Children

How to Use Mindfulness to Help Your Child

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boy with baloon2-01Mindfulness has become mainstream. The InnerKids Foundation in LA has been teaching mindfulness to inner city kids since 2001. The Goldie Hawn Foundation sponsors a program called MindUp that has trained thousands of teachers. In all likelihood, mindfulness is coming to a school near you, with very good reason. Mindfulness works.

MindUP has shown a 90% increase in children’s ability to get along with other children; an 80% increase in optimism; and a 75% improvement in planning, organizational skills, and  impulse control when kids practice. Several studies have shown that mindfulness practice brings a sense of well being and decrease in stress.

Our world has gone crazy, and our children are having problems with anxiety, stress, depression, and the resultant physical symptoms: stomach aches, headaches, and chronic tiredness. Anxious, stressed out kids build stories in their minds that circle, grow, and separate them from what is real and manageable. Mindfulness can help.

What is mindfulness?

Mindfulness is a meditation practice that we in the west have stolen from the Buddhists and warped to our own purposes. Through mindfulness practice a child can achieve a state of mind where they aware, focused on the present, and calmly accepting of  themselves and the world around them, without judgement.

Does this not sound like exactly what we want for our kids? Kids who learn to practice mindfulness have in their arsenal a tool that will help them deal with anxiety, stress, impulsiveness, and any number of damaging emotions–with no side effects and at the bargain price of free. No need to join a religion, and anyone can learn it.

How do we do it?

There are many internet sites that can lead you through mindfulness practice with your kids. I particularly like Renee Jain, MAPP, but there are many out there. There is even an iPhone app! The basics are really very simple:

  • First and most important, do it with your child.
  • Find a peaceful, quiet place, sit comfortably (the crossed leg/hands on knee thing is optional).
  • Focus on awareness of one thing.
  • Notice that thing–a sight, or sound, or feeling-any one thing.
  • Acknowledge that thing, then let the thought drift away, without judgement.

Babies are naturals at mindfulness. Stick mushed peaches in their mouths and they will taste them, look at them on their hands, rub them all over their faces, and smell them. They are in the moment and focused on those peaches. We can learn a lot from babies.

Older kids need to be brought back to that sort of focus. Sit with them in a quiet, comfortable place, and guide them to think about one thing. Use something they can hear (a bell or a shaker?) or taste, or smell. Teach them to notice that thing, then let that notice float away. Be aware and focused, but don’t try to conclude anything about what they are focused on and don’t pass judgement. Just hear, or see, or smell-and then let it go.

As kids get older, they can learn more traditional meditation techniques: breath coming into and going out, awareness of their bodies and of passing thoughts, and letting go so that they can be in the next moment, without attachment to what is passed and gone.

There is no one right way to meditate: the point is to be peaceful and live, for that time, in the present without attachment and without judgement. People meditate by arranging sand, by doing yoga, by coloring, by going fishing–whatever works for you and your child.

Why practice mindfulness?

Meditation can teach kids how to break the spiraling cycle of anxiety; how to develop a more positive and optimistic viewpoint; how to live without pronouncing judgement on everything they encounter, and on themselves. It can help them feel better about themselves and learn to regulate their emotions and impulses.

Imagine your child coming home stressed because someone was mean, they have too much homework, or they are last picked for a team. Imagine if they could find a quiet place, trace that stress to its origin, transform it into a color or a breeze in their minds– and let it go.

Better than sitting, stewing in the stress, and letting it spiral and grow until it takes over their evening, yes?

Create a habit of daily meditation.

Take a few minutes every evening and make meditation a routine–maybe right before homework or bed? Reward them for practicing with a hug or a few minutes more of your time, as you reward any behavior of which you want to see more.

Mindfulness is a skill, like riding a bike. If your child practices every day, when he or she needs it they won’t have to think about how to get their feet onto the pedals and make the bike roll forward. It will just be there for them.

Mindfulness works. Mindfulness practice has been shown to improve kids’ coping skills and their sense of well being. It can improve memory and learning by teaching them to pay attention and focus. It can teach them to be aware of their feelings, accept them, and then let them go, so that they can make wise decisions with their minds rather than poor ones based on overwhelming emotions. They can learn to self regulate and control their own emotions and actions.

Give it a try. Everyone can use a few minutes of peace in their day.

DomesticatedMomster
The Blogger's Pit Stop

Top Eight Safety Features for Your Teen’s New Car

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student_driver

Photo credit: Ildar Sagdeje

The dread day is here – your child has his or her driver’s license, and desperately neeeeds their own car. But which car do you buy them? Ignore that grasping hand trying to drag you over to the shiny new sports car. There are reasons why the insurance is so high on those cars.

Teen drivers lack experience, are easily distracted, and have more frequent and severe accidents. Passive safety features (those that work without anyone having to turn them on or fasten them) are the way to go.

