What Parents Need to Know About Dry Drowning

Dr. Christian Wright is an Assistant Professor of Pediatrics at the University of Maryland School of Medicine and specializes in pediatric emergency medicine at the University of Maryland Children’s Hospital. Below he answers everything parents need to know about “dry drowning.”

What is dry drowning?

“Dry drowning” is actually an outdated term. These days, research and health organizations prefer to simply define drowning as a process where being submerged or immersed in liquid leads to respiratory impairment—that is, difficulty breathing. Drowning can be fatal or nonfatal. Sometimes a person can develop difficulty breathing after they have left the water, sometimes even hours later, and sadly there have been cases when children have died of drowning hours after being exposed to water.

In the media, a distinction is often made between “dry drowning” and “secondary drowning.” Again, these are outdated terms, but they do attempt to explain two physiological processes that occur in drowning.

When water is inhaled, it causes a spasm of the airways which causes them to close, which makes it difficult to breathe. This usually happens right after the water has been inhaled, so the person could still be in the water or they could have just left it. In the past, it was thought that in this way a person could drown without water entering the lungs, so this was called “dry drowning.” In reality, though, water enters the lungs in almost every drowning death.

When water gets into the lungs, it interferes with our lungs’ ability to exchange oxygen and carbon dioxide, so oxygen levels in the body drop. Water also washes out surfactant, which is a substance in our lungs that prevents the small air sacs (alveoli) from collapsing when we exhale. This leads to pulmonary edema, or a buildup of fluid in the lungs, and difficulty breathing. A child could develop these symptoms up to 24 hours after exposure to water, and in rare cases this results in death. This has been referred to as “secondary drowning,” though it is really just the culmination of the drowning that started when the child was in the water.

How common is it?

“Secondary drowning” is rare, so there aren’t good statistics about how frequently it happens.

What are the symptoms?

Any time water enters our airway, our body has reflexes that kick in to clear the water. So a child could have coughing, gagging or difficulty breathing. Usually, this is sufficient to clear the airway. However, if water got into the lungs, the child could develop symptoms hours later. These include coughing, difficulty breathing, chest pain, vomiting, irritability or fatigue.

How does someone become a victim of dry drowning?

Any time water is inhaled, it could cause delayed symptoms. This could be after swimming or bathing or even after a short exposure to water like being dunked or the face being submerged in a puddle.

How’s it treated?

Drownings are treated by monitoring lung function and treating as necessary. A patient without symptoms may only need to be monitored. Patients with symptoms will need to have their lung functions monitored and supported. They might need supplemental oxygen, noninvasive forms of ventilation like CPAP, or a breathing tube may need to be placed. These patients will need to be monitored until their symptoms go away and their lungs are working normally again.

What’s the best way to prevent dry drowning?

The best way to prevent “dry drowning” is to exercise good water safety principles, including the following:

  • All children should be closely watched whenever they are are in or near water. Never leave children unattended near water.
  • Swim where there is a lifeguard, but don’t rely on the lifeguard alone to watch your child—continue to closely monitor your child.
  • Make sure pools are properly fenced and guarded. Fences should completely surround the pool area, be at least 4 feet tall, and gates should be self-closing and self-latching.
  • Teach teenagers the dangers of drinking alcohol while engaging in water activities.
  • Teach children to not roughhouse in the water
  • Enroll children in swimming lessons as early as possible
  • Have young or inexperienced swimmers wear U.S. Coast Guard-approved life jackets
  • Learn CPR

To learn more about Pediatric Emergency Medicine at the Universtiy of Maryland Children’s Hospital, please click here.

Summer Safety: How to Treat Your Child’s Cuts and Scrapes

More outdoor playtime usually brings more cuts and scrapes for kids. Here are some tips from the experts at the University of Maryland Children’s Hospital on the best way to treat your child.

What’s the best way to treat a small cut or scrape?

If the wound is bleeding, keep the area elevated and apply pressure to the site with a clean cloth or gauze. Most minor wounds will stop bleeding in about 5 to 10 minutes. Continue to hold pressure until the bleeding stops.

