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QUOTE FOR TUESDAY:

“Alison Datoc

Concussion Care

“Winter Sports and Concussion: Protecting Your Brain This Season

January is National Winter Sports Traumatic Brain Injury (TBI) Awareness Month, a timely reminder to think about brain safety while enjoying the slopes, trails, and ice. Winter sports like skiing, snowboarding, ice skating, hockey, and others offer physical and mental health benefits, but they also carry a risk of concussion.

How Common Are Concussions in Winter Sports?

Traumatic brain injuries are common serious injuries associated with winter sports. Research suggests that up to 47% of injuries sustained during skiing or snowboarding involve a TBI, most often a concussion.

Falls are the most common mechanism of injury, though collisions with trees, fixed objects, or other people also frequently occur. Notably, concussions can occur even without loss of consciousness or without a direct hit to the head, making them easy to overlook.

Why Helmets Matter

Wearing a helmet is one of the most effective ways to reduce the risk of head injury. Studies show that helmets can significantly reduce the risk of head injury in skiing and snowboarding. While helmets cannot prevent all concussions, they significantly lower the risk of more severe brain injuries such as skull fractures or intracranial bleeding.

To be effective, helmets should be:

  • Certified for the appropriate sport/ activity
  • Properly fitted (snug, level, and secured)
  • Replaced after any significant impact or visible damage

Other Ways to Reduce Concussion Risk

Beyond helmets, simple habits can help reduce the risk of concussion:

  • Stay hydrated: Dehydration can worsen fatigue, dizziness, and reaction time (especially at altitude).
  • Know your limits: Fatigue increases fall risk, particularly late in the day.
  • Follow slope rules: Stay in bounds, obey posted signage, and remain aware of others around you.
  • Watch conditions: Icy or low-visibility conditions raise injury risk.

Horizon Neuropsychological Services (Winter Sports and Concussion: Protecting Your Brain This Season – Horizon Neuropsychological Services)

Part I Total Brain Injury – National Winter Sports Month Awareness!

 

National Winter Sports TBI Awareness Month, observed in January, is a time to increase awareness of winter sports TBIs, promote the need for a cure after a traumatic brain injury, and spur advocacy on behalf of those suffering with the emotional, financial and physical burden of TBI injuries.

National Winter Sports TBI Awareness Month calls attention to the fact that, although sports injuries contribute to fatalities infrequently, the leading cause of death from sports-related injuries is traumatic brain injury. Sports and recreational activities contribute to about 21 percent of all traumatic brain injuries among American children and adolescents.

National Winter Sports TBI Awareness Month is a public health and awareness campaign for highlighting the dangers of traumatic brain injury and the importance for taking precautionary measures when engaging in winter sports like skating, tobogganing and skiing. TBI stands for Traumatic Brain Injury which is a common result of injuries that involve the head. Every year, there are approximately 1.7 million head injuries in the United States according to the American Physical Therapy Association. More importantly, about 52,000 people die every year due to TBI. It is commonly caused by falling or crashing into another person or objects while skiing or skating. Many of these accidents lead to head injuries like concussions and traumatic brain injury.

The awareness campaign exists because TBI is usually misdiagnosed which often causes complications or the death of the patient. Thus, it is important to spread knowledge of the symptoms among medical professionals and the public. These symptoms may be experienced immediately after the accident or days/weeks thereafter.

Purpose of National Winter Sports TBI Awareness Month

The Johnny O Foundation and others like it try to raise awareness of the health risks (specifically concussions and traumatic brain injuries) ordinary individuals and athletes face when they participate in winter sports. It also highlights sports safety and preventive measures for avoiding concussions and TBIs. The main goal of the public awareness campaign is to reduce TBIs in the country.

Here are simple tips for preventing head injuries when participating in winter sports:

  • Wear approved, properly fitted and well-maintained safety equipment like helmets
  • Stipulate safety rules like no direct hits to the head or other dangerous play
  • Encourage safe playing techniques and encourage individuals to strictly follow rules of play during winter sports activities

It is also important to take immediate action in case of suspected concussion. Here are the steps that should be taken when a concussion is suspected during winter sports activities:

  • The first step is to remove the individual from play.
  • Make sure that he/she is evaluated by an experienced medical care professional in the evaluation of concussions.
  • Inform the family/friends of the individual regarding the possibility of a concussion and give them informative materials about concussions.
  • Keep the individual out of play until he/she has been thoroughly evaluated by an experienced medical care professional and given permission to return to play.

