RSV episode

WE ARE DOING THIS EPISODE AT THE START OF COLD AND FLU SEASON.  WE THOUGHT IT WOULD BE TIMELY TO TALK ABOUT RSV.

What is RSV?

Why does it have such a bad reputation compared to other colds?

RSV isn’t just a disease for children but we mostly hear about it in children. 

Should we be testing for this more in adults?

What are the symptoms of RSV in children? 

How can parents differentiate between a regular cold and a potential RSV infection?

When should parents worry?

What makes RSV so hard for kids, especially under the age of 2?

And this is where the term “bronchiolitis” comes into play in connection with RSV.   Why does RSV cause bronchiolitis?

How does RSV impact children differently across various age groups?

What symptoms do adults have?

People often say they are worried their child’s cold will “turn into RSV”—do you get that from your patients?  

When should you see your doctor?

Are there specific groups of children more vulnerable to severe RSV complications?  Which kids are at higher risk?

What is the significance of early detection and timely medical intervention?  Is it helpful to come in early

What care can parents give for RSV at home?

What are the treatment options for RSV?

What are the potential complications from RSV?

What preventive measures can parents take to reduce the risk of RSV in their children?

There are two types of immunizations for RSV—one for mothers and one for babies.

AND IF THE MOTHER DOESN’T RECEIVE THE IMMUNIZATION THERE IS ANOTHER OPPORTUNITY FOR THE CHILD

Are there any misconceptions about RSV that you'd like to address?

DO YOU HAVE A FAVORITE RSV STORY?

AND YOU OFTEN SAY YOU ARE TOO THRIFTY TO BUY SALINE DROPS.  WHAT IS THE RECIPE FOR MAKING SALINE AT HOME?

• It is 1/2 teaspoon of salt in 1 cup of warm water

NUTRITION PART 1 — GENERAL NUTRITIONFOR THE NEXT THREE EPISODES WE WILL TALK ABOUT NUTRITION.

IN THIS FIRST EPISODE WE WILL COVER GENERAL NUTRITION.  

WHY ARE NUTRITION DISCUSSIONS SO IMPORTANT IN YOUR PREVENTION DISCUSSIONS?

NUTRITION IS SO FOUNDATIONAL WHETHER YOU ARE HELPING CHILDREN TO THRIVE IN SCHOOL OR IN SPORTS OR TO COMBAT FATIGUE AND HEADACHES

WHAT ARE THE FACTORS THAT CONTRIBUTE TO LOW BLOOD SUGAR?

KIDS HAVE A NEED TO EAT MORE FREQUENTLY THAN ADULTS DUE TO THEIR FASTER METABOLISM

HOW DOES THAT WORK WITH KIDS AT SCHOOL?

IS IT UNHEALTHY TO SCHEDULE EATING VS. WAITING UNTIL A CHILD IS HUNGRY?

SO WE TALKED ABOUT THE TIMING OF EATING

LET’S TALK ABOUT HOW THE KIND OF FOOD MAKES A HUGE DIFFERENCE WITH THEIR PHYSIOLOGY

AND WHEN YOU ADDRESS LOW BLOOD SUGAR YOU ALWAYS COUPLE THAT WITH GOOD HYDRATION--WHAT IS A GOOD WATER GOAL?

DO PARENTS NEED TO BUY GATORADE OR OTHER FLAVORINGS?

AND MAYBE ONE MORE PLUG IN FOR ADEQUATE SLEEP

IS THIS A HARD ASK FOR SOMEONE TO COMMIT TO?

A LOT OF KIDS COME IN WITH CONCERNS FOR FATIGUE AND DIZZINESS AND STOMACHACHES AND HEADACHES AND THE MEDICAL WORK-UP FOR THIS LIST OF PROBLEMS IS MASSIVE.

WHY DOES FOOD MATTER?  WHY DOES NUTRITION MATTER?

AND THIS MAY MEAN SOME COMPROMISE ON FOOD CHOICES LIKE WE TALKED ABOUT WITH PICKY EATERS

WE SAY THIS OFTEN IN A COUPLE WAYS: PARENTS CHOOSE WHAT AND WHEN AND KIDS CHOOSE HOW MUCH;  OR, SAID ANOTHER WAY THAT PARENTS CHOOSE THE CHOICES

LET’S TALK ABOUT THE BROAD STROKES THAT WE CAN PAINT NUTRITION WITH.  WHAT IS ENERGY DENSITY AND NUTRITION DENSITY?

