My Home Doctor, LLC.

Spring Break Saftey Tips

2011-02-28T17:50:00.000-08:00

Spring break is a great time for the family to get away from the cold, dark days of winter and have some fun in the sun. Keep your family safe while on your trip by following these tips from the American Academy of Pediatrics (AAP). Please feel free to use them in any print or broadcast story, with appropriate attribution of source

Sun Safety for Babies

Babies under 6 months of age should be kept out of direct sunlight. Move your baby to the shade under a tree, umbrella or stroller canopy. It is okay to apply a small amount of sunscreen on infants under 6 months if there is no way to avoid the sun.
Dress babies in lightweight clothing that covers the arms and legs, and use brimmed hats.

Sun Safety for Kids

Choose sunscreen that is made for children, preferably waterproof. Before covering your child, test the sunscreen on your child’s back for an allergic reaction. Apply carefully around the eyes, avoiding eyelids. If a rash develops, talk with your pediatrician.
Select clothes made of tightly woven fabrics. Cotton clothing is both cool and protective.
When using a cap with a bill, make sure the bill is facing forward to shield your child’s face. Sunglasses with UV protection are also a good idea for protecting your child’s eyes.
If your child gets sunburn that results in blistering, pain or fever, contact your pediatrician.

Sun Safety for the Family

The sun’s rays are the strongest between 10 a.m. and 4 p.m. Try to keep out of the sun during those hours.
The sun’s damaging UV rays can bounce back from sand, snow or concrete; so be particularly careful of these areas.
Most of the sun’s rays can come through the clouds on an overcast day; so use sun protection even on cloudy days.
When choosing a sunscreen, look for the words "broad-spectrum" on the label - it means that the sunscreen will screen out both ultraviolet B (UVB) and ultraviolet A (UVA) rays. Choose a water-resistant or waterproof sunscreen and reapply every two hours.
Zinc oxide, a very effective sunblock, can be used as extra protection on the nose, cheeks, tops of the ears and on the shoulders.
Use a sun protection factor (SPF) of at least 15.
Rub sunscreen in well, making sure to cover all exposed areas, especially the face, nose, ears, feet and hands, and even the backs of the knees.
Put on sunscreen 30 minutes before going outdoors - it needs time to work on the skin.
Sunscreens should be used for sun protection and not as a reason to stay in the sun longer.

Beach Tips

Drink plenty of water, non-carbonated and non-alcoholic drinks, even if you do not feel thirsty.
Stay within the designated swimming area and ideally within the visibility of a lifeguard
Never swim alone.
Be aware of rip currents. If you should get caught in a current, don’t try to swim against it. Swim parallel to shore until clear of the current.
Seek shelter in case of storm. Get out of the water. Get off the beach in case of lightning.
Watch out for traffic – some beaches allow cars.

©American Academy of Pediatrics 2/10

What's the difference between cold and flu?

2011-01-31T14:14:00.000-08:00

The two winter respiratory illnesses may look alike, but pay attention to tell them apart

How many times have you dismissed sniffles as "just a cold," and carried on with a stuffed nose and sinuses assuming that the symptoms would eventually run their course, perhaps a bit more quickly with a few doses of Mom's homemade chicken soup?

Influenza is another story. The common cold eventually fizzles, but the flu may be deadly. Some 200,000 people in the U.S. are hospitalized and 36,000 die each year from flu complications — and that pales in comparison to the flu pandemic of 1918 that claimed between 20 and 100 million lives. The best defense against it: a vaccine. Yet barely 30 percent of 4,000 U.S. adults surveyed said they'd been inoculated this season, despite a record supply of flu shots, according to a new RAND Corp. survey. (GlaxoSmithKline, which makes flu vaccine, helped pay for the survey.)  

So what is the difference between a cold and the flu – and how can you be sure which one you have?  

What causes the flu? How is it different from a cold?  

The flu is a viral infection caused by the influenza virus, a respiratory virus. The common cold is also a viral infection caused by the adenovirus or coronavirus and there are many, many subsets with a lot of variability. That’s why it's said there's no cure for the common cold [and] there's no real vaccine. The flu is known to be from influenza and is preventable with vaccination.   

Colds tend to produce runny nose, congestion, sore throat. Influenza is more pronounced in that it infects the lungs, the joints and causes pneumonia, respiratory failure and even death. It tends to infect the intestinal tract more in kids, with diarrhea and vomiting. Because of the relative immaturity of the gut, they may absorb more virus and that wreaks more havoc on the intestines. Flu causes epidemics and pandemics with the potential for mortality, whereas the common cold is a nuisance for us.   

How can someone who's feeling ill distinguish between cold and flu, or an allergy?  

Flu typically starts in early November and can go until March. The peak time is now — November to January. Allergy is typical in spring or fall, and cold more so in winter.   

The body can respond in only so many ways, but there are things you can use to differentiate. Allergic symptoms are similar to those of a cold, but [result from] your immune system responding to something benign. Usually there's no fever, and there's an allergic manifestation of itch in the back of the throat or the ears. It's unlikely with allergy to have body aches. With a cold, there's sometimes a low-grade fever.   

You can tell the difference by the length and severity of the illness and whether you've had a similar experience in the past. Both colds and flu usually last the same seven to 10 days, but flu can go three to four weeks; the flu virus may not still be there, but you have symptoms long after it's left. Allergy can last weeks or months.  

Are the treatments for these illnesses different? 

 For any of these things, if it affects the nose or sinus, just rinsing with saline that gets the mucus and virus out is a first-line defense. It's not the most pleasant thing to do, but it works very well. There are classes of medicines that can help the flu — Tamiflu and Relenza — antivirals that block viruses' ability to reproduce and shorten the length and severity of the illness. But they have to be taken within 48 hours or the cat is proverbially out if the bag [because by then] the virus has done the most of its reproduction. For a cold or flu, rest and use decongestants and antihistamines, ibuprofen, acetaminophen, chicken soup and fluids. 

Zinc supposedly helps the body's natural defenses work to their natural capacity and decrease the severity and length of a cold. Cells need zinc as a catalyst in their protective processes, so if you supply them with zinc, it helps them work more efficiently. You should also withhold iron supplements. Viruses use iron as part of their reproductive cycle, so depriving them of it blocks their dissemination.   

The majority of these infections are not bacterial and do not require [nor will they respond to] antibiotics. My rule of thumb is that a viral infection should go away in seven to 10 days. If symptoms persist after that, you'd consider if it's bacteria like Strep or Haemophilus influenzae. Those bacteria cause illnesses that are longer lasting.  

Is that treatment approach the same for kids?  

In general, the same rules apply: Most children will have six to eight colds a year in their first three years of life, and most are viral. It's very easy to test for strep and for that you should have a [positive] culture [before treating with antibiotics].   

Are the strategies for avoiding cold and flu different?  

Avoidance is very similar: Strict hand washing, not sharing drinking cups or utensils, and avoiding direct contact with people who are sneezing. As long as someone has a fever, they have the possibility to transmit infection. After they've had no fever for 24 hours, they're not infectious.  

Jonathan Field, director of the allergy and asthma clinic at N.Y.U. Langone Medical Center/Bellevue Hospital in New York. Following is an edited transcript of our interview with him.   

Cold and Flu Season Update 2010-2011

2010-12-31T09:15:00.000-08:00

Each flu season seems to have some kind of surprise in store for parents and pediatricians.

Last year, the big surprise was that there wasn't a shortage of flu shots. And of course, there was the emergence the swine flu pandemic.

So far, the big surprise this year is the early, widespread availability of flu shots and the expectation that there will be over 155 million doses of seasonal flu vaccine.

Reports of a novel influenza A virus that has been reported, a swine origin influenza A (H3N2) virus, are thought to be cases where a few people got sick from contact with pigs. There is no evidence of human-to-human transmission of this swine flu virus, as we saw in the 2009 H1N1 pandemic, so there is no big surprise with this flu virus.

Flu Season

Flu season got a very early start last year, but concerns that there might have been another wave of flu activity at some point over the summer faded from most parent's minds, well before the World Heath Organization declared an official end to the 2009 H1N1 pandemic on August 10, 2010.

