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Jan 30, 2023

Cellulitis: Breaking The Habit and Good Hygiene

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As bad as breaking a bone or burning yourself can be, most consider infections to be worse due to their ability to spread and potentially come back again. Children are some of the most vulnerable people to contracting a virus because they typically have worse hygiene habits and are less knowledgeable of the signs and symptoms. Cellulitis is definitely one of those bacterial infections to watch out for because if left untreated it can lead to more serious issues.

What is cellulitis?

Cellulitis is a deep bacterial infection of the skin that usually occurs after some type of trauma causes an opening in your child’s skin. Typically, the infection involves your child’s face, arms, and legs. In most cases, human or animal bites or injuries that occur in water can also cause infection and immediate treatment can help prevent the spread of cellulitis. In some cases, cellulitis is considered an emergency and your child’s healthcare provider may treat your child in the hospital depending on the severity of their condition.

Symptoms & Causes of Cellulitis

Cellulitis is a tricky infection because many of the symptoms may appear as something less significant. If your child has swollen or warm skin, bruising, chills, a fever, or a red streak from the original site of pain, there is a good chance they have cellulitis. In some cases, cellulitis is considered an emergency and you should consult your child’s healthcare provider if the area affected is causing your child to complain of numbness, tingling, or other changes in a hand, arm, leg, or foot, if the skin appears black, or if the area that is red and swollen is around your child’s eyes or behind the ears.

Diagnosis & Treatment of Cellulitis

The diagnosis of cellulitis is usually based on the medical history and physical examination of your child. Blood and skin samples may also be taken to confirm the diagnosis and the type of bacteria present.

How to Treat Cellulitis?

Specific treatment for cellulitis will be determined by your child’s healthcare provider based on your child’s age, overall health, and medical history. However, treatment may include oral or intravenous antibiotics, warm, wet dressings on the infection site, surgical intervention, and rest.

If your child’s arm or leg is affected, their provider may also have you elevate the extremity and decrease the amount of activity. Also, based on the physical examination, your child’s physician may treat your child in the hospital depending on the severity of the cellulitis. In the hospital, your child may receive antibiotics and fluids through an intravenous catheter.

Complications and Prevention of Cellulitis

Complications can be reduced with prompt and accurate treatment by your child’s provider. The most common complications include meningitis, septic arthritis, and an infection of a joint caused by glomerulonephritis.

To prevent cellulitis, protect the skin from cuts, bruises, and scrapes. This isn’t easy, especially for active kids or those who play sports. It’s best if your child uses elbow and knee pads, wears a bike helmet when riding, shin guards, long pants, long-sleeved shirts while hiking in the woods, and sandals on the beach.

If your child does get a cut or scrape, wash it well with soap and water followed by applying an antibiotic ointment, then cover the wound with an adhesive bandage or gauze and lastly, check the wounds often for the first few days to see if any signs of cellulitis begin.

When Should I Call My Healthcare Provider?

You should contact your provider if any area of your child’s skin becomes red, warm, and painful — with or without fever and chills. This is even more important if the area is on the hands, feet, or face, or if your child has an illness or condition that suppresses the immune system. Also, if your child gets a large cut or a deep puncture wound but most importantly if an animal bites your child, especially if the puncture wound is deep, contact your provider immediately. Cellulitis can happen quickly after an animal bite. Even human bites can cause skin infections too, so call the doctor if this happens.

Afterthought

To recap, cellulitis is a bacterial infection of the skin that often happens in areas where the skin is broken. Because of this, it’s important that your child always washes their hands before and after touching the infected area to make sure it doesn’t get any worse. With that being said, there are only so many at-home options at your disposal which is why Chai Care will always be here to offer top-notch aid!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.

Itchy, Red, And Dry… Everything To Know About Eczema

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Out of all the different rashes and skin conditions that exist, Eczema is one of the most common that a child can have. As irritating as eczema may be, there are plenty of ways to avoid it and if your child does have it, there are plenty of ways of remedying the pain. So, look no further because Chai Care has you covered in all the ways to help your kid with their eczema!

What is Eczema?

Eczema is a skin problem called atopic dermatitis. Atopic dermatitis often begins in infancy, affecting about 15 to 20% of children. It usually improves as the child grows older and may resolve by school age or puberty, however, some children with atopic dermatitis may have more chronic diseases.

What Causes Eczema?

Children with eczema have a form of sensitive skin that may be more easily irritated by sweating, heat, rough clothing, some detergents, soaps, and cleansers. Children with atopic dermatitis may also have allergies to foods, animals, dust mites, tree pollens, and grasses, although it is not clear that these allergies cause eczema in most children. In many cases, identifying these allergies does not help eczema. In rare cases, some children with atopic dermatitis may develop allergies to chemicals in their moisturizers, skin care products, clothing, or topical medications.

What Are the Symptoms of Eczema?

Children with eczema develop red, dry, itchy patches on the skin that result from inflammation. Itching can be severe and constant, causing them much discomfort. With frequent scratching, the skin may develop blisters, oozing, crusting, or sores from the infection. Sometimes, if the child scratches for many weeks to months, the skin may start to become very rough, leathery, and darker in color. In infants, eczema commonly affects the face, scalp, arms, and legs and in older children, eczema may involve only the insides of the elbows and backs of the knees. It’s worth mentioning that some children with severe eczema may have it spread across their entire bodies.

Treatments

Unfortunately, there is no cure for eczema, although it can usually be fixed with a good skincare routine. Frequent follow-ups with your healthcare provider are important so they can see whether the prescribed medicines are working. Your provider may need to adjust treatment during different seasons of the year, during flares, or as your child gets older. Outside of what your healthcare provider may recommend, there are plenty of at-home care options you can use to help your child without having to step foot inside a clinic.

Bathing

For some children, limiting bathing to one to three times a week is helpful. Bathing more often can dry out the skin and actually make the itching worse. For children with environmental allergies such as pollens and animal dander, bathing more often, especially after contact with known allergens, may be helpful. When bathing, use warm water and a gentle, non-soap cleanser or Cetaphil cleanser. This should range from 5 to 10 minutes and when finished, pat the skin dry with a towel and lastly, apply topical medicines or moisturizers as instructed, right after bathing while the skin is still damp.