Conclusion

National Winter Sports TBI Awareness Month is a reminder of the dangers of winter sports and the possibility of TBIs and other injuries. For such reason, it is very important to keep safety in mind and take the necessary precautions to minimize the risk of TBIs and concussions. It is also very important to be aware of the symptoms of a concussion and closely supervise someone who is suspected of a concussion or TBI.

QUOTE FOR MONDAY :

You can’t see, smell or taste radon, but it could be present at a dangerous level in your home. Radon is the leading cause of lung cancer deaths among nonsmokers in America and claims the lives of about 21,000 Americans each year. In fact, the EPA and the U.S. Surgeon General urge all Americans to protect their health by testing their homes, schools and other buildings for radon.

Exposure to radon is a preventable health risk and testing radon levels in your home can help prevent unnecessary exposure. If a high radon level is detected in your home, you can take steps to fix the problem to protect yourself and your family.

  1. Test your home – EPA and the U.S. Surgeon General recommend that all homes in the U.S. be tested for radon. Testing is easy and inexpensive.
    • Learn more about testing your home, including how to obtain an easy-to-use test kit.
  2. Attend a National Radon Action Month event in your area –
  3. Spread the word
  4. Spend time during National Radon Action Month encouraging others to learn about radon and test their homes.
  5. Buy a radon-resistant home”

United Stated Environmental Protection Services EPA (National Radon Action Month Information | US EPA)

Part II January National Radon Month

National Radon Month3  National Radon Month5

Four Things You Can Do During National Radon Action Month:

1-Test your home –

EPA and the U.S. Surgeon General recommend that all homes in the U.S. be tested for radon.  Testing is easy and inexpensive.

Learn more about testing your home, including how to obtain an easy-to-use test kit.

2-Attend a National Radon Action Month event in your area –

Look for radon events in your community.

3-Spread the word –

Spend time during National Radon Action Month encouraging others to learn about radon and test their homes.

Tell your family and friends about the health risk of radon.  Encourage them to test their homes.

Plan an activity in your community to help raise awareness.

Write an op-ed or letter to the editor using samples from the event planning resources.

Attract media attention by working with a local official to get a radon proclamation.

View or order EPA’s free radon publications.

4-Buy a radon-resistant home –

– If you are considering buying a new home, look for builders who use radon-resistant new construction. Read more about radon-resistant new construction, “Building Radon Out: A Step-by-Step Guide to Build Radon-Resistant Homes“.

Build Green: It’s Easy to Build New Homes Radon-Resistant …”The good news is you can build your customers a safer, healthier, radon-resistant home. The techniques to prevent radon from entering a home are practical and straightforward for any builder. It’s an inexpensive way to offer families a benefit that could reduce their risk of lung cancer. And it’s a smart way to build trust between you and your customer.”  Fuad Reveiz, Member of the National Association of Home Builders.

5 WAYS YOU CAN PARTICIPATE:

 Promote radon risk reduction during National Radon Action Month and throughout the year.

Set a bold goal for your community to reduce radon risk.  Whether you are conducting a single National Radon Action Month event, or developing an entire radon risk reduction program for your community, it is important to set goals to define what you will achieve.

Collaborate with local radon partners.  Coordinate with your state radon program and local radon professionals to hold events and measure results.

Plan a National Radon Action Month activity or event to kick off your campaign.  Conduct activities and events designed to raise awareness, recognize successful efforts and share best practices. Set goals and establish ways to measure results from your activities and events.

An excellent way to get your entire community involved is the National Radon Poster Contest. Students ages 9-14 are encouraged to create posters that raise radon awareness. Entries will be accepted from March through October from students in all U.S. states, tribal nations and U.S. territories.

Visit to Kansas State University National Radon Services for more information about this year’s contest and how you can get involved.

Promote your activity or event on EPA’s Web site and elsewhere. Use tools such as blogs and the Share Your Story feature on Radonleaders.org to promote your activities and share outreach ideas with the broader radon community.

Work with the media to spread your message.  Work with your local media outlets to run Public Service Announcements (PSAs) and generate media coverage of radon topics, events and activities in your community.

QUOTE FOR THE WEEKEND:

January is Radon Action Month, the perfect time to check if your home is safe from radon; a colorless, odorless radioactive gas that naturally occurs from the breakdown of uranium in soil, rock, and water. Radon is also one of the leading yet lesser-known causes of lung cancer. Unfortunately, radon can seep into homes and commercial buildings, exposing occupants to high levels of radon over time. This invisible threat can put your home and loved ones at risk.

Radon testing is the only way to determine if your home or business is exposed to elevated levels of this dangerous gas. According to the EPA, 1 in 15 U.S. homes have radon levels exceeding the recommended action level of 4.0 pCi/L. The EPA recommends considering mitigation for levels of 2.0 pCi/L or higher. In areas known for naturally high radon levels, such as Colorado, Pennsylvania, Iowa, and North Dakota, the risk is even higher.”

