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Labial agglutinationLLabial agglutinationLabial agglutinationEnglishGenital and reproductiveBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NAReproductive systemConditions and diseasesCaregivers Adult (19+)NA2009-11-10T05:00:00ZJoley Johnstone, RN, BScN7.7000000000000063.6000000000000972.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Labial agglutination occurs when the skin around the vagina sticks together. Read about possible treatments including estrogen cream and zinc oxide.</p><h2>What is labial agglutination?</h2><p>The labia are thin folds of skin around a girl's vagina. When a young girl's labia are stuck together, this is called labial agglutination. Sometimes the skin covers part or all of the opening of the vagina. Sometimes the skin also covers part of the urethra, where urine comes out. </p><p>Labial agglutination is also called "labial adhesion" or "fused labia". However, the labia are not permanently stuck or fused together. </p><p>Labial agglutination is usually painless. In fact, most parents and children do not notice the condition until a parent or doctor sees the genital area. In some cases, the condition is noticed because the skin is interfering with urination. </p> <figure class="asset-c-100"> <span class="asset-image-title">Labial agglutination</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Labial_adhesions_MED_ILL_EN.png" alt="Normal clitoris, urinary and vaginal openings, labia minora and labia majora and fused labia minora in labial agglutination" /> <figcaption class="asset-image-caption">There is a very thin skin called the labia minora that surrounds the openings of the vagina and urethra. Labial agglutination occurs when the inner lips become fused together. This may cover all or some of the vaginal and urethral openings.</figcaption> </figure><h2>Key points</h2> <ul> <li>When the skin around the vagina sticks together, it is called labial agglutination. </li> <li>Sometimes a doctor will prescribe estrogen cream to help the labia to open. </li> <li>Barrier creams, such as petroleum jelly and zinc oxide, can also help. So can good hygiene practices. </li> </ul><h2>No one knows what causes labial agglutination</h2> <p>Labial agglutination happens most often in girls aged between three months and six years old. In girls this age, the skin around the vagina is very delicate. This skin does not contain the female hormone called estrogen. Estrogen helps to stop the labia from sticking together. When girls go through puberty and their bodies start making estrogen, labial agglutination usually goes away without treatment. </p><h2>Diagnosing labial agglutination</h2> <p>If your child has labial agglutination, she may be sent to a gynaecology clinic. The doctor there will examine her and ask questions. The doctor will want to make sure the child can urinate without problems, and that there are no other problems with the vagina or the skin around it. </p> <p>If your child is old enough, the doctor and nurses will explain to her what is going on, using words she understands. This will ensure that your child is not scared and does not feel pain during the examination. </p> <h3>Mild cases</h3> <p>If the labial agglutination is small and your child can go to the bathroom without problems, your child may not need treatment. You will be asked to apply a barrier cream such as petroleum jelly (Vaseline) or zinc oxide on the labia. This will keep the labia from sticking together any more. As your daughter gets older and she begins to produce her own hormones, the labia will probably stop sticking together on their own. </p> <p>If the skin is sticking together more than before or if your daughter has trouble going to the bathroom, you should take her to the gynaecology clinic for another examination.</p><h2>Treating labial agglutination with hormone creams</h2> <figure><span class="asset-image-title">Treatment for labial agglutination</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Labial_adhesion_treatment_MED_ILL_EN.jpg" alt="Cotton swab over fused labia minora, with upward and downward arrows indicating movement of cotton swab" /> <figcaption class="asset-image-caption">Your doctor may give you medicated cream to treat labial agglutination. Place the medication along the line of the fused labia with a cotton swab.</figcaption> </figure> <p>Sometimes the doctor will prescribe a hormone cream. The hormone cream contains estrogen. Put a pea-sized amount every day on the place where the labia are stuck together. Use a cotton swab or fingertip to gently apply the cream.</p><p>The cream may take a few weeks to open the labia. The doctor or nurse will show you how to apply the cream directly on the line of agglutination.</p><p>Sometimes, the estrogen cream will make the skin around the vagina change colour. The skin colour will go back to normal after the treatment.</p><p>Sometimes the cream has side effects. If it is used for a long time, or in large amounts, it can make a girl's breasts grow a little. This is a normal and temporary side-effect. Your child's breasts will go back to normal once the treatment is stopped.</p><h3>Surgery for labial agglutination is very rare</h3><p>Rarely, if the cream does not work, surgery may be needed. If your daughter needs surgery, she will be put to sleep with medicine during the operation.</p>labialagglutinationhttps://assets.aboutkidshealth.ca/akhassets/Labial_adhesion_treatment_MED_ILL_EN.jpg
Laboratory and blood testsLLaboratory and blood testsLaboratory and blood testsEnglishNeonatologyPremature;Newborn (0-28 days);Baby (1-12 months)BodyNATestsPrenatal Adult (19+)NA2009-10-31T04:00:00ZKim Dionne, RN, MN, NNP9.2000000000000055.90000000000001007.00000000000Flat ContentHealth A-Z<p>Learn about laboratory and blood tests for premature babies. Blood work will likely be required a number of times, to monitor a premature baby's progress.</p><p>A premature baby will likely require multiple blood tests to diagnose specific conditions and then to monitor the baby's progress.</p><h2>Key points</h2> <ul><li>Some blood tests are standard and will be done whether a problem is suspected or not; other blood tests will only be done if a problem is suspected.</li> <li>Blood tests include complete blood count (CBC); blood sugar analysis; electrolyte tests; coagulation tests; renal and liver function tests; and chromosomal testing.</li> <li>An examination of the umbilical cord and placenta, as well as other body fluids will also be conducted.</li></ul>https://assets.aboutkidshealth.ca/akhassets/female-doctor-with-preemie-_EN.jpg
Labour and deliveryLLabour and deliveryLabour and deliveryEnglishPregnancyAdult (19+)Body;UterusReproductive systemNAPrenatal Adult (19+)NA2009-09-11T04:00:00ZNicolette Caccia, MEd, MD, FRCSCRory Windrim, MB, MSc, FRCSC11.800000000000042.0000000000000448.000000000000Flat ContentHealth A-Z<p>Read about childbirth, which include labour and delivery. The three stages of vaginal delivery are discussed. Answers from Canadian Paediatric Hospitals.</p><p>Roughly speaking, vaginal birth, also called labour and delivery, is divided into three stages. The first stage of labour lasts from the time when you start having contractions until the time that your cervix is fully dilated, or open. The second stage is the "pushing" stage where the baby is actually delivered. The third stage of labour is the delivery of the placenta. Each woman experiences these stages differently, and the stages may differ from one pregnancy to another. Sometimes the signs of each stage may overlap.</p><h2>Key points</h2> <ul><li>Labour and delivery is divided into three stages, though every woman experiences these stages differently.</li> <li>Before going into labour, you will want to learn about the details and what to expect.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/labour_and_delivery.jpg
Labour inductionLLabour inductionLabour inductionEnglishPregnancyAdult (19+)Body;UterusReproductive systemNAPrenatal Adult (19+)NA2009-09-11T04:00:00ZNicolette Caccia, MEd, MD, FRCSCRory Windrim, MB, MSc, FRCSC10.700000000000048.5000000000000889.000000000000Flat ContentHealth A-Z<p>This page describes the reasons that labour may need to be induced, and the techniques that are used to induce labour. Prostaglandin gel, artificial rupture of fetal membranes, and oxytocin are discussed.</p><p>If labour is not beginning or progressing as it should, your health-care provider may want to induce or enhance your contractions. Believe it or not, nipple stimulation or sexual intercourse can sometimes be an effective way to get those contractions going! However, sometimes other measures are needed. These may include application of prostaglandin gel, artificial rupture of the fetal membranes, or administration of a drug called oxytocin. </p><h2>Key points</h2> <ul><li>Labour may have to be induced if your baby is not thriving in the womb, the placenta has stopped working properly or if your pregnancy is overdue.</li> <li>A health-care provider can induce labour by administering prostaglandin gel to the cervix, artificially breaking the amniotic sac or giving synthetic oxytocin intravenously.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/labour_induction.jpg
Lactation aidLLactation aidLactation aidEnglishNutritionNewborn (0-28 days);Baby (1-12 months)NANANon-drug treatmentCaregivers Adult (19+)NA2009-11-10T05:00:00ZIola Panetta, BScN, RN, IBCLC, RLC;Debbie Stone, RN, IBCLC, RLC;Joyce Touw, BScN, PNC(C), RN, IBCLC, RLC6.3000000000000075.20000000000001940.00000000000Health (A-Z) - ProcedureHealth A-Z<p>A lactation aid is a way to give your baby more nutrition while breastfeeding. Read about what supplies are required and tips for successful feeding.</p><h2>What is a lactation aid?</h2> <p>A lactation aid is a device that lets you give your baby extra breast milk or formula while your baby is feeding at your breast. This extra liquid food is called a feeding supplement. A feeding supplement may be any of the following: </p> <ul> <li>Milk that you take from the breast with your hand or a breast pump. This milk is called <a href="/Article?contentid=443&language=English">expressed breast milk</a>. </li> <li>Baby formula.</li> <li>A liquid or powder that you add to breast milk or to formula for extra <a href="/Article?contentid=1197&language=English">calories</a>.</li> </ul> <h2>Why use a lactation aid?</h2> <ul> <li>Your milk supply is low. </li> <li>Your baby needs extra calories or liquids to gain weight. </li> <li>Your baby gets tired easily during feedings.</li> </ul><h2>Key points</h2> <ul> <li>A lactation aid is a method of getting your baby more nutrition and calories while breastfeeding.</li> <li>To use a lactation aid, you will need some supplies.</li> <li>Your baby should know how to latch and suck.</li> <li>Feedings with lactation aids should continue until your baby has grown and gained enough weight. Talk to your doctor.<br></li> <li>Use of a lactation aid needs to be supervised by a breastfeeding specialist or doctor once you are discharged from the hospital.</li> </ul><h2>Using a lactation aid</h2><p>A lactation aid works best for babies who have learned to latch (attach) on to the breast properly and to suck well. Getting started with a lactation aid can sometimes be hard. It takes a bit of practice, but using a lactation aid gets easier each time you do it. Ask your nurse to help you with one of these two methods of using a lactation aid.</p><h3>Method 1: Taping the lactation aid to your breast before your baby latches to the breast</h3><ol class="akh-steps"><li> <a href="/Article?contentid=1981&language=English">Wash your hands</a> thoroughly.</li><li>Prepare the feeding supplement by following the recipe written by the dietitian.