Whether you are concerned about seasonal flu or swine flu, parents should take steps to avoid the flu to keep their family from getting sick. In addition to getting the seasonal flu vaccine include frequent handing washing, voiding close contact with people who are sick with the flu, disinfecting contaminated surfaces, including toys and kitchen counter-tops.

Fortunately, this year's seasonal flu vaccine provides coverage against the 2009 H1N1 swine flu virus and two other flu viruses, an H3N2 virus and an influenza B virus. And so far, although it is very early in this year's flu season, this seems to be a good match for the flu virus strains that are being found on flu tests.

Flu Season Activity Reports

As of mid-December, the CDC states that flu activity 'remained relatively low in most of the United States, however certain key flu indicators are increasing.'

No states are reporting widespread flu activity.

Four states, Georgia, Kentucky, Mississippi, and Nevada, and Puerto Rico, are now reporting regional flu activity.

Twenty states, Alabama, Arizona, Connecticut, Florida, Hawaii, Illinois, Iowa, Louisiana, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, and Virginia, are now reporting local flu activity.

Twenty-one states, Alaska, Arkansas, California, Colorado, Idaho, Indiana, Kansas, Michigan, Missouri, Montana, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Rhode Island, South Dakota, Washington, West Virginia, Wisconsin, and Wyoming, the District of Columbia and the U.S. Virgin Islands, are now reporting sporadic flu activity.

Only five states, Delaware, Maine, Nebraska, Oregon, and Vermont, and Guam, are still reporting no flu activity.

Remember that when it comes to flu activity reports, widespread > regional > local > sporadic > no activity.

Google's Flu Trends, which relates flu searches in an area to how many people are actually sick with the flu, now reports a low level of flu activity in the United States, which has increased from the previous minimal level over the summer. Remember that Google Flu Trends is supposed to 'estimate flu activity faster than traditional systems,' like the CDC and based on their scale, flu activity has declined to its lowest level in the past few months.

Knowing where there is flu activity can be helpful, because if you have classic flu symptoms in an area where there are a lot of flu infections, especially widespread or intense flu infections, then you likely have the flu and should see your doctor right away to see if you are a candidate for one of the flu medications, such as Tamiflu or Relenza.

Flu Deaths

Each year, the flu is reported to be responsible for almost 36,000 deaths, including about 46 to 74 deaths in children. Last year (2009-10 flu season), 281 deaths in children were reported to the National Notifiable Diseases Surveillance System.

There has been one pediatric death from flu during the 2010-2010 flu season.

Kids Safe Toys & Gifts Month

2010-12-08T06:08:00.000-08:00

It likely doesn't come as a surprise to anyone that December is Safe Toys and Gifts Month.

Each year, Prevent Blindness America, encourages people to make toy safety priority as they do their holiday shopping, including that they:

Buy age appropriate toys.

Look for toys and other gifts that meet American Society for Testing and Materials (ASTM) standards.

Review warnings on the toy's box.

Avoid shooting toys and toys that have pieces that shoot or fly off.

Remember that BB guns and air guns are not really toys.

The American Academy of Pediatrics also provides tips for choosing a safe toy, including that you look for a toy that is sturdy, made with nontoxic materials, not too loud, and if it is an electric toy, that it is UL approved.

In addition to general toy safety guidelines, the Consumer Product Safety Commission and other experts have highlighted hazardous toys the last few years, including:

Toys with small magnets, which can be swallowed and lead to serious medical problems if two or more magnets are swallowed.

Toys with lithium button batteries that can be easily removed without a screwdriver and can be a hazard if swallowed.

Lead paint on recalled toys.

Metals in children's jewelry, which can include lead, cadmium, and other toxic metals.

Unfortunately, most of these toys weren't found to be hazardous until they were recalled after having been on the market for some time. That makes it important to inspect toys before you buy them to make they are well made and don't have any hidden hazards.

What you need to know about this flu season

2010-10-29T19:35:00.000-07:00

There's no worldwide flu pandemic this year, no shuttered schools, no crisis atmosphere. But doctors, health officials and especially private pharmacies are ready to needle us again, anyway.

The 2010-2011 influenza season will be different in several ways. First, the H1N1 ``swine flu'' that disrupted our lives last year is still around, but without its old punch. And it'll be joined by two other flu viruses more typical of seasons past.

Second, last season's flu struck children and pregnant women hardest. This year's more typical season could be tougher for senior citizens. Drug makers have even created a stronger vaccine for them.

Also unlike last year, vaccine shortages are not expected. Federal officials, criticized for issuing swine flu vaccine very late last year, opened this year's pipeline in August. Pharmaceutical companies plan to pump out 165 million doses, a 40 percent increase.

And this year, due to a new law, it'll be easier than ever to get flu vaccine from private pharmacies.

Still, health officials can't say whether it will be a hard flu season or an easy one.

``Flu seasons are unpredictable,'' says the U.S. Centers for Disease Prevention and Control on its website.

Here are some questions and answers about the coming flu season:

Q: How bad a season should we expect?

A: There's no way of knowing. ``Although epidemics of flu happen every year, the timing, severity and length depends on many factors, including what influenza viruses are spreading and whether they match the viruses in the vaccine,'' the CDC says. Last year, nearly 100 percent of all influenza was of the H1N1 ``swine flu'' strain. This year, experts predict a return to older patterns with at least three strains of flu circulating.

Q: What difference will that make?

A: Last year's swine flu was hard on kids, easier on seniors. Only 10 percent of last year's swine flu fatalities were 65 and older. In a typical year, 90 percent of influenza victims are seniors. This flu season is expected to be more like a typical year.

Q: What can seniors do?

A: For the first time, the CDC has approved a new High-Dose Fluzone vaccine for seniors made by Sanofi Pasteur containing four times the amount of antigen (the active ingredient) of a regular flu shot. That's because aging makes a body less able to generate a robust immune response when vaccinated.

Q: Last year, there were two flu shots. This year, there's only one. Why?

A: Every year, health experts get together in February, try to determine what strains of flu are going around and devise a seasonal vaccine against the three most prevalent. Last year, H1N1 influenza showed up after the seasonal flu vaccine was formulated, so the CDC quickly added a second shot for H1N1 swine flu.

Q: What will be in this year's vaccine?

A: This year's vaccine will counter last year's H1N1 virus, the Perth H3N2 virus and the B Brisbane virus.

Q: What are these viruses like?

A: The H1N1 is like last year's swine flu virus. The Perth virus was first identified last year but didn't circulate widely. Those who got last year's seasonal flu shot will not be protected against it, the CDC says. A few cases of Perth cropped up in Iowa in June and July of this year, it says. The Brisbane virus circulated in some areas in 2008. Last year's seasonal flu shot contained antigens for the Brisbane virus, so those who got the shot might have some protection.

Q: Last year, some age groups were asked to wait to get their shots until high-risk groups were vaccinated. Will that be the case this year?

A: No. This year there's plenty of vaccine, and everyone over 6 months of age is urged to be vaccinated unless they have contraindications. People allergic to eggs should avoid the vaccine because eggs are used to make it.

Q: Where can I get the vaccine?

A: From your doctor, county clinics, retail pharmacies and some supermarkets. The Miami-Dade County Health Department is offering flu shots at its Downtown Clinic, 1350 NW 14th St., Miami; its Little Haiti Clinic, 300 NE 80th Ter., Miami; and its West Perrine Clinic, 18255 Homestead Ave. Call 786-845-0550. Shots are free to those younger than 18 and older than 64. Others pay $25. The Broward Health Department urges residents to contact their private physicians. Both departments will work with schools to vaccinate children.

Q: Will pharmacies have the vaccine?

A: In spades. Encouraged by last year's boom in vaccinations, pharmacies are competing to provide the shots. They're dueling on price, charging $20 to $30 for the shots. The enthusiasm stems from a new law allowing pharmacists with special training to give the shots to adults. Until the 2008-2009 flu season, only pharmacies with walk-in clinics staffed by nurse practitioners or physicians' assistants were permitted to give flu shots. Now, pharmacists who take a 20-hour state course in giving shots, handling allergic reactions and administering CPR may give them.

Q: With no dire predictions and no pandemic, will people line up this year to get their shots?

