Eczema, Accidents, and Torticolis – PediaCast 036
- RU Listening Contest – Your chance to win a free iPod Shuffle!
- PediaCast 31 – Eczema
- PediaCast 13 – Accidents
- PediaCast 16 – Poop 1
- PediaCast 17 – Poop 2
- PediaCast 18 – Poop 3
- PediaCast 25 – Torticollis
- Talking to Kids about Tragedy
- Field Guide: Magic Kingdom
Announcer: This is PediaCast
You are listening to the Tripod Network. What's on?
Announcer: Hello, moms, dads, grandmoms, grandpops, aunts, uncles and anyone else who looks after you. Welcome to this weeks episode of PediaCast. A pediatric broadcast for parents. And now, direct from Birdhouse Studio, here's your host Dr. Mike Patrick Jr.
Dr. Mike Patrick: Hello everyone, and welcome to PediaCast, a pediatric podcast for parents. This is Dr. Mike coming to you from Burn House Studio and I'd like to welcome everyone to the program. This week we're going to take a short break from new material and catch up with some feedback and comments and even advice from fellow listeners.
On tops this week, we're going to talk about eczema. Also, accidents around the house. Of course, we're going to stick in a common about poop, right? We can never get away from that on PediaCast. So, we do have some poop comments for you. And then also on a torticollis. So, that's all coming up your way in this program. Don't forget, if you'd like to add to the agenda and have an idea for a topic here on the program, all you have to do is go to pediacast.org and click on the contact link. You can also email me at firstname.lastname@example.org. If you'd like to send a voice comment, you can record one on your computer and attach an audio file to your email. Or you can call the voice line at 347-404-KIDS. That's 347-404-5437.
All right, now I do have a little bit of bad news for you. Although, it's really not too bad a news. It's, I guess it depends on your point of view. This is going to be the last program. No, not forever. Just for about 2 to 3 weeks. And the reason for that is, it has been a long winter in the office. And I tell you it has really clobbered me. We've seen tons of kids with the flu and with strep throat. And it is time for a family vacation. So, we're packing up and heading down to Florida , my mother lives down there, as does my brother. And we have a time share down by Disney World. So, we're going to go and take a break for couple of weeks. In a perfect world I would've had a couple of episodes lined up and just uploaded them to the feed. And you would never have even known the difference. But honestly, it's just been really crazy around here. And I have not had the chance to catch up.
Now, I do have a sort of a topic outline for the next few programs after I do get back. So, we'll be to get into the swing of things pretty easily. And at the end of this show, I'll have a teaser for you with some of the topics that you have requested that will be coming up on the program when we get back live with the show toward the end of May
Now, I would like to say, this is a great opportunity for you to go back into the archives. And I do have all of the shows all the way back to episode number one still in the feed. So, if there's a show that you haven't listened to yet, this would be a good opportunity while we're on vacation to go back and listen to some of the previous shows that have topics that may pertain to your children. Also, most of this information is pretty timeless. We don't have a lot of in your face news kind of stuff. So, it's not like you're going to be listening to old news if you go back into the archives. There's still pretty good material I think back there, so I would encourage you to do that.
Alright, I do want to remind you that the information presented in PediaCast even in this listener feedback and comment episode. It is for general educational purposes only.
We do not diagnose medical conditions or formulate treatment plans for specific individuals. 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.
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Dr. Mike Patrick: Wow! so you can win an iPod shuffle and all you have to do is put a review to PediaCast in one of the major podcast directories. And all the information is available in the show notes. So, there'll be a link on there to the "R U Listening?" contest. And all you have to do is go to the PediaCast show notes at pediacast.org and click on "R U Listening?" promo link and you'll find all the details right there.
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Okay, welcome back to the program. We have some feedback from Kristine. And this pertains to PediaCast episode number 31, which was on eczema, and there will be a link in the show notes to that program.
Kristine says, "Hi Dr. Mike, I have been listening to your podcast, and shortly after you started, and I find it very helpful. I wanted to add something to your discussion from a few weeks back on eczema. When my son was a new born, he had fairly bad eczema. His doctor recommended switching all of our detergent. We had been using draft on his clothes and regular detergent on ours. He wants us to change to the free and clear kind, with no dyes or perfumes and not use fabric softener. Switching our detergent seem too specially important since most of his eczema was where he was touching our clothes".