Bryan Mac Murray, Outreach Specialist at Personal Injury Help, gave us today’s blog on car safety features:

The Eight Most Important Safety Features to Look for in a Car

Regardless of whether you are looking for a new car or an old car for your teen, there are  safety features available that can have a significant impact on the outcome of a crash. Here are the most important safety features, in order, to look for when choosing a car:

  1. Electronic stability control is a must. A mandatory technological feature since the 2012 model year, this helps the driver keep control of the vehicle on slick roads and curves. It has been proven to be an effective safety device cutting the single-vehicle crash risk in nearly half. Because teens are often inexperienced behind the wheel, electronic stability control should be near the top of your priority list.
  2. Anti-lock brakes provide more reliable braking and help the vehicle stop without the brakes locking and causing the car to skid off the road. Anti-lock brakes will bring the car to a stop faster, which is great for teens who may not be as attentive as adult drivers.
  3. Airbags are a necessity. While most newer cars are equipped with six airbags, there are cars that have as many as 10. Each of these airbags can significantly protect in an impact. There are front airbags, front-seat side-mounted airbags, two side mounted airbags, driver’s knee airbags, and even overhead airbags that deploy during a rollover.
  4. Automatic crash notification which is subscription-based. Using a built-in phone system, it will call a live operator who is able to pinpoint the car’s exact location and send emergency services to the location. Several automakers now offer this system and you can even have a system installed on most newer vehicles.
  5. A dedicated navigation system is a good idea, as it can keep teens from using their phone’s navigation while driving.
  6. An app to prevent cellphone use while your teen is driving. Depending on your level of comfort with technology, it may be a good idea to look for one of  these apps and install them for your teens. Some are free; some require a subscription.
  7. Automatic braking can determine if a vehicle is about to be in an accident and will automatically apply the brakes, attempting to avoid a collision. This feature has proven very effective.
  8. Forward-collision warning (FCW) will warn teens when a crash is imminent. It uses radar, laser, and camera to detect an imminent crash and to warn the driver so he or she can attempt to avoid an accident.

Research the Safety Rating

While looking for a vehicle with the proper safety features, you should also research the car’s safety rating. Of course, a five-star safety rating means the car is much safer than the average vehicle. Safer vehicles have good ratings in 4 areas: moderate overlap front, roof strength, side, and head restraint tests. In order for a vehicle to be recommended for a teen, it should earn 4 or 5 stars overall if rated by the National Highway Safety Administration (NHTSA). It’s also a good practice to check for any safety recalls on  any cars you may be considering –  if it doesn’t have proof that it was made safe, you may need to move on.

When purchasing a car for a teen, buy a vehicle with as many safety features as you can afford. Safety features are important for all vehicles, but much more vital for the safety of young inexperienced drivers who are just now venturing out on roads and learning proper driving techniques.

 

DomesticatedMomster
The Blogger's Pit Stop

*This Article was written by Personal Injury Help, however this article is not intended to be legal advice nor should it be construed as such.  To learn more about Personal Injury Help, you can visit their website at http://www.personalinjury-law.org or email them at help@personalinjury-law.org

Did You Know? Truth, Tips, and Treatment for Warts.

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girl-doc-01The common wart, or verruca vulgaris, appears as a small, rough-surfaced bump on your child’s skin, frequently on their hands or feet. Interestingly, kids can be infected for months before the warts actually get big enough to see. Warts are benign, causing little harm to their bearer (the exception being genital warts). They can, however, drive the parent of said bearer insane.

Warts are caused by a virus called Human Papillomavirus. They are contagious. Kids catch them by touching someone else’s wart, or by touching a surface that has come in contact with a wart. The virus prefers to invade through cuts, abrasions, and chewed bits of skin, so children are fertile ground for invasion.

There are about 130 strains of HPV. The type of wart you get depends on the strain and on where it appears.

Types of warts include:

  • Common warts. HPV types 2, 4 and 7, among others, cause the common wart. These warts can pop up anywhere, but they are most often seen on hands. “Periungal” warts are around the fingernails.
  • Plantar warts. Most commonly HPV 1, but can be caused by other strains ( 2, 3, 4, 27, 28, and 58) “Plantar” means on the sole of the foot, so that’s where you find plantar warts. They can be painful, because constant pressure on the sole of the foot forces them to grow inward rather than outward. They can feel like a pebble in a shoe.
  • Mosaic warts are a group of warts clustered together, usually on a foot.
  • Filiform warts. HPV strains 1, 2, 4, 27, and 29.These are rapidly growing long strings, frequently found on eyelids and noses. Luckily they are less common.
  • Flat warts. HPV 3, 10, 28 and 49. These warts are smaller, smooth, and more numerous. Kids will get between 20 and 100 separate warts all at once. They like to show up on the face.
  • Genital warts. There are lots of strains but the worst are 16 and 18, which cause cervical, skin, and anal cancers. This is the one we have a vaccine to prevent, given at age 11 or 12.

There are many therapies for warts, and many interesting traditional remedies. None of them work terribly well. My favorite dermatologist once said, “treating warts is treating a non-disease with a series of treatment failures.” Left alone, warts will resolve on their own, so doing nothing is probably the best option. Duct tape and rubbing with  potatoes are absolutely safe to try.

