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.

“Symptoms range in severity. Your child may need surgery to repair the opening in their spine shortly after birth. In addition, treatment is available to help them manage symptoms throughout their lifetime.

Each year, about 1 in every 2,875 babies born in the U.S. has spina bifida. The exact cause of spina bifida isn’t known. But certain factors may increase the risk. There are ways to reduce the risk. “

MAYO CLINIC (Spina Bifida: What It Is, Causes, Symptoms & Treatment)

  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!

“Spina bifida is a type of neural tube defect that happens when a fetus’s spine and spinal cord don’t close properly during early pregnancy.

The neural tube forms the brain and spinal cord during embryonic development. When it doesn’t close, it leaves a gap in the spine. This gap can affect the vertebrae, spinal cord and nearby nerves. In more severe cases, a fluid-filled sac may stick out through the opening.

Symptoms range in severity.”

Cleveland Clinic (Spina Bifida: What It Is, Causes, Symptoms & Treatment)

Healthline states the following about Adult ADHD:

• “Adult ADHD may manifest as difficulties with organization, relationship management, focus, restlessness, and managing emotions.
• To receive an ADHD diagnosis as an adult, you must exhibit at least five symptoms associated with ADHD for a minimum of six months.
• If you’re experiencing disruptive ADHD symptoms, seek professional evaluation. Solutions like therapy, stress management, and medication are available to help manage the condition.”

Healthline (Adult ADHD: 14 Signs and Symptoms)

Though that ADHD is something that kids would outgrow.

We now know this is not true.

ADHD is neurobiological disorder that affects individuals across the lifespan.

ADHD doesn’t end at age 18. When adult ADHD goes undiagnosed, is misdiagnosed, or is not adequately treated, the effects can extend well beyond the individual.

The doctor for adults never diagnosed or miss diagnosed for ADHA will examine the consequences when this happens to adults with ADHD that can also include patients with  management that was discontinued, or care poorly managed, including increased risks related to employment and economic stability, relationships, physical and mental health, substance use, driving and injury, and involvement with the justice system.

For policymakers, these are not simply healthcare concerns. The effects of undiagnosed and inadequately treated ADHD can ripple through the workforce, families, schools, healthcare systems, public safety, and communities. They have a direct financial and social cost to their constituents and communities.

Approximately 15.5 million adults have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). In early adulthood, ADHD may be associated with depression, mood or conduct disorders and substance abuse. Adults with ADHD often cope with difficulties at work and in their personal and family lives related to ADHD symptoms.  Many have inconsistent performance at work or in their careers; have difficulties with day-to-day responsibilities; experience relationship problems; and may have chronic feelings of frustration, guilt or blame.

Individuals with ADHD may also have difficulties with maintaining attention, executive function and working memory.  Recently, deficits in executive function have emerged as key factors affecting academic and career success. Executive function is the brain’s ability to prioritize and manage thoughts and actions. This ability permits individuals to consider the long-term consequences of their actions and guide their behavior across time more effectively.  Individuals who have issues with executive functioning may have difficulties completing tasks or may forget important things.

Healthline states that:
FDA Approves ‘First-in-Class’ NDSRI for ADHD in Adults and Children

A new medication to help treat attention deficit hyperactivity disorder (ADHD) will be available later this year. Otsuka Pharmaceutical has received approval from the Food and Drug Administration (FDA) for SIMTRIYO, a daily extended-relief tablet that contains the active ingredient centanafadine.

The new medication is approved for use in adults and children 6 years and older who weigh at least 44 pounds. Otsuka officials say their drug is the first norepinephrine, dopamine, serotonin reuptake inhibitor (NDSRI) to treat ADHD.

Max Wiznitzer, MD, a professor of pediatrics and neurology at Case Western Reserve University in Ohio and the co-chair of the Professional Advisory Board for the organization Children and Adults with ADHD (CHADD), said he also plans to use SIMTRIYO as a backup treatment for people who aren’t seeing benefits from current medications. Wiznitzer said he needs more evidence that SIMTRIYO is more effective than stimulant-based medications before prescribing it more often, but he is glad to have it available. “It’s good to have another alternative,” he told Healthline.  Remember its a NEW DRUG so you need time to see its effectiveness just like with Covid 19 that is why the vaccine was changed in time from the initial vaccine that was made with research done in a few years after 2020.

“ADHD Awareness Month is celebrated every October,  the facts to know on ADHD

• Males are almost three times more likelyTrusted Source to be diagnosed with ADHD than females.
• During their lifetimes, 13 percent of menTrusted Source will be diagnosed with ADHD. Just 4.2 percent of women will be diagnosed.
• The average ageTrusted Source of ADHD diagnosis is 7 years old.
• Symptoms of ADHD typically first appear between the ages of 3 and 6Trusted Source.
• ADHD isn’t just a childhood disorder. About 4 percent of American adults over the age of 18 deal with ADHD on a daily basis.”

Healthline (www.healthline.com)

“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.”

Lung Institute (Healthy Lung Month – Lung Institute)