</li><li> <figure> <span class="asset-image-title">Lactation aid using a syringe</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Lactation_aid_tube_taped_1_EQUIP_ILL_EN.jpg" alt="Mother feeding baby with lactation aid using a syringe" /> <figcaption class="asset-image-caption">Fasten the syringe to your clothing.</figcaption></figure> <p>If you are using a syringe, fasten the wide end of the feeding tube to the tip of the syringe. Remove the plunger from the syringe. Pour the feeding supplement into the syringe. Put the elastic band around the top of the syringe. Then put a safety pin through the end of the elastic so that you can fasten the syringe to your clothing. The bottom of the syringe should be at the same level as your baby's head.</p></li><li> <figure> <span class="asset-image-title">Lactation aid using a bottle</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Lactation_aid_tube_taped_4_EQUIP_ILL_EN.jpg" alt="Mother feeding baby with a lactation aid using a bottle" /> <figcaption class="asset-image-caption">The bottle should be at the level of the baby's head.</figcaption> </figure> <p>If you are using a bottle, put the small end of the feeding tube through the enlarged nipple hole, leaving the large end of the tube touching the bottom of the bottle. Pour the supplement into the bottle. Put the bottle on a flat surface close to you, at the level of the baby's head.</p></li><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/Lactation_aid_tube_taped_2_EQUIP_ILL_EN.jpg" alt="Holding baby’s head up to breast with lactation aid attached" /> <figcaption class="asset-image-caption">Hold the breast with your thumb on top and fingers underneath. Tickle the baby's lip with the nipple.</figcaption> </figure> <p>Tape the small end of the feeding tube to your breast. The feeding tube should come down from the top of your breast or come from the side of your breast. The feeding tube should end just at the end of your nipple.</p></li><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/Lactation_aid_tube_taped_3_EQUIP_ILL_EN.jpg" alt="Correct position of lactation aid tube in baby’s mouth" /> <figcaption class="asset-image-caption">Milk will flow along the tube when the tube is in the correct position.</figcaption> </figure> <p>Latch your baby onto your breast so that their mouth covers the end of the tube and the breast. When they open wide, as wide as a yawn, quickly pull them towards your breast. The baby's chin comes to your breast first, then their lower lip, then their upper lip last. Cover more of the areola with the lower lip than the upper lip. The tip of the nose may touch or be close to the breast.</p></li></ol><h3>Method 2: Sliding the lactation aid into the baby's mouth after the baby latches onto your breast</h3><ol class="akh-steps"><li>Wash your hands thoroughly.</li><li>Prepare the feeding supplement by following the recipe written by the dietitian.</li><li>If you are using a syringe, fasten the wide end of the feeding tube to the tip of the syringe. Remove the plunger from the syringe. Pour the feeding supplement into the syringe. Put the elastic band around the top of the syringe. Then put a safety pin through the end of the elastic so that you can fasten the syringe to your clothing. The bottom of the syringe should be at the same level as your baby's head.</li><li>If you are using a bottle, put the small end of the feeding tube through the enlarged nipple hole, leaving the large end of the tube touching the bottom of the bottle. Pour the supplement into the bottle. Put the bottle on a flat surface close to you, at the level of the baby's head.</li><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/Lactation_aid_tube_slide_1_EQUIP_ILL_EN.jpg" alt="Breastfeeding baby" /> <figcaption class="asset-image-caption">Latch your baby onto your breast.</figcaption> </figure> <p>Latch your baby onto your breast. Your baby should be latched on well and feeding.</p></li><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/Lactation_aid_tube_slide_2_EQUIP_ILL_EN.jpg" alt="Sliding tube beside nipple and into baby’s mouth while baby is latched on" /> <figcaption class="asset-image-caption">Slide the feeding tube in beside the nipple in the corner of the baby's mouth.</figcaption> </figure> <p>Once your baby is sucking well at the breast, slowly slide the feeding tube into the side of your baby's mouth. Aim the feeding tube toward the roof of the mouth on top of the tongue. Stop moving the tube when you see the feeding supplement start to move in the feeding tube towards the baby's mouth. You may find it helpful to hold the feeding tube against the breast with your finger, or you can tape the feeding tube to your breast.</p></li><li> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/Lactation_aid_tube_slide_3_EQUIP_ILL_EN.jpg" alt="Correct position of lactation aid tube in baby’s mouth" /> <figcaption class="asset-image-caption">Milk will flow along the tube when the tube is in the correct position.</figcaption> </figure> <p>With either method 1 or method 2, you will know that the feeding tube is in the right place if you can see the feeding supplement start to move along the feeding tube each time your baby sucks.<br></p></li></ol><h2>Cleaning your lactation aid is easy</h2> <p>Wash your lactation aid with warm soapy water, using a dish washing soap. Make sure to run the water through the tube as well. Attach the syringe to the blue end of the tube. Fill the syringe with soapy water. Insert the plunger and push the water through the tube. Rinse well with clean warm water. Again, run this water through the tube. Make sure there is no dry feeding supplement left in any part of the lactation aid. Fill the syringe with air and push the air through the tube to remove the water. </p> <p>Put the lactation aid in a clean towel or plastic bag. For home use, the feeding tube can be used for seven days or until the feeding tube becomes hard. </p> <p>Note: You should not boil the lactation aid because boiling will make the plastic hard too quickly.</p><h2>Supplies you will need to use a lactation aid to feed your baby</h2> <ul> <li>A number 5 French feeding tube that is 36 inches long.</li> <li>A baby bottle or a syringe without a needle that will hold 30 to 60 mL of liquid. A syringe is a hollow tube that has a plunger and holds liquids.</li> <li>Adhesive or clear medical tape.</li> <li>A feeding supplement such as expressed breast milk, expressed breast milk with added calories or baby formula.</li> <li>If you are using a syringe, an elastic band and safety pin or a flat surface to put the bottle on.</li> <li>A plastic bag you can seal to store the feeding tube.</li> </ul> <p>Ask your nurse or lactation consultant where to buy these supplies. You can buy a ready-made lactation aid called a Supplemental Nursing System or Starter Nursing Kit. These supplies may be available at your local hospital. Some drugstores and medical supply stores may also carry these supplies. If you are unable to get these supplies at your location, they can also be ordered in person, on the phone or online from The Specialty Food Shop at The Hospital for Sick Children in Toronto. For details, go to: <a href="https://www.specialtyfoodshop.ca/products/baby-kids/infant-feeding-supplies/breast-pumps-supplies" target="_blank">http://www.specialtyfoodshop.ca/specialtyfoodshop/</a> or call 1-800-737-7976. The Specialty Food Shop may be able to ship these supplies to your location.</p> <p>The Supplemental Nursing System and Starter Nursing Kit are also available from the manufacturer. For details, go to: <a href="http://www.medela.ca/" target="_blank">www.medela.ca</a>.</p><h2>At SickKids</h2> <p>You can buy supplies for the lactation aid at the Specialty Food Shop on the main floor of the hospital. You may not be able to buy all of them at your local drug store. Speak to your nurse about how to care for this equipment while your baby is at SickKids.</p> <p>The Specialty Food Shop sells ready-made lactation aids called the Supplemental Nursing System or the Starter Nursing Kit, as well as other breastfeeding supplies.</p>https://assets.aboutkidshealth.ca/akhassets/Lactation_aid_tube_taped_2_EQUIP_ILL_EN.jpg
Landau-Kleffner syndromeLLandau-Kleffner syndromeLandau-Kleffner syndromeEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesCaregivers Adult (19+) EducatorsNA2010-02-04T05:00:00ZElizabeth J. Donner, MD, FRCPC11.000000000000042.00000000000001538.00000000000Flat ContentHealth A-Z<p>Read about the causes, symptoms, and treatments for Landau-Kleffner syndrome epilepsy, a rare condition in which children have difficulty with speech.</p><p>Landau-Kleffner syndrome is a rare condition in which children lose the ability to speak and understand speech. This change is associated with seizures that are usually infrequent or easily controlled with medication and with a specific EEG pattern known as electrical status epilepticus in sleep (ESES).</p> <p>Landau-Kleffner syndrome seems to be part of a continuum of syndromes that involve an abnormal EEG pattern and various different symptoms. A related syndrome is epilepsy with continuous spikes and waves during slow sleep (CSWS), which is also discussed below.</p><h2>Key points</h2> <ul><li>The signs of Laundau-Kleffner syndrome usually appear when a child is between three and eight years old. They include mild seizures along with a gradual loss of speech and loss of ability to understand speech.</li> <li>The exact cause of Landau-Kleffner syndrome is not known. It may be caused by an underlying brain problem, such as a malformation at or around birth, a cyst or a brain tumour.</li> <li>Seizures can be treated with medications and usually disappear by age 15.</li> <li>Language difficulties can sometimes be treated with medications, but in most cases special teaching methods and classroom supports are needed.</li></ul>
Laparoscopic surgeryLLaparoscopic surgeryLaparoscopic surgeryEnglishNAChild (0-12 years);Teen (13-18 years)AbdomenNAProceduresCaregivers Adult (19+)NA2009-11-10T05:00:00ZJoley Johnstone, RN, BScN9.6000000000000051.40000000000001082.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Laparoscopy surgery uses small cuts to insert a camera and tools into the abdomen to perform a surgical procedure. Learn about laparoscopy surgery.</p><figure> <span class="asset-image-title">Laparoscopic surgery</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Laparoscopic_surgery_MED_ILL_EN.jpg" alt="Laparoscope and gas inside abdomen" /> <figcaption class="asset-image-caption">A small incision is made at the belly button. A long tube-like camera called a laparoscope is inserted through this incision into the abdomen. The abdomen is inflated with gas so that the doctor can see the organs inside. One to three other small openings may be made elsewhere on the abdomen for other instruments.</figcaption> </figure> <h2>What is laparoscopic surgery?</h2><p>Laparoscopic (lap-uh-ra-SCOP-ic) surgery is a way to perform operations using only very small incisions (cuts) into the skin. This type of surgery uses a thin rod-shaped instrument with a tiny camera on the tip, called a laparoscope. The laparoscope is put into the body and moved from the outside by the surgeon. The camera sends pictures to a TV monitor or other viewing device. During the operation, the surgeon can see the organs inside the body on the viewing device.</p><p>Because this modern surgical technique does not require opening up the body as much as traditional open surgery does, medical people call laparoscopy minimally invasive surgery.</p><p>Laparoscopy is used for many different types of surgery on the abdomen and pelvis. Depending on the type and reasons for the surgery, the laparoscopy may take several hours.