There are medical treatment options if the warts are driving you nuts. (check out the American Academy of Dermatology)

  • Chemical peels. Paint the wart with an acid every day after a good soak. Then abrade off the top layer of the wart with an emery board or pumice stone. (Don’t use the board or stone for anything else). You can buy salicylic acid over the counter, or a doctor can prescribe a stronger version. Some docs will also use tretinoin or glycolic acid, especially for flat warts.
  • Cryotherapy, or freezing.We use liquid nitrogen to form a burn blister under the wart, so that the wart will die and scab off. This frequently requires repeated treatments every two weeks or so.
  • Imiquimod (Aldara cream). This is a cream that encourages your body to make interferon, a part of your immune system that will fight off the virus.
  • Canthariden. This is a poison made from beetles injected into the wart–not FDA approved.
  • Electrosurgery and Curettage. Fancy words for burning it then scraping it off. Ouch.
  • Excision. Cutting it out.
  • Lasers (usually a pulse dye laser) and Infrared Coagulators. Painful and can leave a scar, both to your skin and your bank account.
  • Bleomycin. This is a cancer chemotherapy drug injected into the wart. Not ideal, as it is very painful and can cause you to lose pieces of fingernails, or fingers. Just say no.
  • DPCP, or diphencyprone. This is a potent contact allergen. The idea is that when your body reacts to the allergen it will attack the wart. Side effects include itching, welts, and blistering. Did I mention that common warts don’t have any side effects?
  • Cidofovir. The new thing, in trials now. It is an antiviral that actually kills off the virus with minimal side effects. Very cool, but still in the future.

So, all in all, my favorite wart therapy is: do nothing. They will usually go away on their own. Exceptions are if the wart changes color, bleeds without good reason, becomes painful, or interferes with your child’s activities. It is also important to see a doc if your child has a weak immune system caused by AID’s or things like cancer chemotherapy.

So, to end, Mark Twain’s advice, via Tom Sawyer:

Put your hand into water collecting in the hollow of a tree stump at midnight and say: “Barley-corn, barley-corn, injun-meal shorts…Spunk-water, spunk-water, swaller these warts.” Then “walk away quick, eleven steps, with your eyes shut, and then turn around three times and walk home without speaking to anybody. Because if you speak the charm’s busted.”

DomesticatedMomster
The Blogger's Pit Stop

The Weird and Interesting Life of a Flu Virus

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sick-kid-01The first description we have of the influenza virus was from Hippocrates (my hero!) 2400 years ago. He dealt with it every winter, endlessly, just as we do now. Nowadays it makes between 3 and 5 million people sick each year, and kills 250 to 500 thousand people annually. In the US we average 200 thousand hospitalizations and 36 thousand deaths yearly. Persistent, nasty little bugger.

Influenza gets its name from the Italian word for influence, because we initially thought it was caused by the influence of the stars, and later by the influence of the cold. Now we know better.

The influenza  virus is a tiny spherical particle, only 80-120 nanometers in size. It would take a million of them standing in a row to make a 1 centimeter line. Its core is made of 8 separate segments of RNA (we humans have DNA). This core is surrounded by protective proteins and an envelop with 2 types of “glycoproteins”–the famous Hs and Ns you hear about when people talk about which type of flu is causing problems each year: Hemagglutinins and Neuraminidases. NPR has a very cool video of the flu virus invading a cell. The “key” in the video is the hemagglutinin.

The Hemagglutinins (Hs) bind to target cells in your body and inject the virus particle into your cells. How contagious the flu is, what symptoms it gives you, and how sick it can make you depends on the Hs. An H that can bind to cells in your eyes, nose, and mouth is more contagious than one that can only bind to your throat. An H that can bind to a cell deep in your lung is much more serious than one that can only bind to a cell in your throat.

The Neuraminidases (Ns) release the progeny of that prolific particle from that cell so that the little critters can spread further through your body.

The Hs and Ns are the molecules our immune systems build antibodies against, whether we catch the flu or just get exposed to the dead virus in the annual vaccine. The Hs and Ns are also the targets for antiviral drugs. There are 16 different Hs and 9 different Ns. Humans are usually infected with H 1,2, or 3 and N 1 and 2.

There are three groups (genera) of flu viruses in the family Orthomyxoviridae. (I am a nerd–I love that word. Ortho-myxo-vir-i-dae. It would make a killer rap song.) The three groups are simply labeled A, B, and C. Nerds have no creativity. A, B, and C. Sad.

  • Flu A has the most serogroups (Hs and Ns), infects the most different animals, and is the most virulent. It also mutates 2-3 times faster than B. The critters it infects are mostly aquatic birds, but it can infect many other species. We frequently call the flu by which animal is its main host. Human, bird, and swine are the most common strains we humans catch.
  • Flu B has only one serogroup and is almost exclusive to humans. It tends to be less severe and less common. Since it only has one serogroup and mutates slowly, many people develop a degree of immunity to it.
  • Flu C is even less common and less severe.

Flu viruses enter cells so that they can make copies of themselves and spread. As they make those copies they sometimes make mistakes, creating mutations. They average one mistake per copy, so mutation is constant– what we call antigenic drift. That’s why we never get immune to Flu A–it changes every year.

What makes Flu unique: There is one really cool thing about the flu virus that makes it different from most viruses: its RNA is split into 8 segments. Most viruses have one long piece of RNA. This means that if your local pig catches 2 different strains of flu at the same time, these strains can trade segments. When that happens we get antigenic shifts– much larger changes for which people have no immunity. These larger shifts can create a pandemic, like the Spanish flu in 1918 that killed an estimated 21 million people. We average 3 pandemics each century. We worry a lot about pandemics.