Topical Skin Medicines

Your healthcare provider may prescribe topical steroids or other creams or ointments to treat your child’s eczema. When using this, apply a small amount of medicine to the affected areas up to two times a day as needed to keep eczema under control. It’s important to always apply the topical medication at least 30 minutes before applying moisturizer.

If your child’s eczema flares, you may need to use a stronger topical steroid for a short time. Use these steroids twice a day or as instructed by your healthcare provider on areas that have flared in place of your everyday steroids. Contact your provider if the areas are not any better after a week’s time. As your child’s eczema improves, you should be able to use the topical medication less often, ideally two to three times a week to keep your child’s skin clear. Make sure to not overuse or abuse the topical steroids because this may harm your child’s skin, causing stretch marks and spider veins.

Moisturizers

When using a recommended moisturizer, apply a thick layer of cream 30 minutes after you use any topical medicines. This allows time for the medicine to be absorbed into the skin and the moisturizer will then seal in the medicine. Make sure to not use a cream that comes in a pump bottle, as these are usually lotions and won’t be effective.

It’s worth mentioning a few good moisturizers, but your healthcare provider may suggest something else. Creams that parents seem to champion are Cetaphil, Aquaphor, Vaseline, and Aveeno, just to name a couple.

 Antihistamines

Antihistamines are a type of allergy medicine that is used to decrease itching. They are most helpful when given before bedtime due to them making children sleepy. If you’re wondering what Antihistamines are, they are medicines such as Atarax and Benadryl. Some children with environmental allergies may also need to take a daily, non-sedating antihistamine such as Zyrtec, Claritin, or Allegra in the morning to control their allergy symptoms.

Wet wraps

Wet dressings can be placed on the child after applying topical steroid medication. This makes the medication more effective by helping it penetrate deeper into the skin. You may also use an ace wrap or wet cotton pajamas, and after the nighttime dose of topical steroid application is applied, the child can then wear them to bed for an increased duration of treatment. They can also be worn after the application of moisturizing cream to lock moisture into the skin.

Follow-up Visits

Follow-up visits are very important when it comes to eczema. Your healthcare provider will examine your child’s skin and monitor for side effects of steroid medication use and infections and may change the medications being used. It is important to follow their instructions and keep follow-up appointments to ensure maximum healing.

You should call your healthcare provider if your child develops open, oozing areas of skin that are painful or associated with a fever or if your child’s eczema worsens or does not improve with the use of prescribed medications.

Most infants and children with mild to moderate eczema can be managed by their primary healthcare provider as long as the treatment plan is followed and follow-up visits are made. Referral to an allergist or dermatologist is appropriate if certain foods or allergies are suspected, skin infections are frequent, or if your child is not responding to the treatment plan prescribed by the primary care provider after several follow-up visits and adjustments to the treatment plan have been made.

Afterthought

Truth be told, Eczema is not something to lose sleep over. Even though it may cause your child discomfort and in rare cases lead to a more serious skin condition, 9 out of 10 times it is nothing more than a seasonal rash that is easily treatable. Still, no parent enjoys watching their child suffer which is why the dedicated staff at Chai Care will always be here to supply your child with sensitive care!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.

Dislocations & Fractures: What’s The Difference?

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It is every parent’s worst nightmare to see their child with an injury, especially when it is something as serious as a fracture or dislocation. These are extremely common childhood injuries because young children have bones that are growing and are not yet fully developed, making them more fragile than adult bones. Because of this, it is paramount to understand the best ways how to keep your youngster safe, as we all know how adventurous and energetic kids can be.  However, there are some important differences between a fracture and a dislocation that are crucial to know so as not to confuse the two.

What is a Fracture?

Simply put, a fracture is a term used for a broken bone. They can occur in any bone of the body, but the most common fractures in children are in the wrists, arms, and elbows, which usually occur after a fall in most cases, the injury will heal well and cause no long-term complications.

Older children will usually be able to tell you where they are in pain and can explain what exactly happened to better understand the situation. This can make it easier to identify if the injury is in fact a fracture or potentially something more significant. It can be more difficult to identify a fracture in infants or toddlers due to their lack of communication skills. They may cry and not use the affected area, rather than articulate what they are feeling.

What is a Dislocation?

A dislocation is a joint injury. It occurs when the ends of 2 connected bones come apart. Fortunately, it is not common in younger children! This is because their growth plates are weaker than the muscles or tendons. Growth plates are the areas at the end of long bones where the bones grow, making them more common in teens and adults.

A dislocation happens when extreme force is put on a joint. It can occur if your child falls or takes a hit to the body, such as while playing a contact sport. It’s important to note that when a dislocation occurs, ligaments can be torn—these being flexible bands of fibrous tissue, joining various bones and cartilage. They also bind the bones in a joint together. The hip and shoulder joints, for example, are called ball and socket joints. Lots of force on the ligaments in these joints can cause the head of the bone (ball) to come out of the socket partly or fully. The most dislocated joint is the shoulder.

Treatment

Now that we know what both a fracture and a dislocation are, it’s time to discuss how we go about treating them.

In most cases, if your child has a fracture, they will need to restrict movement of the injury site to allow the bone time to heal. Some fractures may require a splint or a partial cast, held in place with bandages. A splint or partial cast helps to support the injured area, allowing the bone to rest and heal while also providing your child pain relief. A splint or partial cast generally does not have to be worn for as long as a full cast. Casts are required for three weeks to three months depending on the type and location of the injury – your healthcare provider will estimate how long it will be required.

If the injury has caused the bones to move out of place, your healthcare provider will need to move the bones back into the correct position which is known as a “reduction.” These procedures are usually done under sedation or anesthesia in the emergency department or operating room. Fractures that require a reduction will need a full plaster cast (one that wraps around the limb) to allow the injury to heal. Full plaster casts stay on your child for up to three months, depending on the injury.