"It turns out he's very sensitive to detergents and this which had a huge impact on his eczema. This easy switch was very helpful for us. And, I thought maybe it would help someone else as well. Thanks for the great podcast, Kristine".
And, Kristine thanks for your comment. That's a good point. You have to remember that a contact dermatitis from detergents might not just come from the clothes that your infant is wearing. But, it could come from your clothes as well. If your infant is touching your clothes with bare skin. So, that is definitely something to think about.
And comment number two on eczema. This one comes from Rebecca from Graceville, Tennessee. Rebecca says, "Dear Dr. Mike. Hi. I am the mother of a 15 month old boy. I've really enjoyed PediaCast. I'm so glad I've discovered it a few months ago. I find you well balanced and appreciate you discussing multiple sources and not being afraid to discuss ideas different from your own".
"I really wanted to thank you for recent episode regarding eczema. My son is, as I have recently learned, a typical allergy baby. He has eczema, is asthmatic and is allergic to eggs and possibly peanuts. I say possibly peanuts because the skin test was questionable. The allergist wasn't positive if it was the peanut or the egg liquid stuff that run down to the peanuts side on his back. These test was prompted by a reaction to egg when he was about 9 months old. Your information regarding eczema was great, you really summarized all the information I had received from my pediatrician, allergist and other reading sources. I really wish that I had made the connection between my breast milk, diet and his eczema outbreaks before now. I bet that if I went back in time, that he had eczema flares when I ate eggs and nuts. So I just wanted to pass on some information and tips that I found helpful, you may want to file mentally, or pass it on to other parents".
Now I'm going to go ahead and pass it on to the rest of the listeners of PediaCast. Because there are some great ideas here. "First, Aveeno makes a great line of products that are fragrance free and some are soap free. We specifically like the creamy wash which is fragrance and soap free. Fragrance free daily moisturizing lotion and oatmeal bath powder for soaking when he has an outbreak. It really seems that any fragrance really irritates the skin. Is all eczema like this?" We'll let me take a step aside, no. I'd say it really depends on the individual kid. I mean, for some children, fragrances really do make a big difference in terms of their outbreak. But for others it's seems to be other chemicals or components. So there's really not a one pattern that you can see with these things. It just depends on your own child and if you notice that heavily fragranced item seem to break your kid out more, then definitely stay away from those.
Okay, on with her suggestions. She says," We religiously apply lotion twice a day, every day. During the winter, we even did 3 times a day especially when it got really cold and we had to turn up the heat". And again, I am making some side notes here, I think you'll be able to figure out which are the commons and which are mine. Pertaining to the heat I just want to remind everyone, that the reason that happens is that when the heaters are kicking on inside the house it really does dry out the air. Decreases the amount of moisture in the air and that tends the eczema flare up as we talked about in episode 31. Okay, she goes on to say, "This isn't a yes but just another perspective. Our allergist told us that daily bathes are okay, but, to avoid drying him of before putting on lotion. To help preserve the moisture on the skin after a bath, we keep the towel wrapped around him and don't uncover any skin until we're ready to immediately apply the lotion.
"I'm sure some water is soaked into the towel, but this helps to keep the water from evaporating and wicking more moisture away from the skin. I would appreciate your comments on this idea, good, bad or otherwise. You know I'd say that's fine. You know, in medicine, you really are hard press to find. Too many rules that are hard and fast. I would say for most kids their eczema does improve when you decrease their bathing. So, if you have a kid, who you're bathing everyday, and then you go to 3 time a week. Their skin usually will get a little bit better just based on the fact that your bathing them less often. And again, remember when you get out of the bath, bath water evaporate. It takes skin water with it so you end up drier than you were before the bathe. However, having said that, if you find that doing this so you go ahead and give him a bathe everyday, and as soon as they get out, you just pat them dry very quickly and then put on the moisturizing cream right away.
And again, you want to good greasy one. So that you're making a fat layer. So that the skin water won't evaporate through that fat, then that's fine. If it seems to help. Now, if you're doing that and the eczema is not getting better, then I would say definitely try to go down to two or three times a week on the bathing. And that might help you out. But if you're doing it everyday and you're following this sort of technique, where you pat them dry very quickly and put the lotion right on. And their eczema is improving or not getting worse, then I think you're fine. So I don't think there's a right or wrong. You just got to look at the results and determine what's best for your family.
