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Kids

I’d like to talk about several common activities involving our children and how to ensure safety and to avoid unnecessary injury.

Playground injuries, mostly from falls, account for over 200,000 emergency room visits per year. The highest risk group is 5-9 years of age. Young children need close adult supervision. Make sure that underneath the equipment there is an adequate shock absorbing material such as chipped wood or any type of rubber product. Also, the equipment needs to be inspected to ensure that it appears to be in good repair.

Bicycling (300,000 emergency visits a year) and skateboarding (30,000 visits) are the leading cause of head injury accidents in children. Proper safety for these activities includes adult supervision of the younger children, routine bicycle maintenance, and mandatory use of head protective helmets. These helmets must be proper to the activity and they must fit appropriately. But most importantly they must be worn!

Swimming accidents leading to drowning, are the second leading cause of injury death among children 14 years and younger. All pools must be adequately fenced in and have properly functioning gates. Injury can be avoided by not running around the pool, not jumping onto floating objects and proper use of a diving board. Again, adult supervision is paramount in preventing swim related activities.

In 1971, trampoline injuries lead to the NCAA eliminating the trampoline from sports competition. I’m sure it’s also why we don’t see this event in the Olympics. Trampoline injuries cause 80,000 emergency visits per year for children age five and younger. If you own a trampoline, do not allow a smaller child to be on a trampoline with a larger child, as the smaller one is much more likely to be injured.  In fact one should follow the manufacturer’s recommendations and not allow more than one person on a trampoline at a time. Safety netting around the trampoline is essential to protect a child but is not fool proof to prevent injuries.  As with all the above activities, adult supervision is mandatory.

Summer Safety

Summer

SUMMER SAFETY

I’d like to share some of my thoughts on making for a very safe summer for everyone.

  • Sunscreen – Almost everyone who spends time out in the sun must wear sunscreen to block the harmful, damaging effects of the sun’s ultraviolet rays on our sensitive skin.  Use a sunscreen that offers protection against both UVA and UVB rays and has an SPF rating of at least 30. Apply it liberally and often (at least every two hours) especially when sweating or swimming.  Parents, protect your kid’s precious skin.
  • Insects – Beware of the many summer bugs lurking out there.  For mosquito protection use a repellant that contains DEET which when used as directed is safe for adults and children over 2 months of age. Regarding the stinging insects such as yellow jackets, wasps and honeybees, avoid them if they are in your vicinity. If you do get stung by a honey bee (which is the only one of the stinging insects that leaves a stinger behind in your skin), remove it as quickly as possible by any means possible.  It is now OK to just pull it out with your fingers and not waste time finding something with which to scrape it off.  Immediately apply ice to the sting. When out in a woody or grassy area always check your entire body for ticks when you get home. If you find one, remove it as soon as possible by getting a pair of tweezers, grabbing the tick  close to the skin and pulling it straight out.
  • Poison oak – The best protection is to recognize it and avoid it. If you come into contact with poison oak with your skin, clothing (including shoes and shoe laces), or garden tools, wash off immediately with soap and water.  Poison oak oil must be washed off of your skin with in a few minutes in order to avoid the dreaded rash. Remember, all parts of the poison oak plant contain the nasty oil, including the leaves, branches and roots.
  • Heat – Heat exhaustion is manifested by extreme sweating, fatigue and cramps. Heat stroke (a life threatening condition) is manifested by lack of sweating, red hot skin,  and a very high body temperature.  Both conditions can usually be prevented by drinking plenty of liquids and avoiding direct sun as much as possible especially between the hours of 11:00 AM and 4:00 PM.
  • Water safety – 4,000 Americans drown every year, mostly men by a factor of 4 times more than women.  Alcohol is frequently involved.  Make sure the kids are supervised in the water every single minute. Watch out for rapid currents, rip tides, rocks, and always be aware of your surroundings.  Boat injuries claim another 700 American lives a year.  Drive your boat sensibly, have enough life preservers on board and do not drink alcohol and drive.
  • Bicycling – WEAR A HELMET!  No matter how obvious this bit of advice is, I still see people riding without a helmet and I really cringe when I see children without this life saving protection. Head injuries are often very serious, if not deadly, and are inexcusable for lack of a helmet. Be aware of your surroundings and be in control of your bike at all times.  Don’t take foolish chances.
  • Eating – Summer picnics can be a common source of food poisoning manifested by vomiting and/or diarrhea..  Food left out too long is the usual culprit. Handling uncooked chicken or eating undercooked chicken is also a common source of this illness.
  • Driving – We all drive more during the summer.  The cheapest form of life insurance while you are in a car is the good old seal belt.  WEAR IT!  Make sure your children are in proper age appropriate car seats.  Hand held cell phone use while driving your car can be deadly and is now illegal. Don’t break the law.