Treatment for a dislocation will depend on your child’s symptoms, age, and general health. It will also depend on how severe the injury is; however, all dislocations need medical care right away to prevent additional injury because untreated dislocations can lead to serious problems. One of the most common forms of treatment is R.I.C.E. which stands for rest, ice, compression, and elevation of the dislocated area. Other forms of treatment would be casting, splinting, repositioning, and in serious cases, surgery.

Post Treatment

Whether it be a fracture or a dislocation if your child was wearing a cast and once it has been removed, your child’s skin may be dry and itchy. Bathe the skin with warm soapy water, and apply a plain, non-perfumed moisturizer.

After a fracture, children normally regain strength by engaging in gentle activity and play. Physiotherapy is usually not needed. Your healthcare provider will give your child specific advice about when and how they can return to sport, in most cases four to six weeks later. If your child had surgery, full-contact sports should be avoided for two to three months, but you should discuss this with your child’s healthcare provider.

Afterthought

It is highly probable that at some point your child is going to face one or possibly both injuries. Rather than looking at it as a negative thing, it’s better to see it as a sign that your child is a typical kid who is active and enjoys playing with their friends. When that day does arrive, you can be your child’s hero by understanding the signs, symptoms, and methods on how to take care of them, but even with your newfound knowledge, the experts at Chai Care will always be here to help!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.

Sports Injuries: Playing It Safe

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Believe it or not, sports injuries are the second leading cause of emergency room visits for children and adolescents, and the second leading cause of injuries in school. Millions of children are seen in hospital emergency rooms for sports-related injuries, and even more, are seen by their primary care physician or a sports medicine clinic for injuries. This is attributable to the fact that young athletes often begin their competitive sports careers as early as age seven, with some youth participating in organized sports activities as early as age four.

A child can endure many different injuries when playing a sport and understanding how to prevent them is crucial to your child’s longevity. Our country’s obsession with sports—football, basketball, and baseball being the most popular, plays a major role in why kids start playing them so young. Even though sports teach many great life lessons such as accountability, being a team player, and hard work, there are still a plethora of injuries your child may face, which is why it’s so important to be as informed as you can.

How Do Sports Injuries Happen?

The first step toward preventing sports-related injuries is understanding how they happen. There are plenty of reasons why they occur, but the most popular reasons are due to poor equipment and technique, overuse, lack of instruction, or simply bad luck! Of course, you can’t anticipate every injury, and some are simply unavoidable, however, your child can reduce their risk of hurting themselves by practicing safe methods of playing.

Which Young Athletes Are Most At-Risk?

Injuries can happen anywhere there are bodies in motion. However, some youth sports involve a higher degree of impact than others, including football, rugby, and hockey. Basketball, and soccer. These sports require athletes to run fast, tackle, and sometimes even collide straight into one another. From the outside looking in, this is a recipe for disaster, but sports require great strength and at times violence which makes it all the more important to be as safe as possible.

The truth is no sport or activity is 100% safe. And beyond the ice, injuries can also happen at the playground as well as on the surfboard or skatepark. However, with the right equipment, coaching and technique, your kids can still have fun while playing safe!

9 Most Common Sports Injuries in Children

According to the American Academy of Pediatrics, children have more than 3.5 million sports injuries each year. All sports carry a risk of injury and while there are steps you can take to prevent sports injuries; these common injuries may still occur.

Sports injuries in children can often be treated with Rest, Ice, Compression, and Elevation (RICE). However, sometimes you should see an orthopedic specialist. If your child experiences one of the following injuries and has symptoms that don’t resolve with home treatment, see your healthcare provider.

  1. Ankle Sprains

One of the most common sports injuries in children is ankle sprains. Ankle sprains occur when the ligaments that support the ankle stretch and tear. This can happen in sports like basketball, tennis, soccer, and football that require cutting or twisting actions. Ankle sprains cause pain, tenderness, swelling, bruising, and instability of the ankle. Most sprains are minor injuries that heal with the RICE protocol, but sometimes they require treatment by an orthopedic specialist.

  1. ACL Tears

The anterior cruciate ligament (ACL) is one of the major ligaments that stabilize the knee joint. It connects the femur to the tibia. An ACL tear can occur due to a blow to the outside of the knee or without impact after a jump or twist.  ACL tears are most common in kids that play basketball, volleyball, tennis, and soccer. An ACL tear causes pain, swelling, and limited movement in the knee.

  1. Osgood-Schlatter

Osgood-Schlatter is another type of knee pain that is different from an ACL tear. It is a traction injury (also known as a stretch injury) to a growth plate at the top of the shin bone called an apophysis. The injury is caused by tightness in the muscles coupled with high activity levels. The injury may present with pain and swelling or a bump at the bottom of the knee.

  1. Little League Elbow

Little league elbow is caused by repetitive stress to the growth place located on the inside of a child’s elbow, resulting in pain and tenderness. It is common among baseball and softball players in positions such as pitcher, catcher, infielder, and outfielder. It may occur in other sports where repetitive throwing is required.

  1. Little League Shoulder

Like little league elbow, only it affects the shoulder and is caused by repetitive stress or micro trauma to the shoulder growth plate. This condition most commonly occurs among children between 11 and 14. As the name suggests, it is common in softball and baseball pitchers, but it can also occur in swimmers and tennis players.

  1. Shin Splints

Shin splints are common sports injuries in children that participate in sports that require repeated running on a hard surface. They can also be caused by overtraining at the beginning of the season without proper conditioning. Shin splints cause pain and discomfort in the front of the lower legs (the shins).

  1. Spondylolysis

Spondylolysis is a stress fracture to the lumbar spine. A stress fracture occurs when a bone breaks after experiencing repeated stress from tension or compression. This injury usually occurs in the low back. It is most commonly seen in young athletes that participate in sports like gymnastics, tennis, rowing, weightlifter, and track and field.

  1. Turf Toe

Turf toe is the hyperextension of the big toe. It occurs when a young athlete pushes off the ground forcefully with the big toe being forced upward. The main symptom of these sports injuries in children is pain, but swelling may also be present.

  1. Concussion

Unfortunately, concussions are not uncommon sports injuries in children. They can occur in many sports as the result of a direct blow to the head. After such a direct hit, the child should be monitored for symptoms like headaches, blurred vision, dizziness, or confusion. While the treatment for most concussions is rest, all concussions should still be evaluated by a medical professional so they can recommend the proper treatment.