Okay. "Also you may want to remind parents that eczema is the itch, not rashes. I took my son to the doctor at least three times thinking he had ear infections because he was crying and raking at his ears. Of course, his ears were clear and he broke out behind his ears within a couple of days. We finally realized that the skin begins to itch before the rash actually comes out".
"This could be helpful information for some parents. Thanks again and keep up the good work". And that comes from Rebecca. So, Rebecca thank you very much for your comments, I really do appreciate it, and we also thank Kristine and we'll be back.
My sound engineer this week is my daughter Katy. And so, she's doing a wonderful job. Let's give it in a round of applause for Katy. Little quick on the promo, but that's alright. You're keeping me out, not the promo. Little quick on the interlude music there. But you're keeping me on my feet, that's fine, I appreciate it.
Okay, next up on the program we're going to have, we have some comments from Heather. Heather is our resident PediaCast listener in Bangkok, Thailand. And she contributes to the program often and usually the information that she, the questions that she has, the information that she provides is fantastic. And we really appreciate her being a part of the show. Recently, she listened to PediaCast episode number 13. And since 13 usually, considers sort of an unlucky number, I thought we'd do accidents, injuries, poisonings, that kind of thing during episode 13. And she has some comments related to that. Again, since we're not going to have a new PediaCast until late May, I would encourage you, if you haven't listened at episode 13, it was actually one of my favorite ones to do. It was pretty fun getting that information together.
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So, Heather says, "Dear Dr. Mike, I just listened to episode 13 and wanted to share, this brought back out of our mistakes with our first children. It is so easy to make mistakes when you are a first time parents, and I think the show was a very valuable one. Our first babies were preemie twins, 2 pounds each. My husband is a physician as well, and between his call schedule and my lack of sleep for months on end, we had some rather painful lessons as did our kids. Here are some things you can add to your show if you do address this topic again". And we're just going to add them here, right now. She says that her baby loves them but is easy to misjudge how far out your baby is. "When my baby was 6 months, I was rushing to get the groceries in the car and home before nap time".
"When shutting the hatch of our SUV, the top came down and graced the top of my baby's head. It was awful. Fortunately she was not terribly hurt but it could've been a disaster. From that point on I always remember to turn to the side and lower the hatch with one hand. Number two, my husband learned, you never take a tray off of a height chair and unbuckle the seat belt until you're ready to lift the child out. Even if you're standing in front of the seat. He turned for one brief moment to put the tray on the counter and my daughter skydived down to the floor". And see, and her husband is a physician, so we all make mistakes. I've been there, I've done it and if you listened to episode 13, I do share some personal experiences of my own with child injuries that make you feel pretty bad as a parent. "Number three, never ignore a two year old tantrum if they are near a staircase".
"Mine was pitching a bit over a toy at the top of the stairs. I told her to sit and calm down, and she freaked out and threw herself to the floor but too close to the stairs and went down them. Number 4, attaching furniture to the walls is a really good idea, and never place a desired toy on something that can be climbed. My twins pull out their dresser's drawers to get a toy, and the dresser came down on them. Number five, when visiting relatives, remind them to place their medicines and poisons out of reach. If they are there for any longer than a day, kids are curious, and grandmas pills look like candy. We never had this one, but a friend of ours did. And number six, make sure if your going to stay with someone, that their pets are child friendly. My nephew went to pet my mom's very friendly dog, and his child like movements spook the dog and my nephew ended up with stitches.
"Wow! Reading this over, it looks like we were really neglectful parents. But first time parents that are tired make very common mistakes and if made aware of them, maybe we would save someone else from doing it. Fortunately for us, our kids never had any serious injuries from any of these things that could have been very serious. Maybe this is a blog idea for your wife to list common mistakes we all make". Yeah, Karen. If you listen to the show and this wonderful idea for a blog entry. "I hope this is helpful to someone else". And it's signed Heather.
Heather, you know, really thanks again for contributing to the program. It takes a lot to admit those mistakes and share them with others. But we've all been there. We've all done it. You try your best to be a good parent. And accidents do happen. It is important to not brush them over, but to seek help if you're worried about the results of an accidents and to learn from your mistakes. And that I think that's an important part of parenting. So, if you're interested in hearing more about injuries, and accidents, and poisonings. That sort of thing, I encourage you to check out PediaCast episode number 13. And again there will be a link to that in the show notes.
