Hello again from San Diego and the AAP national conference. I am sitting in the airport while I write this, and reflecting upon the amazing conference I was lucky enough to attend. As many of you know, leaving work and four kids for almost a week is a feat! I had a two page list of activities that multiple babysitters and my parents had to take the kids too. There were many highlights of this conference, the top three being Zachary Lystedt with the concussion I already blogged about, hearing Hillary Clinton speak (love her, hate her- she is an amazing speaker), and then this fashion photographer who started the organization “Positive Exposure.” He is a famous New York City photographer named Rick Guidotti who has been over the world photographing the most beautiful models in the world like Cindy Crawford. As he tells it, one day he saw a beautiful 12-year-old albino girl at a bus stop and decided he wanted to photograph others like her. He called the albino foundation, and was turned down repeatedly because albinism has always been portrayed in the media as evil or villains. He persisted, and they finally let him photograph a 20 something girl. As he describes it, she came in all scrunched over, poor eye contact, and very timid from year of bullying at school. During the session, he was able to show her how beautiful she was, and she walked out of their with a new-found confidence. That photo shoot blossomed into an entire photographic book on people with albinism from all over the world. The albino foundation uses it for their information book. He didn’t stop there, but went on to photograph multiple genetic disorders. As he describes it, they are all kids at heart, and they are all beautiful. He has redefined for these kids the ways they perceive themselves, and also the way we define the beauty within. His motto, “Change how you see, see how you change.” Check out his website at positive exposure it is truly inspiring!
I am at the American Academy of Pediatrics National Conference in San Diego, the annual conference to learn from the best physicians in the country. I had the honor of hearing the story of Zachary Lystedt from his doctor, his parents, and himself. Zachary was 13 when he suffered a concussion playing football. He came out briefly, and then was sent back in to complete the rest of the game. At the end of the game, he told his Dad he could no longer see. It took 9 months before he was able to speak again. He had to have parts of his skull removed from both sides of his head, and blood clots removed from his brain. He suffered permanent physical and mental damage. Through many years of therapy, he is able to talk and walk a little. After his accident, his parents did not want another family to suffer what they had. In conjunction with their physician, they worked to get a law passed in their state of Washington stating that in any “suspected” concussion, the player had to be removed immediately from the game and could not come back until medically cleared. The Zachary Lystedt law is now in place in all 50 states!
His story is heart breaking, all the more so because it could have been prevented. The second hit insult is generally what can cause severe damage and even death to a player. 3 high school football players died in the past month from concussions. I diagnosed 3 nine and ten years old in the last 2 weeks with concussions from football. Football is not the only sport causing concussions- female soccer players have almost the same rate of concussions as football players do. The answer is not to stop athletics, but to take concussions seriously. If you see a player hit in the head, they should come out and be evaluated immediately. The player is unable to say they are OK. They should not be able to play again until cleared by a physician. Sometime, this can be weeks to months. We get a lot of pressure to return kids to play, but it is our job to make sure they are truly cleared. No game, no season is worth their brain.
You can see the video of Zachary’s story by googling is name- ESPN had a great story on him.
The other day I was grocery shopping and Forever Young was playing. It was the Bob Dylan version. I still remember my High School English teacher playing this song for us prior to graduation and referring to it as “a great song by Bob Dylan that was ruined by Rod Stewart.” That comment still makes me laugh.
That day at the grocery store was right at the start of the school year. I was feeling especially nostalgic because this is the first year all four of my kids are going to school. Of course the song is not about staying young in age, it’s about staying young at heart. One of the things I love the most about my job is how being around children and young adults all day keeps me feeling young. Although, there is nothing wrong with getting older, because, as someone pointed out to me once, what is the alternative?
This summer I taught my two older daughters to water ski, and I learned to wakeboard. It was the perfect mix of getting older and staying young. I hope as parents we can all set good examples and help our children stay “forever young.”
If you have been watching the news on TV or reading it on-line you cannot escape having heard about enterovirus D68. The past 10 days the news stations have been talking about this virus and sharing all of the scary facts about it. But that is what the media does with a story. They let us know what is out there and often give us only the scary details and not the full story. Hopefully I can give you a little more information I also have the time and space to do that which the news people cannot.
Enterovirus D68 belongs to a group of viruses called enterovirus. This family includes over 70 different viruses. To those of you with kids in school or daycare there are a few more well-known enteroviruses that you may be familiar with – polio and coxsackie- otherwise known as the hand, foot and mouth virus. This enterovirus D68 is just one more in the family. It was first discovered in the 1960s and we haven’t seen a lot of it over the years but when we do see it, it can cause some significant illness.
Symptoms of enterovirus D68 can mimic the common cold. A child will start with cough and congestion and may also get fever. For many people who contract the virus these are the only symptoms that they will have. Others will get pretty sick from it and develop a harsh cough, wheezing and breathing problems. These are the kids they have been talking about on the news. Again, I will emphasize that not everyone ends up with these more significant symptoms.
