Back to School: Audience Q&A – PediaCast 414
- 10TV’s Tracy Townsend and Dr Mike entertain back-to-school questions from our Facebook Live audience. Topics include sleep hygiene, breakfast and school lunches, after school activities, immunizations, vision and hearing problems, illness prevention, energy drinks, friends, stress, Pop-Tarts, vaping… and more!
- Back to School
- After School Activities
- Covering Coughs
- Energy Drinks
- Epi Pens
- Family Schedules
- Flu Shots
- Generic Medications vs Brand Name
- Growing Pains
- Hand Foot Mouth Disease
- Illness Prevention
- Middle School
- Protein Shakes / Supplements
- Separation Anxiety
- Sex Education
- Urgent Care Visits
Announcer 1: This is PediaCast.
Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.
Dr. Mike Patrick: Hello everyone, and welcome. Once again the PediaCast, it is a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital, we're in Columbus, Ohio. It is episode 414 for September 13th, 2018. We're calling this one, Back to School: Audience Q&A. Want to welcome all of you to the program.
As you can tell by the title, I have something a little bit different for you this week. In addition to the podcast, this one I do lots of other media worked for the hospital, including our continuing medical education podcast. That one is aimed at pediatric providers of healthcare. We call it PediaCast CME and those who listen can receive free category one, continuing medical education credit. Show's in details available at pediacastcme.org. And then we have a social media elective for medical students and residents.
I've talked about that before on the program. It's an important thing as we train up the next generation of doctors in the digital age. And then I also help our local CBS affiliate 10TV with a weekly segment they do called, ‘What's Going Around? And the basic idea is we just take a quick look at something of interest that's going around Central Ohio that particular week. So, during flu season we might talk about the flu but also croup, the common cold which often are also going around that same time. Or we might talk about ear infections in the summer. We could talk about poison ivy and insect stings, so just, you know, something topical that we are really seeing in the community that's going around, and we present that as a brief segment for the TV news. And we recently expanded to include some Facebook live events on the television station's Facebook page.
So, we had one of these Facebook live events a couple of weeks ago. And the idea was this, the TV station would just announce that we would be doing this Facebook live, and anyone who tuned in, we'd give them the opportunity to throw some questions out there related to back to school. You know, no silly questions, just an opportunity to pick a pediatrician's brain on all things related to going back to school. And the show would be hosted by one of the TV anchors, Tracy Townsend. She's also the one who produces the weekly What's Going Around segments with me. And we just see what kind of response we got, you know, related to viewer questions. Now, what we did have a plan B. So if nobody showed up or the viewers watched, but they didn't ask questions, you know, it was 2:00 local time on a Friday afternoon.
So, we weren't exactly sure how many people would tune in or if those who tuned in would ask questions. So a plan B was just a set of nice questions related to back to school. You know, the sort of things you'd expect, sleep, breakfast and school lunches, classroom behavior, learning difficulties, bullies, after school activities, that sort of thing. But if lots of folks showed up and were asking questions, we would let the viewers rule. You know, we would go with their questions not with our canned ones, and we would discuss what the audience wanted as it relates to back to school-time. Well, as it turns out, we had a great audience. They asked lots of terrific questions. We did not cover all of our planned questions, but on the flip side, we covered many, many topics that we hadn't even really considered, but they were important topics because they were the things that were on the minds of moms and dads who were watching them.
So, let me run through a list of topics covered. And again, these were dictated through viewer participation. And here's the list. They are in alphabetical order because I couldn't really come up with a better way of lumping them together. But so this is, you know, a half an hour, and we cover all of these things. So after school activities, I kind of figured that one would be there; anxiety, related to school of course; breakfast, covering coughs, energy drinks, epipens, family schedules, flu shots, friends and relationships, generic medications versus brand name, growing pains; hand, foot, mouth disease, hand washing, hearing, illness prevention, immunizations, lunch, measles, middle school, milk, pop tarts, protein shakes and supplements, puberty, separation anxiety, sex education, sleep stress, urgent care visits, vaccines, vaping and vision. So a pretty expansive list of topics. It's not exactly what I had in mind, but the beauty of it was, we answered the questions in the hearts of moms and dads in real time.
So, it was great. And so much so that soon afterward, I knew I had to share this event with all of you, because it represents so beautifully what parents want to know as the kids are heading back to school. So that's what I have for you this week, an amazing plethora of back to school topics chosen by our Facebook live viewers, hosted by our CBS affiliate 10TV's, Tracy Townsend with me serving as guest, instead of my usual hosting role. So after the break we'll play the audio of our time together that we did on Facebook live. If you'd rather see the video rather than listen to it. And that's certainly understandable. I will provide a link to it in the show notes for this episode 414 over at pediacast.org. But before you run off and see it, between you and me, the video doesn't really add anything other than close-ups of my face and lots of hand moving because I tend to talk with my hands, which is why you hear occasional microphone bumps in the podcast.
