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Social Media: A Fad Or Here To Stay?

Is social media a fad? Watch this video and come to your own conclusions:

Thanks to Marian Swan from Linked In’s Social Media and Health Care group for circulating this around as seen on UnMarketing Blog.

*This blog post was originally published at Dr. Gwenn Is In*

Child-Proofing Grandma’s House

If you are a family with kids and have grandparents or great grandparents alive, you likely enjoy visiting with your relatives from time to time. While your small children may not always get much out of these visits, especially while very young, they do wonders for our older relatives who so enjoy visits from family and delight in seeing us become parents and expand our families.

I remember vividly visiting my grandparents as they aged, as a child, a teen, a young adult and when I became a parent with my own infants and toddlers. I recall well their delight…and the vivid images of their aging lives: durable medical equipment like canes and walkers in the corner of the room. And, the kitchen counter with rows of medication bottles that made the counter appear like the pharmacist’s counter at the local pharmacy. Given all of my grandparents had arthritis towards the end of their lives, none of those bottles had child-resistant tops.

Whether at home, an assisted care facility or a nursing home, the issue I worry about with small kids are floors and medications. Even if someone is handing an older person their medication, a pill can fall to the floor without being noticed and later found by a toddling child who mistakes it for a piece of candy. That’s what happened last week when 15 month old boy found a shiny pink pill on the floor of his grandmother’s house and didn’t think twice about tossing it in his mouth. Thankfully, it was bitter so he spit most of it out but it was a blood pressure medication so we had to given him activated charcoal, a lot of it, and then observe him in the emergency room for 6 hours.

This story had a happy ending but could have been a disaster had it been a different type of pill or a higher dose, or a group of pills. It’s very, very important that we all take a moment to think about the pill safety of our older relatives – for their sake and the sake of the small children in their lives.  In addition to products that can help dispense pills more safely, making sure floors are clean before visits and supervising kids during visits are essential.

As an aside, the moral to this story can be extended to hotels and homes we may visit that we are not as familiar with. Pills can easily fall out of pockets, purses and luggage. When traveling anywhere with small kids, get on the ground and look under beds, chairs, sofas, pillows and be sure there are not any pills or other small items that we wouldn’t want our small children, or even older children, to touch, or worse – eat!

BTW, can you find the pill in this picture? Hint: it’s blue.

See On The Edge Of Something blog for the “before” shots showing the pill in a spoon on the floor.

Not so easy, huh? Unless, of course, you are a very small child with the eye sight of a falcon and live close to the ground routinely. Now do you get the point?

*This blog post was originally published at Dr. Gwenn Is In*

Getting Sick “After Hours” Costs Billions

During a recent emergency room shift, I treated a 12 year old boy for a swimmer’s ear. During the visit, I learned he was from the South and was in the area visiting relatives before starting school in a couple weeks. It turns out he’s been battling this pain for a couple weeks and his mom is convinced it’s because of all the swimming he’s done this summer. Instead of rushing him to his own pediatrician at home, she has been “riding it out” to see if the pain resolved on it’s own.

This was true music to my ears! Most parents rush their kids to the doctor at the first sign of ear pain, even though the current recommendations are to not use antibiotics in this age group unless the pain persists or worsens past the first few days. So, if his exam were abnormal, my decision making process would be much simpler.

What wasn’t music to my ears was learning I was the second physician to see the boy that week. The grandmother took him to see her physician when she had a scheduled appointment a couple days earlier, “just for a curbside” and learned that he did in fact have “an ear infection”. No medications were given or appointment facilitated with a pediatrician or other physician. This was truly just a curbside. The family was left with no alternative but to use the ER.

The ER often ends up being our only option when visiting an area out of town, isn’t it? If staying at a hotel, many do have a cool option that provides a physician call service so a physician will come to you, as I learned a couple year’s back in Disneyland. And, some cities do have free-standing urgent-care centers that can help with these sorts of non-911 situations. But, by and large, the ER is it in most areas and for most people.

What a backwards situation! The majority of sick people have situations that do not need the ER yet find themselves having to because there are simply no other options. Think about how much time and money would have been spared for this family and the system had that first physician just seen the child as an office visit and written the same prescriptions I wrote 2 days later during the ER visit. Think about the healthcare savings to the system and personal savings to families if we had the same theoretical options to the hundreds of thousands of annual after-hours urgent care visits our system sees each year but is current seeing in the wrong setting!

In the big picture, seeing a basic sick visit after hours in the ER is like trying to crack a nut with a sledgehammer. It makes about as much sense, too. The truth is we just have no place for the after hours regular sick people, which, by the way, are the majority of people who get sick after hours, especially if their doctor is in another state!

It’s really not a shock ER wait times are so long…ERs are over loaded with patient’s just like this boy. Until we find a better system, better take along your iPod and a good book should you find yourself heading to the ER. You’ll be in very good company waiting to be seen so may as well come prepared for the wait.

*This blog post was originally published at Dr. Gwenn Is In*

The Risk Of Dehydration In Hot Tubs

My health club’s outdoor pool’s hot tub has a new sign:

“No children under 12 allowed in the hot tub…this includes dangling feet and dipping toes!”

It’s very large and placed in front of the entrance to the hot tub at the stairs. Not only can you not miss it, you can’t miss reading it – the letters are huge and neatly written.

You only have to be at the club for a few minutes to see why the need for the sign:

1. This week, the high heat: in this weather, kids will dehydrate quickly and put themselves at risk for heat-related illnesses. Just not worth the few minutes in the very hot water. Kids may already be relatively dehydrated if not drinking enough in heat waves so time in hot water will hasten the onset of heat illnesses in that situation.
2. Parents were already ignoring the smaller posted signs.
3. Hot tubs are really grown-up venues and actually have a therapeutic function. They are not toys or meant as recreation so shouldn’t be used or fostered as such.

