Archive | October 2024

QUOTE FOR FRIDAY:

“Your liver is a powerhouse, performing over 500 life-sustaining functions. This 3-pound organ and is located in the upper-right part of your abdomen.  Can you live without a liver? No. The liver is so crucial to existence that while you can live with only part of a liver, you can’t live without any liver at all. Without a liver:

  • your blood won’t properly clot, causing uncontrolled bleeding
  • toxins and chemical and digestive byproducts will build up in the blood
  • you’ll have fewer defenses against bacterial and fungal infections
  • you can have swelling, including deadly swelling of the brain

Without a liver, death would occur in a matter of days.”

Healthline (https://www.healthline.com/health/can-you-live-without-liver)

Why the liver is so vital to our human body!

healthy liver

The liver is like our transmission to the human body—it cleans out end products of what enters our body keeping the essentials we need inside. This is what this organ does for us:

Your liver is your very own chemical processing plant. It receives 30% of the blood circulating in your system every minute – performing chemical reactions to remove harmful toxins and distribute and store essential nutrients. This vital process is called ‘metabolism’ and cells in the liver, known as hepatocytes, are put to work to keep your body working at its best. Essentially, your liver loves and cares for you.

Once carbs have been broken down into glucose in your gastrointestinal tract, the glucose enters the blood stream and is taken straight to your liver to regulate and maintain healthy levels. Your liver also stores excess glucose in the form of glycogen (inactive glucose) and the liver will fill up with this glycogenl (like a gas tank). When the tank of the liver gets full the excess of the sugar floating in your bloodstream is used by our tissues that need it right than.  The sugar that couldn’t go in the liver is extra glucose that now needs a place to store (if the liver is full) than it gets dumped in our fat tissue next. This is how we get obese. This is the logic of eating small meals not 3 large meals a day. The small meals are utilized mostly where there is no extra floating glucose that needs to be stored anywhere like in our case the fatty tissue. The average American doesn’t realize this with knowing that glycogen (inactive glucose) when needed by our body is ready for converting back into glucose when levels drop between meals which usually occurs during exercise or when you’re fasting; which most of us in America don’t do by overall population. For our liver to do these processes of breakdown of our foods (including medications), to convert active glucose to inactive glucose (glycogen), store glycogen in the liver and to do much more the liver has to be working meaning healthy.

And here’s the really clever thing. Your liver can also convert non-sugars, such as amino acids, into glucose to keep levels healthy. It does some pretty impressive things with fats too.

Every time you eat either through food or protein fluid drinks in place of your food, your liver feeds you. Once food is digested, nutrients enters the blood from the stomach after digestion in that organ takes place including the small intestines, which are taken straight to your liver for processing. Depending on how low or plentiful these nutrients are in your body, the liver cells will either release the goodness of these processed broken down nutrient end products to where it’s needed (regarding our tissues of the body) or store they will be stored away for when your body tissues needs a boost later.

And here’s the really clever thing. Your liver can also convert non-sugars, such as amino acids, into glucose to keep levels healthy. It does some pretty impressive things with fats too.

Your liver is your fat processing factory – it breaks down fat and compounds such as lipoproteins, cholesterol and phospholipids. If fat is in excess, the liver combines fatty acids and glycerol to form a storage molecule and transports it to your body’s storage depots, such as the subcutaneous tissue (tissue just under the skin). Then, at times when energy levels are low, between meals and during exercise, this stored fat is converted back into glycerol and the liver turns the remaining fatty acids into an alternative energy supply. To aid absorption of fat and fat-soluble vitamins and flush out unwanted substances from your body, your liver produces bile. It stores the bile in your gall bladder, where it can be emptied into your intestines when needed.

Proteins are also vital for a healthy body, and your liver takes charge of these too. Once proteins are broken down into amino acids in your intestines, they enter the blood stream and flow direct to the liver. Here, the liver cells (hepatocytes) go to work on removing nitrogen from the proteins which rapidly changes into ammonia – a highly toxic substance. Your liver then acts fast to convert this into urea to be excreted into the urine and eliminated from your body. With excess amino acids, your liver converts them into fat for storage or, if your body needs an energy boost, it will use them to create glucose.