It's really the audio that's important and I'll have that for you here in just a few moments. But if you do want to see the video that's fine. And again, that link will be in the show notes. Don't forget, we are in social media, lots of places, Facebook and Twitter in particular. So be sure to check us out there. We do announce each new episode, also highlight some of the past episodes that I think you might be interested in. So that's on Facebook and Twitter. And then we also include some up to date pediatric news things I think would be helpful for parents, in both of those places that aren't necessarily topics that we talk about on the podcast. So just to give you an example, most doctors are not discussing the meningitis vaccine as college outbreaks of meningitis continued. That's from Today.com, HPV vaccine and that sort of public service announcement about that vaccine that is from Healthy Futures and it's very well done.
So that, I did share that in social media. Updated car seat recommendations, the short of it is now, we'd recommend a rear facing until a child is hit the max size for that particular seat, which is usually going to be about age four. That was from CBS News. Lyme disease, a nice summary as summer winds down, that's from Pedia Blog. And then tricky people, this is from the Pedia Mom Blog. Grownups that kids should not trust, you know, teaching kids about stranger danger. So she calls that one tricky people and I did share that on Facebook and Twitter as well. Usually these kinds of things I share in both places. So whichever one you'd like to follow us the most on, you'll be able to find it. I'm also on Instagram as Dr. Mike slash PediaCast.
That one's a little more personal, just so you can get a glimpse into the studio, a glimpse into my personal life and I do try to connect with everyone who connects with me there, so I can get a glimpse into your life as well, and we can kind of share what's going on in our worlds. From my point of view right now, I have family who live on a small island called Holden Beach off the coast of North Carolina. And Florence, Hurricane Florence, which fortunately has been weakening. And so were we, there was a thought and concern that could hit Holden Beach as a category four hurricane, which would be terrible and likely wipe out the island. But it has weakened to a category two. It looks like it's going to come ashore, before Holden Beach.
And so, hopefully they'll be all right. They did have to evacuate to an area of South Carolina, although that was still not that far off the coast, but I've been sharing some pictures, that they've posted. And just to, again, because it's family. It's kind of what's in my world right now. And I'm sure that some of you have folks that are in that area as well. So our thoughts and our prayers go with all those people. And even though I don't want it to hit Holden Beach, it's going to hit someone, and we don't want destruction of property for any people. And of course, we want folks to be safe as well. So in any case, that's the sort of thing, just what's going on. Current events, family, in the news, all that stuff on Instagram.
So, be sure to connect with us there too. One other site I want to tell you about before we move on. It's really cool, especially if you have teenagers. It's a site from Nationwide Children's called, eTeen Health. And it's basically about increasing health literacy among teens and in particular teenage girls are sort of targeted for this. And you know like so many of us, the first place that we often go when we have a question about our health is to the internet. And the Internet is fantastic in terms of being a wonderful resource of up to date, trustworthy, current information about our health and wellness. But we also know there's a lot of terrible things out there. People have agendas, there is advice given that is not rooted in evidence at all. Associations that are sometimes made that are not cause and effect, they just happen to occur at the same time.
So, we have this idea that maybe one causes the other, but there's no proof of it. So as you're searching, one of the things that we have to do is evaluate what are we going to trust and what are we not going to trust so much. And so, there're some ways to do that and this particular site is really aimed at helping teenage girls figure that out. So you know, what's a good way to search for a question that you have? The initial evaluation, is it coming from a government agency, from an educational institution, from a nonprofit, from someone who's trying to make money, which may be fine. There's great information out there from folks who are trying to make money. But you do want to know, you want to test it, you want to know who's in charge of this information.
Do they have an agenda? Is the work that they're presenting or the advice that they're giving, is it based in evidence of some sort? How old is the information? How does it compare with information that you're getting from other sites and then once you've sort of tested and evaluated it, how do you use it? How do you take that piece of information that now you're saying, "Okay, I trust this…. How do you incorporate that into a behaviors and changes in your health and wellness? You know, who should you talk to before making changes, your parents or other trusted adults? Maybe it's an older sibling or a school nurse and of course encouragement to always talk to your medical provider with any questions that you have. So more details on sort of that process of how to search well on the internet and then you can actually try it with the examples of how this all works. So it's a pretty cool and innovative site, I think.
Tracy Townsend: On 10 this morning, we talked about breakfast and how truly important the first meal of the day is.
Dr. Mike Patrick: Yeah. It really is. And when you think about it, you need fuel. Your body needs, fuel, your brain needs fuel, and the breakfast is the opportunity to get the nutrients in, so that your brain can function well and you can pay attention and concentrate in the morning in the classroom.
Tracy Townsend: And so what's the science behind that? I mean, we grown up. Remember they were the cartoon, that little commercials that talked about breakfast being the most important meal of the day. What's really happening?
Dr. Mike Patrick: Well, the brain is kind of special in that it really needs glucose in order to function. So other parts of the body can use different forms of energy, but the brain has to have glucose. So simple sugars are going to be important, but they don't last very long. Your body sort of eats them up quickly. So, carbohydrates are going to last a little bit longer. And then fats and proteins can be turned into sugars, fats particularly. But that's a little bit of a longer process. So you also want some fats in the morning in order to keep fueling your brain, you know, up until lunchtime.
Tracy Townsend: And so when you say some, it's all moderation. You don't want to have a pound of Bacon. Even though a bacon is good thing.