</p><h2>Key points</h2> <ul> <li>Laparoscopy is a common surgical procedure that involves several small cuts in the abdomen (belly). </li> <li>It can be used for diagnosis and treatment of many gynaecological problems, but not for every problem. </li> <li>Your child will probably not have to stay in hospital. </li> <li>Your child should not have very much pain after the procedure. </li> </ul><h2>During a laparoscopic surgery</h2><p>Like traditional open surgery, laparoscopy is done in the hospital. Your child will be prepared for surgery and will probably have to stop eating and drinking several hours before the procedure begins. </p><p>During the procedure, your child will be put to sleep with a special "sleep medicine" called general anesthetic. This helps make sure that your child will sleep through the procedure and will feel no pain. </p><p>Your child's abdomen (belly) is filled with carbon dioxide gas (CO2). This lifts the abdominal wall like a dome. It gives the surgeon a better view of the organs inside the body, like the uterus, ovaries and bladder. It also gives the surgeon more space to work inside the body. </p> <figure class="asset-c-80"> <span class="asset-image-title">Laparoscopic incision points</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Laparoscopy_incision_points_MED_ILL_EN.jpg" alt="Incision points under belly button and on lower abdomen" /> <figcaption class="asset-image-caption">A small incision is made at the belly button. One to three other small openings may be made elsewhere on the abdomen for other instruments. The incisions are about 1-2 cm in length.</figcaption> </figure> <p>The surgeon makes a 1 cm incision (about half an inch) near the belly button for the laparoscope. Then the surgeon makes small 5 mm incisions (about a quarter inch each) in the lower corners of the abdomen. These incisions are for any other instruments that might be needed. </p><p>The number and exact location of the incisions depends on which type of surgery is being performed. If different incisions are being used, your doctor will tell you ahead of time. </p><p>After the operation is finished, all the instruments are removed. The CO2 gas is removed from inside the body. Any remaining CO2 is absorbed and naturally processed by the blood. The surgeon closes the incisions with dissolving stitches and/or steristrips. Steristrips are little sticky tapes used to help hold together and protect the healing skin.</p><h2>After the laparoscopic surgery</h2> <p>Children usually recover faster from laparoscopic surgery than from traditional open surgery. Many patients go home the same day as the surgery. Because of the smaller incisions, scars are very small compared to traditional surgery. </p> <p>Many children return to school after a few days.</p> <p>Depending on the surgery, your child may take a little longer to return to all of their usual physical activities, such as contact sports. Ask your doctor what activities your child can and cannot do in the days and weeks after the surgery.</p> <h2>Managing pain after the operation</h2> <p>Children usually have less pain after laparoscopic surgery than after traditional open surgery. If there is pain after the surgery, your child's doctor may prescribe a pain medication. Or, the doctor may suggest your child take a non-prescription pain medication such as <a href="/Article?contentid=153&language=English">ibuprofen</a>.</p> <p>Your child's shoulders might be sore as the remaining CO2 gas from the operation is re-absorbed into the body. The gas can irritate the diaphragm, which is a muscle in the abdomen. Because the diaphragm muscle shares nerves with the shoulders, some children have sore shoulders after the surgery. </p>https://assets.aboutkidshealth.ca/akhassets/Laparoscopic_surgery_MED_ILL_EN.jpg
Lasix renal scanLLasix renal scanLasix renal scanEnglishOtherChild (0-12 years);Teen (13-18 years)KidneysKidneysTestsCaregivers Adult (19+)NA2013-12-05T05:00:00ZMandy Kohli, Clinical Co-ordinator, Nuclear Medicine8.0000000000000068.0000000000000759.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how a Lasix renal scan is done and how it shows how the kidneys are working.</p><h2>What is a Lasix renal scan?</h2> <p>A Lasix renal scan is a test to look at how the kidneys are working and if there is any obstruction (blockage) in the kidney area.</p><h2>Key points</h2> <ul> <li>A Lasix renal scan is a test to look at how the kidneys are working. It can take up to two hours.</li> <li>Your child will have an injection to get fluids, a tiny amount of radioactive medicine, and Lasix medication. A catheter will then be inserted in their urethra to keep their bladder empty while a special camera takes pictures of their kidneys.</li> <li>Your child will need to urinate more than usual after the test because of the Lasix medication. Give them clear fluids regularly to keep them hydrated.</li> <li>A nuclear medicine doctor will send the results of the scan to your family doctor or paediatrician (child's doctor) within two working days. The person who does the scan cannot give the results.</li> </ul><h2>How long will the scan take?</h2> <p>The scan can take up to two hours. Please add half an hour to this time if your child has a topical anaesthetic before the injection.</p><h2>Will I be able to stay with my child during the scan?</h2> <p>One parent or guardian may stay in the room during the scan, but no other children are allowed.</p> <h2>How is the Lasix scan done?</h2> <p>A nuclear medicine technologist will do the test. They will explain it to your child'step by step.</p> <p>Your child will first have an injection (needle) into their vein to give fluids, a very small amount of radioactive medicine, and medication called Lasix.</p> <p>The technologist will then gently place a small flexible tube called a catheter in your child's urethra (say: yoo-REETH-ra). The urethra is the opening that allows urine to flow out of the bladder.</p> <p>The catheter helps keep your child's bladder empty while the camera takes pictures of the kidneys. The radioactive medicine will be clear in the pictures and will show if your child's kidneys are blocked in any way.</p> <p>Once the scan is done, the technologist will gently remove the catheter.</p> <p>The technologist will do everything they can to respect your child's privacy and make your child as comfortable as possible during the scan.</p> <p>Note: The injection before the scan is not painful, but your child's hand or arm can still be numbed first with a topical anaesthetic (a special cream or cooling spray). If you would like this option, it is best to arrive at least 30 minutes before your appointment to allow the anaesthetic to take effect.</p><h2>Are there any side effects from the scan?</h2> <p>Your child may feel some discomfort, such as a burning feeling, the first few times they urinate (pee) after the test. Your child will also need to urinate more than usual because of the Lasix medication.</p> <p>Drinking clear fluids, such as water, will help to ease any discomfort and keep your child hydrated.</p><h2>How should I prepare my child for the scan?</h2> <p>Take time to explain the scan to your child in the simple words that your family uses to describe how the body works. Children who know what to expect are usually less anxious.</p> <p>Your child may feel some discomfort as the catheter is placed, but remind them that they can take slow deep breaths or pretend to blow up a balloon to help themselves feel more comfortable.</p> <h2>Does my child need to do anything special to prepare for the scan?</h2> <p>No, your child can eat and drink as usual.</p> <p>If your child has a heart problem, however, they might need to take an antibiotic before the test. Your doctor should give you a prescription for the antibiotic and tell you how your child should take it.</p> <p>Your doctor's office will also tell you if your child needs to go for a blood or urine test before the scan.</p><h2>At SickKids</h2> <p>If your child needs a blood test before the renal scan, it can be done in the Ambulatory Centre on the main floor near Shoppers Drug Mart. Please arrive at the hospital early to allow enough time for the test and be on time for the scan.</p> <p>If you have any questions or concerns about the scan or if you need to change your appointment, please call the Nuclear Medicine Department at 416-813-6065.</p><h2>Source<br></h2><p>Alliance for Radiation Safety in Pediatric Imaging (2013). <a href="https://www.imagegently.org/Roles-What-can-I-do/Parent/Nuclear-Medicine"> <em>Image Gently: Nuclear Medicine - What can I do as a parent?</em></a> </p>
Late effects after an allogeneic transplantLLate effects after an allogeneic transplantLate effects after an allogeneic transplantEnglishHaematology;Immunology;OncologyChild (0-12 years);Teen (13-18 years)BodyImmune systemNATeen (13-18 years) Adult (19+)NA2010-03-19T04:00:00ZJohn Doyle, MD, FRCPC, FAAPChristine Armstrong, RN, MScN, NP Peds7.9000000000000062.5000000000000357.000000000000Flat ContentHealth A-Z<p>Learn about the potential late effects after your child's allogeneic transplant.</p><p>Some of the drugs and treatments used to prepare your child for an allogeneic blood and marrow transplant (BMT) may cause damage to healthy cells in the body. This can appear as side effects years later, after your child finishes treatment.</p><h2>Key points</h2> <ul><li>Chemotherapy medicines taken before a BMT may cause side effects for your child later in life, after treatment has ended.</li> <li>Some late effects may be due to the transplant itself.</li></ul>
Late effects after an autologous transplantLLate effects after an autologous transplantLate effects after an autologous transplantEnglishHaematology;Immunology;OncologyChild (0-12 years);Teen (13-18 years)Body;Thyroid;Heart;Mouth;Teeth;Lungs;EyesImmune systemNATeen (13-18 years) Adult (19+)NA2010-03-19T04:00:00ZJohn Doyle, MD, FRCPC, FAAPChristine Armstrong, RN, MScN, NP Peds8.9000000000000055.5000000000000817.000000000000Flat ContentHealth A-Z<p>Learn about the late effects after your child's autologous transplant.</p><p>During your child’s blood and marrow transplant (BMT) they take many chemotherapy medicines. These drugs are important because they kill your child’s diseased marrow cells.</p><p>The treatment is an effective way to prepare your child’s body for the transplant. But some of these medicines may also damage healthy cells in different parts of the body. This can appear as side effects many years after your child finishes treatment. These are called late effects. </p><p>Many of the potential late effects are a consequence of certain kinds of chemotherapy.</p><h2>Key points</h2><ul><li>Late effects of an autologous transplant include fertility, heart, dental and respiratory problems, as well as a risk of developing secondary cancers and cataracts.</li></ul>
