Most of us saw the gut-wrenching coverage this past week of the student athlete in MI who collapsed on the basketball court moments after hitting the game winning shot for his highschool basketball team, and died later at the hospital. It turns out that he had an undiagnosed heart condition, known as dilated cardiomyopathy. I'm not sure how it's possible to read something like that, if you're a parent, and not have a visceral reaction to it. It's every parent's worst nightmare. Inevitably, discussions ensue in the aftermath of something like this, going back and forth about whether something could have been done to prevent it. Was there some way his physician should have known? Were there warning signs? Should everyone with children involved in sports be concerned? How do I know if my child has silent heart disease?
These exact questions have been the center of much controversy in the pediatric and pedatric cardiology fields around the world. Some countries, like Italy, have mandated universal screening with a 12-lead EKG before sports participation. Other countries, like Denmark, have conducted studies looking at whether a universal screening program would be effective in reducing deaths, and have found no proven benefit. The most recent, and comprehensive study to date, done in Israel, addressed this again, and found no proven benefit to a universal screening program. For anyone interested, here is a link to the study details:
http://www.medscape.com/viewarticle/738577?src=mpnews&spon=9
I am curious to get some parent feeback about thoughts, opinions, and comments regarding this controversy. Currently in the U.S., the standard of care is pre-participation screening with a history and physical only. Share your opinions about whether or not you think universal EKG screening should be mandated in the U.S.
Friday, March 11, 2011
Thursday, March 10, 2011
There are only a few absolutes in this life...
...and one of them is that fevers, vomiting, and ear infections in kids always have a nack for showing up after 5pm! After leaving the home of one very sweet little boy tonight, who's late-night ear ache was yet one more piece of evidence supporting my theory, I was inspired to post a few things about ear infections. Here you go:
- The #1 sign of an ear infection in a verbal-aged child? The complaint of isolated ear pain. That may sound ridiculously obvious, but it's absolutely true. A cold can cause some ear plugging and pressure, but there's usually no difference between sides. An ear infection, however, tends to cause severe pain, isolated to the side of the infection, often so severe that the child awakens from sleep in tears. One little girl I saw recently described the pain as something "drilling in my ear." If you're an adult who has had one of these gems of an infection any time recently, you can appreciate how spot-on that little girl was with her description of how awful the pain is.
- The #1 sign of an ear infection in a pre-verbal child? It's anybody's guess. That's not a lie. Ear tugging, fussiness, fever, decreased appetite - none of these symptoms are reliable indicators of an ear infection - it's impossible to predict without having their eardrums examined. There are also always those stories of people who's children are examined for an entirely different reason, and are found to have an ear infection, much to their shock and amazement. It happens!
- Risk factors for repeated ear infections include: age under 2, having family members who smoke, being in group daycare, bottle-propping, and poorly controlled allergies.
- Treatment of ear infections in a pre-verbal child consists of a standard course of antibiotics. For older children, if the pain is mild and manageable with OTC pain-relievers, it's perfectly acceptable to watch and wait without giving antibiotics. The theory here, is that if a child is verbal enough to reliably localize and express their pain, they'll be able to tell you if it's getting worse, in which case you could start the antibiotic at that point. Not everyone chooses to go that route, though, and depending on the severity of the infection, the child's previous history, and other factors, your doctor may choose to treat your older child's ear infection with an antibiotic immediately, instead of waiting.
For more information on ear infections, here's a link to a more in-depth article:
http://www.parents.com/baby/health/ear-infection/what-you-need-to-know-about-ear-infections/?page=3
- The #1 sign of an ear infection in a verbal-aged child? The complaint of isolated ear pain. That may sound ridiculously obvious, but it's absolutely true. A cold can cause some ear plugging and pressure, but there's usually no difference between sides. An ear infection, however, tends to cause severe pain, isolated to the side of the infection, often so severe that the child awakens from sleep in tears. One little girl I saw recently described the pain as something "drilling in my ear." If you're an adult who has had one of these gems of an infection any time recently, you can appreciate how spot-on that little girl was with her description of how awful the pain is.
- The #1 sign of an ear infection in a pre-verbal child? It's anybody's guess. That's not a lie. Ear tugging, fussiness, fever, decreased appetite - none of these symptoms are reliable indicators of an ear infection - it's impossible to predict without having their eardrums examined. There are also always those stories of people who's children are examined for an entirely different reason, and are found to have an ear infection, much to their shock and amazement. It happens!
