Welcome, Blindness, Sleep Problems – PediaCast 001

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Join Dr Mike in the PediaCast Studio for more answers to listener questions. This week’s topics include BOB devices, blindness, varicella vaccines, caffeine consumption, and sleep problems.

Topics

• Welcome To The Show!
• BOB Device
• Blindness
• Varicella Vaccine
• Caffeine Consumption
• Sleep Problems

Links

• BOB Device

• Virginia Couple

• Varicella Vaccine

Transcription

PediaCast Episode 1, July 19th, 2006

Announcer 1: Hello, moms and dads. Welcome to this week's episode of PediaCast, a pediatric podcast brought to you by pediascribe.com. Visit pediascribe.com to explore a collection of thoughts from an American pediatrician. And now, here's your host Dr. Mike Patrick, Jr!

Dr. Mike Patrick:: Hi everyone, and welcome to this very first episode of PediaCast.

It's a special episode since it's our very first one. And I'd like to especially welcome all the Charter members out there. I know there's already been a few subscriptions at iTunes even before our first episode was released. And for those of you who signed up and are listening to the very first one, thanks for your support and hopefully, we'll live up to all your expectations.

And I welcome back to those of you who may have found us down the road, listened to a couple of episodes, and then were interested enough to come back and listen to the first one and maybe catch up. So, welcome back to you as well.

Now, PediaCast is meant to be more of a conversation between a pediatrician and parents. I'm a board-certified pediatrician in a group practice. And it's a busy practice because there aren't a lot of doctors in our town who take care of kids. And one of the most frustrating aspects of the job, really, is you do feel a little bit rushed. Now, obviously, if a kid comes in who has a significant illness, you know, they're wheezing or dehydrated, have pneumonia, you're going to take the time with those parents, there's no question about it. But the kids with some of the more routine things like ear infections, poison ivy rashes — you know, you can name all sorts of things — a lot of times we look at them, and say "Here's what you needed to do, this is what it is," and can't get into any more detail about explanations. And it's really not the doctor's fault, it's not the parent's fault for not asking the question. It's a time issue and when you have a community full of kids who need to be seen, you do have to maintain some sort of time schedule in order to be able to see all of those kids.

0:01:57

So I would like to use PediaCast as a way to be able to talk about some topics in a bit more depth to interest parents. And really, I don't want to get up on a soap box and lecture to you. So I would like it to be, if you have a question or a concern about something, even if it seems silly, go ahead and shoot an email to me and we'll do our best to deal with those topics. And we'll talk a little bit more, as we get on down the road here with this first episode, how you can contact me in order to ask those kind of questions.

I do want to say quickly, that I had been listening to a lot of podcasts over the last few weeks. And I have to tell you, the medical podcasts have not been my favorite. I found that a lot of those are doctors or other health care professionals who are reading from a script and they just kind of drone on and use big words. And I just think, "Gosh, there's no way I could listen to that for very long. The best podcast that I've come across so far are ones that maintain more of a conversational tone, little bit more off-the-cuff, and just seem more real to me. And that's what I'd like PediaCast to end up being.

I do write a weekly column called PediaScribe, which you can find at www.pediascribe.com. Initially, I thought, "Well, we'll do a podcast. We'll read some of the columns." But the more I listen to the how-to podcasts, I came to realize that is not going to work reading the columns. So the columns will be a supplement here. You're more than welcome to go over to PediaScribe and take a look at them and read them. I'm still planning on coming out with those once a week.

But the how-to podcasts, I do want to mention some of those, Podcast411, Podcasting Underground and Podcasting for Dummies. Those had just really been helpful in terms of learning how to do this. So, if anybody out there is interested in doing a podcast for yourself, I highly recommend those podcasts. Because they certainly helped me out quite a bit and I appreciate the time and effort that those folks put in to making those happen. So, hopefully, I 'll be able to able to live up to their expectations and follow their advice.

0:03:59

OK, so without any further delay, we're going to go ahead and move on in to our News section.

[Music]

Our first item in the News segment, and this may end up being a trivia on down the road for those of you who listened from the very beginning. What was the topic of our very first News segment? It's an interesting one actually so it will be easy to remember.