Lead poisoningLLead poisoningLead poisoningEnglishNAChild (0-12 years);Teen (13-18 years)NANAConditions and diseasesCaregivers Adult (19+)NA2010-05-07T04:00:00ZMark Feldman, MD, FRCPC7.0000000000000065.0000000000000856.000000000000Health (A-Z) - ConditionsHealth A-Z<p>An overview of the causes, symptoms, treatment options, and prevention of this rare, but harmful, condition in children.</p><h2>What is lead poisoning?</h2> <p>Lead is present in small amounts in the air, soil, household dust, food, drinking water and products like some cheap jewelry or toys. Lead poisoning occurs when lead builds up in the body. The build-up can take place over months or years.</p> <p>Small amounts of lead can cause serious damage in children or unborn children in the womb (before the baby is born). Children’s small bodies absorb lead easily and are more at risk to its harmful effects. In large quantities, lead poisoning can be fatal to children and adults. </p><h2>Key points</h2> <ul> <li>Lead poisoning occurs when lead builds up in the body. </li> <li>The build-up can take place over months or years. </li> <li>A common cause of lead poisoning is licking a lead-coated object or inhaling dust from lead-based paint.</li> <li>Lead poisoning is linked with harmful effects on children’s growth, attention and behaviour. Low levels of lead can lead to lower intellect and poor hearing.</li> <li>Removal of lead from the child’s environment is the main treatment. </li> <li>Lead poisoning is quite rare in Canada.</li> </ul><h2>Signs and symptoms of lead poisoning</h2> <p>Sudden lead poisoning causes damage to the brain. A child may have seizures or go into a coma. Short-term exposure to high levels of lead can cause the following signs and symptoms:</p> <ul> <li><a href="/Article?contentid=746&language=English">vomiting</a></li> <li><a href="/article?contentid=7&language=English">diarrhea</a></li> <li>convulsions</li> <li>coma</li> <li>death</li> </ul> <p>Severe cases of lead poisoning are rare in Canada. Long-term exposure is more common. Symptoms may include:</p> <ul> <li>loss of appetite </li> <li>stomach pain </li> <li><a href="/article?contentid=6&language=English">constipation</a> </li> <li>fatigue</li> <li>insomnia </li> <li><a href="/article?contentid=29&language=English">headache</a></li> </ul><h2>Causes</h2> <p>Lead poisoning has many causes. A common cause in young children is swallowing or licking lead-coated objects. Babies and young children often put non-food items in their mouth. Children can inhale contaminated dust or eat lead paint chips during a home renovation or move. Lead poisoning can also be caused by drinking water from lead-coated plumbing. Other sources of lead poisoning include:</p> <ul> <li>contaminated air or soil</li> <li>some toys, household items and cosmetics</li> <li>kohl eye make-up</li> <li>glazed ceramics made outside of Canada</li> <li>leaded glass</li> <li>storage battery coverings</li> <li>bullets</li> </ul><h2>What a doctor can do for your child with lead poisoning</h2> <p>Your child’s doctor can order a blood test to determine your child’s lead exposure, however, this is not often necessary as lead poisoning is quite rare in Canada. Discuss your child’s exposures with your doctor to see if blood testing is necessary. Blood screening may be important if there is a high-risk exposure, since lead exposure does not always lead to symptoms in children. Blood lead level tests are recommended only for children with risk factors. </p> <h2>Treatment</h2> <p>To treat lead poisoning, doctors try to flush out lead in the child’s intestines. They also give the child medicine called chelating agents. These are chemicals that can pull lead out of the bloodstream and into the urine so it can leave the body.</p> <p>Removal of lead from the child’s environment is the main treatment. </p><h2>Complications</h2> <p>Lead poisoning is linked with harmful effects on children’s growth, attention and behaviour. Other complications may include:</p> <ul> <li><a href="/article?contentid=841&language=English">anemia</a></li> <li>brain, kidney and nervous system damage</li> </ul> <p>Low levels of lead can lead to lower intellect and poor hearing.</p><h2>When to seek medical assistance</h2><h3>See your child’s regular doctor if:</h3><ul><li>you think your child may have been exposed to small amounts of lead</li> </ul><h3>Take your child to the nearest Emergency Department, or call 911 if necessary, if your child:</h3><ul><li>has swallowed or licked a lead-coated toy or object</li><li>is suffering seizures, convulsions or coma</li></ul><h2>References</h2> <p>Effects of lead on human health, Health Canada, Government of Canada. Last accessed May 2010.</p> <p>Health effects of lead, Toronto Public Health: Last accessed May 2010.</p> <p>Lead and Drinking Water, Government of Ontario, Ministry of the Environment. Last accessed March 2010.</p> <p>Lead risk reduction strategy, Health Canada, Government of Canada. Last accessed May 2010.</p> <p>Yeoh B, Woolfenden S, Wheeler DM, Alperstein G, Lanphear B. Household interventions for prevention of domestic lead exposure in children. <em>Cochrane Database of Systematic Reviews</em> 2008, Issue 2. Art. No.: CD006047.</p>
LearningLLearningLearninglearningEnglishNAChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NALanding PageLearning Hub<p>Helpful information for parents to help their child get the most out of school. Learn about academic milestones, bullying and how different types of health conditions and learning disabilities may affect your child at school.</p>​<p>Starting school allows children to build on the skills they have already started developing at home. Find information for parents to help their child get the most out of school, both in and out of the classroom. Learn about academic milestones for children and what you can do to help your child. Find information about how different health conditions and learning disabilities may affect your child at school. Also find resources about bullying and download some tip sheets for parents about bullying in young children.</p>learninghttps://assets.aboutkidshealth.ca/AKHAssets/learning_and_education_landing_page.jpg
Learning & education: Before your child goes back to schoolLLearning & education: Before your child goes back to schoolLearning & education: Before your child goes back to schoolEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemNAAdult (19+)NA2010-01-15T05:00:00ZJennifer Russell, MC, FRCPC7.0000000000000071.0000000000000789.000000000000Flat ContentHealth A-Z<p>Essential information regarding issues that one should consider and take into account before sending a child with a heart condition back to school.</p><p>If your child has been out of school for some time, going back is a good way to get back into the routine and reconnect with friends. However, the change can be hard. Plan the transition back to school. Your child may have mixed feelings. They may have fallen behind in schoolwork. They may be out of touch with friends and may not be feeling well because of the effects of the treatment. Their school may not have experience dealing with children with heart conditions. </p> <p>Your child may have had tutoring in hospital and/or at home, and their classmates may have kept them in touch with the latest developments. However, returning to school part time or full time can be challenging and tiring. For these reasons, you may need to take a greater role in your child’s schooling from now on. Here are some ideas that might help you. </p><h2> Key points </h2> <ul><li>Speak to your child's teacher and principal before they return to school so they understand how your child's heart condition could potentially impact school performance, learning and attendance.</li> <li>Work with school staff to ensure that school will be physically accessible to your child.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/learning_and_education_before_your_child_goes_back_to_school.jpg
Learning and disabilitiesLLearning and disabilitiesLearning and disabilitiesEnglishDevelopmentalPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-15 years);Late Teen (16-18 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00Z13.800000000000037.10000000000001126.00000000000Flat ContentHealth A-Z<p>Children born prematurely are more at risk for having a learning disability (LD). Parents and other caregivers including paediatricians and other professions should keep an eye out for possible problems, especially in children who were born extremely premature, who are more at risk than children born mildly or moderately premature.</p><p>It should be remembered that a child’s corrected age, should always be taken into account early in life when assessing development, to differentiate between developmental lags due to maturation and true disabilities. Once your child has entered school, however, your child’s academic skills need to be judged by the standards expected for your child’s grade. If test results continue to be corrected for your child’s degree of prematurity, your child may appear to have skills that are age-appropriate, but these skills may not be adequately developed for the child’s grade. If you have your child assessed for a specific learning disability, make sure that the psychologist doing the assessment is knowledgeable about the issues facing children born prematurely. </p><h2>Key points</h2> <ul><li>A child's corrected age should always be considered early in life when assessing development.</li> <li>Early intervention gives a child the best chance at minimizing the effect of a learning disability. </li> <li>Children born prematurely often have language difficulties, problems with visual and motor processing, and working memory and attention problems.</li> <li>Learning disabilities may not become apparent until the child begins school, at which point they will have various assessments.</li> <li>Recommendations and a plan for your child's learning will be made after an assessment.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/learning_and_disabilities.jpg
Learning disabilities at school: An introductionLLearning disabilities at school: An introductionLearning disabilities at school: An introductionEnglishDevelopmentalPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2012-02-01T05:00:00ZRoss Hetherington, PhD, CPsych8.6000000000000051.7000000000000772.000000000000Flat ContentHealth A-Z<p> Learning disabilities are when a child of normal intelligence has significant problems with math, reading, or writing. Learn about learning disabilities and their treatment.</p><p>All children find school hard sometimes. But learning disabilities are different. A child with a learning disability may have average to above average intelligence. But they have a lot of trouble with reading, writing, or math.</p><h2>Key points</h2><ul><li>A child with a learning disability has significant problems in reading, writing, or math. These problems are not due to a global developmental delay or a sensory problem.</li><li>Learning disabilities are often diagnosed with a psychological assessment. This can be done through the school or privately.</li><li>Interventions are used to help children improve their skills when they have a learning disability.</li><li>Accommodations are changes in the classroom such as taking notes for the child. </li></ul>https://assets.aboutkidshealth.ca/AKHAssets/learning_disabilities_introduction.jpg
Learning to think: Cognitive development in babiesLLearning to think: Cognitive development in babiesLearning to think: Cognitive development in babiesEnglishNABaby (1-12 months)BodyNANAAdult (19+)NA2009-09-21T04:00:00ZJoanne Cummings, PhD, Cpsych8.7000000000000059.9000000000000650.000000000000Flat ContentHealth A-Z<p>Read about cognitive development, or learning to think, in a baby's first year of life. Their sense of self and sensitivity to contingency are discussed.</p><p>Cognitive development is the development of your baby’s abilities to see, hear, touch, feel, taste, and smell; to remember and learn; to understand language and then to say words; and to think. All of these processes take place in your baby’s brain, which undergoes tremendous development during the first year of life. </p><h2>Key points</h2> <ul><li>Cognitive development is the development of your baby’s abilities to see, hear, touch, feel, taste, and smell; to remember and learn; to understand language and then to say words; and to think.</li> <li>The initial 12 months of life is a time of great learning, and a baby’s interactions with their caregivers is crucial to their cognitive development.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/learning_to_think_cognitive_development.jpg
Learning to think: The first six monthsLLearning to think: The first six monthsLearning to think: The first six monthsEnglishNABaby (1-12 months)BodyNANAAdult (19+)NA2009-09-21T04:00:00ZJoanne Cummings, PhD, Cpsych8.2000000000000066.9000000000000832.000000000000Flat ContentHealth A-Z<p>Learn about cognitive development, or the ability to think, over the first six months of a baby's life. Improvements in depth perception are to be expected</p><p>Interacting with your baby is important to their cognitive development. Your baby's brain will undergo rapid develop over the first six months of life.</p><h2>Key points</h2> <ul><li>In the first six months, babies will improve their ability to process information, respond to communication and their memory will improve.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/Learning_to_think_the_first_six_months.jpg