- Risk factors for repeated ear infections include: age under 2, having family members who smoke, being in group daycare, bottle-propping, and poorly controlled allergies.
- Treatment of ear infections in a pre-verbal child consists of a standard course of antibiotics. For older children, if the pain is mild and manageable with OTC pain-relievers, it's perfectly acceptable to watch and wait without giving antibiotics. The theory here, is that if a child is verbal enough to reliably localize and express their pain, they'll be able to tell you if it's getting worse, in which case you could start the antibiotic at that point. Not everyone chooses to go that route, though, and depending on the severity of the infection, the child's previous history, and other factors, your doctor may choose to treat your older child's ear infection with an antibiotic immediately, instead of waiting.
For more information on ear infections, here's a link to a more in-depth article:
http://www.parents.com/baby/health/ear-infection/what-you-need-to-know-about-ear-infections/?page=3
Wednesday, March 9, 2011
Clean eating!
Since I'm on the topic of healthy eating, I wanted to share a list of fruits and vegetables that historically have lower pesticides used in the growing process. "Organic" and "Pesticide-free" aren't always the most affordable choices in the supermarket, and if you shop at bulk-membership warehouses (like I do, and most of my friends with multiple kids do), those can be hard to find! Here's a list of ones that you can feel good about, regardless of their label:
1. onions
2. avacado
3. sweet corn
4. pineapple
5. mangos
6. sweet peas
7. cabbage
8. kiwi
9. asparagus
10. canteloupe
11. watermelon
12. eggplant
13. sweet potato
14. grapefruit
15. honeydew
Hope you find this list helpful - there's something from just about every season, so happy clean eating!
1. onions
2. avacado
3. sweet corn
4. pineapple
5. mangos
6. sweet peas
7. cabbage
8. kiwi
9. asparagus
10. canteloupe
11. watermelon
12. eggplant
13. sweet potato
14. grapefruit
15. honeydew
Hope you find this list helpful - there's something from just about every season, so happy clean eating!
Monday, March 7, 2011
Jamie Oliver - Where are you...
when I need you??!! Before bed last night, my 8-year old daughter begged me to let her buy school cafeteria lunch today. "I haven't bought lunch since before Christmas!" she declared. Knowing that was true, I caved, and gave her the okay, but as soon as I did, all I could picture in my head was that frightening food the cafeteria labels as "trail mix." The first few times she came home last year and told me she had "trail mix" at lunch, I have to admit, I was kind of impressed. Trail mix seems like a pretty forward-thinking good protein-packed snack to be offered in a school cafeteria. Even more impressive, was the fact that my daughter had reportedly chosen this, over, say, a chocolate chip cookie. Patting myself on the back for raising such a good eater, I spent the next several weeks in blissful ignorance, until...
I discovered that "trail mix" was actually a little plastic cup filled with marshmallows and froot loops, and maybe a raisin or two thrown in there to make it look good! If you're a parent of an elementary-aged child, join with me in screaming out loud a collective, "WHAT???!!!"
And, so began my distrust of the school lunch menu and my general suspicion that things like "milk", "chicken", or "green beans" might actually be code for other things! So, this morning, I did what any other self-respecting parent would do, and served her a healthy breakfast of fruit and oatmeal, as if that would somehow cancel out what she'll be eating in just a few hours from now. Ahhhhhhhh!
So, with that in mind, I turn back to Jamie Oliver, renowned chef and host of "Food Revolution" (which by the way filmed in Huntington, WV, very close to where I grew up in WV), for some good tips on keeping things healthy in your family kitchen. These tips come from an interview he gave to MSN recently, so in case you didn't catch it, here you go:
1. De-clutter your kitchen - allow it to be the space that it was intended to be, where you prepare food. Don't fall into the trap of having your kitchen be the free-for-all space where you can find anything and everything except the cutting board.
2. If you don't want your family eating it, don't buy it!! I've been saying this one for years! If you don't want your kids to have sugary snacks and chips, don't buy them, put them on the shelf, and then expect them not to crave them!
3. If you don't know how to cook, spend some time learning a few simple cooking technique from a friend, family member, or neighbor who does know how to cook! Healthy foods aren't hard to prepare, but you do have to prepare them (as opposed to most unhealthy foods that come conveniently pre-packaged and require almost no cooking skills.
4. Have a goal to cook fresh foods at least once a week.
5. Teach your kids about the dangers of unhealthy foods now. What good does it do us as parents to hound them about wearing their bike helmet, if we let them come inside when they're done and pound down a bag of chips that's going to lead to things like obesity, heart disease, and diabetes on down the road!