Dr. Mike Patrick: Yeah. A little bacon is fine, pound of bacon is too much, but no, you can. Hard boiled egg is, is a great source of some proteins and some fats. Peanut butter is really good you know, and again, not too much. But a lot of kids like peanut butter and if you have that, you can have some toast with peanut butter on it that we have some carbohydrates, she gets some fats, she gets some proteins. Yogurt is fabulous, with some granola. That way you've got some sugars, a little dairy, get some carbohydrates in there with the granola. So you can, you know, a lot of things that kids like that you can have for breakfast.
Tracy Townsend: I thought it was interesting when we talked earlier this week, what you said about milk. Because you hear so many people talk about soy and almond and whole fat and fat free. So tell us your thoughts on the milk that we should be giving our kids.
Dr. Mike Patrick: Yeah, milk. Well, if as long as you don't have a true milk allergy, cow's milk is fantastic for kids. The question really becomes, do you want to do a whole milk two percent or skim milk and a lot of that really depends on your child's growth. So kids who are a little on the heavier side, you may want to go more than two percent skim milk. Kids who were on the skinny side, whole milk is going to be probably fine, especially up till their preschool age. And then you may want to go to the lower fat milks, but the best thing to do there is to talk to your child's doctor who can look at their growth chart and give you the best recommendation for which milk.
If you have a lactose intolerance, there is a lot of the milk sugar is, there's a lot of lactose in there and that can be a problem for some folks. So that's where you can get into the soy milks, the almond milks that don't have lactose in them. Although, you can also buy lactose free cow's milk that sort of in process galactose taken out.
Tracy Townsend: And if you do use one of those, you know, like almond milk or soy milk, do you have to supplement with calcium or is there enough calcium in that growing kids?
Dr. Mike Patrick: You want to look at the product. The thing with calcium is you also want vitamin D that helps the calcium get absorbed a little bit better in the GI tract. So you want to make sure whatever product, if it has added calcium in it, that it has added vitamin D in it as well. And orange juice by the way, with the vitamin D and calcium added.
Tracy Townsend: That's good. And it tastes like orange juice. So Travis is funny, he said pop tarts and milk. Okay. And you have some thoughts on that?
Dr. Mike Patrick: Yeah, pop tarts. Probably not the best choice, especially if you're doing that, you know, every day of the week. Lots of simple sugars with that. You do get some carbohydrates, not much fat and protein, but so not the best choice.
Tracy Townsend: Moderation?
Dr. Mike Patrick: Yeah. And at the same time, if you have a kid who loves pop tarts, you know, a pop tart once a week. I mean, that's moderation.
Tracy Townsend: Okay. So see, Travis, not so bad. We're talking about eating breakfast, but you know, sometimes it's hard to get your kids up in the morning to come down and have breakfast. Can we talk about sleep a little bit?
Dr. Mike Patrick: Yeah. So, it's really important that kids get enough sleep. You know, for adults we talk about eight hours of sleep a night. A few of us actually get that very busy lives. But for kids you do actually want a little more than that. So school age kids, you know, some of them need 9 to 11 hours. Teenagers, little closer to adults, but still, 9 or 10 hours is really what you're shooting for. And the way that especially the younger kids to get that many hours of sleep is to get them in bed a little earlier, which after a long summer and now you're up until 10 or 11 at night, it can be hard to kind of make that adjustment. With school already starting, hopefully you've made that adjustment. But if not, it can be difficult to make a big switch. So if they're used to going to bed at 10 and now all of a sudden it's 8:00, you know, you may want to back it up by half an hour at a time every few days.
Tracy Townsend: Okay. What about for our kids who are just starting school kindergartners and you know, they're away from home in some cases all day away from mom or dad or their caregiver.
Dr. Mike Patrick: Yeah. Well hopefully they've had some experience with being away from mom for a while. That's one of the reasons that preschool is so good to sort of train them to be in a school environment and to be with kids their age and away from their parents so that can make it easier, but still it's a new classroom. It's definitely a transition. One of the things I find helpful with the little ones is to start talking about it beforehand or, and make it an exciting thing like this is an adventure and make sure you remember some stories to tell me when you get home so that then they're even thinking about mom while they're there and like they were kind of information gatherers, and they're going to go back and let mom know how their day went. So when you do have some separation anxiety, I mean that may be one trick to help them that they're on a mission and you're going to meet back up and talking about it.
Tracy Townsend: Yes, they're going to come and tell you what happened.
Dr. Mike Patrick: Yeah.
Tracy Townsend: So let's talk about lunch since we've kind of raced through the morning there. A lot of people pack lunch, lot of people buy lunch at school.
Dr. Mike Patrick: Yeah. Great recommendation is myplate.gov. And it's really when I was a kid it was the food pyramid, but it was sometimes hard to tell like, "Wait, what's on top? What's at the bottom?… But now it's a plate and if you just think half the plate should be fruits and vegetables. A quarter of the plate should be grains, the carbohydrates, breads that sort of thing. And then the other quarter you want to be protein, so that's going to be your meats. And then just think of a little dessert plate size, is what you want your dairy to be. So if you get those right in the right proportion, then you know that you're getting a good mix of all the nutrients that your body needs. And if you go to myplate.gov has a nice visual that gives some examples of things that you could pack into lunch. And if you think about the school lunch menu, it does sort of follow that you know, in terms of the proportions. Just not a plate sort of trip.