Learning to think: The next six monthsLLearning to think: The next six monthsLearning to think: The next six monthsEnglishNABaby (1-12 months)BodyNANAAdult (19+)NA2009-09-21T04:00:00ZJoanne Cummings, PhD, Cpsych9.2000000000000062.40000000000001383.00000000000Flat ContentHealth A-Z<p>Learn about cognitive development, or the ability to think, over the second six months of a baby's first year. Attempts at speech are to be expected.</p><p>Over the next six months, your baby's cognitive development will continue to grow at an astonishing pace. Follow your baby's lead when it comes to their interests and continue to help them grow their cognitive functioning.</p><h2>Key points</h2> <ul><li>In the next six months, your baby will begin to understand desires and goals, develop stranger anxiety, learn how to solve problems and understand the meaning of some basic phrases.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/learning_to_think_the_next_six_months.jpg
Leaving the hospital after scoliosis surgeryLLeaving the hospital after scoliosis surgeryLeaving the hospital after scoliosis surgeryEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemConditions and diseasesAdult (19+)NA2008-06-01T04:00:00ZSandra Donaldson, BA;Andrew Howard, MD, MSc, FRCSC;James G. Wright, MD, MPH, FRCSC70.00000000000006.00000000000000288.000000000000Flat ContentHealth A-Z<p>Find out what needs to happen in order for a teenager to be discharged from the hospital after having scoliosis surgery, including their physical abilities.</p><p> Before leaving the hospital, your teen must be able to do a number things on their own.</p><h2> Key points </h2> <ul><li> Most teens who have scoliosis surgery stay in hospital for five to seven days. </li> <li> In order for your teen to go home, they must have normal bladder function and have had a bowel movement, be able to drink fluids and eat food, walk a certain distance and use the stairs, and be able to control pain. They may need to have a spinal X-ray done.</li> <li> The doctor will give your teen a prescription for pain medication. </li> <li> Your surgeon will discuss physical activity restrictions, such as lifting, forward bending, and twisting of the spine. </li> <li> Your teen will need help with activities such as showering and getting dressed until they can work their way to doing them. </li> <li> Ensure your teen does not take ibuprofen or aspirin-based drugs without the surgeon's permission. Smoking and second-hand smoke interferes with bone healing and should be avoided.</li> <li>Some patients will need to wear a brace after their surgery. </li></ul>.https://assets.aboutkidshealth.ca/akhassets/LeavingTheHospital__EN.jpg
Lennox-Gastaut syndromeLLennox-Gastaut syndromeLennox-Gastaut syndromeEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesCaregivers Adult (19+) EducatorsNA2010-02-04T05:00:00ZNA11.800000000000037.00000000000001143.00000000000Flat ContentHealth A-Z<p>Read about the causes and symptoms of Lennox-Gastaut syndrome epilepsy and how the condition is treated.</p><p>Lennox-Gastaut syndrome is a progressive epilepsy syndrome that causes tonic and atypical absence seizures and intellectual disability. It is difficult to treat, although some newer treatments are being investigated. Although the long-term outlook for this syndrome is generally poor, some children are able to attend normal classes in school and eventually hold jobs as adults. </p><h2>Key points</h2> <ul><br> <li>The classic features of Lennox-Gastaut syndrome include atypical absence (staring), myoclonic, tonic and atonic (drop) seizures and, over time, mental impairment.</li><li>About 70 per cent of cases of Lennox-Gastaut syndrome are symptomatic and the rest are cryptogenic, with no obvious underlying cause.</li><li>Symptomatic Lennox-Gastaut syndrome can be caused by a number of factors, including a brain injury at or around birth, a brain malformation or an infection of the central nervous system.<br></li> <li>Lennox-Gastaut syndrome may be treated with medications, certain diets and, in some cases, surgery.<br></li></ul>
Letters for your child's schoolLLetters for your child's schoolLetters for your child's schoolEnglishNAChild (0-12 years);Teen (13-18 years)NANASupport, services and resourcesCaregivers Adult (19+)NA2012-06-13T04:00:00ZNA7.2000000000000072.3000000000000315.000000000000Flat ContentHealth A-Z<p>When you have a child with a complex health condition it is a good idea to write a letter to your child's school to give them the information they need.</p><p>When your <a href="/Article?contentid=1148&language=English">child has a complex health condition</a>, it is important that the school understands your child's condition and what they can do to help them. In addition to <a href="/Article?contentid=1145&language=English">talking with your child's school</a> and teachers face to face, it is a good idea to write a letter (on your own or with the help of your doctor or health care team).</p><h2>Key points</h2> <ul> <li>If your child has a complex health condition, it is important that their school understands your child’s condition and what they can do to help them.</li> <li>A letter to your child's school should include information about the condition; your child's strengths and limitations, including any accommodations needed; medications; what to do in an emergency; and feelings or symptoms your child may have.</li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/letters_for_your_childs_school.jpg
LeukemiaLLeukemiaLeukemiaEnglishOncologyChild (0-12 years);Teen (13-18 years)BodyNAConditions and diseasesAdult (19+) CaregiversNA2018-04-03T04:00:00ZLanding PageLearning Hub<p>Information about the symptoms, diagnosis and treatment of leukemia. Also learn about the challenges that parents may face while caring for their child during and after treatment.</p><p>This learning hub will help you understand the symptoms, diagnosis and treatment of leukemia. It also discusses the challenges that parents may face while caring for their child during treatment and many of the late-term outcomes of leukemia treatment.</p>leukemiahttps://assets.aboutkidshealth.ca/AKHAssets/leukemia_learning_hub.jpg
Leukemia and behavioural changesLLeukemia and behavioural changesLeukemia and Behavioural ChangesEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD8.9000000000000054.6000000000000619.000000000000Flat ContentHealth A-Z<p> Learn how to recognize and deal with behaviour changes in your child with leukemia.</p><p>Many children who have a serious illness such as leukemia learn to adjust to their situation over time, with the right support. But like adults, children have good days and bad days. If your child is having a bad day, it may be hard to tell whether the cause is the leukemia, the treatment, or your child just being a child.</p><h2> Key points </h2> <ul><li>Behaviour changes will vary depending on the age of your child with leukemia.</li> <li> Behaviour changes can be accused by changes in routine, fatigue, feeling unwell, stress, or medication side effects.</li> <li> You can reduce problem behaviours by sticking to a routine, developing a strategy when seeing inappropriate behaviour and reacting with consequences, recognizing good behaviour, playing with younger children, and involving older children in discussions about treatment.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/Leukemia_and_behavioural_changes.jpg
Leukemia and bone healthLLeukemia and bone healthLeukemia and Bone HealthEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD8.1000000000000057.2000000000000469.000000000000Flat ContentHealth A-Z<p> Learn how chemotherapy for acute lymphoblastic leukemia (ALL) can damage bones.</p><p>Your child receives chemotherapy as part of acute lymphoblastic leukemia (ALL) treatment. Chemotherapy may also target healthy cells inside our bones. Corticosteroids, like prednisone and dexamethasone, can affect the growth of healthy bone cells. </p><h2> Key points </h2> <ul><li>It is important to regularly follow-up with doctors to try to detect early signs of bone damage caused by chemotherapy.</li> <li> Healthy lifestyle choices can minimize the likelihood of developing bone problems after treatment.</li></ul>
Leukemia and financial issuesLLeukemia and financial issuesLeukemia and financial issuesEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD11.900000000000036.1000000000000254.000000000000Flat ContentHealth A-Z<p> Learn about services available for patients and families to assist with finances during your child's leukemia treatment. </p><p>When your child is undergoing treatment for leukemia, one of their caregivers may need to leave work. This can be a considerable adjustment, since you and your family will have to manage on less income. </p><h2> Key points </h2><ul><li>Health-care professionals within the hospital, including social workers and Interlink nurses, can help families access care and financial services within the community. </li></ul>https://assets.aboutkidshealth.ca/AKHAssets/leukemia_and_financial_issues.jpg
Leukemia and lumbar punctureLLeukemia and lumbar punctureLeukemia and lumbar punctureEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemProceduresAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD8.4000000000000061.1000000000000644.000000000000Flat ContentHealth A-Z<p> Learn why doctors perform a lumbar puncture on your child with leukemia.</p><p>A lumbar puncture, also called a spinal tap, is a procedure that takes a sample of your child's cerebrospinal fluid (CSF), which surrounds the brain and spinal cord. Doctors perform a lumbar puncture to see if leukemia has spread into the central nervous system (CNS). If your child’s leukemia has been diagnosed prior to the lumbar puncture, they will receive intrathecal chemotherapy, which delivers chemotherapy medicines into the CSF.</p><h2> Key points </h2> <ul><li>Doctors perform a lumbar puncture to see if leukemia has spread into the central nervous system (CNS). </li> <li>A lumbar puncture can be used to check the cerebrospinal fluid (CSF) for leukemic cells and to give chemotherapy that will reach the CNS.</li> <li> Your child will be sedated during the procedure.</li></ul>https://assets.aboutkidshealth.ca/akhassets/Lumbar_puncture_MED_ILL_EN.jpg
Leukemia and weight gainLLeukemia and weight gainLeukemia and Weight GainEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD000Flat ContentHealth A-Z<p> Learn why children with acute lymphoblastic leukemia (ALL) are at risk for becoming overweight.</p><p>Some children with acute lymphoblastic leukemia (ALL) may become overweight. They are at most risk of gaining weight during their treatment and up to one year after finishing it. Encourage your child to adopt healthy eating habits and be physically active. Developing these habits early on in treatment is important to prevent obesity, which can put a child at risk for serious health problems. </p><p></p><h2> Key points </h2> <ul><li>Medicines your child takes during leukemia treatment can increase their chances of becoming overweight and can make them feel hungrier.</li> <li> A lack of physical activity during treatment can also increase their risk of being overweight.</li> <li> Being overweight can lead to obesity, which can put a child at risk for health problems.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/Leukemia_and_weight_gain.jpg