Helping Young Athletes Avoid Injuries

So, your child loves sports, all sports, and you are terrified that they are going to injure themselves. Rest assured, there are plenty of preventative measures you can take to ensure your child will be safe!

Safe Habits

As your child learns about safe play, reinforce the good habits they’re discovering such as wearing proper safety equipment, following the rules, and getting adequate rest for their growing bodies. Talk to them about why those habits are important. Encourage them to make healthy habits a part of their daily life. The more support your child receives from their loved ones, the more they’ll feel motivated to do the right thing for their own health and wellness.

Talk To Your Child’s Coach

By communicating with your son or daughter’s coach, you can get a better idea of what your child is learning when it comes to technique and training methods. When you know what’s being taught in practice and on the field, you can help support healthy directions and be aware of common misconceptions that might be dangerous and lead to injury.

Warm-up & Cool Down

For both parents and coaches, mimicking good habits start with you. Whenever you participate in physical activities with your child, that being a pick-up game of basketball or a sprint around the neighborhood, teach your child the importance of warming up, cooling down, and proper stretching to avoid injury.

Overuse

When the competitive drive takes hold, your child might start going all-out on exercising and practicing. It’s important to keep tabs to make sure that your kid’s workouts stay safe and reasonable. Healthcare professionals recommend at least one rest day per week and three months off from a sport each year. Talk to your child about the advantages of balance and control that can lead to physical and mental health setbacks.

Pay Attention to Mental Health

Physical activity can greatly improve your child’s mental health, as long as it’s done in a safe and balanced approach. But watch out for issues like stress. The anxiety of an intensely competitive environment can negatively impact your child both on and off the court. You as the parent should provide healthy support and encouragement as well as understanding and guidance when times are rough.

What Should Be Done?

Early recognition and treatment of injuries are key in returning athletes to their sport safely and promptly. Any injury that involves swelling, deformity, and/or loss of normal function should be seen by a physician immediately while all other injuries that appear to be minor should resolve themselves within a few days. With that being said, if the injury does not heal on its own, and your child is not back to full participation without pain, it is best to have him/her evaluated by a medical professional. Lingering injuries that go untreated can turn into chronic problems that require a much longer time away from the sport to allow the injury to heal properly.

Afterthought

Even though there are many injuries your child can sustain while playing their favorite sport, the risk-reward factor is worth it. Your child will build life-long relationships and skills that will teach them the ever-important value of teamwork and competition. Sports are an amazing way for kids to mature and prepare themselves for the real world, but if they do find themselves with a sports-related injury, Chai Care will always have your back!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.

Childhood Vaccinations: Don’t Wait Until It’s Too Late

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We are blessed to live in a world that has dozens of options for us to heal and rejuvenate ourselves—vaccines being the most important. Thanks to all the doctors and scientists of the world, we now don’t have to be frightened of getting sick, however, when talking about children, vaccinations are that much more important because of their ability to prevent certain illnesses before they ever happen. There are cases where babies are born with protection against some diseases because their mothers pass antibodies (proteins made by the body to fight disease) to them before birth, but getting your child vaccinated is still crucial to their overall health.

Immunization

Immunization (vaccination) is a way to create immunity to some diseases. Sometimes this is done by using small amounts of a killed or weakened germ that causes the disease. Other times the vaccine is simply a small piece of the germ, such as a protein or a piece of its genetic material.

Germs can be viruses (such as the measles virus) or bacteria (such as pneumococcus). Vaccines stimulate the immune system to react as if there were a real infection. It fends off the “infection” and remembers the germ. Then, it can fight the germ if it enters the body later.

Why Childhood Immunizations Are Important

For good reason, childhood vaccines can seem overwhelming when you are a new parent. Vaccine schedules recommended by agencies and organizations, such as the CDC, the American Academy of Pediatrics, and the American Academy of Family Physicians cover just about 14 different diseases. These vaccinations not only protect your child from deadly diseases, such as polio, tetanus, and diphtheria, but they also keep children safe by significantly decreasing harmful diseases that used to spread from child to child.

It’s important to know that vaccines are dead, weakened versions, or part of the germ that causes the disease in question. When children are exposed to a disease in vaccine form, their immune system, which is the body’s germ-fighting machine, can build antibodies that protect them from contracting the disease when they are exposed to the actual disease. However, over the years, vaccines have generated some controversy over safety, but no convincing evidence of harm has been found. And although children can react to any vaccine, the important thing to know is that the benefits of vaccinations far outweigh the possible side effects.

Tracking Immunizations

In most cases, a child gets vaccinated between birth and 6 years. Typically, vaccines are given more than once, at different ages, and in combinations. This means that you should keep a careful record of your child’s shots. Although your healthcare provider will also keep track, people change physicians, records get lost, and the person ultimately responsible for keeping track of your child’s immunizations is you!

Ask your child’s healthcare provider for an immunization record form. This form is incredibly important and every parent should keep it with their other essential documents. Also, you can download an easy-to-read immunization schedule and record form at the CDC website.

Even though most parents and providers do a great job of keeping up with immunizations, studies show that about one-fourth of preschool children are missing at least one routine vaccination, which is important to know because most states will not let your child begin school without a complete immunization record. Sometimes a vaccination is missed when a child is sick, but no matter what the reason, it’s important to make up missed immunizations.

If your child has missed a vaccination shot, you don’t have to go back and start over as the previous immunizations are still good. Your doctor will just resume the immunization schedule, and if for any reason, your child receives additional doses of a vaccine, you shouldn’t sweat it as your child will still need any future doses according to the recommended schedule.

How Many Shots Do Children Need?

Although vaccines are combined to reduce the number of shots needed, the list is still long. So, to give an easy breakdown here is a typical immunization schedule recommended by age 2.

One vaccination for measles, mumps, and rubella (MMR).

Four vaccinations for influenza, a common upper respiratory infection that can also cause meningitis.

Three to four polio vaccinations (IPV).

Four vaccinations for diphtheria, tetanus, and pertussis (DPT).

Three vaccinations for hepatitis B.