After the bleeding stops, wash the wound with lots of water. Soaking the wound in water can be helpful if there is dirt or other debris in the wound. You can use mild soap to clean the wound but don’t use rubbing alcohol or hydrogen peroxide —they irritate the tissue in the wound, which causes pain.

After cleaning the wound, apply antibacterial ointment and cover it with a clean dressing.

How do I know if my child needs stitches?

Here are some examples of wounds that probably require stitches:

  • Cuts that go all the way through the skin
  • Cuts with visible fat (yellow) or muscle (dark red)
  • Cuts that are gaping open
  • Cuts longer than half an inch. Note that smaller cuts can often benefit from butterfly closures or skin glue

Your doctor can examine the wound and help decide the best way to close it.

What is the process for getting stitches?

Getting stitches can be scary for children, but there are many ways to make the experience easier. These include numbing the area, distracting and coaching the child, and giving medications to decrease the child’s anxiety or even help them sleep through the procedure.

There are two options for stitches: absorbable and non-absorbable sutures. Absorbable sutures don’t need to be removed. Non-absorbable sutures need to be removed; how long they stay in depends on where the wound is, so your doctor will tell you when to come back to have them taken out.

What other options will a doctor use to close a cut?

  • Skin glue is helpful for minor cuts. It is applied to the cut while the cut is held closed and allowed to dry. Skin glue is not as strong as stitches, so it is not good for cuts that are under tension from a nearby muscle. But when the cut can be appropriately closed with skin glue, the cosmetic result can be just as good as with stitches.
  • Butterfly closures are narrow adhesive strips that are placed across a cut to keep it closed. They are helpful for small cuts or areas over joints. They aren’t as strong as stitches and can fall off early. Stitches provide a strong closure for wounds and almost always stay in place until they are removed.
  • Staples are a fast way to close certain wounds. In children, they are used most often to close cuts on the scalp.

How soon does my child need to see their doctor for stitches?

While it’s ideal to close the wound as soon as possible after an injury, wounds up to 8 hours old can still be closed. Some wounds can be closed up to 24 hours after the injury.

How can I make my child’s scar less visible?

While your child’s skin won’t look exactly the same as it did before the injury, there are some steps you can take to make the scar less visible. Sunlight can make the scar turn dark, so protect the scar from the sun by covering it with a hat, clothing or sunscreen. You can also massage the scar or apply silicone scar sheets.

For more information, visit umm.edu/childrens.

To make an appointment at one of our locations, call 410-328-6749.

Summer Safety: How to Treat Your Child’s Sunburn

Pool time and outdoor play may increase your child’s chance for developing sunburn. Here are some tips from the experts at the University of Maryland Children’s Hospital on the best way to treat your child.

What causes sunburn?

Sunburn appears within 6 to 12 hours after the skin is exposed to ultraviolet (UV) rays from the sun. Artificial light sources like sun lamps and tanning beds can also cause sunburns. The skin becomes red and painful, and swelling of the skin, tenderness and blisters can develop. Severe sunburn can also cause nausea, chills and malaise (“feeling sick”). The burned area remains red and painful for a few days. Later, peeling may occur as the skin heals.

What are the risks of sunburn?

Exposure to the sun can harm children even when they don’t get sunburn. Over the years, the effects of sun exposure build up and can lead to wrinkles, freckles, tough skin and even skin cancer later in life. Some medications and medical conditions can also make people more sensitive to sunlight. Since people get most of their sun exposure as children, it’s important to teach children sun safety early on so they can be protected from these problems in the future.

Sunlight contains both UVA and UVB rays. UVB rays cause sunburn. However, UVA rays also cause damage in the long run, including skin cancer. Since tanning beds use UVA light, they aren’t healthy and should be avoided.

How is sunburn treated?

If your child has sunburn, he or she should stay out of the sun until the burn has healed completely. Once it’s healed, be sure your child is wearing sun protection, including sunscreen, before going out in the sun again.

You can control pain from sunburn by applying cool washcloths to the area. Over-the-counter sunburn sprays that contain numbing medications like benzocaine or lidocaine can help, although they may also cause irritation to the skin. You can give anti-inflammatory medications like ibuprofen by mouth to help with the pain. As the burn heals, apply a moisturizing lotion. Products that contain aloe vera can be helpful in soothing the skin.

