Great exercise, endless games and the freedom to “travel” as a kid.
But before the kids flip up the kickstands for the season, hit the brakes for a minute.
The National Highway Transportation Safety Administration urges everyone to remember that bicycles aren’t toys—they are vehicles, officially—and even experienced riders should do what they can to minimize risk.
Applying that perspective to your family’s youthful riders should motivate every family to do what we can to prepare and prevent accidents before they happen.
And while it might seem about as fun as a flat tire, knowing, understanding, and taking steps to prevent bicycle mishaps now can make a smooth, happy ride for the rest of the summer.
“Bike riding is a great family activity,” said Jennifer Hoekstra, program coordinator of Spectrum Health Helen DeVos Children’s Hospital Injury Prevention Program and Safe Kids Greater Grand Rapids.
“Lead by example and keep your kids safe by requiring them to always wear a helmet when riding.”
Helmet use is lowest (for all ages) among children ages 11 to 14.
Bicycle helmets have been shown to reduce the risk of head injury and the risk of brain injury.
The Center for Head Injury Services reports that 85 percent of all head injuries in bicycle accidents can be prevented by wearing a helmet.
Bicycle helmets have also been shown to offer substantial protection to the forehead and midface.
Universal use of bicycle helmets by children ages 4 to 15 could prevent between 135 and 155 deaths, between 39,000 and 45,000 head injuries, and between 18,000 and 55,000 scalp and face injuries annually.
Child helmet ownership and use increases with the parent’s income and education level, yet decreases with the child’s age.
Children are more likely to wear a bicycle helmet if riding with others who are also wearing one.
In a national survey of children ages 8 to 12, 53 percent reported that a parental rule for helmet use would persuade them to wear a helmet, and 49 percent would wear a helmet if a state or community law required it.
Bicycle helmet use by every rider, of every age, for every ride should be every family’s rule.
Kids may think they look “babyish” or “uncool” with a helmet. Teach them it’s just the opposite.
When possible, let them pick out their own helmet or add flair if it helps them get into it. And if they still hate it? Tell them it’s the rule to ride and stick with it.
When parents ride without helmets, kids are quick to copy. They may wonder why, if it is a big deal, mom and dad aren’t wearing them, too. The moral of the story is everybody should wear a helmet, every ride.
It’s a no brainer
Correct fit and proper positioning are essential to the effectiveness of bike helmets at reducing injury.
One study found that children whose helmets fit poorly are at twice the risk of head injury in a crash compared to children whose helmet fit is excellent. In addition, children who wear their helmets tipped back on their heads have a 52 percent greater risk of head injury than those who wear their helmets centered on their heads.
“Remember, it can only protect their head if they wear it correctly each and every time they ride,” Hoekstra added.
Many of the women who come to our midlife and menopause clinic have a common problem: sleep issues.
As an OB/Gyn doctor who still delivers babies, I admit I don’t always get as much sleep as I should, but I do strive to get my seven to eight hours most nights.
Also, as a doctor, I am well aware of the problems people often encounter as a result of poor sleep habits: decreased cognitive function (also known as brain fog), difficulty remembering things, decreased job performance, and an increased chance of having a vehicle accident.
If you aren’t sleeping well, your overall quality of life suffers, and you may feel less motivated to follow a healthy and active lifestyle. This, in turn, can cause mood disturbances such as anxiety and depression. You may not suffer from major depression, but even having an underlying sense of dread or being in a bad mood is not a healthy way to live your life.
Having a hard time sleeping?
It may make you feel better to know that you’re not alone. In fact, about 69 percent of people have sleep problems, and women have 50 percent more problems with sleep than men.
Nearly 20 percent of people have chronic sleep issues that can cause serious medical risks, especially if they average less than six hours per night and have poor quality sleep. Some of these health threats include an increased risk for high blood pressure, heart disease, stroke, Type 2 diabetes and obesity.
These are serious health issues for people of all ages, but for women who are also navigating their way through menopause, sleep issues add more stress to an already difficult time in their lives.
So, why do sleep problems become worse during midlife and menopause, and what can you do to start getting more (and better) sleep?
The answer to the first question has to do with hormones. My experience with helping women in midlife and menopause has shown that a common pattern develops in women during this time, especially as their hormones start to change.
