New Year, New Blog!

I’m sorry that this blog has been on somewhat of a lull for awhile.  I have actually started a new blog, and this one has been neglected.  But, feel free to check out the new blog!

http://doctormumma.wordpress.com/

Antibiotics don’t kill viruses, people!

For some people, this season is called Fall, for pediatricians, it is called the beginning of sick season.  Kids are in school, or what I like to call “The Great Petri Dish” and they are just letting their germs mingle.  Allergies are in their high season, and don’t even get me started on asthma.  Our office has been getting pretty crazy lately.  Coughing and sniffles create perfect harmony in our waiting room. We are going through rapid strep tests as if they are going out of style.  Kids are missing school due to fevers, and are coming in for the ever important doctor note that will allow them re-entry.  Parents are coming in and demanding that we “fix their kids!”

Yes, as pediatricians, we are in the business of making sick kids feel better.  And we always to try to whatever can to make that happen.  Unfortunately, a lot of sick season is due to pesky little things called viruses. Viruses are the bane of our existence.  They are small but mighty.  They can bring a grown man to his knees.  And worst of all, we have no medication to cure them!  What? What about that pink medicine?  It seems like the cure-all.

It seems like this is almost a daily battle for me at the office.  A sick child comes in and is diagnosed with a virus.  I discuss, in detail, what a viral illness is and that it is important that we make little Johnny feel as good as we can while we let this nasty virus run its course. The only thing that will cure a virus is time. He may need some Tylenol or Motrin for the fever, and that honey is a great natural cough suppressant (for those children over a year).  He needs tons of fluids to flush the nasty virus out and he may not want to eat a lot right now, and that is ok.  We talk about the merits of a humidifier and nasal saline.  We talk about good hand washing and tons of sleep.  Then, the dreaded question comes, “That is all fine doctor, but Johnny only gets better if he gets an antibiotic. So we are going to need a script for that before we go.”  Sigh.  I can see why there is an overuse of antibiotics, because sometimes, us doctors are worn down and just don’t feel like arguing anymore.  I mean, I can only give my “viruses and antibiotics” speech so many times in a day before I crack.

So, sometimes, a kid gets an antibiotic when he doesn’t need one.  And he will get better on it, because the natural course of the virus corresponds with the course of antibiotics.  Thus, for most parents, this means that the antibiotic worked! Thus, they will be expecting that pink stuff with the next runny nose too.  It is a very frustrating cycle.

But, in case anyone is interested in treating a viral illness “the old fashion way”, I recommend this honey-based cough medicine, and this nasal irrigation system.  Happy Sick Season!

Now that is a strong parent

I feel that the strongest parents in the world are parents of children with special needs.  I am always amazed by their patience, endurance and compassion. For most of these parents, this is not a job they asked for or applied for (and for those few out there who have fostered and adopted these children…well, they did apply for this job, and God bless them for it).  These parents started out the same way most parents do: pregnant and excited to see their new bundle of joy.  But in addition to a wonderful bundle of joy, they were also given a ton of new responsibilities.

Specifically, parents of children with autism never fail to amaze me.  Unlike a child in a wheelchair, or a bald child going through chemotherapy, many times children with autism look like any other child.  At least for a split second, before something overstimulates them and sets them off.  Then, they appear to be the “unruly” child, the “misbehaving” child.  Spectators may be asking themselves, “Why can’t that parent control their child?”  Or thinking, “I’m glad that is not my child.”  Sometimes they will just shake their head in dismay. As if the parent doesn’t have enough to focus on without having to fend off curious bystanders.

This topic came to mind because, over this past week, I have had several patients with autism come into the office to get checked out.  For one child in particular, the visit is always difficult.  She is not a big fan of the office (she is no fool, it is the land of the silver needles) and is always in meltdown mode by the time her feet touch the waiting room floor.  We usually wisk her into a room quickly so that her mom can turn on her Ipad touch to distract her.  I am always amazed by how calm and collected her mother is during our visit, especially when I am sweating bullets after maneuvering in every which way to get in an adequate exam. She is always talking to her daughter in the most loving manner, even when her daughter is trying to throw stools at her.  She rarely seems frustrated, even when her own child does not have the ability to communicate feelings and emotions to her.  Her daughter has never said I love you, mom.  Her daughter has never even looked her in the eye and smiled. Yet, everyday this mother gets up and does the hardest job in the world.

This mother has my utmost respect.

 

 

Trick or Treat! AKA Begging for free candy while in costume…

Tomorrow is arguably one of the most exciting holidays in a child’s young life  I mean, really, what can top being able to dress up as your favorite superhero or princess and go door to door to beg for an unlimited supply of free candy?  It is a win-win situation!  I remember, when I was little, my sister and I would take big ole pillow cases with us, fill them to the brim, return to the house to unload and then return to the hunt.  Holy cow was that a lot of candy!  Then, we would come home and the real work would begin.  We would sort our candy and negotiate trades.  I was a chocoholic (who are we kidding, I still am) and my sister loved the more fruity variety.  Wall street had nothing on our negotiation tactics.

So, now that I am a pediatrician, I am going to tell you that Halloween is bad and that candy is the devil, right?  Nope.  Although I will preach healthy eating and tout fruits and vegetables any day of the week, I don’t feel that one day of an extreme sugar high will do any permanent damage to a child.  A kid may be too wound up to sleep and may get a monster tummy ache the next day, but nothing too serious, in my opinion.

