Cradle Cap in Babies

There are lots of cradle cap remedies online but I will tell you what worked for me. By the way, what does cradle cap look like?

Photo credit: Wikipedia

It is oily yellowish patches that appears on the scalp of babies. It is mostly common within 3 months of life and can last up to 1 year. It is not contagious and does not harm the baby.

In my experience, my little one had it and I was really worried but the GP said not to worry that it goes away before most babies one year birthday. However, that was not enough for me. I simply wanted it to go away as soon as possible.

I read a lot online, watched YouTube videos and was not happy with my findings. None seemed to be say what I wanted to hear.

Many sources recommended the usage of olive oil and combing it out after 15 mins. Meanwhile, that was my baby's hair oil. Strangely, the front part of the scalp where I cover with lots of oil was coated with cradle cap.

I was convinced that 'Olive oil' was the culprit and cannot be my solution. This was further confirmed by an article I read too. The link to the article is available at the end of this post.

I searched for shampoos but was worried trying those chemicals on my little ones scalp. Then,  a friend told me she had same issue but theirs was very little and gradually disappeared. She said her GP prescribed Capasal therapeutic shampoo for her baby but she never used it.

It was as if that was all I needed - something prescribed by a professional!

I used it on my little one and it worked like magic. The first time,  I was really careful both on application and on combing of the hair. It worked and I was happy. The second day, I was more confident in using it and most of it came off. On the third day, my baby's scalp was neat, no traces of cradle cap.

I could not believe the past few weeks and all the time I had spent online reading lots of stuffs that amounted to nothing.

I hope this post gets to someone who needs remedy that I needed or to someone that knows someone. However, every baby is different. What worked for mine might not be suitable for yours.


Below are sites for further reading on the topic. I found them very informative.

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011380/full

http://www.nhs.uk/conditions/cradle-cap/Pages/Introduction.aspx

Disclaimer: This cannot substitute for a professional medical advice and treatment. 

Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome commonly known as ARDS is a life-threatening medical condition whereby the lungs cannot provide sufficient oxygen for the body.
Causes
This condition develops when the lungs has become infected or sustained an injury leading to inflammation. The inflammation causes fluid from nearby blood vessels to leak into the tiny air sacs in the lungs, making breathing increasingly difficult.
 Inflammation can be caused by:

• Sepsis
• Pneumonia
• Severe chest injury  
• Accidental inhalation of vomit, smoke or toxic chemicals
• Acute pancreatitis
• Blood transfusion reaction

Clinical Features
Theses can occur within 24 to 48hrs of illness and can include:

• Severe shortness of breath
• Rapid, shallow breathing
• Low blood pressure
• Tiredness, drowsiness or confusion
• Feeling faint
• Organ failure

Normally, these patients are so sick that they cannot complain of symptoms.

Diagnosis

A full assessment is carried out and include the following:

• Physical examination
• Blood test to ascertain oxygen saturation and check for signs of infection
• Arterial blood gases(ABG) for continous monitoring of respiratory state, blood volume and electrolytes.
• Blood and urine culture
• Pulse oximetry test for continuous monitoring of oxygen saturation
• Chest X-ray and a computerised tomography (CT) scan – to look for evidence of ARDS
• Echocardiogram to picture the heart ; to rule out heart failure.
• Sputum culture and analysis
• Broncoscopy can be carried out in certain cases.

Treatment
-Admission into intensive care unit for breathing support via Ventilator. 
-Antibiotic administration to fight infection.

My Encounter with ARDS
I had to look after after a Mr. X diagnosed with ARDS and Intracranial hyperosmolar. It turned out to be a very busy and interesting shift.   

• Cardiovascular: Blood pressure was initially high but was supported with Noradrenaline infusion and it was managed. - Mean arterial pressure (MAP) target was above 70mmhg  - Heart rate was sinus rhythm -Central venous pressure showed that he was well  filled. 

• Respiratory: Was intubated and ventilated. Settings include: pressure control mode of 24, peep 14, FiO2 70%, respiratory rate 15,  peak 38. The above high settings were changed slightly throughout the day. ABG revealed; high PCO2, low O2, high hydrogencarbonate, high base excess, high sodium, low potassium and high glucose. All electrolytes were replaced and a slidiing scale was in place to control his blood glucose level.