Tracy Townsend: Right. Everywhere, that's universal. So now you know, kids are back. They're socializing and so sometimes that's a really good thing. Sometimes it's not so great. I'm just thinking, you know, there's a story that made headlines with the kid who had some problems and unfortunately took his life. What are some of your thoughts on how we as parents can kind of help our kids get through some of the social things they run into?
Dr. Mike Patrick: Well first I think it's a great idea from his early of an age as possible, is to have a really loving relationship with your kids and just talk about everything. And after the schoolday, ask them how it's going, you know, who are your friends, what are your friends up to, what you've been talking about. And not like grilling them but making it conversational. I can then share with them like some of the things that happened during your day and the people that you're engaged with. And if you have difficult coworkers, you know, talk about it because. But we all have, you know, there are people we get along with and there are people whose personality who's just a little different than ourselves, and we don't get along with them as well.
And so if you kind of let your kids know about what's happening in your life, then maybe they'll also be more open to telling you what's happening in their life and just talk about those things. If they're not talking about it and you notice just changes in their personality, you know, maybe there's a part of the day they don't want to talk about. You know, that can be a little bit of a warning signal that maybe there's something else going on and then you do need to start asking some pointed questions, but always do so. You know, in a loving way that you know, even if there's something terrible going on, let's talk about it and I'll still love you. You know, that kind of thing.
Tracy Townsend: If you're just joining us, this is a Facebook live conversation with Dr. Mike from Nationwide Children's Hospital. Great time to get your questions answered related to back to school. This is kind of one of those times when we're all busy. There are forms coming out as every single day that have to be turned in and our kids are coming up against deadlines and new friends and old friends and issues and so, we're picking Dr. Mike's Brain on how we can all get through that successfully. We're really just talking about some of that anxiety that some of our kids feel and I wanted to kind of pick up on that because sometimes you ask your kids how the day went and you get good.
Dr. Mike Patrick: Oh, so I have a 21-year-old son who is taking college classes and that's still what we get to. It's true.
Tracy Townsend: It doesn't get better.
Dr. Mike Patrick: No, and we kind of joke about it. But then you know, you start asking a little more pointed questions like, what are you talking about in your class today and what are you learning and what's been challenging? What is easy? Some kids are just, you know, some want to talk about it. Others want to get on with their day and do what they're doing. If you're not sensing that there's an issue, and they don't really want to talk about it, I guess I wouldn't force them to but at least give them that opportunity and I think as you share more of your day, they start to open up and want to share more of theirs.
Tracy Townsend: Okay, let's see. Flu shots have arrived. Is it too early to get your child a flu shot? Do they wear off if you get them early? That question is from Kelly Bateman.
Dr. Mike Patrick: Yeah, that's a great question. So I would say that mid-September is really when we start thinking about flu shots. If the flu shots are in at your doctor's office, and they they started to give them. It's not. I wouldn't say it's not too early, you know, there is that possibility as you get into sort of late spring, if we have a late flu season that maybe immunity could start to wear off. On the other hand, you don't want to put it off and miss it. So if you have a really busy family schedule and this is the opportunity when you can do it and your doctor has those in, you know, with anything in life for weighing the benefits versus the risks.
And, so personally, I would say wait a little bit longer until mid-September, and that'll probably get you in, you know, farther into the spring before the immunity starts to wear off. But again, if you have a really busy September and you know, as soon as they have available, it's better to get it than to forget it and not do it at all.
Tracy Townsend: You know, we've been seeing a lot of stories about measles surging. I guess maybe over in Europe, but this is an opportunity to talk about the importance of immunizations. Vaccines.
Dr. Mike Patrick: Yeah. Well, you know, measles is a viral illness, so we don't really have a treatment for the measles itself and it can cause things like meningitis, pneumonitis. It can cause, you can get blood infections but secondary bacterial infections.
Tracy Townsend: From measles?
Dr. Mike Patrick: You can because your body's immune system is fighting that virus often. So you become more susceptible to other pathogens. So, the measles can still be deadly. It's certainly a very uncomfortable disease to have, even if it doesn't result in death or severe complications. So we do want to prevent it. It's also really contagious. Back in the day before the vaccine, when you could have a whole classroom being affected and staying home because it just passed so easily.
So, measles shots are definitely important and the reason that we're seeing a resurgence is from folks who don't get their kids measles vaccines and that can be dangerous for kids even who have gotten their vaccine because whenever you get a vaccine, most people make antibodies against whatever it is you're vaccinating against. But there's a small percentage of people who don't convert, so they don't make those antibodies. And in the past when everybody else is immunized and protected, there's just not much of the natural measles out there. So even though you got the shot and you were one of the small number of people who didn't make immunity, you were still protected by the community immunity. But as we see more folks not getting their shots, then there is that potential even in kids who did get vaccines to be exposed and to get the disease.
Tracy Townsend: So your advice to our friends who are watching is to follow the immunization schedule?
