What is a liver biopsy?

In a liver biopsy, the doctor passes a needle through your skin between two ribs on the right side of your chest. Then the doctor removes a tiny sliver of liver tissue. This is called a tissue sample and it is examined in a medical laboratory for any signs of health problems. There is no big incision (cut) into your body. You will not need any stitches and there will be no scar from the biopsy.

Will I be awake during the liver biopsy?

You will be awake but you will be very sleepy. Before the biopsy starts, the doctor or nurse will give you medicine through a shot and/or an (IV) intravenous line to help you relax and to numb the area where the needle will go.

How long does it take to do the biopsy?

The biopsy will take about 20 to 30 minutes. After the biopsy is finished, you will rest in the hospital for about 4 hours to be sure you are OK and ready to go home. Altogether, you will probably be at the hospital for 5 or 6 hours.

How do I prepare for the biopsy?

Before you have the biopsy, the doctor will take a blood sample to make sure your blood clots properly. If you take Coumadin, you will have to stop taking it for 5 days before the biopsy. Your doctor will tell you how to stop taking Coumadin and when to start again after the biopsy is done. You must also stop taking any aspirin, Ibuprofen or Motrin for two weeks before the biopsy. Do not eat or drink anything after midnight the day before the biopsy. If you take insulin, you should take only ¹/₂of your regular dose on the morning the biopsy is scheduled.

How will I feel after the biopsy?

You will be very tired. You will probably feel a little soreness where the needle went into your liver. Some people also feel a little pain in the right shoulder. This is caused by sore muscles. Any pain you feel should go away within a few hours or days. You can take Tylenol for pain, but you must not take aspirin, Ibuprofen or Motrin for one week after the biopsy.

Because you will be resting at the hospital for several hours after the biopsy, it is a good idea to bring something to read or music with headphones. You will still feel sleepy when it is time to go and you will not be allowed to drive. You must bring a friend or family member to help you get home safely.

This document is intended to provide health related information so that you may be better informed. It is not a substitute for your care team's medical advice and should not be relied upon for treatment for specific medical conditions.

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What is pneumonia? 

Pneumonia is an infection in one or both lungs. Pneumonia can be caused by bacteria, viruses, fungi, or parasites. Viruses are usually the cause of pneumonia in children. Children with viral pneumonia can also develop bacterial pneumonia. Often, pneumonia begins after an infection of the upper respiratory tract (nose and throat). This causes fluid to collect in the lungs, making it hard to breathe. Pneumonia can also develop if foreign material, such as food or stomach acid, is inhaled into the lungs.

What may increase my child's risk for pneumonia? 

  •      Premature birth

  •      Breathing secondhand smoke

  •      Asthma or certain genetic disorders, such as sickle-cell anemia 

  •      Heart defects, such as ventricular septal defect (VSD), atrial septal defect (ASD), or patent ductus arteriosus (PDA)

  •      Poor nutrition

  •      A weak immune system

  •      Spending time in a crowded place, such as a child care center

What are the signs and symptoms of pneumonia? 

The signs and symptoms depend on your child's age and the cause of his or her pneumonia. The signs and symptoms of bacterial pneumonia usually begin more quickly than they do with viral pneumonia. Your child may have any of the following:

  •      Fever or chills 

  •      Cough 

  •      Shortness of breath or trouble breathing

  •      Chest pain when your child coughs or breathes deeply

  •      Abdominal pain near your child's ribs

  •      Poor appetite

  •      Crying more than usual, or more irritable or fussy than normal

  •      Pale or bluish lips, fingernails, or toenails

How do I know if my child is having trouble breathing? 

  •      Your child's nostrils open wider when he or she breathes in

  •      Your child's skin between his or her ribs and around his or her neck pulls in with each breath

  •      Your child is wheezing, which means you hear a high-pitched noise when he or she breathes out

  •      Your child is breathing fast:

       •      More than 60 breaths in 1 minute for newborn babies up to 2 months old

       •      More than 50 breaths in 1 minute for a baby 2 months to 12 months old

       •      More than 40 breaths in 1 minute for a child older than 1 to 5 years  

       •      More than 20 breaths in 1 minute for a child older than 5 years

How is pneumonia diagnosed? 