Even if your periods are regular, as you get older, your hormones can change three days before your period, causing night sweats. Early in the transition, you might not even think you are having night sweats, but waking three nights in a row in the middle of the night can actually be a slight nighttime hot flash.
Unfortunately, what happens to we busy women is that we turn a simple night of waking up into a catastrophe that may look something like this:
“OMG—I’m awake! I cannot afford to be awake. Oh geez, I have to pee, but I don’t want to get up to pee. Now I really have to pee, but if I get up, I might not be able to fall back asleep. What should I do? Oh, I will just lie here. Well, that is not working. Toss, turn, toss, turn. Fine—I will get up! Now that I’m up and can’t sleep, maybe I should clean, or check email, or watch TV, or check Facebook. Maybe then I will feel tired.”
Of course, then you fall back asleep at 4:30 a.m. or so, and the alarm goes off at 5:30 or 6 a.m. You wake up and you feel stressed, cranky and craving sugar.
Does this scenario sound familiar? If so, you know how poor sleep makes you feel, and it’s not good. To make matters worse, as women progress into perimenopause and then into menopause, the symptoms can stretch from happening three days a month to every night.
The result is what I call a hot mess.
What can I do about it?
Don’t fret. There is hope.
There are several treatments for sleep disorders, but it really comes down to how well you follow the recommendations and treatment guidelines from your physician. It’s important to treat any medical conditions, such as snoring, sleep apnea and obesity, that may be causing your sleep issues to worsen.
I talk to patients about using hormone replacement therapy for improving sleep issues. Such therapy is not a sleep medicine, but it can reduce hot flashes and night sweats, thereby reducing nighttime waking events.
We also discuss sleep hygiene, which includes developing a regular sleep schedule, avoiding stimulation such as caffeine or screen time before sleep, avoiding naps longer than 20 minutes in the afternoon, and keeping a regular exercise schedule of at least 20 minutes per day.
Probably the most effective recommendation I make for my patients is to make time each night before bed for metered breathing.
If you’re not familiar with this technique, here’s a quick explanation: Find a peaceful place in your house, outside of the bedroom. I call this your Zen spot. Turn on a low light and get into a comfortable position. Close your mouth, open your eyes, stare at a particular spot in the room, and just breathe. Breathing should not deep or forced. It should be relaxed.
Be aware of the sound of your breath. As you are aware of your breathing and focused on one visual stimuli, your mind will become still. If an annoying thought or worry enters your mind, simply think about it for a second and then go back to the sound of your breath.
Do this for five minutes, then go straight to bed, close your eyes and enter dreamland.
It may take several nights of practice before it works effectively. If you wake in the middle of the night and can’t fall back asleep, go to your Zen spot and do your metered breathing.
You will be pleasantly surprised how well it works.
Story and photos by Alan Neushwander, Spectrum HealthBeat
Rhonda Reilly trained for months to run her first half-marathon.
The 59-year-old from Athens, Ohio, was at her summer cottage in Ludington, Michigan, on Aug. 7, 2018 when she decided to continue training with a 4-mile run along Hamlin Lake. The picturesque setting on a warm summer afternoon seemed to present a perfect opportunity to take a break from preparing for a visitor.
Paula Milligan, a nurse at Spectrum Health Ludington Hospital, drove home from work that day along the same route. While driving on a road atop a bluff overlooking the lake, she noticed two bicyclists standing over a woman lying in the roadway.
The woman happened to be Rhonda. Face down, blood oozed from her head. At first, it appeared she may have been hit by a car. Milligan used her nursing skills to assess what may have happened.
“She was blue, which gave me an idea she had either a heart or lung issue,” Milligan recalled. “Once I rolled her over, I noticed there were no injuries to her hands or wrists. She also had sores on her knees which gave me an indication she had flopped down on the pavement.”
Rhonda suffered cardiac arrest. Milligan immediately began CPR.
“When I started compressions, her color started to come back and I’d get an occasional agonal breath,” Milligan recalled. “I just kept pumping hard to keep her color good and to protect brain function. I had no idea how long she’d been there.”
Milligan performed CPR for about 18 minutes before first responders arrived with an automated external defibrillator. They shocked Rhonda twice with the AED before rushing her to Spectrum Health Ludington Hospital.
Jane Doe
When Rhonda arrived in the emergency room, she had no form of identification on her. She went running that afternoon without her phone or any belongings.
