What NOT to buy at the drug store

In continuing my series on what NOT to buy we are going to discuss the drug store.  Many things are sold that don't work and they are just on the shelf because people spend money on them.

Let's start with lotions.  The best moisturizer is petroleum jelly (vasoline).  All the ones with fragrance don't work very well.  Baby lotion in particular doesn't work at all and often times the baby gets a rash from the perfumes.  If petroleum jelly is too greasy for your taste you might want to try Eucerin cream. 

Moving on to medications.  Cough and cold medications don't work in kids.  The most useful medication is pseudoephedrine for kids over age 5 for nasal congestion.  This is the Sudafed that you have to ask the pharmacist for.  Don't buy the one off the shelf (it is a different ingredient).  Also, there is no need to buy Vapo Rub.  It doesn't help and makes many young kids more congested. 

Have you ever read a Qtip box?  It says on the package that it is not to be used in ears.  We find that it pushes the wax further into the ear.  We also sometimes see kids who have scratched the inside of their ear canal with the Qtip and then it bleeds and is painful.  So unless you plan to use the Qtips for something else you can just leave them on the shelf.

Baby powder is also not a necessary purchase.  A thick diaper ointment such as petroleum jelly works best to treat and prevent diaper rash.  Also when you use baby powder it commonly gets into the air and you and your baby can breathe it into your lungs.

Lastly I would not buy the teething remedies.  This includes Orajel and Teething Tablets.  They don't work and often are used any time an infant is fussy so are significantly overused.  Try giving your child a teething ring to chew on or a wet washcloth.  Infants love to put things in their mouths.

I hope this helps you save your money!

Synthetic Pot

I didn't know that there was such a thing as synthetic pot until I read this information from DrugFreeAZ.org.  It is sold legally and can have horrible health effects.  So, I"m passing the information on.  Please discuss with your teens and preteens

ALERT: Synthetic Marijuana - Spice (K2) Fact Sheet

Marketed as incense.

use as incense. However, people are smoking the incense because it produces a high similar to

marijuana, but of longer duration. The incense is sprayed with JWH-018, a synthetic THC, before it is

packaged for sale. This spray is reportedly an "analgesic chemical which acts as a cannabinoid."

Spice/K2 is a legal substance marketed since 2006 as a dried, herbal blend for

More potent than marijuana.

brand, it can be more potent than marijuana.

Depending on the synthetic compound in the specific commercial

Not for human consumption.

colors/flavors-usually sold in foil packaging or in small glass containers. It is sold as incense and marked

Spice is sold in smoke shops and head shops in a variety of

“not for human consumption”. The

average cost is $30.00 a gram, more expensive than marijuana.

Most likely users:

14-27 yr. olds

Prisoners/probationers

Military (use now banned by all military branches)

Significant health risks.

unidentified toxic substances which contribute to various adverse health effects (also cause

hallucinogenic effects similar to effects of PCP. Symptoms/side-effects may include:

Spice is causing a significant health risk. Spice/K2 is often contaminated with

mimics marijuana “high” (often induced more quickly/more intense than “real” marijuana)

hallucinations

seizures/tremors

coma/unconsciousness

vomiting

numbness/tingling

increased respiration rate

elevated blood pressure (reported up to 200/100-medically dangerous)

elevated heart rate (reported up to rate of 150-medically dangerous)

increased level of anxiety/agitation leading to panic attacks (possible suicide attempts)

All effects of K2/Spice drugs may not be known for a very long time because of long time period that

body stores them.

Developed for research, never tested on humans.

Huffman, a Clemson University professor, as part of research for the National Institute for Drug Abuse

(NIDA) on endogenous cannabinoid receptors-but never tested on humans nor approved by the FDA. Dr.

Spice/K2 was developed by Dr. John W.

Huffman said in an interview to WebMD, “It is like Russian roulette to use these drugs. We don’t know a

darn thing about them for real. It shouldn’t be out there.”

Marketed under various names.

Spice, Spice Silver, Spice Gold, Spice Diamond, Smoke, Skunk, Yucatan Fire, Genie & Zohai Orange

Dragon Smoke, Black Mamba,Blaze, Red X, and Dawn.

