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Health Information Blog : Double Duty
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I'm a pediatrician by training with an undergrad degree in journalism. I spend my days teaching and mentoring future pediatricians. My wife and I spend our evenings and weekends keeping up with very active twins. This blog will chronicle my thoughts on current children's health care issues and trends, trials and tribulations as a parent and husband mixed in with a lot of life experience.

 

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About Our Author

photo William Stratbucker, MD
Archives
 
Tuesday, October 18, 2011
Help Manage a Child's Fear about Halloween
by William Stratbucker, MD at 01:45 PM

Guest blogger Steven L. Pastyrnak, PhD, is a Spectrum Health Medical Group pediatric psychologist and practices at Helen DeVos Children's Hospital.

Halloween is right around the corner. Most kids look forward to the fun and enjoy the costumes and trick or treating. But it is also a time when some children can feel more fearful, especially kids around the ages of 3 to 6.

During this time, kids develop an awareness of what they perceive as potential dangers in the world—tornados, monsters, the dark, etc. However, they do not yet have a well developed understanding of how they are in control of their environment or of the likelihood of dangers. Kids in this age group also develop an active imagination and cannot always differentiate between a real danger versus an imagined one or understand that things like nightmares are not real. It is important to keep in mind that this is a temporary stage that many kids go through. By the time most kids reach the first or second grade, they develop a better understanding and many of these fears subside.

Bedtime Checklist for Young Children

A common problem when a young child feels fearful is that they can't get to sleep. If this is happening to your child, there are a number of things you can do to help them feel more secure at night:

  • Do a "monster check." At bedtime, have your child watch as you carefully check through the closets and under the bed and offer reassurance that nothing is there. Keep a nightlight on.
  • You can also keep the door open with a light on in the hallway or let your child sleep with a flashlight.
  • Reassure your child that you are close by. Even if you believe your child already knows this, repeating the words every night can go a long ways towards making your child feel safe at bedtime.

Tips to Relieve Fears in Older Kids

There are also techniques you can use with older children when they are scared, whether it is at bedtime or another time of day:

  • Concentrate on breathing slowly. I like to tell children to breathe in slowly like they are smelling a flower, and out like they are blowing out a birthday candle. Slow and controlled breathing is the same technique used by adults in practices like yoga—and it works.
  • Coach them on how to direct their imaginations towards positive images. For instance, before bed, you can ask them to imagine a peaceful or fun place they might like—such as the beach or an amusement park. Help them focus on the calming and fun details in their "picture" so when you leave the room they have something positive to direct their mind towards.
  • Develop new and positive associations with things to help them feel secure. For instance, at Halloween, your child might see a scary mask and associate it with danger. To overcome that fear, you could go with them to a store and let them try on different masks.
  • Have them recite positive affirmations. I like to call this the "Jedi Mind Trick." Have them say to themselves positive statements like, "I am strong," "There is nothing to be afraid of." The more that they practice, the more they will internalize the positive messages and block out the scary ones.

Another thing to keep in mind—your child's fears might seem irrational to you—or sometimes even a bit humorous. But this is not cause to tease or to scare them further, which can create some trust issues. I remember early in my career, sometime after the movie "E.T." came out, two different children came to my practice in the same week who were frightened of the E.T. character and could not sleep. Although a parent might not understand a fear like this, you still must respect that the fear is real to your child, and to be as reassuring as you can.

On a related note, though, I think when you can use humor with your child you should—when you can genuinely laugh at something, it is hard to be afraid of it.

- Dr. Pastyrnak

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Wednesday, October 12, 2011
New Billboards Raise Awareness of Suicide Prevention
by William Stratbucker, MD at 10:04 AM

Guest blogger Steven L. Pastyrnak, PhD, is a Spectrum Health Medical Group pediatric psychologist and practices at Helen DeVos Children's Hospital.

Have you noticed the new billboards around Grand Rapids? They show mothers holding photos of their teen sons who have committed suicide. They read: "No one is better off without you. Just ask mom."

These billboards send a powerful and important message. Oftentimes when an individual is considering suicide, he or she feels that the world would be better off without them. Or they may not even consider the impact that this may have on family and friends. If these billboards inspire just one person to seek help, then the campaign is certainly worth it.

Although the rate of teen suicide is not necessarily increasing in our area, I do have concerns. It seems that life is becoming more complicated for kids and some have problems adjusting. There is a combination of factors contributing to this: pressure to grow up too quickly, being faced with a barrage of unrealistic images of who and what they should be, and being subjected to more sophisticated bullying via the Internet. Also, with increased online communication, kids can even seek out others to discuss such things as cutting behavior and suicide.