Back at their cottage, Rhonda’s husband, Steve, began to worry. His wife’s run was taking longer than expected.
“I drove around for two hours looking for her,” Steve said. “I thought she may have taken a wrong turn and got lost. Finally, I called the hospital to see if anyone matching her description had come in. That’s when they told me what had happened and that she had been airlifted to Grand Rapids. I found out later that I had driven by where they had already rescued her.”
A superhero nurse
Rhonda credits Milligan with saving her life.
“I was very close to being dead,” Rhonda said. “I was blue when she found me. Less than 10 percent of people who have cardiac arrest outside of the home survive. Had she not found me and started CPR right away, I wouldn’t be here.”
Milligan, however, is modest about her lifesaving efforts.
“I don’t feel I did anything different than any other nurse would’ve done,” she said. “It just happened to be that I was the one who came across this person and responded to her.”
After being released from the hospital, the two reunited with a surprise visit Milligan made to Rhonda and Steve’s cottage.
“Paula is amazing,” Rhonda said with a smile. “She’s such a fun and happy person. We now have a special bond that will last a lifetime. This just goes to show that one person can really make a difference.”
Don’t take good health for granted
Rhonda appeared to be the model of good health. She didn’t take medication, had great blood pressure and maintained her physical fitness.
She spent nine days in the hospital, including four days in the intensive care unit. A defibrillator was placed in her chest to help protect against future cardiac arrests.
“You can be the perfect picture of good health and still have something like this happen,” Steve said. “Don’t think you’re immune just because you’re fit and a runner.”
Everyone should be prepared to do CPR
There are two lessons the couple wants people to learn from Rhonda’s incident.
First, always carry identification if you are exercising alone.
“Steve didn’t know what was happening or where I was,” Rhonda said. “I didn’t have any ID on me. It would’ve been so much easier for my husband if someone could’ve called him to let him know what was happening.”
There are several different types of wearable identification items runners can wear such as a wristband ID, shoe tag, pocket card and necklaces.
More importantly, Rhonda knows CPR saved her life and urges everyone to learn basic CPR skills.
“It’s really not that hard to learn CPR and the difference you can make is incredible,” she said.
I’ve told all of you about my mantra—lean and ease of movement—in some of my earlier blogs.
My plan to help me achieve this mantra is to eat small, frequent meals of complex carbohydrates and protein, plus one simple carb treat each day.
How many of you came up with your own mantra to help you make good decisions every day? I ask that question because I really believe everyone needs a little help to make smart choices, especially during middle age and menopause.
One of the most important reasons to choose what you eat wisely is because of the relationship between middle age, menopause and belly fat.
Even if you have always had a flat stomach, or mostly gained weight below your waist, you may have noticed that has changed as you’ve reached middle age (and beyond). A common complaint I hear from women who visit my practice is that they gain belly fat easily and have a difficult time losing it.
Why is belly fat so bad? There are several reasons, including both medical and personal issues, with belly fat:
Belly fat makes you feel unhealthy.
Belly fat can change your mood from cheerful to irritable.
Belly fat greatly increases your risk for heart disease, diabetes and overall weight gain.
Belly fat adds more insulation, which can cause or worsen hot flashes and night sweats.
In addition, belly fat is extremely powerful because it is inside your abdominal cavity, not just under the skin like fat elsewhere on your body.
When fat is so close to your liver, it can cause a condition called “insulin resistance.” This means that your insulin receptors on your cells require more insulin to make the sugar go into your liver, muscle or brain cells. Thus, as insulin increases to meet this demand, it increasingly makes you crave sugar and promotes fat storage.
When you answer the craving and eat sugar, the sugar goes directly to the belly fat and makes it bigger, which then makes your insulin increase even greater. You get the picture: The belly fat has a voice that says, “Feed me.” That “voice” is insulin, and the only way to shut it up is to starve it of simple sugar.
So, what’s the answer?
It’s simple: Get off the sugar.
There are simple carbs all around you every day, but you need to figure out how to stay away from them without feeling cheated. I was at a baseball game recently, and you can imagine how many simple carbs were right next to me—blueberry muffins, licorice, hot dog buns, slushes.