Your child's healthcare provider will examine your child and listen to his or her lungs. Tell the provider if your child has other health conditions. Your child may also need any of the following: 

What is carpal tunnel syndrome (CTS)? 

CTS is a condition that causes pressure to build in the carpal tunnel. The carpal tunnel is a small area between bones and tissues in your wrist. Swelling in this area puts pressure on the median nerve. The median nerve controls muscles and feeling in the hand. 

What increases my risk for CTS? 

•      Activities that use forceful or repetitive movement of your wrist and hand

•      A past or current wrist injury

•      Pregnancy

•      A health condition, such as diabetes, arthritis, or hypothyroidism 

•      Obesity

What are the signs and symptoms of CTS? 

•      Dull, sharp, or shooting pain in your hand

•      Numbness, tingling, or a burning feeling in your thumb, first finger, and middle finger

•      Arm pain that may extend to your shoulder

•      Weakness in your hand

•      Swelling in your hand

•      Not being able to control how your hand moves, or you drop objects

How is CTS diagnosed? 

Your healthcare provider will examine your hand and arm. He will ask how long you have had symptoms and what makes them worse. You may need any of the following: 

•      Tests may be done to check for pressure on your nerve or to test how well your nerves are working. Your healthcare provider will tap, squeeze, press on, and gently move your wrist in different ways

What is croup?

Croup is an infection that causes the throat and upper airways of the lungs to swell and narrow. It is also called laryngotracheobronchitis. Croup makes it harder for your child to breathe. This infection is common in children 5 years or younger, but your child can get croup at any age. Your child may get croup more than one time. 

What increases my child's risk for croup? 

Croup is commonly caused by a virus. The virus is spread through the air when others cough or sneeze. It can be spread if your child touches contaminated items and then touches his or her mouth, nose, or eyes.

What are the signs and symptoms of croup?

Croup may start like a cold with a stuffy or runny nose and fever. As your child's airway becomes swollen, he or she may have any of the following:

•       Barking cough that is worse at night

•       Noisy, fast, or difficult breathing 

•       Hoarse or raspy voice 

How is croup treated? 

•   Moist air may help your child breathe easier. If your child has symptoms of croup, take him or her into the bathroom. Close the bathroom door, and turn on a hot shower. Do not put your child into the shower. Sit with your child in the warm, moist air for 15 to 20 minutes. Use a cool mist humidifier in your child's room. If it is cool outside, take your clothed child outside in the cool, moist air for 5 minutes. This may also make it easier for your child to breathe and help decrease his or her cough

•   Medicine may be needed to help with your child's cough. Ask your child's healthcare provider what medicine to give your child for a cough. Most cough medicines cannot be given to children under 2 years of age. Your child may also need medicine for fever. Do not give aspirin to children under 18 years of age: Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen

How can I prevent the spread of croup? 

•    Wash your hands often. Use soap and water. Wash your hands after you use the bathroom, change a child's diapers, or sneeze. Wash your hands before you prepare or eat food

•    Do not let your child share cups, forks, spoons, or plates with others

•    Keep your child home from school or daycare

Call 120 if: 

•    Your child stops breathing or breathing becomes difficult

•    Your child faints

•    Your child's lips or fingernails turn blue, gray, or white

•    The skin between your child's ribs or around his or her neck goes in with every breath

•    Your child is dizzy or sleeping more than what is normal for him or her 

•    Your child drools or has trouble swallowing his or her saliva

When should I seek immediate care? 

•    Your child has no tears when he or she cries

•    The soft spot on the top of your baby's head is sunken in

•    Your child has wrinkled skin, cracked lips, or a dry mouth

•    Your child urinates less than what is normal for him or her

When should I contact my child's healthcare provider? 

•    Your child has a fever

•    Your child does not get better after sitting in a steamy bathroom for 10 to 15 minutes

•    Your child's cough does not go away

•    You have questions or concerns about your child's condition or care

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

© 2017 Truven Health Analytics LLC All illustrations and images included in CareNotes^® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics. 

What is pneumonia?

Pneumonia is an infection in your lungs caused by bacteria, viruses, fungi, or parasites. You can become infected if you come in contact with someone who is sick. You can get pneumonia if you recently had surgery or needed a ventilator to help you breathe. Pneumonia can also be caused by accidentally inhaling saliva or small pieces of food. Pneumonia may cause mild symptoms, or it can be severe and life-threatening. 