The Warning Signs of Teen Suicide

If you notice changes in the following areas, your teen may be experiencing depression which can contribute to suicidal thoughts:

Behavioral changes
Is the child acting differently than usual? Is there an increase in risk-taking behaviors or aggression? Is the child involved with drugs and/or alcohol? Are they having a difficult time keeping a job?

Emotional changes
Is the child increasingly sad? Does he or she no longer enjoy the things that they used to? Does the teen talk about feeling helpless or hopeless? Be aware that instead of appearing sad, some teens become more irritable or are quicker to anger.

Academic changes
Is the child suddenly struggling with academics?

Physical changes
Is the teen eating more or less than usual? Having sleep problems?

Social changes
Is the teen having more conflicts or fewer social interactions? Does he or she talk or write about death? Do friends or family have concerns about the child's Facebook postings?

It's important to note that some kids do not exhibit any clear warning signs.

How to Support Your Child

How can you support your child when you suspect that he or she may be struggling with his or her emotions? Keep these things in mind:

Initiate conversations with your child about a range of issues, even if it may be uncomfortable
Kids are not always able or willing to talk about how they feel on their own. Also, it is absolutely okay if you are concerned about your child to ask directly if they have had thoughts about hurting themselves or ending their lives. Kids are typically open when talking about those things. Be a good listener, too.

Promote a healthy lifestyle
Promote good nutrition, good sleep habits, regular exercise, limited media exposure and other healthy habits.

Know that depression is an illness, not a character flaw
Just like treating an illness, kids with depression may need a full range of supports and services. Get your child to a counselor. Talk to your doctor about medication strategies if necessary.

A suicide attempt is serious and shouldn't be taken lightly. National statistics show that if a teen has made one attempt, even just a gesture, there is a 50 percent chance they will try it again, and there's a 20 percent chance that another attempt will happen within a year. These subsequent attempts oftentimes become more harmful. However, with improved education and open communication, there is hope.

- Dr. Pastyrnak

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Friday, October 07, 2011
Does Your Child Suffer from Social Media Overload?
by William Stratbucker, MD at 03:44 PM

Guest blogger Allison Fabian, DO, is a Spectrum Health Medical Group family medicine physician.

Recent polls show that nearly one-quarter of kids "Facebook" (yes, it's now a verb) more than 10 times a day, and at least 50 percent of kids are logging in more than once a day. Do you know how often your child "Facebooks" or uses other social media?

My son Aiden is two, so he's not using Facebook yet—but I can tell that time will come sooner than I think. Already, he can turn on my Mac and play the virtual piano, watch a movie on my iPad and take pictures of himself with my iPhone. We also Skype with grandma and grandpa twice a week. It's amazing to think how rapidly technology and social media is evolving and how it has become integrated into our family life.

There definitely are some great things happening with kids and social media—for instance, I can now accept confidential e-mails through My Spectrum. It is a great way for teens (or adults) to email their physician and ask questions or schedule appointments.

But, I have to admit I have plenty of concerns: the overuse, misuse or unsupervised use of social media by kids can have all sorts of negative and long-term repercussions. To ensure social media is a positive influence on your child and family, I encourage you to get involved and stay involved.

Safety
Tell your kids never to share phone numbers, addresses or personal information, even if it seems harmless. Kids don't realize how easy it is for information to get into the wrong hands.

Health
Some teens and tweens tell me they use Facebook for three to four hours a day—in addition to watching a few hour-long TV programs. This is after sitting in their desks at school most of the day. This is practically a recipe for obesity and poor health!

What's fact, what's fiction
Today, most teens get their health information from their peer group or the Internet—and social media forums combine these two sources. It's true that this can be a helpful resource for teens, however, with something as important as their health, kids need your help sorting out what's fact from fiction.

Here today—not gone tomorrow
What's posted today could exist indefinitely. Have candid discussions about the appropriateness of what your child is posting. Ask questions such as, "Would you be embarrassed if your grandma/college admission representative/coach saw this?"

After you've had a conversation and continue to dialogue with your kids, there's ongoing work to be done.

1. Set screen time limits
I usually set the upper limit at two hours a day, which includes the time spent using the computer for homework.

2. Monitor the use of portable devices
This is perhaps even more important than monitoring your kids' home computer usage.

3. Don't spy—it leads to mistrust
Instead, stay involved. For instance, go through "friend lists" with your kids regularly. If it's someone you don't recognize, ask questions.

4. Keep up with technology
Gain solid technology skills, so you can both support and monitor your child's online presence.