Here’s what I did before I went to the game: I had a late breakfast of brown rice, poached egg and mixed greens. Plus, I took a baggy of frozen grapes to munch on during the game. I was completely satisfied and had no craving for that blueberry muffin next to me.
You can’t always avoid simple sugars, but you can make smart choices.
Ice cream with the family? Choose a baby cone and throw away the cone (or get the ice cream in a dish).
Heading to a party or a baseball game? Eat a healthy meal or snack before you go and take a sweet snack (like frozen grapes) with you to help you avoid the cravings before they start.
And, keep repeating your mantra—whatever it may be. If you do not feed the fat, you will take back your power to be healthy.
Are you ready for menopause? Or even perimenopause? The storm is coming, so now is the time to act to make it less of a tempest. (Courtesy Spectrum Health Beat)
So many women come to see me when they are experiencing what I call the Perfect Storm.
Their bodies are changing and they are faced with night sweats, increased belly fat, irritability, depression, lack of energy, irregular or heavy periods and decreased sex drive. That’s quite a list!
The Perfect Storm occurs when two fronts collide and cause havoc with your body.
The first front is caused by changing hormones, which then leads to an array of symptoms: night sweats, hot flashes, disturbed sleep, anxiety, irritability, decreased motivation and sex drive, and cravings of sweets and simple carbs. The second front is the change in your body chemistry, including changes in hormone levels.
The result? Good cholesterol levels go down, bad cholesterol goes up, insulin resistance increases, belly fat builds up and brain chemicals drop.
To more fully understand the Perfect Storm, it helps to know the three phases every woman goes through in adult life: reproductive phase, perimenopause and menopause.
Here’s a brief summary of each phase:
Reproductive phase—Many women in this phase feel normal and experience regular periods. This is the time we really don’t have to think about our hormones, and our body just makes sense. Toward the end of this phase, symptoms such as menstrual migraines, night sweats, mood changes and sugar cravings sometimes start. These symptoms are predictable and occur the three days before your period starts.
Perimenopause—This stage is sometimes referred to as midlife, and it’s also where the Perfect Storm occurs. Your periods start to become irregular, closer together and heavier, and symptoms like night sweats, sleep difficulties, mood changes and belly fat weight gain can become worse. You may even skip some periods and then begin having regular periods again.
Menopause—This phase means you haven’t had a period in 12 months—yeah! However, it’s important to note that if you go three months without a period and then you get one, the clock starts all over again. Approximately 80 percent of women experience symptoms during menopause, which typically last between two and five years after the start of menopause. The good news is that women who seem to handle the symptoms the best are the ones who continue to kept their weight in the healthy range, remain active, drink plenty of water and get plenty of sleep each night.
After menopause, it is very difficult to alter the course you are on, so if you want to weather your Perfect Storm and keep your symptoms in check, you need to make sure you are on a healthy path right now. What happens during the storm will determine the course of the rest of your life, so ask for the help you may need to sail through your Perfect Storm.
Is it a common cold, or something more? Listening closely to your child’s cough can help you decide if it’s time to seek a doctor. (Courtesy Spectrum Health Beat)
It may be croup, a viral illness that causes swelling and inflammation of the vocal cords. The cough sounds like a bark and it may also be accompanied by stridor—a harsh, high-pitched wheeze—when your child breathes in.
Whooping
It may be pertussis. Commonly known as whooping cough, pertussis is a contagious respiratory illness that can cause coughing fits in which children are forced to inhale with a loud “whooping” sound as they gasp for breath.
Staccato
A repetitive cough with short, staccato sounds is a characteristic sign of the lung infection chlamydial pneumonia, especially in infants.
Dry
A persistent, dry cough may be a symptom of asthma, a disease affecting the lungs.
Wet
The common cold often produces a wet, productive-sounding cough with mucus or phlegm behind it.
Although it may go against your parental instincts, Dr. McGee advises caregivers to resist the temptation to medicate children with a cough suppressant. Doing so, he warns, may do more harm than good in most cases.
But parents should also know when enough is enough.
“If your child has had a persistent cough for a week or more, don’t just write it off as the common cold,” Dr. McGee said. “Make an appointment with a pediatrician to determine if something else is going on.”
Seek immediate medical help if your child appears ill and is working hard to breathe, he said.