Dr. Mike Patrick: Oh, absolutely. Yes. Definitely. And the measles vaccine as relates to school, you would get that before kindergarten.
Tracy Townsend: Okay. Jeanne Baker says she wants to know are students screened for vision and hearing problems?
Dr. Mike Patrick: Well, they should be. I think it's a good idea to do a vision and hearing screen, especially before kindergarten, just to make sure that you're not missing anything. And not a bad idea to screen for those things. And you know, every few years as you go through school. But at the first sign of any problem at all, definitely do another screening. Things that would make you concerned if kids aren't doing well in school. I mean, you know, we talk about attention problems. There could be learning difficulties but not being able to see or hear very well can also cause difficulties in the classroom. So when you encounter that, one of the first things you want to do is make sure our vision and hearing are okay. If you have a child who always wants to sit really close, you know, and they have trouble seeing the blackboard, that's going to be a warning sign that we ought to check vision and maybe hearing too, because some things aren't as loud in the back of the classrooms as in the front.
Tracy Townsend: And many of us are always on a screen especially our kids. So maybe you want to get that, check your vision.
Dr. Mike Patrick: Yeah. Well you know, the screen itself is not going to cause any problems with your vision, although the light from the screens at nighttime can stop your brain from making as much melatonin which then causes you not to be sleepy. And so we do recommend screens, you know, turn those off an hour or two before bed. And because that light, that artificial light entering into the eye, your brain still thinks it's daylight. And so you want to start lowering the lights in the house. So you start making Melatonin and get sleepy.
Tracy Townsend: Okay. Here's a question. I apologize if I'm saying your name incorrectly. Shanta Brian Fogarty, wants to know if you screen for genetic factors before giving vaccines.
Dr. Mike Patrick: No, there really isn't any reason to do that. Any genetic problem that would lead to an issue with the vaccine would be very difficult to tell ahead of time, but those are exceedingly rare occurrences. You're at much more risk if you're riding in a car that you'd be in a car accident and to have something bad happen with a vaccine based on some undiagnosed genetic issue. So, while you do hear occasional reports of that, I mean, the one person who wins the mega millions, it's even less than that. So being very unusual. So again, when we talk about healthcare and really any decision in our lives, you're looking at risks versus benefits. And so, the benefit of these vaccines and preventing these diseases that can be deadly far outweigh any remote tiny risks that there could be a problem with them.
Tracy Townsend: Okay.
Dr. Mike Patrick: And I'm not paid by any pharmaceutical companies to say that. You know, you hear like, doctors are in the pocket of big pharma and I don't know what doctors get that money, but it's not me.
Tracy Townsend: It's not Dr. Mike, friends. Keep your questions coming. Jeanne Baker is back with a question about hand foot and mouth disease. What is it and how long are kids contagious?
Dr. Mike Patrick: Yeah, that's a great question. We see it a lot in the summer, so hopefully as we get into the fall season that'll start to simmer down. It's caused by a type of enterovirus called Coxsackie virus, it causes little tiny blisters on the hands, feet, in the mouth primarily. Although you can get them anywhere and in the groin area, under the underwear and the diapers, that's the next most common place. I've already said it should be called hand foot, mouth, groin disease, but you can get it anywhere and it doesn't even have to be in those places. You can get a similar rash on the trunk, just on the arms and legs, but it has a distinctive look to it.
The right time of the year, high fevers, very common, or you can get the little sores in the mouth. No treatment for it because it's a virus. Just what we would call supportive care, so rest and fluids, your immune system is fighting off that virus and then you know, Ibuprofen and Tylenol for fevers or discomfort. But the good news is usually within a week you're feeling a lot better. A one interesting thing about hand foot mouth disease is that even after you're feeling better, you still for a few weeks can shed some of that virus in the stool. And so that's why it's important always to wash your hands after you go to the bathroom. And that's also probably why we see it a lot in the summertime because you're in the pool and then that virus can get into the pool water if you have some diarrhea and even if you've been better for a week or two. So, not something pleasant to think about.
Tracy Townsend: I know.
Dr. Mike Patrick: It is what it is.
Tracy Townsend: With babies but there was a football team in Ohio and they got hand, foot and mouth disease. Let's see. So what else can we talk about? Please keep your questions coming. This is great. I love to hear from everybody. So let's see. Afterschool, are we overscheduling our kids. Do you have thoughts on that?
Dr. Mike Patrick: Well, some people are and some people aren't and it's really, there's not like a set number of activities that's good or bad. It's really family dependent and for each child. There was a study that was done that looked at if you let kids pick their own activities, they do tend to over pick because everything seems fun. Their friends, one set of friends doing this and other set of friends doing that. And so they can sort of over choose their activities, so it's a good idea to sit down with your kids and kind of pick and choose what things to do this year.
Maybe it'll be a different set of things next year. You can try some different activities, but it's important to just like with our diet, it's important to have some moderation. You also want to have some time for your family. You want to have some time for rest, for your homework, you know, just to get outside and play. And so if you overschedule, you tend to have less time for other things that also make us holistic and are important in our family life.
