Home Births, Evidence-Based Medicine, and More- PediaCast 124

Topics

  • Show Feedback
  • Home Births
  • Baby Wearing
  • Evidence-Based Medicine
  • Sleep Issues After Illness
  • Babies In The Home Office
  • Honey
  • Poop
  • Getting Sick FROM The Doctor's Office
  • Co-Bathing

Transcription

Announcer: Bandwidth for PediaCast is provided by Nationwide Children's Hospital. For every child. For every reason.

[Music]

Announcer: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from Birdhouse Studios, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone, and welcome to PediaCast, a Pediatric podcast for moms and dads. It's episode 124 for Monday, May 12, 2008. Rants, Raves and More.

Before we get started, I'd like to remind you that this week's episode sponsor is The Minute Pie Mold Company, makers of great camping cookware since 1962. Be sure to visit them online at minutepiemold.com.

01:11

All right. Coming up just a few minutes actually, Karen is going to enter Birdhouse Studio and join us for our Rant, Raves and More show. We have Rants and Raves like we did a few episodes of that. But not quite as many.

Well I had just as many to include but I mean, some of them were duplicates where you people are basically saying the same thing and I didn't want to say, bore you. Since it is the listeners who wrote in. you know when you start hearing the same thing over and over again you just have to pick the few that are the best written. So this time I'm also going to include some of your questions.

That's the "and More… part. I pick the ones that I thought Karen would be particularly qualified to weigh in all right. Some of these questions are from deep within the question archive.

02:00

So if you've written in but you've not heard that, pay close attention to the second half of this show because we might finally get to your topic. All right, so far in Pediacast, I have tried my best to avoid discussing, you know, the topics that are not supposed to be discussed in public forums.

Things like politics and religion and you know it's because my goal here is not to push an agenda. The point of Pediacast is to educate; to try to attempt any way to get into the truth of things even when the truth might not be the most popular thing. But unfortunately I do have to cross the political line today.

No, I'm not going the Oprah route endorsing a candidate. Far from it. Actually I want to correct a misstatement from one of the presidential candidates.

03:00

It's in regard to a statement that Senator John McCain made a couple of months ago. Now I know I'm late to the party on this one. And the reason is, you know, I went back and forth on whether I should mention it at all because I don't want to be accused of bringing politics into Pediacast because again that's not the goal here.

But this issue does pertain to parenting and it was a gross misstatement that he has not corrected. So I'm throwing caution to the wind and I'm going to address it. In late February, see I know I told you it was a little while ago, at a town hall meeting in Texas, Senator McCain said the following. He said: "it's indisputable that autism is on the rise amongst children. The question is what's causing it? And we go back and forth and there's strong evidence that indicates that it's got to do with a preservative in vaccines….

There are several problems with Senator McCain's statement.

04:01

And they're big problems and they're problems that the Senator has unfortunately made no effort to correct. Please again; don't take this as judgment for or against the man's politics. I just want to set the records straight on his statement since he isn't doing it.

Number 1, whether autism is on the rise is disputable. Certainly, the diagnosis of autism is on the rise and awareness is on the rise, but that doesn't mean the disease is on the rise. Many in the medical community, myself included, feel kids who used to get labeled slow or LD or mildly retarded are now finding their rightful place within the autism spectrum.

Number 2, the medical community is not going back and forth at all. We are moving forward with research and the discovering the true cause of autism. We have always thought there's a strong genetic link and that continues to be the place evidence is pointing. The only thing that is going back and forth is public opinion which is not based on evidence and easily swayed by emotional arguments and anecdotal reports.

05:09

And stars like Jenny McCarthy. There has never been strong evidence linking preservatives in vaccines to autism. In fact there is no evidence linking the two. None, and if I'm wrong about that, please send me the evidence and I will recant.

Does Senator McCain have knowledge of some secret studies done in the bowels of Washington, one whose findings are being held from the public by a band of conspirators? I mean that sort of thing may happen in a Dan Brown novel but it's not the stuff of the real world.

So despite the fact, Senator McCain and I have some common political leanings and despite the fact that I really do wish to leave politics out of this show, I just could not sit on this one any longer. And what's more senseless than the original statement is the fact that Senator McCain has made absolutely no effort to set the record straight. OK see, so you get me started on these things.

06:01

All right, Karen will be along after the break. So let's see what are we going to talk about? In terms of your Rants and Raves, some show feedback. We're going to discuss home birth and baby wearing again, very briefly though.
And we're going to talk about evidence based medicine and then we're going to answer some of your questions including sleep issues after illness, babies in the home office, honey, poop, getting sick from the doctor's office and co-bathing. And if you want to hear more from Karen, be sure to join her every day on Pediascribe.
Pediascribe, the blog. So she's going to weigh in during this show, and if you like what she has to say, and even if you don't like what she has to say, you then may have some interesting comments to make on her blog, you can find that again on pediascribe.com.

Don't forget the information presented in Pediacast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.

7:00

If you have a concern about your child's health, call your doctor and arrange a face to face interview and hands on physical examination. Also your use of this audio program is subject to the Pediacast terms of use agreement which you could find at pediacast.org. With that in mind we will be back with Karen, and your Rants and your Raves, right after this short break.

[Music]

Dr. Mike Patrick: OK we are back and we are joined by my lovely wife Karen. Hi Karen.

Karen Patrick: Hi there Dr. Mike.

Dr. Mike Patrick: Now you don't call me Dr. Mike, that's just weird.

Karen Patrick: I know. People ask me if I call you Dr. Mike at home.

08:02

Dr. Mike Patrick: Yeah, I prefer you just call me captain.

Karen Patrick: OK cupcake

[Laughter]

Dr. Mike Patrick: OK that's a little too much information. No but seriously we're glad to have you back and you're sitting on the hot seat.

Karen Patrick: Yes I am. The brand new Ikea hot seat.

Dr. Mike Patrick: Yeah we discovered there is an Ikea store in Cincinnati which is not too far from us and so we journeyed there..

Karen Patrick: Three times in a week. [Coughs] Three times.

Dr. Mike Patrick: You forget about the price of gas. But of course we had good reasons each time.

Karen Patrick: But the furniture is so cheap in Ikea it makes up for your gas.

Dr. Mike Patrick: Anyway this chair is kind of, we wouldn't put it in the living room. It's kind of a little too freaky for the living room. But it's great for the studio.

Karen Patrick: That's right. And comfy.

Dr. Mike Patrick: which you know it's all about the comfort.

Karen Patrick: That's right.

Dr. Mike Patrick: OK so we have finished our cream slushes from sonic.

09:04

Karen Patrick: Yes, strawberry cream slush.

Dr. Mike Patrick: And I had lime. Those were good by the way.

Karen Patrick: Those were good and I think they're good for you because they are basically made out of fruit and ice.

Dr. Mike Patrick: The cream part may be an issue.

Karen Patrick: Yeah. But they don't really say what that cream part really is so I'm just going to go with fruit and ice.

Dr. Mike Patrick: OK. Just say you're not going to have one every day.

Karen Patrick: And this is why I have to buy a bigger dress for formal night. Cause I don't fit in to my old one.

Dr. Mike Patrick: Because of the cream slushes?

Karen Patrick: I think it is. I think I should write a nasty letter to sonic.

Dr. Mike Patrick: They'll send you a coupon.

Karen Patrick: Probably.

Dr. Mike Patrick: All right. OK so we are going to kind of do this as a two-parter this time. Last time we just did Rants and Raves and we're going to do that this time around. Then we're going to take a break and actually answer some listener questions. And I picked some that I thought you'd be able to chime in on because of personal experience.

Karen Patrick: OK

10:05

Dr. Mike Patrick: to get the mom's perspective as some listeners have requested. OK so let's just go ahead and jump right in to this. The first is actually from iTunes.

I don't do this very often but I did. I had to get this one from iTunes and see what you thought about it. This says, "This podcast used to be… Oh by the way, there's no name or location because it's from iTunes.

Karen Patrick: Right, just some username.

Dr. Mike Patrick: Yeah and I don't even remember what it was. "This podcast used to be informative, now it's all about "Doctor… Mike… Like I'm not really a doctor, "trying to crack himself up.
His Rants and Raves show is all about defending himself with his wife to back him up, no less. I used to get a great deal out of this podcast, not it has becoming totally political. His sarcasm is a major turn-off and we're turning him off….

Karen Patrick: I bet they won't. It's another one of those "We're not going to listen anymore…& and they turn out, they're actually listening.

11:03

Dr. Mike Patrick: Yeah probably.

Karen Patrick: And you know what, "and his wife to back him up…? I mean that's the last thing I'm going to do. I contradict you all the time.

Dr. Mike Patrick: I know. You call me on it.

Karen Patrick: I will.

Dr. Mike Patrick: You know, I can understand the sarcasm turning people off. I can. I can understand that. But that's me, and Pediacast is not a Parenting 101 infomercial.

Karen Patrick: Correct.

Dr. Mike Patrick: there's got to be an entertainment element and if there weren't, I wouldn't be doing this. You know we've talked about this before.

Karen Patrick: Yeah.

Dr. Mike Patrick: I don't want to be the dead horse. But the reason that I wanted to include this comment is the political accusation. And I want the rest of the listeners out there and so I would address the person writing the comment, but she's gone maybe.

Karen Patrick: She doesn't listen.

Dr. Mike Patrick: Maybe she doesn't. But I mean really, I'm not here to push an agenda. I did talk about Senator McCain in the intro to set the record straight about his autism and vaccine comment.

12:10

Dr. Mike Patrick: But again, that's not to put any political judgment on him. It's just to set the record straight about a misstatement that he made. So this isn't about being conservative or liberal, or pro vaccine or anti vaccine or pro home birth or anti home birth. It's about getting to the truth of matters based on the best evidence that's out there.