So, those are the ABCs of the flu virus. If you crave something more useful, like what you can do about it, check out my post on colds and flu or info on fever.

Now wash those little hands with soap, keep them away from noses and mouths, break out the alcohol (not the drinkable kind) and bleach, and go get those flu shots! This year’s shot covers Flu A H1N1 and H3N2, and two strains of B.

DomesticatedMomster
The Blogger's Pit Stop

How to Get Kids to Do Their Homework

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girl with books-01If it seems like you are always fussing at your child to get his or her homework done, it’s because you are always fussing at your child to get his or her homework done. There are more than 2000 school days in your child’s life, all of which seem to end with homework. Over time that means you need to inspire your children to do about 4000 hours of schoolwork at home, when friends and screens are calling their names.

I, of course, have a few suggestions on how to get that mountain of homework done with less argument and frustration:

First, establish the habit of homework long before they actually have any. When they are little, arrange time in the evening when the TV is turned off, activities are done, and you as a family can sit and read, build things, or play games that involve a little brain work. Do this during the two hours before bed and the kids will also sleep better.

Keep the goal in mind. What do kids gain from doing homework? We want them to learn the material, of course. More importantly, we want them to learn how to learn, and to love doing it. We want to furnish them with skills that will prove useful in real life. If homework can teach your children to examine facts, explore knowledge, organize and take personal responsibility for their work, and manage their time efficiently – what might he or she accomplish in life? These are the very skills that form a foundation for success.

Where to do it? Choose a place. There is no “right” place. If your child learns better in a quiet environment, a desk in his or her room would work well. If she needs a little supervision, the kitchen table might work better. Wherever you choose, turn off the TV, videogame, and cell phone (quiet music is usually fine, and sometimes can even help children concentrate). Make sure they are comfortable and the lighting is good. Have the supplies they need – pencils, paper, calendar, dictionary? – nearby. Get rid of any distractions.

When to do it? Pick a time. Again, there is no “right” time. Some kids will do better right after school; some will need to blow off steam and may do better after dinner. Choose the time that works best for your individual children, involving them in the decision. Then make this schedule a routine, because children’s brains accommodate habits well. Kids don’t argue over something they have done every day for years; they argue endlessly over change and unpredictability.

Give your children a warning a few minutes before their free time is ending, so they can finish whatever they are doing before you drag them away.

Order homework by subject. Start the hardest subjects first; position assignments which require memorization (spelling, math?) early and repeat after breaks.

Keep your expectations appropriate for your child’s age. As a general rule of thumb a child should have about 10 minutes of homework per grade level. Children in elementary school will need help organizing their work and staying on task; teenagers should be able to do their work without supervision. If all goes well, somewhere in middle school they learn to take responsibility.

Since you as parents won’t always be around to supervise, let your teenager fail in high school when they make poor choices. Summer school is cheaper and immensely less life altering than flunking out of college; repeating algebra is torture, but less traumatic than loosing a job.

Expect problems. Approach problems with diplomacy and respect for the person who is your child. Label the problem: “You get distracted by your cell phone.” Don’t label your child: never “You’re lazy.” Be willing to compromise with your child to solve the problem. “If you will turn off the cell phone while you do your work, you can have 5 minute breaks between subjects to catch up, call and text.” Agree to the compromise; it is a contract with your progeny. If you need to, write it down and both of you sign it. Read my blog on How to Fight with a Child.

Rewrite this contract when the first one flops, until you find an arrangement that enables your child to learn and you to not run screaming from the room.

Allow the child’s input as much as possible. Let him decorate his workspace up to the point where he puts in distractions. Let her decide subject order, as long as it works. Let them choose their break activity, up to a time limit.

Reward success. We as humans are hard wired to respond better to rewards than to punishment. How long would you go to work if you did not get a paycheck?

Sadly, it is not realistic to expect a better grade to be your child’s only reward. That grade is too far into the distant misty future, over a mountain of hard labor.

Rewards work best if they are small, and given for small increments of good behavior. A hug, a smile and pride in their accomplishment is all they need when they are small. When they are a little bigger, take time to read a book together or play a game. Keep rewards simple, small, and frequent.

Older children also need small, frequent rewards, though probably not as simple. They always have items that they want, but don’t need; these items make great rewards. Study time, completed homework and test grades can all earn them points toward a want. There is no need for an argument when he or she doesn’t do their work before picking up the phone; they just won’t get that essential point.

Homework is training for life. Choose the place and time, working with your child to fit it to your family routines, your child’s personality, and his or her age. Endeavor to teach self-discipline, time management and responsibility equally with reading, writing, and arithmetic. Reward success. Keep in mind that the goal is not to learn how to spell that list of words, but rather to inspire a love of learning which will propel your child to succeed, now and into the future.

DomesticatedMomster
The Blogger's Pit Stop

Che, Che, Che, Changes… and Children

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Change- just aheadBack-to-school season is the perfect time to think about how change impacts children, how to help them through it, and the positives that come when kids learn to be flexible and resilient.