Tracy Townsend: I also wanted to have you talk about when we need to bring our children to urgent care or when we need to go to our family doctor? Because you know, things happen, and we're heading into a holiday weekend.
Dr. Mike Patrick: Well I would say that have this conversation with your child's doctor before you need to actually make that decision.
Okay. So ask them, you know if it's after hours and my child's not feeling well, what do you want me to do? Should we call you? Should we just go ahead and go into an urgent care? In what situations would we go to the emergency department? Just sort of have that conversation ahead of time because your doctor is going to know what facilities and resources are going to be best in your particular community. And so, if you've not had that conversation, I would always just call your doctor's office, you know if you're concerned about your child's health. If you can't get a hold of them and you're concerned about your child, absolutely go to an urgent care. Preferably one that is used to seeing kids. And then if you're really concerned, so if they're having any difficulty breathing, they're bleeding and you can't get it to stop. They look like they have an obvious deformity because they have a broken arm or broken leg, you know, then you're going to want to go to an emergency department or call 911.
Tracy Townsend: Okay. What causes growing pains and knees and our ankles?
Dr. Mike Patrick: So, there's no research to know exactly. You can't really design a study that looks at, does growth hurt? That'd be very difficult to do. But a lot of kids do complain of aches and pains and my feeling is for the most part, that this has just caused by the same kind of a repetitive use injuries, sprains, strains that adults get. So kids are very active, you know, they're running, playing, jumping, and they can pull muscles and tendons just like adults can. They typically feel it more at night because you're distracted during the day. And then in the evening you lay down in bed, you're trying to drift off to sleep.
"Oh, hey, my knee hurts…. Now on the other hand, cancers especially like leukemia because this is starting in the bone marrow, these kinds of cancers, and they can cause pain in legs and knees. It's usually a nagging pain that's there all the time. So you know, when we have a concern and we hear kids complaining of significant pain and it's not going away, it's lasting all day. You know, sometimes we'll do some blood work to make sure that's not going on. But those are rare circumstances and I think most of what we call growing pain is really just muscle pulls and strains.
Tracy Townsend: There's been a lot in the headlines about epinephrine in the generic form that's going to be available to people whose children have those, you know, allergies in where they need epipen. Is it really no difference in the generic form and the brand name or?
Dr. Mike Patrick: You know, I would not think that there would be a difference.
Epinephrine is epinephrine. Sometimes, we worry with generic forms is the delivery system as good and this is going to be more of an issue with medicine that you take by mouth. So whatever else the pill is made of, does it dissolve as well? Does the medicine really get absorbed into the bloodstream? And so sometimes, the brand name may have a little bit of a better delivery system for that drug. But with Epinephrine, it is epinephrine and it's injected directly into a muscle. And so, I wouldn't think that there would be much difference or concern between a generic and a brand name form.
Those are important by the way. So if your child does have a food allergy, is at risk for anaphylaxis, you really do want to have that with you at school and you know, make sure you talk to the school nurse sometimes. They want to lock that up in a school office beside. You want to make sure that they do have that with them.
Tracy Townsend: Okay. Tanya wants to know how you help your child handles stress from school.
Dr. Mike Patrick: So, it's a great question. And again, I think just having a loving, nurturing relationship with your child and being able to talk about things and not necessarily complaining about the stress, but just sort of again, the more that we share with our kids that "Yeah, our job is stressful too…. Not in a flippant way, not like, "well you know, it's just stress…. But just to share that this is a common human experience and then to try to give them some ideas to sort through that stress. I think that one way that kids can really be helped with this is to have some empathy for other kids. So like I'm having stress, but maybe what's causing me to have stress is because of the way other kids are acting. But then when you kind of with all of us, if we kind of step into other people's shoes and see, well why might they be acting that way?
It doesn't make it better or give that other person permission to act the way they are. But the more we understand each other, I think the more insight that you get and that can really help with stress. And then anything that you can do to mitigate that stress. So if it's too much homework, if it's academic difficulties, talking to the teacher earlier rather than later, that can really help. So it kind of depends on what the specific stresses, whether it's related to school work or other kids.
Tracy Townsend: And our kids are always watching us. It probably pays for us to model the right kind of behavior when we handle stress.
Dr. Mike Patrick: Absolutely. Yeah, I agree 100 percent.
Tracy Townsend: I don't do it all the time but just saying.
Dr. Mike Patrick: Yeah, and we let our kids know that. You know, we let our kids know, we don't always handle stress the right way. But what we've learned is this kind of works. This doesn't work and you're probably as a child, you're going to respond to the stress in ways that work and don't work. And that's part of learning as a human being.
Tracy Townsend: Okay. All right friends, anybody else have any other questions? This is great. Oh, this is a great one. You know, this is one of my things and it comes from Angel Daily who says, let's remind everyone always wash their hands to help reduce colds.
Dr. Mike Patrick: Yeah, absolutely. No, that is a fantastic best way to prevent illness is with hand washing. Now you can also wash your hands too often so you don't need to wash your hands every hour, but you definitely want to wash your hands after you go to the bathroom, before you eat, if you've been playing with any or are using any chemicals, you know, anything that can be on your hands. If you've been outside playing in the dirt for a while, there could be any fertilizers or insect killers or anything like that. So any time your hands, you think that they could be contaminated after you go to the bathroom and before you eat, you definitely want to wash. And the best practice with that is to get it into a lather and sing either the ABC song or the Happy Birthday Song a couple times in a row and that'll be long enough.
