The N.Y. State Health Department states the following:

There are many reasons parents give for delaying a vaccination, from “My baby cries when she gets the shot,” to “My child is too young to get so many vaccines.” More important than all of these excuses is one simple fact: A child’s immune system is more vulnerable without vaccinations. And if it weren’t for vaccinations, many children could become seriously ill or even die from diseases such as measles, mumps and whooping cough.

We live in an increasingly global world, with increased risks around every corner. Travelers entering into New York create an even greater risk of exposure. On a regular basis there is a new report regarding a disease outbreak somewhere in the world – including in the United States and New York State. The Centers for Disease Control and Prevention reports outbreaks around the world and provides health information for travel to more than 200 international destinations. (cdc.gov) From mumps, to pertussis to the measles, diseases once thought to be eradicated are coming back because people are not being vaccinated as they once were. If you think tears from a needle are hard to watch, imagine the suffering your child will experience if he or she contracts a serious disease that could have been prevented.

While misinformation in the media has led many parents to delay vaccinations as a result of either Dr. Andrew Wakefield’s false claims about autism or Dr. Bob’s Alternative Schedule (aap.org), many diseases have begun to reemerge among children around the world. Don’t let your child become a statistic — make sure they get all the recommended vaccinations. And if you’re worried about autism, visit “The Truth About Autism.”

Yes there are side effects to vaccinations but the odds are slim and the reason for the vaccinations in childhood including adulthood outweighs the possible risk for side effects.  I have been a RN 31 years and have received the MMR (measles, mumps, and rubella) every 10 years, flu every year, & pneumonia every 5 years and have never gotten a side effect from them.

The threat of death by disease isn’t the only medical consequence of skipping vaccinations. An unvaccinated child faces lifelong differences that could potentially put him or her at risk. Every time you call 911, ride in an ambulance, go to the doctor or visit the hospital emergency room, you must alert medical personnel of your child’s vaccination status so he or she receives distinctive treatment. Because unvaccinated children can require treatment that is out of the ordinary, medical staff may be less familiar, and less experienced, with the procedures required to appropriately treat your child.

Women who are pregnant but not vaccinated can be vulnerable to diseases that may complicate their pregnancy. A pregnant woman who contracts rubella in the first trimester may have a baby with congenital rubella syndrome (CRS), which can cause heart defects, developmental delays and deafness.

People who choose not to vaccinate their children also put others at risk if their child isn’t vaccinated and becomes ill. Special groups of people cannot be vaccinated, including those with compromised immune systems (e.g. those with leukemia or other cancers). These people rely on the general public being vaccinated so their risk of exposure is reduced.

There are also social implications of not vaccinating your child — from exclusion to quarantine. If sick or exposed to disease, your child may need to be isolated from others, including family. If there is an outbreak in your community, you may be asked to take your child out of school and other organized activities, causing your child to miss school and special events. Your child’s illness or inability to go about their daily activities also may impact your work and household income. For more information on vaccination requirements for schools in the state of New York, see New York State Immunization Requirements for School Entrance/Attendance (PDF, 71KB, 2pg.).

Everyone 6 months and older should get a seasonal flu vaccine every year. It’s important to reiterate that every year the flu remains a threat, and every year children still die as a result of having the flu. One of those children was Joseph Marotta. At 5 years old, Joseph contracted the flu. Less than 10 days after contracting the flu, Joseph died. His parents, along with other members of Families Fighting Flu (familiesfightingflu.org), are strong advocates for annual flu vaccines and encourage all families to get vaccinated. It’s important that everyone 6 months and older receives an annual flu vaccine. Every year a flu vaccine is skipped, your child is at risk.

The CDC states:

“As a result, many parents are inundated with horror stories of vaccine dangers, all designed to eat away at them emotionally while the medical and scientific communities have mounted their characteristic response by sharing the facts, the data, and all of the reliable peer-reviewed and well-cited research to show that vaccines are safe and effective. ”

U.S. National Library of Medicine/National Institutes of Health

“Most cases of cough are temporary.  But even a short-term cough can be a sign of a bigger health issue that needs to be addressed by a doctor. Here’s how to narrow down the possible culprits—from asthma to pneumonia to whooping cough says Peter Dicpinigaitis, MD, director of the Montefiore Cough Center and professor of clinical medicine at Albert Einstein College of Medicine in New York City.”

Fox News.