Humanity is naturally comfortable with routine. We are confident in our ability to get through the day when we have done it all before. We are secure, and safe. We don’t have to particularly think about anything. To varying degrees, we all like to know what to expect–whole books are written about it!

This need for routine and stability is far more pronounced in a child. A toddler has no real sense of time–they live in the moment, and the future is a complete unknown. Older kids may have a better sense of time, but surprises can still incite strong emotion. Teens have so many changes going on already that seemingly small transitions can make them feel overwhelmed and out of control.

Yet change is inevitable, and the pace of change increases every day.  Parents today change jobs and geography more than did any previous generation; divorce is more common; the 24 hour cycle flings news at us continuously from around the planet.

Improvements in technology and rapid changes in our cultures remake our world the minute we turn our backs. So…

How to help children cope with change:

  • Be a good example. If you take things in stride and don’t appear worried or scared, they will imitate your reaction.
  • Build strong relationships. If they know they are loved and secure, a move or loss will not be so overwhelming.
  • Stay Healthy. Eat nutritious food, exercise, and get enough sleep. Everything is easier to deal with if you feel good and are not tired.
  • Warn them that change is coming. Imagine if even something as wonderful as Christmas happened without advance warning. There’s a tree in the living room, Dad is dressed up in a crazy suit, everyone is excited, and all the normal routines are suspended. Scary stuff! Let them know what is coming, and give them time to process.
  • Explain what is happening, and why it is happening, at their developmental level. Answer their questions. Give them information about the changes that are coming, and explore the possibilities. Imagine the good things that could happen as a result of the change as well as the bad and scary stuff.
  • Keep to routines when you can. Morning regimens, family meals, and bedtime routines are the foundation of a good day. Nothing feels safer than snuggling up with someone who loves you and a bedtime story.
  • Allow them their feelings. Don’t discount them. If the thing they are angry about the most with Grandma’s death is that no one will give them Tootsie Rolls anymore, nod solemnly and say you understand.
  • Expect bad behavior. Kids will regress with transitions, and will act out if they feel insecure. Discipline them in exactly the same way you would have before the change, because if they get away with bad behavior it will heighten their anxiety. If they still get a time out for saying that bad word, then things must not be that different. Bad behavior successfully disciplined establishes new borders and validates their security.
  • Let them have an impact on the change. Let them choose some flowers for an event, or the color of their new room for a move. Humans feel better when they have done something, no matter how small. Action shrinks fear.
  • Carve out time every day for a little one-on-one. ‘Nuf said.
  • Allow time for relaxation and fun. Laugh. Listen to music. Renee Jain, MAPP has a few excellent mindfulness activities for children here. I especially like her practice of “dissolving a thought.” Kids can devolve into what is called catastrophic thinking and spiral downward into a place where nothing is right with the world, and nothing ever will be. Mindfulness practice can stop that spiral and bring them back into the moment.
  • Avoid activities that increase stress, like competitive sports or games. This is not the time to play Monopoly. Simplify your schedule, and let things go.

Change is inevitable; learning to deal with it is a necessary skill. Kids who can adapt to new situations are better at everything from learning vocabulary to making friends to succeeding in the workplace.  Being able to manage your emotional responce to change is part of being a grownup. Knowing when to accept change and when to insist that you have an impact creates a fulfilling life. Last, seeing the good that can come from a transition is how you grab an opportunity.

The ability to adapt is one of the things that made humans special since we first started using that opposable thumb. Encourage your kids to learn it.

 

Domesticated Momster

 

The Blogger's Pit Stop

Zika Virus: An Update

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Aedes mosquito-01The Zika virus was first isolated from a Rhesus Macaque monkey in 1947 in the Zika Forest in Uganda (zika meaning “overgrown” in the Luganda language–gotta love useless trivia!); it was first isolated from a human in 1954 in Nigeria. It appeared sporadically along the equator in Africa and Asia for several decades until it spread to French Polynesia in 2013 and then to Latin America, Mexico, the Caribbean, and now the US.

Illness from Zika was rare until the pandemic began in 2007. The illness it caused was mild and self-limited until October 2015, when we began to see babies with microcephaly (very small brains) born to mothers who had been infected while pregnant. Evidence shows that these babies may also have eye abnormalities that will  effect their vision. There have been links to serious deformities in the joints in the arms and legs of affected babies. A report published August 30, 2016 noted that 6% of the babies affected by Zika also have hearing loss. According to the AAP as of November 4, 2016, their are five main birth defects: severe microcephaly with partially collapsed skull, decreased brain tissue with subcortical calcifications, extreme muscle tone, eye damage with macular scarring and increased pigment, and limited joint motion range.

There have now been more than 1500 cases of microcephaly in Brazil; in the most severe areas the incidence has been as high as 1:100 births.  On August 15, 2016 a state of emergency was declared in Puerto Rico, where they now have 10,690 confirmed Zika cases, including 1,035 pregnant women. Currently, more than 500 pregnant women in the US have shown evidence of a possible Zika infection.

Symptoms

Zika is a flavivirus related to Dengue, Chikungunya, and West Nile encephalitis. It is transmitted by several species of Aedes mosquitos which can, after biting an infected human, infect another person. Transmission has also been reported through blood transfusions and sexual contact.