Have a very enjoyable safe summer.

Heart Health

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You don’t have to spend a lot of money or take medication to maintain a healthy heart, just follow these guidelines:

  1. Quit smoking.  Smoking causes high blood pressure, decreases exercise tolerance, increases blood clotting, and double the odds of a heart attack.
  2. If you drink alcohol, do so in moderation. Alcohol can increase the blood pressure and in higher doses can significantly weaken heart muscle.
  3. Exercise the heart as much as you would do for any other muscle to help strengthen it and keep it healthy. 30 minutes a day of moderate intensity exercise, such as brisk walking five days a week, or 20 minutes of vigorous activity, such as jogging three days a week.  Try to make your exercise enjoyable (bring a friend or listen to music) and be persistent.
  4. Eat plenty of fiber such as fruits, nuts, whole grains and vegetables. Avoid saturated fats such as those found in most meats, chicken skin and many dairy products.  Instead, eat good fats such as olive oil, nuts, avocados and olives.
  5. Maintain a normal blood pressure. High blood pressure increases the work load on the heart and eventually will cause it to become thicker, stiffer and weaker.  This can lead to heart attacks and heart failure.
  6. Maintain as normal a weight as possible. As with hypertension, excess weight also increases the workload of the heart leading to the same end result of heart damage. Recent research shows that people who carry most of their weight around their middle (apple shaped as opposed to pear shaped), are at an even greater risk of heart disease.
  7. Controlling diabetes is important because up to three quarters of people with diabetes will die of some form of heart disease.
  8. Keep calm. Stress triggers the release of certain hormones that have an adverse effect on the heart muscle.  Studies have shown that clam and happy people have fewer heart attacks than those who are angry and discontent.  “Don’t worry – be happy”.
  9. Avoid salt as much as possible especially if you have high blood pressure. The recommended daily limit of salt is 2,300 mg. (one teaspoon). Try to avoid processed food and read food labels to steer clear of the worst offenders.
  10. Maintain levels of vitamin D. Research shows that people with low levels of vitamin D were twice as likely to have a heart attack as those who have adequate levels. The new 2010 recommended daily allowance (RDA) is 600 IU for those 1-70 years of age, and pregnant or breastfeeding women, and 800 IU for those over 71 years of age.

The above guidelines are tried and true methods of significantly improving your odds of decreasing heart disease and thereby promoting a healthier, happier, and longer life.

Colon Cancer

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Cancer of the colon and rectum is the third leading cause of cancer in men and the fourth leading cause in women and is more commonly seen in the western industrialized world.

Risk factors can include: age (50 years and older), family history of colon cancer, a high fat diet, smoking, and excessive alcohol intake. Most colon cancers begin from polyps in the colon which usually start out as benign, but after time can become malignant. Therefore, timely diagnosis and removal of the polyp can help to prevent the development of colon cancer, and thereby significantly decrease the mortality of this mostly preventative cancer.

A colonoscopy exam is the current best method for detecting colon polyps. During this same procedure, the doctor can easily remove the polyp. Colonoscopy is essentially painless, is an outpatient procedure, and is a small price to pay for the possible early detection of colon cancer.

The more common symptoms of colon cancer include rectal bleeding and/or blood in the stool, a change in bowel habits, a feeling that your bowel doesn’t empty completely, weakness or fatigue, and unexplained weight loss. Any of these symptoms should get you to see your doctor as soon as possible.