Car seats and boosters can save lives. Just ask this family – The Smith kids, Olivia (4), Blake and Evan (1) get ready for a road trip. The Smith family, Ben and Janna, and kids Olivia, Blake and Evan, 1. (Courtesy Spectrum Health Beat)
In 2011, Janna Smith was riding in the back seat of the car with 4-month-old daughter, Olivia. Her husband, Ben, was driving when they were hit broadside by another car. The impact took place on Olivia’s side.
“I could see the base and carrier of Olivia’s car seat move slightly with the impact but then return to its original position, which was exactly what it was designed to do in an accident,” Janna explained.
While Janna suffered some painful injuries, Olivia was unharmed. And it was her car seat that saved her. While that’s a happy ending, the story doesn’t end there.
Always count on change
Fast forward to 2014.
After many struggles to become pregnant with Olivia, Janna and Ben decided to try for a sibling. They focused on their appreciation of Olivia, no matter what the future held.
When they found out they were having twins, they couldn’t have been happier. Nearly as surprising was how complicated it became to find a new car that would fit all three kids across one bench seat.
The Smiths knew from their scary accident how important it would be to have that row of car seats lined up in rock-solid, life-saving perfection.
“We looked at so many cars,” Janna said. “Will three car seats fit? No kids in the way back. Is there enough cargo room? Scratch that one, it’s got a console in the middle. Can it tow our trailer?”
Finally, they found a used Lincoln Navigator that fit the bill.
Brothers Evan and Blake, were born five weeks early on April 24, 2014. They spent their early weeks in the Helen DeVos Children’s Hospital Neonatal Intensive Care Unit. Did Janna and Ben assume the knowledge they already had was up to snuff when it was time to take the new babies home?
“No way,” Janna said. “You can’t leave anything to chance. We knew all too well from our accident with Olivia how important it is to have everything snapped and perfectly adjusted. She was safe from the direct hit because the straps were adjusted for her body. You can’t underestimate the value of that, which is why we still have our seats checked as the kids grow. How do you know they are buckled right? You go to the pros. We’re on a first-name basis.”
What you might not know
While awareness of proper child restraint use in cars has increased, the National Highway Transportation Safety Administration still estimates that about 75 percent of child seats and boosters are improperly installed in family vehicles.
The Smiths considered themselves lucky to be part of the positive 25 percent.
In the Smiths’ case, and for all families whose babies are going home after a NICU stay, there is extra assurance that all is well. NICU babies must pass a car seat test with monitors attached, before they can be discharged from the hospital. This automatically ensures that NICU parents receive expert guidance from the first ride home. But every healthy baby going home is just as precious, and help is easy to find.
So, before Evan and Blake got to check out of the hospital, the Smiths consulted the experts at Helen DeVos Injury Prevention program, with Olivia and the two new car seats. They learned how to get all three seats properly secured on the bench seat and confirm how to assess strap and buckle placement for each child.
“It’s not just about the car seat user manual, either,” Janna added. “Look in your car’s owner’s manual to confirm how your vehicle is designed to work with infant/child safety seats. At the Safe Kids car seat safety check events, they thoroughly install your seat in your car with your kids. They installed an additional convertible car seat in my mom’s conversion van, too. If grandparents or babysitters will be transporting your kids, their vehicles are just as important.” To get started, watch our video on how to properly secure your baby in the car seat.
If possible, plan for each car to have its own car seats. If that’s not an option, make sure everyone who is moving the seats from one car to the next is completely educated on the details. If in doubt, stop in at a local fire department to have the seats checked or to be installed in the other vehicle before transporting. Having little ones safe at every trip, in every vehicle is critical.
Today, Olivia Smith is a charming, precocious 4-year-old. She loves her role as big sister of her equally adorable twin brothers, who just turned 1 year. And Ben and Janna Smith enjoy the peace of mind that comes with knowing their kids are as safe as can be, every trip, every car, every time.
Your dishwasher may get those plates spotless, but it is also probably teeming with bacteria and fungus, a new study suggests.
Microbes—from bacteria to viruses to fungi—are everywhere, including within and on the human body. So it’s no surprise, the researchers said, that a kitchen appliance would be hosting them.
So do people need to worry about getting sick from their dishwashers? No, said Erica Hartmann, an assistant professor at Northwestern University who was not involved with the study.