The newly infected person may not have any symptoms at all, or may develop symptoms of illness within 2 weeks: fever, a bumpy red rash, sore joints, and pink eye. Less common symptoms include aching muscles, headache, and vomiting. The illness itself is usually mild and self limited.

Treatment

There is no preventative vaccine available yet and no treatment, other than pushing fluids, resting, and treating the symptoms with acetaminophen (Tylenol). The ill person should not take aspirin, ibuprofen (Motrin, Advil), or naproxen (Aleve) until Dengue fever is ruled out, to avoid the risk of bleeding.

Where is it?

As of now, local transmission has been reported in more than 0 countries and territories. Current recommendations are that women who are pregnant, especially in their first trimester, do not travel to any of these areas. If they have to travel, they should do what they can to protect themselves from mosquito bites: wear long pants and long sleeved shirts, preferably treated with permethrin insect repellant; sleep in air conditioned rooms, screened in areas or with permethrin treated mosquito nets; and wear insect repellant, because these mosquitos are active during the daytime.

If you do travel to these areas and develop the symptoms of Zika after returning home, pregnant or not, see your doctor. Avoid mosquitos for the first few days, so that you will not be the source of spreading infection.

Men who have had Zika should use barriers during sex for at least 6 months after the infection; women for 8 weeks. Use of a barrier is recommended for at least 8 weeks after travel to endemic areas even if you have no symptoms.

As of today, we have had 1962 confirmed cases of the infection in the US, with 413 in Florida. Twenty eight of those were caught from local mosquitos. We have the Aedes mosquito along our southern coast and in southern California.

Prevention

In all likelihood the same measures we used to contain Denque in the US will contain Zika, but its spread is still possible. Taking precautions is certainly sensible.

  • Get rid of standing, stagnant water.
  • Clean up piles of garbage, because mosquitos love to breed in trash.
  • Put up or repair your window screens.
  • Spray.

Another possibility to limit spread of the infection is releasing GMO mosquitos with a lethal gene, to decrease the population of the bugs. When this was done in the Caman Islands the mosquito population decreased by 80%.

If you are pregnant, stay out of the endemic areas when possible. Take sensible precautions: clean up standing water and trash, put up or repair window screens, and wear insect repellant.

And keep an eye out for current recommendations from public health officials, because the places and numbers change daily.

DomesticatedMomster
The Blogger's Pit Stop

We Hold These Truths…

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Young Teenage Girl Standing And Looking On Empty Picture Frame

Truth: all humans are created equal. We can sometimes distinguish ourselves by our actions in life, but to believe that one person is inherently better than another because of something they were granted unearned at birth–whether it be skin color, religion, sex, or bank balance–is to live in a juvenile world of fairy princesses. Such a world is not fair to our daughters, or our sons.

When I was growing up, sexism was acceptable and assumed. It was displayed out in the open without shame, because obviously women were not equal to men. We weren’t strong enough to be bosses, couldn’t do math, and we made decisions based on emotion rather than fact. Daughters were expected to be mothers, teachers, or nurses.

Young women today tell me that no one is sexist anymore, but it has not been extinguished so thoroughly. It simmers beneath the surface, creeping unnoticed through our subconscious. This election brought it bubbling to the surface.

A woman I know took me to task years ago for saying how ridiculous I thought it was to have a president who couldn’t pronounce the word “nuclear.” She told me that I needed to have more respect for the office that he held, even if I hadn’t voted for him. That woman, this week, said on the internet that Hillary Clinton was a “rat-faced whore.”

How is it possible to contain those two thoughts in the same brain and not notice the imbalance? Deeply held, unconsidered prejudice.

Amy Richards said, “the last time most of us had a powerful woman in our lives, we were children and she was our mother.” We have no picture in our heads of what a powerful woman should look like. We expect the impossible of every woman–she must be pretty, personable, useful, bright, successful–so we apply that in the extreme to a woman who is breaking down walls. Then we stir in a little jealousy because who does she think she is to accomplish so much more than we did? As Ms. Richards added, “we punish her for excellence and success.”

The State Department and the Senate Intelligence Committee made mistakes in Benghazi, and four people died. Investigation into the incident found many at fault; the report mentioned Clinton one time. She did, however, assume responsibility, because she was  Secretary of State.

97 people died in  20 embassy attacks when George Bush was president. Only one was ever investigated at all.

The recent email scandal occurred because Clinton used her private account for official business, rather than a State Department account. This was common practice at the time, and indeed both Colin Powell and Condoleezza Rice did the same, as did the head of the CIA. No-one has called Colin Powell a criminal and demanded that he be jailed.

The anger toward this one woman is out of proportion, an extreme overreaction caused by beliefs instilled in our brains when we were still too young to reason.

I understand that people do not want to vote for someone just because she is female. We want our children to grow up in a world free of bigotry, not just reverse its direction. But I hope that they do not refuse to vote for her out of unconscious sexism. We are not obligated to vote for a woman simply because she is a woman; we are obligated to not blindly swallow the lies people spew out of a rancid sea of prejudice, because we have daughters.