How is sunburn prevented?

The sun doesn’t need to be shining brightly to be dangerous. Children can be exposed to UV rays even on foggy or hazy days, and exposure is greater at higher altitudes or when UV rays are reflected off of water, snow, sand, or other surfaces. UV rays are strongest when the sun is the most intense, so try to keep your child out of the sun between 10 am and 4 pm. Infants and young children can quickly develop serious sunburns.

Dermatologists recommend using a sunscreen with a sun protection factor (SPF) of at least 30. Check the label to make sure the sunscreen blocks both UVA and UVB rays. Apply sunscreen 15-30 minutes before going outside. Reapply sunscreen every 2 hours. Since no sunscreen is waterproof, you may need to reapply sunscreen more frequently if your child is spending lots of time in the water.

Appropriate clothing is also important for sun protection, such as wide-brimmed hats and lightweight cotton clothes with long sleeves and pants.

Keep babies under six months of age out of the sun and in the shade as much as possible. Avoid sunscreen in babies less than six months old.

For more information, visit umm.edu/childrens.

To make an appointment at one of our locations, call 410-328-6749.

 

Mothers and Substance Use

By Christopher Welsh, MD

Women have some unique challenges when it comes to alcohol, tobacco and drug use and misuse. These differences are based on both biology and culturally defined expectations of women. Hormonal changes, the menstrual cycle, fertility issues, pregnancy, breastfeeding and menopause can all impact a woman’s use of substances. Women often use smaller amounts of a substance for shorter amounts of time before developing a problem. They also may have greater physical problems from their substance misuse.

Alcohol, tobacco and drug use during pregnancy can present significant problems for both the mother and the fetus/baby. Different substances can increase the chances of:

  • miscarriage,
  • stillbirth,
  • premature birth,
  • small head size,
  • low birth weight, and
  • delayed physical and brain development.

When a woman uses substances – especially opioid pain killers, sedatives and alcohol – during pregnancy, the baby may go through withdrawal after birth. This condition is often called neonatal abstinence syndrome (NAS).

Although it can be hard for anyone with a substance use disorder to stop, women, in particular, may be afraid to get help during or after pregnancy due to concerns over possible legal or social services involvement. Issues related to child care also make it harder for women to get treatment.

If you have a problem with substance misuse, it is important to get help. Counseling and medications can be very helpful, as FDA-approved medicines do exist to help with addiction to opioids, alcohol and tobacco.

Call the University of Maryland Medical Center’s Outpatient Addictions Treatment Services (OATS) at 410-328-6600. The program even has a play center where children are watched while you participate in counseling.

Dr. Welsh is the medical director of Substance Abuse Consultation Service and medical director of the Comprehensive Recovery Program at University of Maryland Medical Center, and an associate professor of psychiatry at University of Maryland School of Medicine.

Physical Fitness and Sports Month: Commonly Asked Questions About Sports Injuries with Dr. Packer

Dr. Jonathan Packer is an orthopaedic surgeon with the University of Maryland Department of Orthopaedics and an Assistant Professor of Orthopaedics at the University of Maryland School of Medicine.  Dr. Packer specializes in sports medicine and is a Team Physician with the University of Maryland Terrapins.  Below he answers common questions about sports injuries.

What are the most common sports-related injuries you see in your clinic?

The most common sports related injuries are ankle sprains and contusions.  The most common knee injuries that I see are meniscus tears and knee ligament injuries, such as the MCL (meniscus collateral ligament) and ACL (anterior cruciate ligament).

What can an athlete do after an injury to recover quicker?

The treatment depends on the specific injury and the severity of the injury.  The athlete should have the injury evaluated by the team Athletic Trainer, who can then determine whether the injury requires an evaluation by a physician.  Low grade injuries typically respond well to rest and different treatments to reduce the inflammation (elevation, ice, anti-inflammatory medications – i.e. Ibuprofen or Naproxen).

Why should an athlete use ice and not heat on an injury? 