It is marketed under a variety of names including K2, Spice, PepNot just smoked.

http://www.drugfreeaz.org/Spice is most often smoked but can be mixed in with food or drink.

What NOT to Buy Your Child

Since the shopping season is upon us I thought I would take a few minutes to save everyone some money. First off I would avoid all infant/toddler DVDs.  These include Baby Einstein and Your Baby Can Read..  They have very convincing advertisements but the research shows that they do not help your child.  One study even showed toddlers who watched them learned fewer words than toddlers who watched nothing.

Also I would not buy a baby walker.  The ones with wheels are dangerous.  Do you really want to chase your child before they are walking!  The walkers do not help infants walk faster.  Instead the research shows they walk and TALK later if they use a walker.  The ones without wheels are fine (such as an Exersaucer) but they do not help infants learn.  They simply entertain your child while you do the dishes.

As parents we all think our children are advanced for their age but I would urge parents to pay attention to the recommended age range of a toy before buying it.  Toys are usually targeted to a developmental level and children not at that level can become frustrated and not enjoy a toy. Also toys with small pieces are not labeled for young children for safety reasons.

Lastly I would urge parents to pay attention to the ratings of DVDs and video games before you buy them.  There is a reason for T, M and PG-13 ratings.  What may look just like a racing game may have inappropriate language or actions.

So... what to buy?  Books, puzzles, board games are timeless and will get used.  Also building (such as Legos) and craft supplies help a child's creativity.  As my children have gotten older we have given gifts of activities such as tickets to a play.  These have been some of the most popular and memorable gifts in our house.

Happy Black Friday!

Traditions

Kids (and adults!) love routine.  We all like to know what to expect and when it is going to happen.  It is this love for routine that produces family traditions.  These traditions produce great family time and wonderful memories.

The holidays are a great time for family traditions.  Remember to schedule time for them this season.  Your kids are more likely to remember things you do together instead of what toys they got for Christmas.  If you don't have any traditions there is always time to start some.  Try cooking or baking together or have a family game night.

I Love Fruits and Vegetables!

I recently discovered Bountiful Baskets.  I have never been so enthusiastic about fruits and veggies before. Bountiful Baskets  is a food co-op where you get two laundry baskets full of fruits and veggies each week that you participate.   It feels like Christmas to me because it is a complete surprise what you get in your basket.  It has made me try new foods and gives me a challenge to figure out new recipes to use them in.

It's easy and cheap.  On Tuesday or Wednesday you go to their website and place an order.  It is $15 for the 2 laundry baskets (one of fruit and one of veggies).  You select a pick up site and then on Saturday morning you show up at that time and pick them up.  You need to bring bags or your own laundry basket to carry them home in.  There is no commitment so you can participate every week or however often you want.  Give it a try and let me know how it goes.

http://bountifulbaskets.org/

Adolescents and the Media

"The easiest way to get teenagers to adopt a certain behavior is to make it seem as if everyone is doing it."  This quote from Pediatric Annals sums up the effect of media on teenagers perfectly.  For teens the media can have both positive and negative influences but unfortunately it is mostly negative.

Teenagers see 2000 beer commercials a year. Also violence and sex are ubiquitous in the media.  The media portrays drinking, smoking, and sex as fun and commonplace.  It rarely shows the negative consequences of these behaviors.

So, what's a parent to do?  Actually the answer is the same as for younger kids.
1. Make sure your teen is watching / playing age appropriate tv / video games.  Become familiar with the rating systems.  Also there is often information available online or in the newspaper geared to parents as to what is in a movie that might be inappropriate for certain ages.
2. Talk with you teen about media pitfalls before they occur.  Some subjects include "sexting", internet bullying, and what is appropriate to post on social media such as Facebook.
3. Consume media with your teens.  Watch tv and movies together, listen to their choice of music with them, friend them on Facebook.  Not only will you have fun with your teen but by doing these things together you can more easily discuss sensitive topics.  Try not to lecture your teen instead ask them questions about what do they think about something. Or what would they do in a particular situation.  You often get very entertaining answers!

