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Doctor insights on: Does Daycare Usually Have High Caregiver Turnover

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If someone has a chronic leukemia does their WBC stay high?

If someone has a chronic leukemia does their WBC stay high?

ONLY IN CLL: Chronic leukemia is two main types. Chronic lymphocytic leukemia most of the times do not need treatment and yes , counts may stay high. Chronic myelogenous leukemia always need treatment and counts should normalize with treatment. ...Read more

Dr. Benjamin Lessig
131 doctors shared insights

Caregiving (Definition)

Caregiving is the act of helping others take care of ...Read more


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What does it mean if a child (5.5 months) has consistently (over 3 months) high lym (2-3x more) and low gra (5-10x less) values in blood tests?

What does it mean if a child (5.5 months) has consistently (over 3 months) high lym (2-3x more) and low gra (5-10x less) values in blood tests?

Can be serious: The absolute counts matter much more than the percentages. If the absolute lymphocyte count is high, our first concern is lymphoblastic leukemia and the physician is already addressing this. If the granulocyte counts are well-below reference range, pediatric hematology subspecialist consultation is in order. Be sure to comply, and this may be serious, lasting disease. Hoping for the best. ...Read more

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Does increasing oxygen work if patient is in respiratory distress and if they have low hemoglobin?

Does increasing oxygen work if patient is in respiratory distress and if they have low hemoglobin?

It does. : It will help if the patient o2 saturation is low. You would like to see it between %96-100 by adjusting o2 flow of 1-2 lit per min. But the main goal should be raising the hemoglobin to normal level. ...Read more

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How many nightmares do toddlers usually have on average? 2 y/o with normal active life with no known stresses she does watch age appropriate tv

How many nightmares do toddlers usually have on average? 2 y/o with normal active life with no known stresses she does watch age appropriate tv

Scary, but harmless: Tiddlers usually have night terrors, a sleep disorder during transition from stage 3 non-REM sleep to stage 4 non-REM sleep, 1 1/2 -3 hours hours after sleep onset. A regular bedtime, adequate sleep & not being awakened during an episode help; stress & fatigue ^ them. See http://m.kidshealth.org/parent/medical/sleep/terrors.html. Kids 2 & > can have a maximum total "screen time" of 2 hours/ day. ...Read more

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How typical is it for high functioning autistic adults to live with their parents?

How typical is it for high functioning autistic adults to live with their parents?

Depends : High functioning individuals may still struggle with the skills needed to completely live independently and require additional help. If they do not live in an area that has services for adults this role may completely fall to the parents. If they are fortunate there may be supervised adult housing and vocational training that will lead to increased independence. ...Read more

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Does daycare attendance influence the number of colds a child gets?

Does daycare attendance influence the number of colds a child gets?

Yes: Daycare is a great way to build up your child's immune system by exposing him to lots of different viruses. All kids get sick, but kids who go to daycare do tend to get more colds. But don't despair, good daycares are also a fun place to play, socialize with other kids, and enjoy toys you don't have at home. ...Read more

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Is it true that low IgA levels in children can be due to their age and go away as immune system forms completely? Are labs ever wrong on the levels?

Is it true that low IgA levels in children can be due to their age and go away as immune system forms completely? Are labs ever wrong on the levels?

Not entirely true: Some child experiences transient hypogammaglobulinemia involving all classes of immunoglobulins, not just iga. Selective IgA deficiency is very common affecting 1 in 500 individuals, a good number of them are asymptomatic though. ...Read more

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What does high iron mean in cancer patient who has ceased treatment , now palliative care. Can this end life before cancer itself?

What does high iron mean in cancer patient who has  ceased treatment , now palliative care.  Can this end life before cancer itself?

Ignore it: A variety of lab changes may take place during the final stages of cancer. It's not inconceivable that the iron's been released from wasting tissues or hemorrhage into tumor. I can think of no treatble life-threatening complication of cancer that will raise the serum iron. "treat the patient, not the labs." i'm also glad your friend has you to care during her lsat illness. Thanks for asking. ...Read more

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How much time usually for mds to progress from low level to high risk mds. Is progress unstoppable. Or u can remain with low risk mds for 20 yrs?

How much time usually for mds to progress from low level to high risk mds. Is progress unstoppable. Or u can remain with low risk mds for 20 yrs?

