Archive for the ‘F-J’ Category
To all my readers happy Valentine’s month! This is the month of celebrating friendship and love. Since we celebrate with delicious chocolate, plenty of candy and pink and red hearts, I am dedicating this blog to the heart. Kids’ hearts that is!
The heart is an amazing muscle which pumps approximately 1.3 gallons per minute or 1872 gallons of blood in 24 hours! The heart starts beating at approximately the 6th week of gestation. For the pregnant mommies who want to ensure a healthy cardiovascular start for the baby, make sure you are eating a good healthy diet especially rich in folic acid and take your prenatal vitamins as recommended. All the major organs are formed by the first trimester. Always check with your doctor if taking any medications as some medications can cause birth defects and affect the development of the cardiovascular system which includes heart and vessels. If there is a family history of heart defects or unusual heart rhythms especially in first degree relatives like siblings or parents you need to tell your obstetrician as soon as possible. Usually a specialist called a perinatologist can do a very advance level 2 ultrasound which may be able to detect major heart structural abnormalities.
The American Academy of Pediatrics is now recommending heart screening for all newborns by doing a very simple test called pulse oxymetry. This consists in putting a small probe on the baby’s finger and matching the heart rate with oxygenation at room air. If there are any discrepancies further testing will be ordered. Since this is just a recommendation most hospitals are just starting to adopt it as a policy in most newborn nurseries. You can ask your pediatrician and request this very simple test.
Heart murmurs are a very common finding in perfectly healthy newborns and children. If any heart murmur is detected at birth it needs to be followed by the pediatrician who then will refer to the pediatric cardiologist or may order an ultrasound of the heart. A heart murmur is the sound of blood going through the different structures of the heart. If there is a structural abnormality the sound deviates from the usual sound that we appreciate with the stethoscope. In newborns and older children the majority of the murmurs are innocent but they always need to be investigated. If an infant is not gaining appropriate weight or he/she is having major difficulties feeding always asks your doctor as this can be a sign of heart trouble.
In school age children and adolescents signs and symptoms of heart disease are exercise intolerance, with extreme fatigue, weakness, almost passing out with or without exercise and syncope. Abnormal heart beats very rapid, skip beats or irregular heartbeats should always be investigated with the pediatrician and even may require a cardiology referral. For athletes with any of these symptoms competitive sports should be put on hold until cleared by a cardiologist and although not a universal requirement I would even recommend a screening EKG for any child playing competitive sports at the varsity level in high school and planning to play in college. Chest pain very rarely is related to heart problems more commonly maybe a sign of respiratory or musculoskeletal issues.
Childhood obesity increases the risk for early cardiovascular disease. We are starting to see many obese children with high cholesterol, high triglycerides, high blood pressure and diabetes.
For a healthy heart a well balanced diet, consisting of fruits and vegetables, lean meats, grains and legumes is essential. Avoid processed sugars, foods that come prepackaged with high levels of sodium, and preservatives, juices that are bottled or come in boxes, and sodas. A good diet, daily exercise and a good dose of laughter are the secrets for a healthy heart.
The Flu Season has already begun are you and your little ones prepared? I am sure that you are all seeing and hearing the commercials to come and get “The Flu Shot.” They are giving them at your local pharmacy, at the health department, and in your primary care physician’s office. Before you make your decision about receiving this vaccine, I’m sure you have several questions.
What exactly is this “Flu Shot?”
There are two types of influenza vaccines: a live and non live. The live means an actual viral particle is given to the patient, this vaccine is popular because is non injectable and given through a nasal spray. The live vaccine should never be given to children under age 2 years, children who have asthma or recent history of wheezing or anybody who is immunocompromised. The non live is injectable but it contains the inactivated virus as the main component of the vaccine. There are also a preservative free or with preservative version of the vaccine. In this case the preservative is thimerosol which contains small traces of mercury. I never like to give my children or my patients anything with mercury preservative if I can prevent it. Ask your provider which version they have so you can make the best decision for you and your child(ren).
Why is there a new vaccine every year?
There are different influenza strands and every year the virus mutates or changes. Therefore a new vaccine is made using a combination of strands from the most recent outbreaks worldwide. Once the vaccine is given to a patient it will start working in the immune system at day three of vaccination, but it is not until after day 7 that you will have full immunity. If during that period you are exposed you will still get the flu.
Who is more susceptible to the flu?
