“January is National Thyroid Awareness Month. According to the American Thyroid Association, 1 in 10 people suffer from a thyroid disorder. They also found that at least 1 in 8 women will develop a thyroid disorder during her lifetime.

Did you know, more than half of the people in America that suffer from a thyroid disorder are undiagnosed? Raising awareness about the thyroid is important because it plays a significant role in the human body.

The thyroid is a small butterfly shaped gland located just above your collarbone and in front of the windpipe. This gland controls numerous important functions in the human body.”

The Surgical Clinic (https://thesurgicalclinics.com/national-thyroid-awareness-month/)

“The damage caused by glaucoma can’t be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if you catch the disease in its early stages.

Glaucoma is treated by lowering intraocular pressure. There are treatment options.  Glaucoma treatment often starts with prescription eye drops. ”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/glaucoma/diagnosis-treatment/drc-20372846)

“Secondary glaucoma is the name used to describe glaucomas that occur as a side effect or “secondary” to another underlying medical condition or trauma. This differs from primary glaucoma, where there’s no identifiable cause for the glaucoma to develop. Even though the cause of primary and secondary glaucomas may be different, the increase in eye pressure and the resulting damage to the optic nerve are the same.”

Glaucoma UK (https://glaucoma.uk/about-glaucoma/what-is-glaucoma/secondary-glaucomas/)

“The two main types of glaucoma are Open-Angle and Angle-Closure. But did you know that there are at least eight additional types of glaucoma? Most other types of glaucoma are variations of the open-angle or angle-closure types. These glaucoma types can occur in one or both eyes. What most types of glaucoma have in common is an increase of intraocular pressure (IOP), or pressure inside the eye.”

Glaucoma Research Foundation (https://glaucoma.org/learn-about-glaucoma/types-of-glaucoma/)

“Tetralogy of Fallot (teh-TRAL-uh-jee of fuh-LOW) is a rare condition caused by a combination of four heart defects that are present at birth (congenital).

These defects, which affect the structure of the heart, cause oxygen-poor blood to flow out of the heart and to the rest of the body. Infants and children with tetralogy of Fallot usually have blue-tinged skin because their blood doesn’t carry enough oxygen.

Tetralogy of Fallot is often diagnosed while the baby is an infant or soon after.  There are times it is diagnosed later in life; it depends on the severity or the condition.”

MAYO CLINIC

What is it?

A heart defect that features four problems.

They are:

• a hole between the lower chambers of the heart
• an obstruction from the heart to the lungs
• The aorta (blood vessel) lies over the hole in the lower chambers
• The muscle surrounding the lower right chamber becomes overly thickened

More information for parents of children with Tetralogy of Fallot

What causes it?

In most children, the cause of tetralogy of Fallot isn’t known. It’s a common type of heart defect. It may be seen more commonly in children with Down syndrome or DiGeorge syndrome. Some children can have other heart defects along with tetralogy of Fallot.

How does it affect the heart?

Normally the left side of the heart only pumps blood to the body, and the heart’s right side only pumps blood to the lungs. In a child with tetralogy of Fallot, blood can travel across the hole (VSD) from the right pumping chamber (right ventricle) to the left pumping chamber (left ventricle) and out into the body artery (aorta). Obstruction in the pulmonary valve leading from the right ventricle to the lung artery prevents the normal amount of blood from being pumped to the lungs. Sometimes the pulmonary valve is completely obstructed (pulmonary atresia).

How does tetralogy of Fallot affect my child?

Infants and young children with unrepaired tetralogy of Fallot are often blue (cyanotic). The reason is that some oxygen-poor blood is pumped to the body through the hole in the wall between the right and left ventricle instead of being pumped to the lungs.

What can be done about tetralogy of Fallot?

Tetralogy of Fallot is treated surgically. A temporary operation may be done at first if the baby is small or if there are other problems. Complete repair comes later. Sometimes the first operation is a complete repair.

Temporary Operation

In some infants, a shunt operation may be done first to provide adequate blood flow to the lungs. This is not open-heart surgery and doesn’t fix the inside of the heart. The shunt is usually a small tube of synthetic material sewn between a body artery (or the aorta) and the pulmonary artery. The shunt is closed when a complete repair is done later.

Complete Repair

Complete repair tends to be done early in life. The surgeon closes the ventricular septal defect with a patch and opens the right ventricular outflow tract by removing some thickened muscle below the pulmonary valve, repairing or removing the obstructed pulmonary valve and, if needed, enlarging the branch pulmonary arteries that go to each lung.

Sometimes a tube is placed between the right ventricle and the pulmonary artery. This is sometimes called a Rastelli repair. It’s similar to the type of repair used for some other heart defects.

Will my child’s activities be limited?

Your child may need to limit physical activity, particularly for competitive sports, if there is leftover obstruction or leak in the pulmonary valve, which is common after repair. Children with decreased heart function or rhythm disturbances may need to limit their activity more.

