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Monday, December 2, 2013

Heel Pain in Children

Heel pain is common in people of all ages, but the cause of heel pain can diiffer dramatically between adults and children. Because of this, treatment for heel pain in children is different than for adults, and generally a foot specialist is needed to accurately diagnose the source of heel pain in a child. This article will discuss the various causes of heel pain in children, and how treatment differs.Heel pain is caused by many different conditions. In adults, heel pain is caused by strain to tissue in the arch called the plantar fascia. The resulting condition is commonly referred to as plantar fasciitis, and mistakenly known as a heel spur (which may or may not be present) Children can get this condition, especially if they have very flat feet, but this is not common. Childhood plantar fasciitis tends to be due to arch fatigue from flat feet, causing chronic arch fatigue after standing for awhile. This in turn strains the plantar fascia after awhile, but not in the same acute way that adults injure their foot. Simple stretching exercises and prescription orthotics shoe inserts tends to relieve this condition in children, while adults require additional medical treatment to resolve the more severe inflammation component they develop.The most common heel pain cause in children is inflammation within a growth plate on the back of the heel bone. The child's pain is usually located on the back or the back bottom of the heel and is present with increased activity like running, or even present with simple standing or walking. This pain typically occurs from the age of 10 until the early teen years, when the growth plate 'closes' and stops growing bone. Certain high impact activities, like running, sprinting, and jumping, can force this condition to develop. In many cases, this inflammation simply develops on its own, without injury. To be accurate, it will generally resolve on its own. However, help is needed to accelerate the process and bring the child back into activity. The condition is called calcaneal apophysitis, and is easily diagnosed by foot specialists, and generally pediatritians as well. X-rays are needed to rule out fracture, which, though rare, is possible. The growth plate can be sensitive to crush injuries of the heel bone, and on occasion an injury in which the Achilles tendon pulls forcefully upward or the back of the heel is struck against an object can produce a fracture at the growth plate. In this case, the foot needs to be immobilized in a cast or walking boot to allow it to heal. For the more typical case of apophysitis, treatment is conservative, and can include some combination of temporary activity/sports cessation, icing, anti-inflammatory medications, Achilles stretching, and heel lifts or cups. Of all of these, activity and sports cessation is the most important, as this condition simply needs time to rest. The other components allow for inflammation reduction and heel support. However, if the heel is not rested, the treatment course will not succeed and the pain will persist for many months. Most children improve back to normal after a month or two of rest. Unfortunately, it is this author's experience that many children and their parents will refuse to rest, citing the need to continue with year round sports like baseball or basketball, even if in pain. They simply expect a more convenient solution. In all likelihood, most children in early adolescence are not yet world class athletes who require sustained training, and a couple of months of rest from sports will not spoil their dreams of athletic stardom. Parents need to keep this in mind when their children develop this condition.Other causes of heel pain in children, beyond traumatic fractures of the heel bone, can include simple skin-based problems like a painful wart, or foreign body that has entered the skin. Children often walk barefoot, at home, in public, and at their friend's homes. This increases the likelihood that the child will step on some object that can cause harm. If that object is a small flake of skin tissue from someone who has a wart, then the virus that caused the wart can potentially infect the barefoot child, and form a wart of its own. This viral infection does not cause the immune system to activate against it, presumably because it is limited to the outer layer of the skin and does not circulate in the blood stream. This allows a favorable environment for the virus to exist in the skin, and this may lead to more warts to form as a result of the action the active virus has on the skin. It is not uncommon for warts to form on the bottom of the heel, which can be painful when weight bearing pressure is applied to the wart. Treatment for this usually involves using mild skin acids to stimulate an immune response, and force the body to destroy the virus. Other treatments include freezing the wart with liquid nitrogen, injecting anti-tumor medications, and using other immune-system modifying topical medications. Surgery is performed for stubborn cases, but rarely results in full immunity from the virus like non-surgical treatments achieve. Therefore, it is not uncommon for a wart to return in a nearby location after surgical removal. Barefoot activity also places children at risk for stepping on small sharp objects that can pierce the skin and sit just under it's surface. These objects include splinters, glass and ceramic fragments, sharp plant material, and metal shavings. When inside the body, the skin will naturally wall off these smaller particles into a scar-like ball of tissue, almost like an oyster forms a pearl around sand. The resulting small capsule can push into skin nerves, and cause pain when pressure is made on the bottom of the foot. Inflammation of the surrounding tissue develops, and sometimes bacteria on the small particles cause a local infection. Treatment involves antibiotics for infections, and usually a minor skin procedure to remove the remaining foreign object and surrounding capsule.Less commonly seen causes of heel pain can include foot symptoms of systemic diseases like juvenile rheumatoid arthritis. There are a group of diseases that involve the immune system attacking tissue in joints and the tissue that connects to bone. These conditions can create chronic heel pain and inflammation deep near the heel bone. Although very uncommon, these conditions need to be assessed and treated by a rheumatologist (joint specialist), especially when they develop in childhood. Treatment of the overall disease tends to help reduce heel and foot symptoms. One final uncommon cause of heel pain can include symptoms associated with tumors of the heel bone, both benign and cancerous. Heel bone masses are very uncommon, and heel bone cancer is even less common. Certain expansive cysts and cartilage masses can develop within the heel bone, causing pain and possibly leading to weakening of the heel bone and fracturing. Treatment generally involves removal of the bone defect and filling in with bone chips. More serious tumors of the heel bone are cancerous, and require immediate and aggressive treatment to save the child's leg and life. To be certain, these tumors are very rare, but need prompt diagnosis and treatment when present.When properly assessed, most childhood heel pain can be easily treated. The usual cause does differ from adult heel pain, and therefore the proper treatment program needs to be employed specific to the cause of the child's heel pain. Ignoring the pain, or assuming it is simply 'growing pains', simply leads to a longer duration of pain, and unnecessary loss of the child's activity.