Karen Patrick: Just the facts.

Dr. Mike Patrick: Right, just the facts ma'am.

Karen Patrick: And your opinion. It is your podcast after all.

Dr. Mike Patrick: Yeah but my opinion is based on an educated view of the facts.

Karen Patrick: Right.

Dr. Mike Patrick: OK

Karen Patrick: Right.

Dr. Mike Patrick: Either you trust it or you don't. If you don't like my opinion, then you can go elsewhere.

Karen Patrick: Turn it off then.

Dr. Mike Patrick: Yeah. OK.

Karen Patrick: Because, you know, I'm sure there's a lot of other pediatric podcast out there. Not.

Dr. Mike Patrick: Well, yeah. And if this were my livelihood, you know, but this is my side job, so. I kind of have some fun with it.

Karen Patrick: Even if it was your livelihood I don't think you'd change because you've never been one just to, you know, kowtow the people and what they say about you.

13:05

Dr. Mike Patrick: Kowtow?

Karen Patrick: Is that the word? Is that the phrase? I don't know.

Dr. Mike Patrick: I've heard the phrase before but I'm not sure what that word means.

Karen Patrick: I mean you don't want an explicit rating on your podcast so I won't, you know, use other words that could be.

Dr. Mike Patrick: speaking of quitters, Shanna

Karen Patrick: She doesn't listen anymore for she threatened.

Dr. Mike Patrick: No she does. No she does.

Karen Patrick: I know.

Dr. Mike Patrick: this is Shanna in Virginia and this is the listener who, in our last Rant and Rave show, said they were turning me off, and they weren't going to listen anymore. So she listened to the Rant and Rave show

Karen Patrick: I'm glad. I'm glad she's back.

Dr. Mike Patrick: And here's her response: "This was GREAT!… and GREAT is in all capitals with an exclamation point after it. "Karen was a wonderful addition,… see you saved the day, "I liked hearing the interaction between the two of you. You know how context and tone can be difficult to communicate through email. I think a lot of the humorously made sarcastic comments in previous shows haven't made it across to me because the second person was missing to help fill in the context….

14:09

Karen Patrick: OK wait, so I joined in with my humor and sarcasm and suddenly it's very clear to her by using humor and sarcasm? How is doubling the humor and sarcasm going to make it?

Dr. Mike Patrick: Maybe because when I say things, you laugh?

Karen Patrick: Well than could be. Yeah. The thing is I'm looking at you, so I'm actually laughing at you; not at what you're saying.

Dr. Mike Patrick: Yeah. To my face. She goes on to say, "I'm very sorry for the allegations I made on the heat of anger. It was unfair to refer to Dr. Mike as arrogant and presumptuous. I should have not let my emotions reaction cloud my better judgment. And it was especially not cool for me to attack on a personal level. This was a really really really great show. I will of course keep listening….

Karen Patrick: Well that's very nice.

15:00

Dr. Mike Patrick: I don't think I'm going to get a similar email, though, from that iTunes one. She sounded pretty angry.

Karen Patrick: Yeah.

Dr. Mike Patrick: OK. Well Shanna, I just want to say welcome back. It's, you know, we're one big happy family and I'll try not to be quite sarcastic. I don't think it's going to happen.

Karen Patrick: And I'm glad I could help bring you back into the Pediacast fold. You know like, I'm glad it was me who helped bring you back.

Dr. Mike Patrick: Yeah all right.

Karen Patrick: Because you know, you were ready to just chuck Dr. Mike. But, you came back for me. That's sweet.

Dr. Mike Patrick: I wonder if she reads your blog.

Karen Patrick: I don't know. Maybe.

Dr. Mike Patrick: OK let's move on, because we're…

Karen Patrick: if not, she should. OK.

Dr. Mike Patrick: we've got to keep ourselves moving. Do you remember in our last Rant and Rave show, the lady who was living with her in laws?

Karen Patrick: Oh yes.

Dr. Mike Patrick: And she was having trouble getting her baby to go to sleep.

Karen Patrick: And we did not know if it was a baby baby or an older baby.

Dr. Mike Patrick: Right, yeah you remember.

16:00

Karen Patrick: So we kind of gave two sets of advice based on yeah.

Dr. Mike Patrick: She wrote back.

Karen Patrick: Cool.

Dr. Mike Patrick: So this is Anne in Maryland. She says, "Hello Dr. Mike and Karen, thank you for addressing my question on your show. I was listening at work when I heard it. And was so excited, just wanted to clarify…. OK I'm going to stop there for a second. You know I have a lot of people who say that they'd listen at work.

Karen Patrick: I know. I wonder how much productive we would be as Americans if we'd do our work at work.

Dr. Mike Patrick: You're right, instead of listening to podcast. No I think it's great. I think it's great that people listen to podcast at work.

Karen Patrick: Right. Everyone should listen to Pediacast at work. All working Americans.

Dr. Mike Patrick: My little guy is fourteen months old; sorry I left that important detail out. So we lived with my in-laws since he was two months old until just last week. We've been in our new house for almost a week now. We're putting him to sleep in his new room. But he whines up in bed with us several times through the night and will not go back to sleep without nursing. I am going to take your advice and let him learn to fall asleep in his crib but just during nap time for now. I'm hoping that we'll then progress to night time which will then help with weaning.

17:09

Dr. Mike Patrick: Another comment, I enjoyed Karen being on the show. I think she has a great sense of humor. I also think it complements your program to have a mom's point of view. Thanks again for your show and I made sure I turned the caps lock off for this email. She may want to send an email to your dad and I'll bet he's been better.

Karen Patrick: Yeah. You know I try and send emails to my dad all the time in all caps hoping that he gets the point. That never works.

Dr. Mike Patrick: Right. What do you think about the way she's doing this with helping him learn to fall asleep in his crib but just during nap time for now and hoping that it will progress to night time?

Karen Patrick: Well it's a start and we mom's, you know, it's hard to let our babies cry. It's easy for you. You know, you go to work and you hear babies cry all the time. And you actually don't even hear them. So you can tune that kind of stuff out. But sometimes you just have to take baby steps; and if this is working for her so far, she can move on to the next step later. That would be my professional advice.

18:09

Dr. Mike Patrick: See I would just do it all.

Karen Patrick: You would just slap him in his room and let him cry out until morning.  

Dr. Mike Patrick: But you would only do that a couple of nights.

Karen Patrick: I know.

Dr. Mike Patrick: It wouldn't take long at all; and then everybody's sleeping well.

Karen Patrick: Right.

Dr. Mike Patrick: And you still love them.

Karen Patrick: Right.

Dr. Mike Patrick: OK. Maybe that's the difference. And that's not the doctor in me, that's just the practical person. It's not being mean.

Karen Patrick: That's just the testosterone in you.

Dr. Mike Patrick: I don't know about that.

Karen Patrick: Estrogen flowing women, you know. We're a little more sensitive to those kind of things.

Dr. Mike Patrick: All right.

Karen Patrick: I mean, yeah eventually, and probably sooner rather than later, because it's just going to get harder and harder as time goes on. You know, when he's four and he's getting out of bed on his own and that's something.

Dr. Mike Patrick: And he gets a mixed signal. OK so if the sun is shining, then she'll come and get me. But if it's dark out, then she won't. I mean, OK so I'm not really bigger than the nipple confusion. I probably, this is crib confusion. But no, I mean, I don't know. It's just, to me, especially since it goes away so quickly. OK. All right.

19:12

Karen Patrick: Right.

Dr. Mike Patrick: I guess before we move on, I just want to say, Anne let us know how it goes with the way you're doing this. Because if she takes the baby steps and all goes great, I'd like to know. If she decides to take plunge and d the night time and day time together and let them cry, let me know the time it takes for it to go away.

Karen Patrick: And for some people, this is OK. You know the fourteen month old coming into bed a couple of nights, I mean that's fine with some people. Maybe, you know, mom does not work out of the house or whatever. You know, she can deal with a little sleep deprivation. But you know, someone who works out of the house and has to be up at six, and ready to go. You know it gets a little more important that the baby stays in bed so mom and dad could get a good night sleep.

Mr. Mike: But you would agree that moms should not fall asleep with the baby in the bed?

20:03

Karen Patrick: Yes I would agree with that.
Dr. Mike Patrick: OK. All right. Home births and baby wearing. So a couple of comments here from Aimee from Utah. Aimee says, Hi Dr. Mike. I just listened to your Rants and Rave show with Karen; loved it. I have been listening since I got my iPod at Christmas. Always interesting and something of worth for me and my family. We have four kids almost 8, 4, 2-1/2 and 9 months; yes I am a very busy mom. I just wanted to comment on a couple of items from your show. Number 1: Hospital versus home birth. I totally agree. While the hospital may not be as comfy, you are able to have as little intervention as necessary. My last three were born in a hospital with no meds, no IV, just me and my husband and midwife. I had an epidural with number 1 which was a horrible experience along with being near help. You don't have to clean up the mess.

Karen Patrick: Oh, that is so true.

Dr. Mike Patrick: Very practical.

21:00

Karen Patrick: Yeah.

Dr. Mike Patrick: Thankfully there were no complications with any of my births but I had peace of mind knowing I would be well taken care of. Before we move on to her number 2, I mean, she makes a good point that you, there are midwives who practice within the context of a hospital who may be more inclined to follow your birthing plan as, you know, as long as safety is still kept in mind. And yet there is an obstetrician on call and you're near the operating room if you would have abrupted placenta or there are some other emergency. I mean I do see you point.