If you'd like to sign Jamie Oliver's petition to improve the condition of school lunch in your area, click the link below!
http://www.jamieoliver.com/campaigns/jamies-food-revolution/petition
I discovered that "trail mix" was actually a little plastic cup filled with marshmallows and froot loops, and maybe a raisin or two thrown in there to make it look good! If you're a parent of an elementary-aged child, join with me in screaming out loud a collective, "WHAT???!!!"
And, so began my distrust of the school lunch menu and my general suspicion that things like "milk", "chicken", or "green beans" might actually be code for other things! So, this morning, I did what any other self-respecting parent would do, and served her a healthy breakfast of fruit and oatmeal, as if that would somehow cancel out what she'll be eating in just a few hours from now. Ahhhhhhhh!
So, with that in mind, I turn back to Jamie Oliver, renowned chef and host of "Food Revolution" (which by the way filmed in Huntington, WV, very close to where I grew up in WV), for some good tips on keeping things healthy in your family kitchen. These tips come from an interview he gave to MSN recently, so in case you didn't catch it, here you go:
1. De-clutter your kitchen - allow it to be the space that it was intended to be, where you prepare food. Don't fall into the trap of having your kitchen be the free-for-all space where you can find anything and everything except the cutting board.
2. If you don't want your family eating it, don't buy it!! I've been saying this one for years! If you don't want your kids to have sugary snacks and chips, don't buy them, put them on the shelf, and then expect them not to crave them!
3. If you don't know how to cook, spend some time learning a few simple cooking technique from a friend, family member, or neighbor who does know how to cook! Healthy foods aren't hard to prepare, but you do have to prepare them (as opposed to most unhealthy foods that come conveniently pre-packaged and require almost no cooking skills.
4. Have a goal to cook fresh foods at least once a week.
5. Teach your kids about the dangers of unhealthy foods now. What good does it do us as parents to hound them about wearing their bike helmet, if we let them come inside when they're done and pound down a bag of chips that's going to lead to things like obesity, heart disease, and diabetes on down the road!
If you'd like to sign Jamie Oliver's petition to improve the condition of school lunch in your area, click the link below!
http://www.jamieoliver.com/campaigns/jamies-food-revolution/petition
Friday, March 4, 2011
"In the great green room, there was a telephone, and a red balloon...
...and a picture of the cow jumping over the moon." Who doesn't have the entire Goodnight Moon book memorized??!! There was a time in my early mommy years when I thought I might never be able to go for a run again without inadvertantly having those hypnotizing words pop into my head and play over and over and over! (Now it's the lyrics to Justin Bieber songs, but I digress...)
I read an interesting study this morning out of Loyola University Health Systems talking about the impact of reading on childhood development. It's no big secret that reading to children is good for their cognitive development, but what was interesting was how they were able to break it down by age-group and derived benefit. For example, they found that for infants, parents reading to them is a very valuable experience, but it turns out it's not so much what you read, as how you read it. Have an important work report that you are saddled with, but suffering from the mommy-guilt that we all suffer from - you know, the guilt that you're not spending quality time with your infant when you're home in the evenings? No worries - just read that work report out loud, in a sing-songy voice, and your baby will love it just as much! As babies morph into toddlers, they love faces, so books with pictures of other babies, children, and even adults are always favorites. A photo album will even do, as long as you narrate the pictures that you're looking at. Narration and interactive reading, where you point to pictures, ask your child questions, and have dialogue mixed in the middle of reading, have been found to be extremely beneficial to children's language development. So, if you're a Type A Personality, like me, you're just going to have to get over the fact that interruptions mid-sentence are part of the process! Your kids may even (gasp) want to shut the book and get a new one after you've only read the first two pages! It's not a sign of ADHD...it's a sign that they're enjoying books, and wanting a rich literary experience! As children move through the toddler stage, they love repetition. Hence, the Goodnight Moon reference. If they want to read the same book over and over again, don't worry that they're not getting exposed to enough variety. It's very normal for them to want to read the same book every night for two weeks in a row. Go ahead and just surrender to the fact that you'll always be able to finish those words by heart:
"....goodnight stars, goodnight air, goodnight noises everywhere."
A group that's doing great things to promote literacy in children: http://www.readingfoundation.org/
A great idea for a birthday gift for the baby or toddler who has everything? Donate a book in their name to a local library, to their preschool classroom, or childcare center!