• Neurologically, he was sedated and paralysed using Propofol and Actracurium infusions.  Fentanyl was given for pain. Pupils were 2 and nonreactive. Richmond sedation agitation score was -5(deeply sedated and unarousable)

• Nutrition: on nasogastric feed- Nutrison  and ng water at 40ml and 30ml respectively as he had high sodium.

• Elimination: Good bowel movement and urine output. However, furosemide was given to push more fluid out of the lungs. 

I hope you are getting the gist? I am not going to bore you with my nursing care bits. So, let me wrap it up by telling you the issues and plan for that day. 
Problems:

• ARD
• Septic shock
• Neutral fluid balance(off target)
• Electrolyte abnormalities
• Permissive hypercapnia

Plan:

PC Ventilator settings - sedated and paralysis

Manual recruitment post sunctioning

No nebs - Suction 6hrly

Ng water @ 30ml/hr

Furosemide infusion Urine output greater than 100ml/hr

Continue antibiotics Meropenem and Teicoplanin

Discuss with microbiology daily.

Lastly, .ARDS is a killer illness. I was practically on my feet throughout the shift as Mr. X was unstable and I had lots of infusions that were running out at different times amongst other tasks. Suctioning was quite scary that day as Mr. X could desaturate within secs. Oh! I ended up staying 45mins extra to do my documentations.

References 
NHS Choices (2015) Acute respiratory distress syndrome  http://www.nhs.uk/conditions/acute-respiratory-distress-syndrome/Pages/Introduction.aspx Accessed 29th Oct. 2016.

MedilinePlus (2016) Acute respiratory distress Syndrome https://medlineplus.gov/ency/article /000103.htm  Accessed 4th Nov 2016.

P.S.
Thanks for reading. Sorry for the medical jargons- I tried to minimse them. When your loved ones or friends are sick or look unwell, please encourage them to go the hospital to get a medical assistance.Ours lives are so precious. 

Disclaimer: This cannot substitute for a professional medical advice and treatment. 

Liver Diseases

I have come across lots of articles and case studies on liver diseases and the rapid health decline of most sufferers. So, I will like to share some of my knowledge of the liver and liver diseases. I will tell it like a story and cite where necessary. 

Before I start, what melted my heart the other day was when I met a very young girl who has undergone two liver transplants. In this girl's case, her former transplant failed because her body system rejected the organ. The later transplant is pretty new and she complained of so much pain and discomfort. As I write this, my heart reaches to her, I wish her a speedy recovery and hope this is her last organ transplant. 

The liver is the second largest organ in the body and the biggest reservoir for blood. It serves as the body factory and plays lots of significant roles that are vital to life. The liver is located in the upper right side of the abdomen, beneath the diaphragm and on the top of the right kidney.

The main functions of the liver include;

• Filtration and cleansing of the blood 
• Fights against infections and diseases
• Production of proteins that makes blood clot( i.e when you bleed)
• Aids in digestion
• Destroys and deals with poisons and drugs
• Excretion of wastes.

There are lots of other roles the liver play in the body. It is a very powerful organ than we think. 

Onset of liver disease:- Acute- Whereby it happens over a short period of time

                                   -Chronic- Here, the disease manifests after couple of years e.g 5-8 years

Main causes: -Heavy alcohol consumption or alcohol misuse (the commonest)

                      -Undiagnosed hepatitis

                      -Obesity

Types of Liver diseases

-Alcohol related liver diseases- Liver damage occurs due to years of heavy alcohol consumption.

-Non-alcoholic fatty liver diseases-  

-Hepatitis- Inflammation of the liver

-Haemochromatosis i.e an inherited disorder whereby there is iron overload in the body

-Primary biliary cirrhosis

All these types of  liver diseases can cause scarring of the liver, which is called Cirrhosis (www.nhs.uk)

Pathophysiology

Photo credit: Youtube images

The liver responds to injury by becoming inflamed. Any form of inflammation of the liver is known as hepatitis. This can happen suddenly (acute) or over a long period of time (chronic). Repeated injuries cause the liver cell not to regenerate any more, fibrosis gradually forms.