Karen Patrick: I think hospitals are more conducive to that now than they were. You know years and years ago. I think that would be a good selling point for hospitals. You know, that cater to these people really make it like a home setting. You know you have like the holiday inn express where you have a little kitchenette in your room or whatever you can make up plan however you want. Unless there's an emergency, you don't have to veer from it.

22:00

Karen Patrick: You really market that and promote it.

Dr. Mike Patrick: Right. And with all the competition for deliveries these days at least in Columbus, I mean it seems like their birthing centers are trying to outdo each other to get your business.

Karen Patrick: Exactly.

Dr. Mike Patrick: All right. Slings. I love my sling as much as the baby.

Karen Patrick: Does she love her sling as much as the baby loves her sling? Or does she love her string as much as she loves the baby.

Dr. Mike Patrick: See English. It's all about the English.
Karen Patrick: Yes. Grammar.

Dr. Mike Patrick: I love my sling as much as the baby and there is a natural weaning of the sling that happens as the baby gets more mobile. For my baby's being snuggled and warm with me. What's comforting to them and special bonding time for me. The time passes so quickly, it's nice to enjoy the little bits when they come. Yeah, I mean, I think she definitely makes a good point there with the slings.

Karen Patrick: And I saw a blog post from Mommin' It Up. They did a little review of the Moby wrap and I wanted to talk to you about that. But maybe having another baby so, I could use a Moby wrap because they look cool. It's a very cool sling.

0:23:11.0

Dr. Mike Patrick: If you want to try the Moby wrap with the baby, I'm sure we could find a mom that needs an evening out.

Karen Patrick: Because I tried it with the cat, and he didn't like it very much. And he scratched me up and it was ugly. So, I need a baby.

Dr. Mike Patrick: Yeah. The cats don't like it.

Karen Patrick: Someone let me borrow your baby so I can Moby wrap it.

Dr. Mike Patrick: Yeah. For about an hour.

Karen Patrick: Maybe an hour and a half.

Dr. Mike Patrick: No. I do like kids. No I'm a pediatrician, I come across this like, let them cry.

Karen Patrick: Oh let them cry, I hate kids. Putting them down in their bed.

Dr. Mike Patrick: I hear crying all day.

Karen Patrick: No, you don't. You don't hear crying at all.

Dr. Mike Patrick: But you're right. You're right, I tune it out. It's true.

Karen Patrick: OK moving on.

Dr. Mike Patrick: Sometime I hear what nurses are saying either. But that's another issue.

Karen Patrick: Yeah. But at times you don't hear what I am saying. But that's a whole another podcast, isn't it?

Dr. Mike Patrick: OK. I think we need to move on.

24:00

Dr. Mike Patrick: She goes on to say, Number 3: Of course, you came off very arrogant, about nurse practitioners but I tend to agree with you completely that pediatrician missed our 3-year old's pneumonia last winter. But I would venture most nurse practitioners would have called it asthma as well. Don't worry, we have a new and very thorough MD. Thanks for the podcast, I really do enjoy it and understand your sarcasm.

Karen Patrick: That is so important.

Dr. Mike Patrick: Your opinion is valued.

Karen Patrick: If you don't understand sarcasm, you don't get me and Dr. Mike. Just, we kind of, are sarcastic people.

Dr. Mike. Yes, yes. OK. There's something really important that Aimee has sparked in my mind and it's going in a little bit of a different direction than what you may have imagined. The pediatrician missing her 3-year-old's pneumonia last winter, some important pints to make with this. Number 1: I do believe that if you see your doctor and they diagnose your child as having an upper respiratory infection, you know, cold, and you went to an emergency department two hours later and they heard sounds of pneumonia and you needed some extra oxygen and you've got to admit it and the chest X-ray shows a pneumonia, you know, your doctor missed the pneumonia.

25:16

Dr. Mike Patrick: Right?

Karen Patrick: Right. Right. Right. Right. Yeah.

Dr. Mike Patrick: You agree with that?

Karen Patrick: Yes.

Dr. Mike Patrick: OK. But if the pneumonia is diagnosed the next day, I don't think that's automatically a problem. Because we've all been in that situation on both sides of it. I mean I've seen kids whom one of my partners saw the day before. When I listened to them, they have a pneumonia and I'm sure my partners have had kids that I said have a cold and the next day they come in with a pneumonia. So, I mean, disease progresses. Diseases progress.

Karen Patrick: And same thing with like, ear infections. Well my doctor said I did not have any ear infection yesterday.

Dr. Mike Patrick: Right. It happens. It can.

Karen Patrick: But it just the signs, you know, might have been going towards that but there was no physical indication of an ear infection when they left.

26:01

Dr. Mike Patrick: Yeah. I mean if you have a kid with a fever and a running nose and they're coughing and you listen to their lungs carefully, and you might hear, you know, a faint wheeze because obviously I think this doctor had thought it was probably asthma.

Karen Patrick: It sounds like it.

Dr. Mike Patrick: And then they come in the next day or maybe the couple of days later and then they hear the little crackles or rales and you know, then it gets diagnosed as a pneumonia or maybe that doctor ordered an x-ray and that's how they found it. But chest x-rays are not full proof either especially in kids because as an adult, if you ever had a chest x-ray, they take a big deep breath and hold it.

Karen Patrick: All right. It's hard to make a 3-year-old to cooperate like that.

Dr. Mike Patrick: Yeah and if they are, if they happen to snap the picture during anything but full inspiration, your lung is going to be partially collapsed. Because your lung collapses, no it's not like a collapsed lung, but your lung partially collapses when you exhale because you're emptying it of air and not replacing it with anything.

27:01

Dr. Mike Patrick: So, that makes the lung collapse on itself which is called atelectasis and atelectasis can look like fluid on the chest x-ray. So a lot of times in kids, their lungs would sound clear. And if you have a good radiologist that's used to looking at pediatric films, they'll say "Oh it looks more like atelectasis than an infiltrate… which will be fluid.  
So I see kids from the emergency department all the time. They get diagnosed with "pneumonia… but it's because their x-ray, it they did not get them in full inspiration when they took it. And so they didn't have a pneumonia. So pneumonia is not always black and white.

Karen Patrick: You know, and even hours later. Because I remember when Katie was about three and a half and she had pneumonia, that doctor listened for a good five minutes and finally he said: "You know what, I think I might hear the very beginning of pneumonia… and then I remember that he gave you the stethoscope and you listened. You had to listen for a long time and you heard it.

28:06

Karen Patrick: But that was a late afternoon appointment. That was 4 o'clock in the afternoon. If I had taken Katie, you know, 10 in the morning, maybe even that wouldn't have been there. You know maybe he would have listened for four minutes and not heard anything. You know.

Dr. Mike Patrick: And then in the next day it would have been very obvious.

Karen Patrick: It would have been obvious. Right. I mean it was just so much.

Dr. Mike Patrick: Right. And with pneumonia actually hydration is a factor too because if kids are actually a little bit dehydrated, they may not have as much fluid in their lung with their pneumonia which you then you don't hear this much and you don't see it on the x-ray as much too.

Karen Patrick: Yeah.

Dr. Mike Patrick: So if you have a kid whose kind of dry and your doctor does not hear it, and then they continue to vomit, they get drier, you go to the emergency room, they get some IV fluids going, you hydrate them up and then suddenly you hear it. Sometime that kind of thing happens too.

Karen Patrick: And sometimes having to listen to kids who are screaming. Just depends on are they crying or are they taking deep breaths. Are they sleeping and not breathing in deeply at all.

29:03

Dr. Mike Patrick: Yeah.

Karen Patrick: So strictly.

Dr. Mike Patrick: And then in the last point that I wanted to make with this is that even if you, especially with infectious disease, but in particular with infectious disease, if you see a doctor and they tell you, "yeah it's a virus. It's going to go away…. And then you see another doctor and they say, "Oh there's pneumonia,… and they put you on antibiotic. It doesn't mean that you would not have gotten better without that antibiotic. Your immune system works.

Karen Patrick: Right.

Dr. Mike Patrick: And so do you have to have an antibiotic every single time? I mean, that's up to the, you know your doctor's judgment on how bad it is. But my point is there are a lot of kids who have pneumonia who, you never knew they had it. They had a bad cough, the parents got them some, you know, cough medicine treated it themselves. They have a fever for a few days. They did not go in to see the doctor. They had pneumonia.

Karen Patrick: Right.

Dr. Mike Patrick: But it went away on its own. So it's not necessarily automatically bad things going to happen just because the diagnosis like that is missed.

Karen Patrick: Right.

Dr. Mike Patrick: But there's potential for it. OK. Anyway it's not a black and white world.

30:04

Dr. Mike Patrick: All right. Katie in Florida says: "Dr. Mike I'm listening…

Karen Patrick: We heading down towards Katie.

Dr. Mike Patrick: No actually, by the time this airs, we will be back in Ohio. So don't get everybody excited.

Karen Patrick: That's kind of depressing.

Dr. Mike. Yeah, I know. Katie in Florida says,… Dr. Mike I'm listening to your Rants and Raves episode and wanted to pass along my story about I recommend giving birth in a hospital. I gave birth to my first child in February 2007 and I had a normal complication free pregnancy, there were never any problems or concerns for myself or my baby.
Labor and delivery of the baby was also without complication. My trouble began when I started to deliver the placenta. It didn't detach from the uterus wall properly which resulted in an inverted uterus.
I had to be rushed to the operating room and while new surgery was performed it did take some maneuvering on the doctor's part to put my uterus back into place. While this particular condition is rare, it confirmed for me there is no better place to deliver your baby than in a hospital if you can….