Leukemia follow-up visitsLLeukemia follow-up visitsLeukemia follow-up visitsEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseases;Healthy living and prevention;Health care professionalsAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD000Flat ContentHealth A-Z<p>Learn what will happen during follow-up visits after your child's leukemia treatment ends.</p><p>After leukemia treatment ends, your child will need to stay in touch with several different health care professionals. It is important that you keep all follow-up appointments, even if your child is healthy and feeling well. </p><h2> Key points </h2> <ul><li>In the first year after treatment, your child will go to a follow-up clinic once a month to be checked for potential long-term effects of treatment.</li> <li> It is important to keep your child's paediatrician up-to-date on your child's condition.</li> <li>Follow-up visits will also address psychosocial issues, such as family stress and behavioural issues.</li></ul>
Leukemia relapseLLeukemia relapseLeukemia relapseEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD000Flat ContentHealth A-Z<p> Learn about factors that influence your child's response to therapy if their leukemia has relapsed.</p><p>In some cases, even when a child has received optimal care, the leukemia cells will return. When the disease comes back, the leukemia is said to have relapsed. This can happen when the child is still receiving treatment or after completing therapy. </p><h2> Key points </h2> <ul><li>Your child's leukemia subtype, prior therapy, length of time from initial diagnosis can all influence how well they response to treatment after they relapse.</li> <li> It is often more difficult to get the leukemia of a child who has relapsed back into remission than it was at the time of initial diagnosis.</li></ul>
Leukemia treatment and learning and memoryLLeukemia treatment and learning and memoryLeukemia Treatment and Learning and MemoryEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD11.000000000000043.80000000000001073.00000000000Flat ContentHealth A-Z<p> Learn how treatment for acute lymphoblastic leukemia (ALL) can cause neurocognitive changes in your child, such as learning difficulties.</p><p>Learning and memory skills depend on the brain’s ability to process information and apply knowledge. This ability is called neurocognition. It includes language, memory, concentration, and ability to grasp new concepts. These skills are applicable in education, on the playground, and in the workplace. </p> <p>More than half of children treated for acute lymphoblastic leukemia (ALL) do well and go on to lead normal lives. However, some children experience neurocognitive changes, such as learning difficulties, during and after treatment. </p><h2> Key points </h2> <ul><li>Neurocognitive effects can emerge years after a child with acute lymphoblastic leukemia (ALL) finishes treatment.</li> <li> Slow processing speed, problems with motor skills and attention difficulties are some symptoms of neurocognitive changes. </li> <li>Children who receive radiation to the brain are generally at greater risk of developing neurocognitive problems than those who receive only chemotherapy.</li> <li> Young brains are more vulnerable to effects of treatment.</li></ul>
Leukemia: Central venous lineLLeukemia: Central venous lineLeukemia: Central Venous LineEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemProceduresAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD6.5000000000000075.50000000000001094.00000000000Flat ContentHealth A-Z<p> Learn why your child acute myeloid leukemia (AML) will receive a central venous line (CVL) and how to care for it.</p><p>Once your child is diagnosed with acute myeloid leukemia (AML), they will receive a central venous line (CVL).</p> <p>A CVL is a long, soft, thin, flexible tube that is inserted into one of the large veins leading to the heart. It is a special intravenous (IV) line that is used in children who need IV therapy for a long time. IV therapy means medicine that is put into a vein. A CVL makes it easier and more comfortable for your child to receive medicines such as chemotherapy and IV fluids, and to have blood samples taken. </p><h2> Key points </h2> <ul><li>Children with acute myeloid leukemia (AML) will receive a central venous line (CVL). </li><li> A CVL is a special intravenous (IV) line inserted into the major blood vessels leading to the heart. </li><li> A CVL allows children with AML to receive chemotherapy and other medicines more easily and comfortably. </li> <li> Your child will have a general anesthetic before the procedure to insert the CVL.</li> <li> There must always be a bandage over the CVL site on the chest to keep it clean and secure.</li> <li> It is important to ensure the CVL and end of the catheter are always taped to prevent them from being pulled out.</li></ul>https://assets.aboutkidshealth.ca/akhassets/Central_venous_line_MED_ILL_EN.jpg
Leukemia: Understanding diagnosisLLeukemia: Understanding diagnosisLeukemia: Understanding diagnosisEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD000Flat ContentHealth A-Z<p> Learn how leukemia is diagnosed and which tests help doctors determine its subtypes. </p><p>Diagnosis is an important stage in understanding what is happening with your child. Hearing that your child has leukemia may be overwhelming. This is a life-changing diagnosis and comes with a lot of new information and vocabulary. You will be meeting with your child’s doctors and other members of the heath care team often. It is a good idea to bring a pen and paper or electronic device with you and write down any new information they give you during the meeting and note down questions as you come up with them. You may also want to take a friend or a relative with you to take notes. </p><h2> Key points </h2> <ul><li>If your child shows symptoms of acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML), your doctor will order a complete blood count (CBC) test. </li> <li>Your child may have a bone marrow aspiration and sometimes a biopsy after the CBC, as well as a lumbar puncture (spinal tap). </li> <li>Samples of your child's bone marrow will help diagnose ALL or AML. Cell morphology, immunophenotyping, cytogenetics and molecular tests help identify the type and subtype of leukemia.</li> <li>Your doctor will usually know if your child has leukemia the same day the bone marrow tests are performed, but additional tests are done on your child's bone marrow samples to identify the type of leukemia. </li></ul>
Levels of newborn careLLevels of newborn careLevels of newborn careEnglishNeonatologyNewborn (0-28 days)BodyNANAAdult (19+)NA2009-10-28T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPC12.600000000000042.1000000000000786.000000000000Flat ContentHealth A-Z<p>Read about the different levels of care that involved in the treatment of a newborn baby. Basic care, specialty care and subspecialty care are discussed.</p><p>There are three different levels of newborn care available at different hospitals. These are referred to as low-risk care, specialty care, and subspecialty care. The level of care is based on the specific needs of the newborn baby.</p><h2>Key points</h2> <ul><li>There are three levels of newborn care available referred to as low-risk, specialty, and subspecialty care.</li> <li>The level of care a newborn receives depends on how the specific needs of the baby and their health condition.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/levels_of_newborn_care.jpg
Life in the NICULLife in the NICULife in the NICUEnglishNeonatologyPremature;Newborn (0-28 days);Baby (1-12 months)NANASupport, services and resourcesPrenatal Adult (19+)NA2009-10-31T04:00:00ZThe Reverend Michael Marshall, M. Div. M10.200000000000057.20000000000001486.00000000000Flat ContentHealth A-Z<p>Life in the NICU can be stressful and is usually a challenge for parents. Acknowledging emotions and remaining communicative are good coping strategies during this difficult period. </p><p>Parents are often overwhelmed by their experiences in neonatal intensive care unit. Health-care professionals do their best to help parents cope and parents are encouraged to communicate with each other, the staff and their families about their experiences. Finding a balance between life in the NICU and life outside can be a challenge for many parents.</p><p></p><h2>Key points</h2> <ul><li>Many parents are overwhelmed by their experiences in the NICU and may find it difficult to cope with their different emotions and the stress of balancing life in and out of the NICU.</li></ul>https://assets.aboutkidshealth.ca/akhassets/nurse_and_mom_in_nicu_EN.jpg
Life support during heart surgeryLLife support during heart surgeryLife support during heart surgeryEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemProceduresAdult (19+)NA2009-12-11T05:00:00ZDavid Edgell, BA, MHSc, CCP, CPC11.300000000000046.10000000000001463.00000000000Flat ContentHealth A-Z<p>During heart surgery, your child will likely be supported by mechanical ventilation, cardiopulmonary bypass, extracorporeal life support, hemoconcentration, circulatory arrest, or selective cerebral perfusion.</p><p>During your child's surgery, it is very likely that your child will be supported by a number of machines and techniques to keep them stable. These include but are not limited to mechanical ventilation, cardiopulmonary bypass, extracorporeal life support, hemoconcentration, circulatory arrest, and selective cerebral perfusion. </p><h2> Key points </h2> <ul><li>Mechanical ventilation passes oxygen and air into your child's body from the ventilator machine in order to help them breathe or take over completely.</li> <li>A process called cardiopulmonary bypass (CPB) allows blood to move through the body artificially using a bypass machine after the surgeon has stopped the heart during surgery.</li> <li>Extracorporeal life support (ECLS) involves using an "artificial lung" to get oxygen into the blood and a pump or circulatory assist device. </li> <li> During or after bypass, hemoconcentration removes fluid from the blood to increase the concentration of hemoglobin and red blood cells.</li> <li>Selective cerebral perfusion provides blood flow and metabolic support to the brain while the blood flow to the rest of the body is stopped during circulatory arrest in complex surgery.</li></ul>
Lifestyle choices for children with heart diseaseLLifestyle choices for children with heart diseaseLifestyle Choices for Children with Heart DiseaseEnglishCardiologyTeen (13-18 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-14T05:00:00ZRoss Hetherington, PhD, C.Psych11.000000000000050.0000000000000976.000000000000Flat ContentHealth A-Z<p>Read about lifestyle choices. Major life decisions should be made keeping in mind how the heart condition will influence overall health and well-being.</p><p>It is important to be fully informed about a heart condition and make informed and wise lifestyle choices on the basis of this information. For instance, if a condition is complex and care needs are high, a young adult may decide not to leave home but take advantage of the security of living with their parents. Major life decisions — education, career, living arrangements — should be made keeping in mind how the heart condition will influence overall health and well-being. Being "realistically optimistic" is the key. </p><h2> Key points </h2> <ul><li>Drinking alcohol may worsen a heart condition, cause symptoms like palpitations, or interact with medications. </li> <li>Smoking results in circulation problems and possibly blood vessel damage, and can affect drug levels in the body.</li> <li> Illicit drugs can directly affect the heart or interact with heart drugs. </li> <li>Any procedure that draws blood, including piercings and tattoos, puts teens at risk for bacterial endocarditis .</li></ul>