One vaccination for varicella (chickenpox) no earlier than age 12 months and only if your child does not develop chickenpox on his or her own (must be verified by a health care provider).

Three vaccinations for rotavirus, a type of infection that causes severe diarrhea.

Four vaccinations for pneumococcal disease, a common cause of ear infections and pneumonia.

From age 4 to 6, your child will need booster shots for DPT, IPV, MMR, and chickenpox. Children should also start receiving a yearly flu shot after the age of 6 months. A vaccination for hepatitis A is recommended for all children. This is a lot to keep track of and why you need an immunization records form.

Vaccine Concerns

There are some parents who may hesitate to have their kids vaccinated. The concern is that their child might have a serious reaction or get the illness the vaccine prevents, but the components of vaccines are weakened or killed and in some cases, only parts of the germ are used. Thus, making them unlikely to cause any serious illness. Some vaccines indeed cause mild reactions, such as soreness where the shot was given or a fever however, serious reactions are rare. The truth is that the risks of vaccinations are small compared with the health risks of the diseases they’re intended to prevent.

Afterthought

At the end of the day, immunizations are one of the best ways to protect your family from contagious diseases. Vaccinations have allowed us to live more freely and be less frightened of all the illnesses our unforgiving world has to offer, and luckily, the friendly staff at Chai Care will always be here to give your child the medicine they need to live a beautiful life.

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.

Ear Infections: Protecting Your Child & Keeping Them Safe

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Among the most common injuries a young child can face, ear infections are smack in the middle. They cause extreme discomfort for anyone who has had the misfortune of enduring them and even an adult will tell you how truly irritating they are. Sadly, kids get them regularly for several reasons, but as a person gets older, ear infections tend to happen less frequently. Besides knowing the signs and symptoms of this nasty infection, it’s important to know exactly how they start and why they occur, so you can greatly reduce the odds of your child ever having one!

What is an ear infection?

Chances are you will hear the commonly used term “ear infection”. In the medical world, it is referred to as acute otitis media or a sudden infection in the middle ear (the space behind the eardrum). The truth is anyone can get an ear infection, however, they are one of the most common reasons young children visit healthcare providers.

In many cases, ear infections clear up on their own. Your healthcare provider may recommend a medication to relieve pain and if it has worsened or not improved, your healthcare provider may prescribe an antibiotic. In children younger than the age of two years, an antibiotic is usually needed for ear infections.

It’s important to see your healthcare provider to make sure the ear infection has healed or if your child has ongoing pain or discomfort. Hearing problems and other serious effects can occur with ongoing ear infections, frequent infections, and when fluid builds up behind the eardrum.

What causes an ear infection?

Essentially, ear infections are caused by bacteria and viruses. Many times, they begin after a cold or other respiratory infection. The bacteria or virus will travel into the middle ear through the eustachian tube, and the bacteria will plant its nasty self and take control. This tube connects the middle ear to the back of the throat. The bacteria or virus can also cause the eustachian tube to swell, thus making the tube so swollen that it will become blocked. This will cause the normally produced fluids to build up in the middle ear instead of being able to be drained away.

Another issue is that the eustachian tube is shorter and has less of a slope in children than in adults. This physical difference makes these tubes easier to become clogged and more difficult to drain. The trapped fluid can become infected by a virus or bacteria, causing pain, which is why children are more susceptible to ear infections.

Where is the Middle Ear?

We have been using the term “middle ear” quite a bit and if you’re wondering why it is because it’s rather important to know. The middle ear is behind the eardrum and is also home to the delicate bones that aid in hearing. These bones are the hammer, anvil, and stirrup. This is also where the infection will take hold and live during its duration of time. In addition to the middle, there are also the outer and inner parts of the ear. The outer ear is the outside external ear flap and the ear canal, and the inner ear contains the snail-shaped labyrinth that converts sound vibrations received from the middle ear to electrical signals. The auditory nerve carries these signals to the brain.

Even though the infection will reside in the middle part of the ear, understanding the body part in its entirety can help your child when they tell you where they feel the pain and exactly what they’re going through. Some children will become so vexed by the irritation that they will struggle with articulating exactly how they feel so it’s best to be aware as much as you can.

What Are the Symptoms of An Ear Infection?

There are plenty of symptoms to look out for and your child will tell you all about them. The most obvious is ear pain. This symptom is obvious in older children and adults, but in infants and children too young to speak, look for signs of pain like rubbing or tugging ears, crying more than usual, trouble sleeping, and acting fussy/irritable. Other signs to watch out for would be loss of appetite, irritability, poor sleep, fever, drainage from the ear, and trouble hearing.

Who is Most Likely to Get an Ear Infection?

Ear infections are the most common childhood illness other than a cold. They occur most often in children who are between ages 3 months and 3 years and are common until age 8. Some 25% of all children will have repeated ear infections. Adults can get ear infections too, but they don’t happen nearly as often as they do in children.

It is also important to note that people with certain allergies, chronic illnesses, and even your ethnicity can affect how often your child gets an ear infection. It’s important to know your family’s medical history so you can provide your child’s healthcare provider with the proper information that can prevent any potential threats.

How is an Ear Infection Diagnosed?

Ear exam

Your healthcare provider will look at your or your child’s ear using an instrument called an otoscope. A healthy eardrum will be pinkish-gray in color and translucent. If an infection is present, the eardrum may be inflamed, swollen, or red.

Your physician may also check the fluid in the middle ear using a pneumatic otoscope, which blows a small amount of air at the eardrum. This should cause the eardrum to move back and forth. The eardrum will not move as easily if there is fluid inside the ear.

Another test they may perform is called tympanometry. This uses air pressure to check for fluid in the middle ear. This test doesn’t test hearing. If needed, your healthcare provider will order a hearing test, performed by an audiologist, to determine possible hearing loss if you or your child has had long-lasting or frequent ear infections or fluid in the middle ears that are not draining.

Other checks

Your healthcare provider will also check your throat and nasal passage and listen to your breathing with a stethoscope for signs of upper respiratory infections.

How is an Ear Infection Treated?