The initial treatment goals after an acute injury (first 48 hours) are to reduce inflammation and swelling.  Cryotherapy, such as ice, is an effective method of reducing the swelling and bleeding into the tissues.  Heat is used for chronic injuries to relax and loosen tissues and to increase blood flow to the area, typically before participating in sports.

Can an athlete play with a cast or brace? 

It depends on the injury and the sport.  Athletes are frequently cleared to play with either a cast or a brace.  Your sports medicine physician will be able to make the decision whether or not it is safe to play with a cast / brace or not given your injury and sport.

When does an athlete need to see a physician? 

If the athlete’s team has an Athletic Trainer, s/he should evaluate the athlete and determine whether a referral to a physician is necessary.  In general, if the injury is accompanied with a “pop” or if a joint has a large amount of swelling, then it is concerning for a more serious injury that should be evaluated by a physician.  Other reasons to see a physician are joint instability and failure to improve with rest and anti-inflammatory treatments.

How can sports injuries be prevented?  

Sports injuries are best prevented by a dedicated prevention program that would ideally start at least 6 weeks before the start of the season. The prevention programs should focus on flexibility, muscle coordination and strengthening, neuromuscular control, plyometrics, body mechanics, and proper landing techniques.  The prevention programs are especially important for preventing ACL tears and have been shown to reduce non-contact ACL tears by up to 80%.  There are many different prevention programs that can be found online.  Two of the most well-known and established programs are the Prevent Injury and Enhance Performance (PEP) Program and the Knee Injury Prevention Program (KIPP).  Athletes and their coaches can find these programs online here and here.

Why should athletes choose University of Maryland Department of Orthopaedics to diagnose and treat their sports injuries?  

The University of Maryland has many physicians that specialize in Sports Medicine and treat all types of sports injuries. If at all possible, we will try to get you back to your sport without surgery. However, if surgery is necessary, we have the expertise to treat even the most complex injuries. The Sports Medicine team has extensive experience and are the team physicians for 12 high schools and for the University of Maryland Terrapins.

To make an appointment or to learn more about the University of Maryland Department of Orthopaedics sports medicine specialists, call 410-448-6400, or visit their website.

3 Things to Know about Mother-Child Relationships

By Sarah Edwards, DO

  1. Healthy moms = healthy children and families. Healthy moms are essential to building children’s healthy brains and helping everyone in the family grow well and love well. Maternal depression, anxiety and stress can affect how a mother interacts and develops a relationship with her baby. Babies need a safe and stable connection with a caregiver for social, emotional and cognitive development. If this attachment is not strong, it can have lasting effects on a child’s brain, and puts children at risk for behavior and emotional problems.
  2. Family bonding is key to a healthy family. The good news is that there are effective ways to help caregivers bond with their children and promote a healthy relationship for the whole family. Finding joy in themselves and each other helps everyone feel loved and part of something important: their family.
  3. Help is available. If you have concerns about your relationship with your young child, contact the University of Maryland Medical Center’s Secure Starts Clinic at 410-328-3522 to make an appointment.

Dr. Edwards is the medical director of child and adolescent psychiatry services at University of Maryland Medical Center and an assistant professor of psychiatry with the University of Maryland School of Medicine. For a consultation, call 410-328-3522.

Fertility: 12 things you didn’t know (and 1 to never ask)

By Katrina Mark, MD

1. Fertility naturally declines as we age

That alone doesn’t mean you should start to worry. The general advice I give a woman is if she has been trying to become pregnant for a full year with no luck, she might consider a fertility evaluation. For a woman over age 35, she might consider it after six months. If a woman is younger and has irregular periods, it’s likely she isn’t regularly ovulating, so she might want to be evaluated sooner.

2. Sometimes there’s a reason for infertility – and sometimes, there’s not

There are some things we know cause infertility. About 20 percent of the time, we find no reason for it. For a woman, infertility can be due to a condition that causes you to not ovulate regularly such as diabetes, thyroid disease and polycystic ovaries. It can also be caused by blocked fallopian tubes or a history of ectopic pregnancy. For men, it can be due to semen issues such as a low sperm count.