To fairly evaluate a female presidential candidate we need to see past the overlay with which prejudice has painted them; we need to allow a strong woman to be a positive thing; and we need to look at actual facts.

Dig in. Think. Then Vote.

DomesticatedMomster
The Blogger's Pit Stop

Summertime Rashes

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little cute girl near the pool with a circle for swimmingWhen the days warm up, pediatric offices see a lot of summer skin problems. Kids aren’t often ill during the summer, but they do get sunburns, bites, jellyfish stings, and rashes.

Sunburn

No one thinks about sunscreen on that first glorious sunshiny day, so sunburns are usually our first evidence that summer is here. Remember to use sunscreen, of course, and don’t forget to reapply it every hour.

If your child does burn, give ibuprofen immediately – it helps with the inflammation and can actually reduce the depth of injury. Use aloe generously: it lessens the pain, moisturizes the skin, and helps heal the damage. If the burn is bad, call your doctor. Prescription steroids and burn creams will help.

Bug Bites

Bug bites are also very popular in the summer, from mosquitos, fire ants, yellow flies, and fleas. Insects inject toxins into children’s skin when they bite; how much a particular child reacts depends on how sensitive he or she is.

Cover up little arms and legs when you can, especially if you are going to be outdoors around twilight. There are excellent clothing treatments available that will keep bugs away and last through several washings, protecting your child indirectly.

If your child is older than 2 months, use insect repellant with DEET on exposed skin, even though it’s nasty. It works and it’s a whole lot better than getting insect borne encephalitis. 10% DEET lasts about 2 hours; 30% lasts about 5 hours. Don’t use anything stronger than 30% on a child. Don’t reapply in the same day, and do wash it off when you go back inside.

Creams with pramoxine or calamine will help with itchiness. Cortisone creams help itch and also swelling and redness, but can only be used a couple of times a day. If there are lots of bites, an antihistamine by mouth will also help with swelling and itch.

Never use antihistamine creams (benadryl is the most common), because children can react to the topical antihistamine and actually get worse instead of better.

Bee stings

Bee and wasp stings are treated much the same way, after making sure to remove the stinger and apply a cool compress (and yes, Grandma’s idea about the wet mud does help).

Poison ivy, oak, and sumac

If your child is a forest dweller, he or she will at some point get poison ivy, oak or sumac. These plants produce a poison called urushiol in their sap and leaves, causing redness, itch and blistering.

The severity of this reaction also varies depending on your munchkin’s sensitivity. My brother’s eyes would swell shut if someone burnt it a block away; I could pull it up and throw it away with no reaction.

Wash both the child and his or her clothes as soon as possible. No lounging on the furniture! The toxin can stay on surfaces for months. Once the toxin is either absorbed into the skin or washed off, the rash is no longer contagious. Blister fluid does not contain urushiol.

The rash will develop first where the most toxin was deposited, in streaks and patches. It can spread for a week or so to the areas where less toxin landed, then take another two weeks to clear.

If the rash is mild, you can treat it at home with cool compresses, baking soda or oatmeal baths, the same creams you used for those pesky bug bites, and that antihistamine by mouth. See? Grandma was right again.

If the rash is not mild, or your child has it on their face, around their eyes, or on their genitals (and how did that plant get there?) call your doc. We can put them on steroids, which help enormously.

Jellyfish stings

If you harbor a small mermaid or man in your home, she or he may get stung by a jellyfish. There are some extremely dangerous jellyfish, so if your child has any trouble breathing, is weak or nauseated, has pain away from the sting, or has sweating, cramping, or diarrhea, call your doctor immediately.

If it is a simple sting, first remove the barbs by scraping it with a towel or a credit card. Don’t rub. Put suntan oil or salt water and hot sand on the sting; heat will deactivate the poison.

Do NOT wash the sting with fresh water – it will make the nematocysts (poison sacks) explode and release more poison into the skin. Your child will scream and not love you anymore. Put only fluids with lots of particles in them on the sting: sting-away, vinegar or steak sauce, for example. Ibuprofen will also help the pain and inflammation.

Allergic rashes

Last, we see allergic reactions to everything from sunscreen to henna tattoos to jewelry to pool chemicals from fun in the sun. Kids with sensitive skin or eczema will rash out in the summer from the heat, humidity and sweat.

By now you can probably sense a common theme (or you could just ask Grandma): give your itchy red bumpy child a cool bath with mild soap. Moisturize and apply topical steroids or give antihistamines by mouth.

If any of this doesn’t work, call me! It gets lonely in a pediatric office during the summer when all the kids are healthy.

DomesticatedMomster
The Blogger's Pit Stop

Summertime Injuries: Preventing the Scary Stuff

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safety signSafety is not simple. There is no clear division between “this activity will be safe,” and “this activity will injure my child.” We could wrap our children up, keep them indoors, and not allow them to play with anything remotely dangerous—but then we would have a child who is lonely, overweight and really bored…who would get into trouble and injure themselves… Or not get in trouble and develop diabetes, heart disease and knee problems from obesity.

Kids need to be active, and summertime brings many interesting opportunities for exercise, adventure and injury.

Wouldn’t it be great if some doctor type person would tell you what activities were the most likely to bring ER bills into your life?