“The risk is probably in the realm of a shark attack,” she said. That is, most people face little to no risk, but there are select groups who may be at higher risk—in this case, people with conditions that weaken their immune defenses.
Dishwashers are an interesting case when it comes to microbes because they are actually an “extreme” habitat, Hartmann explained.
“People don’t think of them that way. It’s just your dishwasher. But it really is an extreme environment,” said Hartmann, who studies the microbiology of the indoor environment.
Dishwashers create constantly fluctuating conditions—wet to dry, high heat to cooler temperatures, low to high acidity. They also harbor mixtures of detergents and dinner scraps. So, only certain microbes will thrive.
The new study looked at which bacteria and fungi are actually dwelling there, and what factors seem to influence that microbial makeup.
Specifically, the European researchers took samples from the rubber seals of 24 household dishwashers.
Overall, they found, the most common bacteria included Pseudomonas, Escherichia and Acinetobacter—all of which have strains that are “opportunistic pathogens.” That means they are normally harmless, but can cause infections in people with a compromised immune system.
The most common types of fungus were Candida, Cryptococcus and Rhodotorula—which also include opportunistic pathogens.
Nina Gunde-Cimerman, a professor of microbiology at the University of Ljubljana, in Slovenia, worked on the study.
She said dishwashers and other microbe-hosting appliances are “generally safe” for healthy people. It’s “sensitive groups,” she said, who may need to be more cautious.
Gunde-Cimerman said she and her colleagues suspect dishwashers might play a role in fungal infections called mycoses in certain immune-compromised patients. A fungus commonly found in those patients, she said, is known as Exophiala dermatitidis, or black yeast.
And while that fungus is “hardly known in nature,” she said, it’s easy to find in dishwashers.
However, Gunde-Cimerman stressed, that’s speculation. No one has yet proven a connection between dishwasher microbes and mycoses infections.
How do fungus and bacteria get into dishwashers? The “main entry point” for fungi is the tap water that supplies the appliance, Gunde-Cimerman said. But food, people and pets are other potential sources, she added.
As for the bacteria, the source isn’t clear, according to Gunde-Cimerman. “But we speculate that contaminated food is the main entry route,” she said.
It is possible for dishwasher microbes to break free from their home: They can get out via waste water, or through the hot air produced at the end of the dishwasher cycle, Gunde-Cimerman said.
So one way to keep the microbes contained is to avoid opening the dishwasher before it has cooled down, according to Gunde-Cimerman.
“Do not open the dishwasher when it is still hot and humid,” she said, “to prevent the release of aerosols in the kitchen.”
Wiping the rubber seal with a dry cloth at the end of a cycle can also limit microbe buildup, Gunde-Cimerman said.
Hartmann agreed that people who are concerned can wipe down the dishwasher seal.
But she also emphasized the positive aspects of the microbial communities living in all our homes: Scientists have made great discoveries by studying microorganisms.
Hartmann pointed to the example of a bacterial enzyme discovered in the hot springs of Yellowstone National Park. It was instrumental in developing a breakthrough technique called polymerase chain reaction, which is now used to study DNA in research and clinical labs everywhere.
“Your kitchen might not be Yellowstone,” Hartmann noted. But, she added, it may host some “pretty amazing” microbes.
So if you are ever presented with the opportunity to have researchers swab your kitchen, Hartmann said, consider it.
The study was published in the journal Applied and Environmental Microbiology.
For Ollie, timing and technology came together to make possible the operation, and its happy outcome.
Ultrasound reveals a problem
Kimberly and her husband, Anthony, had no clues of the drama ahead as they prepared for the birth of their second child. They looked forward to welcoming a younger sibling for their 5-year-old son, Elliott.
At 20 weeks, Kimberly had a routine ultrasound near her home in Holland, Michigan. Because the baby’s kidneys and bladder were enlarged, Kimberly’s doctor referred her to the maternal fetal medicine specialists at Spectrum Health.
A few days later, the Lotts visited Dr. Romero and she performed another ultrasound. It, too, revealed enlargement of the bladder, kidneys and the ducts that connect the two.
“It looked like the baby had an obstruction, most likely below the bladder,” she said.
That tiny piece of plastic saved his life.
Kimberly Lott Ollie’s mother
It was hard to get a detailed picture. A developing baby generally floats in amniotic fluid, which aids visualization of the anatomy. But in Ollie’s case, there was essentially no amniotic fluid. Dr. Romero could not even see if the baby was a boy or girl.