Ending line the liver breaks down our Calories & CHOs, Fats, and Proteins that enter our body.

Our liver watches out for us. When harmful toxins and substances enter your blood stream, your liver acts fast to detoxify and destroy them. Some may simply be a by-product of a normal metabolism, others may be ingested or inhaled substances such as drugs and alcohol. Filtering the blood, your liver removes dead cells and invading bacteria, processes nitrogen and cholesterol and neutralises harmful hormones.

The problem comes when the body liver can’t do this function anymore, meaning it can’t break down or do the processing of out nutrients we eat causing toxins to build up in our body. Soon this break down of the liver with no reversal or without treatment will go into liver failure. Liver failure can put a big hold up in your life but if you can reverse it your smart since you addressed the problem in getting cared for by a doctor. You can even be better than this in being healthy to your body which is you taking PREVENTION in allowing yourself never to deal with this headache.

Liver failure or hepatic insufficiency is the inability of the liver to perform its normal synthetic and metabolic function as part of normal physiology. Two forms are recognized, acute and chronic.

Acute liver failure defined as “the rapid development of hepatocellular dysfunction, specifically coagulopathy and mental status changes (encephalopathy) in a patient without known prior liver disease.”.

Chronic liver failure usually occurs in the context of cirrhosis, itself potentially the result of many possible causes, such as excessive alcohol intake, hepatitis B or C, autoimmune, hereditary and metabolic causes (such as iron or copper overload, Steatohepatitis or non-alcoholic fatty liver disease).

CHRONIC can be prevented. How important is your health?

QUOTE FOR THURSDAY:

“October is Healthy Lung  Awareness.  Tips to keeping a healthy lung are the following:

1-Cigarette smoking is the major cause of lung cancer and chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Cigarette smoke can narrow the air passages and make breathing more difficult. It causes chronic inflammation, or swelling in the lung, which can lead to chronic bronchitis. Over time cigarette smoke destroys lung tissue and may trigger changes that grow into cancer.

2-Whether you are young or old, slender or large, able-bodied or living with a chronic illness or disability, being physically active can help keep your lungs healthy.

3-Secondhand smoke, chemicals in the home and workplace, mold and radon all can cause or worsen lung disease.”

American Lung Association (https://www.lung.org/lung-health-diseases/wellness/protecting-your-lungs)

Healthy Lung Month

October is a month set aside for lung awareness. It’s National Healthy Lung Month, and Lung Health Day is October 28. National Respiratory Care Week is October 25-30. It may seem arbitrary to set aside a particular month for health awareness, but it’s useful to remind ourselves of the things in our environment that can harm us and to act with compassion toward those who have already been harmed.

Lung disease affects a staggering number of Americans. About 10 million adults are diagnosed with chronic bronchitis each year, and about 4.7 million others have ever been diagnosed with emphysema. Chronic bronchitis and emphysema constitute the diseases that make up Chronic Obstructive Pulmonary Disease (COPD). About 25 million people live with asthma as well.

Occupational lung diseases, which include asbestosis and mesothelioma, also affect many Americans. Occupational illnesses are estimated to cost $150 billion annually. Chronic Obstructive Pulmonary Disease (COPD), typically caused by long-term exposure to lung irritants that damage the lungs and airways, is attributed to occupational exposure 19.2% of the time.

In support of Healthy Lung Month, let’s raise awareness about the rapid escalation of lung disease in the United States.

The notion that harmful air pollutants exist only outdoors is false. Some pollutants occurring in the home can be more harmful than those commonly encountered outdoors. Modern homes harbor many sources of respiratory irritation, but it’s not terribly difficult to lung-proof your home. Some common lung irritants found indoors are lead, formaldehyde, radon, cleaning agent vapors, and fire-retardants. Natural pollutants also make their way into the home, including pet dander, dust mites, and mold. Here are a few simple ways the people, especially those with lung disease, can avoid these lung damaging agents.