When the fibrosis spreads out due to persistent harm not been addressed, the liver shape and function is disrupted.and is known as compensated cirrhosis. As damage progresses, the liver is unable to function effectively (decompensated) and begins to fail. This stage is termed end stage liver disease this allows toxic chemicals and wastes to build up in the body causing  jaundice, ascites and hepatic encephalopathy (i.e. a brain disorder due to toxins in the brain). Further deterioration may lead to multiple organ failure and death. 

Signs and Symptoms:
It is important to know that liver diseases can go on for a long time before the clinical manifestations sets in. They include:

• Loss of appetite
• Weight loss or sudden weight gain 
• Jaundice i.e yellowing of the skin
• Itchy skin and bruises
• Fluid retention (oedema)
• Brownish or orange tint in the urine
• Light coloured stools
• Confusion, disorientation, personality changes

Treatment and Management  
This can achieved mainly the use of drugs or surgery
-Diet control; Avoiding too much or little protein.
-Drugs:-Lactulose;This works by changing the stool acidity which prevents bacterial growth and reduces                    ammonia production.
            -Neomycin; An antibiotic which kills intestinal bacteria and minimises ammonia production.
            -Rifaxiimin; An antibiotic used in reducing the recurrence of hepatic encephalopathy.
-Surgery: -Paracentesis: This is the removal of fluid that has accumulated in the liver due to ascites
                 -Liver transplant: This occurs in cases where liver transplant is inevitable.

Prevention

The commonest type of liver diseases is the Alcohol liver disease, which means we can make liver diseases unpopular.

• Avoidance or minimal alcohol intake (you need to know your limit: Ask)
• Diet: reduced protein intake is advised to minimise ammonia(waste) production
• Exercise- This is good for you to stay fit. Being overweight or obese can affect the progress or treatment your liver condition. Thus, avoid sendatary lifestyles.
• Get vaccinated against hepatitis B.
• Health education about liver and causes of liver disease: Equip yourself by reading or watching videos or discussing with health professional about the liver.

References: 

British Liver Trust, 2014

http://stemcellfoundation.ca/en/diseases/liver-failure
www.nhs.uk, 2014

Disclaimer: This cannot substitute for a professional medical advice and treatment. Research further and seek help when need be.

P.S. It's quite a lengthy post. Thanks for your time😄

Caring for People With Learning Disabilities

I sighted a lovely pretty teenager who was very chatty and loud. She was in the company of two older ladies, who I would assume were looking after her. At first, she seemed alright but within few minutes, you could clearly tell that she has a learning disability.

Copyright: nhs.com

The teenager would not stay at a place and those two other ladies with her kept trying to make her stay calm. I will refer to as her 'carers'.

We were all in an eatery waiting to be served. She will look up at the menu board and shout the names of the foods displayed. At one point, her carers said to her, 'you have told us severally what you want to have can you please stay calm? It was as if they were talking to themselves as she shout louder and became more hyperactive; jumping up and down and moving from place to place.

They tried to calm her down by talking to her. 'Every other person is quiet apart from you' can you please try and stay calm?' one of them pleaded with her.

I was amazed by how polite those carers were with the young girl. They were very professional and made their job look so easy. Eventually, when it got to their turn, she placed her order, got it and they left the eatery.

Copyright: gepl.org

My thought goes to families of those suffering from all sorts learning disabilties and their carers. I hope they get the support they need. The work you all do are priceless. You deserve the best reward.

Most importantly, I hope all people suffering from learning disabilities get the maximal love, care and support that they truly desire.

*Thanks for making out time to read my post. I wish you and all your loved ones a beautiful christmas season and a fruitful newyear in advance.*

Do Not Ignore Unsual Bumps That Won't Heal Easily

Recently, while I was with a colleague I noticed a round-like ulceration on his face, just underneath his right eye and wondered what it could be. As we talked, he scratched the surrounding and acted like its really nothing to worry about.