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Okay, moving along, we have a poop comment. You knew that we weren't going to get away from one of those. This comes from Jackie. Jackie says, "Hi, Dr. Mike. I was one of the many that fan your website by plugging the word poop into the Google search engine, sad but true. Even sadder yet, was that I was riveted to both to infant and toddler episodes, had you chatting in my kitchen as I made dinner". Oh my god, poop talk during dinner preparation. She goes on to say, "my life is ruled by poop, I have a three year old girl who is potty trained for pee but not for poop due to withholding. And what I truly believe is the inability to know how to push because she is held back for so long. And now a seven month old girl who is doing fine until the introduction of solid foods, pears, prunes, peaches, oatmeal, cereal, butter nut, and sweet potato. And the transition to some formulas, still partially breast fed".
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"I have tried switching the formula for the baby and of increased prunes, and started giving her some juice which is led to increase frequency and more of it. Though still more form than I would expect, and rather dark possibly classified black in color. Maybe not good with the iron content of formula". Although, I think you still want good iron in the formula even if you have to address a constipation issues. That's my little side poop. "I feel we're on the right track and she is not as fuzzy as she was. Though, still waking fairly frequently at night and crying, which is not like her. Such a happy baby by day. Based on your recommendation I intend to see her doctor this week just to be sure, as for the 3 year old, your wife summed it up, lies, bribes and threats. I have her on a training schedule where we sit on the toilet and read books for 20 minutes in the morning and the evening. With infrequent success, but there is improvement. She's been on Miralax for some time, and for her gastro MD, we are playing with the dose to make her go once a day with some effort".
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"I have swung from the going too much and too easily side, to going to too little and too difficult. And I'm doing the pendulum back and forth to find the happy middle ground. I also put my hand on her tummy to give her some feedback. And was amazed to find out how much coaching was needed to actually get her to use her tummy muscles and not just hold her breath and make the appropriate noises. Anyway, I am sure you did not need my life history", well that's fine, "it was just so nice to hear your input and I wanted to thank you for making my crazy poop world life sound almost normal. We'll be listening again. Thanks for great service". And that is from Jackie. So thanks Heather and Jackie for your comments, always appreciated and trust me Jackie the poop craziness is a normal thing, I can't even begin to tell you how many people find PediaCast because they do a Google search for poop.
I'm just so proud that when people do a poop search on Google, PediaCast usually comes up on the front page of the result. Lovely, just lovely. All right we're going to talk about torticollis. And that is coming up, right after this.
Okay, this comes from Suzana in Vancouver, British Colombia. "Hi Dr. Mike. I just got to PediaCast number 25, in which you spoke about congenital torticollis. My son had this and I felt like I'd like to add some additional information. My son is a preemie and when he was sent home, I thought we were free of the medical system. But shortly after he was diagnose with torticollis and plagiocephaly. We were lucky it was caught early by our excellent pediatrician Dr. Peacock in Vancouver, British Colombia. But it was still devastating. Little did we know what a long tough road we had ahead. First of all, parents will want to know what caused it. Birth injury will often be blamed, but I don't personally believe that is true, what is probably more likely is the baby's neck was constricted in utero due to crowning, caused either by a big baby or small mom or low amniotic fluid. It's like a clubfoot but it's in the neck. My son was affected by low amniotic fluid and I know he rarely change position toward the end of my pregnancy".
;"Next, I felt that you did not express the whole range of medical professionals the parents might expect to see. The child should be sent for an x-ray to rule out a bone caused to the tilt. And be seen by an orthopedic surgeon in case surgery or bracing becomes necessary. Back curvature can result from the neck tilt as the child uses their body to compensate. The child's head shaping should be assessed in case the plagiocephaly is severe enough to require helmeting". Although that is a controversial area whether helmets are really needed or not. But that kind of goes beyond the scope of our feedback episode here. I ought to add that to the list of address that in coming episode. Okay, she goes on to say, "their child should be followed by a pediatric ophthalmologist to check for signs that one eye's becoming dominant which can lead to habitual tilting even once the child has full range of motion. And of course there are the physio and occupational therapist".