31:06

Dr. Mike Patrick: "You never know what can happen and when you will be the one in whatever, who has a complication that could have not have been predicted no matter what tests or precautions you took before the birth.
I would hate to think I could have bled out before reaching a hospital, preventing me from enjoying the baby I had worked so hard to bring in to the world. Nothing is more important than being able to parent the child you are delivering.
A healthy baby and mom should matter more than any birthing plan. While you can have ideas about the perfect delivery, moms need to understand coming home with a healthy child is the perfect delivery. Just wanted to pass that along…. Thanks for writing that in, Katie. You know, I agree. You agree with her?

Karen Patrick: Yeah. And it's just another normal delivery gone bad. You know.

Dr. Mike Patrick: And with that, we're going to leave the home birthing topic. And I actually have several other emails like Katie's of bad stories. You know, bad things that happen that were, you know, narrowly avoided. But I think everyone's have enough of the home birthing issue.

32:05

Karen Patrick: You know though, this is interesting. Because you know there has to be bad things that happened with home births but you don't hear about them. Are those mothers like silenced by the home birth mafia or something? I mean.

Dr. Mike Patrick: The home birth mafia?

Karen Patrick: I don't know, like,

Dr. Mike Patrick: Now you're going to get me in trouble with the gangsters.

Karen Patrick: You're not going to tell anyone about a home birth gone bad.

Dr. Mike Patrick: All right, the gangsters are going to be writing in now.

Karen Patrick: But you know, you don't hear a bunch of stories about: "Oh yeah, I had a home birth and I almost died…. Or "You know, I had a home birth and, you know this was, my baby did not survive because of something that could have, he could have survive if he was in the hospital…. You know?

Dr. Mike Patrick: So you are saying that all home births end well?

Karen Patrick:& No. I'm sure they don't.

Dr. Mike Patrick: No I think what really is, I think it's because there aren't very many that actually take place. People talk about it but do they really do it?

Karen Patrick: Yeah.

Dr. Mike Patrick: You think?

Karen Patrick: Yeah.

33:01

Dr. Mike Patrick: Not just, what's his name? You know, Tom Cruise.

Karen Patrick: Was that a home birth?

Dr. Mike Patrick: I think it was.

Karen Patrick: I know there are a whole bunch of restrictions. Like no talking and all else.

Dr. Mike Patrick: Well, anyway I thought that he'd, maybe because there are all these restrictions I just kind of equated it in my mind. The home birth. That's bad.

Karen Patrick: OK.

Dr. Mike. No. I don't know. I mean so you think there are a lot of them and that they all go well?

Karen Patrick: No I don't think they all go well, I just think it's curious that you don't hear about the ones that go bad.

Dr. Mike Patrick: Yeah.

Karen Patrick: There's got to be some that go bad.

Dr. Mike Patrick: Well, they've never written in but.

Karen Patrick: Well if you had a home birth and you died as a result of that experience, write to us.

[Laughter]

Karen Patrick: OK.

Dr. Mike Patrick: Well that's insensitive.

Karen Patrick: I know.

Dr. Mike Patrick: OK. Now this next one is from Megan who is the author of an upcoming picture book on autism.

34:02

Dr. Mike Patrick: So it's written for kids to help them understand kids with autism.

Karen Patrick: OK.

Dr. Mike Patrick: So maybe that book is coming out, I wanted to. I've been in contact with the author. It's really a good book and when it's actually gets published we're going to have her on the show to talk about it. But in the meantime, Megan from Indian says, "I'm in the middle of podcast 118 and I have to comment. You're discussing the slings and carriers right now…. And just like the last comment was the end of the home birth topic, this is the end of the sling topic for a while.

Karen Patrick: Oh, OK. It was my talk about having another baby that's. You've kind of freaked out.

Dr. Mike Patrick: Yeah, no more sling talk. This is it. No more sling talk. "I'm in the middle of podcast 118 and I have to comment. You're discussing the slings and carriers right now. My first baby was very much a high spirited, to put it lightly, baby. I used a sling baby Bjorn…

Karen Patrick: Bjorn

Dr. Mike Patrick: Bjorn, yeah that will be it. That's right.

Karen Patrick: The Norwegian kind of word.

Dr. Mike Patrick: Yeah, yeah.

35:03

Dr. Mike Patrick: Baby Bjorn and see we didn't have those one when our kids were little. I don't think, did they?

Karen Patrick: Yeah.& Yeah they did.

Dr. Mike Patrick: Baby Bjorn?

Karen Patrick: I think so.

Dr. Mike Patrick: OK. I'm sure I've seen them; I just didn't know that's what they were called.

Karen Patrick: But they did not have a Moby wrap; and I want a Moby wrap.

Dr. Mike Patrick: For the cat. "And a backpack carrier. She used the models available when he was an infant. They kept him content and I enjoyed them as well. On the podcast you have some reservations mainly how do you break the baby of the sling habit. I had that same concern but thankfully as he matured and became mobile, he did not want to be carried as much. It really was not an issue. The sling weaning just happened naturally. I used carriers quite often in the early months until around three or four months and went down from there. When he started crawling around 10 months we hardly use the carrier except when we go out. While shopping, my husband and I enjoyed carrying him on us instead of placing him in a germy shopping cart….

36:00

Dr. Mike Patrick: "He's not seventeen months and he's pretty much done with them altogether.
Though sometimes we still put him on the backpack carrier but not often. Now he's happy venturing around on his own. I think the carriers help save my sanity from the greater bond between us and gave him a sense of security so he would be confident in being independent.
Plus with freelance writing and taking care of the baby full time, it allowed me to get some work done. I am thirteen weeks along with my second and will definitely use the carrier with that one.
As always, keep up the good work don't be afraid to share your opinions, that's why I tune in. not necessarily because I agree with everything you say but because I do value you opinion. After all it's your podcast. If people don't like it, they don't have to listen….

Karen Patrick: And there are several who said that they won't.

Dr. Mike Patrick: Right. Exactly.

Karen Patrick: OK. I need to clarify Megan, it was Dr. Mike who had the reservations about the sling. Just, you know, not me. I'm all for it.

And I wish that when Katie was little, that there had been the support of like the internet, you can Google baby sling and get a bazillion websites back with, you know, all the different kinds and how to do

37:06

Karen Patrick: YouTube videos on how to stick your baby in them the correct ways they don't fall out but the internet was brand new when Katie was brand new and there was really, it was not a big thing to carry your baby around.

Dr. Mike Patrick: I'm not against baby carriers.

Karen Patrick: No. your reservations were how you get them out of the baby carrier or you're going to be carrying around an 8-year-old.

Dr. Mike Patrick: Yeah. I was just asking the question.

Karen Patrick: I was just, I had a little hesitation. I think she picked up on your part.

Dr. Mike Patrick: Yeah. OK. You know, on the other hand, I don't think carriers are for everyone. Yeah I don't think that moms who don't use carriers should feel guilty for not using them.

Karen Patrick: Oh absolutely not.

Dr. Mike Patrick: you know like if they don't have skin to skin contact all day long that it's going to be a problem.

Karen Patrick: No. I turned out fine. I think.

[Laughter]

38:02

Dr. Mike Patrick: OK. That's up for debate. But you know, OK.

Karen Patrick: Love you too.

Dr. Mike Patrick: We're going to move on to a couple of my personal favorites.

Karen Patrick: OK.

Dr. Mike Patrick: No. I mean these two, these next two emails really are like the best emails that I have received since I started doing the podcast.

Karen Patrick: Really? That good?

Dr. Mike Patrick: I love, yeah these are really that good. In my opinion.

Karen Patrick: Do they get a prize?

Dr. Mike Patrick: Others may disagree. Theirs is no prize for that, no.

Karen Patrick: Oh. That's sad.

Dr. Mike Patrick: They'll get over it. They'll be fine, really.

Karen Patrick: I give prizes away at my blog all the time.

Dr. Mike Patrick: Yeah I know, and that's one reason that people should check it out. OK. Larry in Berkley, California says, "Hi Dr. Mike. After hearing all those listener rants I thought it was time in on the progressive issue. I have to admit it greats on me when you equate progressive with sloppy thinking about science.

39:02

Dr. Mike Patrick: I'm a progressive by the only definition I am aware of politically. But I'm also a scientist and share you on every time you educate people about how to think critically about scientific evidence or lack thereof. My politically progressive friends are by and large highly technically and scientifically literate. So I can't quite figure out what you mean by progressive. If anything I think people who rely on alternative medicine which I think is a euphemism for not evidenced based are regressive to a time before science. Perhaps this confusion is part of your other listeners' problems too. Maybe you should just directly refer to whether an idea is evidenced based medicine or not without using a totally unrelated label that is clearly confusing people. Keep up the great work. I love the podcast…. And the reason why I love this so much is he is exactly right. I mean it's not about, you know, politics when I used the word progressive.

Karen Patrick: Right.

Dr. Mike Patrick: It's about evidence. Show me something works in a controlled and reproducible fashion and I'll buy it.

40:07

Dr. Mike Patrick: I do see Larry's point with using the word progressive which, in my defense, was not originally coned by me because there was a listener who accused me of being anti progressive and instead of challenging his use of the word progressive, which wasn't the right word, I mean he meant alternative. Nonwestern, some others have put it. And instead of challenging his use of the word progressive, I kind of clung to it and began using the commoner's definition of the word progressive which is not the correct definition. I should have been using alternative all along. Of course that will offend an entire new set of listeners.

Karen Patrick: All Right. All right.

Dr. Mike Patrick: I can live with that.

Karen Patrick: I'd like to learn about Larry's other friends. You know, the ones that are not politically progressive. Because he says his politically progressive friends are by and large highly technically and scientifically literate. But what about his other friends that are not politically progressive. Are they not highly technically and scientifically literate?

41:15

Dr. Mike Patrick: Where are you going with that?

Karen Patrick: I don't know. I just, I don't know.

Dr. Mike Patrick: I need a road map.