'Does it hurt?' I asked. 'Oh! This...,' he pointed towards his face. 'It doesn't. It is a skin cancer, the type that doesn't spread.' He laughed as he explained the condition to me. 'So sorry to hear that and I am delighted to know it does not cause you much pain,' I added. 'No, I am fine Dear and I am currently undergoing some radiotherapy.'

Photo credit:medicinet.com

I met him again in a fortnight but this time the affected area was very pinkish and sore. I enquired to know how he was faring and the progress of the radiotherapy he has been undergoing and he made me understand that he was fine and bubbling. According to him, an artificial skin was placed on the affected area owing to the effect of the radiotherapy. As we talked on, I got to know that that he has a good knowledge of the condition and how to cope well with it.

'In fact, earlier today when I went into a shop I saw a little boy who was drawing the mothers attention towards me, it was funny to watch. I kept smiling back at the boy while the mother was acting like she didn't know what the child was talking about,' He joked and we both laughed. I suppose he has a good sense of humour as well.

It is important that we pay attention to our skin and health in general as it can help us prevent and or combat certain health conditions. Thus, early detection aids prompt treatment.

I know there are some of us out there who do not pay much attention to their health, in the sense that would rather have it worsen before they seek a medical help. However, this is not the ultimate approach.

Let me share some symptoms of Skin cancer so that we can be informed and do not hesitate to seek for a medical help when necessary. Skin cancers can appear as:

• A spot or sore that does not heal within 4 weeks
• A spot or sore that continues to itch, hurt, scab, crust or bleed for more than 4 weeks
• Areas where the skin has broken down or become an ulcer, you can't think of a reason for this change, and it does not heal within 4 weeks
• An ulcer is an area that is breaking down and begins to get deeper. This can be called erosion.

The three most common types of skin cancer are:

• Melanoma: Melanoma begins in melanocytes (pigment cells). Most melanocytes are in the skin. Melanoma can occur on any skin surface. In men, it's often found on the skin on the head, on the neck, or between the shoulders and the hips. In women, it's often found on the skin on the lower legs or between the shoulders and the hips. Melanoma is rare in people with dark skin. When it does develop in people with dark skin, it's usually found under the fingernails, under the toenails, on the palms of the hands, or on the soles of the feet.

• Basal cell skin cancers: They look like a small, slow growing, shiny, pink or red lump. They can also look like red scaly patches. If left, basal cell skin cancers tend to become crusty, bleed, or develop into an ulcer. They are commonest on the face, scalp, ears, hands, shoulders and back. They are usually painless although they may itch and bleed.

• Squamous cell skin cancers They are usually pink lumps. They may have hard or scaly skin on the surface. They are often, but not always, tender. They can bleed easily and develop into an ulcer. They are most often found on the face, neck, lips, ears, hands, shoulders, arms and legs.They do not heal.

Lastly, do not ignore any unusual lump or lesion on the body surface that wouldn't heal after four weeks, seek help to know what exactly it is.

Dementia And The Bird.

Having been already informed about his condition, I knew I was going to be very careful and most times repeat myself to him. 

On  reaching there, he was dressed in an outing attire and was so full of life. Few minutes later, whistling by a bird at the corner drew our attention. One of my colleagues who seem to know more about birds went closer and I followed her just for curiosity sake. She was asking him for the species, who gave it to him, how long he has had it and what he had named the little creature. 

We all got chatty. .He said, it was a Christmas present from his son and he can't think of a name yet and simply calls it baby. Mmm... How am I supposed to know a mere bird can be called baby as well. We all laughed. I admired his sense of humour. 

It struck me that it was a present. I thought to myself, won't he be doing some more cleaning because of this bird, so much noise and distractions but then I viewed it in a more positive and healthy perspective and concluded that his brilliant son has bought that to make him more attentive, keep him busy and also keep him company or for some other reasons.

He was pleased to have us around. He talked about his housing issues and how he called an ambulance three days ago when he felt so unwell. He looked much stronger and said he felt much better. If my guess was right, he enjoyed our company and wanted us to come more often. I can tell because loneliness is friend of no man.

When we were about leaving, we mentioned our names to him once more and made sure he locked the door before we headed for the stairs.