It's called the BOB device. Have you heard of this? It stands for Bring On The Balance and it was created by a Boulder, Colorado company called Hopscotch Technology. They're the ones that developed BOB. And they developed this little system in response to a study that came out not too long ago by the Kaiser Family Foundation which found that children who were between the ages of 8 and 18, on average — and these numbers are kind of crazy, this is what they're reporting, I'm not making them up — even during the school year,  spend about 30 hours per week watching TV, seven hours per week using a computer for non-school related activities and seven hours per week playing video games. So when you add that all up together, you get 44 hours a week that the average 8 to 18-year-old watches TV even during the school year. And that's a full-time job. It's just unbelievable numbers.

It was also found in the study that two-thirds of kids between 8 and 18  have a television in their bedroom and one-third of them have a computer in their room.

So in response to this, this Hopscotch Technology company came up with BOB. It's a device that looks like an old-fashion calculator with an LCD screen and a number pad. And then, BOB plugs in to a wall electrical outlet. And then, you plug the electronic device, whether it be TV, video game system. I guess you could probably just put any electrical device in it. You may want to put your Toaster or something.

[Laughter]

0:06:00

Anyway, you can put any electrical device and it's going to control power to that device. And in order to access it, you have to punch a code number on the pad which will show up on the LCD screen. And then, it recognizes who punched it in and how long of a time period they get with that device. So each person in the family can have their own code number and once they plug it in, they're only going to be able to do that however many times a day you tell them that they can. And then, the power's only going to last as long as you tell them that it can be on.

So, I supposed this is going to be most useful for older kids who may be coming home from school and they're home alone and their parents don't want them to watch TV but to work on their homework. They may watch TV for half an hour or something like that. I would think when the parents are home, that parents would have a little bit of control over saying, "Hey, you can't watch TV" or "Hey, you got to put the video game away now."

So, you know, how much time are these kids spending at home by themselves, I guess, becomes a question. So, I don't know, if your kids spends a lot of time at home ad you don't trust them to do what you tell them and to respect the limits that you place on electronic devices, then you might want to look at BOB.  

For those of you with younger kids, I would highly encourage you if you don't want to buy BOB in the future, to go ahead and start setting limits now so that kids get used to knowing that they have a limited amount of television time.

You know there's this big hubbub right now about kids and obesity, and American kids are just getting fatter and fatter, less and less exercise,  eating more and more food. And when you look at it, 44 hours a week, the average eight to 18-year-old spends watching the screen, just too much. So something to think about.

OK, on to our second news story. Oh, this one's interesting too. A couple of good ones here for our first episode. And this comes from Fairfax, Virginia. And, let's see, a couple had adopted four blind children. Now, I guess if these four blind kids are all related which is certainly possible, that's a really good thing to do. Just to put yourself out there and adopt four blind children – just incredible, passionate, compassionate parents. Oh, and maybe, passionate about having blind kids.

0:08:12

But, in any case, if they're not related, when you're taking on four blind kids, boy, you're really doing them a service. That just seems like so much work.

Well, anyway, this couple who adopted four blind kids built a 2.2-million-dollar house. OK, in this neighborhood in Fairfax, Virginia where they built their 2.2-million-dollar home, the contractor apparently removed a dozen 25-year-old, 100-foot tall trees from the back of the property. Well, they did this without the couple's consent. Although, did the couple not know they were doing it? I don't know, maybe they weren't around watching them.

In any case, they did this illegally as well. Apparently, there is legislation in Fairfax, Virginia, in their neighborhood, that these trees could not be removed. The news story did not go into any details and Google search did not result in any other details about this either. But, apparently, in their neighborhood, it was illegal to take these trees out of the backyard.

So, the county in response had barred them from moving into their 2.2-million-dollar house with their four blind children until they agreed to plant 20 new trees in their backyard. Well, the family claims that the trees, the new trees and the stakes and the ropes will be hazardous to their blind children. And the mother said and I quote, "The trees look like a bunch of evil people saying 'Red rover, red rover, blind kid, come over.'"  And then she goes on to say that, "When you purchase a property you should be able to do what you want with the land."

Well, that may be true, however, before you get into buying property, you might have wanted a lawyer go over the deed restrictions or any loss in that area that affects your property. And when you buy property, you are bound by the law and if you don't want to remove those trees, maybe you should go some place else.

0:10:04                            

And it's kind of hard to believe that this contractor took out a dozen 100-foot-tall 25-year-old trees without the couple knowing about it, at least after the first one or two that they took down. What it turns out the contractor has agreed to pay a $100,000 in damages. A $100,000 for 20 new trees? I don't know.