Temporary Solution

The cough reflex is one of humans’ most vital defenses, highly effective in clearing secretions and preventing foreign materials from entering the lower respiratory tract. However, when a pathological cough persists without serving any useful purpose, it can be highly irritating and disruptive, causing significant sleep disturbance, chest pain, urinary incontinence, frustration, anger, and depression. “It’s easy to underestimate the tremendous quality of life issue that cough is, not only for the patient but for the family. Some of our patients have been coughing every single day for ten, twenty, even thirty years,” founded at the Montefiore Cough Center, one of the few specialty cough centers in the United States.

The Montifiore Cough Center found the following information via there research:

Despite the prevalence of cough, researchers have yet to fully understand its mechanism and relationship with the brain. Stimulation of the vagus—a cranial nerve with motor function in the larynx, esophagus, lower respiratory tract, and ear—can stimulate the cough reflex. The transient receptor potential vanilloid (TRPV1) receptor, a sensory nerve channel known as a “cough receptor,” induces the reflex when stimulated by irritants such as capsaicin (derived from red chili peppers), hydrogen, heat, low pH, certain enzymes, and anandamide (a naturally occurring, euphoria-inducing brain neurotransmitter).

The cough mystery presents a particular challenge to those who attempt to diagnose and treat it.  Physicians need to maintain the protective cough, an important barrier reflex that prevents complications like bronchitis, pneumonia, and lung collapse, but eliminate the maladaptive cough. To do this successfully, the cough’s underlying etiology must be identified and addressed.

Manypatients cough due to post-nasal drip, or upper airway cough syndrome (UACS). UACS is often treated with a combination of a first-generation decongestant /antihistamine and other nasal corticosteroids, nasal ipratropium bromide, or nasal cromolyn. Newer generation, non-sedating antihistamines such as Claritin, Zyrtec, and Allegra, which circumvent drowsiness because they don’t pass the blood-brain barrier, are ineffective for treating UACS-associated cough.

Asthma, whether “cough-variant” (where cough is the sole or predominant symptom) or “classic” (with symptoms including wheezing) is the second most common cause of chronic cough, found in 24-29% of patients at Montefiore. Coughing inflames the sensory afferent nerves (those that carry messages from receptors to the central nervous system). Leukotrienes, lipid mediators whose production also generates histamines, are thought to contribute to the inflammation. Asthma therapy (usually a combination of inhaled bronchodilators and steroids) can take up to eight weeks to show improvement. An oral leukotriene receptor antagonist known as zafirlukast has in some cases been more effective than steroids in reducing asthma-associated cough, possibly because it more effectively suppresses the interaction of eosinophils (white blood cells that fight concomitant infection during asthmatic reaction) with cough receptors. Non-asthmatic eosinophilic bronchitis, a condition characterized by chronic cough without the airway remodeling common to asthma, is often misdiagnosed as cough-variant asthma because it responds similarly to inhaled corticosteroids.

Gastroesophageal reflux disease (GERD) is among the most common etiologies of cough, and perhaps the most difficult to diagnose. Most patients with reflux-associated cough have no other symptoms of GERD, though the characteristic heartburn, nausea, and regurgitation may subsequently appear. The standard GI workup for GERD—endoscopy, barium esophagram, prolonged esophageal acid monitoring, and impedance monitoring—may not detect mild acid exposure, brief reflux events, rapid esophageal clearance, and distal or “high” reflux. “You might send your patient for a full GI workup and receive test results that are unremarkable, but that patient’s reflux still causes an incredibly life-jarring cough”.

Chronic cough can also result from laryngopharyngeal reflux (LPR), a subtype of GERD in which reflux reaches the upper airways. People with LPR often cough when eating, drinking, laughing, talking on the telephone, or getting up in the morning, and may experience hoarseness or other voice change.

The current GERD diagnostic options and treatment therapies may be inadequate, though better options are beginning to emerge. Twenty-four-hour catheter-based pH monitoring, for example, is invasive and often inconclusive as patients typically modify their activity and diet the day they wear the nasal catheter. Better but costlier options include the Bravo™ pH Monitoring System, in which a tubeless monitoring capsule is placed in the mucosal wall of the esophagus, transmitting pH data to a pager-sized receiver worn on patient’s belt over a 48-hour period; and Multichannel Intraluminal Impedance (MII) Testing, which assesses acid and non-acid reflux, adequacy of acid suppression, and symptom-reflux association. Treatment for GERD—usually aggressive acid suppression therapy, an approach that requires significant diet and lifestyle modification—may still be inadequate, and the addition of prokinetic therapy with additional medication may be necessary. Those who don’t respond sufficiently to acid suppression and prokinetic therapy may be candidates for laparoscopic Nissen fundoplication, or “antireflux surgery,” which, based on small published reports, has yielded quality of life improvements in up to 90% of patients who have undergone it.