A: ``It's a difficult situation,'' says Samir Elmir, director of environmental health for the Miami-Dade Health Department. ``We will try to educate the public as well as possible about the need to vaccinate.''

By Fred Tasker.

Turnoff Week

2010-09-22T06:48:00.000-07:00

TURNOFF WEEK - The American Academy of Pediatrics encourages everyone to participate in Turnoff Week this week and 'go for a week without screen time.'

A report this earlier this year by the Kaiser Family Foundation found that the average child in the United States between the ages of 8 and 18 years old spends just over 10 1/2 hours a day (10:45) using some type of entertainment media (screen time), including watching TV, listening to music, playing video games, and surfing the internet, etc.

Considering those statistics, it is easy to see why the American Academy of Pediatrics encourages everyone to participate in Turnoff Week and 'go for a week without screen time.

Many people probably think that really going a week without any screen time is unrealistic for the average family, and if you are one of those people, keep in mind that kids who get too much screen time are more likely to get poor grades, less likely to get along well with their parents, and are more likely to report being sad or unhappy.

My kids probably get too much screen time, as they do like to watch TV and play games on their iPods and PlayStation. On the plus side, they would rather play outside, they are very active in at least one sport each season, and they do well in school and like to read. Instead of cartoons or other shows, they have also gotten to where they mainly like to watch sports on TV. So I'm not sure I really need to limit their screen time very much at this point.

One thing I would like to do during Turnoff Week is break their habit of automatically turning the TV on when they get home. Having a TV on in the background when you aren't really watching a show and are doing something else is a bad habit that many kids and adults have.

A report by the Kaiser Family Foundation has found that the average child in the United States between the ages of 8 and 18 years old spends just over 10 1/2 hours a day (10:45) using some type of entertainment media (screen time), including:

• 4:29 watching TV shows, either on a TV, cell phone, or iPod, etc.

• 2:39 listening to music

• 1:29 on a computer (online and offline)

• 1:13 playing video games

• :25 watching movies in a movie theater

Use of all of these types of media has been increasing over the past 10 years. The only thing that they found that had decreased was the amount of time kids spent reading each day, which is down to just 38 minutes a day.

Screen Time

Keep in mind that these times are in addition to the average half-hour a day (:33) they spend talking on their cell phones and 1 1/2 hours they spend texting.

Even when you consider that kids do many of these things together, the Kaiser Family Foundation found that the average child was spending about seven hours and 38 minutes watching TV or using their computer, cell phone, and iPod, etc.

Although that clearly sounds like too much time using these devices, that is even easier to see when you consider that kids who are heavy users of these types of entertainment media are:

• more likely to get poor grades

• less likely to get along well with their parents

• more often bored

• more likely to get into trouble a lot

• more likely to report being sad or unhappy

Schedules and Activities for Kids

If your child shouldn't be in front of the TV or computer or on his cell phone all of the time, what should he be doing?

Experts recommend that school age children and teens:

· 9 (teens) to 10 (8-12 year olds) hours a night

· Excersise for at least one hour every day, including moderate-intensity aerobic physical activity each day (bike riding, brisk walking, skateboarding, etc.), muscle-strengthening physical activity (push-ups, sit-ups, swinging on playground equipment, etc.), bone-strengthening physical activity (hopping, jumping, running, etc.), and more vigorous-intensity physical activity (running, playing soccer or basketball, jumping rope, etc.) at least three days a week.

· Eat a meal together with their family each night

· Limit screen time (which should include time watching TV, using a computer, playing video games, or using an iPod, cell phone, or other media device) to no more than one or two hours a day

Limiting Screen Time

To help decrease your child's use of all of the different types of entertainment media (screen time), it can help to:

• remove most media devices from your child's bedroom, including their television or computer, especially if it has internet access

• take away your child' cell phone and other mobile media devices (iPod, Nintendo DS, etc.) around an age-appropriate bedtime

• make sure your kids are getting a good night's sleep and aren't staying up late talking on the phone, texting, or listening to music, etc.

• use parental controls on your TV and computer to limit when they can be turned on and used

• encourage active free play after-school with friends.

• encourage your child to participate in an organized sport, hobby, or other extracurricular activities

• turn the TV off during meals and when your kids aren't watching a specific show so that the TV isn't on in the background all of the time

• set a good example by being active and limiting your own use of screen time

• avoid using extra screen time as a reward

Most importantly, don't use your child's media devices as a babysitter. Spending more time with your kids is probably the best way to get them off their computer or away from the TV.

Back to School Health Primer

2010-08-29T17:15:00.000-07:00

Back to School Health Primer

The start of a new school year is always exciting with new challenges and new expectations. Everything that occurs during the school year from September through June will impact our children’s health – mostly in positive ways but there are always a few speed bumps along the way at unexpected times. Here’s a snapshot of the most important issues nuts and bolts to consider as you march through a new school year with your kids.  

The Annual Well Child Examination

Most public school systems require an official physical examination, or well child examination, on record entering Kindergarten, Middle School and High School, and for sports participation. The American Academy of Pediatrics, however, actually advises a checkup annually from 3 to 21 years of age. This is really the only way to be sure your child’s health and well being is stable year to year and to catch subtle issues that need attention. During those visits, the entire child’s health is looked at, not just the physical exam. A year’s overview of a child’s emotional, developmental and academic ups and downs is what gives ups a picture of a child’s health. We can tell you a great deal about your child based on what has changed, or not changed, from one year to the next and help you prepare for what changes are anticipated next.

Finally, keep in mind that since the point of the visit is to get a sense of your child’s health, it is important for your child to weigh in on issues. Most pediatricians and nurse practitioners work hard to help a child learn to talk about themselves during these visits as they get older. What helps is if the child is given an opportunity to answer the questions first with you filling in the blanks later. In some offices, the parent talks with the pediatrician separately and during the actual physical is more of a fly on the wall.

When A Child Is Sick

Kids can and do get sick during the school year. During cold and flu season, many illnesses are hard to avoid. Given that kids get 6-12 illnesses a year, it is not surprising that most of these illnesses occur during the school year when kids are in close proximity of one another. Luckily, most illnesses are minor and self-limited but that doesn’t mean they won’t impact your child’s school attendance and your ability to go to work. What can create great peace of mind is having some basic information, including return to school guidelines. Your school will have specific guidelines in place created by your public health department but these are the general rules of thumb we follow in pediatrics:

Most illnesses are viral and take time to resolve.

A simple cold last 3-5 days but a stronger virus up to 2 weeks. That can seem like forever sometimes!

Fever and even a rash can be part of many viral illnesses but some due require medical attention so you’d want to notify your doctor if sick symptoms develop with BOTH a fever and a rash.

Fever alone is not a concern if your child looks well and is acting well.

More important than the height of the fever is how your child looks with any degree of fever.

Your child is contagious with fever needs to stay home from school until fever free for a full 24 hours.

It is important to remember that even minor illnesses take time to recover from. Kids don’t learn well when they are worn down. It is lousy enough to be sick and get behind in school, it is even more upsetting for a child to be back in school before the illness has cleared enough to really function well. Time really does cure most ails so be patient and don’t push your child back to school until you are sure your child is really ready. Your pediatrician can help guide you if you are uncertain.

Common School Year Illnesses

Your child will likely not get all of these but here’s a list of the typical sick and urgent complaints kids in general are prone to each September to June:

Mono

Strep Throat

sniffles: common cold or allergy

injuries

chicken pox – even if having had the shot

vomiting and/or diarrhea

headaches

“not feeling well”

starting an antibiotic: no school for 24 hours or until fever free for 24 hour

needing medications at school

asthma

rash

fever

flu symptoms

Your school nurse’s office usually sends around notices if any of these illnesses are in your child’s school or building. What is important is to be sure your child is diagnosed properly and not to push your child back to school until your child is ready. Your pediatrician is the best guide for both of these important decisions.

Medication Use In School

With the school year starting, take a minute to think about the types of medications your child may need at school, both prescription and nonprescription. This is particularly important for conditions that could be live threatening, such as allergies to food or stings and asthma. Make sure the school has necessary inhalers, benadryl and epipens. If your child has an asthma action plan, the school should have a copy.