Adults, too, shouldn’t be in a hot tub for very long when the outside temperature is in the mid 80’s and above with high humidity. We, too, can become dehydrated and put ourselves at risk for heat exhaustion and heat stroke. However, sometimes us adults need the hot tub for therapeutic reasons, such as after exercise, to aid in the healing of injury, arthritis, etc. That’s how I use the hot tub and why I found myself sitting in it for a few minutes on an 85 degree, very humid day. My healing back needed a few minutes of intense heat and those jets after my usual swim. I kept my eye on the time and after 10 minutes got out and downed some cold water.

The sign did keep away most people and most older kids and adults did respect it. But, a few blatantly did not. One mom actually read the sign for a good few minutes and then when her toddler tossed a fit because she wanted to go in she finally relented but said “only your toes…that’s allowed.” Well, actually not. The sign specified no toes specifically so I’m not sure how she made the leap that her daughter’s toes were the exception.

Her daughter didn’t dip for long before a lifeguard came over and shooed her away. The mom looked miffed but hopefully will be wiser next time and not attempt to pull one over on the staff or the rest of the people there to have fun and were willing to follow the rules.

Safety aside, the ultimate issue here, the other important issue is teaching our kids that rules are meant to be followed. If we break the rules and don’t follow them ourselves, our kids will grow up thinking they, too, can break rules, that they are “above the rules”. Those are the kids who tend to get themselves into all sorts of trouble as teens. The seeds of risk taking and bad behavior do start young and are often planted by watching us.

So, have a blast this summer but follow the posted rules. You’ll not only keep your kids safe today…but tomorrow, too.

For more information on heat illness in kids, click here.

*This blog post was originally published at Dr. Gwenn Is In*

30 Years Of Happy Meals

It’s always a bit of a landmark when something like the Happy Meal reaches a big milestone in years. This week marks it’s 30th anniversary of being introduced into our lives. That’s a lot of years, a lot of meals and a lot of small cute toys!

A meal in a box…who would have thought! I do remember when they first came out and parents with little kids flocked to them like flies to sticky paper. However, coming in at 600 calories for an average meal, packed a huge punch on the typical child’s health and waist band. Indeed, as noted by ABC News, childhood obesity has increased by 4x over the last 3 decades moving from only 4% the child population to 17%!!

The McDonald’s rep interviewed by ABC News mentioned that the “most popular” Happy Meal, the chicken nuggets with apples, is now only 360 calories. That is a great decrease by just shy of 50%.

Let’s not celebrate yet. What we need to consider is what proportion of a daily calorie amount this mean eats up.

Calorie amounts vary by age and gender. Here’s how it breaks down with recent recommendations from the American Academy of Pediatrics:

  • Toddlers: 1000 calories a day
  • 4-8 yr old girls: 1200 calories a day
  • 4-8 yr old boys:1400 calories a day
  • 9-13 yr old girls: 1600 calories a day
  • 9-13 yr old boys: 1800 calories a day
  • 14-18 yr old girls: 1800 calories a day
  • 14-18 yr old boys: 2000 calories a day

Now, let’s look at some of the most popular Happy Meal calorie counts:

  • Chicken nugget meal with Apple dippers & Apple Juice: 380 cals
  • Chicken nugget meal with fries, 1% chocolate milk: 580 cals
  • Hamburger meal with apple dippers, white milk: 460 cals
  • Hamburger meal with fries, chocolate milk: 650 cals
  • Cheeseburger meal with apple dippers, white milk:500 cals
  • Cheeseburger meal with fries, chocolate milk: 700 cals

Finally, what percentage of a child’s daily calorie count will each of these meals snatch up for a toddler at 1000 calories a day?

  • Chicken nugget meal with Apple dippers & Apple Juice: 38% Chicken nugget meal with fries, 1% chocolate milk: 58%
  • Hamburger meal with apple dippers, white milk: 46%
  • Hamburger meal with fries, chocolate milk: 65%
  • Cheeseburger meal with apple dippers, white milk:50%
  • Cheeseburger meal with fries, chocolate milk: 70%

What about if the child is a 5 year old girl requiring only 1200 cals/day?

  • Chicken nugget meal with Apple dippers & Apple Juice: 32%
  • Chicken nugget meal with fries, 1% chocolate milk: 48%
  • Hamburger meal with apple dippers, white milk: 38%
  • Hamburger meal with fries, chocolate milk: 54%
  • Cheeseburger meal with apple dippers, white milk:42%
  • Cheeseburger meal with fries, chocolate milk: 58%
  • The kicker here is that if we run these numbers for the teens, the percentages wouldn’t be quite as bad but teens go for the bigger meals which put them right back into these ranges in the end! (A Quarter Pounder alone is 400 calories! Check this list out for more details.)

    Fast food such as Happy Meals is one of the big players in obesity in general for all populations. There are times we all have to grab and go because of work, travel and circumstances beyond our control. The key to not have the loaded calories make too much of a long term dent is to have a fast food plan and to work on being more healthy over all. Here are my suggestions:

    1. Pick small portions and healthy alternatives at fast food places, and teach our children to do so as well. When in doubt, down size and pass on the fries or split them.
    2. Eat healthy in general so the fast food day is the exception, not the rule.
    3. Be as active as possible daily so your body and your children’s bodies have a way to burn the added calories.

    McDonald’s job is to sell food and lure you and your kids’ through the doors. Your job is to keep your kids healthy and teach them how to be healthy life long. Have a Happy Meal once in a while…but do so thoughtfully and don’t delude yourself that these meals are anything close to healthy. The new packaging and food choices are just new hype for the same old unhealthy song.

    *This blog post was originally published at Dr. Gwenn Is In*

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