MEDICAL TESTS FOR CHILDREN: ECG AND EEG
Electrocardiogram (ECG)
An electrocardiogram, or ECG, is a recording of the electrical impulses of the heart. These impulses are what makes the heart beat in a regular rhythm. To make such a record, an ECG machine is attached to the patient with electrodes, metal plates that are placed on the arms, legs, and chest. These electrodes pick up the electrical impulses that move through the body. The impulses cause a needle in the machine to move on a piece of paper, as the paper moves through the machine. Where the needle touches the paper, it makes a line. The physician studies the pattern on the paper to see if the heart rhythm is normal.
The ECG does not hurt the patient, but it is important for the patient to stay very still while the recording is done.- All muscle movements, not just movements of the heart muscle, are caused by electrical impulses. Therefore, any movement can affect the ECG recording and give an inaccurate picture of the heartbeat.
An ECG is done to check for irregular heart rhythms (arrhythmias), an enlarged heart, heart valve disorders, heart malformations, and many other heart disorders. The test can be done in a doctor’s surgery or an out-patient laboratory.
Electroencephalogram (EEG)
An electroencephalogram, or EEG, is a recording of electrical activity in the brain. It is a painless procedure similar to an ECG. The metal plates known as electrodes are attached to the patient’s head and to an EEG machine. The electrodes pick up the brain’s electrical impulses. These impulses activate a needle, which traces the pattern of the impulses on a piece of paper moving through the machine. The physician compares the pattern on the recording to patterns of normal brain activity, and determines if there is an abnormality. Recordings from opposite sides of the brain can also be compared to see if the patterns match.
An EEG is done to test for epilepsy, brain tumours, encephalitis (inflammation of the brain), and other brain disorders.
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BOWLEGS AND KNOCK-KNEES IN CHILDREN
Bowlegs and knock-knees are two conditions in which the legs are not as straight as they are in most persons. In bowlegs, the legs bend outward so that the knees are farther apart than usual. In knock-knees, the legs bend inward so that the knees are closer together.
Theoretically, when a child stands straight, the ankle bones should touch or almost touch each other, and the knee bones should touch or almost touch each other. With an infant lying on the stomach or back, the legs can be pulled straight with the toes and knees pointed straight ahead to determine whether the bones of the knees and ankles come together. If ankles touch but the knees do not, the child can be said to be bowlegged. If the knees touch but the ankles do not, the child is knock-kneed.
By these standards, however, all infants, children, and adults are bowlegged or knock-kneed to some degree, so you should not become alarmed. Most infants appear bowlegged until they walk. Then when they start to walk, they walk “cowboy” style. This condition usually corrects itself by age two. Most preschoolers stand knock-kneed, especially if they are plump. This condition also corrects itself.
True bowlegs and knock-knees either are due to rickets (vitamin D deficiency) or are inherited. Once common 50 and more years ago, rickets is now rare. An unusual form of bowlegs, often occurring only on one side, is Blount’s disease, in which the top of the tibia (shin bone) becomes deformed.
Signs and symptoms
Have the child stand with the legs straight and the toes pointed forward. Then observe if there is any distance between the knees or ankles. Remember that any distance between the ankles or the knees varies from person to person and that these differences are usually normal. If you think that there might be a problem, ask your doctor.
Home care
In most cases, no home care is needed. To prevent rickets, all children should receive about 400 international units of vitamin D daily. This amount is found in many commercial infant formulas and in most commercial milk. Some vitamin D is present in breast milk, but the amount varies. If your child is being breast-fed, ask your doctor whether the child is receiving enough vitamin D.
Precautions
• If you think your infant or child is bow-legged or knock-kneed, watch to see if, after several months, the condition worsens. If it does, consult your doctor.
• Do not use orthopedic shoes without your doctor’s prescription.
• Do not give your child vitamin D supplements unless your doctor has prescribed them. Overdoses of vitamin D can be harmful.
Medical treatment
In most instances, your doctor will examine your child and then prescribe no treatment—except to wait and watch. X rays of the knees may be required as well as blood tests for rickets. Use of orthopedic shoes or night splints is rarely necessary. For Blount’s disease, braces or corrective operations on bones may be required.
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ALCOHOL IN DIABETES
The Australian dietary guidelines suggest that alcohol intake should be limited. In diabetes there are additional reasons why intake should be limited.
1. Alcohol may affect blood glucose levels.
2. The effects of too much alcohol may be similar to the symptoms of hypoglycemia. (It may be important for friends to be aware of this.)
3. Many alcoholic beverages contain significant amounts of carbohydrate.
4. All alcoholic beverages are high in energy. This is important where weight control is a problem.
5. Alcohol may induce high blood fat levels and would need to be avoided if this were a problem.
A moderate intake of alcohol should not affect your diabetes. The following points should be kept in mind.
1. Don’t drink on an empty stomach. Food in the stomach will help slow the rate of absorption of alcohol from the stomach.
2. Choose beverages with a low carbohydrate content – Spirits, Dry Wines, Dry Sherries, Dry Vermouth.
3. For a longer drink mix with low carbohydrate drinks: Diet Coke, LoCal Lemonade, water, Soda Water, Natural Mineral Water, artificially sweetened Tonic Water, LoCal Dry Ginger, Diet Pepsi.
4. Avoid using alcoholic beverages with high carbohydrate content – Sweet Wines, Sweet Sherries, Sweet Vermouth, Liqueurs, Port and Stout.
5. Beers – all varieties contain carbohydrates (including diabetic beer). A low alcohol variety however contains less alcohol, is lower in energy and would be better.
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