Grow up with growing pains
Dr Vivek Sharma

Eight-year-old Saloni can’t fall asleep because her legs hurt. Six-year-old Aryan wakes in tears, with the same complaint. Coincidence? Probably not.

Between the ages of two and 12 years, children go through a growth spurt period. Along with this transition, may be discomforting symptoms such as aches and pains but when children stop growing, or when the teenage arrives, these pains tend to stop.

Growing pains typically end by teen years. No firm evidence shows that the growth of bone causes pain

An estimated 15 per cent of children experience occasional night-time leg pain without an apparent cause, often called growing pains. It can be a frightening experience for the children, especially when there is a combination of dark, quiet and pain.

Growing pains aren’t a disease. In fact, the term “growing pains” may be a misnomer because there is no evidence that growth hurts. Still growing pains are real for many kids. It’s important to take your child’s complaints seriously. Occasionally, growing pains may be due to an underlying condition that can be treated. Growing pains typically end by teen years. No firm evidence shows that the growth of bone causes pain.

Some symptoms:

Aches or throb in the legs, concentrate in the muscles rather than the joint.

loften in the front of thighs, the calves or behind the knees.

lusually both legs hurt, occasionally the muscles of the arms may be affected; the child may also complain of headache.

Aggravating factors

Running, climbing and jumping can be hard on a child’s musculoskeletal system. Muscle pain at night after a child has had an intense athletic day is the most likely cause of growing pains.

Diagnosing the causes

See how child responds to touch while in pain. Kids who have pain from a serious medical disease don’t like to be handled because movements tend to increase the pain. But those with growing pains respond differently; they feel better when they are held, massaged and cuddled.

When to seek medical advice

lConsult your doctor if you are concerned about your child’s leg pain or the pain is persistent

lStill enough to interfere with child’s normal activity

lAccompanied by other signs such as swelling, redness, tenderness, fever, limping rash, loss of appetite, weakness or fatigue.

Help the child

There is no specific treatment for growing pains but you can help ease your child’s discomfort.

lRub your child’s legs. Some children respond to gentle massage. Others feel better when they are held or cuddled.

lStretch your child legs during the day and again at bedtime.

lUse a heating pad. Heat can sooth sore muscles.

lTry a pain-reliever. Offer your child Ibuprofen or paracetamol. Avoid Aspirin tablet.

It may also help the child if you simply offer your support. Remind your child that growing pains are normal. Support and reassurance that growing pains will pass as kids grow up can help them relax.

The writer is a consultant paediatrician at Rungta Hospital, Jaipur

eYESIGHT
Treatment for keratoconus
Dr Mahipal Sachdev

Keratoconus is a progressive eye condition in which the normally round cornea thins out and begins to bulge into a cone-like shape. It rarely appears in an individual until puberty. This cone shape causes distorted vision. It usually affects both eyes, although one eye is affected before the other.

Often early diagnosis of keratoconus is missed because it develops slowly. However, in some cases, it may proceed rapidly. As the cornea becomes more irregular in shape, it induces progressive myopia and irregular astigmatism, causing more distorted and blurred vision. Keratoconic patients often have frequent changes in their glasses’ power. Although no one can be sure how far keratoconus will progress in an individual, the condition does not cause blindness.

Treatment

In the early stage of keratoconus, glasses or soft contact lenses may help. But as the disease progresses, glasses or soft contacts no longer provide clear and sharp vision.

In moderate and advanced keratoconus patients the treatment options available include the following:

Gas permeable contact lenses: If keratoconus progresses, then RGP contact lenses are usually the preferred treatment. Their rigid lens material enables RGP lenses to vault over the cornea, replacing the cornea’s irregular shape with a smooth, uniform refracting surface to improve vision.

Piggyback contact lenses : This method involves placing a soft contact lens, over the eye and then fitting a GP lens over the soft lens. This approach increases wearer comfort because the soft lens acts like a cushioning pad under the rigid GP lens.

Intacs: Intacs or corneal inserts received US’ FDA approval for treating keratoconus in August 2004. These tiny plastic inserts are placed just under the eye’s surface in the periphery of the cornea and help re-shape the cornea for clearer vision.

C3-R: Another new procedure for treating keratoconus, known as C3-R (corneal collagen cross-linking with riboflavin), is a non-invasive method of strengthening corneal tissue to stop bulging of the eye’s surface.

Researchers conclude that this simple method of treatment might significantly reduce the need for corneal transplants among keratoconus patients. After halting of the progression of keratoconus with the use of C3R an implantable contact lens or intacs are used to reduce the dependence on glasses or contact lenses in such patients with excellent results.

Corneal transplant: In the advanced stage of keratoconus, contact lenses or other therapies no longer provide acceptable vision. The last option available is corneal transplant. The results of corneal transplant in keratoconus are very good.

It is estimated that almost 21 per cent of keratoconus patients ultimately progress to an advanced stage of disease requiring corneal transplantation surgery to restore corneal architecture and improve eyesight.

However, now with the availability of these options, the need for corneal transplants can be delayed or reduced to a great extent.

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: drmahipal@gmail.com

Ayurveda and You
Good digestion key to good health
Dr R. Vatsyayan

Ayurveda gives supreme importance to the digestive system. It believes that it is the undigested or improperly digested food which behaves like a pathogen and breeds toxins in the body and lowers the immunity. Though all of us normally take food, it is important for us to take care of the digestive system so that it adequately extracts and utilises the dietary support to the body.

We should be aware of the fact that the origin and exacerbation of various allergies, respiratory disorders, rheumatoid arthritis, episodes of migraine, low immunity and premature ageing has also been linked up with improper food and its subsequent improper digestion.

Eating the right kind of food at the right time and that too in the right amount is vital for healthy digestion. Most people who visit doctors for digestive problems are those who defy these basic rules. In today’s competitive world, mental stress has compounded the diseases manifold, including the digestive problems..

Experts believe that people are most active in the early hours, so they need energy from a good, high-fibre breakfast and then a subsequent adequate lunch. Giving to the present-day trend of late night dinners, it should be borne in the mind that a light dinner with enough time gap to go to sleep is good for avoiding midnight digestive upsets and morning hangovers. Eating a balanced and varied diet containing sufficient wholegrain fibre, vegetables, lentils and fruits with pulp go through the intestinal tract faster and it helps to manage constipation better.

When we put food in our mouth, the process of digestion may appear to be simple, but it gets a little complex after that. All fast foods are slow in digestion and similarly one should also limit the intake of fatty and fried items. Spices no doubt are an essential constituent of the Indian diet and help to release digestive juices and increase the bioavailability of the nutrition, but these should only be used in a measured manner.

Taking too much of tea, coffee and alcohol and excessive smoking disturb normal digestion as much as the sedentary lifestyle slows it down. Similarly regular use of antibiotics, painkillers and laxatives also badly effect the normal gastrointestinal functioning. To keep the digestive system healthy, one must curb the tendency to overeat and should always take meals in a disciplined manner.

The writer is a Ludhiana-based senior ayurvedic physician. Email — yourhealth@rediffmail.com