  • Clean the Air:Buy a vacuum with a HEPA filter to reduce lead, chemical build-up, and allergens such as pet dander in the home. Follow this step by mopping with a microfiber mop to soak up any leftover particles.
  • Avoid exposure to indoor pollutants that can damage your lungs.
  • Minimize exposure to outdoor air pollution.
  • Green Your Space:Fill your place with plants! Indoor plants help purify the air, removing toxins such as formaldehyde, benzene, toluene, and xylene. Spider plants and aloe vera plants are good choices for the home.
  • Go Natural: Fragrances in cleaning products, laundry detergents, and air fresheners can all damage the lungs opt for fragrance-free whenever possible.
  • Test for Radon: Make sure your home has a radon detector. This colorless, odorless gas is the second leading cause of lung cancer in the United States today.
  • Don’t Vape or Smoke

Your entire body depends on your lungs to keep breathing and distributing oxygen-rich blood throughout your body and to get rid of the body’s gaseous waste, carbon dioxide. Our bodies do have a natural defense system designed to protect the lungs, keeping dirt, germs and other irritants at bay. But there are some important things you can do on a regular basis to keep your lungs healthy and reduce the risk of disease.

Sometimes we take our health for granted. Lungs keep us alive and well and for the most part, we don’t need to think about them.  Remember without lungs we couldn’t survive.  Love your lungs this October and work to make any necessary changes to keep yours healthy!

QUOTE FOR WEDNESDAY:

“Spina bifida is a type of birth defect affecting the development of the baby’s spine. It occurs when a developing baby’s spine does not develop or close properly, leaving a section of the spinal cord and nerves exposed.

In the first month of pregnancy, a special set of cells form the neural tube. The top of the neural tube forms the baby’s brain and skull, while the rest of the neural tube becomes the baby’s spinal cord and other structures surrounding the spinal cord. Normally, the neural tube completely closes 28 days after conception. In people with spina bifida, though, parts of the neural tube stay open. An open neural tube leaves the brain or spinal cord exposed and at risk for damage, potentially causing physical and intellectual disabilities.”

Radiology Affiliates Imaging-RAI  (https://4rai.com/2022/09/15/october-is-spina-bifida-awareness-month/)

Part III Spina BIfida Awareness Month – How its diagnosed and treated!

 

How is Spina Bifida Diagnosed:

In most cases, spina bifida is diagnosed before birth (prenatal). However, some mild cases may go unnoticed until after birth (postnatal). Very mild forms of spinal bifida are found when doing tests for other conditions or may never be detected.

PRENATAL DIAGNOSED:

The most common screening methods used to look for spina bifida during pregnancy are maternal serum alpha fetoprotein (MSAFP) screening and fetal ultrasound.  A doctor can also perform an amniocentesis test.

  • Maternal serum alpha fetoprotein (MSAFP) screen.  At 16 to 18 weeks of pregnancy, a sample of the mother’s blood is taken to measure the level of a protein called alpha-fetoprotein (AFP), which is made naturally by the fetus and placenta.  During pregnancy, a small amount of AFP normally crosses the placenta and enters the mother’s bloodstream.  Abnormally high levels of AFP may indicate that the fetus has spina bifida or other neural tube defect.  This test is not specific for spina bifida and cannot definitively determine that there is a problem with the fetus.  This means that a high AFP level alone is not enough to be sure the fetus has a neural tube defect.  If a high level of AFP is detected, the doctor may request additional testing, such as an ultrasound or amniocentesis.

The second trimester MSAFP screen may be performed alone or as part of a larger, multiple-marker screen.  Multiple-marker screens can look for neural tube defects and other birth defects, including Down syndrome and other chromosomal abnormalities.  First trimester screens for chromosomal abnormalities also exist but signs of spina bifida are not evident until the second trimester when the MSAFP screening is performed.