Your doctor will most likely do a rectal exam (don’t be shy, as this is very important), perform a rapid chemical test of a sample of your stool to check for blood, take a blood sample to check for anemia, and most likely schedule a colonoscopy exam.

Surgery is the most common treatment for colon cancer. Chemotherapy and radiation are also often used depending on the extent and location of the cancer.

The bottom line is that colon cancer, if diagnosed early enough, has a very favorable prognosis.  If found too late after it has metastasized (spread) to other organs, it has a much poorer survival rate.

Talk to your doctor about colon cancer screening with colonoscopy and check with your health insurer about what is covered. You should begin screening if you are 50 years old or older, or if you are younger and have a family history of colon cancer.

See your doctor if you have any of the above mentioned symptoms, and if you do, don’t settle for anything less than a colonoscopy exam. Denial or delay can be a matter of life or death.

Youth Sports Injuries

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Your child may be one of the estimated 50 million children participating in organized sports throughout the country. Sports programs are great in teaching the children about teamwork, competition, and providing much needed exercise.  However, statistics show that 1 in 3 of these children will be injured enough to miss a practice or a game and over a million are expected to visit an emergency room this year for a sports related injury with medical expenses costing over a billion dollars a year.

The majority of organized sports related injuries occur during practice rather than games. The top sports for injuries are football, basketball, soccer, baseball, volleyball, wrestling, cheerleading, gym, and track and field.

The most common injuries are to the head, face, fingers, knees, and ankles. The most common injury diagnoses are sprains/strains, fractures, contusions/abrasions, concussions, lacerations, and dislocations.

Concussions in particular, have received much attention recently and appropriately so. There is no longer any doubt about the short term and potential long term dangers of this injury, especially to the young developing brain. We now have very specific guidelines about when to allow a child with a head injury to return to games or practices, as well as how best to treat a child with a significant head injury/concussion.

Symptoms of a concussion are loss of consciousness no matter how brief, headache, vomiting, memory loss, and behavioral changes especially confusion and/or feeling “foggy”.  Any of these symptoms necessitate prompt medical attention.

There is also the issue of overuse injuries involving tendons, bones, and joints. This is due to playing the same sport and performing the same movements too often, too hard, and at too young an age without adequate rest and recovery.

Sports related injuries are inevitable, but there are some things that can be done to help prevent and treat injuries. Be sure your child is involved in a sports program that is properly maintained and adequately coached. Coaches should be certified in CPR and have a plan to respond to emergencies.

Make sure your child has and uses proper gear for a particular sport in order to reduce the chance of injury.

Encourage your child to perform warm up and cool down routines prior to and after sports participation. The warm up will make the body’s tissues warmer and more flexible and the cool down will loosen muscles that may have tightened during exercise.

Be sure your child has access to adequate liquids during exercise and while playing. Emphasize the importance of maintaining hydration to prevent dehydration and heat illness.

Encourage liberal use of sun screen to protect the skin from the sun’s damaging rays and help to prevent future melanoma.

Get professional help if you think your child’s injury is serious, such as when you suspect a fracture or dislocation of a joint, severe pain or swelling.

Statistics show that only 1 in 4 young athletes become elite players in high school and only 1 in 1600 high school athletes go on to professional status. Therefore the emphasis in youth sports should be in the enjoyment and long term involvement in exercise and sports. And remember to match your child’s abilities to the sport and not to push him or her too hard into a sport they may not like or be incapable of doing.

Food Poisoning

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Summer is the time for picnics and social gatherings. This brings about an increased chance of food poisoning which is vomiting and/or diarrhea that comes about from eating contaminated food.  The most common form of food poisoning is from infectious organisms, such as bacteria and viruses.  When eating outside the home, these organisms can contaminate food at any point during its production,  processing, or serving. More commonly, contamination can also occur in the home. This happens because of food that is improperly handled, incorrectly cooked, or inadequately stored. The most common food culprits are chicken products, fish,  and shellfish. Another common source of food poisoning is from food that has been cooked and left unrefrigerated for too long, especially at buffets and outdoor picnics.

