Lump Behind the Ear in Someone with Down Syndrome: Causes
Parents of those with Down syndrome may be very concerned upon discovering a lump behind the ear of their child (or adult with this genetic condition).
“I have not specifically heard about an isolated lump behind the ear in Down’s patients.,” says Dr. Stacey Silvers, MD, of Madison ENT & Facial Plastic Surgery in NYC, who is board certified in otolaryngology (ear, nose and throat specialty).
“However, an enlarged postauricular lymph node, like most others, is an inflammatory response.”
The postauricular lymph node is located behind the ears.
The function of a lymph node is to drain lymphatic fluid, and those located behind the ears are responsible for draining the fluid from the head and neck.
Dr. Silvers continues, “Down’s patients are more prone to ear infections and upper respiratory infections due to their variations in head and neck anatomy and palatal muscle tone.
This makes Down’s patients more prone to infection, as their anatomical protective mechanisms don’t function as well.
Therefore, the more infections, the more lymph nodes will react and therefore enlarge.”
An infected lymph node is usually, but not always, tender or uncomfortable upon being touched.
“As ear infections are quite common, most Down’s patients require multiple sets of ventilating ear tubes in their lives,” continues Dr. Silvers.
“A chronically inflamed postauricular lymph node may be expected.”
An NYC expert in ear, nose and throat care, Dr. Silvers has been named among America’s Top Physicians and Surgeons in facial plastic surgery and otolaryngology numerous times since 2003.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Wearing a Mask During Intense or Heavy Deadlifts: Guidelines
You don’t know what it’s like to wear a mask while working out until you do a 5 x 5 RM deadlift. It’s not pretty, but it’s doable. Here are guidelines.
I had to try three different kinds of masks before I found one that fit halfway decently and didn’t irritate the area under my eye.
After about three months of lifting weights at home when gyms were closed, I finally got back into the gym.
Few people were wearing a mask (before mandates). I was one of those few.
It was a no-brainer; wear the mask for the entire workout, including 5 x 5 RM deadlifts – which was my first routine on back day, and they were intense and heavy.
What Deadlifting Feels Like with a Mask
It made me think of what people with COPD probably feel like when lightly strength training or, in more severe cases, when walking across a room.
COPD stands for chronic obstructive pulmonary disease.
I also wondered if the feeling was similar to what someone with chronic heart failure feels like.
People with COPD and heart failure aren’t the people you’ll find doing deadlifts.
But it’s food for thought: Wearing a mask while lifting heavy shorts you on oxygen. You’ll be breathing noticeably harder. And I’m referring to wearing the mask OVER your nose, not just over your mouth.
Your mask may get sucked into your face with each deep breath following an intense set. Rather than remove it, lightly pull it out a bit while catching your breath.
Another optiion: After completing each max set, steal away to a corner (rather than near people or in a heavily trafficked area), pull the mask down and gulp air for 30 to 45 seconds.
As time goes on with subsequent gym visits, you’ll find you’ll no longer need to pull the mask off to catch your breath; you’ll be able to do it with it fully on.
But this also depends on the thickness of the mask (mine is thicker than the common blue disposable ones).
It was only after deadlifting 5 RM that I had to (initially) pull down the mask (I soon adapted and only pulled it out to recapture my breath while it was still over my nose).
I had no problem keeping it on while recovering from other movements such as the leg press, tire squats, heavy dumbbell squats and incline barbell press.
The mask did NOT reduce my lifting capacity for any strength training including the 5 x 5 RM deadlft. I killed it my first day back at the gym! You can too with a mask!
Another way to describe deadlifting heavy while wearing a mask is that the feeling is perhaps pretty close to what it’d be if working out at an altitude 2,000 feet higher than what you’re used to.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Freepik.com, 8photo copper wear mask
When Joint Replacement Surgery Causes a Pulmonary Embolism
What happens when a pulmonary embolism forms after joint replacement surgery?
A piece of a deep vein thrombosis, postop, can break off, travel to the lungs and suffocate the patient.
Joint replacement surgery is a major risk factor for a blood clot that travels to the lungs and becomes a pulmonary embolism, so how is this diagnosed accurately?
Diagnosis of a Pulmonary Embolism After Joint Replacement
“A PE is usually diagnosed with clinical signs, symptoms and radiologic studies,” says Henry Boucher, MD, clinical instructor of Adult Reconstruction, Medstar Union Memorial Orthopaedics, Baltimore, MD.
“Patients may complain of shortness of breath and or chest discomfort,” continues Dr. Boucher.
“Their oxygen saturation level may decline and they may have an elevated heart rate and respiratory rate.”
The joint replacement patient (as well as other surgery patients) are monitored for oxygen intake.
If it dips below a certain level, this triggers a sound alert to medical staff.
“Usually a pulmonary embolism is confirmed by a CT scan or ventilation perfusion scan,” says Dr. Boucher.
What about why joint replacement surgery patients are not routinely placed on telemetry to monitor for cardiac disturbances that can result from a pulmonary embolism — which, from a mathematical standpoint, kills one person every six minutes in the U.S.
Dr. Boucher explains, “Most patients are not routinely placed on telemetry unless there is a cardiac issue, and telemetry itself is not indicated for the routine joint replacement patient for the purpose of early identification of a PE.”
He adds, “Pulmonary emboli can vary in size and many can be asymptomatic or have few outward clinical signs.
“However, a large PE (i.e., saddle embolism) can be rapidly fatal without warning or treatment; fortunately these are uncommon.”
Dr. Boucher’s specialties are hip and knee surgery, replacement and revision, and sports medicine surgery. He has been the recipient of the Golden Apple Award for teaching excellence multiple times.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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