Free Family Event on Saturday Oct. 16

Chandler is hosting a Day of Play at Tumbleweed Park this Sat. from 8-12am.  This is a free festival celebrating health.  It is sponsored by Shape Up US.  There will be inflatables, NFL Alumni, team mascots such as the Suns Gorilla and Diamondbacks Baxter, booths, and live entertainment. What a fun way to spend a nice morning with the family!

TV Viewing and Childhood Obesity

I"m going to continue our discussion on the effect of media on children.  This information was taken from Pediatric Annals September 2010.

Children are now spending more time watching TV than any other activity other than sleeping.  There is evidence that increased TV viewing is related to increased weight in children. There are several reasons how TV contributes to weight gain.

For one, increased use of media (TV, video games, computer) displaces time spent doing more physical activities.

Secondly, TV viewing influences dietary habits.  Children are exposed to 5,500 food and beverage advertisements a year.  Most of these foods are high in salt, fat, and sugar.  Studies show that children exposed to these ads eat 45% more regardless if they are hungry or not.  My husband hates food ads on late night TV because he says they always make him feel hungry!  Also, studies show an association of heavy TV viewing and frequent snacking. When watching TV while eating it is hard for a child (or adult!) to pay attention to how much they are eating and are less likely to stop when they are full.

Thirdly, TV viewing at bedtime can contribute to sleep problems.  More than two-thirds of children have a TV in their bedroom.  Many parents think that TV is calming and that it helps their child sleep but it actually contributes to problems falling asleep.  Decreased sleep is a risk factor for obesity in children.

Experts recommend parents do several things.
1.  Remove the TV from your child's bedroom.  This decreases overall screen time and helps with sleep.
2. Turn the TV off while eating.  This way children and adults can concentrate on what they are eating and increase family time.
3. Encourage mindful viewing.  Have your child pick a specific show or two to watch and then turn it off.  Watch TV with your child and discuss the content with them.

Infant Media Viewing

Recently the pediatric journal Pediatric Annals devoted an issue to children and the media.  Now I have to admit I don't read every journal but this one had me glued to it cover to cover.  So I'm going to summarize some of it in my next few blogs.

If you have been to a baby shower lately you have seen how common baby DVDs have become such as Baby Einstein and Your Baby Can Read.  A recent study was done on 1000 children under age 2.  For children ages 7-16 months who watched baby DVDs it was found that they had poorer language than children the same age who didn't watch them.  Specifically, for each hour of baby DVDs watched the children studied knew on average about 6-8 fewer words.  Another study in Thailand found that infants who watch two or more hours of TV a day had a sixfold increase in the likelihood of speech delay.

I also found another study interesting.  It found that when a TV is on (in the background, the infant is not watching it) the infant vocalizes less and has fewer parent-child interactions.

The Academy of Pediatrics recommends no TV or video viewing for children under age 2.  This seems rather strict but when you consider the outcomes of these studies it makes more sense. So save yourself some money and don't buy baby DVDs.  Then turn the TV off and play with your child!

Growing Lettuce in a Grocery Bag

I am very good at raising children but I can't grow a plant if my life depended on it!  But even I am intrigued about how you can grow lettuce in a reusable grocery bag.  Turns out you can actually grow all sorts of things in containers, such as herbs, flowers, and tomatos. This way you can grow something without baking in the Arizona heat or trying to dig in the rock hard ground.  This would be a great project to try with your kids and many kids are more willing to eat something that they grew themselves.  Give it a try and let me know how it turns out.
http://containergardening.about.com/od/vegetablesandherbs/ss/LettuceBag.htm

TV Turnoff Week

My family loves to play games.

This week is TV Turnoff Week.  (Sept. 19-25)  My daughter and I are going to give it a try.  The idea behind this week is to spend more time with family.  I have discovered that if I leave the TV off I get everything accomplished faster so that I have more free time.
So, what to do instead of TV.  For one, don't replace it with other screen time such as the computer or video games.  Instead try playing a game, going outside (it is supposed to cool down!), cooking together, reading to your child, going to the library, or going to the park.  The possibilities are endless!
Today I saw a billboard on I-10 that was advertising fishing.  It pointed out that your children are not going to have any lasting or special memories of days spent watching TV.  So true!