The next day, I ran into him in an event and he recognised me, I was impressed though he didn't remember my name, which I reminded him of.

At this juncture, I want to get us acquainted with the condition.

Photo credit: Daily mail.

Dementia is a syndrome associated with an ongoing decline of the brain and its abilities. This includes problems with:memory loss,thinking speed,mental agility, language,understanding and judgement.

It usually affect people above the age of 65, though on fewer occasions could have an early onset.

Symptoms include:

• Increasing difficulties with tasks and activities that require concentration and planning
• Depression
• Changes in personality and mood
• Periods of mental confusion
• Difficulty finding the right words
•  Hallucinations i.e they may see or hear things that other people do not or they may make false claims or statements.
• A catastrophic reaction i.e when put in circumstances beyond their abilities, there may be a sudden change to tears or anger .A common symptom of dementia is for dementia sufferers to deny that relatives, even relatives in their immediate family, are their own relatives.
• Disorientation- this occurs in the later stages of the condition, whereby subjects may be disoriented in time (not knowing the day, week, or even year), in place (not knowing where they are), and in person (not knowing who they and/or others around them are).

On the contrary, with appropriate management and care, they lead an active and fulfilled live. 

Photo credit: NL Group

Conclusion
Aging do come with certain conditions and dementia seems to be very popular among them. Do try and treat the elderly with much care and concern, you never can tell what condition(s) they are battling with.

Follow @AyinotuV

HIV Infection Does Not Spell Death.

I am writing this post in regards to my previous one. There were many biased responses and questions from people. Well, I have always liked discussing about or writing on HIV and related topics, so this was the kind of go-ahead I have always waited to write again. Don't worry it's not going to be very professional rather an easy-read. Bam!

Human immunodeficiency virus (HIV) is a special kind of virus that causes acquired immunodeficiency syndrome(AIDS). AIDS is a condition where progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.

HIV infection occurs when there is transfer of an already contaminated blood, semen,vaginal fluid, pre-ejaculate, or breast milk between people. Within these body fluids, HIV is present as both free virus particles and virus within infected immune cells. Hence, proper care should be taken in all procedures or acts that entails coming in contact with any of those fluids.

HIV infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells) and as a result leads to low levels of CD4+ T cells. This occurs through a number of mechanisms including: apoptosis of uninfected bystander cells, direct viral killing of infected cells, and killing of infected CD4+T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections.

Having known the different ways HIV can be transmitted it is equally important that we stay abreast with its preventive measures and stick to them. Always bear in mind that it can be contacted by different means.

Actually, what touches my heart is the stigmatisation that comes with this condition. Obviously, when allowed to get to the stage of full blown AIDS, it gives one the ghost-like, ugly and lifeless image but a lot can be done to avoid that stage.

HIV testing is very important and should be done as often as possible. It always comes with counselling, which would look into ones health and sexual history including other important aspects as well.

Thanks to free medication which is now available for its management. I would encourage anyone who is affected to stick to their drug- take your drug judiciously. In the HIV clinic, prior to the commencement of the drug they do attend classes to ascertain they are fully aware of their condition and how to live positively with it. They would have to take their drugs for the rest of their lives just like in cases of Diabetes and hypertension.

However, early detection and prompt commencement of drug makes a great health difference. This condition has become quite common lately. It's not written on anyone's forehead but it is how they manage themselves that matters.

Meanwhile, I would like us all to treat everyone with equal respect. For some that loses much weight in a short time and feel lots more sick, it's not just the condition that takes them that fast but the way we treat sufferers and the already assumed perception they have. They feel like they are mere shadows of themselves while they are still living. I know it can be difficult for us to see these people differently but we should try and be the reason they smile and find the strength and more reasons to live. All we need to do is to ensure we are always safe while dealing with them. It's neither airborne nor can be gotten by mere touch.

Thank Goodness!

Fortunately with proper antenatal clinic visits, infected mothers can give birth to HIV- negative babies. Awesome! Isn't that great? I mean there are so many instances in life where innocent children become victims but here there is hope for them.

