The lazy days of summer are finally here! Have you been having fun with your family so far? We’ve been enjoying the nice weather and taking advantage of not having such zany schedules.

My favorite part of the summer is to embody the “lazy” from the “lazy days of summer” motto and attempt to find ways to convince my family to embark upon that journey with me. Far from becoming couch potatoes, slowing down is more of a state of mind…a way to refuel and take some time to just go where the wind blows and unclog our minds from the months of road dust that our more hurried lives had deposited.

The unique elements of the summer are the prefect backdrop for this much needed change of pace, but also need to be considered for their powerful seasonal characteristics. To get you on your way, here are my Lazy Summer tips:

Lube up! The sun is stronger this time of year and puts everyone at risk for burning so lube up everyone liberally (2 months and older) with sunscreen SPF 15 or higher.

Always hydrate. Heat illnesses are serious and can creep on kids and adults quickly. Keep everyone hydrated and if anyone seems overly tired or looks dehydrated, seek care immediately.

Zap those bugs. Biting bugs can carry infection so be sure to use DEET bug spray 10-30% for children 2 months of age and older.

You only have one head so protect it! If someone is in motion on a bike, skateboard or even jet ski, they need to protect the head. Having a “no helmet, no bike/skakeboarding/etc policy” and wearing a helmet yourself goes a long way in reinforcing this rule.

Swim smartly. The American Academy of Pediatrics recommends all kids 4 and older take swim lessons. However, this isn’t a replacement for adult supervision near water but a way to assist children in becoming more water safe as they get older and stronger.

Unplug! Use the summer to unplug and get outdoors. Untethered by technology, you’ll all see the world differently and find yourselves unwinding in ways impossible to during the school year.

Mowing is for adults. Lawn mowers injuries are incredibly serious and avoidable. Kids younger than 12 should never operate push mowers and kids under 16 should never operate ride-ons. And, kids should never ride on mowers with anyone else…ever!

Move and groove every day! Take advantage the long days of summer to get everyone moving more and every day.  You may even find a few activities that can carry over into the next school year.

Eat for the season. The summer is a goldmine for wonderful, fresh fruits and vegetables that make eating new and exciting, even for kids. Take advantage of that to find new, healthy foods for your family that can carry over into the fall and winter, and help balance out the yummy summer ice cream treats.

Remember to focus on fun and family! Family time can be a precious commodity in the school year so grab it while you can this summer and just go for broke with fun being the only rule.

Here’s to a fantastic summer!

Hi!

It’s been a while since I’ve posted a true Editor’s Corner but I have a fantastic excuse – I’ve been writing a book…and it’s just about ready for launch. It’s truly exciting and I can’t wait until it’s on the shelves ready for you to see. But, I can give you a glimpse as the listing just went live on Amazon.

The book is on the the one topic you know is near and dear to my hear – cyber safety. In fact, the book is called Cyber Safe! It will hit the shelves on October 1 and I’ll have much more to say as the date nears…until then, here’s a sneak peak:

I’m planning my book tour and media appearances now so if your group, school or organization is interested in hearing about the many topics in the cyber world from texting to cyberbullying, let me know. All the information you need about the book is on the contact page.  If you’re a member of the media, the contact information for you is on that page, too.

In other Pediatrics Now news, I hope you are enjoying the new look and easier navigation for both Pediatrics Now and Dr. Gwenn Is In. If you see any issues, please let me know and we’ll look into them for you.

Finally, be sure to check out all the updated content on both Pediatrics Now and Dr. Gwenn Is In, tailored to what you need to know right now.  With my interested in cyber safety and all things high tech, you’ll start to see a slant in both sites towards that direction but I’ll never completely abandon the foundation of information you’ve come to trust on parenting and child health topics over the years. After all, we live in the offline world and that information is important, too!

We’re off to enjoy some summer family fun for a bit and I hope you’ve been able to take some time to do the same. To help you enjoy your family get aways and adventures, check out the Pediatrics Now Summer Tool Box I posted over on Dr. Gwenn Is In…everything you need is there and if not, drop me a line and I’ll dig up what you need.

