What is cardiomyopathy?

Cardiomyopathy is a disease of the muscles in the heart. It causes your heart muscles to become enlarged. The extra thickness and stiffness of the muscles can weaken your heart over time. A weak heart cannot pump blood easily. When your heart has difficulty pumping blood, it can cause irregular heartbeat. It can also cause heart valves problems and even heart failure. People of all ages and races can have cardiomyopathy.

There are various types of cardiomyopathy. They include:

• Dilated cardiomyopathy (enlarged ventricles of the heart; common in men and children)
• Hypertrophic cardiomyopathy (thickened heart muscle; presents in early childhood or early adulthood; often inherited and can be fatal)
• Restrictive cardiomyopathy (stiff or scarred heart muscle; inherited and common in men)
• Arrhythmogenic right ventricular dysplasia (inherited and common in men)
• Transthyretin amyloid cardiomyopathy (ATTR-CM) (a rare type involving protein deposits)

Symptoms of cardiomyopathy

Symptoms of cardiomyopathy may be the same as the symptoms of heart failure. These include:

• Shortness of breath
• Fatigue
• Coughing
• Trouble breathing, especially while lying down
• Edema(swelling) of the feet, ankles, and legs
• Abdominal bloating
• Chest pain
• Dizziness, lightheadedness, and fainting
• Palpitations

What causes cardiomyopathy?

Cardiomyopathy can have many causes. It may be caused by:

• Coronary artery disease (blocked arteries)
• High blood pressure
• Infections (particularly certain viruses)
• Certain medicines
• Diabetes
• Thyroid disorders
• Alcohol abuse

Rarely, cardiomyopathy can happen during the last trimester of pregnancy or the first few months after having a baby.

How is cardiomyopathy diagnosed?

Your doctor will ask about your personal and family medical history. It is important to tell your doctor if someone in your family has cardiomyopathy or another form of heart disease. Some of these conditions can run in families. Your doctor may do tests to see if you are at risk.

Your doctor will also examine you. They may perform some tests on your heart and blood.

Can cardiomyopathy be prevented or avoided?

Cardiomyopathy can be inherited (it runs in families). You cannot prevent this type of cardiomyopathy. But you can make healthy lifestyle choices to reduce your risk of complications associated with cardiomyopathy.

You can also develop cardiomyopathy as the result of another disease or condition. Sometimes early treatment of that disease can help prevent you from developing cardiomyopathy. Managing your chronic health conditions, such as diabetes or high blood pressure, can reduce your risk of cardiomyopathy.

Even though you can’t always prevent cardiomyopathy, you can do things to make it less likely that you’ll have complications related to the disease. According to the National Heart, Lung, and Blood Institute, you should:

• Avoid using alcohol and illegal drugs.
• Get enough sleep and rest.
• Choose heart-healthy foods.
• Exercise or be physically active.
• Quit smoking.
• Manage stress.

Cardiomyopathy treatment

Treatment depends on the cause of the cardiomyopathy. For example, if you have high blood pressure, your doctor may prescribe medicine to help control it.

If you smoke or drink alcohol, your doctor will probably advise you to quit. You may need to lose weight if you are overweight or obese. Physical activity is an important part of a healthy lifestyle. However, you should check with your doctor before starting an exercise program.

Your doctor may prescribe medicine to treat cardiomyopathy. They may also suggest that you eat less than 2,300 mg of salt or less per day. Sodium intake is linked to high blood pressure and heart disease.

If you have significant heart failure, you may need a small device that is like a pacemaker to help your heart work correctly. You will need surgery to place the device in your body.

In serious cases, a person who has cardiomyopathy may need a heart transplant. A cardiologist (heart specialist) can help you and your doctor make that decision.

Living with cardiomyopathy

Some people who have cardiomyopathy have mild symptoms or no symptoms at all. If you fall into this category, you may not need treatment. Talk to your doctor about monitoring your disease.

If you have moderate or severe symptoms, work with your doctor to control them. Make recommended lifestyle changes. Take medicines as prescribed by your doctor. Doing these things can help control your symptoms and even prevent the disease from getting worse.

Questions to ask your doctor

• What is the likely cause of my cardiomyopathy?
• If another condition is causing my cardiomyopathy, will treating that condition cure me of my symptoms?
• What is the best treatment for me? Medicine? Surgery?
• Do I need to make any lifestyle changes?
• Am I at risk of heart failure?
• Will I need a heart transplant?

Resources

American Heart Association: Cardiomyopathy

Centers for Disease Control and Prevention: Cardiomyopathy

National Heart, Lung, and Blood Institute: Cardiomyopathy

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What is glaucoma?

Glaucoma is an eye disease that may cause loss of vision. It usually happens when fluid builds up in the eye, causing an increase in pressure. This damages the eye’s optic nerve.