Not that long: Mds tends to progress over a period ranging from several months to a few(1, 2, 3 max 5)years. What are your blood counts like now? If the abnormality is affecting all 3 blood cell types, then it is likely to not sit still beyond one to two years. ...Read more

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Hospices are for persons in their last weeks. Where does a single older person live when gravely ill but not hospice eligible and has no caregiver?

Hospices are for persons in their last weeks. Where does a single older person live when gravely ill but not hospice eligible and has no caregiver?

This would be a good: question to pose to a social worker who works with this type of placement. The person's doctor may be able to refer to such a social worker. Take care. ...Read more

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C-Reactive Protein is high at 8.4 mg/L (range 0.0 - 4.9). Does this require follow-up or is it not high enough to warrant concern? No infections.

C-Reactive Protein is high at 8.4 mg/L (range 0.0 - 4.9).  Does this require follow-up or is it not high enough to warrant concern?  No infections.

Need evaluation: Elevated C-reactive protein is one of the markers for risk of heart disease. You may wish to consult a cardiologist for an evaluation. ...Read more

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Dementia pt had aspiration, back on o2, to be bed bound, very robust appetite now plummeted, has hospice care of some kind. What does this portend?

Dementia pt had aspiration, back on o2, to be bed bound, very robust appetite now plummeted, has hospice care of some kind. What does this portend?

Ask the Dr: From your description, it does sound like the pt is not expected to live very long - but that may reverse in many. Still, this is an ill individual who will require some level of supportive care in all likelihood. No one can predict w/ certainty - so plan for the worst and hope for the best. ...Read more

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Do low or high blood serotonin level in children affect their bone growth ? To what extent it's effect?

Do low or high blood serotonin level in children affect their bone growth ? To what extent it's effect?

Under investigation: I've heard little since 2011 but it's true that hi levels played a role in suppressing bone growth. There was a NYTimes piece: http://www.nytimes.com/2008/11/27/health/research/27bone.html and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2940494/ Other systems ae involved too. It's not candy! ...Read more

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How come clinical signs in sickle cell anemia don't appear until the child is a year old?

How come clinical signs in sickle cell anemia don't appear until the child is a year old?

Fetal hemoglobin: Sickle cell disease results from a mutation in the beta hemoglobin gene. In infants, the beta hemoglobin gene is largely not used by the body (the gene is "off"). Instead, babies use a different gene named gamma hemoglobin. The gamma hemoglobin does not carry the sickle mutation. During the 1st year of life, the body gradually switches from using gamma to beta. Thus, symptoms can be delayed. ...Read more

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What does it mean if an adult has very high bilirubin numbers in their blood?

What does it mean if an adult has very high bilirubin numbers in their blood?

Liver disease: High levels of bilirubin usually result from liver disease. However, there are different types of bilirubins with different implications. ...Read more

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How high would a child's heartrate go when they have a fever of concern if their sleeping baseline is about 100bpm? (4yo cellulitis, bactrim (sulfamethoxazole and trimethoprim) begun am)

How high would a child's heartrate go when they have a fever of concern if their sleeping baseline is about 100bpm? (4yo cellulitis, bactrim (sulfamethoxazole and trimethoprim) begun am)

Rule of 10's: I generally expect a kid's heart rate to increase 10 beats per minute for every degree of fever above baseline.Activity will add more. Breathing rate follows a rule of 5's, increasing 5 breaths per minute for each degree. Both parameters mark the increase of fuel needed to sustain the work of healing, the fuel being oxygen & the heart pushing it around where its needed. ...Read more

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Is it common for women in their 20's and 30's to have low hemoglobin levels?

Is it common for women in their 20's and 30's to have low hemoglobin levels?

Yes: It is quite common for young women to have anemia especially if you dont eat right and if you have heavy menses. Having said that, there are many other things that can cause anemia. Please see your doctor and have your doctor evaluate you further for the cause of your anemia and direct the treatment based on the cause. ...Read more

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If someone gets high blood pressure, are they stuck with it for life (like diabetes )? Why does BP tend to increase with age ?

If someone gets high blood pressure, are they stuck with it for life (like diabetes )?  Why does BP tend to increase with age ?

great question: BP does tend to increase with age. If i could answer why, there would be a nobel prize waiting for me! if you're overweight or salt your food, you may be able to reverse it by losing weight and avoiding salt. Otherwise, you'll need medicine. The good news: outcome studies show that when BP is well controlled, you lower your risk of heart failure, heart attack, stroke, kidney failure, and death. ...Read more