Having actually been able to care for some affected individuals makes me feel really good right in the inside. There was a time I was attending to an infected man, who already was critically ill. Beside him was always his kind-hearted pregnant wife, each time I come, I do pray with them, in my heart I think about this woman, her hope, future and that of their unborn baby. 

Finally, it is not like they have lost their personalities or no longer have a life, they still do and need love and affection like everyone else. Their situation should not be treated with so much isolation because I do not think they are guilty of a certain abominable crime. Anyone can be a victim.

Prader-Willi syndrome

You might be a lover of Prada products but this is something else...

Prader-Willi syndrome(PSW) is a rare genetic disorder that causes characteristics such as obesity due to an excessive appetite. 

 Signs and Symptoms

• Newborns are often small and floppy.
• Male infants may have undescended testicles.
• Trouble eating as an infant, with poor weight gain
• Almond-shaped eyes
• Delayed motor development
• Narrow bifrontal skull
• Excessive intake of food due to feeling of permanent hunger 
• Rapid weight gain  

• Short stature 
• Very small hands and feet in comparison to the child's body.
• Sex glands produce little or no hormones
• Slow mental development. 
• learning difficulties
• lack of secondary sexual development
• behavioural problems, such as temper tantrums or stubbornness

Children have an intense craving for food and will do almost anything to get it. This can result in uncontrollable weight gain and morbid obesity.

 Causes

-Prader-Willi syndrome is caused by a gene missing on part of chromosome 15 .Normally, each parents pass down a copy of this chromosome. Most patients with Prader-Willi syndrome are missing the genetic material on part of the father's chromosome. Others often have 2 copies of the mother's chromosome 15.
The genetic changes occur randomly.

-Sufferes usually do not have a family history of the condition.
 












Investigation

Genetic testing is available to test children for Prader-Willi syndrome.
As the child grows older, laboratory tests may show signs of morbid obesity, such as:

• Abnormal glucose tolerance
• Above normal level of the hormone insulin in the blood
• Decreased level of oxygen in the blood
• Failure to respond to luteinizing hormone releasing factor 
  
  Management

If a child with PWS follows a restricted diet and control their weight, they would be able to enjoy a good quality of life although, its highly unlikely that they lead a fully independent lives.

Heimlich manoeuvre;a procedure for managing a chocking patient, is been taught to parents or guardians of patients because they are at high risk of choking as compulsive eating abnormally expands their stomach.

There is no cure for PWS, so treatment aims to manage the symptoms and associated problems. For parents, this includes dealing with their child's behavioural problems and excessive eating.

Limiting calories will control the obesity, but the family, neighbors, and school must work together closely because the child will try to get food wherever possible.

Growth hormone is approved by the Food and Drug Administration for the treatment of Prader-Willi syndrome. It can help:

• Improve physical strength and agility
• Improve height
• Increase lean muscle mass and decrease body fat
• Improve weight distribution
• Increase stamina
• Increase bone mineral density

There have been some concerns that taking growth hormone therapy may lead to sleep apnea. A child who takes hormone therapy needs to have annual sleep studies to monitor for sleep apnea.
Low levels of sex hormones may be corrected at puberty with hormone replacement.
 

Complications

• Type 2 diabetes
• Right-sided heart failure
• Bone (orthopedic) problems.
  
  This is a terrible health condition, at first parents would ensure that their children feed well and then try to restrain them from over eating. Lastly, they do not have a long life expectancy when compared to other children.

? Proteus Syndrome

 I came across the story of a Lady with a rare condition and how she has been able to cope positively with it.

Mandy Sellars.

  Proteus Syndrome is a very rare condition and can present in various forms.

• It occurs as a result of genetic mutation. The affected cells continue to multiple exceedingly and produce more malformed cells.
• This condition starts while in utero; when the baby forms during pregnancy and continues throughout lifetime
• It does not run in families and thereby, cannot be inherited. 

In the case of this Lady, the condition extremely difficult. It was in the year 2006 that Doctors decided to name her condition as Proteus Syndrome after years of varieties of tests including DNA tests.