WHERE DO HIGHLY PROCESSED FOODS FIT INTO THIS DISCUSSION

WOULD YOU SAY THE SAME ABOUT ARTIFICIAL SWEETENERS?  

AND MAYBE JUST A QUICK BASIC COMMENT ON ENERGY CONTENT OF EACH TYPE OF FOOD:

IS THERE A PLACE FOR FOCUSING ON PLANT-BASED FOOD?

LET’S SPEND SOME TIME TALKING ABOUT SPECIFIC NUTRITION COMPONENTS WE NEED TO WORK ON.  THERE ARE SOME NUTRIENTS AND MICRONUTRIENTS THAT CAN BE CHALLENGES TO GET INTO KIDS.

FIBER FIRST.  WHAT IS IT GOOD FOR AND WHO IS AT RISK FOR DEFICIENCY?

HOW IMPORTANT IS IT THAT PARENT’S MODEL BEHAVIOR?

CALCIUM

AND IF THEY WON’T DO MILK.  CAN WE GET THIS ANY OTHER NATURAL WAY?

VITAMIN D—THIS HAPPENS NATURALLY WITH SUN EXPOSURE IS IT ENOUGH?

VITAMIN A

IRON

ZINC

WITH SUPPLEMENTS--WE ARE NOT TRYING TO REPLACE A WELL-BALANCED HEALTHY DIET, BUT SOME KIDS NEED THIS TO BE HEALTHY

LET’S TAKE THAT THOUGHT AND SEGUE TO OUR LAST SECTION ON HOW WE CAN HELP PARENTS ASSESS THEIR CHILD’S EATING.  WHERE DO WE START THE EVALUATION?

IS THERE A DANGER TO SCREENING AND CATALYZING EATING DISORDERS?

WHAT IS A 30,000 FOOT LEVEL VERSION OF HOW YOU WANT TO HELP PATIENTS?

HOW ARE YOU TRYING TO COME AT THIS FROM THE PATIENT / PARENT OWNERSHIP INSTEAD OF A RIGHTING REFLEX

PARENTS WORRY MOST ABOUT THINGS THAT ARE THE HARDEST TO CONTROL: TOILET TRAINING, SLEEP, AND EATING

PORTION SIZES WITH UPSIZING THINGS AT FAST FOOD PLACES AND ENCOURAGING KIDS TO EAT ALL THEIR FOOD

SO TRUSTING KIDS HUNGER AND FULLNESS CUES AND LET THE GROWTH CHART TELL THE TALE IS A KEY

RESOURCES:

FIRST IS THE Website: myplate.gov WHICH HAS SOME GOOD GENERAL FOOD PRINCIPLES

Deceptively Delicious BY JESSICA SEINFELD

THIS EPISODE IS HAPPENING THE WEEK BEFORE SCHOOL STARTS—A TIME WHEN ALL FAMILIES PLAN FOR A GRADUAL TRANSITION FROM SUMMER CHAOS TO A REGIMENTED SCHOOL SCHEDULE.  INVARIABLY THOUGH FAMILIES THINK “OH NO, SCHOOL STARTS TOMORROW.  WE HAD ALL SUMMER TO PREPARE FOR THIS.  GOOD LUCK KIDS”

WHY DO WE NEED SLEEP?

HOW TO ESTABLISH HEALTHY BEDTIME ROUTINES

WHAT DOES BEDTIME LOOK LIKE

IS THERE A BEST TIME FOR GOING TO BED?

WHAT IS THE IDEAL ENVIRONMENT FOR BEDTIME?

YOU TALKED ABOUT DOING THE MATH TO ESTABLISH BEDTIMES FOR CHILDREN.

HOURS OF SLEEP FOR DIFFERENT AGES?

SOME SAY THEY NEED TO READ OR WATCH TV TO FALL ASLEEP.  HOW MUCH OF THAT IS TRUE?