For acute illnesses, usually all you need is a note from the doctor and the prescription medication. Luckily many antibiotics can now be given only once or twice a day but there are still a few that are 3-4 times a day so will need to be given during the school day.

Just in case medications are sometimes needed at school. Migraines are a great example of this. So, make sure your school has what your child needs should a headache begin.

Finally, if your child gets diagnosed with a major condition, talk to the school nurse so she is aware of the treatment plan and medications.

Immunizations

School is a special situation for health care because of the group setting created by the close proximity of teachers and students. For this reason, all States have State mandated immunization laws in place for school entry that are based on the current CDC 2010 Childhood Immunization Schedules.

In most states, parents must provide proof of immunizations when kids are entering Kindergarten, when moving into the school system, and in middle school or high school, depending on the district. Typical immunization requirements for those grades include:

By Kindergarten, students must have proof of:

3 doses of Hep B 5 doses of DTaP/DTP 4 doses of Polio 2 doses of MMR 1 dose of Varicella

By 7th Grade, students must have proof of:

3 doses of Hep B 1 booster dose of Td 3 doses of Polio 2 doses of MMR 1 dose of Varicella if under 13 years of age; 2 doses if over 13 years of age

You can find the school entry immunization requirements for your State here.

Special Vaccines for Special Situations

There are two times special vaccines are needed: travel to other countries and during the flu season. If you are planning a trip over seas, check the CDC.Gov website to see if your family will need pre-travel vaccinations.

For the upcoming flu season, all kids now need an annual flu shot. The risk to kids from the flu is just too high and anti-flu medications ineffective and dangerous. Annual vaccination against the flu is the only way to protect kids from the flu.

If you have an infant under 6 months at home, it is crucial that both parents and all siblings over 6months get the flu shot. This is the only way to protect that very vulnerable infant.

Here's some valuable new information from the CDC on the seasonal flu, including H1N1.

Unexpected Problems

Finally, just like with a check-up on your car, the annual physical examination only is a touch point at that time. And, while your pediatrician can talk to you about issues expected for each age, that doesn’t mean those issues will come up for your child or others won’t occur. Just be open to whatever comes your way and call your pediatrician at the first sign of concern, in you or your child. Better to call and have something be nothing than to find out an issue is brewing your pediatrician can help with. A child’s body is very dynamic and changing all the time. And, a school year has a way to molt our children in new an unexpected ways. While most of those changes are wonderful, some can be a bit rough and we don’t want you to face those alone.

August 2010 by Dr Gwenn

Sun Safety 101: Prevent Skin Cancer by Following These Simple Tips

2010-06-28T19:54:00.000-07:00

Excessive exposure to the sun and other sources of ultraviolet (UV) radiation is clearly associated with a higher risk of multiple forms of skin cancer. Since skin cancer is diagnosed in over one million Americans every year (and rising), experts from the American Cancer Society, the National Cancer Institute, the American Academy of Dermatology, the National Comprehensive Cancer Network, and many other organizations are unanimous in strongly recommending that you should reduce your time in the sun.

That sounds simple, but how much sun is too much? Who is most at risk? What are the most effective ways to protect yourself? Here are answers to frequently asked questions about sun safety.

Am I at risk for skin cancer?

People of all races and skin colors can develop skin cancer, but some are more susceptible than others. If you have one or more of the following risk factors, you should be especially vigilant about reducing your UV exposure:

Fair skin
Blue, green, or hazel eyes
Blond or red hair
Freckles
Moles (especially 50 or more)
Family or personal history of skin cancer

When and where is the sun most dangerous?

UV radiation from the sun is especially damaging under certain conditions, including the following:

from 10 a.m. to 4 p.m.
from mid-Spring through mid-Fall
at latitudes nearer the equator (for example, Florida)
at higher altitudes
when there is no thick cloud cover (and clouds only block 20% of UV rays)
near water, snow, or other highly reflective surfaces

Sun damage accumulates over time, so if you find yourself in these conditions often, consistent protection is a must. Remember that besides skin cancer, the sun can also cause cataracts and other eye problems, a weakened immune system, unsightly skin spots, wrinkles, and "leathery" skin.

What is the most effective way to protect myself?

If you answered "sunscreen," you're wrong. The most effective way actually is to simply stay out of the summer sun in the middle of the day. If that's not possible, wearing dark, tightly-woven clothing and a wide-brimmed hat also works. Only then comes sunscreen, which isn't a panacea and shouldn't be exclusively relied upon. Here are some more tips to protect yourself:

Wear sunglasses that include a warranty stating they provide 99-100% UVA and UVB (broad-spectrum) protection.
Apply one ounce (a palm full) of sunscreen to all exposed skin 15 minutes before venturing outdoors. The sunscreen container should specify a sun protection factor (SPF) rating of 15 or above and should state that it provides broad-spectrum (UVA and UVB) protection. Lotion- or cream-based sunscreens tend to adhere to the skin longer, thus providing better protection.
PABA-free sunscreens are recommended for persons with sensitive skin. Susceptible individuals may also want to avoid oxybenzone and dioxbenzone. Products that contain avobenzone (Parsol 1789), ecamsule, zinc oxide, or titanium dioxide are considered broad spectrum sunscreens and are thus offer protection against UVB and most UVA rays, as well as help reduce the development of wrinkles and skin aging.
Depending on your activity (swimming, sweating), sunscreen should be re-applied at least every two hours.
The SPF number on the sunscreen indicates how many times longer, under ideal conditions, a person can stay out in the sun without beginning to turn red in comparison with the amount of time totally unprotected skin would start to burn. Research indicates these numbers are sometimes overstated.
Avoid tanning salons, beds, and sunlamps.

Do children need extra protection?

Yes. Up to 50% of an individual's lifetime contact with sunshine occurs before adulthood. Studies also show that the more incidents of sunburn kids have, the higher likelihood that they will develop skin cancer decades later. So it is especially critical to protect them from the sun. Here are a few tips:

Babies 6 months of age or younger should be kept completely out of the direct sun at all times. In addition, sunscreen shouldn't be applied to babies this age.

For children over 6 months, apply sunscreen every time they go outside.

Children's swimsuits made from sun-protective fabric and designed to cover the child from the neck to the knees are popular in Australia. They are now available in some areas of the United States.

Are tanning salons healthier than the sun?

No. Tanning lamps give out UVA and frequently UVB rays as well and so can cause serious long-term skin damage and contribute to skin cancer. Remember, tanning is a sign of skin damage and does nothing to protect the skin from further injury. Experts recommend that you prioritize your health over vanity and avoid tanning salons altogether.

The sun causes an estimated 90% of skin cancer cases. Reducing your exposure to UV radiation now is a simple, easy, and effective way to prevent a potentially devastating cancer later.

From Timothy DiChiara, Ph.D.

Sources:

"SunWise Program." Environmental Protection Agency. 15 September 2008.

"How Do I Protect Myself from UV Rays?" American Cancer Society. 15 September 2008.

"Facts about sunscreens." American Academy of Dermatology. 14 September 2008.

"Skin Cancer Prevention Program." California Department of Public Health. 14 September 2008.

Learn how to prevent and treat children with Swimmer's Ear

2010-05-31T19:25:00.000-07:00

Children with swimmer's ear (otitis externa) have inflammation in their external ear canal. It is usually caused by water irritating the skin inside the ear, which then becomes infected with a bacteria, or more rarely, a fungus.

Symptoms of Swimmer's Ear

Ear pain is the most common symptom of swimmer's ear. Unlike the pain of a middle ear infection (otitis media), which might follow a cold, the ear pain from swimmer's ear is made worse by tugging on your child's outer ear. Looking inside your child's ear, your Pediatrician will likely see a red, swollen ear canal, with some discharge.

Diagnosis of Swimmer's Ear

The diagnosis of swimmer's ear is usually made when a child has the classic symptom of outer ear pain that is made worse by tugging on the child's ear.

Swimmer's ear can be confused with a middle ear infection, especially when your pediatrician is not able to see your child's ear drum.

Treatments for Swimmer's Ear

Once your child has swimmer's ear, it is not the time to put alcohol based ear drops, which are often used to prevent swimmer's ear. They will likely burn and make your child's ear feel even worse. Instead, swimmer's ear is usually treated with antibiotic ear drops, either with or without added steroids (which some experts think can reduce inflammation and make symptoms go away faster).