  • Ultrasound.  A fetal ultrasound uses high-frequency sound waves to create a picture of the developing baby inside the womb.  It is highly accurate in diagnosing some birth defects during pregnancy, including spina bifida.  Fetal ultrasound can be performed during the first trimester (usually between 11-14 weeks) and the second trimester (usually at 18-22 weeks), and diagnosis is more accurate during the second trimester.
  • Amniocentesis.  In this test, a doctor removes a sample of the amniotic fluid that surrounds the fetus and tests it for protein levels that may indicate a neural tube defect and genetic disorders.

POSTNATAL DIAGNOSED:

Closed neural tube defects are often recognized at birth due to an abnormal fatty mass, tuft or clump of hair, or a small dimple or birthmark on the skin at the site of the spinal malformation.  Spina bifida occulta is usually found when x-rays are done for another reason.

In rare cases, myelomeningocele and meningocele are not diagnosed during routine prenatal tests.  The baby will be diagnosed when they are born with a bubble on their back.  Babies with myelomeningocele and closed neural tube defects may have muscle weakness in their feet, hips, and legs that result in joint deformities first noticed at birth.  Mild cases of spina bifida (occulta, closed neural tube defects) not diagnosed during prenatal testing may be detected postnatally using ultrasound or X-ray imaging to look at the spine.

Doctors may use magnetic resonance imaging (MRI) or a computed tomography (CT) scan to get a clearer view of the spinal cord and vertebrae.  To evaluate for hydrocephalus, the doctor will request a head ultrasound, CT or MRI to look for extra cerebrospinal fluid inside the brain.

HOW SPINA BIFIDA CAN BE PREVENTED, THE BEST TREATMENT TO GIVE YOUR BABY; being FOLIC ACID!

Women of childbearing age can reduce their risk of having a child with spina bifida by taking 400 micrograms (mcg) of folic acid every day pre-conception. Because it is water soluble, folic acid does not stay in the body for very long and needs to be taken every day to be effective against neural defects. Since half of all pregnancies in the United States are unplanned, folic acid must be taken whether a woman is planning a pregnancy or not. Research has shown that if all women of childbearing age took a multivitamin with the B-vitamin folic acid, the risk of neural tube defects could be reduced by up to 70%.  If you can prevent this the quality life is sure to be the best!

TREATMENTS FOR SPINA BIFIDA:

Some children with myelomeningocele and closed neural tube defects will need surgery to improve the alignment of their feet, legs, or spine.  Children with myelomeningocele usually have hydrocephalus and may require surgery to help drain fluid in the brain, such as the placement of a shunt or ETV.  Multiple surgeries may be required to replace the shunt, which may become clogged, infected, or disconnected.

Some individuals with myelomeningocele or closed neural tube defects require assistive devices for mobility such as braces, walkers, crutches, or wheelchairs.  The location of the defect on the spine often determines the type of assistive devices needed.  Children with a defect high on the spine will have little movement of the legs and will use a wheelchair for mobility.  Children with a defect lower on the spine usually have more strength in the legs.  They may be able to walk independently, or they may use crutches, leg braces, walkers, and wheelchairs depending on the activity.  Children with myelomeningocele usually have some degree of delayed mobility, so they are referred to physical therapists early on to maximize their strength and function.

Treatment for bladder and bowel dysfunction typically begins soon after birth.  Children with myelomeningocele and some closed neural tube defects have damage to the lowest spinal nerves which control typical bowel and bladder function.  Some children may be able to urinate typically, but most will need to drain their bladders with a catheter or thin tube 4-6 times a day to remain dry in between and to prevent kidney damage.  Kidneys are monitored closely so that medications or surgeries can be performed to prevent renal failure.  To prevent bowel accidents many people with myelomeningocele and closed neural type defects will use rectal medications or large volume enemas to have planned bowel movements.  Close follow-up with a spina bifida specialty clinic is recommended to develop a safe bowel and bladder program.

