfall does not foretell a more severe WNV season. It is helpful to know some key points about the differences in types of mosquitoes and the features of West Nile virus transmission:

 

The type of mosquitoes that hatch after severe flooding are primarily the species of mosquitoes classified as "nuisance mosquitoes". They bite aggressively and cause lots of itchy bites, but they are not typically involved with transmission of diseases.


Floodwater mosquito populations tend to die out 3 weeks after the rains stop and the sun dries out affected low lying areas.


Culex species of mosquitoes (see photo top right) are the primary vector of West Nile virus.

 

This type of mosquito increases in numbers during mid to late summer when the temperatures climb and the weather pattern is drier.


Since WNV was introduced into Oklahoma, there have been 3 outbreak years – 2003, 2007 and 2012. Each of these seasons were characterized by higher than normal summer temperatures and drought.

 

The Oklahoma State Department of Health advises use of insect repellents—particularly those containing DEET, picaridin, oil of lemon eucalyptus (PMD), or IR 3535—when enjoying outdoor activities like gardening, yard work, camping, or other leisure activities.

 

The type of mosquitoes that transmit WNV are most active during early morning and evening hours, so it is important to take mosquito bite precautions during that time of the day.

 

It is also recommended to drain or treat standing water around your home with a mosquito larvacide to reduce mosquito breeding sites.

Monday, 13 July 2015 21:22

Breakfast Can Wait

Pervasive Parenting


When I worked in the newspaper business we had what is known as the "breakfast test". With each article we wrote we had to ask if someone could read it while eating their breakfast.

 

If it was too disgusting we had to then ask if it was worth the risk of grossing out the reader. Well, this week's column probably does not pass that test, so I'm warning anyone with a week stomach to stop reading right now.

 

This is a subject that I think is very important though for families with someone on the autism spectrum.

 


We will now proceed to talk about bowel movements...you were warned.


This was sparked by an article that I read last week about a girl in England that died recently from a heart attack after months of chronic constipation. The girl, who had autism, was withholding stool. She, like many on the spectrum, did this because they she was reluctant to use the toilet.

 


For those wondering how she had a heart attack, the feces had become so impacted that it had compressed the chest cavity and caused displacement of other internal organs, according to the article.

 


So, how does it get to this point? Well, let me just say that we have had this issue with Konner. We monitor very closely what he does with his bathroom visits. However, if you didn't you probably wouldn't know much is wrong with the children. Depending on how verbal they are you most likely won't get much complaint from them.

 


We have to monitor Konner very closely because there are times he is sick and it's hard to tell if you don't know the signs.

 


That being said, the bowel movements are a catch 22 of sorts. They tend to not go to the bathroom for sensory issues. They either don't feel the sensations to have to go like most people do because of under sensitivity, or they have so much pain when they go that they don't want to go. When this happens the real problems begin.

 

They withhold stool so that they don't have to go and put themselves through the agony, but they are only causing more problems. The feces begins to backup into their bowels and causes it to impact and become so big that it causes huge pain when it does come out.

 


With Konner we have used prescription strength laxatives, suppositories, and enemas (I'm sure when he's older he's going to hate me for telling all this about him, but I think it's important). When he finally goes, as a man, I'm amazed at what comes out. I'm not going to go into detail for the sake of the breakfast test (I'm sure we've already crossed that like though).


I would recommend that you keep a close watch on their bathroom habits though. It can be much more of an issue than you would think. The young lady from England is a worst case scenario, but I could see how this would happen quickly.

 

Contact at physician quickly if you have any concerns, and if it seems to be a major issue a trip to the emergency room is not going overboard in my opinion.

 


I know this is not the most pleasant thing to talk about, and I apologize for anyone that I have completely grossed out, but it is something I think everyone should be aware of because it can have tragic results if not properly handled.

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