Karen Patrick: I am in a hot seat. It's very comfortable. I might have nodded off somewhere between Megan and Larry, I'm not sure.

Dr. Mike Patrick: I think your cream slush is kicking in. All right. Here's another great one, I mean this one's really great.

Karen Patrick: But there's no prize. Sorry.

Dr. Mike Patrick: Nope. There's no prize. This is Leart? Or is it Leart? Leart. It's L-E-A-R-T. Is that Leart? It looks like a heart if there were an "H… instead of an "L…. I don't know. And I don't know where Leart is from either, because I got it as an email and he didn't say where he was from. But he says, I', going to say it's Leart.

42:03

Dr. Mike Patrick: He says, "Hi Dr. Mike. I was listening to episode 118, Listener Rants and Raves and I just had to write in response to comments made by some other listeners. More specifically, I want to address the so-called progressives and alternative medicine supporters.

It's a common ploy used by proponents of alternative medicine to argue that western medicine ignores other treatments and that it should be open minded to alternative courses of action. First of all, medicine is medicine.
I don't know what is meant by western medicine. Do they mean science based medicine? Medicine that works? Non magical medicine? It is stupid, I think, imply science based medicine is not open to new treatments.

Doctors, scientists and pharmaceutical companies spend lots of times and tons and tons of money in developing new treatments, drugs and technologies. A core characteristic of science based medicine is the never ending quest for new and better treatments and anyone who disagrees with that is other stupid or dishonest….

43:03

Dr. Mike Patrick: "What proponents of alternative medicine are saying is to accept their hypothetical treatment is true without questioning their validity. They have no scientifically acceptable evidence to back up their claims.
So they cling to anecdotal evidence and an argument about fairness and open mindedness and of course conspiracy. Anyone who proposes home birthing as an alternative to hospital births is making the wild assumption they are equivalently safe.

Either that or they are willing to take the odds. The first is wrong and it does not need explaining. The second is moronic and that does not need explaining either….

Karen Patrick: OK.

Dr. Mike Patrick: No, but I get his point. I understand what he is saying.

Karen Patrick: All right. Right, exactly. Let him offend your audience, it's great.

Dr. Mike Patrick: Yeah. But I have offended them by proxy because I have just said it is one of my favorite emails that's ever been sent in.

Karen Patrick: Oh. Yeah.

Dr. Mike Patrick: "And in an attempt to make themselves feel better, they call themselves progressives. Misunderstood geniuses. I call them regressive…. Do they know each other? Leart and Larry?
Karen Patrick: Well.

44:07

Dr. Mike Patrick: because he called them regressive too.

Karen Patrick: Yes.

Dr. Mike Patrick: "Because anyone who shuns modern medicine in favor of thousand year old fables and superstition is progressing in the wrong direction. I hope you take some time to read my message on the show since they are my words and not yours. At least they can't accuse you of being arrogant…. Although now they can because of my comments. "They can go ahead and insult me all they want. By the way I loved the interaction between you and Karen and hope you give serious consideration as having her as a co-host permanently. I have no solution to your laundry problem that would inevitably arise in that case. But hey, you've got a 13-year-old, let her earn a living. Just joking, of course…. Although it's not a bad idea….

Karen Patrick: Yeah, it's not a bad idea.

Dr. Mike Patrick: "Keep up the good work and please include more such rants on the regular show and if you could add a forums page to your website where people could discuss such things that would be great too…. The only problem with the forum is I think it would be a lot of work.

45:00

Karen Patrick: It would be a lot of work and then you probably would tap; need to be a moderator. I just don't have time for that. That's tough.

Dr. Mike Patrick: You have to have moderators. Yeah.& I'm not going to say no. but we will have to think about that.

Karen Patrick: Maybe someday.

Dr. Mike Patrick: Maybe someday. All right. Well anyway, you know, he used some strong language there, you know moronic and stupid and you know.

Karen Patrick: Yeah.

Dr. Mike Patrick: You know to equate home birth as being as safe as hospital births, it's not. It's not as safe. I don't think you can argue that. Seems pretty obvious to me.

Karen Patrick: And he said that like it's common for the proponents of alternative medicine to argue that western medicine ignores other treatments. And that the western medicine people should be open minded to alternative courses of action. Well, shouldn't the alternative medicine people be open to the alternative courses of action like western medicine?

Dr. Mike Patrick: Yeah.

46:00

Karen Patrick: I mean they want us to be open to their ideas but they don't want to be open to ours.

Dr. Mike Patrick: They don't want to be open minded to close minded people?

Karen Patrick: Yeah. Which makes them closed minded.

Dr. Mike Patrick: Right. Because they are only open about alternative. OK.& I understand what you're saying. Aah. You know it's about the science. Show me, show me that what you're saying works in a controlled and reproducible fashion and then I'm on your side.

Karen Patrick: Right. For me it's all about the fact that he loved me being on the show. Blah. Blah. Blah. Oh look "I love the interaction between you and Karen… I like this guy. Did you get other than that iTunes review that said, you know, I backed up your thinking, your moronic thinking or whatever it was? Did anyone say they didn't like me on the show?

Dr. Mike Patrick: Oh I'm sure there were a few.

Karen Patrick: You didn't forward those to me.

Dr. Mike Patrick: Oh I'm sure they were there.

47:00

Karen Patrick: Oh. They probably don't listen anymore.

Dr. Mike Patrick: No. there weren't any. I got to keep your ego in check. You know, that's all.

Karen Patrick: Yeah. Because I'm just like the most egotistical person.

Dr. Mike Patrick: All right. Leart and Larry, those are my favorite. Leart and Larry. All right, we're going to take a quick break, I think we need to do that, and we're going to be back with some answers to some of your questions. So let's do that.

Karen Patrick: OK.

Dr. Mike Patrick: OK. You're ready?

Karen Patrick: I'm ready.

Dr. Mike Patrick: OK. Why don't you say, "Right after this…?

Karen Patrick: Right after this.

Dr. Mike Patrick: No, you got to put a little more inflection and that.

Karen Patrick: All right. We're going to take a quick break and we'll be right back to answer some of your questions right after this. BREAK. BREAK. BREAK. BREAK. BREAK. That's what the script says. BREAK. BREAK. BREAK. BREAK. BREAK. In all capitals.

Dr. Mike Patrick: All right. We're going to go now.
Karen Patrick: OK. We'll be back. Hang tight.

48:01

[Music]

Dr. Mike Patrick: Ok. We are back and Karen is here again, only this time instead of rants and raves and just you know, random comments, we are actually going to answer some listener questions. And there are some things that I brought you into this because I thought they were topics that you would have some wise words on.

Karen Patrick: I don't understand that.

Dr. Mike Patrick: You're a nurse by training, and a mom. So I think you're going to have a good insight on these.

49:00

Karen Patrick: Yeah, but you know as a mom, we always feel like we just did not do a good job and you could have done it better. So here I am going to give advice to people. I did this.

Dr. Mike Patrick: No, you've got to trust yourself. OK. So this is how we're going to do it: I'll read the question and then I'll let you give your thoughts first. And then if you're right, I'll let everyone know. If there's a problem with your advice then I'll say that too. No. I'm just teasing. Oh I'm going to get more arrogant emails now.

Karen Patrick: Yeah.

Dr. Mike Patrick: Ok. Samantha in Charles Ville, Virginia says "My question is in reference to sleep issues that arise after an illness. Our daughter is about twenty months old, normally we have a great routine and nap time I simply say: "It's nap time… and she runs to her room. We read a book, have a quick snuggle and I pop her in bed.
She would always go to sleep on her own without any problems the same applied to bedtime routine. We are always consistent and timely and only had sleep issues when she was teething or had a bad dream, etc….

50:01

Dr. Mike Patrick: "Recently we have all been ill with two different viruses. Long story short, all three of us have had both viruses over the course of the past month. Needless to say, routine out the window. Our daughter was very ill with vomiting and the like. She needed lots of extra care and attention.

Now she has the second virus and again extra care is needed. So she has come to expect lots of holding and sleeping on mom or dad. We never did such things normally but she was so ill she sometimes needed the extra soothing to rest at all. How do you get back to a normal routine after facing such a period?

We have never liked letting her cry for long periods or trying to let her cry for say 10 minutes at a time, and we go in, reassure her and come back out but it just resets her crying session which results in a worst tantrum each time. We feel like we were doing the right thing. She needs to let her learn to sleep on her own again but we are so stressed and tired.

How do you know if your child really needs you or she's just milking it? She is still slightly ill with the cold. Should we not let her cry until she is fully well? I worry the longer we baby her, the worst it would be to break. What are your suggestions from making the transition after illness to a normal routine go smoother? Many thanks….

51:13

Dr. Mike Patrick: So what do you think?

Karen Patrick: I think that if she's actively ill right now, she needs the extra attention.

Dr. Mike Patrick: Then you give it to her?

Karen Patrick: Yeah.

Dr. Mike Patrick: I agree.

Karen Patrick: I mean, within reason. I mean don't, if she's not going to sleep, you don't get her up, give her a snack, pop in a, who's the big thing? It's not Barney anymore, a wiggles video or whatever.
You don't do that. But I don't think there's anything wrong with you know, making sure that her needs are met and her, whatever she needs to make her feel better with her illness is taken care of. For now.

Dr. Mike Patrick: Yeah. I agree.

Karen Patrick: It's not they have a really good routine pre illness.

Dr. Mike Patrick: I think she'll get back to the habit.

Karen Patrick: I think she will get back to that.

Dr. Mike Patrick: I mean I agree with suspending the bedtime, the nap time plan with the illness. But once they're well again the vacation's over.