Photo by Chris Clark, Spectrum HealthBeat
The lack of fluid can lead to damage of the urinary tract, kidneys and lungs.
“The baby releases urine to the amniotic cavity, and then the baby swallows and breathes the fluid, allowing the lungs to develop,” Dr. Romero explained. “Low amniotic fluid can result in underdevelopment of the lungs—pulmonary hypoplasia, a life-threatening condition.”
In the early stages of pregnancy, the placenta creates the amniotic fluid. The kidneys take over the job after week 17.
By retaining urine, the blockage in Ollie’s bladder disrupted that cycle. Later tests showed he had posterior urethral valves, which means he had extra flaps of tissue in the tube through which urine leaves the body.
Depending on the degree of the obstruction, the condition can be fatal.
‘We will try it’
The Lotts, reeling from the news of their baby’s prognosis, struggled to comprehend the options laid out for them. They could wait and let nature take its course, loving their child for his brief life on earth.
Or they could see if a shunt could be placed in utero in the bladder.
“It sounded kind of far-off,” Kimberly said. “I didn’t know if that was going to work. It seemed weird. But we said we will try it.”
First, they had to see if Ollie was a candidate for surgery. The maternal fetal medicine team had to make sure Ollie’s kidneys still worked and could produce urine. The surgery would not benefit him if the kidneys were so damaged they could not function.
I was so scared. I didn’t want to get my hopes up.
Kimberly Lott Ollie’s mother
Dr. Romero performed a bladder tap, using ultrasound to guide her as she placed a long needle through Kimberly’s uterus and into Ollie’s bladder.
From that tiny sac, she withdrew about a teaspoon of urine.
Photo by Chris Clark, Spectrum HealthBeat
“I felt it. It wasn’t good,” Kimberly said. “That first bladder tap was the worst. My whole uterus contracted. I was crying. I was upset. I was swearing.”
And most difficult of all: She had to repeat the bladder tap the next day. The second test would show if the bladder filled with urine again, indicating Ollie still had functioning kidneys.
Kimberly didn’t hesitate.
“I wanted to do everything I could do,” she said.
Daring to hope
The tests showed good renal function, so Dr. Romero performed the surgery. Kimberly was 23 weeks pregnant.
Using a larger, hollow needle, Dr. Romero placed the shunt into Ollie’s grape-sized bladder.
The tube, called a pigtail catheter, curled into a loop on each end. She placed one end coiled up inside his bladder. The other end looped in a circle outside his body, along his belly.
Urine flowed through the catheter from the bladder to the amniotic sac, bypassing the blockage.
For the rest of the pregnancy, Kimberly returned for repeated follow-up tests to make sure the catheter remained in place. Babies often manage to pull them out.
With each visit, Kimberly worried about whether the shunt still worked, whether her baby was growing.
“I was so scared,” she said. “I didn’t want to get my hopes up.”
As the weeks progressed without problems, she began to be hopeful. She stopped researching palliative care options and started reading about kidney issues. A few weeks before the delivery date, she finally allowed herself to buy a few baby outfits for him.
Throughout the pregnancy, the maternal fetal medicine team also monitored the growth of Ollie’s chest.
“We were all worried about how his lungs were working,” Dr. Romero said. “We noticed his chest was growing, so we hoped his lungs were growing, too. But we wouldn’t know until the baby was born.”
They planned to induce labor at 37 weeks. But three days before the delivery date, an ultrasound showed a drop in fluid levels. The catheter was not visible on the scan. The maternal fetal medicine specialists decided to deliver him that day.
That night, Dr. Romero performed a C-section, and Anthony Oliver Lott was born. He weighed 6 pounds, 15 ounces.
“He came out and just started wailing,” Kimberly said. “It was such a relief to us.”
Photo by Chris Clark, Spectrum HealthBeat
On his belly lay the coiled catheter that had been so elusive on the last ultrasound.
“Everyone was pointing at it and saying, ‘There it is! It’s in there,’” she said.
It didn’t take long to see it was still doing its job.
Ollie’s lungs managed to avoid major damage. In the children’s hospital neonatal intensive care unit, he didn’t need to be on oxygen.
His kidneys sustained major damage, but that had been expected.
