It is that time of year again when I spend a lot of time trying to talk people into getting their child immunized against the flu. (A big thank you to those that readily get it every year!) I have been thinking lately about why many choose not to follow my recommendation and it makes me wonder what people think my motivations are.
Basically my motivation is simple. I care about you and your child. Nothing makes me sadder than to hear about serious illness or death in my patients or their families. It is even sadder if the problem could have been prevented.
My next motivation is experience. I have had patients and parents die from influenza. Every year I have some patients that get hospitalized from it. I also have had patients miss important things in their lives because of the flu such as prom, AP / AIMs tests, spring break trips, and sports competitions. Also parents often miss over a week of work when their child gets the flu. (and then another week when they catch it too!) Flu can have a significant impact on your life.
I am also motivated by supporting scientific literature and recommendations from such groups as the ACIP (Advisory Committee for Immunization Practices) and AAP (American Academy of Pediatrics). I have not been brainwashed by a government / big pharma conspiracy. I am an intelligent human being who spent years going to school. I also regularly read scientific journals and keep up to date with current medical information.
In case you were wondering there is no financial incentive for me to give your child a flu immunization. Quite frankly I make more money when I see your child because they are sick than giving the flu vaccine.
In conclusion, my motives are good so please just get your child immunized! (By the way I don't care where you get your child immunized -- we are happy to do it but it is fine to do it at a pharmacy or your work.)
Saturday, October 11, 2014
Thursday, September 18, 2014
Over the Counter Medication
I hate to shop. My goal at the store is to get what I need and get out as fast as possible. The other day though I couldn't find what I was looking for so took a tour of the pharmacy section of the store. I noticed a big display of Nasacort nose spray. I thought I would write about this because I suspect few people will use it correctly so I want to make sure everyone gets their money's worth (it's not cheap!)
Nasacort is a nasal steroid and it is in the same family of medications such as Flonase, fluticasone, and Nasonex. I usually prescribe the generic Flonase since it is usually the cheapest. The nasal steroids are used for allergies and work best at preventing allergy symptoms. They need to be used daily during allergy season for them to work. It takes 1-2 weeks before they start working.
I recommend that my patients blow their noses before using the nasal steroid and then squirt one spray in each nostril one time a day. Do not sniff in when it is used. I tell my patients to breathe normally when they use it. If you sniff hard when you use it the medication then gets sucked up to the back of the nose and throat and then it won't work and you likely will have a bad taste in your mouth. Do not blow your nose after you use it because then you blow the medicine out. If your child sneezes or forgets and blows their nose right away it is fine to give another dose right away. It doesn't matter what time of day the medication is used. Whenever you are going to remember is best!
The most common side effect I see is bloody noses. If this happens then I recommend stopping it for 1-2 days and then restarting it. You don't want to stop it for long or your allergy symptoms will come back.
I suspect that I will see two common mistakes. For one I will see people using it for illnesses and cold viruses. It won't work -- nasal steroids only work for allergies. Secondly, I suspect it will not get used daily. It won't work if you only use it a day or two here or there. (It doesn't work right away like a pain reliever helping a headache.)
In summary, nasal steroids are great medications for allergies and have few side effects so it is good news that Nasacort is now over the counter. (Just save yourself money and use it correctly!)
Nasacort is a nasal steroid and it is in the same family of medications such as Flonase, fluticasone, and Nasonex. I usually prescribe the generic Flonase since it is usually the cheapest. The nasal steroids are used for allergies and work best at preventing allergy symptoms. They need to be used daily during allergy season for them to work. It takes 1-2 weeks before they start working.
I recommend that my patients blow their noses before using the nasal steroid and then squirt one spray in each nostril one time a day. Do not sniff in when it is used. I tell my patients to breathe normally when they use it. If you sniff hard when you use it the medication then gets sucked up to the back of the nose and throat and then it won't work and you likely will have a bad taste in your mouth. Do not blow your nose after you use it because then you blow the medicine out. If your child sneezes or forgets and blows their nose right away it is fine to give another dose right away. It doesn't matter what time of day the medication is used. Whenever you are going to remember is best!
The most common side effect I see is bloody noses. If this happens then I recommend stopping it for 1-2 days and then restarting it. You don't want to stop it for long or your allergy symptoms will come back.
I suspect that I will see two common mistakes. For one I will see people using it for illnesses and cold viruses. It won't work -- nasal steroids only work for allergies. Secondly, I suspect it will not get used daily. It won't work if you only use it a day or two here or there. (It doesn't work right away like a pain reliever helping a headache.)
In summary, nasal steroids are great medications for allergies and have few side effects so it is good news that Nasacort is now over the counter. (Just save yourself money and use it correctly!)
Thursday, June 26, 2014
Summer Fun
It can be a challenge to find things to keep your kids busy over the summer when it is too hot outside to send them out to play so I thought I would give some suggestions.