Symptoms

At first, glaucoma has no symptoms. It causes no pain and your vision is normal. Eventually, without treatment, you will start losing your peripheral (side) vision. You might miss seeing objects out of the corner of your eye. Over time, it will seem like you’re looking through a tunnel. If your glaucoma is left untreated, your vision may gradually decrease until it is completely gone.

Many people who have glaucoma aren’t aware they have the disease. By the time they notice loss of vision, the eye damage is severe.

Rarely, an individual will have an acute (sudden or short-term) attack of glaucoma. In these cases, the eye becomes red and extremely painful. Nausea, vomiting, and blurred vision may also occur. This is an eye emergency. Call your eye doctor right away if you experience these symptoms.

What causes glaucoma?

Normally, fluid in your eye nourishes the eye and keeps it healthy. After the fluid circulates through the eye, it empties through a drain in the front of your eye. In people who have glaucoma, the fluid doesn’t drain properly. Instead, it builds up and causes increased pressure in the eye and damages the optic nerve.

How is glaucoma diagnosed?

Glaucoma is usually diagnosed by an optometrist or ophthalmologist. These are people specially trained to provide care for eyes. They will give you a complete eye exam, including tests that can diagnose glaucoma. The tests include:

• Visual acuity test: This measures how well you see at different distances.
• Visual field test: This measures your peripheral vision.
• Dilated eye exam: This allows your eye doctor to examine your retina and optic nerve for signs of damage or other eye problems.
• Tonometry: This measures the pressure inside the eye.
• Pachymetry: This measures the thickness of your cornea (the outer layer of your eye).

Can glaucoma be prevented or avoided?

Some people are at a higher risk of developing glaucoma. They include people who:

• Are 40 years of age or older
• Have a family history of glaucoma
• Have high pressure in the eyes
• Have diabetes
• Have hypertension
• Have heart disease
• Have near-sightedness (it is difficult for you to see objects in the distance)

There’s nothing you can do to avoid getting glaucoma. But you can prevent it from having a big impact on your vision. The best way to do this is by getting an eye exam regularly by an optometrist or ophthalmologist. People 18 to 60 years of age should have an eye exam every 2 years. After age 60, you should have an eye exam once a year.

If you have diabetes, hypertension, or heart disease, follow your doctor’s instructions for managing and controlling those conditions to reduce your risk of glaucoma.

Early diagnosis and treatment of glaucoma can prevent damage to the eye’s nerve cells and prevent severe vision loss.

Glaucoma treatment

There are several treatment options for glaucoma. The first treatment option usually is either medicated eye drops or pills. These aim to lower the pressure in your eye, prevent further nerve damage, and stop vision loss. This treatment works for many people. Keep in mind it may be hard to remember to take your medicine. That’s because glaucoma often doesn’t cause symptoms. But it’s important to take it as your doctor prescribed.

If the eye drops or pills don’t help relieve the pressure in your eye, your doctor may suggest laser treatment. During this procedure, a laser is used to open the drain where fluid flows out of your eye. It’s a painless procedure. If that procedure doesn’t work, you may need surgery to create a new channel where fluid can flow out of your eye. Talk with your doctor about the best option for you.

Living with glaucoma

If your glaucoma is caught and treated early, you might not notice any difference in your vision. You can lead a normal life with no symptoms, as long as you take your medicine every day. Your eye doctor will likely want to see you every 3 to 6 months for a check-up.

If you have lost some of your vision, talk to your eye doctor. They may be able to suggest some services or devices that can help you make the most of your remaining vision. Also, community agencies may offer counseling, training, or other special services for people who have impaired vision.

Questions for your doctor

• What is the right treatment for me?
• Will I have to continue my treatment for the rest of my life?
• Does this treatment have any side effects?
• Is surgery an option for me? Will I need to use eye drops after surgery?
• Should I continue to drive?
• Can I continue with my current activities?
• Are there any lifestyle changes I should make?
• What’s the difference between an optometrist and an ophthalmologist?
• Will my glaucoma get worse?

Resources

Centers for Disease Control and Prevention: Don’t Let Glaucoma Steal Your Sight!

National Institutes of Health, MedlinePlus: Glaucoma

National Institutes of Health, National Eye Institute: Glaucoma

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Bonding is a special connection you have with your baby. Bonding with your baby is not a one-time event. It is a process that takes time. For some people, bonding begins at birth. For other people, it can start several weeks later.

Babies rely on their parents for all care. A lot of bonding happens while you’re providing your baby’s basic needs. You may become emotional or have feelings of joy and relief.

Why is bonding important?

Your baby’s bond with you is the first they have with anyone. They begin to form trust, security, and confidence. Lack of bonding has effects on both you and your baby. You might not have deep feelings of closeness. You both might struggle with self-esteem. They could have a hard time forming future bonds. It also could slow your baby’s mental or social growth.

Try not to focus on what you think is normal. Each child and bonding experience is unique. Talk to your doctor if you are worried about bonding or how your child is developing.