WHAT IS THE RELATIONSHIP BETWEEN BLUELIGHT AND MELATONIN PRODUCTION?

WHAT ABOUT EXERCISE BEFORE BED?  AND SOMETIMES KIDS HAVE ACTIVITIES THAT RUN LATE AT NIGHT

WHAT ABOUT MUSIC AS A TOOL TO GO TO BED?

WHAT ABOUT NAPS AND DO NAPS DISRUPT NIGHTTIME SLEEP?

SLEEP DEFICIT AND TEENS WANTING TO SLEEP IN UNTIL NOON FOR SLEEP DEFICIT PAYBACK ON THE WEEKEND

IT SEEMS EASIER TO HAVE THE CHILD SLEEP WITH A PARENT INSTEAD OF SOLVING THE PROBLEM OF HAVING THEM SLEEP IN THEIR OWN BED?

IT MAY SEEM MORE EXHAUSTING TO TACKLE THE PROBLEM THAN JUST PUTTING UP WITH HOW YOU ARE DOING.

LET’S FIRST ADDRESS DIFFICULTY GOING TO SLEEP

What are solutions for children who have a difficult time falling asleep

WHAT IF WE DO ALL THESE THINGS AND WE STILL ARE HAVING A HARD TIME GETTING THEM TO SLEEP?

HOW DO YOU HELP KIDS WITH INSOMNIA

WHAT IF ANXIETY IS THE OBSTACLE TO FALLING ASLEEP

ARE THERE ANY MEDICATION SLEEP AIDS THAT YOU USE?

LET’S MOVE THE SECOND CATEGORY OF SLEEP PROBLEMS—DIFFICULTY STAYING ASLEEP

WHAT DOES THAT LOOK LIKE IN THE MIDDLE OF THE NIGHT?

WOULD YOU TRY TO FIGURE OUT WHY THEY ARE WAKING UP?

COULD WE BE MISSING ANY MEDICAL REASONS OR MEDICAL PROBLEMS THAT ARE CAUSING THEM TO WAKE UP AT NIGHT?

SLEEP APNEA

AND LET’S BRIEFLY MENTION RESTLESS LEGS SYNDROME AS AN UNCOMMON  PROBLEM THAT KEEPS PEOPLE FROM FALLING ASLEEP AT NIGHT

IS THERE A TREATMENT FOR IT?

FOR THE LAST SEGMENT, LET’S TALK ABOUT SPECIFIC CONDITIONS THAT ARISE DURING SLEEP AND THEY ARE GROUPED INTO SEGMENTS—

THE non-REM PARASOMNIAS ARE THE NIGHT TERRORS, SLEEP WALKING, AND SLEEP TALKING.  THE REM PARASOMNIAS ARE NIGHTMARES

LET’S COVER NIGHT TERRORS, SLEEP WALKING AND SLEEP TALKING FIRST.  

AND THEN FOR NIGHTMARES, THESE ARE DIFFERENT FROM THE OTHERS BECAUSE THE CHILD IS STILL IN REM SLEEP

AND YOU LIKE TO ADVOCATE FOR EMPOWERING CHILDREN?

A TIMELY TOPIC IS THE USE OF SLEEP EVALUATION DEVICES LIKE CELL PHONES OR WEARABLES.  HOW HELPFUL ARE THEY?

BUT YOU WOULD RECOMMEND A SLEEP STUDY IF NEEDED AT TIMES?

AND DO YOU HAVE ANY REFERENCES FOR SLEEP RESOURCES 

ANY LAST PARTING COMMENTS?

THAT WRAPS UP THIS EPISODE—HAPPY SLEEPING!

Healthy Sleep Habits, Happy Child--Weisbluth

Solve Your Child's Sleep Problems—Ferber

Medical Music

genotelab.com for sleep music, 1 month trial without cost.

In this episode we cover care for newborn and infant skin.

SKIN PART 3—BABY SKIN

IN THIS LAST EPISODE ON SKIN, WE COVER ALL THINGS RELATED TO BABY AND INFANT SKIN.  ISN’T BABY SKIN JUST THE BEST?!

ARE THERE ANY CHALLENGES TO START OFF AS WE TALK ABOUT BABY SKIN?