Radon.org (RADON ACTION MONTH – Radon.org)

Part I January National Radon Month Awareness

 National Radon Month   National Radon Month4

Radon is a naturally occurring gas that seeps out of rocks and soil. Radon comes from uranium that has been in the ground since the time the earth was formed, and the rate of radon seepage is very variable, partly because the amounts of uranium in the soil vary considerably. Radon flows from the soil into outdoor air and also into the air in homes from the movement of gases in the soil beneath homes. Outside air typically contains very low levels of radon, but it builds up to higher concentrations indoors when it is unable to disperse. Some underground mines, especially uranium mines, contain much higher levels of radon.

Radon is present outdoors and indoors. It is normally found at very low levels in outdoor air and in drinking water from rivers and lakes. It can be found at higher levels in the air in houses and other buildings, as well as in water from underground sources, such as well water.

Radon breaks down into solid radioactive elements called radon progeny (such as polonium-218, polonium-214, and lead-214). Radon progeny can attach to dust and other particles and can be breathed into the lungs. As radon and radon progeny in the air break down, they give off radiation that can damage the DNA inside the body’s cells.

 How are people exposed to radon?

1-At home and in other buildings.

For both adults and children, most exposure to radon comes from being indoors in homes, offices, schools, and other buildings. The levels of radon in homes and other buildings depend on the characteristics of the rock and soil in the area. As a result, radon levels vary greatly in different parts of the United States, sometimes even within neighborhoods. Elevated radon levels have been found in every state.

Radon gas given off by soil or rock can enter buildings through cracks in floors or walls; construction joints; or gaps in foundations around pipes, wires, or pumps. Radon levels are usually highest in the basement or crawl space. This level is closest to the soil or rock that is the source of the radon. Therefore, people who spend much of their time in basement rooms at home or at work have a greater risk for being exposed.

Small amounts of radon can also be released from the water supply into the air. As the radon moves from the water to air, it can be inhaled. Water that comes from deep, underground wells in rock may have higher levels of radon, whereas surface water (from lakes or rivers) usually has very low radon levels. For the most part, water does not contribute much to overall exposure to radon.

Radon exposure can also occur from some building materials if they are made from radon-containing substances. Almost any building material made from natural substances, including concrete and wallboard, may give off some level of radon. In most cases these levels are very low, but in a few instances these materials may contribute significantly to radon exposure.

Some granite countertops may expose people to different levels of radon. Most health and radiation experts agree that while a small portion of granite countertops might give off increased levels of radon, most countertops give off extremely low levels.

According to the US Environmental Protection Agency (EPA), it’s very unlikely that a granite countertop in a home would increase the radiation level above the normal, natural background level that comes from nearby soil and rocks. Still, people concerned about radon from countertops and from other household sources can test these levels using home detection kits or can hire a professional to do the testing (see the section “How can I avoid exposure to radon?”).

According to the EPA, the average indoor radon level is about 1.3 picocuries per liter (pCi/L). People should take action to lower radon levels in the home if the level is 4.0 pCi/L or higher. The EPA estimates that nearly 1 out of every 15 homes in the United States has elevated radon levels.

Outdoors, radon generally disperses and does not reach high levels. Average levels of radon outdoors, according to the EPA, are about 0.4 pCi/L.

2-At certain jobs

 In the workplace, people working underground, such as some types of miners, are among the most likely to be exposed to high levels of radon. High death rates from lung problems among miners in some parts of the world were first noted hundreds of years ago, long before people knew what radon was. Studies of radon-exposed miners during the 1950s and 1960s confirmed the link between radon exposure and lung cancer.

Higher levels of radon exposure are also more likely for people who work in uranium processing factories or who come in contact with phosphate fertilizers, which may have high levels of radium (an element that can break down into radon).

Does radon cause cancer?

 Being exposed to radon for a long period of time can lead to lung cancer. Radon gas in the air breaks down into tiny radioactive elements (radon progeny) that can lodge in the lining of the lungs, where they can give off radiation. This radiation can damage lung cells and eventually lead to lung cancer.

Cigarette smoking is by far the most common cause of lung cancer in the United States, but radon is the second leading cause. Scientists estimate that about 20,000 lung cancer deaths per year are related to radon.

Exposure to the combination of radon gas and cigarette smoke creates a greater risk for lung cancer than either factor alone. Most radon-related lung cancers develop in smokers. However, radon is also thought to cause a significant number of lung cancer deaths among non-smokers in the United States each year.