Enjoy the lazy, hazy days of summer and I’ll be back in touch soon with back to school info and, of course,  all the updates on CyberSafe.

Stay cool!!

Dr. Gwenn

July 2010

Technical Names: Lyme Disease

Lyme Map: Lyme has a definite geographic distribution. According to the CDC you’ll find Lyme in these three areas:

• Northeast: Massachusetts to Maryland.
• North-central states: especially Wisconsin and Minnesota.
• West Coast: especially northern California.

Nicknames: Lyme Disease, Lyme

What it is: tick-borne infection from ticks of the Ixodes genussed by the bacteria borrelia borgoferi

Typical Ages for Illness: any

Typical Symptoms: Lyme Disease has three stages.

• Early: is a characteristic rash at the site of the tic bite called erythema migrans. Its main property is an expanding, red circle.
• The second phase is more disseminated: multiple erythema migrans patches occur in 15% of patients, other symptoms that can occur during this phase are arthritis, conjunctivitis, nerve palsies, headache and fatigue. Other uncommon issues can develop during this phase if untreated.
• Late disease is chronic arthritis of the large joints, usually knees. This is very, very uncommon in kids who have been treated.

Etiology: Borrelia burgdorferi , a spirochete bacteria

Seasonal Issues: spring and summer when tics are out; geographic distribution includes New England, eastern mid-Atlantic states, upper Midwest in Minnesota and Wisconsin.

How’s It Spread? Via tick bite of infected tic

Incubation Period: 1-55 days with a mean of 11 days. Late symptoms occur months to years later.

Diagnosis: clinical if rash present; quick lab assay that will remain positive for life – so it can be used for diagnosis but not to confirm if treatment was effective.

Prevention: REMOVE THE TICK if you remove the tic with in 2 days, Lyme will not get transmitted from the tick to the person its attached to. So, the sooner than better. How to remove? Take a tweezers and grab the tick on the head. Gently pull up and the tic will release. Don’t worry if the tikc’s small pincers stay attached to the skin – those don’t carry disease and will not cause harm.

Treatment:

Antibiotics for 14-21 days orally for early disease. More complicated disease and late disease needs to be treated longer and sometimes by IV antibiotics.

Call Your Pediatrician if your child has: A tick bite where a characteristic rash began to form.

School and After school Activity Issues: no restrictions. This is not contagious person to person.

Internet Resources For Parents

CDC Lyme Page

Tick Management Handbook

Tick Bite Prevention

Internet Resources for Kids and Teens

Lyme Info For Kids

Lyme Info For Teens

Are you an “opt in” teen parent or an “opt out” teen parent? And, does it matter? I think it does!

My daughter recently participated in Relay For Life with some friends in her freshman high school class and I was stunned to discover that the parents were harder to rally than the teens. Read on.

Relay is an amazing event. Organized nationally by the American Cancer Society, this one event teaches teems the true value of teamwork, community service, and volunteerism.

The American Cancer Society always makes it easy to participate in these events between their printed materials, website and meetings.  However, because the teams are teens, lead by teens, there does need to be adult involvement to pull this off and to keep the event safe. In addition to implying that parents be involved behind the scene, there’s a strict chaperone requirement for the entire 12 hour overnight.

Parent involvement started a month before the event by requiring a signed permission slip. That part occurred easily. Multiple phone calls, emails and Facebook posts began around the same time outlining deadlines, needed supplies and the chaperone requirements.  It took my husband getting involved a week before to pull that together. Parents, in general, were resistant to commit.

Our team pulled it off in the end. A few other teams were not so lucky and were prohibited from participating because not a single parent would step up to chaperone. And, on a few teams, teens intending to participate failed to show up with their supplies because their parents wouldn’t let them participate at the 11^th hour without warning.  We heard through the grape vine that social plans were the typical reason.

Weekends are crazy for everyone and I’m not suggesting we all volunteer for every event our kids consider doing. However, not all events are made equal. We should be applauding the mature and altruistic interests of our kids and bending over backwards to help them fulfill their goals. Those are the events we need to be involved with. Those are the events we should be pausing our lives for in order to bear witness to our kids’ lives. Those are the events, in fact, we should put a priority on for our teens because they teach our teens important skills that will help shape their future lives.