SO THIS WOULD INCLUDE ALL LOTIONS, SOAP, SHAMPOO, DETERGENTS, FABRIC SOFTENERS AND THEY NEED TO BE HYPOALLERGENIC.

LET’S START WITH THE BRAND-NEW NEWBORN.  THEY HAVE BEEN UNDERWATER FOR 9 MONTHS SO THEY WILL LOSE THEIR FIRST LAYERS OF SKIN.

WHAT CAN PARENTS DO FOR MANAGEMENT—ESPECIALLY WHEN THEY HEAR IN THE NURSERY TO NOT PUT ANYTHING ON THE BABY’S SKIN?

ARE THERE ANY OPTIONS FOR PARENTS TO USE CONSISTENTLY?

WHEN SHOULD THE FIRST BATH TAKE PLACE?

THEN GOING FORWARD, HOW OFTEN SHOULD A CHILD BE BATHED?

WHAT TYPE OF PRODUCTS SHOULD WE THINK ABOUT REGARDING THEIR HYGIENE?

LET’S MOVE NOW TO DIFFERENT SKIN FINDINGS THAT PARENTS MAY WONDER ABOUT.  LET’S START FROM THE NEWBORN PERIOD AND WORK OUR WAY BACK.

WHAT IS MILIA ?

HOW ABOUT THE ANGEL KISSES AND STORK BITES?

AND THEN YOU HAVE THE COMMON 
RASH THAT HAS THE NAME THAT YOU DON’T LIKE--ERYTHEMA TOXICUM

YOU DESCRIBE IT AS LOOKING LIKE FLEA BITES.

WHAT OTHER BIRTH MARKS SHOW UP EARLY?

WHAT ABOUT THE BIRTH MARKS FORMALLY KNOWN BY THE NAME  "Mongolian spots”

NOW LET’S MOVE TO PROBLEMS THAT ARISE WITH CARING FOR INFANT SKIN.  THE FIRST TOPIC WOULD HAVE TO BE DIAPER RASHES.

LET’S START WITH COMMON IRRITANT DIAPER RASH AND GO FROM THERE.

BECAUSE THIS RASH COMES FROM IRRITATION, THE SOLUTION TO FIXING IT IS TO HAVE A GOOD ENOUGH BARRIER.

YOU LIKE THE ANALOGY OF PUTTING ON THESE PRODUCTS “AS THICK AS WEDDING CAKE FROSTING”

WHAT ABOUT CLEANING THE SKIN?

SO WE HAVE A MNEMONIC USING A-B-C-D-E FOR SKIN MOLES BUT THIS ALSO APPLIES TO DIAPER RASH CARE:

Air

Barrier

Cleansing—mild, hypoallergenic products

Diaper—change as often as every 2 hours

Education

ANY PRODUCTS FOR EXTRA SEVERE CASES?

Coloplast Brand

Critic-Aid Skin Paste

Product #1944

ANY PRODUCTS TO AVOID?

ARE THERE DIAPER BRANDS TO AVOID?

ONE THINGS THAT MIMICS COMMON IRRITANT DIAPER RASH IS A DIAPER YEAST INFECTION.  HOW DOES A YEAST INFECTION APPEAR DIFFERENT FROM DIAPER RASH?

WHERE DO YEAST INFECTIONS COME FROM?

HOW DO YOU TREAT IT?

ANY STEPS UP IF NOT IMPROVING?

LAST ON DIAPERS IS BACTERIAL INFECTIONS.  HOW DO THESE LOOK?

ANOTHER VERY COMMON PROBLEM IS CRADLE CAP.  

SO WE CAN TREAT IT THE SAME WAY?

THE KEY AS YOU SAID IS THE AMOUNT OF TIME THAT THE MEDICATED SHAMPOO IS IN CONTACT WITH THE SKIN

ANY OTHER PRODUCTS THAT ARE HELPFUL?

AND THEN WE HAVE A SKIN CONDITION THAT SHOWS UP JUST IN TIME FOR BABY PICTURES—BABY ACNE

WHAT DO WE NEED TO DO TO MANAGE BABY ACNE?  ANYTHING?