Early menopause in women under the age of 40 is rare, but it can run in families and cause infertility. Lifestyle factors such as smoking and obesity contribute to infertility in both women and men.

3. Taking birth control for long periods of time does not hurt fertility

No, taking birth control stops you from getting pregnant, but it doesn’t hurt fertility once you stop taking them.

4. If you are having trouble conceiving, consider these culprits:

  • Lifestyle factors: If you smoke, try to quit. If you are obese, try to lose weight. Vigorous exercise and low body weight can also cause ovary issues. Marathon runners and gymnasts have this issue frequently. Luckily, increasing body fat percentage or decreasing exercise a small amount can often correct it.
  • Chronic conditions: If you suffer from a chronic condition such as diabetes or hypertension, make sure you are managing it and keeping it under control.
  • Ovulation issues: For women who aren’t ovulating regularly, the first line is usually Clomid, a pill that makes a woman’s body produce eggs and ovulate each month. Many OB-GYNs will prescribe this, so you don’t necessarily need to see a fertility specialist.

If there’s no known reason trouble conceiving, your OB-GYN may refer you to a fertility specialist for treatment. Fertility specialists and even some OB-GYNs perform intrauterine insemination (IUI), where sperm are placed directly in the uterus around the time the ovary releases one or more eggs to be fertilized. In vitro fertilization (IVF) is when the sperm and egg fertilize outside the woman’s body and then the fertilized egg is implanted in the uterus.

5. Your OB-GYN can often provide some fertility assistance

If a woman is trying to conceive, she should share this with her OB-GYN. If she is having trouble, an OB-GYN can provide a general evaluation to look for causes, as well as provide education, which often is very helpful.

6. Don’t worry if it’s been a month or two and you’re not pregnant

Ninety percent of couples get pregnant within a year. Don’t worry if it’s only been a few months. This is normal and usually there’s nothing wrong with you.

7. The overall rate of infertility hasn’t changed

Although more are seeking treatment. In this age, more women may be delaying fertility because of better access to education and career opportunities. The average age of a woman when she has her first child has gone up over the last few decades. Delaying childbearing increases the likelihood for a woman to experience fertility issues. There also may be more people pursuing fertility treatment now because there is better access to treatment.

8. Egg freezing is much better than it used to be

Typically, egg freezing is recommended for those who desire it when a woman is between the ages of 35 and 38. If a woman is interested in having eggs frozen, she should speak with a fertility specialist. This technology has gotten better in the last several years and there has been better success. Fertility specialists can now freeze eggs without having to fertilize them. Insurance generally doesn’t cover egg freezing unless there is a medical reason.

9. Fertility treatments have come a long way

Overall, fertility treatment has high success rates these days. In vitro fertilization (IVF) has a very high success rate. Even for women who have premature ovarian failure, which is loss of ovary function before the age of 40, can opt for a donor egg and carry a pregnancy. Sometimes it depends on what a person is willing to go through and what you can afford, although many insurances cover some fertility treatment. Most don’t cover everything and it can be expensive.

10. There are reasons not to consider fertility treatment

Some treatments can be quite expensive. Some people may have moral objections. In some cases, a woman may have a chronic condition that it wouldn’t be recommended or safe to pursue pregnancy, such as certain heart conditions. Sometimes if either partner has a genetic disorder that is hereditary, they may not want to risk passing it along to a child. If a couple chooses not to pursue fertility treatment but still wants to have children, adoption or a donor egg are also options.

11. Fertility treatments aren’t just physically demanding

They’re also mentally draining. There have been studies that have shown a woman going through fertility treatments may experience the same level of depression as someone going through cancer treatment. The psychological aspect of fertility treatments is under-recognized. We view pregnancy as a positive thing because you get a baby at the end, but fertility treatment can make a person anxious and terrified – while trying to conceive and also during pregnancy and after the baby is born. Some women are traumatized from the experience and develop an anxiety disorder. Women often go through these struggles in private because they often don’t want to tell anyone. The same is often true with miscarriages. Many women experience very real grief and depression during these times. It’s important to make sure people are getting counseling because a lot of times they aren’t even talking to their friends or family about it. If you have breast cancer, people bring you food. There is no greeting card for infertility.

