How is Spina Bifida Diagnosed:

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

PRENATAL DIAGNOSED:

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

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

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

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

POSTNATAL DIAGNOSED:

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

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

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

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

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

TREATMENTS FOR SPINA BIFIDA:

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

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

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

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

“Hispanic women have the highest rate of having a child affected by spina bifida, when compared with non-Hispanic white and non-Hispanic black women. The estimated lifetime cost of care for a person with spina bifida, with caregiving costs, is $791,900. ”

Center for Disease Control and Prevention – CDC (https://www.cdc.gov/ncbddd/spinabifida/data.html)

  SPINA BIFIDA

TETHERED SPINALCORD (shown above)

FETUS WITH HYDROCEPHALUS (shown above)

  HYDROCEPHALUS

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

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

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

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

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

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

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

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

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

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

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

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

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

Non-modifiable risk factors to breast cancer means factors we cannot change:

Modifiable risks risk factors to breast cancer. This means factors we can control:

Weight. Being overweight is associated with increased risk of breast cancer, especially for women after menopause. Fat tissue is the body’s main source of estrogen after menopause, when the ovaries stop producing the hormone. Having more fat tissue means having higher estrogen levels, which can increase breast cancer risk.

Diet. Studies are looking at the relationship between diet and breast cancer risk and the risk of recurrence. The Women’s Health Initiative Trial suggested that a diet very low in fat may reduce the risk of breast cancer. More research is needed in this important area for women who are interested in eating well to reduce their risk of ever getting breast cancer.

Diet pretty much affects your weight.  Unless you have a high metabolism or are severely active eating fattening foods will put on weight.

In the meantime, here’s what dietitians suggest:

• Keep your body weight in a healthy range for your height and frame. Body mass index, though not a perfect measurement, can help you estimate your healthy weight.
• Eat plenty of vegetables and fruit (more than 5 cups a day).
• Try to limit your saturated fat intake to less than 10% of your total calories per day and limit your fat intake to about 30 grams per day.
• Eat foods high in omega-3 fatty acids.
• Avoid trans fats, processed meats, and charred or smoked foods.

You’ll find that processed foods generally don’t fit in this type of diet as well as fresh foods do. For more information, visit our page on healthy eating to reduce risk of breast cancer in the Nutrition section.

Exercise. Evidence is growing that exercise can reduce breast cancer risk. The American Cancer Society recommends engaging in 45-60 minutes of physical exercise 5 or more days a week.

Alcohol consumption. Studies have shown that breast cancer risk increases with the amount of alcohol a woman drinks. Alcohol can limit your liver’s ability to control blood levels of the hormone estrogen, which in turn can increase risk.

Smoking. Smoking is associated with a small increase in breast cancer risk.

Exposure to estrogen. Because the female hormone estrogen stimulates breast cell growth, exposure to estrogen over long periods of time, without any breaks, can increase the risk of breast cancer. Some of these risk factors are under your control, such as:

• taking combined hormone replacement therapy (estrogen and progesterone; HRT) for several years or more, or taking estrogen alone for more than 10 years
• being overweight
• regularly drinking alcohol

Recent oral contraceptive use. Using oral contraceptives (birth control pills) appears to slightly increase a woman’s risk for breast cancer, but only for a limited period of time. Women who stopped using oral contraceptives more than 10 years ago do not appear to have any increased breast cancer risk.

Stress and anxiety. There is no clear proof that stress and anxiety can increase breast cancer risk. However, anything you can do to reduce your stress and to enhance your comfort, joy, and satisfaction can have a major effect on your quality of life. So-called “mindful measures” (such as meditation, yoga, visualization exercises, and prayer) may be valuable additions to your daily or weekly routine. Some research suggests that these practices can strengthen the immune system.

The National Cancer Institute estimates an outstanding 80% of cancer in America is do to our lifestyles particularly DIET and EXERCISE. That includes Breast Cancer. I am not saying it is the only reason but a large percentage has to do with it and with changing it to a healthy one if your diet is not already including your exercise it lowers the probability for a large amount of people in America from getting cancer.  This principle also pertains to many other diseases (Ex. Obesity, High blood pressure, Diabetes, etc…)

Breast cancer is a polygenic and multifactorial disease for which estrogens have been recognized as the main risk factor, and for which lifestyle plays a key role. Previous epidemiologic cancer research performed in Uruguayan population delimited its dietary and anthropometric profiles (use for identification, use for the purposes of understanding human physical variation and in various attempts to correlate physical with racial and psychological traits). Recognizing the difficulty for universalizing a nutritional basis for prevention due to different eating patterns among regions and countries, what was summarized was the existent knowledge linking nutrition, estrogens, metabolism and Breast Cancer. As an attempt towards primary prevention of Breast Cancer, present recommendations mainly based on country-specific research findings and modifiable putative risk and protective factors, proposing to modify the intake of meats and other fatty foods – especially sources of Ω-6 and Ω-3 fatty acids – adding olive oil, selected vegetables, citrus fruits and working towards adequate body fat/muscle proportions. From a medical and ethical viewpoint, it is justified to recommend certain nutritional changes to women, because no adverse side effects are expected to occur.

