Author Archive
Sep 12, 11 | Posted by: Sharyl Paley, M.D.
Change – the turning of another year
In July I turned 44. It was also the month that I start my 16th year of practice. It is hard to believe that I finished my residency at Children’s Hospital of Wisconsin that long ago, even though it seems like it was just yesterday. The changes are starting to happen. Several of my mentors are leaving their positions at Children’s Hospital of Wisconsin. I salute my mentors. They are the people who have made me the pediatrician that I am today. They continue to be the people I rely on when I am stumped, when I need a pick me up, or when I just need to discuss the changing face of medicine. My mentors taught me more then just medicine. Every day I am reminded that each child is an individual and everyone responds differently to illness. It is my mentors that taught me the importance of looking at each person and not just read the books. Children do not read the books. I am still amazed how some physicians are quick to jump and predict the future for a child. I take care of one child that when she was born was told(by another physician) she would never do more then a six month old could do. Today she is reading, playing, and being a child. It was a mentor who taught me to give hope; children are amazing and often respond better then we think they will. Everyday I learn new things and apply them to my practice of pediatrics. This was also impressed upon me by my mentors. They reminded me medicine is always evolving and we need to keep striving to be better. I hope that I have influenced some residents and medical students and have been mentors to them. Changes always happen. We might not agree with them or like them, but as mentor continues to remind me even today, change can bring about good.
Apr 27, 11 | Posted by: Sharyl Paley, M.D.
Is there Spring Sun?
I had a bad moment this past weekend. After reminding my patients for the past two weeks to get out the sunscreen and start using it, I forgot to remind my daughter to put some on. Although, am I really at fault? It is hard to know what kind of day we are going to have in Milwaukee during the month of April and May, especially on the east side. Even though we keep hearing it is going to rain, part of the day may be partly sunny and nice enough to play outside. I still felt really badly when I woke up Monday morning and my youngest daughter’s cheeks were all red from playing outside on Sunday. She was in and out for a few hours but it was enough. Especially after her fair skin had not been in the sun for months.
So, get out the sunscreen and use it. As I have reminded people the past few weeks, even though I forgot, even when it is 50 degrees out, if it is sunny or even partly cloudy, those rays are coming through and you can get a sunburn. Our kids so want to be outside , and they should, but we have to help protect their skin.
First thing, make sure you have new sunscreen. The active ingredients do tend to wear down over time and not work as well. And, it is also hard to remember year to year which is the newer sunscreen, so I always recommend starting each season fresh. It is important to get a sunscreen that offers both UVA and UVB protection. There are a few active ingredients that I look for when choosing a sunscreen. These include; titanium dioxide (like zinc oxide but easier to spread), avobenzone (parasol 1789), oxybenzone. Helioplex is a stabilized version of avobenzone so that it doesn’t break down. Ecamsule is a newer ingredient in the United States that is in L’oreal products that is suppose to be effective also. At my house we like to use the Neutrogena Shade products, Bullfrog, Banana Boat. I have not yet tried Vanicream’s sunscreen, but would like to since it is not suppose to make you look you have cream on.
Most importantly, you want to use it correctly. Try to put it on 15-20 minutes before going outside, this is often the hardest part. Make sure you are using enough to cover your entire body. This takes more then you realize. Reapply, reapply, reapply. At least put more on every two hours. More often if you burn easily or if you have gone in the water. Also, remember to use other shade as available and to avoid the sun during the hours where the rays are most active, from 11AM to 2 PM.
Apr 13, 11 | Posted by: Sharyl Paley, M.D.
Spring Sneezing
Wow, I couldn’t believe it yesterday when my eyes were itching me all day. Dr. Linsmeier was looking at my like I was crazy rubbing my eyes like a kid. Then I got home and both my girls were complaining how their eyes were itching all day. It is hard to believe where we live that spring is actually here, but it is. Every year I remind my allergy patients who have spring allergies to start their preventative drugs in March, but everyyear it is easily forgotten. Believe it or not, the tree allergies are starting. Even though we don’t see the blooms yet, althought I do see some flowers starting in my garden, the pollens and buds are starting in the trees. Even if you are not bothered one year, you may be bothered another year. I usually am bothered in the fall, but something is blooming now that has gotten to me.
Allergies affected millions of people. Some have itchy eyes and itchy noses. Others are sneezing, sniffing, snorting, chortling, or any other noise you can think that may come from the nose. Many others are coughing and wheezing. While your child may be active and seem ok, these symptoms can be very bothersome. They can also affect how they do in school because it can be hard to concentrate.
Allergies are caused by our bodies immune response to something that it sees as abnormal. Typically our immune response protects against bacteria and viruses that cause problems. In allergies, our immune system sees common things as dust, pollen, and dander as abnormal and mounts a response. This causes all different types of cells to come in and try to “protect” our body from these invaders. I often tell my patients it is an exaggerated response to normal parts of the enviornment, and boy can it make you miserable.
There are some simple things you can do to help your child or yourself. First, don’t sleep with your windows open. This is a hard thing to do in Wisconsin since there is not a lot of time we can enjoy the fresh air, but the pollen accumulating on pillows can really increase symptoms. Next, make sure to wash hands and even faces after playing outside, even if they weren’t rolling in the grass. Pollens are all over and can reside on the hand and then the child goes and wipes their eyes or nose and the whole process explodes.
If your child is having a lot of problems talk with your pediatrician. There are a lot of over the counter antihistamines to use and you can discuss the pros and cons of a particular one. As of today all the antihistamines we recommend, Claritin, Zyrtec, and Allegra are over the counter. If those are not working we have an entire armenmatarium including nose sprays and eye drops.
Remember, don’t let your child suffer. We want them to enjoy the outside and not have to suffer from itchy eyes, sneezing, coughing and wheezing.
Apr 11, 11 | Posted by: Sharyl Paley, M.D.
Snack Time
Every now and then I get on some new kick to talk to kids and parent about during their well checks. As everyone has heard the United States is fighting an obesity battle. Every year we see kids getting higher and higher on their growth curves and having to work backwards and help them slow the growth and/or if they are older lose weight. It would be great to work in a preventative fashion as opposed to a reactive. That means, lets teach healthy eating early on. More »
Feb 3, 11 | Posted by: Sharyl Paley, M.D.
Vaccine Struggles – Part I
I can say last week I was quite disheartened. A patient was in the room and we were discussing her baby and the fact that she didn’t want to give her any more immunizations. The mom was crying, I was dismayed, but luckily the baby didn’t understand what we are talking about and was happily playing away.
Once a week I get into a discussion about immunizations and the pros and cons. At times it seems like a debate. Unfortunately it is one that I just don’t understand. I try to look at it from my parent’s perspective, and I realize that the information out there is confusing to a parent. We have had studies from well respected physicians, reports from well known people in the political world, and information blown up by the media about the evils of vaccines and how they are harming our children. Andrew Wakefield issued a report in the Lancet and then later in the British Medical Journal in 1998 that showed how the MMR vaccine could be a cause of autism. For years I have had patients scared because of this report and hesitant to give this vaccine and others. In the past few months the British Medical Journal has come out and shown that this well respected physician’s research was fraudulent. He wanted to make a point, but his research did not prove it so he altered it. Wow! The majority of the medical world did not believe in his research to begin with, but celebrities and playboy bunnies became spokespeople for autism and played on parents fears and convinced many not to vaccinate their children.
I cannot tell you the cause of autism. I cannot give you a 100% guarantee that certain children with immune problems who receive vaccines may not develop a problem. More »
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