Treatment for progressive tethering of the spinal cord (called tethered cord syndrome) can be treated with surgery to help prevent further neurological deterioration.

 

 

 

 

 

 

 

 

 

QUOTE FOR TUESDAY:

“The cause of spina bifida is still unknown. Researchers believe it may be a combination of genetics and the environment that causes the condition. There are some things women who are pregnant or could get pregnant can do to help prevent spina bifida, including:

  • Take at least 400 micrograms of folic acid each day. Spina bifida happens early in a pregnancy, often before a woman even knows she is pregnant. All women who are sexually active should take folic acid supplements. While taking folic acid and getting the best prenatal care cannot completely prevent spina bifida, it can reduce the risk.
  • Talk with your primary care physician or pharmacist. If you’re planning to get pregnant or are sexually active, understanding how any prescriptions, over-the-counter medicines or supplements could affect a potential pregnancy can help you make decisions about your care.
  • Work with your provider to monitor and manage your medical conditions. If you have a condition such as Type 1 or Type 2 diabetes or are overweight, you will want to work with your OB/GYN or primary care provider before getting pregnant. Once you are pregnant, your OB/GYN may refer you to a maternal-fetal medicine specialist to get extra care during your pregnancy.
  • Avoid overheating your body (such as in a sauna or hot tub), and treat any fever you may have.”

NORTON Children’s (https://nortonchildrens.com/news/news-what-is-spina-bifida/)

Part II Spina Bifida Awareness-The complications that can arise from Spina Bifida!

  SPINA BIFIDA

   

TETHERED SPINALCORD (shown above)

 

FETUS WITH HYDROCEPHALUS (shown above)

  HYDROCEPHALUS

Spina Bifida is one of the causes of Tethered Spinal Cord and Hydrocephalus.

Tethered Spinal Cord is a stretch-induced functional disorder associated with the fixation (tethering) effect of inelastic tissue on the caudal spinal cord, limiting its movement. This abnormal attachment is associated with progressive stretching and increased tension of the spinal cord as a child ages, potentially resulting in a variety of neurological and other symptoms.

Hydrocephalus is caused by either increased production of CSF or impaired circulation and absorption

Spina bifida is a birth defect that affects the spine. Here are the latest national statistics on spina bifida in the United States:

1.)Each year, about 1,400 babies are born with spina bifida, or 1 in every 2,758 births, according to the U.S. Centers for Disease Control and Prevention. The exact cause of spina bifida is unknown. There is no cure but most people with spina bifida lead long and productive lives.

2.)Who it effects the most: Hispanic women have the highest rate of having a child affected by spina bifida, when compared with non-Hispanic white and non-Hispanic black women. Data from 12 state-based birth defects tracking programs were used to estimate the total number of pregnancies affected by spina bifida compared to the total number of live births (also called the prevalence of spina bifida) for each racial/ethnic group:

  • Hispanic: 3.80 per 10,000 live births
  • Non-Hispanic black or African-American: 2.73 per 10,000 live births
  • Non-Hispanic white: 3.09 per 10,000 live births

The symptoms listed below are some of the ways in which tethered spinal cord syndrome may be exhibited in children:

  • Lesion on the lower back
  • Fatty tumor or deep dimple on the lower back
  • Skin discoloration on the lower back
  • Hairy patch on the lower back
  • Back pain, worsened by activity and relieved with rest
  • Leg pain, especially in the back of legs
  • Leg numbness or tingling
  • Changes in leg strength
  • Progressive or repeated muscle contractions
  • Bowel and bladder problems

Spina bifida consequences that may occur, know the type of the spina bifida gives an idea of how many problems the patient will have:

  • Abnormal sensation or paralysis, which mostly occurs with closed neural tube defects and myelomeningocele.  People with these conditions typically have some degree of leg and core muscle weakness and loss of feeling in the groin and feet or legs.  The sensation can be more significant on one side of the body.
  • You may see deterioration of the gait in the patient’s walking.  Typically, the lower in the spine where the condition occurs results in less weakness and loss of feeling.  The strength and feeling do not improve with age due to nerve damage.  People with these types of spina bifida may lose strength and sensation as they grow and mobility can become more difficult with age.  People with these conditions may walk independently or use some combination of leg braces, walkers, crutches, or wheelchairs.  As they age, they may require more of these supports.
  • Chiari II malformation, in which parts of the brain called the brain stem and the cerebellum (hindbrain) protrude downward into the spinal canal or neck area.  It is almost always seen on advanced imagining of the brain in people with myelomeningocele, but it rarely causes symptoms.  When it does, this condition can press on the spinal cord and cause a variety of symptoms including difficulty breathing, swallowing, and arm weakness.  Surgery is sometimes required to reduce pressure in this area.
  • Blockage of cerebrospinal fluid, causing a condition called hydrocephalus.  Hydrocephalus is the abnormal buildup of the fluid that surrounds the brain.  Most people with myelomeningocele have this condition, which is not seen in the other types of spina bifida.  This buildup can put damaging pressure on the brain.  Hydrocephalus is commonly treated by surgically implanting a shunt—a hollow tube—in the brain which allows drainage of the excess fluid into the abdomen where it is absorbed by the body.  The tube is tunneled under the skin and not very noticeable to others.  Another treatment option is an endoscopic third ventriculostomy or ETV, a procedure that creates a new path for the fluid to flow.
  • Meningitis, an infection in the meninges covering the brain.  It can sometimes be associated with shunts.  Meningitis may cause brain injury and can be life-threatening.
  • Tethered cord syndrome can occur with all forms of spina bifida, although it is very rare in individuals with spina bifida occulta.  Usually the spinal cord and nerves float freely.  A tethered cord means that there is some type of tissue attached to and pulling the cord down.  This can cause damage to the nerves and decrease feeling and strength, as well as problems with bowel and bladder control.  It is surgically treated if a person has symptoms.
  • Bowel and bladder incontinence affect most individuals with myelomeningocele and closed neural tube defects.  The nerves at the very bottom of the spine control bowel and bladder function and don’t usually work properly in people with these types of spina bifida.  Most people with myelomeningocele and some types of closed neural tube defects need a regimen or other assistance to drain their bladders periodically or to have regularly scheduled bowel movements.
  • Learning disabilities, including difficulty paying attention, understanding concepts, impaired motor skills, impaired memory, and difficulty with organization and problem solving are commonly seen in children with myelomeningocele.  People with strength lower down in their legs tend to have less difficulty than those with more leg weakness.  Evaluation for an individualized education plan is recommended for all children with myelomeningocele.
  • Other complications such as skin ulcers, low bone mineral density, impaired male fertility, obesity, and kidney failure can be seen in people with myelomeningocele and neural tube defects as they age.  Additionally, people with myelomeningocele are at risk for precocious puberty (when changes to that of an adult occur too soon), sleep apnea, and depression.

The estimated lifetime cost of care for a person with spina bifida, with caregiving costs, is $791,900.

Learn tomorrow how you can prevent Spina Bifida with much more!

 

 

QUOTE FOR MONDAY:

“October is Spina Bifida Awareness Month—a time to celebrate the hundreds of thousands of people living with Spina Bifida. Every October, we highlight community stories that challenge us to raise more awareness and support for those living with Spina Bifida.  As a community, we can do this by raising awareness about Spina Bifida either in our own circles or larger networks. It’s also a great time for us to challenge ourselves to find new ways to get involved in raising awareness and advocacy activities.

Spina Bifida is a birth defect that is something you are born with, its not something you develop over time.  There is no cure to Spina Bifida. ”

Spina Bifida Association (https://www.spinabifidaassociation.org/awareness-month/)

Part I Spina Bifida Monthly Awareness-What it is, the risk factors and the 4 different types!

spina3  4 

                      spina4

Spina Bifida is the most common permanently disabling birth defect in the United States.