1. Arts and crafts. Kids of all ages love to draw and paint and make things. There is also the old stand by of Play Doh. Out of ideas then check out Family Fun Magazine online for lots of great ideas. http://www.parents.com/familyfun-magazine/
2. Check out your local library. They have lots of fun programs for teens and younger kids as well as they have their summer reading program going. They will give your child prizes for reading a certain number of pages or books over the summer. http://summer.mcldaz.org
3. Water fun. Many local pools are inexpensive and even have fun events such as dive in movies. You can also have fun at home with a sprinkler, hose, squirt guns or water balloons. http://www.gilbertaz.gov/departments/parks-and-recreation/aquatics
4. Learn something new. Try a new activity with your child since there are fewer time commitments and pressures. Try cooking together and making some new recipes. Try building something together or learning to sew. Make some photo albums together or do some scrapbooking.
I hope everyone has a memorable and fun summer!
1. Arts and crafts. Kids of all ages love to draw and paint and make things. There is also the old stand by of Play Doh. Out of ideas then check out Family Fun Magazine online for lots of great ideas. http://www.parents.com/familyfun-magazine/
2. Check out your local library. They have lots of fun programs for teens and younger kids as well as they have their summer reading program going. They will give your child prizes for reading a certain number of pages or books over the summer. http://summer.mcldaz.org
3. Water fun. Many local pools are inexpensive and even have fun events such as dive in movies. You can also have fun at home with a sprinkler, hose, squirt guns or water balloons. http://www.gilbertaz.gov/departments/parks-and-recreation/aquatics
4. Learn something new. Try a new activity with your child since there are fewer time commitments and pressures. Try cooking together and making some new recipes. Try building something together or learning to sew. Make some photo albums together or do some scrapbooking.
I hope everyone has a memorable and fun summer!
Wednesday, June 4, 2014
Summer Eating Habits
I recently read an article that talked about how across the United States kids gain more weight over the summer than they do during the school year. I have observed this in my patients and thought that it was because of the heat and how hard it is to play outside this time of year. It turns out that the weight gain is due to extra eating over the summer. Because kids are home all day with little structure they tend to spend a lot of time snacking. So what can you do to prevent this extra weight gain...
1. Limit the junk food in the house. If you don't keep chips, soda, and cookies in the house then there is less temptation. Keep easy to grab fruits and veggies around instead.
2. Review the rules with your kids. School age kids should be asking permission before getting a snack. Limit them to one small snack in the afternoon such as a fruit or veggie. If older kids can't follow the rules you set then perhaps they are not ready to be left home by themselves.
3. Be aware that if they are not as active that they will need to eat less than during the school year. Limit extra servings of meats and pastas at mealtimes. If your child is still hungry offer fruits and veggies instead.
4. Try and keep them active. We have many low priced public pools around here that are always popular with the kids. You can also run a sprinkler or have them play with squirt guns. (Don't forget the sunscreen!) Go to the playground or take the dog for a walk first thing in the morning or when the sun is going down in the evening.
1. Limit the junk food in the house. If you don't keep chips, soda, and cookies in the house then there is less temptation. Keep easy to grab fruits and veggies around instead.
2. Review the rules with your kids. School age kids should be asking permission before getting a snack. Limit them to one small snack in the afternoon such as a fruit or veggie. If older kids can't follow the rules you set then perhaps they are not ready to be left home by themselves.
3. Be aware that if they are not as active that they will need to eat less than during the school year. Limit extra servings of meats and pastas at mealtimes. If your child is still hungry offer fruits and veggies instead.
4. Try and keep them active. We have many low priced public pools around here that are always popular with the kids. You can also run a sprinkler or have them play with squirt guns. (Don't forget the sunscreen!) Go to the playground or take the dog for a walk first thing in the morning or when the sun is going down in the evening.
Wednesday, May 14, 2014
Teen Beliefs about Eating and Exercise
In talking to teens I have discovered that they have some interesting beliefs.
1. "If I work out I won't get fat." Certainly exercise is important but it is one can easily eat more calories than what they burn in their workout and gain unwanted weight.
2. "I'm trying to gain weight to get more muscle." Muscle does weigh a little more than fat but you do not eat more to get muscle. You get muscle through exercise and strength training. It is recommended in kids and teens to do strength training through low weight high repetition exercises. It is not recommended to use high weights due to developing bones and muscles.
3. "'Protein shakes help me build muscle." People who eat a typical American diet get plenty of protein and do not need extra. It is important to have protein in your diet but carbohydrates are very important as well. Your body uses carbs and glucose to power your brain and muscles. If you have mostly protein then your body has to break down your muscles to supply the brain what it needs. Chocolate milk is the current recommendation as a good choice after a work out.
4. "Eating fruit is for old people." I have found that teens think that they can wait until they are old and have health problems before they have to eat healthy and take care of their body!
5. "I drink juice so I don't have to eat fruits and veggies." When you juice you lose a lot of the nutrients and all of the fiber from the plant. Mostly you end up with simple sugars instead. I recommend that you eat your fruits and veggies and drink water instead. (Smoothies are fine as long as you put the the whole fruit/veggie in and not just the juice.)