Flumist Now Available

We just received our shipment of Flumist in the office for patients with private insurance.  Flumist is the live virus nasal immunization against the flu.  Children can receive Flumist if they are older than age 2 and have no health problems such as asthma.  If your child doesn't have asthma but has had an episode of wheezing in the last 2 years they should not receive Flumist because it can trigger wheezing.

Adult Flu Shots Have Arrived

Our flu shots for adults are now available in the office. Cost is $30. You can call for an appointment or let us know you would like one when you are in the office with your child. Kids love to see their parent getting a shot just like them!

As an aside you might have heard in the news that the flu shot "Afluria" is not recommended in children. Our office does not use this brand. We use Fluzone (made by Sanofi Pasteur) for all ages and Fluarix (made by GlaxoSmithKline) for ages 3 and up. If you have a question please let us know.

Gun Safety

Injuries are the leading cause of death and disability in children and teenagers. When I see you in the office I talk about car seats, bike helmets, teenage drivers etc. but then I always run out of time to talk about gun safety. Quite frankly, guns freak me out but I realize that guns are important to many people so let's talk about how to keep your child safe.

First of all, think carefully about whether you really need a gun or not. The easiest way to keep your child safe is to have no firearms in the house.

Second, if you do have a gun please store it unloaded and locked with the ammunition locked separately.

Third, ask if guns are present in the homes where your child is babysat or plays. If there are firearms there that are not safely stored consider having playdates at your house instead. My daughter tells me that I worry about her too much. I tell her that I trust her to make good choices but that someone else's choices can effect or hurt her. Such as a teenager who pulls out a parent's gun to show it off and someone accidently gets shot.

Fourth, remember that BB guns can be deadly as well. I have seen serious injuries from what is often considered a "safe" gun.

Happy Better Breakfast Month!

Mom was right! Breakfast is the most important meal of the day. It gives your body and brain fuel for the day. Also, studies show that people who skip breakfast end up eating too many calories later in the day leading to extra weight.

So what is a better breakfast? A good breakfast includes some sort of lean protein. This includes yoghurt, skim milk, eggs (not fried), turkey bacon/sausage, nuts, and peanut butter. Also a good breakfast includes fiber and whole grains such as bran cereal, oatmeal, whole grain bread. Many products now advertise that they include whole grains but you might want to check the label. They label should read 5 or more grams of fiber. Protein and whole grains help keep your blood sugar steady throughout the morning and keep you feeling full longer.

Flu Shots are Here!

Today we received our first shipment of flu vaccines. We have the inactivated flu vaccine available for our patients with private insurance. The live nasal flu vaccine should be available in the next few weeks and we are uncertain when our Vaccines for Children vaccines will arrive. (The Vaccines for Children (VFC) provides immunizations for children who are uninsured, underinsured, or have AHCCCS, Kidscare, or CMDP insurance) Call and make an appointment today.

Immunization Cards Save you Time and Money

Whoever invented the immunization card deserves a Nobel prize in my eyes. My first child (now an adult) was born in Ohio and I accumulated a bunch of different papers that had his immunization dates on it. It was a pain to keep adding to the collection. Then my daughter was born here in Arizona and they gave me a blue card for me to take to the doctor each visit and have her shots written in it. I was delighted! I promptly had the doctor make up a card for my son as well. Those cards have gotten a lot of use over the years when kindergarten, jr. high, high school, and even college asked to see their records.

So, how does a simple blue card save you time and money. By having a current record of your child's shots it makes it unlikely that they will get duplicates of shots they have already received. Also by bringing it to the doctor each visit you also save yourself time by not having to make another trip back to the office to get it updated. Then, when school, day care, or camp asks for a copy you simply hand them the card. If you don't have your child's record you otherwise have to spend time calling our office, getting and signing a release (HIPAA rules), and then waiting for us to fax it.

Don't have a blue card for your child? Just ask and we will make you one! If we have time we will do it while you are in the office but if not we will put it in your child's chart for the next time you are in the office or in the area. Then put it in a safe place at home and your life too will be easier!