Path to better bonding

Bonding with your baby is a process. It even can start during pregnancy. You can connect to your baby by talking to them in the womb. You interact with them when they kick your stomach. Partners should be in the delivery room and visit your baby in the nursery after birth. You also can ask your doctor to share a hospital room with your baby.

Certain everyday events lend themselves to bonding. You spend time with your baby during feedings, baths, and diaper changes. You also sleep near your baby. You can have a separate crib in your room or one that attaches to your bed. It is important not to put your baby in your bed. It puts the baby at risk for sleep-related deaths.

There are other ways to promote bonding. Some babies, like premature ones, need extra movement. Infant massage can help increase flow and relax nerves. Be careful because newborns are growing and might be fragile. Talk to your doctor and educate yourself before trying a massage.

You also can include your baby in daily activities. Wear them in an approved carrier while running errands. Place them in a seat so they can watch you doing chores or working.

Communication

You are getting to know your newborn as much as they are getting to know you. Babies can’t talk, but there are other ways to communicate. Their senses, like touch and sound, are sensitive. Doctors recommend moms and dads have skin-to-skin contact with their baby. You can stroke their skin or give them kisses. Take turns holding, cradling, and rocking your baby. Assist your baby to feel your hair and face, and other things around them.

As your baby’s eyes adjust, they will make better eye contact with you. They will start to watch you and copy your moves and looks. Your voice also is a big part of bonding. Babies react to different voices and tones. Calm and happy voices tend to be soothing. Loud, harsh voices make babies anxious.

Your baby’s first verbal response is crying. This is how they tell you they need something. Sometimes, it might seem like all they do is cry. Babies respond differently, so take time to learn. You might find that certain types of crying mean certain things. One type of cry means they are hungry. Another type means they need a diaper change. They might cry if they get scared, and all it takes is your voice to calm them.

You always should respond to your baby’s cries, even if you don’t know why they’re crying or what they need. This aids in the bonding process. Your baby will learn to trust you. You will feel proud and happy for protecting your baby. It is impossible to “spoil” you baby in the first few months of life.

Once your baby is 2 to 3 months old, their responses will improve. They will recognize your touch, voice, and face. Your baby might copy what you do, like smile or laugh. You will start to see their personality. The more time they spend awake, the more alert and curious they become. This gives you more time to interact with your baby.

Play

You should practice talking, reading, and singing to your baby. Begin to play with them more one-on-one and with toys. They also will begin to learn and explore all sorts of new things. You’ll get to watch your baby find their hands and feet, and hear all the sounds they can make. All of these things help your baby learn and grow.

Encourage types of play, such as:

• Tummy time. According to the National Institute of Child Health and Human Development (NICHD), you can do this 2 to 3 times a day. Start with short periods of 3 to 5 minutes and increase as your baby grows. Tummy time strengthens muscles and promotes movement. It also helps prevent flat spots on your baby’s head. Always watch your baby during tummy time. You also can engage in tummy time alongside your baby. Only practice this when your baby is awake, like after a nap or diaper change. Do not put them on their tummy when they are sleeping. This increases the risk of sudden infant death syndrome (SIDS).
• Educational toys. Provide age-specific toys that engage their senses. Try out different colors, textures, and sounds. Allow them to focus and explore. Be careful not to overdo it at one time. Never leave your child alone with any toys.
• Movement exercises. You can practice certain motions with your baby. Practice clapping their hands together. Do stretches with their arms and legs. Dance and move with them while you sing or talk.

Things to consider

Some things can delay or prevent bonding, such as:

• Painful or difficult delivery.
• Multiple babies at once or other children.
• Premature birth or baby with health issues. It can be hard to bond with your baby when they need to stay in the hospital. Or they might have a device or condition that acts as a barrier. Work with your doctor and hospital staff on other ways to bond with your baby.
• Adoption or foster care. It might seem harder to bond with your baby if you didn’t carry and deliver them. Bonding is not related to genes. It might just take extra time to get to know and bond with them.
• Hormonal changes or emotional issues. Some people suffer from postpartum depression after giving birth and need medical help.

None of these suggest you are a bad parent. In fact, you are doing great by providing your baby’s basic needs. You can get creative on how to interact with your baby. Maybe they like something different or new. Try not to get down if it takes longer than you thought it would. Consult your doctor for advice if you are worried.

When to see your doctor

Talk to your doctor if you are struggling to bond with your baby. You might have symptoms that point to postpartum depression. Your doctor can prescribe medicine or suggest joining a new parent class or group. It can help to meet and talk with parents who are going through the same thing as you.

You also can contact your doctor if your baby’s crying seems unnatural. Most of the time nothing is wrong, but your doctor can help. If you notice crying that leads to uneven breathing, low motion, or poor eating, your baby might be sick. The doctor will check for fever, pain, or other health issues.

Questions to ask your doctor

• How can I bond with my baby during pregnancy?
• Can my baby hear and feel me when they are in the womb?
• What can I do if my baby bonds with one parent more than the other?
• What is the “cry it out” method and should I use it?
• Can I spoil my baby by responding to their crying too much?

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