I recommend the flu vaccine every year for all children who are six months and up especially for little ones with chronic conditions like asthma, diabetes, history of extreme prematurity, and heart disease.
What are the possible side-effects?
All vaccines have potential side effects. The possible side effects of the flu vaccine can range from nothing, to minor redness and swelling at the site of the vaccine, to pain and soreness of the site for several days after the vaccine; to the most unusual but possible fever, body aches and headaches. Other possible side effects may present if the child is allergic to any components of the vaccines, then the child should not receive the vaccine: the possible side effect can be hives, wheezing, difficulty breathing which are signs of severe allergy called anaphylaxis. The vaccine contains some chicken egg component therefore if a child is allergic to eggs he/she should not receive the vaccine. Thankfully the most severe side effects are very rare.
As I stated in my previous posting the best preventions for the Flu are hand washing and the vaccine. I arm myself, my family, and my patients with the flu vaccine every year.
For more information on the flu vaccine visit http://www.cdc.gov/vaccines/pubs/vis/#flu .
Two years ago, my daughter Sarah woke up feeling extremely weak, with terrible chills and an uncontrollable fever of over 103. It took me less than two minutes to realize what she had, “The dreaded FLU!” The flu is a contagious illness caused by the influenza virus which symptoms include: fever, body aches, sore throat, severe cough, and in some cases abdominal pain, vomiting and diarrhea. I’m sure these all sound familiar, so how can you tell that your little one has more than just a cold? Look for these main differences:
- Body Aches
- Constellation of all the symptoms
- Unbreakable fever
- The duration of the symptoms- the fever can last up to 7 days and the cough can stay for 2 more weeks!
The treatment for the flu is usually supportive. In the most uncomplicated cases physicians will recommend plenty of fluids, rest and ibuprofen or acetominophen for the fever and body aches. In cases where the patient may be at risk for complications he/she may be prescribed antiviral medications to shorten the duration of symptoms. If you or your little ones are experiencing these symptoms be sure to consult with your primary care physician right away.
According to the CDC and the Journal of the American Medical Association, every year in the US approximately 36,000 people die from complications of influenza, especially very young children, the elderly and those with weakened immune systems. The US influenza season starts in September, ending in May with a peak in January-February. The best prevention for any infection other than vaccination is hand washing. This can protect you and your little ones from “the flu,” and all other viruses that can cause severe infections. I give myself and my entire family the vaccine every year, and I recommend for children six months and up to prevent yearly infections.
We are getting ready for my favorite time of the year: The holidays. It all starts with Thanksgiving and ends with New Year. But whether you celebrate Christmas, Hanukkah or Winter Festival you know very well that there is one common denominator: Delicious food and lots of it!!!
Dr. T wants to remind you that there is still place for healthy eating at the Thanksgiving Meal and during the holiday season:
- Main Course-If you are cooking a turkey or chicken or other meats there are now the hormone free, and naturally grown free range poultry available in the green section of your local supermarkets.
- Sides: Look for alternative recipes to your common dishes. Some feature healthier ingredients or substitutes for the high calorie foods. For example if the ingredients that require butter or mayo: there are olive oil butter and olive oil mayo in the market. The good news is that all Thanksgiving foods can be very healthy: Vegetables dishes like carrots, green beans, corn, pumpkins, brussel sprouts, sweet potatoes and mashed potatoes are the popular side dishes.
- Fruits and Vegetables: Choose organic fresh fruits and vegetables. Take advantage of new local farmer markets they are becoming very popular and I guarantee there is one near you. Visit http://www.localharvest.org/ to find your nearest one. If this option is not reasonable for you instead of canned veggies try frozen, but of course fresh is always best!
- Drinks: Serve water, or naturally prepared juices (not boxed juices). No sodas, or other carbonated or diet drinks are good for children.
- Desserts: For desserts choose fresh apple pie, fresh cherry pie, pumpkin pie and breads. If you make it at home even better! If you decide you want cakes and cookies it is time to get that the recipe book and make it yourself. It is always healthier if you use fresh ingredients rather than from a box. If preparing cakes, or cupcakes you can substitute apple sauce instead of oil for moisture. If the recipes require eggs use whites only egg. Instead of white refined sugar use brown sugar.
I am wishing you and your wonderful families a safe and healthy Thanksgiving! I am thankful for my family, patients, health, and to those of you reading my posts and sharing this valuable knowledge.