There is evidence for an inverse association between physical activity and breast cancer risk. The evidence is stronger for postmenopausal breast cancer than for premenopausal breast cancer.

The National Cancer Institute states 80 percent of all cancers is due to our lifestyles. For some who are already active and eating healthy your already ahead of many in prevention of cancer but for those who don’t you dramatically alter your risks going towards higher probability of possibility getting cancer. If your one of those people I have great news this risk is controllable and you can fix it.

The modifiable risk factors are ones like your eating and exercise, which you have full control of. I am not saying become a weight lifter or workout in a gym 4 x/wk if you don’t now. What I am saying is increase your activity with some exercise like walking a mile a day or what you can tolerate and increase your exercise overtime.  If you get yourself up to 2 to 5 miles a day, great! If you become a regular at the gym or weight lifter great but you don’t have to go to that extreme of being a Sylvester Stallone or Rocky.

Non modifiable+modifiable risk factors:

“October is Spina Bifida Awareness Month—a time to celebrate the hundreds of thousands of people living with Spina Bifida.  Spina Bifida occurs in the first 28 days of pregnancy.  Spina Bifida is the most common permanently disabling birth defect compatible with life.  Often referred to as the “snow flake” condition.  Each year over 1,600 babies are born with this condition in the United States.  By 18 years old all those diagnosed with Spina Bifida will have had at least 8 surgeries.  There is no cure with Spina Bifida.”

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

“U.S. We rarely think about breathing except when we have trouble doing so and that’s why every October is Healthy Lung Month.  Tuberculosis, or TB, has been among the most prominent lung diseases in history, with traces of it even being found in ancient Egyptian mummies. It was tuberculosis that prompted the start of the American Lung Association in 1904.  

More recently anti-smoking movements have joined in the healthy lung movement. Cigarette packaging warnings were established in 1966 and years of campaigning have  successfully led to the change in perception of smoking among the American public, with Americans now realizing smoking is a major cause of cancer.

Lung disease affects a huge number of Americans. Around 10 million are diagnosed with chronic bronchitis each year, 25 million are believed to be living with asthma, and over 150,000 die from lung cancer annually. Our lungs are important and Healthy Lung Month is an opportunity to create awareness around healthy lifestyle choices. ”

National TODAY (https://nationaltoday.com/healthy-lung-month/)

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

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

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

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

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

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

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

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

“Bullying is a form of aggressive behavior in which someone intentionally and repeatedly causes another person injury or discomfort. Bullying can take the form of physical contact, words, or more subtle actions.

The bullied individual typically has trouble defending him or herself and does nothing to “cause” the bullying.

Cyberbullying is verbally threatening or harassing behavior conducted through such electronic technology as cell phones, email, social media, or text messaging.”

American Psychological Association (https://www.apa.org/topics/bullying)

“3 Principles to Keep Love Alive:

1. The act of loving is gratifying for both the lover and the loved one.

The state of being in love is passive and easily dissolves into an internal fantasy about being in love. This fantasy gradually becomes a substitute for actual love. The act of loving involves behaviors that keep a close relationship alive and vital

2. Maintain your individuality and appreciate your partner’s individuality.

When you know someone well or long, it is easy to lose sight of them as an individual person. Therefore, it is important to respect your partner by encouraging his or her unique interests and personal goals, independent of yours. This means being sensitive to your partner’s wants, desires, and feelings, and placing as much value on them as you do on your own. It means regarding your partner separate from any expectations you may have or any role he or she may be fulfilling in relation to you.

3.     Ignore your critical inner voice

To varying degrees, we all have an enemy within, a part of ourselves that operates inside our heads much like a malicious coach, criticizing us and offering up bad advice. This enemy, with its destructive point of view, is your critical inner voice. It supports your defenses, which wouldn’t be a bad thing except that, for the most part, your defenses are archaic. And lastly, when we are romantic, we can ignore our critical inner voice when it tries to influence us to defend ourselves and not be loving and vulnerable.

PsychAlive