Common otic (ear) drops that are used to treat swimmer's ear include:

Ciprodex*

Cipro HC*

Cortane-B*

Cortisporin*

Domeboro Otic

Floxin

Vosol

Vosol HC*

*antibiotic ear drops that include a steroid.

Although expensive, Floxin, Ciprodex, and Cipro HC, are most commonly prescribed, as they have less side effects, can be used just twice a day, and may provide better coverage against the bacteria that cause swimmer's ear.

For mild cases of swimmer's ear, you might ask your pediatrician if you can first try a solution of half strength white vinegar ear drops (half water/half white vinegar) twice a day -- a common home remedy that some parents try.

Pain relievers, including acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) can also be used to to reduce your child's pain until his ear drops start working.

If there is enough swelling, so that ear drops can't get into your child's ear, your pediatrician may place an ear wick inside his ear canal.

Prevention of Swimmer's Ear

In general, you can prevent swimmer's ear by keeping water out of your kids' ears. Fortunately, that doesn't mean that your kids can swim and enjoy the water. Instead, use an over-the-counter ear drying agent that contains isopropyl alcohol (rubbing alcohol), such as Auro-Dri or Swim Ear, or one with acetic acid and aluminum acetate (Star-Otic).

If you like, you might also create your own homemade swimmer's ear prevention solution by mixing equal parts of rubbing alcohol and white vinegar, and putting it in your child's ears after he swims.

Although some experts think that earplugs are irritating and can lead to swimmer's ear, you can also keep water out of your kids' ears by using a barrier, like earplugs, including Mack's AquaBlock Earplugs or their Pillow Soft silicone Earplugs. If your kids have a hard time keeping their earplugs in, consider also using the Aqua-Earband or Ear Band-It neoprene swimmer's headband.

What You Need To Know

Swimmer's ear is usually caused by an infection with the Pseudomonas aeruginosa or Staphylococcus aureus bacteria. 
You can often prevent swimmer's ear by keeping water out of your child's ears. 
Pools that are poorly maintained are more likely to spread swimmer's ear. 
Swimmer's ear can be treated with prescription antibiotic drops, either with or without steroids. 
Once your child is better, you should continue to use his ear drops for an additional two or three days, during which time he stays out of the water. 
Ear wax may be protective against swimmer's ear, so don't aggressively remove wax from your child's ear. Cleaning your child's ears with a cotton-tip applicator may also put them more at risk for swimmer's ear. 
In addition to swimming, kids can be at risk for getting swimmer's ear if they get water in their ears when bathing or showering. 
Oral antibiotics are rarely needed to treat uncomplicated cases of swimmer's ear. 
Malignant otitis externa is a rare complication of swimmer's ear. 
Fungal infections and noninfectious disorders, including eczema, psoriasis, seborrheic dermatitis, and allergic contact dermatitis, can also cause otitis externa, and should be suspected in chro

De-stressing in stressful times

2010-04-16T11:08:00.000-07:00

Glance at the 10 leading causes of death in America, and you won’t find the word “stress” anywhere. Yet many well-respected studies link stress to a variety of ailments, including heart disease, stroke, and cancer. Depression and anxiety, which afflict millions of Americans, can be caused or exacerbated by stress. Stress also triggers flare-ups of asthma, rheumatoid arthritis, and gastrointestinal problems, such as irritable bowel syndrome. Sometimes just thinking about embarking on a program of stress control can be stressful. Rather than freeze in your tracks, start small. Pick just one stumbling block or source of stress in your life, and see if these suggestions work for you.

Often angry or irritated? Consider the weight of cognitive distortions. Are you magnifying a problem or leaping to negative conclusions without checking to see if they have any foundation in fact? Take the time to stop, breathe, reflect, and choose.

Unsure of your ability to do something? Don’t try to go it alone. If the problem is work, talk to a co-worker or supportive boss. Write down other ways that you might get the answers or skills you need. Turn to tapes, books, or classes, for example, if you need a little tutoring.

Overextended? Clear the deck of at least one time-consuming household task. Consider what is truly essential and important to you and what might take a backseat right now.

Feeling unbearably tense? Try massage, a hot bath, mini-relaxations, progressive muscle relaxation, or a mindful walk. Practically any exercise — a brisk walk, a quick run, a sprint up and down the stairs — will help, too. Done regularly, exercise wards off tension, as do relaxation response techniques.

Upset by conflicts with others? State your needs or distress directly, avoiding “you always” or “you never” zingers. Say, “I feel ________when you _____.” “I would really appreciate it if you could ______.” “I need some help setting priorities. What needs to be done first and what should I tackle later?” If conflicts are a significant source of distress for you, consider taking a class on assertiveness training.

Mini-relaxation Mini-relaxations can help allay fear and reduce pain while you sit in the dentist’s chair or lie on an examining table. They’re equally helpful in thwarting stress before an important meeting, while stuck in traffic, or when faced with people or situations that annoy you.

Here are a few quick relaxation techniques to try.

When you’ve got 1 minute. Place your hand just beneath your navel so you can feel the gentle rise and fall of your belly as you breathe. Breathe in slowly. Pause for a count of three. Breathe out. Pause for a count of three. Continue to breathe deeply for one minute, pausing for a count of three after each inhalation and exhalation.

When you’ve got 2 minutes. Count down slowly from 10 to zero. With each number, take one complete breath, inhaling and exhaling. For example, breathe in deeply saying “10” to yourself. Breathe out slowly. On your next breath, say “nine,” and so on. If you feel lightheaded, count down more slowly to space your breaths further apart. When you reach zero, you should feel more relaxed. If not, go through the exercise again.

When you’ve got 3 minutes. While sitting down, take a break from whatever you’re doing and check your body for tension. Relax your facial muscles and allow your jaw to fall open slightly. Let your shoulders drop. Let your arms fall to your sides. Allow your hands to loosen so that there are spaces between your fingers. Uncross your legs or ankles. Feel your thighs sink into your chair, letting your legs fall comfortably apart. Feel your shins and calves become heavier and your feet grow roots into the floor. Now breathe in slowly and breathe out slowly. Each time you breathe out, try to relax even more.

Reprinted from Stress Management: Approaches for preventing and reducing stress, a Special Health Report from Harvard Medical School, Copyright © 2008 by Harvard University. All rights reserved., a Special Health Report from Harvard Medical School, Copyright 2008 by Harvard University.

Spring Allergies & Parents Allergy Guide - Allergy Symptoms and Treatments

2010-03-17T10:20:00.000-07:00

Pediatric Allergy Basics

Allergies can be a big problem for kids.

Learning more about allergies can help parents get their kids some much needed relief.

The first step in treating allergies is trying to make sure that your child really has allergies to begin with, as allergy symptoms are often confused with cold symptoms.

Allergy Symptoms

If your child doesn't have a cold, then he may have allergies.

Although most parents just think of a runny nose when they think of allergies, there are actually a range of allergy symptoms, such as:

itchy red skin rash - from nickel, known as contact dermatitis
runny nose and itchy eyes - from ragweed, known as allergic rhinitis
itchy red rash that comes and goes - from peanuts, known as hives

Of course, if you are thinking of the classic allergy symptoms and signs that are associated with hay fever (allergic rhinitis), then they can include:

runny nose with clear discharge
stuffy nose (congestion)
sneezing
itchy nose
red eyes, with tearing and itching
dark circles under the child's eyes (allergic shiners)
a crease near the bottom of the child's nose (allergic crease)
rubbing the nose a lot (allergic salute)

Food Allergies

Although you can be allergic to almost any food, 90% of children with a food allergy are going to be allergic to one of these allergy foods:

cow's milk
eggs
peanuts
soybeans (soy milk, tofu, etc.)
wheat
tree nuts (walnuts, cashews, almonds, pecans, pistachios, etc.)
fish (cod, salmon, tuna, etc.) and shellfish (shrimp, crab, lobster)

If your child eats a food that he is allergic to, he will quickly develop any number of food allergy symptoms, which can range from simple hives and vomiting, to a life-threatening anaphylactic reaction.