1. "If I work out I won't get fat." Certainly exercise is important but it is one can easily eat more calories than what they burn in their workout and gain unwanted weight.
2. "I'm trying to gain weight to get more muscle." Muscle does weigh a little more than fat but you do not eat more to get muscle. You get muscle through exercise and strength training. It is recommended in kids and teens to do strength training through low weight high repetition exercises. It is not recommended to use high weights due to developing bones and muscles.
3. "'Protein shakes help me build muscle." People who eat a typical American diet get plenty of protein and do not need extra. It is important to have protein in your diet but carbohydrates are very important as well. Your body uses carbs and glucose to power your brain and muscles. If you have mostly protein then your body has to break down your muscles to supply the brain what it needs. Chocolate milk is the current recommendation as a good choice after a work out.
4. "Eating fruit is for old people." I have found that teens think that they can wait until they are old and have health problems before they have to eat healthy and take care of their body!
5. "I drink juice so I don't have to eat fruits and veggies." When you juice you lose a lot of the nutrients and all of the fiber from the plant. Mostly you end up with simple sugars instead. I recommend that you eat your fruits and veggies and drink water instead. (Smoothies are fine as long as you put the the whole fruit/veggie in and not just the juice.)
Thursday, April 24, 2014
Commonly Asked Questions at the 2 Month Visit
Many parents have similar questions at their baby's 2 month appointment so I wanted to address some of the common ones.
1. Will putting cereal in the bottle make them sleep through the night?
No, this is an old wive's tale that is not true. Babies usually start sleeping through the night between 2 and 4 months of age. They have to be able to eat enough throughout the day and be awake enough during the day so that they sleep at night. I recommend feeding and waking your baby at least every 3 hours during the day to help them. We usually start cereal in a bowl (not bottle) between 4-6 months of age to help them learn to use a spoon.
2. What do I do if my baby runs a fever?
Fever is a temperature at or above 100.4 degrees (38 degrees Celsius). Fever is the body's way of fighting infection. It does not hurt you but makes you feel bad. If your baby (2 months of age or older) runs a fever and is uncomfortable we recommend giving acetaminophen (Tylenol). The dose is listed on your child's handout from their well child check. Babies cannot have ibuprofen (Motrin or Advil) until they are 6 months of age. Please call us the next day if your infant 2-6 months of age is running a fever. Young infant's immune systems are weak and we like to see them to make sure there is no sign of a serious illness.
3. What should I do with my baby?
Talking to your baby is the best way to help them learn. I do not recommend baby talk -- the more words your child hears, the more they learn! Vary your child's position. Put them on their tummy when they are awake and put some toys around them. A blanket on the floor works well for this so you don't have to worry about them falling off anything. Take them for a walk -- babies love to be outside! We do not recommend that children under age 2 years watch TV, videos or computers. There have been some studies that show when children under age 2 watch screens they learn less words than children who do not. Children learn best from people!
4. When can I travel with my baby?
You can travel with your child at any age. Keep in mind that when you travel you are around a lot of people so your child is at increased risk of getting sick. Have people wash their hands before touching your baby and keep sick relatives and friends away. When your child is older avoid public play places when you are traveling.
1. Will putting cereal in the bottle make them sleep through the night?
No, this is an old wive's tale that is not true. Babies usually start sleeping through the night between 2 and 4 months of age. They have to be able to eat enough throughout the day and be awake enough during the day so that they sleep at night. I recommend feeding and waking your baby at least every 3 hours during the day to help them. We usually start cereal in a bowl (not bottle) between 4-6 months of age to help them learn to use a spoon.
2. What do I do if my baby runs a fever?
Fever is a temperature at or above 100.4 degrees (38 degrees Celsius). Fever is the body's way of fighting infection. It does not hurt you but makes you feel bad. If your baby (2 months of age or older) runs a fever and is uncomfortable we recommend giving acetaminophen (Tylenol). The dose is listed on your child's handout from their well child check. Babies cannot have ibuprofen (Motrin or Advil) until they are 6 months of age. Please call us the next day if your infant 2-6 months of age is running a fever. Young infant's immune systems are weak and we like to see them to make sure there is no sign of a serious illness.
3. What should I do with my baby?
Talking to your baby is the best way to help them learn. I do not recommend baby talk -- the more words your child hears, the more they learn! Vary your child's position. Put them on their tummy when they are awake and put some toys around them. A blanket on the floor works well for this so you don't have to worry about them falling off anything. Take them for a walk -- babies love to be outside! We do not recommend that children under age 2 years watch TV, videos or computers. There have been some studies that show when children under age 2 watch screens they learn less words than children who do not. Children learn best from people!
4. When can I travel with my baby?
You can travel with your child at any age. Keep in mind that when you travel you are around a lot of people so your child is at increased risk of getting sick. Have people wash their hands before touching your baby and keep sick relatives and friends away. When your child is older avoid public play places when you are traveling.
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