So, don’t blindly “opt out” of volunteer events involving your teen until you are sure you won’t be kicked in the face later on by doing so. Social time is something we can always carve out more of but time to support our teen and the causes important to them is time limited with graduation day being the end point.

Wouldn’t you rather be part of the action and witness first hand your teen doing the amazing things your teen is trying to do than end up sitting in the parents’ section on graduation day wishing you had?

Does your family dream of amusement park rides every summer? This time of year the amusement park ads are in full bloom getting everyone itching to get to their local parks.

There is no doubt that amusement parks can be a great family outing and offer something for everyone – even non-ride people. At the same time, while it’s easy to assume that a clean-looking, well-run park is “safe”, statistics suggest otherwise. Safekids.org recently reported 6500 emergency room visits in 2001 for amusement park injuries in the United States – and the majority of those actually avoidable and due to families and attendants bending the posted rules. Equipment problems do occur but result in a small amount of injuries overall. Continue Reading

It never fails.

In fact, not only can I count on this, so can you:

2 kids + 1 back yard trampoline = injury

The injury can be mild to major and can involved one or both kids but it WILL happen and often includes sprains, contusions, lacerations, head traumas, spinal traumas, dislocations, bumps, bruises and concussions. Safety nets don’t prevent these from happening; they just prevent your kids from getting injured on the ground.

You may think that most sound parents, including ourselves, would be swayed by the reams of data that support the dangers of trampolines and keep their kids off. But, more times than not I hear parents say “What can I do? She (or he) just loves it so much!” This is usually mentioned to me during an evaluation for an injury, by the way.  Now do you see why I’m worried?

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Common Household Pets:

Hamster, cat, dog, guinnea pig, ferret, gerbil, rabbit, mouse

Do these pets carry a rabies risk? No.

Can I get infected from being bitten by my pet? Yes. Mouths of pets have bacteria and can infect you. As with all bites and cuts, you want to do the following:

1. Clean well with warm soapy water.

2. Apply antibiotic ointment.

3. Cover with bandaid/dressing and change when needed.

4. Keep a close eye on the bite site for signs that active infection is forming which include:

Redness

Warmth

Tenderness

Pus

If your pet or a friend’s pet has bitten you, find out about the health of the pet:

• How has the pet been acting?
• Is the pet up to date on shots? This applies to dogs and cats.
• When in doubt, contact a vet to see if the pet needs to be evaluated for infection. Often a vet can tell you over the phone if a type of pet needs to be seen or will put a person at risk from a bit.

What animal bites do I need to worry about for rabies risk?

Wild animals and unimunized cats and dogs.  So, if you don’t know the ownder of a cat or dog, those are the  cats and dogs to worry about. Also, all dog bites need to be reported to the local police by law.

Bites from the following animals need to be evaluated right away for rabies shots: bat, skunk, raccoon, fox, coyote, or large wild animal. Keep in mind that for bats, a bat in the house counts as a bat bite since bats often leave no bite marks.

Links For More Information

Dog Bite Law Site

University of Michigan Pet Bite Information

Have you ever consulted a doctor for an opinion about your health but found yourself unsure whether to follow the advice given? Even as a physician, I’ve been in that position and it isn’t at all comfortable.

In my case, I suddenly found my self with achy joints, not an uncommon situation for adults as they “get older”. The problem is I’m not that old! I was soon diagnosed with a form of arthritis after consulting a rheumatologist at one of the top hospitals in Boston, which wasn’t too surprising given my family history.

The medication regimen proved a bit intense and my husband and I were not thrilled with the recommendation for the next step of treatment. We found this group very focused on treatment first, life impact second and decided to seek alternate opinions to see if there was a way to treat the joints while have some sort of quality of life considerations.

The next rheumatologist had a better handle on the life impact issues but had a different major flaw: he opted to ignore key diagnostic tests done with the first group and attempt to shake up the entire diagnosis without adding any insight into treatment.

So, we’re pushing for another opinion. That’s right, a third opinion.