Treatment of ear infections depends on age, the severity of the infection, the nature of the infection, and if fluid remains in the middle ear for a long period. Your healthcare provider will recommend certain medications to relieve your child’s pain and fever. If the ear infection is mild, depending on the age of the child, your healthcare provider may choose to wait a few days to see if the infection goes away on its own before prescribing an antibiotic.

Antibiotics may be prescribed if bacteria are thought to be the cause of your child’s ear infection. Then, your provider may want to wait up to three days before prescribing antibiotics to see if a mild infection clears up on its own when the child is older. If your or your child’s ear infection is severe, antibiotics might be started right away.

Afterthought

Even though the chances of your child experiencing an ear infection are extremely high, this shouldn’t be of much concern if you act quickly and are knowledgeable of your family’s health history. Chances are the infection won’t last very long and as your youngster ages, it will soon become a bad memory. Even though there are many over-the-counter drugs and at-home remedies you can use to help heal your child, the healthcare experts at Chai Care will happily take a look as they supply their expert knowledge and quality care!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.

Staying Informed on Your Child’s Head Trauma

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Out of every injury a child can get, head trauma is considered to be the scariest. They can lead to all sorts of issues, especially later in life, which is why it is paramount to be as informed as humanly possible. The truth is head injuries can happen from many things, not just direct blows to the head or contact sports which is why understanding the signs and symptoms of them are even more crucial to be aware of.

What Are Head Injuries?

Unfortunately, head trauma is common in children and teens. They can hurt the scalp, skull, brain, or blood vessels. They can be as mild as a bump on the head, or more serious, like a concussion. In kids, most are mild and don’t injure the brain. A head injury is a broad term that describes an extensive array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the child’s head. Head injuries are also commonly referred to as brain injury, or traumatic brain injury, depending on the extent of the head trauma.

Causes & Types of Head Injuries

In most cases, head injuries in childhood are due to falls and slips, however, they can also occur from car crashes, bike accidents, sports injuries, and child abuse. These are the most common methods, but the truth is there are many other ways your child may sustain head trauma.

Essentially there are two different types of head injuries: external and involving the scalp and internal involving the skull, brain, or blood vessels.

It’s also important to know that injuries can potentially cause a concussion, contusion, fracture, or bleeding. If this does happen, you should bring your child to their healthcare provider immediately for further observation.

What Are the Signs & Symptoms of a Head Injury?

The list can be very long for the signs of a head injury depending on the severity of your child’s injury but the most important symptoms to look out for would be a swollen scalp, headache, loss of conciseness (in serious cases), confusion, irritability, ringing in the ear and fatigue. Again, head injuries can be complicated and even discrete which is why if you fear your child may be experiencing one, you should take them to their healthcare provider for a professional opinion.

How Are Head Injuries Diagnosed?

Healthcare providers diagnose head injuries by asking questions about how the injury happened and doing a careful examination of the head and checking to see how the nerves are working. Most children with a mild brain injury don’t need medical tests, however, providers will often do a CAT scan of the head if the injury is more serious. In this case, your child may need to get blood tested, X-rayed, or receive an MRI.

What Should I Do When a Child Has a Head Injury?

You should contact your health care provider immediately if your child had a head injury is an infant, has lost consciousness, even for a moment, wines of head and neck pain (younger children who aren’t talking yet may be fussier), vomits more than one time, won’t awaken easily, becomes hard to comfort, or isn’t walking or talking normally.

If your child is not an infant, has not lost consciousness, and is attentive and behaving regularly after the fall or blow, put an ice pack or instant cold pack on the injured area for 20 minutes every 3–4 hours. If you use ice, always wrap it in a washcloth or sock. Ice placed right on bare skin can injure it. Watch your child carefully for the next 24 hours. If the injury happens close to bedtime or naptime and your child falls asleep soon afterward, check in a few times while they sleep. If your child’s skin color and breathing are normal, and you don’t sense a problem, let your child sleep unless the doctor tells you otherwise. There’s no need to keep a child awake after a head injury. It’s also important to trust your gut. If you think your child doesn’t seem to be acting like they normally do, partly awaken your child by sitting them up. They should fuss a bit and attempt to resettle. If your child still seems very drowsy, try to awaken them fully. If you can’t wake your child, call your healthcare provider or 911 for an ambulance.

Can Head Injuries Be Prevented?

The hard truth is that you can’t protect your child from every injury, but you can help prevent head trauma with precautions and by teaching them how to play safely. Your child should always wear a bike helmet that fits well and use the proper sports equipment for inline skating, skateboarding, snowboarding, skiing, and contact sports. Make sure they wear a safety seat or seatbelt every time they’re in the car and if they do sustain a head injury, wait until their healthcare provider says it’s OK before returning to rough play or sports. If the brain gets injured again while it’s still healing, it will take even longer to completely heal.

Afterthought

Head Trauma is a scary injury that no parent wishes to see their child suffer from. This is why by understanding the signs and symptoms of them and teaching your child how to safely play, you greatly reduce the risk of your child sustaining any sort of head injury. It’s an unfortunate part of life that we all get banged up every now and again but the team of dedicated staff members at Chai Care will always make sure to be here if your child ever needs a helping hand!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.

Jan 10, 2023

Sprains & Strains: Keeping Your Child Safe

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Children can be wild and intense when monkeying around with their friends or even by themselves. Whether it be on a playground, basketball court, or a park, kids love to play and explore their surroundings. Unfortunately, with this curiosity, inevitably an injury of some sort is bound to happen. The most common being some sort of sprain or strain. Most people believe these two things to be the same. Even though they sound alike, sprains and strains are completely different types of injury – and both are very common in children. Here, we will go over the differences between these two injuries and how your child can avoid them.

What Causes Sprains and Strains?

Sprains happen when a ligament suddenly stretches, twists, or tears. This injury can occur when a child falls or suffers a hit to the body. Sprains often affect the ankles, knees, or wrists.

Strains happen when a muscle or tendon is pulled or torn. This type of injury can happen suddenly, such as when a child overstretches a muscle, in a quick, jerking movement. Or it can happen over time if a child overuses a muscle or tendon. Overuse can occur during activities that require movements that are performed over and over.

Who is at Risk for Sprains and Strains?