And then rinse well and dry. You can use the alcohol based hand sanitizers, very convenient. You just want to know they don't kill 100 percent of germs. There are some viruses that aren't killed by those, some of the vomiting and diarrhea virus is in particular. But you know, they killed 98 percent, and they're sometimes easier to use if you're not near a sink and access to soap.
Tracy Townsend: See somebody else. Somebody named Kit also is with me on the hand washing and hand washing is serious, right?
Dr. Mike Patrick: It's important.
Tracy Townsend: Sometimes kids want to take supplements to get more protein, to build muscle while on sports. What do you think?
Dr. Mike Patrick: Yeah, balanced diet is going to give you plenty of protein to do that. Now if you are in a really high functioning sport, you know you're doing weightlifting. Then there may be some instances where a little increased protein would be a good idea, but I would go with if you have a certified athletic trainer who is working with you and hopefully if you're in that level of sport you do, they would have great advice in terms of if you do need to bump your protein, you can do too much protein.
Tracy Townsend: What's the risk?
Dr. Mike Patrick: Well, the risk is if you already have an undiagnosed kidney disease and you do too much protein, could be a problem. If you have normal kidneys and it's a little more protein, it's probably not going to be an issue. But protein can be hard on the kidneys, especially if you already have a kidney disease.
Tracy Townsend: What are your thoughts on energy drinks? I'm tired. I'm in the 10th grade and I had to write a paper on that study and I got to get up in the morning.
Dr. Mike Patrick: Yeah, I would not suggest them and the reason is that they're unregulated in terms of how much caffeine and some of those can have a significant amount of caffeine which elevates your heart rate. Can elevate your blood pressure, you know, little caffeine is not good. I mean for some of us, you know, it's more than a little caffeine. But for young kids in particular, you know, you don't want those really high levels of caffeine and some of those energy drinks can have that. In terms of some of the other ingredients that make claims that they can increase energy, it's probably not true.
Tracy Townsend: Okay. I want to go with, we talked about hand washing, Kit said please tell people how to cover a cough. That's a good advice for right now.
Dr. Mike Patrick: Yeah. You know, the way that you think the best way would be is to cover with your hand. But then, you're using your hand to open doors or shake people's hands. So I kinda like the into your arm up here is probably the best way to cover it because usually we're not rubbing shoulders.
Tracy Townsend: Certainly it looks weird, but it's the right thing to do.
Dr. Mike Patrick: Yeah. I mean at least then because that can go quite a distance. And so if you're coughing into your you're at least blocking it. And of course, turn away from folks.
Tracy Townsend: Okay. All right friends, we're going to take just a few more questions. We have really enjoyed picking Dr. Mike's brain and your questions have been really.
Dr. Mike Patrick: Can I mention something about hand washing again?
Tracy Townsend: Absolutely.
Dr. Mike Patrick: So, sometimes if you're washing your hands a lot, they can get dry. Because as the water evaporates and you rubbed the water off, some of your natural skin water goes with it. And so you may experience dry hands, especially in the winter when also the air is dry. So just you know, use a nice moisturizing cream. Something Aquaphor, Lubriderm, Vaseline, even if it's little more greasy, but just using a moisturizing cream couple times a day can also help prevent your hands from drying out too much from washing.
Tracy Townsend: And getting paper cuts. There's another thing there too. So we've covered back to school. We talked about the forms and vaccines that kids need. So we talked about elementary school. Can we talk about junior high, middle school?
Dr. Mike Patrick: Yeah. So those kids in junior high that middle school age that can be really tough because you're kind of in that limbo between you know, really doing what the teachers say. You know, you look at adults as authority figures. And then in high school, you're really have more independence and autonomy and can even make some choices about what classes you're going to take. And in middle school, you know, it can be difficult because you're kind of stuck in between those two and you're in that transition. So I think in the middle school years it's even more important even though kids are starting to separate from their parents a little bit, it's still important to have that relationship with your kids and ask them about their day and talk about stresses. And maybe in middle school, you know, more important than other times.
Tracy Townsend: Parents have anything they need to remember about that time of life. It's kind of hard to let your baby go.
Dr. Mike Patrick: Yeah. And then there's the puberty thing, you know, it's starting in, and kids have a lot of questions. And it's a good idea to arm yourself with the answers because I mean, you want your kids to be comfortable asking you anything. And so even if you aren't an expert on that, there are plenty of online resources, you know, from good places that can help you. You know if you just google sex education for teenagers and then kind of vet out where you're getting the information from. And of course, if you have any questions, talk to your child's medical provider.
Tracy Townsend: What are your thoughts on vaping? I don't know if that's a big thing in some of the high schools. Teens seem to think it's safer than smoking cigarettes.