Anyway, the take-home message here, I guess, is if you're going to build a $2 million house, make sure you know the deed restrictions. And then, the other thing too is why adopt four blind kids? I don't know. Either these folks are angels or have some issues.

OK, now, we're going to kind of change direction. Instead of family news, we're going to talk a little about health news. There's actually a new chickenpox shot out for adults, Varicella vaccine. You know, when the chickenpox shot first came out, there were some issues. How long is the immunity from it going to last? Are we going to have a population of adults who get chickenpox? And then, chickenpox to an unborn baby can be devastating. So are there going to be woman out there having kids who are stillborn or have birth defects, miscarriage because of the chickenpox?

Well, this particular vaccine actually is not in response to winning immunity which is a different issue in childbearing woman. But it's actually geared more toward adults who are age 60 and older, and its purpose is basically to prevent shingles. Now, shingles – let me kind of jump back a little bit — when you get chickenpox as a kid, whether it be the natural disease or whether it's from the vaccine, the chickenpox virus stays in your body in a dormant state, a very small amount of it, even after you get over the disease and after you had the immunization. So your immune system takes care of the infection or the amount that was introduced in the vaccine. But a little bit of the virus stays alive in your body basically the rest of your life. But your immune system is able to keep that virus in check and keep you from having any disease.

0:12:08

Well, if your immune system suffers a little bit of a hit — whether it be because of aging or because you have a lot of stress in your life or because you have another disease that the immune system is fighting — so if the immune system takes a little break, that virus can reactivate. Now, it's living in nerve cells, so whatever skin that nerve goes to is where you're going to have to breakout of the shingles. That's why it follows sort of a patch where you have it. So it's reactivation of the chickenpox virus.

So, the FDA approved this new vaccine. It's the first vaccine in 30 years that's intended exclusively for senior citizens and that it's a large dose of the virus. Now, of course, it's attenuated virus. That means it's a less potent form of it. It's not going to actually make you sick. It's just going to make your immune system to make antibodies. But it's equivalent to 14 doses of the pediatric chickenpox vaccines. So, it's a lot bigger dose.

There's 1 million cases of shingles in the United States every year. The lifetime risk of any particular person getting shingles is 10% to 30%,  but if you're over 85 years old, it's 50% chance that you're going to have shingles. And, again, that's because your immune system is getting weaker and not able to keep that virus in as long.

A three-year pre-marketing study for this vaccine found the occurrence of shingles was reduced by 50% among vaccine recipients. And of those who still develop shingles even though they got the vaccine, two-thirds of them have less pain and discomfort. So you may want to let your grandparents know if they're 60 and older or for moms and dads out there, your parents I should say, let them know about this because it may help them have a less chance of getting shingles or having complications. If they still get it, they won't have much pain and discomfort from the illness.

And also I think it's important for parents to know about this because you're going to hear news stories about "There's now an adult chickenpox vaccine," and one of the first things you think of was, "Oh no, the vaccine that my kids getting is going to wear out and we're going to have problems." But this is really not meant for young and middle-aged adults. It's for the elderly, so keep that in mind.

0:14:19

OK. And then, our last news story, this is another interesting study. It has to do with the caffeine in teenagers, 20% to 25% of adolescents report some type of sleep disturbance, according to a recent study. And this sleep disturbances include difficulty falling asleep, waking up in the middle of the night, feeling tired, drowsy on awakening or difficulty getting back to sleep once you're awake.

So keep that in mind. And then, caffeine is the most widely consumed psychoactive drug. Over 75% of United States teenagers and adults consume caffeine everyday. Now for teenagers, soft drinks are the primary source of caffeine. Some of them are going to drink coffee but most of them are soft drink drinkers.

Well, investigators at the US Department of Health and Human Services — so this is your government agency at work, the US Department Health & Human Services in Rockville, Maryland — they examined questionnaire data from over 15,000 teenagers who were in Grade 6 through 10. So based on their answers to these questions, they were divided into groups according to the how much caffeine they drink. So they were divided in the either very low caffeine drinkers, low, moderate, and high. And what they found was that those in the high intake group were almost twice as likely to have sleep difficulties compared to those in the very low group.

So our government agency theorizes that connection between high caffeine intake and sleep problems must exist and they use this as a sort of leverage to be able to say, "Hey, let's take a look at soda machines in schools and we should educate parents about the risks of high caffeine."

0:16:01

Now, while I personally agree that kids should not be drinking as much soda mostly because of the sugar intake, carbohydrates and the obesity problem that we have, the caffeine issue is interesting. There are some problems with this study. And when you hear about this kind of stage, you got to think about a little bit more in-depth.