5. Set clear boundaries
Even though I have a 2-year-old, I know the boundaries I set now will help set the stage for years to come. No matter what age your child is, set clear limits around technology and social media use.

- Dr. Fabian

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Thursday, October 06, 2011
“Cocooning” Can Help Prevent Whooping Cough
by William Stratbucker, MD at 12:14 PM

Guest blogger Daniel P. McGee, MD, is a Spectrum Health Medical Group Physician who practices as a  pediatric hospitalist at Helen DeVos Children's Hospital.

Pertussis, commonly known as whooping cough, has been on the rise for the last few years. Last year, we had almost 1,600 cases in Michigan alone. This year, it’s on the rise again—in fact, it’s come to the point that I no longer find it unusual to see a case of whooping cough in the hospital. Sometimes we'll have two kids hospitalized with it at the same time.

So what can parents do to prevent it, especially in infants who are unprotected until they've completed their first three shots in a series—which happen at two, four and six months? It helps to understand how children are contracting pertusiss. When a source of pertussis in an infant can be identified:

  • 75 percent of the time it's an immediate family member (mom, dad, sibling or grandparent) 
  • 25 percent of the time it's linked directly back to grandma or grandpa

Cocooning Can Help Protect a Baby

On September 26, 2011, the American Academy of Pediatrics issued a formal recommendation for grandparents who care for infants to get immunized.  This is part of a strategy know as “cocooning” which involves immunizing all who come in contact with a baby—such as parents, siblings, grandparents and other caretakers—in order to create a protective barrier around a baby who is not fully immunized. I highly recommend adopting this strategy as well.

Vaccines prevent millions of children and adults around the world from contracting serious diseases and illnesses every year. Yet, unfortunately, in recent years there has been a lot of misinformation out there regarding immunizations and health risks. Because of this, some of the adults in your family and caregiver circle may object to being immunized. In this case, what can you do?

Why Adults Should Be Vaccinated

I suggest discussing the facts in a straightforward manner, asking them to review reputable information about pertussis (such as on the American Academy of Pediatrics or Centers for Disease Control and Prevention) and urging them not to do it for themselves, but for the baby. Here are five key points to emphasize:

  1. Pertusiss is highly contagious.
  2. Even if a baby is immunized, he or she is not fully protected until six months.
  3. 75 percent of the time, it is an adult who brings the disease home to the baby.
  4. If an adult gets whopping cough, it is much less severe—I would consider it more of an annoyance. But babies are much more severely affected and it can be life threatening.
  5. We now know that immunizations don't last forever, which is why adults need to be re-immunized.

One final thought: Through my work at Helen DeVos Children’s Hospital, I see firsthand what happens to babies who contract pertusiss, and I can tell you it is very difficult. In fact, pertussis used to be called the “100-day cough”—that probably gives you a sense of what’s involved. An infant or child who has it coughs repeatedly in a violent and rapid manner until they are out of air, then inhales and makes a loud "whooping" sound that gives the disease its nickname—then they start coughing again and this continues for weeks. Although the cough usually becomes less severe over those 100 days, it can be extremely challenging. Children have stayed at Helen DeVos Children’s Hospital for two weeks or longer after contracting pertussis.

-  Dr. McGee

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Monday, October 03, 2011
National Child Health Day
by William Stratbucker, MD at 10:39 AM

Today is National Child Health Day. Helping Children Lead Healthy Lives is the theme for the event this year. A web site was created by those behind the activities of the day to feature important resources to assist families in finding health care services.

Resources featured on the site include:

  • 311 Prenatal Hotline
  • Insure Kids Now
  • Family-to-Family Health Information Centers
  • Text 4 Baby
  • Find a Health Center Locator
  • Maternal and Child Health Program

National Child Health Day organizers hope the information will reach thousands of families to assist them in finding vital health care services. I learned about the day from Jon L. Nelson who is the Acting Associate Administrator for the Maternal and Child Health Bureau.

As doctors, we know families are finding information in new ways all the time. Text 4 Baby is one of my favorite. Text 4 Baby is a service supported by several funders making it free to receive healthy text messages about your expectant infant or recently delivered baby. If you are pregnant or know someone who is or who has recently delivered, you or they may be interested in receiving the messages.

I direct many families to healthychildren.org which is sponsored by the American Academy of Pediatrics. The site includes many frequently asked questions from parents and answers from pediatricians. Our web site offers KidsHealth content where families can research answers to many common questions.

Where have you located information about finding healthy family-oriented activities in your area? Do you use the web to find healthy recipes and have you sought access to your medical information available through MySpectrum or possibly your family's insurance provider that is helpful in promoting health?

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