Adults Need Shots Too!

I am frequently asked by parents, "When is my child done with their shots?" My answer is, "Never, you continue to need immunizations throughout your lifetime." Talk to your doctor about what you might need but I wanted to discuss two immunizations for adults that can help protect your children. The flu vaccine is now recommended for everyone older than 6 months of age. Also there has been a pertussis (whooping cough) vaccine available for adults since 2005 but it is not widely used. Both the flu and pertussis will make an adult very sick but are usually not life-threatening to you. The problem is when you give these diseases to a young child they can become very ill. By immunizing yourself you can help protect your child.

Whooping cough (pertussis) is an illness that we still see frequently. Our office generally sees several cases a year. Until 5 years ago there was no immunization for pertussis for people older than age 6 so most people lost their immunity to pertussis by the time they were teenagers. When an older child or adult has pertussis they have a chronic cough that lasts a month or more. Most people who have pertussis never know they have it unless they infect a young child who gets very sick and is then tested.

The immunization for pertussis is combined with the tetanus shot (Tdap). If you have had a tetanus shot in the past 5 years you might be protected. Unfortunately many hospitals and doctor's offices are using the old tetanus vaccine (Td) that does not protect you from pertussis. Ask your doctor which vaccine you received. The pertussis vaccine is especially important for adults who will have contact with young children and new babies. It can't be given to anyone older than age 65. It is not commonly given to pregnant women(ask your OB) but it is safe to receive while breastfeeding.

The flu vaccine is recommended for everyone every fall. The strains in the vaccine change each year based on what strains are expected. H1N1 is included in this year's vaccine. Even if you had H1N1 or the vaccine, it is recommended that you get a flu shot this fall.

Our office is now providing pertussis vaccines for parents and family members of our patients. In the fall (most likely October)we will be offering flu shots as well for adults. Please call the office for more information.

Parenting Classes for Parents of Teens

You would think that parenting would get easier after you get past temper tantrums and waking at night. Noooooooooooo, the teenage years come along to challenge you. Here's information about some free classes. You can pick and choose which ones you want to attend. Contact information to register for the classes is at the bottom of the post.

New Parent Resources in Maricopa County – PARENT WORKSHOPS focusing on SUBSTANCE USE and ABUSE

Partnership for a Drug Free America – AZ Affiliate is excited to be able to offer this new free resource for parents. Our research has shown us that substance abuse is the greatest threat to our children and that parents feel inadequate when it comes to recognizing, understanding and helping their children with substance abuse and supporting their efforts to stay “clean and sober”. Our Parent Workshops address these issues and more in a series of 12 one-hour workshops. See below and attached for registration information and additional details.

AZ Parents Connect Presents its Parent Workshops

Parent Workshops are designed for those parents or caregivers of tweens and teens at risk for substance abuse to give them information and practical tools to assist them in their efforts to help their children. We are offering these Parent Workshops free of charge. The limited size of the workshop is designed for maximum participation and space is limited. Reservations are necessary.

Workshops are led by Master Level Professional Counselors and are held on Saturday’s from Noon to 1:00 PM in Central Phoenix.

Topics and Session Dates:

Session 1 It’s Just a Little Pot, Right?

Aug. 21 Find out if your child is at risk for Adolescent Substance Abuse and Dependency

Session 2 What’s in Your Child’s World?

Aug. 28 Identifying drugs and other chemicals most commonly abused by our children, and their effects

Session 3 What Happened to my Teen’s Brain?

Sept. 11 Understanding the mind of a teen and understanding the underlying reasons kids use drugs

Session 4 Is My Child Addicted or Just Experimenting?

Sept. 25 The four stages of addiction and the phases addicts go through

Session 5 My Teen Doesn’t Talk!

Oct. 2 Ways to get your child talking to you and how to make the conversations meaningful

Session 6 “We can handle it: It’s not like it’s a big problem or anything.”