Her Condition

• Her legs grew massively. 
• At a time,  her upper body weighed 38kg while the lower part weighed 95kg. She wears only trousers specially made by her mother and outgrows them in a short duration.
• Has had deep vein thrombosis; formation of blood clots.
• Consequently, she was paralyzed for few weeks.
• Developed Sepsis;Infection of the blood
• Suffered kidney failure
• Had MRSA; Methycillin-Resistant Staphylococcus Aureus( a bacterial  infection).
• Later, her infected left leg was amputated.
• Unexpectedly, the stump grew out of proportion when compared to her right leg. It's width went up to 2m i.e same as a size 34.

Her Lifestyle

She is a very cheerful person and enjoys having fun despite her condition. Her parents have been there for her and had given her all the care and support she needed. She said she has always got anything she asked for and only got to knew how about how abnormal she is during her teens.

She has a degree in Graphic Design and Psychology and has studied courses such Sociology, Criminology, Sign Language and Mediation. In addition, She has worked voluntarily in different fields. She lives alone though family and close friends always pop in to know how she is faring.

She has a specially designed wheelchair and a special car. And does cooking, washing and cleaning by herself.
As a very independent and optimistic person , she hopes one day there would be a cure for her condition.

According to her, her condition do not affect her love life as she has previously been in two long-term relationships. She enjoys hanging out with friends and going places.

However, she has always feared she could be bedridden by the time she turns 85 years if her condition worsens.

Hope

Following a  recent DNA test and researches, a drug has been identified which could help her shrink her legs. She has commenced it and within  three months a significant improvement was noticed.

For the first time, X-ray showed the size of her legs were reducing rather than its usually increase.
She had noticed that because her trousers fits her properly and her mother has not made new ones but waited patiently to hear from the health experts. She and her parents were thrilled on hearing the news, just like they were the day they heard a tiny drug could do the job.

Hopefully in the next couple of years there would be a tremendous reduction in her legs.

Rapamycin

This is a drug commonly used to prevent organ and bone marrow transplants rejection.

It is found  to be very useful in Mandy Sellars case as it stops a specific protein that is involved in cell division. Nevertheless, its side effects include lung toxicity and increased risk of cancer.

 Lastly, in some sufferers, this abnormal body enlargement could be seen in the abdomen, around the chest and on the hands. Other signs and symptoms can be present, depending on sites affected. Follow @AyinotuV

Tiny Left Toe.

I came across a leg condition and want to talk about it.

Please for my friends who may not have appetite for reading certain  health issues, I apologise.

A close relative of mine have been having some discomfort on his left tiny toe for years now which seems to be recurrent; as it heals over time and comes back whenever it wills.

Initially, he thought it could be from the kind of shoes he wear and tend to have loads of variety now but none was deemed fit by this tiny toe. It kept disturbing.

How it starts
He simply notices a bit swelling of the foot especially very close to the last toe.
It builds up as each day passes by and so does its pain intensity as it looks as though it is stretching the skin and compressing some nerves as well. And of utmost importance reducing blood supply to the affected area.

In matter of days, it bursts from the region that attaches the tiny toe to the rest of the foot.
Sometimes,  it could be clear fluid and other times it turns out to be purulent- containing pus I mean.

The worst of all, is that it is very painful and pain-killers like paracetamol doesn't do the job except the likes of Ibuprofen or codradamol.

These phases last and for a while and then gradually subside and appear healed.
Although some home remedies were always of help.
For instance: Applying of hot compress
                    Washing the area properly twice a day
                    Applying antibiotic.

But it does not heal completely in the inside as it re-appears in about a month time or a bit longer.

After so much antibiotics prescriptions by GPs
Many episodes
It was time to hit the hospital.

Interestingly to me, I learnt that at the hospital most doctors did not know about the condition and were kind of seeking each others opinion till an Indian doctor came by and called it 'AINHUM'.  And it remained Ainhum.

It was time for X-ray and MRI which actually confirmed diagnosis and show the extent of damage done.
Then, Specialists took over.

His case never got this bad anyway.

Treatment
In hospitals, it is mainly by surgery either to link the connecting bone properly or to cut off the tiny toe.

I guess you now know what Ainhum is and looks like. It is on the tiny toe but can never be ignored.
You know what to do for more information. Before I forget, it was a bit hardwork writing this without medical jargons and structure.