‘We can deal with that’
Kimberly gave Ollie a bottle as her son Elliott played a computer game nearby. She talked about the challenges her infant son has already faced in his short life.
Five days after birth, he underwent surgery to remove the valves that blocked his urethra. Tubes were placed in his kidneys to drain urine from them. And he had a port placed so he can have dialysis in the future.
He will need a kidney transplant eventually. Kimberly hopes she will be able to give him one of hers.
He also has a feeding tube to make sure he gets enough nutrition. Children with kidney disease often have poor appetites, Kimberly explained.
Ollie’s health challenges don’t faze her. She just marvels at her son’s bright eyes and alert gaze, his wiggly arms and legs, his sweet smile.
“When he came out and all that was really damaged was his kidneys and urinary tract system, I said, ‘This is manageable. We can deal with that.’ There’s lots of kids in the world who have kidney disease and they are fine.”
She looks to his future with hope.
“He’s a little fighter,” she said. “He has been since the beginning.”
Photo by Chris Clark, Spectrum HealthBeat
She opened a small bottle and tapped out a plastic tube, curled at both ends: the catheter that had been implanted in utero.
“It saved his life,” she marveled. “That tiny piece of plastic saved his life.”
Ollie’s progress is also deeply rewarding to his physicians.
“This is why you go into medicine, because you want to save lives,” Dr. Romero said. “You want to do good for people.”
She credited Kimberly and her doctor with seeking specialized care as soon as the problem with his bladder appeared. The timing was crucial to the success of the shunt surgery.
Dr. Quiroga praised the Lotts and their vigilance in managing Ollie’s complex health issues, during pregnancy and after birth.
“The family is awesome,” he said.
As for Ollie, he said, “He’s doing great. He’s surprising us. He’s keeping us busy but he’s doing well.”
Reprinted with permission from Spectrum Health Beat.
Your life partner has a much greater influence on your longevity than the genes you inherited from your family, according to a new analysis of the family trees of more than 400 million people.
“While it is a widely held belief that lifes pan heritability ranges from approximately 15 to 30 percent, the findings discussed in this paper demonstrated that the heritability of human longevity is likely well below 10 percent,” said lead researcher Cathy Ball. She is a chief scientific officer for Ancestry, the popular genealogy website.
Earlier estimates were skewed because they didn’t account for the strong influence that a person’s spouse or life partner can have on their longevity, Ball and her colleagues said.
People tend to select partners who share traits like their own, the researchers explained. If you have a lifestyle that’s going to contribute to a longer life, you’ll likely choose a mate who shares that lifestyle.
Dr. Gisele Wolf-Klein is a geriatrician with Northwell Health in Great Neck, N.Y. She said, “Chances are you’re going to try to partner with someone with equal interests in terms of health habits. If you find someone who wants to run a marathon with you rather than be a couch potato, chances are you’ll keep running more marathons.”
Wealth could be another nongenetic trait shared by mates, the researchers suggested. If income contributes to lifespan and wealthy people tend to marry other wealthy people, that could also add to their longevity.
After correcting for the effects of such mating, Ball’s team concluded that genetics contributes not more than 7 percent to longevity, and possibly even less.
“The research findings expose the complex dynamics of longevity,” Ball said. “Although there is a genetic component, this study shows that there is a major impact from many other forces in your life.”
For the study, researchers combed through 54 million public family trees generated by Ancestry.com subscribers, which represented 6 billion ancestors.
From there, the team refined the records until they wound up with a set of human pedigrees that included more than 400 million people, each connected to another by either birth or marriage.
Things got interesting when the researchers started looking at people related only by marriage. They found that siblings-in-law and first-cousins-in-law had similar life spans, even though they aren’t blood relatives and generally don’t live under the same roof.
Further analysis showed that factors important to life span tend to be very similar between mates. People are choosing folks who share values that will either shorten or extend longevity, the researchers noted.
The findings were published Nov. 6 in the journal Genetics.
“I think it’s a very optimistic and positive message for us,” said Wolf-Klein, who was not involved in the research.
“It outlines something that’s becoming more and more obvious to all of us—we have a certain control over who we are and what we become,” she added. “Regardless of your genetics, if you adhere to good diet, good exercise, healthy habits, you can overcome some of the dooms of genetics.”