How can you help your child? First of all, what do we always say at Bayshore Pediatrics- the best way to help your child is to make sure they are resting and drinking lots of fluids. If they are younger nasal saline and suction can be helpful. Nasal saline also helps older children as does a humidifier (cool mist of course) in their room. We are not able to distinguish between this more mild form of the illness and the common cold.
It is important to watch for worsening or changing symptoms, that can happen quickly. We want to see them if they are having difficulty breathing or wheezing or have a new fever. We also would want to see them immediately if they have any of the following symptoms:
- Turning gray or blue around the mouth
- Pulling in by the ribs while breathing
- Difficulty speaking because they can’t breath
- Not drinking much and little urination
While watching the news makes it seem like all children should be seen, if their symptoms are mild and more like a cold they do not have to come in. We do not have a medicine that will make it go away and treatment is supportive only. At the same time, if you are worried or you think they do not look right we absolutely want to see them.
How can you prevent this virus? This virus is spread like most other respiratory viruses you need someone who has the virus to cough or sneeze on you. So if your child is sick keep them home from school AND activities. Good hand washing is also important. Also, although this is really hard with kids, remind them to try not to touch their face frequently, especially their eyes, nose, and mouth .
I always try to remember that the media is helpful in spreading news about what is going on. I also want to help our patients see our take on the news and hopefully help provide you with some more information. This is a serious virus and many kids are getting really sick from it. Many of those are just getting cold like symptoms. A smaller percentage are going to the hospital and needing supportive care. So please don’t immediately get worried if your child starts with cold like symptoms. Watch them closely and if you are worried or they showing concerning symptoms call us or come in and be seen.
My kids recently begged me to have a lemonade stand. It was one of our rare warm days, the sun was out, and they wanted to make some money, The problem is, I am not a huge fan of lemonade stands. I worry that it is a way for child predators to find out where children live, find out their names, and make them a target. We live in a nice, safe area but so did Elizabeth Smart. On the other hand, having kids work to earn money is a great thing. It teaches them that making money takes time, that it can be really boring, and they have to deal with rejection. In addition, I grew up doing lemonade stands, and it was also a lot of fun. It is sad that something so sweet and innocent has to be tarnished by the reality of the world we live in.
So, what did I do? I let the kids have their stand in front of our house. However, they first had to listen to a lecture about stranger danger. In addition, they could only man the stand when I was in the yard with them (just how I like to spend my summer days). The stand went well. Primarily only neighbors came by, and they had a lot of fun trying to sell the lemonade. I am not sure I made the point about making money takes a lot of time, since some nice lady gave them $20 for their lemonade! Overall, it was a great experience for them.
The moral I learned from this story is that fear shouldn’t rule how we let our children experience life. We give them as many tools we can to deal with the unexpected, but you also have to let them experience new things. Part of being a parent is learning to let go a little.
We have been seeing a lot of Hand, Foot, and Mouth Disease at Bayshore Pediatrics lately. A lot of parents hear that diagnosis and get very nervous. Although this illness can cause some serious discomfort, it is not a serious problem. In fact, most cases can be easily treated at home. It is a common infection in children that is usually caused by the coxsackie virus or other viruses. It can cause mouth sores and a rash on the hands, feet, or buttocks. Your child may have a sore throat, drooling, or pain when swallowing. Fevers are common, but should not last more than 3 or 4 days. Kids are no longer contagious 24 hours after the fever is gone. It can be easily spread from one person to another and usually appears about 1-3 days after exposure, so it is important to wash hands and not share food or drink with anyone who may have it. The illness usually lasts about 7-10 days. Because it is a virus, there is no medicine that can stop it or make it go away faster, but there are things you can do at home to help your child feel better. The most important thing is to make sure your child is comfortable. Some things to aid in that are:
- Offer plenty of fluids.
- Alternate Tylenol and ibuprofen every 3-4 hours to help with pain and fevers.
- If your child is old enough to swish liquid in his/her mouth and spit it out, you can try “Magic Mouthwash”
o To make it, mix 25mL diphenhydramine liquid (such as Benadryl) with
25mL antacid liquid (such as Mylanta).
- Swish and spit 5mL of the mix every 6 hours.
- Give your child cold liquids, ice, or frozen juice bars may help soothe mouth pain. Avoid giving your child spicy or acidic foods.
- A cool-mist humidifier in your child’s room can help your child breathe more easily. Be sure to clean the humidifier often using directions from the company that made it.
There are some times you should call the office:
- If your child is unable to drink.
- If your child has signs of dehydration such as crying less tears, dry mouth, no urine for 8-10 hours and decreased activity.
- The rash gets much worse and the joints are swollen, red or painful.
- If your child is breathing faster or has a hard time taking breaths.
- New ear or face pain.
It can stink big time to see your child with hand, foot and mouth. The frustration can be endless to see your child so uncomfortable, but have comfort in the fact that it will pass and children are very resilient.