Technical Names: Allergic Rhinitis

Nicknames: Hayfever, Allergies

What it is: allergic reaction to something in the environment such as pollen, dust, molds, animal hai. It is an overreaction of the immune system – a “normal” reaction on overload. People can grow in and out of allergies throughout their lives. Genetics determines some predisposition but environmental factors can also overload the immune system.

Seasonal Issues:

Many people have season allergies particularly around season change times. Some people are allergen specific and others have year ’round allergies.

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One of the situations I found most challenging working in emergency rooms and urgent care settings was when a teen came in for “medical clearance”. This phrase is code for “a teen in an emotional crisis who may need be having a major psychiatric issue…or not.” My job was look into any possible medical issues of the mood changes and then to call the on-call psychiatric crisis team in for the remainder of the evaluation, if needed…which was the majority of the time.

I recall one 17 year old teenager who had threatened to commit suicide earlier that day.  I remember being struck by two observations: how sad she appeared and how “normal” her family was by all standards. They were basically like any of our neighbors.

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While our government leaders are busy debate “health reform”, I often get the sense they forget that most of us have medical needs now that need to get addressed in today’s very broken system. Our medical needs and those of our kids are actually blind and deaf to their discussions because they just wanted to get addressed – today.

While today’s system is far from perfect, there is still a lot we can do to get the care we need. Instead of blindly accepting the system as is, we can become more empowered and partner with our physicians as advocates of our own health care, and those of our loved ones such as our kids. This means speaking up when we have questions and becoming more health literate. This also means working with our physicians to be sure the treatment we receive works for our lives. To accomplish this, we may have to seek more than one opinion on a health matter, and that’s not only ok to do but possible even in today’s chaotic health climate.

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As sure as the sun rises and sets every day, resistance from sports parents and young athletes with return to play recommendations, especially when it comes to concussions, is something I’ve come to expect in my work as an urgent care pediatrician. This is one of the biggest uphill battles we face as pediatricians but one we can’t afford to lose without resulting in dire consequences for an athlete and a family.

For concussions, Boston Bruin’s Patrice Bergeron’s story and his cautious, step-wise slow return to play when he returned to the ice in early 2009 the exact play book we need to follow when handling concussions in athletes of ages, and is consistent with current recommendations from the American Academy of Pediatrics as explained in the January 2009 Pediatrics (Volume 123, Number 1 pagers114-123).

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With childhood obesity becoming a national focus due to First Lady Obama’s Let’s Move campaign, many families are beginning to think about ways to help their children understand the many issues at play with health eating and staying in shape. One of our most powerful assets as parents is to use books aimed that not only educate our kids but due so in a fun and humorous way. For childhood obesity, Fat Tale, by librarian and puppeteer Karen Land, is one of the best.

What sets this book apart from many others on the market is that it is written for kids, it is simple, and it focuses not only on eating but on empowerment. This book has a happy ending and shows kids how easy it is to not only create a problem due to food but turn it around by being honest about the issues that created the weight gain. And, that working as a team with your family is the way to get to that happy ending.

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Q) Dear Mom:

Can I have a cell phone? All my friends have one…We promise to be responsible!

Love, your daughters

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With the federal health reform bill inching closer to becoming a true law, it’s still up for debate whether it will even begin to put a dent in turning around our very confusing, disjointed, expensive and chaotic health care system.

The issue, of course, is that health insurance is not even the tip of the iceberg. Without reforming the innards of the health care system and giving people a system that they can understand and use more easily, it matters very little whether people have insurance coverage.

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Q)
Dear Dr. Gwenn:

My daughter is 3 ½ years old. I just spent the last year raising her alone while my husband was in Korea. Since we are a military family, our lives change every so often when it has to. Lately our daughter takes up to 3 hours to go to sleep, we have left her by herself and we have to take her back into her room at least 6 times. We’ve tried reading stories in her bed and staying in her room until she falls asleep. On occasion, she has lain in our bed for hours before falling asleep.

During the evening struggles, she often throws fits and kicks and screams. I need help!!! This is affecting my marriage and now I have become one of those mothers that I didn’t want to become with a spoiled child. Please help!!!

Thank you,
Rebecca

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Do you know what preparing for a ski vacation and getting your children off to school during the freezing winter months have in common? More than you may think! Not only are the elements the same – ice/snow/wind/cold, but the dangers and the precautions needed are really the same. Yet our expectations for how we dress our children are somehow very different. If your family is anything like mine, they look far from artic warriors when they head off to school but could be mistaken for Eskimos on the slopes.

The vast majority of schools in Massachusetts have fairly strict guidelines for outdoor activities that our children are expected to follow at school. Use this to your advantage and expect them to follow these rules all the time, even at home or when walking to school. So, if the children are expected to wear certain clothing at school before being allowed outside, require the same at home or on the slopes. And, if its too cold for outdoor recess, than its likely too cold to build a snowman in the backyard!

Keep in mind that not all accidents are many variables are out of our control. At the same time, paying attention to the areas we can control will not only reduce the chance of preventable injury but maximize your family’s fun.

1. For sports requiring special equipment, be sure the equipment is well made and fits your child properly. Many outdoor stores do carry a full line of equipment, including used equipment, and can help you outfit your child properly. You may also want to check out the Consumer Product Safety Commission web site (www.cpsc.gov) to be sure any equipment you are considering has not been recalled.
2. For any winter sport, including sledding, your children should wear a good ski helmet. We only have one brain and it is not as easy to fix as a broken arm. So, if your child won’t wear the helmet, don’t let him participate – the risk of injury is too high otherwise!
3. Don’t forget eye protection – not only from the snow or ice but the sun. Good eye goggles or sunglasses are crucial for winter sports safety and will minimize the risk of injury should your child fall in the snow or be hit with some snow/ice.
4. Keep an eye on the local weather and don’t underestimate the danger that extreme cold can cause. The windchill is the number to pay attention to – that is how cold it feels outside due to the blowing, arctic wind. The more below zero it feels, the faster the wind is blowing, the more dangerous it is to be outside.
5. Avoid the tempation to leave small children in a parked car for even a few minutes when it is very cold – it only takes 5 minutes of extreme cold to cause hypothermia or frostbite. Better to take your children with you than to leave them in a car unattended – even for a few minutes.
6. Dress your child in layers underneath the snow suit to lock in the heat. Thermal clothing is the best but medium weight cotton clothing will work fine as well. Long underwear, turtlenecks and thermal socks are all essential for most outdoor winter sports. If your child gets too warm, she can always remove a layer.
7. Finally, don’t forget the hat – most of our heat is lost from our heads so keep them covered!

Here’s to a fun and safe winter.

(Originally posted November 2003; Updated December 2009)

If there are two pearls of wisdom I can impart to you about toddlers it is this: they will have many boo-boos and there will be times you will be convinced your toddler is “always sick” and you should change your address to that of your pediatrician’s office.

Toddlers are the captains of the boo-boo and “bug” brigades.  While most boo-boos are minor and require nothing more than a kiss, and most “bugs” are viruses that clear before you can reach for the phone, there are times some injuries and illnesses can be serious and require more care. As with all things toddler, those times also tend to be very obvious once you know what the key factors are to focus on. Continue Reading