Dr. Kilberg provides compassionate and complete foot and ankle care to adults and children in the Indianapolis area. He is board certified by the American Board of Podiatric Surgery, and is a member of the American Podiatric Medical Association. He enjoys providing comprehensive foot health information to the online community to help the public better understand their feet. Visit his practice website for more information.

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Thursday, November 28, 2013

Deriving Nutrients From Ocean Life

The oceans cover 71% of the planet's surface. They are home to an uncountable number of different species of plants and animals. Just like on land, these animals have adapted to their surroundings by many different methods. Some grow like weeds do on the surface. Some swim throughout the oceans whereas others grow slowly over millennium. Many of these animals and plants are rich in minerals and nutrients which makes them perfect for your garden. Everything from fish to sea weed can be used to give your plants all of the essential ingredients for a healthy garden. The main nutrients surface plants need to thrive are nitrogen, phosphorous, potassium, some trace elements, amino acids, and vitamins. There are many fertilizers that already provide all of these nutrients but many of them can also be obtained naturally from the sea. Some of the life in the sea that is useful as nutrients for your plants includes kelp meal and extract as well as fish emulsions. Besides these main two there are many other marine-based plant fuels.Kelp grows naturally all over the ocean. You often see it drifting to shore and washed up on beaches. It is the weed of the ocean. Kelp and some of the other seaweeds are great sources of essential nutrients for plant growth. Kelp meal is available to anyone interested in growing in either a meal form which takes the form of a dried powder or as an extract which is a liquid. Kelp meal can be applied to the top layer of soil or mixed into the pot prior to planting. It slowly breaks down over time giving plants everything they require. Kelp extract on the other hand can be mixed into any hydroponic solution or put in water that will later be applied to plants. There are several important nutrients contained in kelp including phosphorous, nitrogen, and potassium and it is an organic source of over 60 different trace elements. All of these resources are in a water soluble state. Seaweed and kelp also are very rich in many vitamins as well such as A, C, E, and B-12. They also contain amino acids and plant hormones. There are other advantages to a kelp based diet for plants. Kelp breaks down quickly making essential nutrients quickly available to plants. Kelp also increases the activity of the ecosystem around the plants roots. The one downside to using kelp is that earthworms are unable to break it down. Besides this kelp works wonders in the garden.Fish can also be a great source of plant food. Fish meal and fish emulsions are both organic and are highly nutritious (at least to plants). Fish meal is dried and ground whole fish or fish trimmings with the majority of the fish oil removed during the drying process. This is done to keep the fish meal from going rancid. Fish meal, similarly to kelp, contains nitrogen, phosphorous, and an abundance of trace elements. However, it is not a good source of potassium. Similar to kelp it is also a bio-activator. The one downside to using fish meal as plant fuel is the order. It smells strongly of fish. In order to control the odor you can cover the fish meal with a layer of top soil.Fish emulsion is the liquid form of fish meal. It is made by using enzymes that partially digest and ferment fish remains. Fish emulsion is high in nitrogen, phosphorous, and contains many trace elements. Since it has already been broken down and is in liquid form when compared to fish meal the nutrients it contains are made available to plants almost immediately. It is also almost impossible to overfeed making it quite safer than fish meal. Fish meal can also be used with hydroponics setups.Whether you decide to use kelp based sources of nutrients or decide to go with either fish meal or fish extract your plants will be happy. The ocean is full of biodiversity and much of that biodiversity can be used for many different home based uses. From food to plant nutrients the water has always benefited humanity.

