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Thursday, January 26, 2012

Flu - Stay away!

Lots of people have been asking about whether or not I've been seeing lots of cases of influenza lately.  My answer?  Not yet.  Every year, in the Charlotte, influenza starts to rear it's ugly head sometime after the 1st of the year, and usually lasts into March.  Already 3 weeks into January, we're still not seeing many (if any) cases of influenza, which is a great thing, but certainly not an indicator that we're out of the woods.  Experts are expecting the peak of influenza season to hit us sometime in February of this year.  So, is it time to panic?  No, but it is time to start thinking smartly.  I've made no secret of the fact that I'm a huge supporter of all children over 6 months of age getting a flu shot, so if you haven't done that yet, there's still time.  Also, get outdoors and get your kids outdoors - the weather in Charlotte has been pretty mild lately, so put off that homework until a little later in the afternoon and give them some good outdoor play time after school.  There is strong evidence to support that fresh air has positive effects on the body's immune system, and that being indoors in a closed space for long periods of time is one of the biggest factors in terms of why influenza spreads so easily during the winter months.  I'll keep everyone posted on influenza activity in the Charlotte area over the coming weeks.  In the meantime, make sure those kiddos are getting plenty of fresh fruits and vegetables, plenty of exercise, and plenty of sleep....the three things that I consider to be the core components to good health!

Friday, January 6, 2012

Sleepwalking

The first time my oldest daughter sleepwalked, my husband and I were totally unaware that was what was happening.  We'd tucked her into bed about 2 hours before, and we were just getting ready to head upstairs for the night ourselves, when we rounded the corner of the hallway downstairs to find her standing in the foyer, seemingly wide awake.  Once we landed (we had both jumped about 10 feet in the air, we were so startled to see anyone standing in the foyer), we immediately began to investigate, "What are you doing up?  Why are you just standing there?  Did you have a bad dream?"  After we realized that she was clearly not awake, we quietly escorted her back to her bed.  The next morning she had absolutely no recollection of the event.

Sleepwalking falls into a category of conditions referred to as parasomnias.  Parasomnias includes everything from sleepwalking to sleeptalking to sleepeating to night terrors to bedwetting to teeth grinding.  Parasomnias are extremely common during early childhood (from about 18 months through age 7 or 8) and as children get older they are likely to outgrow the problem, usually by early to mid teenage years.  Of course, some adults still suffer from nighttime walks through the house, but that percentage is fairly small.  So what causes parasomnias?  Well, it's a disruption in one of the stages of sleep (there are 5 stages of sleep that we all cycle through about 4-5 times a night).  Sleepwalking typically occurs during stage 3 of sleep, which often happens about an hour or two after falling asleep.  It tends to run in families, so if one or both of the parents had a history of sleepwalking or another parasomnia themselves, the child is more likely to have issues as well.  Aside from genetics and being a normal phenomenon in childhood, there is no specific cause that has been identified.  Sleepwalking is not caused by children going to bed too late or too early, being sick, having emotional trauma, having low iron or other vitamin deficiencies, or any other identifiable trigger.  The only concern with sleepwalking is the obvious safety issues that arise when a child is prone to wandering out of their bed at night.  Here are a few tips that parents might consider, if you have a child who sleepwalks:

1.  Consider installing a door chime style alarm on his/her bedroom door, that would alert you when the door is opened in the middle of the night.
2.  Remove any objects from the child's room that might be potentially dangerous (sharp objects, etc.)
3.  Keep windows in the entire home locked, not just in the child's bedroom.
4.  Keep external doors locked in the entire home.
5.  If a child is prone to getting into a particular part of the home (the pantry, the refigerator, a particular closet, for example), consider putting a child-proof lock on the doors of those locations.

If you're interested in a much more in-depth look at this issue, here's a link to a great overview article:
http://www.medscape.com/viewarticle/491438_8

Wednesday, January 4, 2012

Will the real dose of infant tylenol please stand up?

I've gotten more than a few calls lately from parents who are rightfully confused about the recent change in the formulation of infant tylenol.  The old infant tylenol drops (with that little awful medicine dropper attached to the lid of the bottle) are now a thing of the past. 
But...to confuse things as much as possible, many stores are still stocking the old formulation, sometimes right beside the new liquid formulation, not to mention that many parents still have the old infant drops in their medicine cabinets at home.  If you count yourself among the many confused parents out there, here's the skinny on the new infant tylenol dosing guidelines.  READ THE FRONT OF THE BOX OR BOTTLE THAT YOU HAVE AND MATCH IT UP TO ONE OF THE CHARTS BELOW.


Infants’ Acetaminophen
Concentrated Drops – "Old" Concentration
80 mg/0.8ml

Weight (lb)
Age (mos)
Dose (ml)
6-11 lbs
0-3 mos
0.4 ml
12-17 lbs
4-11 mos
0.8 ml
18-23 lbs
12-23 mos
1.2 ml
24-35 lbs
24-36 mos
1.6 ml



 
Infants’ Acetaminophen
Oral Suspension – "New" Concentration
160 mg/5ml

Weight (lb)
Age (mos)
Dose (ml)
6-11 lbs
0-3 mos
1.25 ml
12-17 lbs
4-11 mos
2.5 ml
18-23 lbs
12-23 mos
3.75 ml
24-35 lbs
24-36 mos
5 ml

Tuesday, January 3, 2012

New year, new resolutions, new villages

Yes, the calendar officially flipped over to 2012 this past weekend.  More importantly, for me, my oldest baby is getting ready to turn 9 (gasp!), I just signed up for my 7th marathon this spring (yikes!), my mother is undergoing a kidney transplant in 2 weeks (hurray!), I'm gearing up for a certain, ahem, milestone birthday this year (ahhhh!), and I officially closed the book on the first full year of the life of Pediatric Housecalls (roar!).  As I fight the urge to feel overwhelmed at all that life has in store this coming year I find myself looking forward to finding new ways to connect to others....to create that "village" that sustains so many of us.  And I guess that since I personally anticipate calling upon my own  "village" for help a lot this year, I'd like to make a better effort at contributing to that collective "village" that I imagine all of you rely on to help you make the best decisions, accomplish your greatest dreams, and move forward with ease and confidence.  So here you go...my renewed committment to sharing information, and connecting to my patients and families.  I plan on meeting you all here more often this year, and I hope that you'll consider me part of your village.