52:06

Karen Patrick: Yeah in an attempt to do that, you know the plan, definitely you know, when she goes down for a nap or goes down at night, read her a book, snuggle, that sort of thing, I mean don't just give that up knowing that she's probably going to cry and call you in 10 minutes. You know, so.

Dr. Mike Patrick: Yeah. Because she may really just be wanting that old routine back again.

Karen Patrick: Right. Right.

Dr. Mike Patrick: Yeah. But once she's well, and if she's wanting you over and over again, then you've got to bite the bullet and just, and do it.

Karen Patrick: And then by then everyone else in the family should be well. Sounds like they've all been ill lately.

Dr. Mike Patrick: Yeah. Yeah.

Karen Patrick: And their stressed and tired and the illness will do that to you.

Dr. Mike Patrick: Yeah. So I think this will get better and especially if her, if she was so good with the routine before.

Karen Patrick: Right. Right.

Dr. Mike Patrick: So I think she'll get back to that. OK. Margarita in San Antonio Texas says, "We recently moved in to a small three bedroom home and I have a 3-year-old and a five month old. I work from home part time and I have to share my office with the baby….

53:01

Dr. Mike Patrick: "I've learned I can lay her down and she would put herself to sleep without a fuss. I work while she is napping and sometimes I work at night while she is sleeping. Is it harmful to have the computer in such close proximity to her? Am I disrupting restful sleep for her?

She seems just fine right now but I do worry about the future mainly how long can I continue to work before she starts to be bothered by the constant typing and occasional phone calls?
I would never have dreamed of sharing an office with my older child because as a first time mom, I figured she would never adjust to noise in close proximity. But in this case, the noise doesn't seem to bother the baby. Any thoughts on this?…

Karen Patrick: I think it's fine sharing the office with the baby. If it's working, the baby's sleeping it's the computer and the phone aren't disrupting her? Go with that.

Dr. Mike Patrick: Right. And she asked, "Am I disrupting her sleep?… But she's not disrupting her sleep as long as she's sleeping.

Karen Patrick: No. Right. If the baby's sleeping through it.

Dr. Mike Patrick: Yeah.

Karen Patrick: And I think it's funny. The first time moms. And I did it too.

54:01

Karen Patrick: "Oh I can't vacuum when the baby's sleeping. Oh close this door very carefully, don't want to wake the baby…. And the second one is. That first kid slamming around and it's all noisy and they sleep right through it anyway.

Dr. Mike Patrick: Right.

Karen Patrick: Just too fun.

Dr. Mike Patrick: Right. And if it does become disruptive for the baby, she's going to know it because then the baby's is going to become disruptive for her to get her work done.

Karen Patrick: Yes right. Right.

Dr. Mike Patrick: So you know it's time to separate the two of you when you can't get your work done anymore.
Karen Patrick: Oh and I wonder why the 3-year-old and the five month old don't share a room. I mean that's an option too. If it becomes a problem, they stick the two of them in together and then the two can have a nice quiet atmosphere and she can have her office.

Dr. Mike Patrick: Yeah but the 3-year-old may not let the baby. There's a difference between mom typing in the background and the 3-year-old, you know, doing whatever a 3-year-old does to be disruptive of the baby's sleep.

55:00

Karen Patrick: But if they're both sleeping. They're not being disruptive at all.

Dr. Mike Patrick: Yeah. But there may be an issue with getting the, then you get a new problem with the 3-year-old be able to go to sleep with the baby in the room.

Karen Patrick: Yeah.

Dr. Mike Patrick: you know, maybe.

Karen Patrick: It's hard to say. But lots of people have babies and toddlers share a room together.

Dr. Mike Patrick: Yeah. It's worth a try. I mean but although

Karen Patrick: I mean if it becomes a problem.

Dr. Mike Patrick: Yeah and I agree.

Karen Patrick: Or in

Dr. Mike Patrick: If it's not a problem you know, leave it alone.

Karen Patrick: Ikea sells this really cool room dividers. She could always get a room divider that would separate the baby from her computer. Shop your local Ikea.

Dr. Mike Patrick: OK. No promotional fee paid for that.

Karen Patrick: Right. We need to get Ikea as a sponsor.

Dr. Mike Patrick: No. I don't think it's good.

Karen Patrick: No I think at this point, if it's working out for everyone, it's fine. Just leave it.

Dr. Mike Patrick: Just leave it alone. Yeah. I agree.

Karen Patrick: You got a good thing, your baby sleeps.

Dr. Mike Patrick: Yeah, I'm with you. Samantha in Scottsdale Arizona says, "Hi Dr. Mike. I appreciate the fact you answered my questions last fall regarding the difference between humidifiers and vaporizers in colds and coughing….

56:01

Dr. Mike Patrick: "In your answer you referenced the honey solution for coughing in kids over twelve months of age. Now I have a follow-up question, exactly how is one supposed to dispense said honey? Just them lick it off the spoon?
Do we dilute it in something like tea which was the first thing that came to mind?… You know, before we go to our second question, let's just answer that real quick. You just let them take it off the spoon. They have to swallow it slowly.

Karen Patrick: I'd use a very little spoon, so I don't get her a, like a table spoon of honey all at once. You know, you can always dig back in there and get more.

Dr. Mike Patrick: the key is to let them swallow it slowly [56:41] the back of the throat. Because you're trying to eliminate that tickle feeling that makes you have the cough urge. So you want to basically, look at up the spoon but try to get it to swallow it slowly. Which is easier said than done.

Karen Patrick: Right.

Dr. Mike Patrick: Realize. OK any other issue than that?

Karen Patrick: No.

Dr. Mike Patrick: OK,

57:02

Karen Patrick: No issues. I wouldn't do it and something like tea.

Dr. Mike Patrick: No.

Karen Patrick: Because your baby will stop coughing but they'll be climbing the walls of the caffeine.

Dr. Mike Patrick: No let's get decaffeinated tea. But no, that's not going to help.

Karen Patrick: Yeah.

Dr. Mike Patrick: The action that you're looking for is the coding at the back of the throat with the sticky stuff. OK.

Karen Patrick: Exactly.

Dr. Mike Patrick: And don't use it for kids less than a year old because of the risk for botulism toxin.

Karen Patrick: Botulism.

Dr. Mike Patrick: OK. My second question is related to poop. I have three boys and all three have had strange poop and I'm very curious what causes it? Occasionally, it appears in my son's diapers as though he has made a meal out of potted plant soil. I would presume this to be the case if we had potted plants in the house for him to munch through;& however, we don't. He's poop will randomly become a bit soft and really, really gritty. It's hard to clean from his four posterior and I find I really have to scrub his tush to get it complete off. Everything else about him or them when it happen to my other two seems fine, eating, sleeping, etc. could it be his love for raisins ? what goes on in that little gut to create this massively strange poop. Again love the podcast and hearty congrats for not only reaching but surpassing 200 reviews clearly, you're quite a loyal following me included Samantha from Scottsdale, Arizona.& PS my poor older boys would just die if they know their mum was publicly discussing their poop.

[Laughter]

Karen Patrick: Love it, love it.

Dr. Mike Patrick: So what do you think about this one?

Karen Patrick: you know if I had a penny for every google search about baby poop that, you know, that bough people to the Pediascribe or Pediacast I wouldn't even had to do this the podcast anymore cause I'll be rich. I mean, there's poop comes in all kinds of strange colors and textures and all that and it's all normal. Thought me that is not all normal. There's definitely some abnormal, but there's a very wide range of normal and if he's healthy and growing and eating and it's occasionally.

59:15

Dr. Mike Patrick: I have a theory on this one.

Karen Patrick: I know. What's your theory?

Dr. Mike Patrick: all right. She says that the poop is like potted plants and it's gritty. Right? I think that it could be the
gel stuff from the inside of the diaper.

Karen Patrick: no, that's not really gritty. That's kind of blobby.

Dr. Mike Patrick: No, you can get the absorbent stuff. If the lining of the inside of the diaper breaks open and you do, you get like a grit. It's like the little moisture absorbing particle

Karen Patrick: Yeah, I know what you're talking about, but I don't remember them being gritty. To me, it sounds like she's talking about, sandy, you know like when you go to the beach and you get sand and cracks you never know you had.  

Dr. Mike Patrick: But that's not normal for poop, the grittiness, that's not normal. I mean you can come different textures and color but gritty would not necessarily be one of the — unless their digestive tract is sending undigested products through but in little babies, what are they eating that's …

1:00:25

Karen Patrick: Right, you see it's he eats raisins.

Dr. Mike Patrick: Well that will make it big and soft. I agree. But the gritty, I don't know. OK I have to see it to [cross-talk] …  &   &  

Karen Patrick: And please, do not send us one of his gritty poop diapers

[Laughter]

Dr. Mike Patrick: I mean in the office if someone were to describe this poop, I would probably say, next time he has one. Save it and you know bring it in. Let me take a look at it.& But still… I think it could be the diaper, I really do, I think so.

Karen Patrick: OK. I don't know .

Dr. Mike Patrick: When was the last time you changed the diaper?

Karen Patrick: When was the last time you changed the diaper?

Dr. Mike Patrick: I open up baby's diapers everyday .

Karen Patrick: But you don't wipe their behinds

Dr. Mike Patrick: No, usually I have the parents to do it.

1:01:08

Karen Patrick: How hard it is to get their poop off

Dr. Mike Patrick: No, but the inside, the gel like stuff, I could see that. I could see they get these little particles

Karen Patrick: My advice would be to… he's on a kind of regular schedule for pooping like, oh, he always seems to poop at around 10 in the morning after breakfast. Plan a bath time for 10:30. That'll be easy to get it off.

Dr. Mike Patrick: Yeah, right.

Karen Patrick: I'm kind of a practical side.