Limb lengthening and reconstructionLLimb lengthening and reconstructionLimb lengthening and reconstructionEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Arm;LegsBonesConditions and diseasesCaregivers Adult (19+)NA2018-01-19T05:00:00Z000Landing PageLearning Hub<p>The purpose of limb lengthening and reconstruction surgery is to treat limb length discrepancy, limb deformity and fractures. Learn about the different limb lengthening and reconstruction treatment options.<br></p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/j4-YG1rKubw?rel=0" frameborder="0"></iframe> <br></div><p>The purpose of limb lengthening and reconstruction surgery is to treat limb length discrepancy, limb deformity and fractures. Learn about the different limb lengthening and reconstruction treatment options.<br></p>limbshttps://assets.aboutkidshealth.ca/AKHAssets/limb_reconstruction_learning_hub.jpg
Limb lengthening and reconstruction: Goal of treatmentLLimb lengthening and reconstruction: Goal of treatmentLimb lengthening and reconstruction: Goal of treatmentEnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00Z​Simon P. Kelley, MBChB, FRCS (Tr and Orth)​;Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc8.4000000000000064.20000000000001275.00000000000Flat ContentHealth A-Z<p>Find out how limb reconstruction surgery can lengthen and repair shorter or crooked limbs.<br></p><h2>Key points</h2><ul><li>Limb length discrepancy occurs when one limb is shorter than the other. Depending on the difference in length, it can be treated with a shoe lift, surgery or, in extreme cases, an artificial limb.</li><li>Limb deformity occurs when a limb has an abnormal shape or position, usually due to a medical condition, poor recovery from an injury or a problem with one or more joints.</li><li>A fracture is a break in a bone because of an injury. It can usually be treated with a cast or surgery to fix the bone back together.</li><li>Your child’s surgeon and healthcare team will explain the best treatment options for your child’s situation.<br></li></ul>
Limb lengthening and reconstruction: How to care for pin and wire sitesLLimb lengthening and reconstruction: How to care for pin and wire sitesLimb lengthening and reconstruction: How to care for pin and wire sitesEnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00ZSim​on P. Kelley, MBChB, FRCS (Tr and Orth);Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc​6.5000000000000074.6000000000000677.000000000000Flat ContentHealth A-Z<p>Learn how to change your child's dressing and keep their pin and wire sites clean during limb lengthening or correction. <br></p><h2>Key points</h2><ul><li>If your child has an external fixator, it will be kept in place with pins and wires. <br></li><li>Your child's pin and wire sites (the places where the pins and wires enter the skin) will be covered with a dressing. You will learn how to change the dressing before your child leaves the hospital. <br></li><li>Contact your child's health-care team if you notice any pus, swelling, warmth or pain around the sites. These could indicate an infection.<br></li></ul>
Limb lengthening and reconstruction: Intramedullary nailLLimb lengthening and reconstruction: Intramedullary nailLimb lengthening and reconstruction: Intramedullary nail EnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00ZSim​on P. Kelley, MBChB, FRCS (Tr and Orth);Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc​8.0000000000000068.0000000000000528.000000000000Flat ContentHealth A-Z<p> Find out how a motorized intramedullary nail helps lengthen your child's limb.</p><h2>Key points</h2><ul><li>A motorized intramedullary nail can lengthen and sometimes also straighten a bone.</li><li>The nail is placed inside the bone during surgery and has a special motor that responds to a remote control. The remote control is programmed with instructions from your child’s surgeon.</li><li>Your child will need to use crutches to help them walk while the nail is in place.<br></li></ul>
Limb lengthening and reconstruction: Living with a fixatorLLimb lengthening and reconstruction: Living with a fixatorLimb lengthening and reconstruction: Living with a fixator EnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00Z​Simon P. Kelley, MBChB, FRCS (Tr and Orth)​;Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc8.0000000000000068.00000000000001130.00000000000Flat ContentHealth A-Z<p>Learn how your child's routine will change as they adjust to life with a fixator.</p><h2>Key points</h2> <ul> <li>At home, allow extra time for day-to-day tasks such as moving around and getting in and out of the car and other transport.</li> <li>Before your child’s limb reconstruction surgery, talk to your child’s school principal about your child’s needs so they have time to plan your child’s return to school activities.</li> <li>If your child has an external fixator, they can wear snap-on pants or loose-fitting skirts or have their clothes altered to fit over the device.</li> <li>Your child’s surgeon will tell you when your child can shower and bathe, when it is safe to swim and if your child needs supplements or more calories to help their bones heal.<br></li></ul>
Limb lengthening and reconstruction: Managing the impact on your familyLLimb lengthening and reconstruction: Managing the impact on your familyLimb lengthening and reconstruction: Managing the impact on your familyEnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00Z​Simon P. Kelley, MBChB, FRCS (Tr and Orth)​;Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc10.000000000000054.0000000000000491.000000000000Flat ContentHealth A-Z<p>Discover how best to manage the emotional, social and financial impact of limb lengthening and reconstruction. </p><h2>Key points</h2> <ul> <li>Limb lengthening and reconstruction is a treatment that will affect your whole family in different ways.</li> <li>Your child will likely experience changes in their emotions and behaviour as they go through treatment. It is a good idea to plan how you will support your child during this time and involve your child’s siblings in their care.</li> <li>Before your child’s surgery, set up a reliable network to help you with practical tasks and offer personal support.</li> <li>Check with your health insurance provider or talk to the hospital social worker about options for covering the cost of certain equipment, medications or services.</li> </ul>
Limb lengthening and reconstruction: Monolateral railLLimb lengthening and reconstruction: Monolateral railLimb lengthening and reconstruction: Monolateral rail EnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00ZSim​on P. Kelley, MBChB, FRCS (Tr and Orth);Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc​8.3000000000000064.4000000000000931.000000000000Flat ContentHealth A-Z<p>Learn how a monolateral rail can lengthen or correct a limb.</p><h2>Key points</h2><ul><li>A monolateral rail features a metal rod that is attached to the limb with metal pins.<br></li><li>A knob on the side of the rail is adjusted to force the metal pins, and the bone ends, apart. The gap in the bone allows new bone to grow to lengthen the limb.<br></li><li>The surgeon will create a program of instructions for adjusting the rail and may adjust it based on your child's progress after surgery. You will be taught how and when to adjust the rail before your child goes home after surgery.</li><li>Your child may not be allowed to bear weight on their operated limb until their new bone starts to harden.<br></li></ul>
Limb lengthening and reconstruction: Possible complications after surgeryLLimb lengthening and reconstruction: Possible complications after surgeryLimb lengthening and reconstruction: Possible complications after surgeryEnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00ZSim​on P. Kelley, MBChB, FRCS (Tr and Orth);Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc​8.8000000000000060.70000000000001575.00000000000Flat ContentHealth A-Z<p>Learn about the possible complications your child may experience after limb lengthening and reconstruction surgery and how to respond.<br></p><h2>Key points</h2><ul><li>Limb lengthening and reconstruction can come with a range of possible complications, including infection, rapid or delayed bone healing, stiffness and swelling.</li><li>To minimize the risk of infection, you will be taught how to clean and manage your child’s pin and wire sites before your child leaves the hospital. Your child will be encouraged to move around to minimize the risk of stiffness.</li><li>Your child’s health-care team will work to minimize other complications by monitoring your child’s progress and checking your child’s fixator at regular follow-up appointments. </li><li>Contact the health-care team as soon as possible if your child has a fever higher than 38.5°C or pain, warmth or swelling at a pin, wire or incision site or if they have trouble moving or feeling part of their limb.<br></li></ul> <h2> <br> </h2> <p>If you have an urgent concern, please call SickKids locating at 416-813-7500 and ask to speak with the orthopaedic resident on call.<br></p>
Limb lengthening and reconstruction: Taylor Spatial FrameLLimb lengthening and reconstruction: Taylor Spatial FrameLimb lengthening and reconstruction: Taylor Spatial Frame EnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00ZSim​on P. Kelley, MBChB, FRCS (Tr and Orth);Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc​7.8000000000000068.50000000000001108.00000000000Flat ContentHealth A-Z<p> Learn how the Taylor Spatial Frame works to lengthen or correct your child's limb. </p><h2>Key points</h2><ul><li>The Taylor Spatial Frame includes two full or partial rings that are connected by six rods, or struts. It is attached to your child's limb with metal or wire pins during surgery.</li><li>You will get a prescription to tell you when and how to adjust the struts. Always follow the prescription until your child's healthcare team tells you otherwise.</li><li>You will be taught how to adjust the frame and follow the prescription before your child leaves the hospital. Call your child's healthcare team if the struts are too stiff to adjust.</li><li>Your child can bear weight on their operated limb with the Taylor Spatial Frame in place.</li></ul><br>
Limb lengthening and reconstruction: Types of surgeryLLimb lengthening and reconstruction: Types of surgeryLimb lengthening and reconstruction: Types of surgeryEnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00ZSimon P. Kelley, MBChB, FRCS (Tr and Orth);Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc​8.0000000000000066.00000000000001484.00000000000Flat ContentHealth A-Z<p>Discover the different types of surgery that can help lengthen or straighten a limb.</p><h2>Key points</h2><ul><li>Gradual limb lengthening and deformity correction involves attaching an external fixator, or frame, to a limb to slowly lengthen and/or correct it.</li><li>Epiphysiodesis is a simple surgery that removes cartilage from a longer limb to allow the shorter limb to catch up over time with normal growth.</li><li>Hemiepiphysiodesis involves attaching a temporary metal plate to one side of the bone to halt its growth while the other side of the bone continues to grow.</li><li>Acute deformity correction involves dividing and repositioning a bone and holding it in place with permanent metal plates, rods or screws.<br></li><li>Limb shortening is surgery to remove part of a bone of a longer limb. It is usually used if <span style="text-align:left;color:#444444;text-transform:none;text-indent:0px;letter-spacing:normal;font-family:"segoe ui", segoe, tahoma, helvetica, arial, sans-serif;font-size:13px;font-style:normal;font-variant:normal;font-weight:400;text-decoration:none;word-spacing:0px;white-space:normal;cursor:text;orphans:2;float:none;background-color:transparent;display:inline !important;">th</span><span style="text-align:left;color:#444444;text-transform:none;text-indent:0px;letter-spacing:normal;font-family:"segoe ui", segoe, tahoma, helvetica, arial, sans-serif;font-size:13px;font-style:normal;font-variant:normal;font-weight:400;text-decoration:none;word-spacing:0px;white-space:normal;cursor:text;orphans:2;float:none;background-color:transparent;display:inline !important;">e</span><span style="text-align:left;color:#444444;text-transform:none;text-indent:0px;letter-spacing:normal;font-family:"segoe ui", segoe, tahoma, helvetica, arial, sans-serif;font-size:13px;font-style:normal;font-variant:normal;font-weight:400;text-decoration:none;word-spacing:0px;display:inline;white-space:normal;cursor:text;orphans:2;float:none;background-color:transparent;">re is only a 2-5 cm difference in limb length</span> and the child has finished, or almost finished, growing.<br></li></ul>
