Don't Wake Child Who Is Sleepwalking

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DEAR DR. DONOHUE: Please discuss sleepwalking in children. -- Anonymous

ANSWER: It's surprising to learn that 15 percent of children sleepwalk at some time. It happens mostly between the ages of 5 and 12, with the peak years being those between 4 and 8. During a sleepwalk, the child's eyes are open, and he or she is unresponsive, with a blank look on his or her face. On average, a typical sleepwalker experiences an occurrence two or three times a month. Frequently, a relative on either the mother or father's side will have been a sleepwalker.

Sleepwalking occurs one to three hours after falling asleep, during the phase of deep sleep, when brain-wave activity is at its lowest.

Almost never is sleepwalking a sign of physical or psychological abnormalities. Medicines are not routinely used to correct it. Provisions for the child's safety are needed. A ground-floor bedroom is best for a sleepwalker, if that is possible. Latches should be put on the outside of windows and the bedroom door. Don't wake the child during an episode. Gently guide him or her back to bed. Most children outgrow this by adolescence.

DEAR DR. DONOHUE: When one loses weight, is the fat loss removed through elimination processes, or what? Does it just drop off? -- P.H.

ANSWER: Fat is burned to produce energy and heat, just like gas heats a house. Some of the fat-burning process generates carbon dioxide, which is exhaled. Other waste products are eliminated by the kidneys. It's all done very discreetly.

DEAR DR. DONOHUE: I have a multinodular goiter. My thyroid lab work is normal. Can you explain what this is? I am due for an ultrasound soon. -- S.S.

ANSWER: A goiter is an enlarged thyroid gland, the U-shaped gland at the bottom of the neck. Nodules are common in that gland, and their number increases with age. So, you have a larger-than-normal gland with nodules in it. Your doctor has to confront two issues. One is assessing the production of thyroid hormone by the gland. In your case, laboratory work indicates that hormone production is normal. So you're free and clear on one count.

The second task is determining the nature of the nodules. Whether any of the nodules harbor cancer cells is the question that needs to be answered. A large nodule or one that grows rapidly is suspicious for cancer. The cancer question can be answered by having a biopsy of any questionable nodule. The biopsy is often done with a very slender needle, and no cutting takes place. An ultrasound of the gland provides information on which, if any, nodule needs a biopsy.

It's reassuring to learn that 12 percent of adults have a multinodular goiter but very few of these people have thyroid cancer.

The thyroid booklet deals with overactive and underactive thyroid glands but not thyroid cancer. Readers can order a copy by writing: Dr. Donohue -- No. 401W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

© 2008 North America Synd., Inc. All Rights Reserved

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