Oh, wait… That’s me! So:

The most common causes of accidental death are gunshots, motorized vehicle and bike accidents, drowning, poisoning, and fire. Drowning, MVAs, bike accidents, and trampoline accidents are all more common in the summer, when kids are out of school.

Water Safety

Drowning is every pediatrician’s worst nightmare. It is currently the fifth leading cause of accidental death. An average of 700 children drown each year: about 2 each day. Most are under 4; 80% are male. For every death, there are 5 more children who drowned but survived, commonly with irreversible damage to their brains.

Infants and toddlers drown in bath tubs, buckets, toilets – it only requires is about an inch of water, just enough to cover their nose and mouth. Older children drown in pools, rivers, lakes, and oceans.

Never leave any child alone for even a moment near open water, whether it is an ocean, a bathtub, or a water bucket. All it takes is one moment of inattention for a child to slip away. If there is open water, you need to be within touching distance and focused on your child. The story I have heard over and over is, “We were right there, just talking, but nobody noticed anything until we realized he was gone.” Keep your kids in sight, and don’t let yourself get distracted. Be especially careful at the end of the day, as the water empties and people are gathering up their belongings and leaving. Children will want to swim just a minute more, or will attempt to go back for that last toy floating in the water.

Pools should be fenced in and closed off with a self-latching gate at the end of the day, and all the toys should be put away. Life vests are fabulous for a parent’s mental health and relaxation (swimmies and floaties are not life jackets). Life preservers and a shepherd’s crook should be placed obviously nearby wherever kids are swimming.

Sign your kids up for swimming lessons, even if you are afraid. A middle schooler or teen will never admit to their friends that they don’t know how to swim. They will fake it, sometimes unsuccessfully. Don’t, however, trust a young child to remember his or her swimming lessons when they need them. If they are startled or scared, they will forget everything they learned and just sink to the bottom.

Know what to look for. In real life, drowning does not look like it does in the movies. It is possible to miss someone drowning right in front of you if you do not know what you are seeing. They do not shout for help and wave their arms. They tire, and panic. A drowning child might never make a sound, but quietly slip under the water. An older child might keep themselves above the water for a while, but their head might be low in the water, with their mouth at water level, or perhaps with their head tilted back. Their eyes might be blank or closed. They will sometimes hang vertically in the water without paddling their legs, or appear to paddle with no purposeful movement. A drowning person is very easy to miss if you are not vigilant; and easy to help if you are.

Somebody should know CPR—why not you? Your local fire department or hospital will have classes.

Swimming is a necessary skill, fun, and excellent exercise; it is also a time for close observation and care.

Motorized Vehicles

The other motorized vehicles—ATVs, dirt bikes, snowmobiles, and Sea-Doos—are also commonly out in the summer. They are the perfect storm: they go fast, have no outside framework, roll over easily, and the only things that keep them from crashing are your children’s foresight, common sense, and trained reflexes. The United States averaged 23,800 dirt bike crashes requiring emergency room visits every year between 2001 and 2004; these numbers go up as dirt bikes become more popular. Don’t. Really, just don’t. You do like the kid, right?

Bikes

Bikes come out of the garage when the weather warms up and the roads are not covered in ice. And yes, the dorky bike helmet is an excellent idea.

Thousands of children are injured or killed every year due to bike accidents, frequently right near their homes. In 2010 alone, there were 800 deaths, 26,000 traumatic brain injuries and 515,000 emergency room visits after bike accidents.

Asphalt is not soft, even right next to your house. When a car hits a child, the child flies through the air. The heaviest part of the child—the head—lands first.

Make them wear the dorky helmet, on top of the head please, covering the top of the forehead, and tied snugly under the chin, not dangling on the back of the head. Hang it on the bike handlebars when not in use so that it is the first thing on and the last thing off. Keep a big lock handy so that if you catch them on the bike without the helmet, you can lock it up and they can walk for a week. Sorry kid, that was the rule and you knew it. There is no need for any argument.

Please don’t buy a bike two sizes too big. Your child will fall off. Children should be able to place the balls of their feet on the ground while their rump is on the seat, and their whole foot should be flat when they are standing over the crossbar. An extra bike or two over the years is cheaper than a broken child.

Trampolines

Trampolines are a huge source of income for surgeons and orthopedists. If you would like to make them poor, don’t buy a trampoline. If you have one, please be careful. Most trampoline accidents occur when there is more than one person on the trampoline, especially when they are not the same size. The smaller one goes flying or is fallen upon. Safety nets and pads are better than no safety nets and pads.

On second thought, forget I said all that. Let’s go back to no trampolines. Kids break bones, damage their kidneys, and hurt their heads and spines.

Children will at some point injure themselves because they need to be free to run, swim, and climb monkey bars and trees. Try not to obsess over scraped knees, a goose egg on the forehead, or a few stitches. Everybody gets those, and your children will find a way. Concentrate on the risks that will kill them or seriously injure them: motor vehicle accidents, drowning, fires, poisonings, and gunshots. Don’t go out of your way to buy things that will hurt them, such as trampolines and ATVs. Make it so they have to get creative if they want to injure themselves. Creativity is good, right?

Domesticated Momster
The Blogger's Pit Stop