I read an interesting study this morning out of Loyola University Health Systems talking about the impact of reading on childhood development. It's no big secret that reading to children is good for their cognitive development, but what was interesting was how they were able to break it down by age-group and derived benefit. For example, they found that for infants, parents reading to them is a very valuable experience, but it turns out it's not so much what you read, as how you read it. Have an important work report that you are saddled with, but suffering from the mommy-guilt that we all suffer from - you know, the guilt that you're not spending quality time with your infant when you're home in the evenings? No worries - just read that work report out loud, in a sing-songy voice, and your baby will love it just as much! As babies morph into toddlers, they love faces, so books with pictures of other babies, children, and even adults are always favorites. A photo album will even do, as long as you narrate the pictures that you're looking at. Narration and interactive reading, where you point to pictures, ask your child questions, and have dialogue mixed in the middle of reading, have been found to be extremely beneficial to children's language development. So, if you're a Type A Personality, like me, you're just going to have to get over the fact that interruptions mid-sentence are part of the process! Your kids may even (gasp) want to shut the book and get a new one after you've only read the first two pages! It's not a sign of ADHD...it's a sign that they're enjoying books, and wanting a rich literary experience! As children move through the toddler stage, they love repetition. Hence, the Goodnight Moon reference. If they want to read the same book over and over again, don't worry that they're not getting exposed to enough variety. It's very normal for them to want to read the same book every night for two weeks in a row. Go ahead and just surrender to the fact that you'll always be able to finish those words by heart:
"....goodnight stars, goodnight air, goodnight noises everywhere."
A group that's doing great things to promote literacy in children: http://www.readingfoundation.org/
A great idea for a birthday gift for the baby or toddler who has everything? Donate a book in their name to a local library, to their preschool classroom, or childcare center!
Thursday, March 3, 2011
When will this sick winter ever end??
If you're feeling like you need to Clorox all of your walls, floors, and doors, and you're contemplating whether or not you need to develop, patent, and mass-market an antibacterial lotion that you could just coat your children in from head to toe, you're not alone! This winter has been pretty brutal in terms of childhood illnesses. Thankfully, it's been brutal in the not-life-threatening-but-just-pesky-enough-that-I-can't-get-all-of-my-kids-healthy-at-the-same-time sort of a way. Nonetheless, it's frustrating - I know first-hand with all of the illness that's been floating through my 3-kid household. When a trying sick season attacks your family personally, it's tempting to scream, "What am I doing wrong???!!" The first reality, is that every year, from October through March, we see an upswing in typical childhood illnesses. I remember in med school when I rotated through pediatrics for the first time. The doctors I trained under kept referring to "RSV Season" and "influenza season." I remember thinking, "Pediatric illnesses are so bad that they actually refer to on them as seasons??!" The second reality, is that it doesn't take much to make a so-called perfect storm. Here's what I mean: your daughter started preschool this year, your son suddenly developed an obsession with sticking his fingers in his mouth , you took that trip to visit the cousins up in NY and they were all sick, your kids got invited to exactly 57 birthday parties in a span of 3 weeks...the list could go on and on, but the bottom line is this: If you've had the misfortune of suffering from a particularly long winter sick season in your home, shed the guilt, quell the worry, and wear it proudly as a badge of parental honor that this was your year, and next winter it'll be the family down the street who's children haven't missed a single day of school this year. It's the law of averages!
Lastly, I thought I'd share some information on the use of temporal artery thermometers. If today's post applies to your family, and if, like my kids, your children look at you sideways when you suggest that you need to check their temperature, you may be interested to read this recent study on temporal artery thermometers! (Right-click on the link to take you directly to the page).
http://appliedclinicaltrialsonline.findpharma.com/appliedclinicaltrials/Phase+News/New-Study-Finds-Temporal-Artery-Thermometry-Equiva/ArticleNewsFeed/Article/detail/707862
Lastly, I thought I'd share some information on the use of temporal artery thermometers. If today's post applies to your family, and if, like my kids, your children look at you sideways when you suggest that you need to check their temperature, you may be interested to read this recent study on temporal artery thermometers! (Right-click on the link to take you directly to the page).
http://appliedclinicaltrialsonline.findpharma.com/appliedclinicaltrials/Phase+News/New-Study-Finds-Temporal-Artery-Thermometry-Equiva/ArticleNewsFeed/Article/detail/707862
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