Seasonal Allergies

Classic triggers of seasonal allergies include:

ragweed and other weeds (late summer and fall)
trees (early spring)
grasses (late spring and early summer)
outdoor molds (season varies depending on where you live and can be year-round in some areas)

You can often tell that your child has seasonal allergies if his allergy symptoms start or get worse each year during a specific season, although that is sometimes hard to track. You may also notice that your child's seasonal allergy symptoms are better on days that it rains and are worse when it is dry and windy, since pollen can move around better on those days.

Indoor Allergies

While most things that cause seasonal allergies are outside, these children with year-round or perennial allergies are usually allergic to things inside your house, such as:

dust mites
indoor molds
animal dander (cat and dog allergies)
cockroaches

Learning to control these allergy triggers is important to reduce your child's indoor allergies.

Other Allergy Triggers

In addition to foods, dust, and pollens, other common allergy triggers can include:

medications, especially antibiotics like penicillin and sulfa drugs
latex
poison ivy
ingredients in topical medications, such as neomycin and bacitracin (antibiotics), PABA (sunscreens), and lidocaine (topical anti-itch creams)
additives in foods or medications, such as the food dye tartrazine (Yellow No. 5) and sulfites
insect bites and stings

Allergy Relief

To get allergy relief for their kids, it can help if parents:

Avoid allergy triggers as much as possible, which can range from putting a special allergy-proof cloth mattress cover on your child's mattress if he is allergic to dust mites to keeping windows closed in your car and home when pollen counts are high if he has seasonal allergies

figure out what is triggering your child's allergies with a symptom diary or allergy testing
try nasal washes to clear allergens, irritants, and mucus from your child's nose
consider giving your child an allergy medicine everyday, especially during his allergy season
consider a combination of medications, such as an antihistamine and a nasal steroid
consider allergy shots if you child has moderate to severe allergy symptoms that are hard to control

Allergy Medicines

Since avoiding allergy triggers can be tough, especially if your child has seasonal allergies, many children with allergies require allergy medicines for allergy relief. Fortunately, a variety of allergy medicines available, even for younger children.

Allergy medicines can include:

Older sedating antihistamines - Benadryl (diphenhydramine), Extendryl (chlorpheniramine)
OTC antihistamines - Claritin(loratadine), Zyrtec (cetirizine)
Prescription antihistamines - Allegra (fexofenadine), Clanrex (desloratadine), Xyzal (levocetirizine)
Leukotriene Antagonists - Singulair (montelukast)
Steroid nasal sprays - Flonase (fluticasone), Nasonex (mometasone), Omnaris (ciclesonide), Rhinocort Aqua (budesonide), Veramyst (fluticasone)
Antihistamine nasal sprays - Astelin (azelastine), Patanase (olopatadine)
Allergy eye drops - Acular (ketorolac), Optivar (azelastine), Pataday (olopatadine), Patanol (olopatadine), Zaditor (ketotifen)

What You Need To Know

Allergy shots are overlooked as an option to treat children with hard-to-control allergies. Some parents don't think that they are available for children, while others don't think that children will tolerate getting allergy shots every week.  

Allergy testing can be helpful if your child has hard to control allergies, asthma, or eczema.  

A pediatric allergist can be helpful to diagnose and manage your child's allergies.  

Most common Question

Q. Every year, around March or April, my son gets a persistent runny nose, water eyes and he sneezes all of the time. Could he have allergies?

A. Allergy symptoms do commonly include a runny nose, with a clear, watery discharge, watery eyes, and repeated sneezing. Other symptoms can include having an itchy nose, congestion, itchy eyes, frequent throat clearing, frequent nosebleeds, and a cough. Children with allergies also often have dark circles under their eyes or 'allergic shiners'. These symptoms usually last for weeks or months for children with seasonal allergies. If your child just has a clear runny nose for up to 1-2 weeks, especially if it turns green or yellow or is accompanied by a fever, then it may just be a cold.  Since your child's symptoms only occur during a specific time of the year and seem to linger, he likely does have seasonal allergies, which in the spring are often caused by pollen from trees and grasses.  In addition to daily use of an antihistamine, such as Claritin™, Clarinex™, Zyrtec™ or Allegra™, children with allergies also often take a nasal steroid, such as Flonase™, Nasonex™, Rhinocort Aqua™, or Nasacort AQ™, to help control their allergy symptoms. A decongestant, either alone or in combination with an antihistamine (Claritin D™, Zyrtec D™, Allergra D™, etc.) may also be used. Over the counter allergy medications, which can be more sedating than newer medications, should usually be avoided if needed on a regular basis.  Singulair™ is another medication that can be used to treat children with allergies. It is available as oral granules and a chewable tablet for younger children who can't swallow pills.

It may also help to keep track of daily pollen counts and avoid a lot of outdoor activities on days when the pollen counts are moderate or high. Although it is not usually possible or desirable to stay indoors on all high pollen days, there are some steps you can take to decrease your child's exposure to pollen that he may be allergic to. For spring allergies, pollen counts are usually highest in the early morning (tree pollens) and afternoon/early evening (grasses), so limiting outdoor activities during these times may be helpful. You should also keep windows at home and in the car closed if possible, avoid hanging clothes outside to dry, and have your child take a bath in the evening to wash off pollens before bedtime.  Should you have allergy testing? If your child's allergies aren't controlled with standard allergy medicines, if you aren't sure that he really has allergies, or if his allergies are leading to a lot of complications, such as recurrent sinus or ear infections, then allergy testing and allergy shots may be useful. Allergy testing is probably more useful for children with year round or perennial allergies, since you are more likely to find something that you can avoid, such as dust mites, mold or pet dander.  In addition to standard skin testing, blood tests, such as the ImmunoCAP test can also be helpful. There are useful regional profiles available for different parts of the country to test for the pollens that your child is most likely to be exposed to.

2010 Childhood Immunization Schedule

2010-02-15T17:20:00.000-08:00

Immunization Basics

Each year, the Advisory Committee on Immunization Practices (ACIP), together with the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP), publishes new recommendations for immunizations for children and teens.

2010 Childhood Immunization Schedule Changes

While there were some changes in the 2010 childhood immunization schedule, these changes likely won't mean any extra shots for most kids.

One of the changes is that the immunization schedule now states that the use of combination vaccines is "preferred over separate injections," so this schedule may actually mean that your kids get fewer shots at each visit to the doctor. For example, at his two-month check-up, your infant might get the single Pentacel shot, instead of the separate DTaP, IPV, and Hib vaccines. The previous immunization schedule said that combination vaccines "may be used."

Another change will mean an extra shot for some kids, but only those high-risk children who need the meningococcal conjugate vaccine, including children with persistent complement component deficiency (a rare type of inherited immune deficiency), anatomic or functional asplenia (they don't have a spleen or their spleen doesn't work well), and some other immune system problems. These children usually get a dose of the meningococcal conjugate vaccine when they are between two to six years old, and it is now recommended that they get a second dose three to five years later, depending on when they got their first dose.

Some other changes are:

Children should get the last dose of the polio vaccine after their fourth birthday and at least six months after the previous dose.

All children aged two years and over can get the hepatitis A vaccine for protection against hepatitis A, even if they don't live in a high-risk area

Starting when they are 11 to 12 years old, girls can get either Gardasil or the newer bivalent HPV vaccine (Cervarix) to protect them against HPV

Boys between the ages of 9 to 18 years old can get Gardasil for protection against genital warts

_Sources:

_{Morbidity and Mortality Weekly Report Weekly. January 8, 2010 / 58(51&52), 1-4. Recommended Immunization Schedules for Persons Aged 0 Through 18 Years -- United States, 2010.}

MHD responds to Haiti earthquake

2010-01-15T15:52:00.000-08:00

My Home Doctor is responding to the major earthquake that devastated Haiti’s capital on January 12th by sending two of our best on the ground to rescue lives.

Patrick Kavanagh, M.D., an emergency medicine physician Board-Certified in Internal Medicine with a specialty in Infectious Disease.

Liana Gold, ARNP, an adult nurse practitioner with experience in emergency medicine and trauma at Jackson Memorial Hospital Miami and in Israel.