"Once referred to this slew of medical professionals there's sort of an expectation that the child will receive some treatment administered by a medical professional and go home. But, torticollis is not like this. The parents are primary treatment agents, this can be a problem not only because of the time involved, but because the treatment plan involves a lot of things the baby will hate. I didn't feel that you prepared parents well enough for the reaction their child is likely to have. There will be a lot of screaming. Parents should be encouraged to be stoic about it because it's important. The parents will determine whether the outcome is successful. You know, I think that is just a wonderful point, I mean this is just fantastic to hear this coming from a parent who has been there. She goes on to say, "frequently the parents will have been putting their child in their infant car seat or bouncy chair, et cetera. Because the child prefers to sleep partially sitting up. They must be made to lay sleeping flat on their back, though they will protest and may sleep poorly".
"One trick I use was to go back into my son's room and turn his head after he fell asleep. The parents will be directed to give their babies daily tummy time as all parents are. But their baby will hate this. Propping up the torso with a rolled up towel will help. The parents will be directed to do some stretches, ear to shoulder, and chin to shoulder. And their baby will hate this too. But it is important to do with the frequency directed by the therapist and to do the stretch completely, not halfway. It may help the parents to be reminded that these children don't even like their head to be touched. And part of the screaming is from that not necessarily from pain. You did not mention the tort collar, a custom contraption of surgical tubing that will remind the child to keep their head vertical. It should not be used for propping. Our son's scream for the whole 20 minute we first had it on him. And he was gradually able to tolerate it but there were a lot of screaming and crying to endure first".
"It's necessary to stick with it. And alternative treatment is called taping and accomplishes a similar goal. A normal bandage is applied to the neck, again as a reminder to keep the head vertical. As well as stretching to increase range of motion, some attention should be paid to increasing strength. The lap came, wibbleton to wobbleton was a funny way of helping this. Anything that tips the child from side to side to force them to attempt to right their head to vertical. I should also mention that parents may read about an alternative form of treatment called craniosacral therapy. Some people have recounted miraculous success with this, personally I had a bad experience with it and wouldn't recommend it. I found much better success instead with massaging my son's neck and back with my gentle soapy hands while he was in the bath. He seemed to enjoy it and I do think it help loosen his neck a bit and maybe just helped him to have a pleasant association with touch on his neck instead of always a negative one". That's a great point.
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"Over all it was a difficult, difficult time. This website a support group for parents was very helpful in helping us make it through. And that's www.torticolliskids.org, and of course there will be a link to that in the show note. So www.torticollis.org. Even if this information is not able to fit in to your program", ah, but it was, " it will help you with the next set of parents to whom you must give a torticollis or plagiocephaly diagnosis. Parents must understand that they are the key players in the treatment of their child and that they must endure the crying. And pediatricians and other medical professionals must realize how hard it is to listen to your own child scream in your hands and give them as much support as possible. Thanks very much for your podcast I'm enjoying it and learning a lot. Suzanna in Vancouver, British Colombia".
I do want to mention, thank you very much, Suzanna. Your comments are appreciated. I think it's wonderful for parents to hear from a mom who is been through this. I do want to remind everyone though, that there are different degrees of all of this things. And torticollis is no exception. There are some babies who respond very well to just some stretching. It's not really too big of a deal in terms of dealing with them at home. They cry a little bit, but it's not nearly to the extreme that Suzanna is talking about. And then you're going to have the kids who are on the extreme and don't anyone touching them, and really, they need the help from lots of different people and lots of different ways and in terms of the tort collar and seeing the physical therapist and all this things.
So, there is a range of severity with this. And as a pediatrician we really do see the whole range from mild to severe. And each of those is going to require a little bit of a different approach to what referrals are made and how you go about finding the resources for these parents. So, do keep that in mind. Also as with anything treatments, if you lineup a hundred experts, whether they're pediatricians, whether they're pediatric orthopedic doctors, or they're pediatric physical therapist. You lineup a hundred of them and they ask how do you treat a torticollis in kids?. What sort of evaluation needs to happen?, and then what treatment ensues. You're not going to get consensus. You're going to have, some say do it this way, some say do it that way, that these referral's important, that referral is important. This work up, that work up. So you're going to have some difference in opinion, so you want to keep that in mind as well.
Okay, so we're going to go ahead and move on. I know this is kind of a shorter program this week as we get into some of this, into these comments and feedback. But that's all we have, I have lined up for you this time. So we'll be back and close up the show right after this break.