It’s important that I have a doctor that looks at me as a person, not a diagnosis. It’s important that my doctor consider treatment options for me that take into account my life, as a mom, wife and physician, and not just focus on marching through a protocol. It’s important that I find someone who listens and doesn’t discount what my body is telling me even if it doesn’t fit nicely into some diagnostic box. Human bodies don’t tend to work that way. As I learned early in medical school, human bodies don’t read medical books and why we have to practice the art of medicine with a solid clinical background.

The art of medicine is what I want my doctor to practice…not some lab focused, protocol oriented medicine, which seems to be a bit more common these days. Whether for me, my husband or my children, this is the type of medicine I feel is a must to get the care needed for any problem, large or small.

Good care is still possible in a dysfunctional system and don’t let any health care provider tell you otherwise. You always have the power to change and should use that power to find the provider who meets your health and wellness needs, or those of a family member if you are acting as an advocate.

By the way, notice I never mentioned health insurance once. The core of what we need from our health and wellness system isn’t about health insurance reform, it’s about health and medical reform and finding providers who still believe in the value of providing good care in a run down system.

Fostering healthy eating and fitness is often a wrestling match of Olympic proportions. In one corner, our kids highly motivated but under trained in the rules of health. In the other, the tag team of activity and food which can change as fast as a chameleon from working for the health of your child to a pure health enemy.

You never know what you’ll get in the ring – exercise or video games. Cookies or carrot sticks. You, the parent, are the referee, and get to play dirty. This is one match where referee interference is not only expected but crucial for our kids to have the winning move.

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Common and Technical Names:

Poison Ivy: Toxicodendron rydbergii

Poison Oak: Toxicodendron diversilobum

Poison Sumac: Toxicodendron vernix

Plant Identification: see this link: Cornell Poisonous Plants Information Database)

What it is: Allergic reaction to urushiol oil from the poison ivy/oak/sumac leaves. The rhyme “leave three let them be!” can help kids remember to avoid clusters of three leaves together. 85% of kids can have allergic reactions to the oil.

Exposure Issues:

• Plants: poison ivy, oak and sumac leaves
• Non-plants: oil on toys and shoes that had been in contact previously with the oil; the oil can actually remain active for 1 year!

Typical Ages for Illness: any age in a susceptible person, someone who is sensitive to the oil

Typical Symptoms: rash and itching in the areas of skin in contact with the oil. This can be from direct contact with the plan or by fingers who touch the oil on the skin

Seasonal Issues: The plants are perennial but have different appearances as the seasons progress. See KidsHealth for great pictures of poison ivy through the seasons.

Incubation Period: rash typically starts 1-2 days after exposure to the plant oil

Diagnosis: by the distinctive appearance of the rash which has a bubbly look. For a typical appearance of the rash click here.

Symptom Duration: the rash can take 2 weeks to clear. It is not contagious.

Treatment:

Symptomatic! Stop the itch!!!!

• over the counter products such as calamine lotion
• oatmeal baths and lotions: Aveeno is the name brand to look for
• antihistamines such as benadryl or claritin
• 1% hydrocortisone cream to small areas 2 times a day but do not use to large areas of the body or the face, or more frequently, without consulting your pediatrician
• local cold compresses

If these simple measures do not work and your child is very uncomfortable, call your pediatrician for further advice.

Exposure Prevention:

• Teach your children to recognize the poison ivy plant.
• Wear long pants, long sleeves, gloves and boots when in suspect areas.
• Use barrier creams such as Ivy Block.
• Remove plants if necessary (this should be done with caution—do not burn the plants since inhaling the smoke can lead to very serious reactions).

Call Your Pediatrician if your child has:

• wide spread areas of rash
• rash near the eyes or mouth
• any areas or the rash that appear infected, have frank push or appear red or angry looking, are tender, have red streaking, or the child has a fever

Internet Resources For Parents

American Academy of Dermatology Poison Ivy/Oak/Sumac Page

Children’s Hospital Boston Information on Poison Ivy and After Care Instructions

Lucile Packard Children’s Hospital

Internet Resources for Kids and Teens

American Academy of Dermatology Pesky Poisonous Plants Page

KidsHealth Information for Kids on Poison Ivy

KidsHealth info for Teens on Poison Ivy