80% of these are located in the lumbar and sacral areas (lower back) of the spine.

Spina Bifida literally means “split spine.”

Spina Bifida happens when a baby is in the womb and the spinal column does not close all of the way. Every day, about 8 babies born in the United States have Spina Bifida or a similar birth defect of the brain and spine.

Spina bifida occurs during the third and fourth weeks of pregnancy when a portion of the fetal spinal cord fails to properly close. As a result, the child is born with a part of the spinal cord exposed on the back.

No one knows for sure the exact cause of spina bifida but have their ideas. Scientists believe that genetic and environmental factors act together to cause the condition.

Spina bifida is a birth defect that mainly affects the spine. Normally in the first month of pregnancy, a special set of cells forms the “neural tube.” The top of the tube becomes the brain and the remainder becomes the spinal cord and structures around it.  In spina bifida, the neural tube doesn’t close all the way and some of the bones of the spine don’t close in the back.

Often, abnormalities of the brain (such as hydrocephalus, described below) accompany abnormalities of the spine because the neural tube closes first in the middle and then closure proceeds both upward and downward—meaning that if something happens that prevents normal formation of the spine, it may also prevent normal formation of the part of the brain that is forming (closing) at the same time.

The term neural tube defect describes a group of conditions, including spina bifida, that occur when the neural tube does not close all the way.

Although doctors and researchers don’t know for sure why spina bifida occurs, they have identified a few risk factors:

  • Race. Spina bifida is more common among whites and Hispanics.
  • Sex. Girls are affected more often.
  • Family history of neural tube defects. Couples who’ve had one child with a neural tube defect have a slightly higher chance of having another baby with the same defect. That risk increases if two previous children have been affected by the condition.
  • In addition, a woman who was born with a neural tube defect, or who has a close relative with one, has a greater chance of giving birth to a child with spina bifida. However, most babies with spina bifida are born to parents with no known family history of the condition.
  • Folate deficiency. Folate (vitamin B-9) is important to the healthy development of a baby. Folate is the natural form of vitamin B-9. The synthetic form, found in supplements and fortified foods, is called folic acid. A folate deficiency increases the risk of spina bifida and other neural tube defects.
  • Some medications. Anti-seizure medications, such as valproic acid (Depakene), seem to cause neural tube defects when taken during pregnancy, perhaps because they interfere with the body’s ability to use folate and folic acid.
  • Diabetes. Women with diabetes who don’t control their blood sugar well have a higher risk of having a baby with spina bifida.
  • Obesity. Pre-pregnancy obesity is associated with an increased risk of neural tube birth defects, including spina bifida.
  • Increased body temperature. Some evidence suggests that increased body temperature (hyperthermia) in the early weeks of pregnancy may increase the risk of spina bifida. Elevating your core body temperature, due to fever or the use of saunas or hot tubs, has been associated with increased risk of spina bifida.
  • If you have known risk factors for spina bifida, talk with your doctor to determine if you need a larger dose or prescription dose of folic acid, even before a pregnancy begins.

There are 4 different types of Spina Bifida:

occulta, closed neural tube defects, meningocele, and myelomeningocele.

1-Occult Spinal Dysraphism (OSD) Infants with this have a dimple in their lower back. Because most babies with dimples do not have OSD, a doctor has to check using special tools and tests to be sure. Other signs are red marks, hyperpigmented patches on the back, tufts of hair or small lumps. In OSD, the spinal cord may not grow the right way and can cause serious problems as a child grows up. Infants who might have OSD should be seen by a doctor, who will recommend tests.

2-Spina Bifida Occulta It is often called “hidden Spina Bifida” because about 15 % of healthy people have it and do not know it. Spina Bifida Occulta usually does not cause harm, & has no visible signs.  Spinal Cord & nerves are usually fine.