12. Don’t shy away from a friend who’s having trouble conceiving

If you someone close to you who is going through fertility issues, don’t completely ignore it or become distant. Be a friend, act normal and open yourself up to the person for conversation if he or she wants to talk. A lot of times people want to talk about it but don’t know how. Give them the hope and space to talk as much or as little as they want. Everyone deals with a loss and struggles differently; some are private about it and don’t want to talk about it, but others do.

Don’t ever ask a woman when she’s going to have a baby

For someone who is going through fertility treatment, being constantly asked when they’re going to have a baby can be devastating. You don’t know what someone may be going through.

Dr. Katrina Mark is an OB-GYN at University of Maryland Medical Center and Assistant Professor of Obstetrics, Gynecology and Reproductive Sciences at the University of Maryland School of Medicine.

 

 

 

Brain Injury Awareness Month

By Jameson Roth, Communications Intern

At UMMC, we recognize individuals who have experienced Traumatic Brain Injury, directly and indirectly, throughout the month of March with the acknowledgment of Brain Injury Awareness Month.

Traumatic Brain Injury (TBI) is defined as a complex injury caused by an outside force on the brain, which can result in the permanent or temporary loss of brain functions. Individuals who have survived a TBI may experience symptoms such as memory loss, impaired cognition, headaches and mood swings following their injury.

The leading causes of TBI include motor vehicle crashes, said Karen McQuillan, lead clinical nursing specialist at the R Adams Cowley Shock Trauma Center. As a 30-year veteran of trauma nursing, McQuillan has seen it all. Other causes of TBI include sports activity, physical assault, gunshot wounds, domestic violence and falls. “Falls dominate the cause category for individuals aged 65 and over for TBI,” McQuillan said.

McQuillan is an active proponent of TBI prevention tactics. To prevent TBI in individuals age 65 or older, McQuillan suggests removing floor obstacles and installing wall railings in home hallways and bathrooms. One way to prevent motor vehicle crash-related TBI is by putting a stop to distracted driving. “A motor vehicle crash is 23 times more likely while texting,” McQuillan said. For individuals who ride bikes or drive motorcycles, McQuillan suggests wearing a helmet for head protection.

While not all individuals diagnosed with TBI make a full recovery, McQuillan suggests for an optimal recovery:

  • When appropriate, formalized rehabilitation
  • Plenty of rest
  • Reliance upon a strong support system
  • Patient-specific cognition activities to help patients overcome deficits

To learn more about the R Adams Cowley Shock Trauma Center’s role in TBI recovery, please visit http://umm.edu/programs/shock-trauma/patients/survivors-network

What Can Women Do to Prevent Early Menopause?

About Early Menopause

The average age a woman goes into menopause is 51. Menopause is considered abnormal when it begins before the age of 40 and is called “premature ovarian failure.” Common symptoms that come with menopause include hot flashes, night sweats, sleep problems, sexual issues, vaginal dryness, pain during sex, pelvic floor disorders (urine, bowel leakage, pelvic organ prolapse), losing bone mass, and mood swings.

Menopause is mostly genetically predetermined, which means you generally can’t do much to delay it from happening. What we can do is work to counter-balance or prevent the symptoms and effects that tend to develop during menopause.

What You Can Do

Women can do a lot of things to prepare themselves for changes that will come with menopause. These include modifying our lifestyles so we are eating a healthy diet and exercising regularly.

Diet and Exercise

Related to diet, women should look into their caloric intake and make adjustments like eating smaller meal portions, and eating a well-balanced diet that includes lots of fiber and protein and less carbohydrates. Avoid eating late at night or snacking, which means no eating two to three hours before bed time.

Take calcium and vitamin D supplements for bone health to prevent osteoporosis. Well-balanced food with decreased caffeine intake also helps to decrease night sweats.

Exercise is one of the most important and modifiable factors that all women must take advantage of. Cardio workouts including walking or jogging three times a week will boost your cardiovascular system and endurance, and also help you control your weight. It’s also important to do weight-bearing exercises regularly to build up bones and prevent osteoporosis.