Okay, on the PediaScribe blog, I want to tell you that we do have a article that I wrote on talking to kids about tragedy. And this sort of comes on the heels of the recent events at Virginia Tech. And of course here at PediaCast, our thoughts and prayers continue to be with the survivors and families of all those involved.
And it does become little bit tricky in terms of talking to your kids about tragedies like this that happen in the classroom, even though it's at a college. And so I do have an article that I wrote called "Talking to Kids About Tragedy". And there will be a link to that in the show notes so you'll be able to find that. Also, keep in mind that my other project "Mouse Matters", which is a weekly column on anything and everything Disney. We recently wrapped up an imagineering tour of the magic kingdom. So, if you are a Disney buff or you're interested in facts and trivia about the magic kingdom you might want to check that out. And there is a link to the first in that series which was "Field Guide, Magic Kingdom", there's a link to that article. And then once you're at the "Mouse Matter", site you can look at the rest of the articles in that series which just look at some of the secrets imagineering wise in the magic kingdom. We did kick that off with main street USA. So if you're a Disney buff, and you like Disney trivia, you definitely want to check out that series in "Mouse Matters", which is my weekly Disney column that I do. And, again there'll be a link in the show notes.
All right, once again I want to say thanks to all the listener out there. And thank you to everyone who's given feedback in iTunes, that's really appreciated. We are going to go on a brief hiatus, just for 2 to 3 weeks. We will be back in mid to late May with another new episode of PediaCast. And just some of the topics lined up for the first few when we return. We're going to talk about cystic fibrosis, stork bites, freckles, eye color, dental visits and dental injuries. Night terrors, lead poisoning, colic, tracheomalacia, obstructive sleep apnea, and some more information on head lice.
So, that's all coming your way late May and into June. We will have new episodes every week throughout the summer. It's a lot easier for me to do this in the summer because the office is not as nearly as busy as it is during the winter month. So, I know I've skipped a couple weeks here and there, I've gotten out shows as quickly as I could and as often as I could. And I appreciate all of your patience in terms of the times when it's been a couple of weeks in between episodes. But, I have no plans on giving this up. I love doing PediaCast and there'll be lots more to come in late May with episodes new ones every week. So stay tune for that. Thanks go out to all of my media partners. Vladstudio creator of the artwork on our websites and the feed. And also home to wonderful desktop wallpapers and poster friends. You can find Vlad online at vladstudio.com.
Also, Medical News Today, the largest independent health and medical news website, with at least 16 new articles everyday including weekends. And that's more articles than any other health news site.
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And you can visit Medical News Today at medicalnewstoday.com.
Also, thanks to Devin Technologies. Makers of robust research and database software for the Macintosh platform. And for more information visit their website at devin-technologies.com.
And of course thanks to my loyal listeners by subscribing, listening and contributing to PediaCast. You we're the ones who ultimately keeps this project going.
And of course thanks to my family. And in particular thanks to Katy this week for being my sound engineer. Reminders. if you like to suggest a topic for the program. Just go to pediacast.org and click on the contact link. You can also email firstname.lastname@example.org. You can attach an audio file or you can call the voice line at 347-404-KIDS, 347-404-5437. Promotional materials are available on the poster page at pediacast.org. And as always in lieu of a co pay, you can leave a review in iTunes or at digg.com, that's digg with 2 g's.
And of course that "R U Listening?" contest gives you a chance to win a free iPod shuffle. And there is a link with all the details available in the show notes. So be sure to tell your friends, family, co-workers, and neighbors about the show so we can empower more parents to make great decisions regarding the health and well-being of their children. So until next time, this is Dr. Mike saying stay safe, stay healthy and stay involved with your kids. So long everybody.
Announcer: The Tripod Network. What's on?
Dr. Mike Patrick: So, Katy. These, you know, people who don't actually turn their iPods off as soon as the show is over. We want to give them a little bit of something. You know what I mean?
Katy Patrick: Yeah.
Dr. Mike Patrick: Yeah? Do you have a joke or something to share?
Katy Patrick: What has four legs, is green and fuzzy and if it falls from a cradle, it hurt you?
Dr. Mike Patrick: I have no idea.
Katy Patrick: A pool table! I didn't say it was in a tree. I said, if it falls from a tree, it will hurt you.
Dr. Mike Patrick: Oh. [Laughter]