Visible indications of spina bifida occulta (SBO) can sometimes be seen on the newborn’s skin above the spinal defect, including:

  • An abnormal tuft of hair
  • A collection of fat
  • A small dimple or birthmark.  Meningocele A meningocele causes part of the spinal cord to come through the spine like a sac that is pushed out. Nerve fluid is in the sac, and there is usually no nerve damage. Individuals with this condition may have minor disabilities.
  • Many people who have spina bifida occulta don’t even know it, unless the condition is discovered during an X-ray or other imaging test done for unrelated reasons. People find out they have it after having an X-ray of their back. It is considered an incidental finding because the X-Ray is normally done for other reasons. However, in a small group of people with SBO, pain and neurological symptoms may occur. Tethered cord can be an insidious complication that requires investigation by a neurosurgeon.

3-Meningomyelocele is a type of spina bifida. Spina bifida is a birth defect in which the spinal canal and the backbone don’t close before the baby is born. This type of birth defect is also called a neural tube defect.  Meningocele occurs when the bones do not close around the spinal cord and the meninges are pushed out through the opening, causing a fluid-filled sac to form. The meninges are three layers of membranes covering the spinal cord, consisting of dura mater, arachnoid mater and pia mater. In most cases, the spinal cord and the nerves themselves are normal or not severely affected. The sac is often covered by skin and may require surgery. This is the rarest type of spina bifida. 

4-Myelomeningocele (Meningomyelocele), also called Spina Bifida Cystica.  Myelomeningocele is the most severe form of spina bifida, occurring nearly once for every 1,000 live births.

Number 4 – This is the most severe form of Spina Bifida.

It happens when parts of the spinal cord and nerves  come through the open part of the spine. It causes nerve damage and other disabilities.  70 to 90% of children with this condition also have too much fluid on their brains HYDROCEPHALUS. This happens because fluid that protects the brain and spinal cord is unable to drain like it should. The fluid builds up, causing pressure and swelling. Without treatment, a person’s head grows too big, and may have brain damage. Children who do not have Spina Bifida can also have this problem, so parents need to check with a doctor. Usually, however, tissues and nerves are exposed, making the baby prone to life-threatening infections.  A portion of the spinal cord or nerves is exposed in a sac through an opening in the spine that may or may not be covered by the meninges. The opening can be closed by surgeons while the baby is in utero or shortly after the baby is born. Myelomeningocele is often called a snowflake condition because no two people with the condition are the same. Typically, the lower in the spine the opening occurs relates to less symptoms in the person. People with myelomeningocele require close follow-up with physicians throughout their childhood and lifespan to maximize their function and prevent complications such as kidney failure.

Neurological impairment is common, there is brain structure changes including:

  • Muscle weakness of the legs, sometimes involving paralysis
  • Bowel and bladder problems
  • Seizures, especially if the child requires a shunt
  • Orthopedic problems — such as deformed feet, uneven hips and a curved spine (scoliosis)Treatment for spina bifida depends on the severity of the condition.

    In general, Spina Bifida Treatment:

  1. Most people with spina bifida occulta require no treatment at all.
  2. Children with meningocele typically require surgical removal of the cyst and survive with little, if any, disability.
  3. Children with myelomeningocele, however take the longest road with treatment.  It require complex and often lifelong treatment and assistance. Almost all of them survive with appropriate treatment starting soon after birth. Their quality of life depends at least partially on the speed, efficiency, and comprehensiveness with which that treatment is provided.  A child born with myelomeningocele requires specialty care.  If the hospital the baby is in does not have newborn neuro surgery than the following is done:
  1. The child should be transferred immediately to a center where newborn surgery can be performed.
  2. Treatment with antibiotics is started as soon as the myelomeningocele is recognized; this prevents infection of the spinal cord, which can be fatal.

The operation involves closing the opening in the spinal cord and covering the cord with muscles and skin taken from either side of the back.

Remember the most common complications are tethered spinal cord and hydrocephalus, which can have very severe consequences.  This is discussed in the next couple of topics!

Updated 10/19/2021