Now, what you wonder is how many of these kids have sleep problems for some other reason and what they found is that when they drink soda and have an increased caffeine intake that it's able to help keep them awake. So perhaps the kids who don't have sleep problems, don't drink as much soda because they feel OK anyway whereas the kids who were tired all the time have learned that "Hey, if I drink a Mountain Dew in the morning, I'm able to stay awake in the classroom, I'm able to do my homework better." And so is the caffeine really causing the sleep problems or is there some other underlying issue that then they have learned, "Hey, if I drink caffeine, it's going to help me get through the day"?

This makes sense because caffeine is actually a similar drug to the medicines that we use for ADHD. So kids who were on Adderall, Ritalin, Concerta, all these kinds of medicines, they're basically taking caffeine in the pill. That's not actually caffeine but it's a very closely related drug that obviously last a lot longer than a cup of coffee would or a can of soda would last. But maybe some of these kids have ADHD that's undiagnosed and they've learned to treat it themselves by drinking caffeine.

We do know that if you have kids who have untreated ADHD, that they are much likely to drop out of school, be involved in car crashes, be in juvenile detention center. That's all pretty much established data. So then you have to say, OK, so if these kids who are having sleep problems are drinking caffeine to help themselves out — and then you say "Hey, don't drink caffeine anymore," but they still don't go to the doctor and get their underlying ADHD under control —  by taking their caffeine away, are these kids going to be involved in more car crashes, might be more likely to drop out of school or end up in juvenile detention places?

0:18:16

That's something that you have to consider and look at and these studies that just look at data from questionnaires are just terrible studies because you don't know if the association that you're seeing is real one or there just some underlying thing that makes the two go together. So something to think about, and as Pediacast goes on down the road, as I see studies like these, we'll try to bring them to your attention.

OK. So that's our first News Segment. We're going to move on over into our Feature Segment.

[Music]

Dr. Mike Patrick: Welcome back to Pediacast. I'm Dr. Mike Patrick Jr with you. The Feature Segment this week is actually going to talk a little bit about me. So you're going to have to bear with me. But I think it's important for listeners to have a little idea of where the host is coming from, what their background is.

First, I should say that I almost went in to broadcasting rather than medicine. Well, my parents were managers of the skating rink and I work ed as a disc jockey actually from the time I was about 10 or 11 years old. They had a Kids Fun Skate every Saturday morning and I worked for pizza and Coke. Sometimes, they give me a hot pretzel, too. But anyway, it wasn't for cash. And I did a two-hour Kids Fun Skate session at the skating rink which was a lot of fun. As time went on, I got in to radio a little bit. I worked at two different college radio stations. And then, when I went to medical school, I pretty much forgot about broadcasting altogether.

My kids, they had heard that I'd done this but had never really listen to me do a radio kind of thing. So this has all been kind of interesting for them, too.  I have a nine-year old son and a 12-year old daughter, by the way. So I'm not only talking to you as a pediatrician but as a parent as well who's been through a lot of the things that we're going to talk about.

0:20:09

But anyway, I'm getting sidetracked. I almost went into broadcasting and then, medical school sort of pulled me away from that. I went to college at a small liberal arts college in Ohio. I went to medical school at Ohio State University and then, trained my pediatric training at Columbus Children's Hospital. And then, actually, I did a little bit of pediatric emergency medicine fellowship after my residency, and then joined a private pediatric practice. Threes a group of six of us who practiced together and I've been in that group since 1998. So, in terms of practicing pediatrics, I've been doing it about ten years or so.

I also always like to write. And a few months ago, I launched a weekly column called PediaScribe which you can find at www.pediascribe.com. PediaScribe, it's basically kind of like a written form of this program although it's certainly more formal in terms of its language. But it does cover pediatric topics, family topics, parenting things that you might be interested in. So you might want to check that out. And then, Pediacast sort of grew as an extension of that.

I also, as it turns out, love Disney, anything Disney. Disney World, we belong the Disney Vacation Club, go there quite often. Kids love it and I love it. And there's a place on the Internet called the DISboard, wdwinfo.com. And a couple of weeks ago, I started writing a weekly column on that as well called Mouse Matters which is pretty much just about anything Disney. Well, the DISboard also have a podcast that they've developed. And so, I started working with that a little bit and then that got me listening to some more podcasts. And then, the broadcasting bug kind of hit me again and I thought, "Wow, this is a way to really do it." So I guess that's how PediaCast grew and we'll see where it heads.