What increases my risk for pneumonia? 

•      A cold or the flu

•      Health conditions, such as heart or lung disease

•      A weakened immune system caused by HIV, cancer, or steroid use

•      Recent hospitalization

•      Smoking

•      Excess alcohol use

•      Older age

What are the signs and symptoms of pneumonia? 

•      Fever or chills

•      Cough

•      Shortness of breath or rapid breathing

•      Chest pain when you cough or breathe deeply

•      Headache

•      Vomiting

•      Fatigue or confusion

How is pneumonia diagnosed? 

Your healthcare provider will listen to your lungs. Tell him or her if you have other health conditions. Give your provider a complete list of all medicines you have taken recently. You may need any of the following: 

•      Blood tests may show signs of an infection or the bacteria causing your pneumonia. Blood tests can also show how much oxygen is in your blood

What is COPD?

COPD stands for chronic obstructive pulmonary disease. People who cough up a lot of mucus or have trouble breathing out used air may have COPD. If it is hard for you to breathe out used air, it is also hard for fresh, healthy air to come in to your lungs.

To understand COPD, you need to know how your lungs work. When you breathe in air through your nose or mouth, the air travels down your windpipe (also called trachea) into your lungs. In your lungs, airways (called the bronchial tubes) branch out like an upside-down tree. At the end of each branch are many little air sacs (called alveoli). The air you breathe travels down these airways into the air sacs. The air sacs have very thin walls full of tiny blood vessels (called capillaries). From these blood vessels, oxygen moves into your bloodstream while carbon monoxide (used air) goes out of your blood.

What happens to the lungs when you have COPD?

In healthy lungs, the airways are clear and open and the air sacs are small, elastic and springy. When you breathe in, each air sac fills up with air like a small balloon, and when you breathe out, the balloon deflates and air goes out. When you have COPD, changes occur in the airways and the air sacs. These changes happen because of two related kinds of lung disease that are part of COPD.

Chronic bronchitis makes your airways red and swollen (inflamed). Mucus collects in your airways and clogs them up.This is why it is hard for people with chronic bronchitis to breathe.

Emphysema injures your air sacs, leaving scar tissue that makes them stiff. Because of this, people with emphysema have trouble getting oxygen into their blood and carbon monoxide out of their blood.

Some people have chronic bronchitis that leads to COPD. Others get COPD as a result of emphysema. What happens to your lungs when you have chronic bronchitis may be different from what happens when you have emphysema. But either way the treatment for COPD is the same.

How does my doctor know I have COPD?

The symptoms of COPD are: 

•   A chronic, persistent cough

•   Increased mucus

•   Shortness of breath, especially during physical activity

•   Wheezing

•   A tight feeling in the chest

If you have these symptoms, your doctor will want to test for COPD. Your doctor will probably refer you for pulmonary function tests to see how well your lungs are working. In this test, you take deep breaths and then blow into a machine. The machine measures how deeply you can breathe and how fast you can move air in and out of your lungs. In most cases, this test (called a spirometry test) is all the doctor needs to make a diagnosis. In some cases, the doctor might also suggest a chest x-ray. The x-ray cannot tell that you have COPD but it can show signs of COPD.

What causes COPD?

Most people get COPD because they smoke cigarettes. Sometimes, people can get it even if they do not smoke. It is not yet known whether second-hand smoke can lead to COPD but people who live with or work with smokers are more likely to have respiratory diseases in general. People who breathe in large amounts of chemical fumes or dust at work or at home may also be at risk for COPD. COPD runs in some families, making people in those families more likely to get COPD, especially if they smoke.

What can I do if I have COPD?

What is bedwetting?

Bedwetting, or nocturnal enuresis, is a condition that causes your child to urinate in his bed while he sleeps. The condition occurs in children who are 5 years or older. Your child may wet his bed at least 2 times each week. He may never have had a dry night. He may have dry nights for at least 6 months and then begin to wet the bed again. 

What causes bedwetting? 