Limb lengthening and reconstruction: Your child's healthcare teamLLimb lengthening and reconstruction: Your child's healthcare teamLimb lengthening and reconstruction: Your child's healthcare team EnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00Z​Simon P. Kelley, MBChB, FRCS (Tr and Orth)​;Catharine Bradley, MSc, BScPT;Alexandra Maxwell, BSc10.000000000000059.00000000000001182.00000000000Flat ContentHealth A-Z<p>Learn about the members of your child's limb reconstruction healthcare team and how they will help your child during treatment. </p><h2>Key points</h2> <ul> <li>Your child will meet a number of healthcare professionals as they go through limb lengthening and reconstruction. These include the orthopaedic surgeon, physical therapy practitioner, physiotherapists, nurses and administrative assistants.</li> <li>You and your child may also meet with a child life specialist and members of the social work or pain team if needed.</li> <li>Although a number of professionals will be helping your child, you and your child will also play a vital role in making sure your child’s treatment is a success.</li> </ul><p>You can reach the members of your child's healthcare team at <span style="font:400 13px/20.8px "segoe ui","segoe",tahoma,helvetica,arial,sans-serif;text-align:left;color:#444444;text-transform:none;text-indent:0px;letter-spacing:normal;text-decoration:none;word-spacing:0px;display:inline !important;white-space:normal;orphans:2;float:none;background-color:transparent;">Sic</span><span style="font:400 13px/20.8px "segoe ui","segoe",tahoma,helvetica,arial,sans-serif;text-align:left;color:#444444;text-transform:none;text-indent:0px;letter-spacing:normal;text-decoration:none;word-spacing:0px;display:inline !important;white-space:normal;orphans:2;float:none;background-color:transparent;">kKids </span>at the numbers below.</p><h3>Orthopaedic surgeons</h3><p>Dr. Simon Kelley (assistant: Bonnie Louie) (416) 813-6435<br> Dr. Unni Narayanan (assistant: Lourdes Buencamino) (416) 813-6432<br> Dr. Andrew Howard (assistant: Maricar Aruta) (416) 813-6430<br></p><h3>Physical therapist practitioner</h3><p>Catharine Bradley (416) 813-8414</p><h3>Physiotherapists</h3><p>Marcia Kromkamp (416) 813-6755<br> Alison Anthony<br> Vanessa Mucci<br> Gillian Arseneau</p><h3>Questions about clinic appointment times</h3><p>Orthopaedic Clinic Reception (416) 813-5840</p><h3>Questions about anaesthesia</h3><p>Pre-Anaesthesia Clinic (416) 813-8465</p><h3>Booking an optional Pre-Operative Preparation Program</h3><p>Child Life Specialist Department (416) 813-6216</p>
Limb lengthening and reconstruction: Your child's hospital stayLLimb lengthening and reconstruction: Your child's hospital stayLimb lengthening and reconstruction: Your child's hospital stay EnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00ZSimon P. Kelley, MBChB​, FRCS (Tr and Orth);Catharine Bradley, MSc, BScPT​​;Alexandra Maxwell, BSc​8.1000000000000066.00000000000001603.00000000000Flat ContentHealth A-Z<p>Find out what to expect as your child recovers from limb lengthening and reconstruction surgery.</p><h2>Key points</h2><ul><li>Your child will usually spend three to five days in hospital after their surgery.<br></li><li>Your child's health-care team will check your child's overall health, their pin and wire sites and pain level. <br></li><li>Your child will only leave hospital when the health-care team is sure that your child is ready and has prepared your child for life at home and follow-up care after surgery.<br></li></ul><p>Hospital visiting hours are 11 am to 8 pm.</p><p>SickKids has a number of options for keeping your child busy and entertained in the hospital if they feel up to it.</p><ul><li>The Child Life team at SickKids provides fun spaces in the hospital for children to visit, such as the Play Park or the Children's Library. Do not hesitate to ask about all the fun spaces in the hospital.</li><li>You will constantly see volunteers on the floor. They are there to help in any way they can such as reading your child a story or playing a card game with them.</li><li>There is a TV and Wi-Fi in each hospital room and a number of DVDs to choose from. Your child may also bring in their own DVDs if they would like to.</li></ul>
Limb lengthening and reconstruction: Your child's patient journeyLLimb lengthening and reconstruction: Your child's patient journeyLimb lengthening and reconstruction: Your child's patient journeyEnglishOrthopaedics/MusculoskeletalSchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsBonesProceduresCaregivers Adult (19+)NA2015-08-31T04:00:00ZSimon P. Kelley, MBChB, FRCS (Tr and Orth);Catharine Bradley, MSc, BScPT​;Alexandra Maxwell, BSc​10.000000000000060.00000000000001265.00000000000Flat ContentHealth A-Z<p>​Discover the phases of your child's limb lengthening and reconstruction treatment.<br></p><h2>Key points</h2><ul><li>Your child's patient journey starts with a discussion of treatment options with your child's team and a decision about surgery.</li><li>After surgery, there will be a short period of latency to allow your child to rest before the fixator is adjusted. From then on, the fixator will be adjusted every day.<br></li><li>Once the limb is lengthened or corrected, your child will continue to have regular check-ups and wear the fixator while their bone heals and strengthens. <br></li><li>Once the fixator is off, your child will be guided back to normal activities and return to the clinic every three to six months until their limbs return to full function.<br></li></ul><p>You will need to arrive at the hospital at least two hours before your child's limb reconstruction surgery. Please register at the Surgical Registration Desk. Staff there will direct you to the surgical waiting area.<br></p>
LimpingLLimpingLimpingEnglishOrthopaedics/MusculoskeletalToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)LegsSkeletal muscle;Skeletal systemConditions and diseasesCaregivers Adult (19+)NA2010-03-05T05:00:00ZMark Feldman, MD, FRCPC7.0000000000000063.8000000000000766.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about possible causes of limping in your child. Limping is not normal in a child and they should be seen by their doctor for diagnosis and treatment.</p><h2>What is limping?</h2> <p>Limping is an abnormal walking pattern. The walking may be laboured or jerky. Limping may be caused by pain or weakness anywhere in the leg, especially the joints. Often a limp is caused by a minor injury. There may be a structural problem with the leg or joints. Other serious conditions can also cause limping. </p> <p>Since children are growing, the bones and muscles they use for walking are still developing. Limping is never normal. Your child's doctor should look into any limping right away. </p><h2>Key points</h2><ul><li>Limping is never normal in childhood.</li> <li>Although limping may be temporary and due to a minor injury or virus, it could also be due to a serious infection or cancer so do not wait for it to pass, see your doctor right away.</li></ul><h2>Signs and symptoms of limping</h2> <ul> <li>walking irregularly</li> <li>hobbling</li> <li>pain or discomfort while walking</li> <li>putting less pressure on one foot</li> </ul> <p>Other children avoid walking, even though they can walk. </p><h2>Causes of limping</h2> <p>Limping has many causes. These include injuries, infections, inherited or developmental problems. Rheumatic disorders and cancer may also cause limping. Your child's doctor will check your child's age, size, the level of pain and when the limp started in order to determine the cause.</p> <h3>Injuries</h3> <ul> <li>sprained or injured ligaments; a sprained ankle is very common</li> <li>muscle strains</li> <li>"toddler's fracture," a common injury from jumping and landing on a twisted ankle </li> <li>fractured bones</li> </ul> <h3>Different leg lengths or hip problems</h3> <p>Some children are born with uneven leg lengths. Other children injure a leg, resulting in a shorter length.</p> <p>Uneven leg lengths can also occur as a result of untreated developmental dysplasia. This condition may leave one leg longer than the other. </p> <h3>Other hip and leg problems that can cause limping include:</h3> <ul> <li>Legg-Calve-Perthes disease: the softening of the growing end of the femur (thigh bone).</li> <li>Slipped capital femoral epiphysis: when the head of the femur slips off the shaft. This is common in overweight teenagers. </li> <li>Transient synovitis: inflammation of the membrane that covers the hip joint. </li> </ul> <h3>Joint or bone infection</h3> <p>A limp can also be caused by infection in the joints or the bones. A joint infection is called septic arthritis. A bone infection is called <a href="/Article?contentid=2311&language=English">osteomyelitis​</a>. These infections are caused by bacteria spreading through the bloodstream from another part of the body. </p> <p>With these types of infection, your child may refuse to walk at all. Your child may also have severe pain, fever or redness in the infected area. </p> <p>Bone or joint infections are serious. If your child has symptoms of a bone or joint infection, see a doctor right away. </p> <h3>Arthritis</h3> <p>Juvenile idiopathic arthritis is a chronic condition that causes joint swelling. The swelling can cause pain in the knees. This can lead to a limp. </p> <h3>Cancer</h3> <p>Certain forms of cancer can cause limping. These include leukaemia, osteosarcoma and Ewing's sarcoma. Children with these types of cancer are usually less than five years old. They may look pasty and pale. They may complain of deep bone pain when resting. </p> <h3>Certain spinal problems can cause limping:</h3> <ul> <li>Spondylolysis: a problem with the vertebrae (back bones) that occurs from injury. It may occur from repeatedly flexing or overextending the spine. Athletic children can develop this condition. </li> <li>Spondylolisthesis: when a vertebra slips forward. </li> </ul> <h3>Other problems that can cause limping include:</h3> <ul> <li>muscle problems like muscular dystrophy</li> <li>appendicitis and other abdominal problems</li> </ul><h2>What your child's doctor can do</h2> <p>Your child's doctor will do a physical examination to try to determine the cause of the limping. Depending on your child's other symptoms, the doctor may suggest blood work, X-rays or other tests. </p><h2>Treatment</h2> <p>Treatment will depend on the cause of the limping. If your child has a sprained muscle or joint, try resting the foot or leg, and treating the injury with ice. Your doctor may suggest giving your child <a href="/Article?contentid=153&language=English">ibuprofen</a> to manage the pain and inflammation. Support bandages or an air cast can reduce the swelling. They can also help prevent further injury to the ankle. Your child may use crutches if they find it hard to walk.</p> <p>Limping caused by other conditions may require specific medications or other treatment. See your doctor for more information.</p><h2>When to see a doctor</h2> <p>Go to the nearest Emergency Department if your child has a limp plus any of the following symptoms:</p> <ul> <li>fever</li> <li>rash </li> <li>poor appetite</li> <li>pale complexion</li> <li>severe pain</li> </ul> <p>Return to see your child's doctor if:</p> <ul> <li>you notice significant swelling around particular joints</li> </ul>https://assets.aboutkidshealth.ca/AKHAssets/limping.jpg

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