[Music]

0:22:16

Well, our Feature Segment was a little bit shorter this week because I can't talk about myself too long. But I'm sure that there are going to be some people who listen to later episodes and want to come back and hear a little bit about the host. So thanks for bearing with me with that.

The next segment each week is going to be Listener Mail. And obviously, since this is our very first episode, I don't have any. But I do encourage you, if you're listening to this, to please email me. There's a couple of different ways that you can get to me. One is to email podcast@pediascribe.com. The homepage for PediaCast is actually at PediaScribe. I hope this isn't too confusing for people but PediaScribe came first, the weekly column, and then from that page, you can get to our podcast. So if you just email podcast@pediascribe.com with any questions or comments, we'll get back to you from there.

There is also a Contact tab on the PediaCast homepage. And PediaCast is at www.pediascribe.com/podcast. And if you click on the Contact tab, you can also submit a question that way.

If you'd like to send an MP3 file with your question, that would be great, too. I don't have anything set up with Skype or ways for you to call in quite yet. I'll be working on that in the coming weeks. But what you could do is just record it and send it as an MP3 attachment to your email and then we'll be able to get you on the show and try to answer your questions.

0:23:46

I do want to take this time, rather than answer questions, to also explain something in a little bit more detail and we'll talk about this as a brief statement during each episode. But it's tough to give actual medical advice over a medium like this when you're talking about a specific child. And that's because there really can never be a substitution between an interactive history and a hands on physical examination. It's like practicing medicine over the phone. When I can't see the rash, when I can't see what the kid looks like, when I can't listen to the lungs, it's hard. And I have so many parents who call in and they just want a prescription cough medicine called in for their kid. But just the one time that their child actually has pneumonia and not a cold that we have caught early, and when that kid ends up in the hospital, the first person that they come to say, "Hey, why didn't you say we have to come in to the office for this cold. I didn't know we could get pneumonia." Those parents do that.

So I can't really answer questions about a specific child during the course of the show, but we can talk in generalities. So if there's a particular topic that you're interested in, we can talk about it in a generic sort of point of view. But for your particular kid, while this does give you a little bit insight on the problem, you really are going to need to see your local doctor and let him do an interactive history and a hands-on physical examination. Because that really is the best way to diagnose a problem and come up with appropriate treatment.

But still, there are going to be issues. For instance, why do poison ivy rashes last so long? And do poison ivy rashes spread even after you've taken a shower or bath or treat them with medicine? Are you going to be able to spread it from one area of your body to another? And, can you get poison ivy from touching a patch of poison ivy on someone's skin?  I'm going to use that as a teaser. I'm not going to actually get into that in this program. Although, if there's anyone out there that's really interested in that, just shoot me an email and then maybe next week, we'll address it. Or if there's some other topic you want us to address, we'll be happy to do that as well.

All right. So I guess we need to wind things down here. I'm at the 25-minute mark or so which is about how long we want this programs to go. I really just appreciate those of you who dropped by and took a chance to take a listen to our very first episode. You have to bear with me a little bit. This is the first time I've done this and I haven't done a broadcasting gig in quite some time.  But it's been fun and I certainly am going to be motivated to continue to come back week after week.

0:26:13

And, like I said, the plan right now is to release this every Wednesday. And maybe they'll become a little more frequent as time goes on and maybe we'll expand a little bit. We'll see where it takes us but I'm really excited about it and I hope you are too.

If you like what you've heard and are looking forward to the show, I would encourage you to go to my site on iTunes. Just do a search for PediaCast or pediatrician. You should be able to find it pretty easily and to leave some feedback because I think that's really helpful. I know when I was looking around for different shows to listen to, you really do use Listener Feedback to let you know whether it's worth downloading or not. There's just so many programs out there these days that you have to be a little bit discriminating in what you pick and what you don't pick.

If you don't like what you've heard so far, you don't have to do that. No, I'm just teasing. Actually, constructive criticism is good. So if there's something that we can improve on, please let us know. In the coming weeks, I do plan on upgrading equipment a little bit. Hopefully, the audios have not been too bad, but I will be getting in new mixer board and microphone and that sort of thing. So, hopefully, the audio quality will improve, too, as weeks go by.

So again, I thank everyone for listening and for this very first edition of Pediacast. I'm Dr. Mike Patrick Jr. So long everybody!

[Music]