Steps to prevent food poisoning:

  1. Wash hands, utensils and food prep surfaces frequently and thoroughly with soap and water.
  2. Keep raw foods separate from ready to eat foods.
  3. Cook foods to a safe temperature.
  4. Refrigerate or freeze perishable foods promptly.
  5. “When in doubt-throw it out.”

Signs and symptoms of food poisoning may start within hours or up to one to two days after eating the contaminated food. The most common symptoms of food poisoning are nausea, vomiting, stomach cramps and diarrhea. The vomiting and diarrhea are the body’s way of eliminating the contaminated food.

There is no easy method to differentiate between food poisoning and common stomach flu other than if more than one person comes down with vomiting and/or diarrhea after eating a common meal, then food poisoning is the probable culprit.  Fortunately, the symptoms of either food poisoning, or of stomach flu, are usually mild and often resolve without treatment.

The best treatment for food poisoning is to let it run its course.  In most cases, once the body rids itself of the contaminated food, the symptoms improve. For this reason, anti diarrhea medicine is not recommended because it may slow down the healing process.  If diarrhea must be controlled because of travel plans or work responsibilities, then an over the counter medication, such as Immodium, may be helpful.

The main goal of treatment is to replace lost body fluids to prevent dehydration. This can be done by drinking lots of liquids, such as electrolyte drinks for adults or Pedialyte for children. A proven method to help prevent dehydration in spite of frequent vomiting is to take frequent small sips of clear liquids until vomiting stops

 

When to seek medical attention:

  1. Inability to keep any liquids down for more than 6-8 hours.
  2. No urine production for 6-8 hours.
  3. Vomiting or diarrhea lasting more than 2-3 days.
  4. Blood in vomit or diarrhea.
  5. Severe abdominal pain.

Have a safe and enjoyable summer. Bon appetit!

Drug Prices

epipen

I am absolutely shocked by the recent news of the incredible rise of prescription drug prices. Attention to this problem started with the actions of CEO Martin Shkreli of Turing Pharmaceuticals who bought the rights to manufacture a one of a kind parasite fighting drug and who then increased the price of the drug from $13.50 to $750 per pill!

Most recently in the news, we’ve heard about the increased price of the Epipen made by Mylan Drugs. The Epipen is a vial of adrenaline which can be self injected by the victim of a life threatening allergic reaction (think bee sting or peanut allergies). This is truly a life saving drug. It contains approximately one dollars worth of adrenaline. Some 5 years ago it sold for $40 and just recently jumped to around $600. (Coincidentally the CEO of the company has seen a salary increase from 2 1/2 million dollars to 18 million dollars.)

This same CEO then came out saying the company would give out coupons which would help some but not all the people who needed Epipens. And now they have developed their own generic version of the Epipen which they plan to sell for $300. Who knows what’s next. This still is a far cry from the price of a few years ago, especially for those many families that need to have on hand several Epipens to care for potential allergic emergencies, not to mention that the devices expire after one year and need to be replaced.

I find these examples of drug price gouging to be unconscionable and unsustainable. For those of us with life threatening diseases, myself included, we seem to be held hostage by the prices of our life sustaining treatments.

Years ago I felt that drug companies did a fantastic job in the research and development of all kinds of new drugs which were offered at fair prices and which helped to conquer a variety of diseases throughout the world. Now it appears they have become greedy. I am all for a free market capitalistic system as we have in the United States, but when it comes to drug companies charging as much as they possibly can, I feel they are holding patients hostage.

Unfortunately, when patients can’t afford their medications, they will often skip doctor’s appointments, tests, or procedures. They may not even fill their prescriptions or take less than directed. All of this is very unhealthy.

The government needs to step in and help to control drug prices because as of now drug companies can charge whatever they want. If it’s a life enhancing or life saving drug, there is little choice but pay the asking price.

The government has various ways to control drug prices such as allowing U.S. patients to purchase cheaper drugs from other countries such as Canada, or by encouraging the development and sales of cheaper generic drugs. We, as citizens and drug purchasers, must contact our elected officials and demand that they help to control drug prices while allowing drug companies a fair profit and enough money to continue new drug development.