Postinfectious or postviral cough, a harsh, dry, persistent hack remaining from an upper respiratory infection, has been historically difficult to treat. This cough creates persistent airway inflammation, which in turn causes enhanced cough sensitivity, creating a vicious cycle that inhibits healing. Postviral coughs can persist for weeks or even months and may respond to antiinflammatory agents, such as inhaled and oral steroids.

More effective cough treatment options are needed, yet no new antitussive drugs have been developed in the last half century. With the discovery of TRPV1, however, pharmaceutical companies’ interest in these medications has surged. Numerous potential novel antitussive agents are now being studied, including antagonists to eosinophil, tachykinin receptor, 5-HT receptor, and TRPV1 receptor; agonists to the delta-opioid receptor, NOP receptor, and GABA-B; endogenous cannabinoids, and large conductance Ca+2-activated K+-channel openers.

The idiopathic (unexplained) cough remains a mystery. Patients with this cough—predominantly peri-menopausal women with a lower capsaicin threshold, many of whom have had an upper respiratory infection preceding symptom onset—may have been inadequately diagnosed. However, even after aggressive, comprehensive testing and treatment, some continue to cough. A percentage of these patients are reported to have lymphocytic airway inflammation and autoimmune diseases, but the link is neither consistent nor definitive.

Chronic cough is the most common reason that patients seek medical care, yet only a fraction of people with UACS, asthma, non-asthmatic eosinophilic bronchitis, or GERD actually experience this symptom, a phenomenon yet to be understood. These individuals may possess an intrinsically hypersensitive cough reflex, more easily triggered by aggravating factors to produce the reaction.

Although cough has been historically under-researched relative to its importance as a medical problem, the last decade has witnessed a significant increase in scientific activity dedicated to understanding the mechanism of cough, and identifying more effective therapies.

“Crohn’s disease may affect as many as 780,000 Americans. Men and Women are equally likely to be affected, and while the disease can occur at any age, Crohn’s is more prevalent among adolescents and young adults between the ages of 15 and 35.”.

Crohn’s and Colitis Foundation

“It is important to know that Crohn’s disease is not the same thing as ulcerative colitis, another type of Inorganic Bowel Disease. The symptoms of these two illnesses are quite similar, but the areas affected in the gastrointestinal tract (GI tract) are different.”

Crohn’s and Colitis Foundation

IBD refers to both Crohn’s disease and ulcerative colitis, however they can be distinguished from one another by their symptoms, GI involvement, biopsy, and antibody testing.

You’ve had stomach cramps for weeks, you’re exhausted and losing weight, and you keep having to run to the bathroom. What’s going on?

It could be an inflammatory bowel disease (IBD).  But which one?

There are two: Crohn’s disease and ulcerative colitis. They have a lot in common, including long-term inflammation in your digestive system. But they also have some key differences that affect treatment.

By the way, if you hear some people just say “ulcerative colitis” you have sores (ulcers) in the lining of your colon, as well as inflammation there.  With Crohn’s disease you may have ulcers.

Facts on Chron’s Disease:

• Inflammation may develop anywhere in the GI tract from the mouth to the anus
• Most commonly occurs at the end of the small intestine
• May appear in patches
• May extend through entire thickness of bowel wall
• About 67% of people in remission will have at least 1 relapse over the next 5 years

Facts on Ulcerative Colitis:

• Limited to the large intestine (colon and rectum)
• Occurs in the rectum and colon, involving a part or the entire colon
• Appears in a continuous pattern
• Inflammation occurs in innermost lining of the intestine
• About 30% of people in remission will experience a relapse in the next year

The symptoms of Crohn’s disease or ulcerative colitis (UC) can be similar. They include:

Belly cramps and pain, Diarrhea, Constipation, An urgent need to have a bowel movement, Feeling like your bowel movement wasn’t complete, Rectal bleeding, Fever, Smaller appetite, Weight loss, Fatigue, Night sweats, Problems with your period. You might skip them, or their timing might be harder to predict.