Giving Help

The American Red Cross is one of the most widely known organizations working in Haiti. The American Red Cross is working with its partners in the global Red Cross and Red Crescent network, including the Haitian Red Cross, and other partners to assist those affected by this disaster.

Your gift to the American Red Cross will support emergency relief and recovery efforts to help those people affected by the earthquake in Haiti. Assistance provided by the American Red Cross may include sending relief supplies, mobilizing relief workers and providing financial resources and recovery. They accept online ( http://www.redcross.org/ ) donations help volunteers arrange to give time or other support, and can accept $10 donations, charged to your cellphone bill, by texting HAITI to 90999.

Doctors Without Borders has been working in Haiti for 19 years, most recently operating three emergency hospitals in Port-au-Prince, and is mobilizing a large emergency response to this disaster. They are asking donors to give to the Emergency Relief Fund. These types of funds ensure that medical teams can react to the Haiti emergency and humanitarian crisis all over the world, particularly neglected crisis that remain outside the media spotlight. Your gift via their website will be earmarked for the Emergency Relief Fund. Please visit http://www.doctorswithoutborders.org/

How to Stay Healthy During the Holidays

2009-12-22T08:54:00.000-08:00

Get adequate sleep, even if your routine is interrupted by guests and/or travel, maintain a regular sleep schedule as much as possible.

Eat healthy, nutritious foods. Avoid getting into the fast-food routine because you're busy.

Take a high-potency multivitamin if you are not already doing so. You may want to take extra vitamin C to help boost your immune system.

Avoid taking on too much. You can't do everything, and you will become stressed and fatigued if you try to.

Attend the parties you really want to go to, not the ones that you just feel obligated to attend.

Streamline your shopping. Use the Internet or mail-order catalogs. Shopping from home will save you energy. In addition, you will avoid crowded stores packed with all types of germs.

Keep up your exercise program.

Avoid excessive drinking. You may end up with a hangover and/or feel drained and fatigued.

Make private time. Relax, read, take a bath - time for yourself will rejuvenate and refresh you. Contributor

Do I Have a Cold or the Flu?

2009-11-27T05:09:00.000-08:00

Figuring out if you have a cold or the flu can be difficult. Learn how to spot the differences

By Krisha McCoy

You feel awful: You are running a fever, your nose is runny, you have a cough, and your head is pounding. Is it just a cold, or could you be dealing with the flu? It's often hard to tell.

Cold vs. Flu Symptoms: Finding the Cause

Both the cold and the flu, or influenza, are respiratory infections, but they're caused by different viruses. A cold can be caused by any one of more than 200 distinct viruses, while there are only a handful of viruses — called influenza viruses — that cause the flu.

As a general rule, the flu is usually more intense and fierce than the common cold. (However, those people who have been stuck in bed dealing with debilitating colds may argue the point.) In some situations, it can be important to know if you have the flu, since it is more likely to lead to serious complications, including pneumonia, bacterial infection, or hospitalization.

Cold vs. Flu Symptoms: Spotting the Differences

Fever, runny nose, fatigue, headache, and muscle aches are symptoms shared by both cold and flu. Although cold and flu share some of the same symptoms, certain indicators are common with each individual condition.

It's difficult to identify if you have a cold or flu because these symptoms overlap. It may be helpful to remember that a runny, stuffy nose is a common indicator of a cold, along with scratchy throat, sneezing, watery eyes, and a mild fever (below 102 degrees Fahrenheit).

Symptoms that indicate flu tend to be more severe than with a cold and include fever (above 102 degrees Fahrenheit), nausea, cough without phlegm, chills, body aches, sweating, and lack of appetite.

In addition to examining your symptoms, watch how these symptoms develop in order to give you a clue as to whether you have a cold or the flu. Cold symptoms tend to develop gradually, while flu symptoms can come on suddenly, without warning.

Cold vs. Flu Symptoms: Seeking Medical Care

Your doctor can perform tests in the first few days after you develop symptoms to determine whether you have a cold or the flu. However, you usually don't need to visit the doctor unless your symptoms are severe, you have a pre-existing health problem that puts you at high risk of a complication, or your symptoms indicate a more serious infection.

Whether you have a cold or the flu, expect your symptoms to stick around for about 10 days. There is no cure for a cold, but in some severe cases of the flu, your doctor may recommend an antiviral medication to speed up your recovery time. Antiviral drugs are considered a second line of defense after flu vaccinations.

Since both the common cold and the flu are caused by viruses, not bacteria, antibiotic medicines are not of any use in combating them.

Get plenty of rest, avoid smoking and alcohol, drink plenty of water and juice, and take over-the-counter medication to treat specific symptoms to help you feel better as your body fights off the infection.

Swine flu facts: H1N1 information guide to protect yourself and your family

2009-10-26T18:11:00.000-07:00

President Obama has declared swine flu a national emergency.

"In recognition of the continuing progression of the pandemic,” Obama wrote in his official proclamation, announced Saturday, “and in further preparation as a nation, we are taking additional steps to facilitate our response.”

But what can you do?

First and foremost, educate yourself with the latest information on the swine flu, or H1N1 virus.

The Daily News linked up with Yahoo! to analyze the tens of millions of swine flu-related searches on their U.S. website over the past month -- and found the ten key questions Americans are asking about the virus.

Dr. Richard Besser, former head of the Centers for Disease Control (CDC) and senior health and medical editor at ABC News, provides the answers.

1. What is swine flu?

Swine flu is the name for the new strain of influenza virus that is circulating around the globe. It first appeared in April of 2009 in the U.S. and Mexico, and has quickly spread to all parts of the world.

2. What are the symptoms of swine flu?

The symptoms of swine flu are exactly the same as the symptoms of seasonal flu, which include fever, coughing, sore throat, runny nose, body aches, and fatigue.  There is nothing about swine flu that tells you it is swine flu and not seasonal flu, so you really have to look to public health and say, “Hey, what’s going on in my community?” This summer, if you had flu symptoms, it is likely that you had swine flu because that was all that was circulating.

3. How many people have died from swine flu?

It’s hard to say exactly how many people have died from swine flu. From April through the end of August, the CDC reported 9,079 swine flu hospitalizations and 593 deaths in theUnited States. From August 30th through October 10th, there were 292 reported swine flu deaths, and another 2,029 deaths that were reported either as influenza or pneumonia - some of those probably weren’t swine flu.

According to the World Health Organization, as of October 17th, there have been more than 414,000 laboratory confirmed cases of pandemic influenza H1N1 2009 and nearly 5,000 deaths. Most likely, there have been millions of cases around the world that have gone undiagnosed and unreported.

4. How long does swine flu last?

In general, you feel pretty lousy for three days, and you start to improve over the next few days though you may have a cough which lingers for weeks. If you don’t start to feel better after three or four days, you should see a doctor. Another important thing to note is that if you are starting to get better and then take a turn for the worse - meaning you get a high fever - then you need to seek medical care right away because that could mean you have a bacterial infection on top of the flu.

5. What is the swine flu incubation period?

The incubation period is the time from when you’ve been infected by the virus to when you start showing symptoms. The usual incubation period with swine flu is one to four days, but it can be up to a week.

6. Is there an increased risk of swine flu for pregnant women?

Pregnant women are at greater risk for swine flu and other respiratory infections for three reasons. During pregnancy, a woman’s immune system changes to allow the development of the baby, which can increase the risk of infection. As the pregnancy goes on, the sheer size of the developing fetus can limit a woman’s ability to take a deep breath by pushing up on the diaphragm, and taking a deep breath is a defense mechanism that forces things out of our lungs. And, lastly, many pregnant women have other children around the house, which can increase their risk of exposure to germs.

7. Swine flu vs. regular flu: How do they compare?

The big difference between swine flu and the seasonal flu has to do with who is at the greatest risk. Younger people are at greater risk for swine flu because they don’t have any underlying immunity or protection. On the other hand, the elderly are at greater risk for seasonal influenza. 90% of people who have been hospitalized for swine flu were under 65 years old. 90% of those who have been hospitalized for seasonal flu were over 65 years old.