Dr. Mike Patrick: So Nicotine is not safe and that's really what you're getting into the body. And then there are also chemicals that cause the flavors and the different smells associated with it. And there really have not been a lot of it. That's a difficult thing to study because what parent is going to say, "Yeah. You can use my kid to expose them to this and let's see what happens…. And it's not been around long enough. So anytime there's new chemicals and you're directly inhaling those into your body, and then we know that nicotine is not good.
It raises blood pressure, it raises heart rate, you know, it's associated with cardiovascular disease. So I would, even though there's not the tobacco in those products, they still are dangerous. The other thing is they're dangerous for any little kids that are in the house because those can be lethal doses of nicotine if they get a hold of that liquid and some of them don't have childproof containers. You know, they can be fun colors and oftentimes the label looks fun. So those products can be very dangerous. Not only for the folks using them, but for littler kids in the home too.
Tracy Townsend: Okay. Well people, friends, this has been great. Thank you for joining us. Dr. Mike has taken a lot of questions and you can always see him on Fridays when we do What's Going Around. You can email me or hit me up on Facebook if you have some other questions. We can use those for future topics because we love to pick his brain and it's great access.
Dr. Mike Patrick: Yeah, this has been great. Thanks for having me.
Tracy Townsend: All right. Thanks Dr. Mike.
Dr. Mike Patrick: All right. We are back with just enough time to say thanks once again to all of you, for taking time out of your day and making PediaCast a part of it. I really do appreciate that. Also, thanks to 10TV and Tracy Townsend, anchor for our local CBS affiliate 10TV and of course, her awesome production team for helping us out with that Facebook live version of this podcast. If you'd like to see the video, you know you probably don't want to watch it from beginning to end if you stuck with this and listened to the audio. But if you just want to peek in, we did record it from the PediaCast studio and I will put a link to the Facebook live version of our back to school discussion in the show notes for this episode 414, and you can find that at pediacast.org.
One more time, I do want to remind you about that eTeen Health site that I mentioned in the introduction. Don't forget to check that out. Really useful particularly for teenage girls. As you know, we try to enlighten folks on best practices for searching for health information online, testing that information, using that information in the whole process. We do have some examples and some things you can click through to actually try it out yourself. So if you have a teenage girl at home or you otherwise engaged with teenage girls, maybe it's in a school setting or a sports setting, whatever it is, this would be a fabulous site to share with them. And again, I'll put a link to it in the show notes for this episode 414 over at PediaCast.org. Don't forget, you can find PediaCast in all sorts of places.
There might be an easier way for you to listen than whatever it that you are listening to me right now. We are in the Apple Podcast App, where you can subscribe. Also iTunes, Google Play, iHeartRadio, even Spotify and most mobile podcast apps to include PediaCast. If there is a particular place where you like to listen to podcasts and you can't find us, be sure to let me know. Just use the contact page over at pediacast.org, and we'll try to get the show added to their lineup as well. And of course there's the landing site where you'll find our entire archive of past programs. The feed just has the last 100 episodes in it. But the landing site has all of them, all 414 episodes. And the show notes for each of those.
A condition called polyhydramnios, which means too much amniotic fluid surrounding the baby when the baby's in the uterus. And you know, what causes that, why is it a concern? What do you do about it? So, that's also on that particular podcast. Insomnia and anxiety related to pregnancy and parenting. So again, lots of great topics and guests with the explanations that parents can easily understand regardless of your background. And sort of the same thing that we try to do here on PediaCast. I also want to remind you that reviews are always helpful wherever it is that you listen. You know, just like anything else in life, I think most of us more and more as our time is just so busy and valuable, you really want to know what other people think of things before you try it out yourself. Whether it's a new restaurant or you're going out to the movies or you're going to have a contractor work on your house.
You read reviews and so, those reviews are helpful. If you listen to PediaCast on a regular basis and you like what you hear or even if you don't, if you have some positive suggestions for us, those are also helpful. So, we do appreciate reviews and that will help other parents judge, engage and then decide where they're going to spend their time getting health care information as it relates to their kids. Again, we're on social media, Facebook and Twitter. We try to share lots of great pediatric and parenting content with you there. A little more personal on Instagram and I'd love to connect with you there. And of course I'll try to connect back, so we can follow each other and have a peek on each other's lives on Instagram. We also appreciate it when you tell others about the program face to face.
So your family, friends, neighbors, coworkers, babysitters, anyone who has kids or takes care of children. And of course that includes your child's pediatric healthcare provider. Please do let them know about this program, so they can share the resource with other families. And while you have their ear, please do tell them about PediaCast CME. Again, continuing medical education, which all physicians I have to have. Same for nurse practitioners and physician assistants. So we all have to have continuing education, nurses as well. So that particular program, it's similar to this one. We do turn up the science a couple notches and offer free category one continuing medical education credit for those who listen. Shows and details are available at the landing site for that program, which is pediacastcme.org. That one is also in Apple Podcast, iTunes, Google Play, iHeartRadio, Spotify, most mobile podcast apps. Just search for PediaCast CME. Thanks again for stopping by. And until next time, this is Dr. Mike saying, stay safe, stay healthy, and stay involved with your kids. So long everybody!
Announcer 2: This program is a production of Nationwide Children's. Thanks for listening! We'll see you next time on PediaCast.