•      The exact cause of your child's bedwetting may not be known. Any of the following can cause bedwetting: 

•      A small bladder

•      Bladder tightening before the bladder is full, causing leakage

•      Large amounts of urine made while your child sleeps

•      Deep sleep that keeps your child from waking to the feeling of a full bladder

What increases my child's risk for bedwetting? 

•      Drinking a lot of liquid before bed

•      A medical condition such as constipation or a urinary tract infection (UTI) 

•      Family history of bedwetting

•      Attention deficit hyperactivity disorder (ADHD)

•      Increased stress such as moving to a new home or the birth of a new sibling

How is bedwetting diagnosed? 

Your child's healthcare provider will ask when your child started to wet the bed and how often it happens. He will check your child's abdomen, spine, and genitals. Your child's healthcare provider will ask if your child wets himself during the day. Your child may need any of the following: 

•      A urine test may show infection or dehydration

•      A blood test may show organ function and sugar levels

What is fatty liver disease?

Fatty liver disease is when you have too much fat in your liver. It is common in the United States -about 1 in 10 people have fatty liver. A more serious form of fatty liver disease is called ''NASH,'' which stands for ''Non-alcoholic steatohepatitis'' and causes damage to the liver.

How can I tell if I have fatty liver disease?

You will not feel any symptoms of fatty liver disease. Your doctor may do blood tests to check your liver. You may also get an ultrasound of your liver to see how much fat there is. Rarely, a biopsy is done to look at a very small piece of your liver.

Why do I have fatty liver disease?

How can I make my fatty liver disease better?

There are no medicines to cure fatty liver disease. You can lower the fat in your liver when you:

•     Lose weight, with a goal of losing 2 pounds a week

•     Exercise daily

•     Take medicines as directed by your doctor, especially if you have high blood sugar or high cholesterol

•     Do not drink alcohol 

What causes diaper rash? 

Diaper rash can occur at any age but is most common between 12 and 24 months. Diaper rash may be caused by any of the following:

•      Irritated skin from urine and bowel movement

•      Not changing his diapers often enough

•      Skin sensitivity or allergy to chemicals in soaps, lotions, or fabric softeners

•      Hot or humid weather

•      Bacteria or yeast

•      Eczema

What are the signs and symptoms of diaper rash? 

The rash may be located on the skin surface, in the skin folds, or both. Your child may have any of the following:

•      Red and shiny skin

•      Raw and tender skin

•      Raised bumps or scales

•      Red spots

How is diaper rash treated?

•      Change your child's diaper often. Change your child's diaper right away if it is wet or soiled from a bowel movement. Check his diaper every hour during the day, and at least once during the night

•      Clean your child's diaper area with plain, warm water. Use a squirt bottle, wet cotton balls, or a moist, soft cloth to clean your child's diaper area. Allow the skin to air dry, or gently pat it dry with a clean cloth. Do not use baby wipes or soap during diaper changes. This may cause the rash area to burn or sting. Make sure your child's diaper area is completely dry before you put on a new diaper

•      Leave your child's diaper area open to air as much as possible. Take off your child's diaper when you are at home. Place a large towel or waterproof pad underneath your child while he plays or naps. The exposure to air can help heal the rash

•      Do not rub the diaper rash. This could make your child's skin worse

•      Protect your child's skin with cream or ointment. Make sure his diaper area is clean and dry before you apply cream or ointment. Petroleum jelly or zinc oxide will help heal his rash

•      Use extra-absorbent disposable diapers. These pull moisture away from your child's skin so it will not be as irritated. If your child wears cloth diapers, use a stay-dry liner to help pull moisture away from the skin

What if my child wears cloth diapers?

Presoak all diapers that have bowel movement on them. Wash diapers in hot water and dye-free or perfume-free laundry soap. Rinse them at least 2 times to get rid of extra laundry soap. Do not use fabric softener or dryer sheets. Try not to use plastic pants. If you must use plastic pants, attach them loosely around the diaper. This will help air flow in and out of the diaper and keep your child's skin drier.

When should I contact my child's healthcare provider?

•      Your child has increased redness, crusting, pus, or large blisters

•      Your child's rash gets worse or does not get better in 2 or 3 days

•      You have questions or concerns about your child's condition or care

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. 

© 2017 Truven Health Analytics LLC All illustrations and images included in CareNotes^® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.