If the tetralogy has been repaired with surgery, and there’s no obstruction or leak in the pulmonary valve, your child may be able to participate in normal activities without much increased risk.

Your child’s pediatric cardiologist will help decide if your child needs limits on physical activity.

What will my child need in the future?

If your child has had tetralogy of Fallot repaired, he or she will need regular follow-up with a pediatric cardiologist. As an adult, your child will need lifelong regular follow-up with a cardiologist who’s had special training in congenital heart defects.

Some long-term problems can include leftover or worsening obstruction between the right pumping chamber and the lung arteries. Children with repaired tetralogy of Fallot have a higher risk of heart rhythm disturbances called arrhythmias. Sometimes these may cause dizziness or fainting.

Generally, the long-term outlook is good, but some children may need medicines, heart catheterization or even more surgery.

What about preventing endocarditis?

Children with tetralogy of Fallot are at increased risk for endocarditis. Some children, including those have had a valve replacement, still have a shunt or have leaks around surgical patches, and need to take antibiotics before certain dental procedures to help prevent endocarditis.

“Truncus arteriosus occurs in less than one out of every 10,000 live births. Truncus arteriosus occurs in less than one out of every 10,000 live births. It can occur by itself or as part of certain genetic disorders. There are about 250 cases of truncus arteriosus per year in the United States.

Before a baby is born, the fetus’s blood does not need to go to the lungs to get oxygenated. The ductus arteriosus is a hole that allows the blood to skip the circulation to the lungs. Every baby is born with a ductus arteriosus. After birth, the opening is no longer needed and it usually narrows and closes within the first few days.  In most children, the cause of PDA isn’t known. Some children can have other heart defects along with the PDA.”

Centers for Disease Control and Prevention (https://www.cdc.gov)

“Birth defects are common, costly, and critical conditions that affect 1 in every 33 babies born in the United States each year. Every 4 ½ minutes, a baby is born with a birth defect in the United States. That means nearly 120,000 babies are affected by birth defects each year. Birth defects are structural changes present at birth that can affect almost any part or parts of the body (e.g., heart, brain, foot). They may affect how the body looks, works, or both.”

Center for Disease Control and Prevention (https://www.cdc.gov/ncbddd/birthdefects/facts.html)

“This preconception visit can also encourage women to maintain a healthy weight and lifestyle. I counsel all of my patients that they will gain weight in pregnancy, and so they should start the pregnancy at a healthy weight. I encourage regular exercise even prior to becoming pregnant, and then continuing that level of activity during pregnancy. Being at a healthy weight prior to conceiving and maintaining a healthy weight throughout pregnancy can help decrease your risk of developing diabetes or elevated blood pressure during pregnancy. Having a body mass index (BMI) of 30 or above can also increase your risk of birth defects, which is why maintaining a healthy weight is also important.”

Harvard Health Publishing (https://www.health.harvard.edu/blog/what-can-you-do-to-reduce-the-risk-of-birth-defects-2020012218703)

Health care providers are encouraged to provide women to plan for pregnancy; avoid harmful substances, like tobacco (2) and alcohol (3); and choose a healthy lifestyle, like eating a healthy diet (4), to increase their chances of a healthy pregnancy. Health care providers also discuss with women any medications they might be taking, both prescription and over-the-counter, to ensure they are taking only what is necessary.  If yours is not maybe you need a new one.  Prevention is the key to giving highier odds the baby will be healthier when born.  Re-enforcement is a great tool and that’s where the medical profession comes into play with pregnant women who is their clientele.

Know that not all birth defects can be prevented. But, we also know that women can increase their chances of having a healthy baby by managing health conditions and adopting healthy behaviors before becoming pregnant. Make a commitment to yourself, to get healthy before and during pregnancy by actively trying to plan ahead, avoid harmful substances, choose a healthy lifestyle, and talk with your healthcare provider.   There are some that can be prevented.

1.Plan ahead.

Get 400 micrograms (mcg) of folic acid every day.
Folic acid is a B vitamin. If a woman has enough folic acid in her body at least one month before and during pregnancy, it can help prevent major birth defects of the developing brain and spine defects like anencephaly or spina bifida. Anencephaly is a serious birth defect in which a baby is born without parts of the brain and skull. It is a type of neural tube defect (NTD). As the neural tube forms and closes, it helps form the baby’s brain and skull (upper part of the neural tube), spinal cord, and back bones (lower part of the neural tube).  Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD).  Spina bifida can happen anywhere along the spine if the neural tube does not close all the way. The backbone that protects the spinal cord does not form and close as it should. This often results in damage to the spinal cord and nerves.  Spina bifida might cause physical and intellectual disabilities that range from mild to severe. The severity depends on:

• The size and location of the opening in the spine.
• Whether part of the spinal cord and nerves are affected.
• There are 3 types and they are: A-Myelomeningocele, B-Meningocele, and C-Spina Bifida Occulta.
• A-Myelomeningocele is the most serious type of spina bifida. With this condition, a sac of fluid comes through an opening in the baby’s back. Part of the spinal cord and nerves are in this sac and are damaged. This type of spina bifida causes moderate to severe disabilities, such as problems affecting how the person goes to the bathroom, loss of feeling in the person’s legs or feet, and not being able to move the legs.
• B-Meninocele is a sac of fluid comes through an opening in the baby’s back. But, the spinal cord is not in this sac. There is usually little or no nerve damage. This type of spina bifida can cause minor disabilities.
• C-Spina bifida occulta is the mildest type of spina bifida. It is sometimes called “hidden” spina bifida. With it, there is a small gap in the spine, but no opening or sac on the back. The spinal cord and the nerves usually are normal. Many times, spina bifida occulta is not discovered until late childhood or adulthood. This type of spina bifida usually does not cause any disabilities.

• Women can get folic acid from fortified foods or supplements, or a combination of the two, in addition to a varied diet rich in folate.
• See a healthcare professional regularly.
  A woman should be sure to see her doctor when planning a pregnancy and start prenatal care as soon as she thinks that she is pregnant. It is important to see the doctor regularly throughout pregnancy, so a woman should keep all her prenatal care appointments. If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Use these checklists to help you write down your goals and have them in a place that you reinforce yourself to maintain them as best as possible for your child’s sake and your own sake as well.

2.Avoid harmful substances.

• Avoid alcohol at any time during pregnancy.  Alcohol in a woman’s bloodstream passes to the developing baby through the umbilical cord. There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. There is also no safe time during pregnancy to drink. All types of alcohol are equally harmful, including wine and beer. Drinking alcohol during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, behavioral, and These disabilities in the child, which occur because the mother drank alcohol during the pregnancy, are known as fetal alcohol spectrum disorders (FASDs). The best advice for women is to stop drinking alcohol when trying to get pregnant.
• Avoid smoking cigarettes.  The dangers of smoking during pregnancy include preterm birth, certain birth defects from cleft lip or cleft palate to even infant death and more diseases inherited by mom through smoking.  Even being around tobacco smoke puts a woman and her pregnancy at risk for problems. Quitting smoking before getting pregnant is best. For a woman who is already pregnant, quitting as early as possible can still help protect against some health problems for the baby, such as low birth weight. It’s never too late to quit smoking.

• Avoid marijuana and other “street drugs”.  A woman who uses marijuana or other “street” drugs during pregnancy can have a baby who is born preterm, of low birth weight, or has other health problems, such as birth defects. Marijuana is the illicit drug most commonly used during pregnancy. Since we know of no safe level of marijuana use during pregnancy, women who are pregnant, or considering becoming pregnant, should not use marijuana, even in states where marijuana is legal. Women using marijuana for medical reasons should speak with their doctor about an alternative therapy with pregnancy-specific safety data.

• Prevent infections.  Some infections that a woman can get during pregnancy can be harmful to the developing baby and can even cause birth defects. Some easy steps to prevent infections include frequent hand-washing, cooking meat until its well done, and staying away from people who have an infection.

3.Choose a healthy lifestyle.

• Keep diabetes under control.

Poor control of diabetes during pregnancy increases the chances for birth defects and other problems for the pregnancy. It can also cause serious complications for the woman. Proper healthcare before and during pregnancy can help prevent birth defects and other poor outcomes.

• Strive to reach and maintain a healthy weight.

Do you know …Your body mass index (BMI)? Calculate it.  Where? Just look it up on the internet anywhere for free.

A woman who is obese (a Body Mass Index of 30 or higher) before pregnancy is at a higher risk for complications during pregnancy. Obesity also increases a pregnant woman’s risk of several serious birth defects. Even if a woman is not actively planning a pregnancy, getting healthy can help boost her health and her mood. If a woman is overweight or obese, she should talk with her doctor about ways to reach a healthy weight before she gets pregnant.

4.Talk with your healthcare provider.

• Talk to a healthcare provider about taking any medications.

 We know that certain medications can cause serious birth defects if they are taken during pregnancy. For many medications taken by pregnant women, the safety has been difficult to determine. Despite the limited safety data, some medications are needed to treat serious conditions. If a woman is pregnant or planning a pregnancy, she should not stop taking medications she needs or begin taking new medications without first talking with her healthcare provider. This includes prescription and over-the-counter medications and dietary or herbal products.

• Talk to a healthcare provider about vaccinations (shots).

Most vaccinations are safe during pregnancy and some vaccinations, such as the flu vaccine and the Tdap vaccine (adult tetanus, diphtheria and acellular pertussis vaccine), are specifically recommended during pregnancy. Some vaccines protect women against infections that can cause birth defects. Having the right vaccinations at the right time can help keep a woman and her baby healthy. She should talk to her doctor about which vaccines are recommended for her during pregnancy.