8. Is the swine flu vaccine safe; what are the side effects?

This should be a very safe vaccine. It is made the exact same way as seasonal flu vaccines, which are given to over a hundred million people in this country every year. In fact, the swine flu vaccine actually went through additional testing this past spring to determine how many doses people would need, and that provided even more safety information. It is expected to have the exact same safety profile and side effects of the seasonal flu vaccine. The most common side effects of the injectable vaccine are redness, soreness, at the site of injection, and mild fever in the couple of days after the shot. The nasal spray vaccine also can cause a mild fever, and maybe a bit of a sore throat. It is important to remember that neither vaccine is really giving you the flu. Your body’s reaction to it is part of the way you develop immunity.

9. What are the ingredients in the H1N1 vaccine?

Again, there are two different vaccines. The nasal spray is what is called a "live attenuated vaccine." They take the virus and change it so that it can’t cause the flu, but it can infect the cells in your nose and cause an immune reaction. The injectable vaccine has a surface protein in it called hemagglutinin. All vaccines contain trace amounts of ingredients that are used in its manufacturing, as well as stabilizers so that the vaccine remains effective.  Also, if your vaccine comes from a multi-dose vial, it will have a very small amount of a preservative called thimerosol. It is important to remember that both vaccines can have trace amounts of egg protein in them, because the viruses that are used to make the vaccine are grown in eggs. People with egg allergies can’t receive either vaccine.

10. Other than taking the vaccine, what swine flu precautions can we take?

It’s important that people don’t forget those basic things that our moms taught us. Wash your hands with soap and water. If you don’t have soap and water, use a hand sanitizer. Cover your mouth when you cough with your sleeve, not your hands. Stay home when you are sick, and keep your kids home when they are sick so the respiratory infection does not spread. If you are a high-risk individual, talk to your doctor about what you should do if you get sick, so that you have a treatment plan. Those things can be very helpful and provide peace of mind.

Calming Children's Cold and Flu Symptoms

2009-09-24T09:29:00.000-07:00

Calming Children's Cold and Flu Symptoms
What can parents do to ease children's cold and flu symptoms? Learn about treatment options available for this flu season.

By Susan L. Sullivan
Medically reviewed by Pat F. Bass III, MD, MPH

It used to be that the biggest decision facing parents for their children’s cold and flu relief was whether “to starve a cold or feed a fever.” Today, we not only know why that question does not apply to flu season, but also that a variety of treatment options are available to help ease children’s cold and flu symptoms.

Flu Season: Is It a Cold or the Flu?

“It’s most important to understand that the cold and flu both start out as upper respiratory infections,” says Henry H. Bernstein, DO, professor of pediatrics at Dartmouth Medical School in Hanover, N.H., and member of the Committee for Infectious Diseases, American Academy of Pediatrics.

Symptoms that the cold and flu have in common include coughing, headache, stuffy nose, fatigue, and muscle aches. Other cold symptoms are a runny nose, fever up to 102 degrees, sore throat, and sneezing. With the flu, on the other hand, a fever may be over 102 degrees and symptoms can include chills, sweats, diarrhea, nausea, vomiting, and loss of appetite.

“You cannot prevent the common cold, but you can prevent the flu by getting a flu vaccine every year,” Bernstein says. “Children age 6 months through 18 years should be vaccinated every year, and other age groups should get the vaccine if they are high risk for complications" like asthma.

Flu Season: Over-the-Counter Relief

Although there is no cure for either the cold or the flu, certain over-the-counter medications may help ease some of the discomfort associated with children’s cold and flu. For fever, headaches, muscle aches, and sore throats, children may take acetaminophen (Tylenol). It is important to use acetaminophen and any cold medications as directed on the package.

“Cough suppressants and decongestants should be used with caution because of side effects,” says Bernstein. “Although decongestants may help dry up secretions, they are a cardiac stimulant and can result in death if not used appropriately.” Other serious side effects from cold medications include convulsions, rapid heart rates, and loss of consciousness. “Cold and cough medications should not be given to children under age 6,” says Bernstein.

In general, doctors do not prescribe antibiotics for cold and flu because they are not effective against cold and flu viruses. However, Bernstein says doctors occasionally may prescribe an antibiotic if there is concern about a bacterial infection.

Never give aspirin or aspirin-containing medicines, including those with salicylate or salicylic acid, to children. The use of aspirin in children has been associated with Reye's syndrome, a potentially fatal disease that affects the liver, brain, and blood.

Flu Season: Cold and Flu Remedies

In addition to these treatment options, Bernstein says there are a number of ways parents can help their children feel better when a cold or flu strikes:

Have children sit upright to help them breathe better.
Use a bulb syringe to remove mucus from the nose.
Use saltwater nose drops to loosen mucus.
Use a humidifier or vaporizer in the child’s bedroom to help loosen nasal congestion.
Have children drink plenty of fluids.
Bernstein also recommends frequent hand-washing helps to kill germs and prevent the spread of colds and flu. Other ways to curtail the spread of cold and flu viruses include:

Teaching children to cough into their elbow and turn toward their shoulder
Not smoking in front of a child
Not sharing tissues
Avoiding crowded daycare centers
Reminding children not to touch their nose, mouth, or eyes
Cleaning door handles, bathroom facilities, and children’s toys with an anti-bacterial disinfectant
While children are not more susceptible than adults to cold and flu, their exposure tends to be higher. “Because of their ability to share their secretions and because they are not inclined to use the best hand hygiene, children spread germs more readily than adults,” Bernstein explains.

Flu Season: Do Homeopathetic Remedies Work?

According to Bernstein, there is no clear-cut home remedy to benefit to common cold. “Vitamin C, zinc, and echinacea are rumored to provide relief, but the research is not conclusive,” says Bernstein. “If you give children vitamin C in the form of orange juice, it will at least keep the kids well-hydrated.”

The steam from chicken soup or any hot beverage such as tea may help congestion and provide needed fluids. Foods high in vitamin A, such as spinach and broccoli, are also good for children suffering from a cold or flu.

Flu Season: When to Call the Doctor

Complications of colds and flu, including bronchitis, sinusitis, or other bacterial infections, need to be treated with antibiotics. Be aware, however, that what you might think is a cold or the flu could actually be strep throat or pneumonia, which also require antibiotics. Seek immediate medical attention if your child has:

Difficulty breathing
A bad headache
Confusion
A persistent fever
Chest pain
If your child does get the flu or a cold, time and TLC will help make the recovery process easier for both you and your little one.

Swimming Pool Safety Alert

2009-07-16T12:02:00.000-07:00

Here's how to prevent accidents in and around the pool.

Each year, about 260 children under 5 drown in swimming pools. In addition, the suction from drains in swimming pools and spas, under certain conditions, can entrap swimmers underwater.

To help protect your family, be sure to take the following steps. Use layers of protection to prevent swimming pool drownings, layers of protection are essential. Place barriers completely around the pool, closely supervise young children, and be prepared in case of emergency. In addition: If a child is missing, always look first in the pool. Seconds count! Knowing how to swim doesn't make a child drown-proof.

Never use flotation devices as a substitute for supervision. Keep rescue equipment and a phone next to the pool. Learn cardiopulmonary resuscitation (CPR). Install physical barriers around the pool to limit access. Fences and walls should be at least 4-feet high and installed completely around the pool. Gates should be self-closing and self-latching. The latch should be out of reach of small children. If your house forms one side of the barrier for the pool, doors leading from the house to the pool should be protected with alarms that sound when the doors are unexpectedly opened. Or, use a power safety cover, a motor-powered barrier placed over the water area, to prevent access by young children. For above-ground pools, steps and ladders to the pool should be secured or removed when the pool is not in use.

Pool and Spa Entrapment Dangers: Never use a pool or spa with a missing or broken drain cover. Be sure a newer, safer drain cover is in place. The new drain covers are usually domed-shaped — instead of the old flat drain covers. Consider installing a Safety Vacuum Release System (SVRS) , a device that will automatically shut off a pump if a blockage is detected.

Have a professional regularly inspect your pool or spa for entrapment or entanglement hazards. Plainly mark the location of the electrical cut-off switch for the pool or spa pump. If someone is entrapped against a drain, cut off the pump immediately. Instead of trying to pull the person away from the powerful suction, pry a hand between the drain and the person's body to break the seal.

Source: US Consumer Product Safety Commission