Dr. Mike Patrick: all right. Samantha, we won't tell your boys that you talked about their poop

Karen Patrick: No, I won't.

Dr. Mike Patrick: OK.

01:01:04

Dr. Mike Patrick: All right let's move on. This one comes from Sarah in Pataskala, Ohio, and we know how to pronounce it. Because you know, it's just right down the road.

Karen Patrick: It's not Pataskala.

Dr. Mike Patrick: No and I think if I didn't know that it's Pataskala, I probably would have said Pataskala which then makes me wonder how many cities and towns in peoples name, I've gotten wrong over the last couple of years of doing this podcast.

Karen Patrick: Like Leart or Larry

Dr. Mike Patrick: Like Leart, exactly.

1:02:14

Dr. Mike Patrick: All right. So Sarah says, "hello Dr. Mike I am one of those who receive an iPad for Christmas that's 2. In this show.

Karen Patrick: two on this show?

Dr. Mike Patrick: I have been a regular listener's since and I've been downloading the previous podcast. I don't know if you have covered this but so far, I have not run across my question in your show. Every time I take my child who's currently 18 months old to his pediatrician either get sick or more ill than he previously was. I understand this is expected from time to time but every time when our doctor office protocols for cleaning exam rooms in between patients. Last time I tried to take snacks and books to keep them occupied but with an average of visit time of two hours he ends up touching everything inside. He came in with the cough left over from the flu three weeks prior and added a runny nose after the visit. He has to go back for a shot and I'm looking for any advice you have to prevent this from happening again. He has started to practice washing his hands and I think I would do that on our way out. We're also near Columbus and maybe I'm just sick of Ohio winter and everyone being sick but he really does pick something up every time we take him to the doctor. Thanks for the great podcast, I'm trying to tell everyone about it, which of course is very much appreciated. I understand what she's saying about Ohio winter.

Karen Patrick: Yes absolutely.

Dr. Mike Patrick: But it's spring now and it's definitely getting nicer.

Karen Patrick: Yes. She's got a definite cause and effect here. She's got a… we go to the doctor, my kid get sick or sicker. But the only way to prove that sort of thing is if you didn't go anywhere else. Like in… two day s before or the day after she went to the doctor did she take him to the grocery store? Did he touch anything else, anywhere else?

Dr. Mike Patrick: Right.

1:04:03

Karen Patrick: You know, he could have gotten sick, he could have pick something up at Kroger the day before and he happened to be at the doctor's office and then two day later he's sick but it wasn't from anything he picked up in the doctor's office and believe me, they are germ pets. I mean, lots of kids go through there and have illnesses. So, it's definitely wise to take Purell or wipes or whatever especially when you go a little one who doesn't quite understand, he can't touch anything. But don't know that you can definitely put a cause and effect to that being exactly where he gets that every single time.

Dr. Mike Patrick: But it's possible.& For many of those times.

Karen Patrick: It is yeah. It definitely is.& And this is where you know- AAP says no TV or anything for kids under the age of two but, you know if you have an 18-month-old and you're sitting there for an hour and you have a portable DVD player and helps that on your lap. And watch the wiggles or Dora or whatever on DVD, I mean is that so horrible?

Dr. Mike Patrick: No.

Karen Patrick: To let him watch a little video or something —

Dr. Mike Patrick: No, definitely appropriate. I do want to make one point here, I see kids who like they say there were in to see me and they have, oh they were there for their well check up or they have a cold and then they come in a week later and they're sicker. And they almost say accusingly like, "Oh, We were just here a week ago. You know like why didn't you catch it then? Or why didn't you figure out why didn't you figure out what was wrong with the then. And I think, no wait a minute, you were here a week ago maybe that's why. It's not that we missed it then. It's that's when he got his current illness.

Karen Patrick: Right. What is you staff's protocol for cleaning the exam room shoe? Should they do it daily?

Dr. Mike Patrick: Well, in between each patient. If there's any messes that you see. You know, they're cleaned up and a quick spray with antibacterial spray on the cushion and then of course you change the paper. And that's pretty much it.

Karen Patrick: What about the waiting rooms? I'm actually usually more leery of the waiting rooms

1:06:01

Dr. Mike Patrick: Yeah.

Karen Patrick: You're sitting across from the kid who's hacking up a lung

Dr. Mike Patrick: We have a cleaning service that cleans it every night.

Karen Patrick: Every night.

Dr. Mike Patrick: Except Sunday, they don't. Because we are open Saturday and Sunday, we see sick kids. And they do come in Saturday afternoon and clean but not Sunday. So the waiting room does go without cleaning on Sunday. But I mean, you know the receptionist go out if there is any big, you know if there's a mess out there, then they'll clean it up.

Karen Patrick: Yeah. All right.

Dr. Mike Patrick: But we do have a TV in the waiting room. You know for kids to watch. We don't have toys, we don't have books. We encourage people to bring their own things and not to share. In a perfect world, will have two waiting rooms. You know, we'd have a well waiting room and a sick waiting room.

Karen Patrick: You know, see, when I used to work in pediatric office, we had a sick waiting room and a well waiting room. But it always looked kind of dicey when the kid was coming in for his well checkup and he was sick. So do you put him on the sick side or do you put him on the well side? Or the kid who's coming in for a sick visit, but their sibling is well. You know, do you stick each sibling on a separate side?

1:07:09

Dr. Mike Patrick: Yeah. That does get confusing.& And then who polices it?

Karen Patrick: Right. Right.

Dr. Mike Patrick: Who's the waiting room cop?

Karen Patrick: Yeah. If someone's got a sick child and they sneak over the well side so their kid does not catch anything else.

Dr. Mike Patrick: Yeah. I could just say, "Hey buddy you sneezed, there's no sneezing in the well room. Get over to the sick room right now….

Karen Patrick: Get over there. I tell you as kids gets older though, you know I mean, ours are eleven and thirteen, and I don't usually worry about it too much anymore because they're not mouthing things in stick in their hands and their faces and all that.

Dr. Mike Patrick: Right.

Karen Patrick: And they're so focused on their office baby sitter called a Nintendo DS that, you know that they're oblivious to anything around them. Now I just worry more about them catching a lice from someone or so.

Dr. Mike Patrick:& Yeah but lices are quite a big deal. No, it's easily taken care of.

Karen Patrick: I've read through your Pediascribe post on cleaning your house of their lice. It's a big deal.

01:08:02

Dr. Mike Patrick: Yeah, OK.

Karen Patrick: Fine. I'll make you do it.

Dr. Mike Patrick: Yeah, no we don't want that.& We don't want lice in the house. You know one thing that I thought with this one too is that… first in terms of the doctor himself… we don't wash our hands in between patients obviously. We use hand sanitizer which I prefer now because especially in the winter my hands will just get so rough.

Karen Patrick: Yeah. They bleed.

Dr. Mike Patrick: You know because of just washing your hands so much and I find that the hand sanitizers are much more gentle on my skin. I think you know… studies have shown that using those can be as effective as hand washing with soap and water. Stethoscopes though. Stethoscopes are an issue, because you know… if a kid drools on the stethoscope, I give it a good cleaning with alcohol and that has happened.

Karen Patrick: Yeah, it does.

Dr. Mike Patrick: I mean you're right there in the drools zone.

Karen Patrick: Baby … right?

1:09:10

Dr. Mike Patrick: And before the well checkups of the little baby I was — give it a good cleaning. But you know, does every doctor between every sick visit clean the stethoscope with alcohol?

Karen Patrick: I guess, it's no.

Dr. Mike Patrick: No. I can guarantee it, it's no.& but then you could also argue, you're touching the skin of their chest which is just normal skin bacteria which we all share the same normal skin bacteria.

Karen Patrick: Right and that's not what makes people sick.

Dr. Mike Patrick: Right, exactly, exactly.& So you know, is cleaning your stethoscope between every single patient is that over doing it?

Karen Patrick:& you know what, she lives

Dr. Mike Patrick: Is that under doing it?

Karen Patrick: She lives just on that… you know opposite side of Columbus from us and our side of Columbus, it was just one elements after another. It was just a bad winter for illness. You know, probably everyone was sic all the time over there. …

Dr. Mike Patrick: Yeah. I wonder she had… if she got her kids flu shots? She didn't mention that.
Karen Patrick: Didn't.

1:10:16

Dr. Mike Patrick: that could you know she had gotten everybody in the house flu shots that might help. If influenza was one of the illnesses that was going around. OK. Let's see where are we.

Karen Patrick: The next one is Krista in Windsor, Connecticut.

Dr. Mike Patrick: Yes, Krista says, "Hi Dr. Mike, thanks as always for the show. I've a question about children bathing together. I have a 6-year-old boy who'll be 7 in May and a 4-year-old girl. They still bathe together at night neither seems to mind. My son the eldest has not shown any signs of modesty or needing any additional privacy. Is there an age when we should separate them? Or should I just wait for the queue from them? What prompted my question is that others seem to think they're too old to be bathing together. I wonder if I was being selfish since it is easier to get it all done at once. And holding on to this ritual longer than necessary but they also genuinely enjoy the playtime together. Love the show, Krista.

1:11:17

Karen Patrick: I think it's fun. Our kids actually bathe — make sure they're not listening. Our kids bathe together for a long time. I want to say Katie was probably 10 may be and Nick was 7-1/2 something. And you know played with their toys together and there wasn't a problem at all. And then it's just, one day and Katie didn't want to do it. And she wanted to take a shower instead and something like that. And it was obvious that she was done with that.

Dr. Mike Patrick: All right.

Karen Patrick: and so they haven't bathe together since then. And all of a sudden it's all the privacy issues. They both want to be alone. So they're going to tell you.