You might not have all of those symptoms all the time. Both conditions can come and go, switching between flares (when symptoms are worse) and remission (when symptoms ease up or stop).

Crohn’s and ulcerative colitis are most often diagnosed in teenagers and young adults — although they can happen at any age — and tend to run in families.

There are similarities between Crohn’s disease and Ulcerative colitis, which are:

1.)Ulcerative colitis and Crohn’s disease affect men and women equally

2.)The symptoms of ulcerative colitis and Crohn’s disease are very similar

3.) Both diseases often develop in teenagers and young adults although the disease can occur at any age.

4.) The causes of both UC and Crohn’s disease are not known and both diseases have similar types of contributing factors such as environmental, genetic and an inappropriate response by the body’s immune system

There are differences between Crohn’s disease and ulcerative colitis and know what they are:

1.) Location –  Ulcerative colitis is limited to affecting the colon (large intestines (colon) to anus; while Crohn’s disease can occur anywhere starting from the mouth to the small intestines to the large intestines (colon) to the anus.

2.)  In Crohn’s disease, there are healthy parts of the intestine mixed in between inflamed areas. Ulcerative colitis, on the other hand, is continuous inflammation of the colon.

3.)  Ulcerative colitis only affects the inner most lining of the colon while Crohn’s disease can occur in all the layers of the bowel walls.

How to get Diagnosed: 

Since the differences between the two conditions mostly revolve around where in the digestive system inflammation happens, the best way for a doctor to give you the right diagnosis is to take a look inside.  To look inside is either a endoscopy or colonoscopy    depending on where the M.D. thinks the disorder is located.

Prior to these invasive tests the M.D. might order:

X-rays that can show places where your intestine is blocked or unusually narrow.

Contrast X-rays, for which you’ll swallow a thick, chalky, barium liquid so doctors can see how it moves through your system.

CT scans and MRIs to rule out other conditions that might cause symptoms similar to an inflammatory bowel disease.

After the M.D. see’s something on these tests indicating more invasive tests now he or she may order:

Endoscopy, in which a doctor uses a tiny camera on a thin tube to see inside your digestive system.

Specific types of endoscopy can be:

• Examine lower part of your large intestines. Your doctor will call this test “sigmoidoscopy”.
• Look at your entire large intestine. This is a colonoscopy.
• Check the lining of the esophagus, stomach, and duodenum. This is an EGD (esophagogastroduodenoscopy).
• Additional testing to look at your small intestine using a pill-sized camera. This is often called pill, or capsule, endoscopy.
• See the bile ducts in the liver and the pancreatic duct. This test is called ERCP (endoscopic retrograde cholangiopancreatography).

Scientists are working to make two blood tests better at helping to diagnose ulcerative colitis and Crohn’s. They check on levels of certain antibodies found in the blood:

“There are a lot of treatment options for thrombocytopenia and ITP. You’ll need to work with your doctor to weigh the pros and cons of each and find a therapy that’s right for you.”

WebMD

Treatment:

There are a lot of treatment options for thrombocytopenia and ITP. You’ll need to work with your doctor to weigh the pros and cons of each and find a therapy that’s right for you.

If you have ITP, your treatment depends on how severe a case you have. If it’s mild, you may only need to get regular checks of your platelet levels.

When you do need treatment, the goal is to get your platelet count to a level that’s high enough to prevent serious bleeding in the gut or brain.

Your doctor will likely suggest these treatments for ITP first:

Corticosteroids. Dexamethasone or prednisone is typically prescribed to raise your platelet count. You take it once a day in the form of a pill or tablet. An increased or normalized platelet count is generally seen within two weeks of therapy, particularly with high-dose dexamethasone. Your doctor will then likely gradually reduce your dose over the next 4 to 8 weeks. The treatment may have to be repeated, but once your platelet count is normalized, none is needed again.

There are some side effects to prednisone, especially if you use it for a long time. Even after a short time, you can get irritable, have stomach upsets, and have other problems such as:

• Sleep problems
• Weight gain
• Puffy cheeks
• Frequent urination
• Lower bone density
• Acne

Besides side effects, another disadvantage to prednisone is that your platelet count may drop once you’ve finished your treatment.

IVIG (intravenous immune globulin). If you can’t get your platelet count up with prednisone, if you cannot tolerate steroids, or if your count drops after you’re done with your treatment, your doctor may suggest IVIG. You take this medication through an IV, usually for several hours a day over a period of 1 to 5 days.