Guru Grow Lights produces high quality made in Canada LED grow lights for use in the hydroponics and agricultural industries. Their grow lights come with a full six month 100% money back return policy.

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Tuesday, November 26, 2013

Workplace First Aid Kits - What Should I Include?

There are no hard and fast rules about what should be in a first aid kit for the workplace. In the UK, many companies market "HSE Approved" first aid kits, but in fact there is no such thing. The HSE (Health and Safety Executive) does make some suggestions as to what might be included; but in fact, it is a pretty incomplete list.On the other hand, the HSE does have some strong views on what should not be included in a workplace first aid kit. Specifically, they say that drugs, prescription or otherwise, such as aspirin or paracetamol, along with creams and ointments, are not appropriate and should not be kept in a first aid box.For a basic starter first aid kit, suitable for up to ten employees, in a low hazard environment such as a library, or offices, here is a suggested list:

A leaflet or book, giving basic first aid advice

20 sterile sticky plasters, individually wrapped

2 sterile eye pads

4 triangular bandages, individually wrapped

6 safety pins

2 large sterile wound dressings

6 medium sterile wound dressings

4 small sterile wound dressings

2 pairs disposable gloves, preferably individually wrapped

1 pair blunt ended scissors

1 roll sticky tape

2 non adherent dressings 10cm x 10cm

1 clean plastic bag e.g. freezer/sandwich bag

If access to clean water is difficult:

1 litre bottle of water or 2 half litre bottles, minimum, preferably sterile

10 moist wipes, non alcoholic, individually wrapped.

Other items may be appropriate, depending upon your individual environment. You may wish to include things like instant cold packs to reduce the swelling on sprained ankles, or if there is an office kettle and a burn is possible, then a small roll of clean clingfilm would make an excellent dressing.Do make sure that first aid kits are kept in an easy clean, marked container. Its location should be easily accessible, known to all employees and marked by a sign consisting of a white cross on a green background. It is essential that there should be an appointed person or, preferably, a trained first aider, whose responsibility it is to keep the first aid kit properly stocked, clean and up to date.The HSE strongly recommends that all appointed persons should have some first aid training. They have introduced the new Emergency First Aid at Work course, a one day, approved and recognised course, to replace the old appointed persons courses, which were unregulated and varied wildly in their content and quality.

Chris Sollars has many years experience in the medical field, both clinically and commercially and has travelled throughout the World, delivering education, training and advice. Chris now owns Sollars First Aid, a UK first aid training company. You can find much more information on first aid and first aid at work training, including HSE approved courses, by going to our website http://www.sollarsfirstaid.com.

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