Those who are most susceptible are teens that are active, but those who play sports are more at risk for a sprain or a strain. These injuries are not as common in younger children because their growth plates are weaker than the muscles or tendons and are more likely to be injured instead of the ligament.

How are Sprains and Strains Diagnosed?

Your child’s healthcare provider makes the diagnosis with a physical exam. During the exam, he or she will ask about your child’s health history and how the injury happened. They will also find where the pain is to help determine where the injury may be. If this is not enough, your child may need an X-ray, MRI, or CT scan.

How Can My Child Avoid Sprains and Strains?

In most cases, sprains and strains happen in some sort of sports injury or other intense physical activity. They are from either injury or overuse of muscles or joints. Many sports injuries can be prevented by ensuring your child warms up first, trains and conditions properly wears the right protective gear, and uses the right equipment.

You can also help your child prevent overuse injuries by making sure your child sets aside one to two days each week for rest from competitive sports and training and takes breaks from a specific sport during the year. This is extremely important and might be difficult because as we all know, children love playing around, but it is crucial to have them understand that by not resting they are putting themselves at risk for an injury. Also, encourage your child to focus on fun, skill-building, safety, and sportsmanship when playing sports which will lead to a proactive lifestyle and a healthy way of competing.

Sprains & Strains Treatment

Overall, treatment will depend on your child’s symptoms, age, and general health. It will also depend on the severity of the condition. Initial treatment for a sprain or a strain includes rest, ice, compression, and elevation (RICE). Other routes to take would be pain medicines, such as ibuprofen, a splint, cast, a removable walking boot, crutches or wheelchair, physical therapy to stretch and strengthen the injured muscles, ligaments, and tendon, and lastly, surgery. Surgery may not be necessary and is not commonly needed, but occasionally is needed if there is a fracture

Afterthought

In most cases, sprains and strains are not something that should keep you up at night. The recovery time is rather quick and 9 out of 10 times, your child will be back to normal in no time. Still, as a parent, you worry and love your child and would never want to see them in anguish. With that being said, do your best to educate them on the dos and don’ts of safe play and if there does come a time when your little one injures themselves, the professionals at Chai Care will make sure they receive the treatment they need!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.

Playing With Fire: Protecting Your Child From a Burn

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If you play with fire you are going to get burned. As adults, we know this already, most likely from a bad experience, but children have yet to figure this out. Burns are nothing to trifle with and can cause serious damage, which is why it is paramount to stay informed and to teach our youth the danger of playing with fire and the consequences that may ensue.

What are burns?

As you already know, burns are a type of injury caused by heat. Heat can be thermal, electrical, chemical, or electromagnetic energy. Most burn accidents occur at home. Interestingly enough, about 75% of all burn injuries in children are preventable. Scalding is the leading cause of burn injury for children, while smoking and open flames are the leading causes of burn injury for older adults.

We all know what a burn is, but many people don’t know what the most common burns are. First off, there are thermal burns. These burns raise the temperature of the skin and tissue underneath. Thermal burns happen from steam, hot bath water, tipped-over coffee cups, hot foods, cooking fluids, etc. Next, there are radiation burns which happen from exposure to the sun’s ultraviolet rays (a sunburn because the skin isn’t well-protected in the sun) or from radiation such as during an X-ray. Then, there are chemical burns that happen from strong acids (like drain cleaner or button batteries) or spilling chemicals (like bleach) onto the skin or eyes. Lastly, electrical burns. These are from contact with electrical current and can happen from things like biting on electrical cords or sticking fingers or objects in electrical outlets, etc. Knowing the type of burn a child has can help with first-aid measures. All burns should be treated quickly to lower the temperature of the burned area and reduce damage to the skin and tissue underneath.

Types of Burns

Simply put, there are first, second, and third-degree burns—1st being the least significant and 3rd being the most serious.

First-degree burns…

…Also known as superficial burns, burns are the mildest type of burns. They’re limited to the top layer of skin. Signs and symptoms to look out for would be redness, pain, and minor swelling. The skin is dry without blisters. Healing time is about 3–6 days; the superficial skin layer over the burn may peel off in 1 or 2 days.

Second-degree burns…

…Which are a bit more serious. These burns are more serious and involve the top layer of skin and part of the layer below it. The burned area is red and blistered and can swell and be painful. The blisters sometimes break open and the area is wet looking with a bright pink to cherry red color. Healing time varies depending on the severity of the burn. It can take up to 3 weeks or longer.

Third-degree burns…

…Are the most serious type of burn. They involve all layers of the skin and the nerve endings there and may go into underlying tissue. The surface appears dry and can look waxy white, leathery, brown, or charred. There may be little or no pain or the area may feel numb at first because of nerve damage. Healing time depends on the severity of the burn. Most need to be treated with skin grafts, in which healthy skin is taken from another part of the body and surgically placed over the burn wound to help the area heal.

Burn Treatment

Most small, blistering burns can be treated and cared for at home, however taking your little one to your healthcare provider will always be your best bet. If you have any questions about whether a burn can, be taken care of at home, discuss it with your physician. If you do choose to take the home-care route, make sure to cool the burn by running cool running water over the burn for about five minutes. This helps stop the burning process and decreases pain and swelling. Do not put ice on a burn and don’t rub the burn, because this can worsen the injury. Do not break blisters as this can increase the risk of infection at the burn site. Make sure to cover the burned area with a clean bandage that will not stick to the burned site. This helps decrease the risk of infection and decreases pain. Lastly, protect the burn. It’s crucial to keep the burn site clean with gentle washing with soap and water. Do not apply any ointments to the burn site unless instructed by your pediatrician. Never apply butter, greases, or other home remedies to a burn before discussing it with your healthcare provider, as these can increase the risk of infection as well.

If you believe that your child is suffering from a third-degree burn and has blisters larger than 2 inches or full-thickness burns with white or charred skin, go to an emergency department. It is important that before coming in you should cover the burn with a sterile dressing or clean washcloth or towel.