Oct. 9 Understanding the effects of drug use on family, relationships, health, finances and legal issues

Session 7 The Toughest Assignment Your Child Will Ever Have: Staying Away From Drugs and Alcohol

Oct. 16 Re-thinking your expectations

Session 8 Will We Ever Have a Normal Life Again? Adding Fun Back into the Family

Oct. 23 Recreation and sporting activities, education in areas of interest, activities with family and (non-using) peers, learning to have fun sober

Session 9 “Stress?? – My Teen has stress?? I have stress!”

Oct. 30 How to help the family create a balanced life

Session 10 My Child’s Drug Use is Wreacking Havoc on Our Lives!

Nov. 6 Coping skills and family support systems to deal with the emotional roller-coaster of living with a child using drugs

Session 11 “Yes, I Believe in You! Now Tell Me the Truth – Are You Drinking or Using Drugs??”

Nov. 11 How you can support your child’s efforts to stay sober

Session 12 “Oh No! Not Again!” Don’t Miss these Warning Signs!

Nov. 20 Relapse: Keeping an eye out, what to do, and how to managing the disappointment

The 12 Sessions will be repeated 3 times over the next 12 months.

To Reserve your space contact Kim Obert at 602-264-5700 ext 103 or via e-mail to Kim.Obert@PartnerUpAZ.org. Please include your name, session dates and number of reservations you are requesting, phone number and e-mail address.

Seafood and Kids

Is it ok for your child to eat fish? Such a simple question but without a simple answer. There is no consensus as to what seafood and how much is safe to eat. Seafood is very healthy for you. It is a great source of protein as well of omega 3 fat which is "good" fat. But there is mercury in seafood as well. What is a parent to do? It is recommended to avoid large fish for young and small children. Large fish such as shark and swordfish have lived longer and eaten more contaminants than smaller fish so they have higher mercury levels.

Here are some great resources to help you when deciding what kind of fish to eat.

http://www.kidsafeseafood.org/faq.php

http://www.montereybayaquarium.org/cr/cr_seafoodwatch/sfw_health.aspx

I hope you find these links helpful. I am delighted that my kids will eat seafood. Now we just need to work on the veggies!

New Computer System

Our office is moving towards electronic medical records (EMR). Our first step was to change the system we use for appointments and billing. Change is never easy so please be patient with our staff. We have to update your address and insurance information for the new system. The new system comes with this nifty insurance card scanner that electronically attaches your card to your account. No more photocopying! The trees are smiling!

Headache Webinar at Phoenix Children's Hospital

Have you tried a webinar yet? I have recently discovered them. They are a great way to learn without leaving your house (or office). And for those who like to multi-task you can fold clothes or do the dishes at the same time!

Phoenix Children's Hospital is offering this webinar for free for parents. It is Friday July 23rd at 12:00.

Speaker: Marcy Yonker, MD, FAHS

Pediatric Neurologist

Phoenix Children’s Hospital

Dr. Yonker will provide information on the following topics:

• Familiarize parents with common types of benign headaches in children

• Review concerning symptoms of headaches

• Recommend strategies to determine appropriate reasons for pediatric and specialty consultation

Online Presentation

Reserve your Webinar seat now at:

https://www1.gotomeeting.com/register/789826296

For more information please contact, Karen Pennington, Physician Relations,

at (602) 546-3300 or kpennington@phoenixchildrens.com

Welcome Sean Kline, C.P.N.P.

We are excited to welcome a new staff member. Sean Kline is a Certified Pediatric Nurse Practitioner. He has a great sense of humor and is a great addition to our office. Please ask to meet him while you are in our office. Here is his biographical info:

Sean is a native of Philadelphia and moved to Arizona in 1991. He obtained his undergraduate degree in nursing from Arizona State University in 1998. As a nurse, Sean has worked in many capacities with both adults and children. For the last four years Sean has worked for Phoenix Children’s Hospital in both the emergency department and East Valley Urgent Care Center. He obtained his graduate degree as a pediatric nurse practitioner from ASU in 2009. Sean is board certified by the Pediatric Nursing Certification Board as a Primary Care Pediatric Nurse Practitioner.
Sean is married and has 6 children ages 2 through 16. He enjoys watching his children grow and play. Having been a foster parent for over 9 years, Sean has a special interest in the care of foster children as well as adoptive / immigrant medicine.