Although radon is chemically inert and electrically uncharged, it is radioactive, which means that radon atoms in the air can spontaneously decay, or change to other atoms. When the resulting atoms, called radon progeny, are formed, they are electrically charged and can attach themselves to tiny dust particles in indoor air. These dust particles can easily be inhaled into the lung and can adhere to the lining of the lung. The deposited atoms decay, or change, by emitting a type of radiation called alpha radiation, which has the potential to damage cells in the lung. Alpha radiations can disrupt DNA of these lung cells. This DNA damage has the potential to be one step in a chain of events that can lead to cancer. Alpha radiations travel only extremely short distances in the body. Thus, alpha radiations from decay of radon progeny in the lungs cannot reach cells in any other organs, so it is likely that lung cancer is the only potentially important cancer hazard posed by radon.

For centuries, it has been known that some underground miners suffered from higher rates of lung cancer than the general population. In recent decades, a growing body of evidence has causally linked their lung cancers to exposure to high levels of radon and also to cigarette smoking. The connection between radon and lung cancer in miners has raised concern that radon in homes might be causing lung cancer in the general population, although the radon levels in most homes are much lower than in most mines. The National Research Council study, which has been carried out by the sixth Committee on Biological Effects of Ionizing Radiation (BEIR) VI, has used the most recent information available to estimate the risks posed by exposure to radon in homes.

You can’t see, smell or taste radon, but it could be present at a dangerous level in your home. Radon is the leading cause of lung cancer deaths among nonsmokers in America and claims the lives of about 21,000 Americans each year. In fact, the EPA and the U.S. Surgeon General urge all Americans to protect their health by testing their homes, schools and other buildings for radon.

Exposure to radon is a preventable health risk and testing radon levels in your home can help prevent unnecessary exposure. If a high radon level is detected in your home, you can take steps to fix the problem to protect yourself and your family.

Radon, being naturally occurring, cannot be entirely eliminated from our homes. Of the deaths that attributes to radon (both independently and through joint action with smoking), perhaps one-third could be avoided by reducing radon in homes where it is above the “action guideline level” of 148 Bqm-3 (4 pCiL-1) to below the action levels recommended by the Environmental Protection Agency.4

The risk of lung cancer caused by smoking is much higher than the risk of lung cancer caused by indoor radon. Most of the radon-related deaths among smokers would not have occurred if the victims had not smoked. Furthermore, there is evidence for a synergistic interaction between smoking and radon.

QUOTE FOR FRIDAY:

“The CDC says that all women of reproductive age consume 400 mcg of folic acid, and pregnant women consume 600 mcg, each day to prevent two types of neural tube defects. During Folic Acid Awareness Week, observed January 3-9, 2021 (as well as the entire month for National Birth Defects Prevention Month), WIC staff are encouraged to take the opportunity to enhance their efforts to educate moms about the role folic acid plays in preventing congenital disabilities, & how their WIC food packages include folic acid-rich foods.  WIC staff can brush up on folic acid basics and find educational resources via Eye on Nutrition: Folate and Folic Acid.”

USDA WIC Works Resource System/U.S. Department of Agriculture

Folic Awareness Month – how it impacts a women childbearing years to geriatric, cautions/concerns on this vitamin and how it protects your future!

 folicacid2  folicacid1

What is folic acid? Folic acid is a type of B vitamin that is normally found in foods such as dried beans, peas, lentils, oranges, whole-wheat products, liver, asparagus, beets, broccoli, brussels sprouts, and spinach.

What does folic acid do for us?

1-Supports Normal Fetal Development. Folate plays an integral role in fetal development and the benefits for pregnant women and their offspring cannot be understated. Folate deficiency during early pregnancy can lead to neural tube defects. This is a serious problem that can lead to pregnancy termination or a baby born with spina bifida. The good news? Studies have found increased folate levels from one month prior to conception to 3 months afterward can reduce the chance of these defects by 50%.

2-Folic acid plays a role with our nervous system.  This B vitamin is required for proper brain function and aids in maintaining healthy emotional and mental health.

3-Cell growth is also significantly impacted by folic acid. This vitamin assists in the production and maintenance of DNA, RNA, and blood cells. This is especially notable during adolescence and pregnancy, when cell health and growth is particularly important.

4-It reduces the effects of our aging process.  Folic acid is not only useful for early development and pregnancy, but it may also prevent age related conditions later in life. One study found that elderly individuals who had high levels of homocysteine and reduced folate levels benefited from folic acid supplementation. Patients showed a reduction in the rate of hearing loss as they aged. Another study showed that patients who took 2,500 mcg of folic acid in addition to 500 mg of vitamin B6 and 1,000 mcg of vitamin B12 daily showed a reduced risk of developing AMD (a condition leading to loss of vision). Having proper levels of folic acid can assist health at any stage of life.