Kegels

Kegel exercises can help prevent pelvic floor disorders (urine, bowel leakage, pelvic organ prolapse). Kegel exercises should ideally be done every day three times a day. Every woman needs to know how to do Kegel exercises properly. Unfortunately, many women think they do Kegel exercises when, in fact, they do not, because the muscles are hidden inside the body. Your physician should be able to help you with it. You can do long squeezes for 10 seconds, or fast squeezes. This helps to maintain strength and endurance of the pelvic muscles in order to prevent urinary or bowel leakages in the future.

Mental Health

If possible, I recommend having regular sex. It improves vaginal lubrication and helps to prevent vaginal dryness and pain with intercourse. It is also good for your overall mood.
Finally, every women should work on developing a positive attitude, and spending time in a healthy environment helps – for example, taking frequent walks in a park or whatever makes you feel good; finding a way to de-stress and/or control any stress in your life. This will improve your mental health.

Hormone Therapy

Hormonal treatment for early menopause and menopause has been out of favor because of concerns with breast cancer, cardiovascular disease, and stroke. With that said, it is still gold-standard treatment especially for hot flashes and night sweats. Hormonal therapies could offer significant benefits to women especially those going through early menopause. Talk to your doctor about what is right for you.

Fertility

A woman going through early menopause is still fertile. Unless you don’t have periods at all anymore, there is still a risk that you can get pregnant, so it’s important to use some form of contraception to avoid pregnancy.

Tatiana V. Sanses, MD, is Assistant Professor of Female Pelvic Medicine and Reconstructive Surgery at University of Maryland School of Medicine and Director of Outreach Program for Urogynecology at University of Maryland Medical System.

 

 

Child Life Month

How Play is Helping UMMC’s Youngest Patients

By: Colleen Schmidt, System Communications Intern

As many parents know, the hospital can be a scary and unfamiliar place for a child. To help relax these fears, UMMC’s team of child life specialists and assistants use a variety of techniques to help children adjust to the hospital setting. Child life specialists, or CLS, aim to provide a positive and non-traumatic hospital experience for all patients at the University of Maryland Children’s Hospital.  UMMC’s Child Life team consists of six CLS and two assistants. They work in the Pediatric Progressive Care Unit (PPCU), Pediatric Intensive Care Unit (PICU) and the Pediatric ER.

Members of the Child Life Team

 

Play is one technique often used by child life team to help normalize the child’s hospital experience.  Various types of play are thoughtfully used to help children meet developmental milestones, express emotions, and understand their medical situation.  For example, during a practice called medical play, a CLS will provide their patient with a “hospital buddy” or small doll that the child can decorate. Next, with the guidance of a CLS, the child is introduced to medical equipment that they can explore and use on their new hospital buddy.  According to Aubrey Donley, a CLS at the pediatric ER, medical play is helpful in addressing misconceptions the child has about medical equipment.

“It gives them a sense of control and mastery over their hospital experience and over what they’ve been through,” she explains. Medical play empowers patients and allows them to have an active role in their hospitalization. Helping the children understand their environment lessens the chances of confusing or traumatizing them.

In addition to medical play, the child life team uses therapeutic play to help children work through a variety of issues that may accompany hospitalization. Sometimes, children who are hospitalized have experienced severe trauma. Unlike adults, children may not be able to verbalize their feelings. Play is how they express themselves and work through their experiences. For instance, one of Donley’s young patients survived a house fire and used play to understand what happened to him. “He was running around in a fireman costume pretending to put out a fire. For an onlooker, it might seem like he was just playing but we understand he is trying to make sense of the chaos and trauma that he had witnessed,” she explained. Therapeutic play can also help children who are at the hospital for long periods of time meet their physical and cognitive milestones.

With backgrounds in child development, the child life team is able to make individual plans for each child that matches their medical, physical, and emotional needs.  The team advocates for the children they support, and work with an interdisciplinary team of medical professionals to provide a comprehensive plan for that child. Child life specialists also provide educational and emotional support for families. All services provided by the child life team come at no charge to families.


For more information on our child life services please visit: http://umm.edu/programs/childrens/services/inpatient/child-life