1:12:01

Dr. Mike Patrick: I think the good rule of thumb is if they don't tell you and they start to show development.

Karen Patrick: Right.

Dr. Mike Patrick: Secondary sexual development, their breasts buds and pubic hair.

Karen Patrick: Which would it be her son would be the first to show it.

Dr. Mike Patrick: Yeah. I think it's definitely time to stop when they start to have any signs of puberty. Time to stop.

Karen Patrick: Right.

Dr. Mike Patrick: Time to stop. Even if their kids are fine with it.

Karen Patrick: Fine with it.

Dr. Mike Patrick: OK. Then I agree when one or both but it's just one ask for privacy and seem embarrassed, it's time to stop.

Karen Patrick: Yeah. Or like in our case, starts closing the door when they go to the bathroom because it's always been sort of an open door policy, you know everyone's in there including the cat. Then if they start closing the door then, you know that's the sign.

1:12:53

Dr. Mike Patrick: But questions are OK.

Karen Patrick:& Yeah. Absolutely.

Dr. Mike Patrick: So just pick you know if you have to a boy and a girl together who are bathing and you know they're… you know 4 and 6 or 4 and 7 you know, they're asking questions about parts that's not the reason to separate them.

Karen Patrick: Absolutely. And you know is the great time to do it because you can give them just the tidbit of information. Answer their question. Don't give them any more information than they ask for… then you just build on that the next time another question comes up and you don't have to be taken your 14-year-old and going from the very beginning of everything.

Dr. Mike Patrick: The birds and the bees.

Karen Patrick: Exactly, cause by that time if you've answered all their little questions here and there as they've come up you know not that much more that I get into.

Dr. Mike Patrick: You know,& that's something we've never actually talk about specifically on Pediacast the birds and bees kind of talk. Sex education. When is the peer period.

Karen Patrick: I thought you actually met birds and bees and I think when you talk about honey —

Dr. Mike Patrick: I can even blame the cream slash anymore. OK

Karen Patrick: well bunny, you're going to have that talk. I'll listen to that show.

Dr. Mike Patrick: The kids, we've already done the birds and bees.

Karen Patrick: No, but I'm talking for other people who have children then you don't know.

Dr. Mike Patrick: Well, I wasn't going to have you listen to the show. I was going to have you be part of that one.

Karen Patrick: OK.

Dr. Mike Patrick: all right. We've covered a lot of ground with this show. Folks if you have the Rants and Raves send them our way but please no more on home births at babies slings or progressives.

Karen Patrick: Why not baby's slings? I understand the whole home birth controversy but why can't people talk about baby slings?

Dr. Mike Patrick: Look OK fine. Talk about slings but we're not having another baby.

Karen Patrick: Can I get a kitten?

[Laughter]

Dr. Mike Patrick: You know with though. People who just happen upon this podcast and they're listening — they're going to think that like this is big argument.

1:15:00

Dr. Mike Patrick: Do you really wanted a baby?

[Laughter]

Dr. Mike Patrick: So you're telling me that you want a baby?

Karen Patrick: I want a baby for about 3-1/2 hours.

Dr. Mike Patrick: See exactly.

Karen Patrick: No, I want to be pregnant again. And I want to give birth but I don't necessarily want to take the baby home 24/7.

Dr. Mike Patrick: See you know that's weird.

Karen Patrick: Why?

Dr. Mike Patrick: You want to give birth?

Karen Patrick: Oh, it's beautiful. Yeah.

Dr. Mike Patrick: OK.

Karen Patrick: I'm good at it.

Dr. Mike Patrick: Yeah. Your delivery is very easy.

Karen Patrick: Even though someone —

Dr. Mike Patrick: so you had fun? Like that was fun?

Karen Patrick: no, it's not fun. It was better than riding a roller coaster but I didn't say it's fun. Even though someone I happened to be married to, told me if I didn't get an epidural he'll refuse to stay in the room with me.

Dr. Mike Patrick: Did I say, I was young. I was young then .

Karen Patrick: Yeah.

Dr. Mike Patrick: That was a decade ago. More than that.

Karen Patrick: Yeah I know.

Dr. Mike Patrick: That's a long time ago.

Karen Patrick: but that's still. It still haunts me.

Dr. Mike Patrick: You can't hold me accountable for that.

1:16:05

Karen Patrick: And guess what people I didn't have an epidural.

Dr. Mike Patrick: Well, that was not your choice. That was because your dilated and when you went to the hospital.

Karen Patrick: Because I stayed at home so long. So I would be too far along —

Dr. Mike Patrick: You almost had the baby in the car.

Karen Patrick: Yeah. That would have been interesting.

Dr. Mike Patrick: No, that would not be interesting.

Karen Patrick: You wouldn't have named your toy [cross-talk]

Dr. Mike Patrick: Anyway, my point here is, that people are going to think that you want a baby and I don't. There's a tension. You don't really want a baby.

Karen Patrick: No honestly and I don't want a kid neither.

Dr. Mike Patrick:& Yes. So don't send this to your kid.
 & Karen Patrick: In fact, I have a cat if anyone wants them. Two cats.

Dr. Mike Patrick: Yeah but then our children will be very unhappy.

Karen Patrick: I know. Then it's all about making the kids happy.

Dr. Mike Patrick: It's all about the kids.

Karen Patrick: We need to teach them disappointment. I mean life is not easy and fair.

Dr. Mike Patrick: I think, Katie just seems starts doing the laundry.

Karen Patrick: that well, see the problem is? She can't reach the detergent dispenser. It would just be a blind poor for her .

Dr. Mike Patrick: that's why God made stools. OK. All she needs is a stool.

Karen Patrick: Excuse me hold on. The kind of stools that God made? I don't think we want her standing on in the laundry room.

Dr. Mike Patrick: OK. Good point.

Karen Patrick: But stools that I can make, so very nice.

1:17:23

Dr. Mike Patrick: Yeah, right exactly. Then she would be fine reaching the soap dispenser.

Karen Patrick: What you're saying is you like pink underwear?

Dr. Mike Patrick: What?

Karen Patrick: Because she's going to dye something to all you whites pink.

Dr. Mike Patrick: Well, not intentionally. That's what I did. Early in our marriage.

Karen Patrick: Yes early marriage. Dye the whole all the whites pink. So then you never have to do laundry again.

Dr. Mike Patrick: There you go. You did not hear that from me. You said it. OK. We're going to go ahead and take a break and we'll be back to wrap up the show here in just a minute. Thanks for stopping by again, really.

Karen Patrick: You're welcome.

Dr. Mike Patrick: You're back by a popular demand.

1:18:11

Karen Patrick: I know. Like my fans. Bring back Karen.

Dr. Mike Patrick: Yeah and I think you're getting more comfortable with it.

Karen Patrick: well, because I'm sitting in an Ikea hot seat.

Dr. Mike Patrick: Yeah.

Karen Patrick: Which is a very comfortable

Dr. Mike Patrick: I'm in an uncomfortable chair but that's OK. Actually this is a nice chair, I like my chair.

Karen Patrick: Yeah.

Dr. Mike Patrick: OK. Where not here to talk about chairs, so we should wrap up the show and we'll do that

Karen Patrick: Right after this break, break, break, break, break.

[Music]

1:19:12

Dr. Mike Patrick: OK. We are back and big thanks to Karen for taking time out of her busy schedule because believe me because it's a very busy one to join us today here in Pediacast. Also thanks to Nationwide Children's Hospital for providing the Bandwidth for our show.

And our episode sponsor today, The Minute Pie Mold Company, you can find out more about them at minutepiemold.com. They're makers of great camping cookware since 1962. Thanks also to Vlad over vladstudio.com for helping us out with the art work and most of all thanks to you, the listener.

We really appreciate you taking the time and making Pediacast a part of your day. And if you like to hear more from Karen you can check out her blog at the Pediascribe blog. She controls that at pediascribe.org. or you can reach that from the show notes at pediacast.org or you can google Pediascribe.

You get the picture. Pediascribe is eclectic mix of parenting and family musings from the mind of Karen. And if you've never check it out before these would be a great time to swing by and give Pediascribe a try.

Don't forget the Pediacast shop is open. We have t-shirts, sweat shirts, tote bags and the like with the Pediacast logo on it. I've said before, we don't make any money from that. It's all about spreading the news of how Pediacast.
So, if you get something and wear it, we would appreciate it. And of course got it in and tell other parents about the show and it we'll be a great talking point with the t-shirt.

I've mentioned too, we're going to have a contest this summer if you get a picture of yourself with a Pediacast t-shirt next to a famous landmark send it in, we're going to have a page this summer with those photographs and one lucky winner a random drawing of all the people who submit pictures will get a $100 Amazon certificate.

1:21:04

iTunes reviews are particularly helpful if you haven't done that yet please do. And a poster page is also available with posters that you can download and print out. And I've mentioned the listener's survey before but I want to mention that again if you haven't had the chance to fill out the latest one literally just takes about 30 seconds of your time. Even if you filled out our longer older one, I would appreciate it if you would go to the side bar at pediacast.org. click on the listeners survey and do that for us. We really would appreciate it.

OK. I hope everyone has a great week and you enjoy the Rant and Raves Part II show and of course and more. As we get another collection of your comments we will throw another one of those together. And until next time. This is Dr. Mike saying "stay safe, stay healthy, and stay involved with your kids. So long everybody.

[Music]

2 thoughts on “Home Births, Evidence-Based Medicine, and More- PediaCast 124

  1. Hi Joe

    We began including transcripts at the beginning of 2012. We are going back and adding them for back-episodes from 2011 and will include them with all new episodes moving forward. It's unlikely we'll get to the 2008 episodes any time soon. Sorry about that. Thanks for your interest and thanks for listening/reading! 

    Dr Mike

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