5-Reducing the risk of heart disease, so vital in America.  Heart disease is a major concern in the United States and folic acid may help lower the rate of occurrence. Through regulating possibly harmful substances, such as the amino acid homocysteine, folates may reduce the risk of heart disease. Studies have shown that patients with high levels of homocysteine have an increased risk of heart disease by 1.7 times and an increased risk of stroke by 2.5 times. Although more research is required to make a definitive link between this amino acid and heart disease, regulating it via folate supplementation takes little effort.

Folic Acid Deficiency

Even if one is not interested in preventative benefits of this vitamin, it is important to maintain proper levels. This can be challenging for some as there are several factors that reduce folic acid levels in the body. Alcoholism, inflammatory bowel disease (IBD), celiac disease, and some medications such as tetracycline (an antibiotic), methotrexate (used for treating cancer, rheumatoid arthritis, and psoriasis), and chemotherapy all significantly hamper folic acid levels by inhibiting absorption.

Deficiency of this B vitamin can lead to:

  • Inhibited growth
  • Loss of appetite leading to weight loss
  • Diarrhea
  • Forgetfulness
  • Fatigue and weakness
  • Irritability
  • Sores and inflammation in or around the mouth

Cautions and Concerns of Supplementation

Folic acid, and B vitamins in general, are not associated with any severe side effects. Because they are water soluble any excess left over is simply excreted through urine. However, extreme dosages may cause:

  • Stomach problems
  • Sleep problems
  • Skin reactions
  • Confusion
  • Loss of appetite
  • Nausea
  • Seizures

Consult a physician if you intend to take more than 800mcg of folic acid. Those undergoing treatment for seizures or cancers should speak to their physician before taking folate supplements.

Protect your Future with Folic Acid

One of the best ways to ensure that you have adequate levels of folic acid in your diet is taking a folate supplement. Although, one usually acquires enough vitamin B9 through a balanced diet, dietary restrictions, food allergies, and food availability may impact one’s ability to ingest the requisite amount of folic acid. Mega B, produced by HoltraCeuticals, provides the needed daily amount of folic acid as well as a supporting cast of B vitamins to ensure the greatest impact. As an easy-to-digest form of B vitamins, Mega B is particularly beneficial for the elderly, vegetarians, and those who have chronic conditions as they are at greater risk of deficiency.

Even if you’re not at risk of deficiency, increasing B vitamin, or more specifically folate intake, can help prevent a slew of debilitating conditions and keep your body running at its best. Because there is relatively little danger associated with vitamin B supplementation, there are very few reasons not to utilize one. By taking a folate supplement and further spreading awareness during Folic Acid Awareness Week and throughout the year, you can fight against B vitamin deficiency and help reduce the occurrence of life-altering conditions.

QUOTE FOR THURSDAY:

“Tetralogy of Fallot is a congenital heart defect that occurs when a baby’s heart does not form correctly during pregnancy.  It is characterized by 4 defects: a ventricular septal defect (VSD), pulmonary stenosis, an overriding aorta, and right ventricular hypertrophy.  These defects affect the way the blood flows through the heart and lungs, potentially causing symptoms like cyanosis due to low oxygen levels in the blood.  TOF is a critical congenital heart defect, and when surgery is often necessary for repair, lifelong follow ups with a cardiac doctor are essential for monitoring and managing the condition.

The causes of tetralogy of Fallot among most babies are unknown. Some babies have heart defects because of changes in their genes or chromosomes. A combination of genes and other risk factors may increase the risk for tetralogy of Fallot. These factors can include things in a mother’s environment, what she eats or drinks, or the medicines she uses.”

Center for Disease Control and Prevention – CDC (Tetralogy of Fallot | Congenital Heart Defects (CHDs) | CDC)

 

Part III Congenital Birth Defects Cardiac-Tetralogy of Fallot

What is it?

A heart defect that features four problems.

They are:

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

More information for parents of children with Tetralogy of Fallot

What causes it?

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

How does it affect the heart?

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

How does tetralogy of Fallot affect my child?

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

What can be done about tetralogy of Fallot?

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

Tetralogy of Fallot patch diagramTetralogy of Fallot shunt diagram

Temporary Operation

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

Complete Repair

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

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

Will my child’s activities be limited?

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

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

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

What will my child need in the future?

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

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

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

What about preventing endocarditis?

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