Of course, there are some tips and tricks (pun intended) that can make trick or treating and Halloween, in general, a safe and happy day for all involved. When it comes to the costumes, parents use your own common sense.  Masks over the face can impede vision and send kids flying over curbs.  Try fun makeup instead.  Costumes should be bright and reflective, so that cars can see them.  No need for a hit and run on this holiday.  You can even add reflective tape to the costume itself (ignore your child when they say it is dorky).  If the child is going to use a prop, such as a sword or wand, make sure they can’t impale themselves with it.  That would make for a sad night in the EC and a premature end to the candy foraging.

Here is a full list of tips from the AAP. Have fun and be safe! (And I will be accepting all offers of peanut butter cups)

Picture Source

Toddlers and Tiaras…or just in diapers

I think in the grand scheme of childhood, toddlers are my absolute favorite age.  Now don’t get me wrong, babies are very cute but their personality is still developing and, quite frankly, until they are mobile, they don’t really do much.  Yet,  I will cuddle and coo with a baby any day.  Teenagers are fun too, when they are not being mopey, snarky and full of ‘tude.  But, toddlers are my favorite.  I mean, who can resist their little stiff-legged walk with a diaper wiggle. I certainly can’t.  And, they always bring a ton of hilarity to the office as well.

Like today, when I walked into a room of a 20 month old girl, who was sitting on her mom’s lap.  As I waved hello to the little diva and her mother, she turned to me and sweetly said “Ciao, Doctor” and blew me a kiss.  She then proceeded to slide off her mom’s lap and managed to walk out the door before I could shut it. Classic!  And where did the kiss blowing come from, Toddlers and Tiaras?

Diet is a fun topic to talk about with these fiercely independent and strong-willed beings.  I am always amazed with the tricks that parents come up with to get some sort of nutrition into their toddler. Carrots dipped in chocolate, cucumbers cut into stars, milk that is only consumed out of  a “pink sparkly princess sippy cup”.  I always let people know what the “normal” toddler diet is.  A ritz cracker one day, and then three full, adult-sized meals with snacks the next day.  I usually say to evaluate a toddler’s diet on a week to week basis, instead of a daily log.  And I am all for getting fruits and vegetables in by hook or crook.

Elimination discussions, aka poop talks, are also a frequent topic and can be quite entertaining.  A few weeks ago, I saw a 2 year old boy who wanted absolutely nothing to do with the potty.  Not a problem, because he was still quite young, except that he had developed a quite nasty habit of pulling his diaper off and wiping his diaper contents over himself and his crib.  Body paint gone terribly wrong.  The frustrated parents actually started duct taping his diaper on, which worked for a while.  That is, until he figured out there is more than one way to skin a cat.  He reached in the leg hole to dig for gold.

Life is always an adventure when there is a toddler in the house (or in the office!)

Who invited the ugly guy?

Every month, the office has a raffle for our patients.  After each visit to the doctor, a child can submit his or her name into a drawing to win a prize.  For the past few months, the prizes have been pillow pets.  These things are pretty cute, and they can double as either a pillow or a stuffed animal.  I am amazed at how many types of pillow pets there are out there.  One day I walked in and there was an armadillo pillow pet! (Later, I was told that it was a dinosaur…)

But, now I walk into the office and I am greeted by this ugly thing to the right.  I could not believe we were raffling off something that looked so ugly.  Wouldn’t it give little kids nightmares?  It reminds me of something that would go bump in the night.  Little did I know that this thing is indeed called an “Uglydoll” and it is apparently very popular. People actually pay twenty bucks for this thing.

Doesn’t it remind you of something you may have made in Home Ec back in middle school?  I am just going to add this to my  list “I wish I had thought of this, because if I did, I would be a millionaire”.   Also on that list are SillyBandz and hair feathers…and Post-It notes

Picture Source

Head Lice Phobia: A Pediatrician’s Story

When you work in medicine, you get used to gross stuff pretty quickly.  I talk about pee and poop on a daily, if not hourly, basis.  I have seen nasty toenails, and pus-filled abscesses.   It takes a lot to gross me out.  But, there is one thing that still gives me the heebie-jeebies…

Head Lice.  Followed closely by Scabies.

I first realized that I was lice-o-phobic (pediculophobic, if we are getting technical) back in elementary school when they would perform random “lice checks” during an otherwise normal school day.  We would all have to line up behind two chairs, as two trained moms would methodically check every single kid’s head to look for any offending bugs.  As soon as they announced that they were going to be doing a check, my head would start to itch.  It would continue to itch through the exam and for most of the rest of that day.  I would always hold my breath until my head got the all clear.  I hated lice checks.

Well, now I am the one expected to do these lice checks.  As soon as I see a lice check on the schedule, I start to itch.  Mind you, I have not even seen the kid yet!  Throughout the exam, my head continues to itch.  For the rest of the day, I obsess over whether or not my hair could have accidentally  touched the child, and if so, could I have contracted a louse.  I am insane when it comes to lice.  Luckily, at my office, I do have a few AWESOME medical assistants who know of my neurosis with head lice and are great enablers.  They will check the kids for me.  Did I mention they are awesome.

Anyways, I thought it may be good to expose some myths about head lice, so your head won’t itch after you read this.

1)  Lice do not jump or fly.  They only crawl.  They are not super human.  This is a good thing.

2) Lice really like clean hair.  So, it is not a “dirty people” disease.  So, the moral is to stop showering.  I kid.

3) Head lice travel by head to head contact, or contact with that person’s stuff.

4) Head lice feed off of human blood (eww).  They can survive off a human head for about 48 hours. The can survive on a head for 30 days (eww a lot).

On that note, I am going to go scratch my head.