After the Burn

Superficial or mild partial thickness burns hurt for about two days and peel like a sunburn in about a week. These burns shouldn’t leave a scar if managed correctly. If the burn is open, your child will need a tetanus booster if it has been more than five years since his/her last tetanus shot, your child has had less than three tetanus shots in his/her lifetime, or if you’re not sure when your child had a tetanus shot last. Your child should get this shot from your pediatrician within three days of the burn. Call your healthcare provider immediately if your child’s burn looks infected. Symptoms include a large red area or streak larger than 2 inches around the burn. A fever may or may not be present. If there is increased redness or notice any signs of infection, bring your child to Chai Care and our top-notch staff will gladly take care of your little one!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.

Men’s Health: Strong, Fit, and Sexy

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It is no secret that men take great pride in being perceived as tough. What does this mean? Providing for their family, being mentally strong, and being confident—adult men put immense pressure on themselves to be the best versions of themselves but ironically, are not willing to do as much as they should.

According to leading experts, most men avoid going to the doctor. As silly as it may sound, these men would rather silently suffer or choose to believe that they can figure it out on their own, rather than taking a simple visit to a doctor. This is not only an unhealthy approach but is also not necessary. It is counter-productive to not utilize healthcare providers and physicians who can help supply proactive information on how to live a healthy lifestyle. It’s important to stay informed to live your best overall life – whether that be nutrition, exercise, or mental health.

Staying Informed About Men’s Health

Believe it or not, men die on average five years earlier than women. This may be due to the fact that men are typically more dangerous and bolder in their decision-making. This isn’t to say that taking a risk is a bad thing, just that men tend to neglect their health and at times ignore their own well-being, telling themselves they will eventually figure it out. However, the top three causes of death for men are (in order), heart (cardiovascular) disease, cancer, and unintentional injury. Besides suffering from an unintentional injury, this is crucial to know because if you monitor your health and make thoughtful decisions, the chances of you living a longer and healthier life drastically increase.

On the bright side, once these facts come to light, one can start their journey to recovery and begin to get their health back on track. Those modifications can come through proper diet, simple lifestyle changes, and if necessary, medical or surgical intervention. There is a great opportunity to improve lifestyle habits in many men. In the United States alone, men self-report numerous risk factors for poor health, which include smoking, obesity, binge alcohol drinking, and not exercising. Improvements in these areas will add years on to a man’s life and will improve mental health as well. Furthermore, social factors that may have a negative impact on health are serving in the armed forces, incarceration, and high-risk jobs such as construction, mining, and shipping. Men should be counseled about the potential employment-related hazards they may encounter in these and other jobs.

Nutrition For Men’s Health

The simplest and best thing a man can do for themselves is eating clean. Yes, we all love a greasy cheeseburger and an ice-cold beer but in the long run, the key to a healthy lifestyle is feeding yourself food that your body actually wants!

There is a reason why you feel groggy and sluggish after a fat-filled dinner—it’s your body rejecting it and telling you that it would rather have something else. There is always going to be a certain vegetable or protein that you don’t want to eat. The great thing is we now live in a world where there is essentially an alternative to everything, allowing you to still indulge in your favorite guilty pleasures.

Dieting isn’t easy and for most men, it can be an excruciating battle. It’s hard to say no to a slice of pizza and not engage in “Taco Tuesday,” but when you lack good health, everything else suffers. Those extra calories are going to slow you down, you will have a harder time concentrating, and will even make you grumpy.

The key is to reward yourself, but only if you put in the work. There is nothing wrong with having a soda or eating a dozen chicken wings as you watch a football game, but doing this every day, that’s where you’re going to run into trouble. Most of your meals should consist of lean protein, organic vegetables, little carbs, and a lot of water. Boring? Of course, it is! But the results will have you feeling energetic and ready to take on the world.

A good strategy to take is setting a day where you know that you are going to want to lounge around all day and binge on your favorite foods—typically on the weekend. Life is meant to be enjoyed and part of the many pleasures we experience comes from a tasty meal. As good as it would be to eat these sugar-filled treats and salty snacks, the hard truth is that it is simply not doable. Setting a day where you do treat yourself will not only allow you to munch on your favorite foods, but it will also help teach the valuable lesson of discipline.

Exercising For Men

For some, clean eating is the tricky part and for others it is exercise. In today’s fast-paced world filled with social media and ten-second video clips, it is easy to feel uninspired when you check your phone only to witness how hard someone else is working which in turn will make you feel as if you are falling behind. There is no point in comparing yourself to how hard or little someone else works because they aren’t you and are not going through the same trials and tribulations. It’s best to stay in your own lane and figure out what works best for you.

Whether you enjoy working out in the gym or at home, the key is to just do it (Nike has a point)!. It’s so easy to say that you’ll start tomorrow. Tomorrow then becomes the weekend, that becomes next Tuesday, then suddenly, a month goes by, and you haven’t exercised a single day. No one expects you to work out like a professional athlete. Whether it be walking around the block for 30 minutes a day, or signing up for CrossFit, exercise is not only great for your body but your mind too. This is a time to be alone with your thoughts and listen to your favorite band or podcast, all the while giving your body what it truly needs.

Even though social media can be a distraction, it is also an amazing place to find information. Nowadays, you don’t even need a personal trainer because, with a few flicks of your thumb, you can find an expert who can give you quick and reliable information on how to get in shape. The best part is a lot of these people create exercises that you can do right from the comfort of your home!

Afterthought

No one said dieting and eating healthy is easy, but that is why it is so rewarding. It is a testament to yourself, a way of proving that through hard work and dedication, you can accomplish something that most men struggle with. The key is to be consistent and not allow yourself to fall victim to your guilty pleasures. There are many ways to stay active without “exercising.” Playing sports with your friends, taking long walks, and even certain interactive video games are awesome ways of being active without the intimidating need to enter a gym. Even though junk food and certain fast food options may seem more affordable, there are simple ways to eat clean without breaking the bank.

Getting started is difficult, but in the end, this journey is worth it. You will feel better, be a kinder person, and will drastically increase your health so you can spend more time with your loved ones. The time for excuses is over. No more saying tomorrow or that you are too busy. Look, we’re all busy and all have other things going on in our lives, but fortunately, the staff at Chai Care can supply you with healthy tips and methods on how to get your life back on track!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.