Expert Blog

Are You at Risk for Carpal Tunnel Syndrome?

 By: Daniel O’Toole, MD Covenant Clinic Oelwein

Common Factors: Female, 30+ years of age, pregnant, or in menopause.
That’s right. The population with the biggest risk for developing Carpal Tunnel Syndrome (CTS) is females over the age of 30 who are pregnant or in menopause. According to WebMD, having two or more of these factors increase women’s chances significantly over men to be diagnosed with CTS.

Some other basic risk factors include doing activities that use finger and hand movements over and over again, previous wrist injuries, being overweight, diabetes, thyroid disease, and having a cyst on the tendon sheath in the wrist.   

CTS develops from pressure on the median nerve in the wrist. The median nerve runs from the forearm to the hand, and when a small piece in your wrist called the carpal tunnel exerts pressure on the nerve, CTS occurs. CTS may cause a number of signs, including:

  • Numbness or pain in your hand or wrist.
  • Numbness or tingling in the fingers of one or both hands, except for the little finger.
  • Numbness or pain that gets worse with the use of the hand.
  • Occasional aching pain from the hand to the elbow.
  • A weak grip.

If you have experienced any of these signs it is important to stop any activity that you think may be causing the numbness or pain. Other prevention or home treatments are to:

  • Use your whole hand to grasp objects.
  • Switch hands and change positions when doing repetitive motions.
  • Take frequent breaks.
  • Ask a health professional about wearing a wrist splint.
  • Pay attention to your posture.
  • Maintain good overall fitness. 

The sooner you start treating the warning signs of CTS, the better your chances are of getting rid of the symptoms and avoiding surgery. It is important to call your local health care provider if you still experience pain after home treatments. If CTS is left unattended, permanent damage to the nerves and muscles in the hand may result.

Sore Throat vs. Strep Throat

By Kristin Bockenstedt, ARNP – Covenant Clinic Arlington

The winter months seem to hit Iowans hard with many different health related illnesses from the common cold to a sore throat. It is not uncommon for doctors to get visits from sick children and worried parents in regard to the ever dreaded strep throat, but not all sore throats are strep throat. When deciding if a doctor visit is necessary it is important to know the difference.

A sore throat is a basic virus that usually clears up on its own without the use of antibiotics and usually accompanies or follows a cold. Some of the symptoms that come with a sore throat are coughing, runny nose, red eyes, and a hoarse throat.  It is when other symptoms start to develop that strep throat is setting in.

The most common symptoms of strep throat include:

  • Severe and sudden sore throat
  • Fever of 101° or higher
  • Swollen lymph nodes in the neck
  • White or yellow coating on the tonsils
  • Stomach pain
  • Loss of appetite
  • Rash

If you notice any two of the three symptoms listed it is recommended to contact your doctor to set up a visit. Strep throat is one of the most common winter illnesses among school aged children and teens. Early detection is key to preventing a more serious illness later and stopping it from spreading.      

Strep throat must be treated with prescribed antibiotics to prevent rheumatic fever.  Rheumatic fever is a disease that develops after strep throat if the strep throat is not treated.

 Along with treatments, many ways exist as to how to prevent sore or strep throat. Some of the most common ways including drinking eight to 12 glasses of water per day, identifying and avoiding irritants that can cause a sore throat, and avoiding contact with people who may have the illness.

But when in doubt about strep throat, always consult your local health care provider. It is better to be safe than sorry.

When is the right time to start potty training?

Written by: Nurse Patty. Source: Centramax

The best time to begin toilet training is when the child is ready to learn. Most children are ready between 2 and 3 years of age. By this age they are competent, confident, and comfortable enough for successful toilet training. However, children will be ready at their won pace, not when parents or day care centers want them to be. The child’s behavior is often a better guide than the child’s age. It is best to start toilet training when the child lets you know when diapers need to be changed because they prefer dry diapers.

Why do kids regress with bedwetting?

Written by: Nurse Sharon. Source: Centramax

The response depends on the age of the child and how long they have been potty trained. Wetting the bed at night is fairly common until age 6. Some children develop bladder control faster than others and most children who wet the bed overcome the problem between ages 6 and 10. Bedwetting is often due to a small bladder and as children grow, their bladders enlarge. This may explain why the problem may go away by itself with age. Problems with bedwetting also tend to run in families. Very rarely is bedwetting caused by a physical problem such as urinary tract infection, diabetes, or a nerve or muscle problem. Some children sleep so soundly they do not feel their bladder getting full or cannot wake themselves up.

Some things you can do to help your child with bedwetting:

  • Remind your child to go to the bathroom before going to bed.
  • Put a nightlight in the bathroom and encourage your child to get up to urinate during the night as needed. Consider a portable toilet if the bathroom is far away.
  • Encourage your child to drink plenty of liquids during the day. This may help produce more urine and help enlarge the bladder. However, limit fluids 2 hours before bedtime and avoid drinks that contain caffeine.
  • Avoid diapers and pull-ups. They do not help your child learn to get up at night to urinate.
  • Protect the mattress from urine with a waterproof pad or cover.
  • Establish a morning routine to deal with wet pajamas and bedding. Have your child help with the clean-up, but do not make the child feel ashamed for a wet bed.

There are some medicines that can be used to treat bedwetting for older children. However, wetting often returns when the medicine is stopped. Bedwetting alarms are often helpful. Ask your provider about using an alarm that goes off at the first sign of moisture in the bed.

Praise your child for dry nights and be understanding on wet nights. Do not punish your child for wetting the bed. A child’s self-esteem can be damaged by parents who punish or embarrass their child for bedwetting, or when siblings or friends make fun of them. Getting angry does not help and may make the situation worse. Restricting fluids or shaming your child do not help the child gain bladder control. These techniques only make your child more anxious. Be patient and supportive and remember that it is not the child’s fault.

Call your healthcare provider if your child is having any other problems with urinating such as pain or burning, a weak or dribbly urine stream, strong odor, or blood in the urine, or blood in the urine. Also call your provider if bedwetting is a new problem, or your child also wets during the day, if your child is constantly thirsty, has abdominal pain, or is over 12 years old.

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