Archive for August, 2012

Last year, my daughter complained to me about back pain. I wasn’t sure what was causing her discomfort until one day when I had to lift her school backpack out of my car. I almost threw my own back out.

I couldn’t believe how heavy it was. It weighed 20 pounds, and my daughter weighed 80 pounds.

Carrying a heavy backpack can be a source of low-level trauma leading to shoulder, neck and back pain in children. This is especially true for those school kids in middle and high school who have neither lockers nor desks to store their books in during the school day.

Experts recommend that children carry backpacks that weigh 10 percent or less of their body weight and no more than 15 percent.

The way a backpack is carried may contribute to the problem. Some kids wear their packs over only one shoulder, often because it’s “cool” or just plain easier. That causes them to walk unbalanced, causing abnormal stresses on their young developing spines.

A heavy backpack may make a bicycle rider top-heavy and less stable on the bike, potentially leading to accidental injuries.

A good backpack should have the following features:

– Lightweight construction

– Two wide, padded shoulder straps

– A padded back, for comfort and injury protection

– A waist belt and multiple compartments to distribute weight more evenly

We as parents need to be aware of this potential problem and be proactive in helping our children make best use of their backpacks.

Children should be taught to pick up their bags properly, by bending at the knees before lifting and using both hands.

Keeping straps tight will help with proper fit.

Remind children to use all of the backpack’s compartments, putting the heaviest items — such as textbooks — near the center of the back. They should not to carry around unnecessary personal items.

Also, take advantage of using available online books that don’t have to be carried around.

If your child continues to have back pain even after making the above adjustments, or has numbness, weakness or tingling in the arms or legs, consult with your doctor.

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I have recently seen an increase in what is called hand, foot and mouth disease, and an increased number of cases have been reported to the county health department. Some countries outside of the U.S. have seen an even greater number of infected people.

Hand, foot and mouth disease is a common illness caused by a virus that mostly affects children younger than 5 years of age. Child-care settings are frequent sources of the disease. Outbreaks usually occur during summer and fall months.

Most of those affected by this disease have no obvious symptoms. Those who do show symptoms will have perhaps a mild fever and small pimple-like lesions on the palms of the hands, the soles of the feet and inside the mouth.

Hand, foot and mouth disease is spread from person to person by bodily secretions, such as saliva, feces, and fluid from the pimple-like lesions and the nose or mouth. One can be infected by touching surfaces or objects that have been contaminated by infected individuals.

Transmission can be reduced by good hygiene. Individuals should wash hands thoroughly with soap and water, especially after changing diapers or using the toilet. Commonly used surfaces and soiled items, including toys, should be washed with soap and water or a solution of 1 tablespoon bleach in 4 cups water. People need to avoid kissing, face-to-face contact and sharing eating utensils or drinking containers with those who have hand, foot and mouth disease.

About a quarter of those affected recently by hand, foot and mouth disease are adults, who are showing a more severe rash and fever than the typical case. This rash often involves the extremities, face, buttocks and torso, in that order. Interestingly, it appears most commonly in skin previously damaged by sunburn or chronic conditions such as eczema.

There is no specific treatment for hand, foot and mouth disease. Treating symptoms of pain or fever with Tylenol or ibuprofen may be all that is necessary.

The most common complication of this disease is dehydration caused by sores in the mouth and throat making it very difficult to swallow. Affected children must be monitored closely for the amount of liquids they take in and the amount of urine they produce. Serious dehydration should be treated at a hospital emergency room.

Workers and students should not return to work or school until their fever has been gone for at least 24 hours and any skin lesions are dry and not oozing any liquid.

The good news is that this common disease usually has no long-term serious consequences and can, to some extent, be prevented by practicing good hygiene.

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I would like to offer my interpretation of the federal government’s Affordable Care Act, commonly called Obamacare.

First of all, insurance companies will be regulated. There will be coverage under the parent’s policy for children up to age 26. There will be no maximum limit on what an insurance company will pay for an individual’s lifetime of health care coverage, and preexisting illness cannot prevent one from obtaining health insurance.

Preventive care, such as mammograms, colonoscopies and other related services, will be covered by all insurance plans with no out-of-pocket expense.

A Prevention & Public Health Fund will be created to promote general health and wellness programs and initiatives to combat obesity and discourage tobacco use, alcohol and drug abuse and other unhealthy conditions.

Added taxes will be placed on pharmaceutical companies, medical device makers and the tanning booth industry.

The government will regulate and control reimbursement to health care providers — that is, physicians and hospitals.

A commission, acting independently of congressional control, will develop new ways of paying for medical care, with a move away from the fee-for-service model. One such new model is called the Accountable Care Organization. This would function somewhat like an HMO, except that ACO patients would not be required to stay within a network.

In addition, there is the “individual mandate” part of the act. This is a requirement that starting in 2014, all U.S. citizens will be required to purchase health insurance. It pertains mostly to the 30 million people who, for whatever reason, are without health insurance.

About half of these uninsured people have incomes high enough to buy health insurance through state-run health insurance exchanges. The others have incomes low enough that they will be covered by the existing state-run Medicaid programs.

For people who choose insurance through the exchange, premiums will be regulated by the government, which will also provide subsidies to help those who cannot afford to buy insurance. People who work for firms with 100 or fewer employees will also be able to purchase their own coverage through the exchanges. Undocumented immigrants will be barred from purchasing insurance through the exchanges.

There will be a penalty to individuals and companies who choose not to purchase health insurance. This penalty — which the law calls a tax — will top out at $695 per individual and $2,085 per family. There will be no criminal or civil action for refusing to pay the penalty; however, the IRS could withhold tax refunds from those who owe penalties.

In summary, the Affordable Care Act is an attempt by the federal government to help provide health insurance to the 30 million-plus citizens who have no coverage. It makes significant pro-consumer changes to existing health insurance regulations and makes an attempt at offering programs that could improve the health of most American citizens.

There are some major questions being asked about this law, such as: Will there be enough medical providers to care for the newly insured millions of Americans? Will there be enough money to finance this ambitious project, and where will it come from? What happens to states that don’t want to increase their Medicaid programs?

This is a large and complex law with many details that still needed to be worked out. In a future column, I will give my personal assessment of its major provisions.

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