HOW LONG DO WE EXPECT THIS TO LAST

SKIN PART 2— INFECTIONS AND TRAUMA

IN PART 2 OF SKIN VISITS, WE TALK ABOUT INFECTIONS AND TRAUMA

LET’S START WITH THE COMMON STAPH AND STREP INFECTIONS OF SKIN—FOLLICULITIS, CELLULITIS, AND IMPETIGO.  THESE ARE ALL INFECTIONS THAT USUALLY ARISE FROM THE BODY’S OWN BACTERIA THAT ARE OPPORTUNISTIC AND CAUSE INFECTIONS WHEN GIVEN THE OPPORTUNITY.

WHAT IS FOLLICULITIS?

WHAT IS THE MANAGEMENT FOR THIS?

NEOSPORIN IS GREAT FOR PREVENTION BUT NOT GREAT FOR TREATING AN INFECTION

HOW CONTAGIOUS IS THIS?

DOES ‘HOT TUB’ FOLLICULITIS FIT IN THIS CATEGORY AS WELL.

THEN WE HAVE THE FUN IMPETIGO WITH YELLOW CRUSTED SORES ON FACES.

WHAT IS THE MANAGEMENT FOR IMPETIGO 

GOOD OPPORTUNITY TO MENTION ANTIBIOTIC STEWARDSHIP—THAT WE SHOULDN’T THROW ORAL ANTIBIOTICS AT EVERY INFECTION UNLESS THEY ARE TRULY NEEDED AS THIS CAN CONTRIBUTE TO ANTIBIOTIC RESISTANCE.

WITH PLAYING OUTSIDE, KIDS GET LOTS OF CUTS AND SCRAPES THAT GET INFECTED AND SHOW UP WITH CELLULITIS.

DO YOU TREAT THIS ANY DIFFERENTLY?

WITH EACH OF THESE INFECTIONS, WHEN SHOULD PARENTS CALL FOR MORE HELP?

LET’S COVER THE COMMON ANTIBIOTIC SIDE EFFECT OF ERYTHEMA MULTIFORME

LET’S FINISH THE BACTERIAL SKIN INFECTIONS BEFORE WE MOVE OVER TO VIRAL SKIN INFECTIONS.  A PARONYCHIA IS CELLULITIS BUT LOCALIZED TO NAIL BEDS

DOES A PARONYCHIA GET CONFUSED WITH AN INGROWN NAIL?

LET’S MOVE TO THE VIRAL SKIN INFECTIONS NOW.

ROSEOLA IS A TOUGH ILLNESS BECAUSE IT PRESENTS WITH FEVER ONLY—AND SOMETIMES A VERY HIGH FEVER AND NO OTHER SYMPTOMS.

AND THEN WHEN THE RASH COMES ON AFTER THE FEVER GOES AWAY THEN YOU KNOW WHAT CAUSED THE FEVER.

HOW IS THIS RASH AND DISEASE DIFFERENT FROM FIFTH DISEASE?

AND FIFTH DISEASE IS MORE DANGEROUS.

LET’S TALK ABOUT HAND-FOOT-MOUTH DISEASE

WHAT DOES THE RASH LOOK LIKE WITH HAND FOOT AND MOUTH

HOW LONG IS IT CONTAGIOUS AND HOW DO WE CARE FOR THE KIDS?

AND THE OTHER COMMON MOUTH VIRUS IS HERPES VIRUS CAUSING COLD SORES

SO MANY PEOPLE GET THIS AS A SMALL CHILD AND NEVER KNOW THEY HAD IT?

AND THIS IS TOUGH TO MANAGE BECAUSE MEDICATIONS ONLY WORK WHEN THEY CAN BE GIVEN BEFORE THE COLD SORES ARISE

WHAT IS SYMPTOMATIC CARE FOR THAT FIRST BAD PRESENTATION OF MOUTH HERPES?

OKAY.  NOW LET’S MOVE TO SKIN TRAUMA ITEMS.  MOST COMMON IS PROBABLY INSECT BITES.  FOR SOME PEOPLE THESE ARE NOT A BIG DEAL AND FOR OTHERS THEY GET BAD REACTIONS.

HOW DO WE HELP KIDS WHOSE BODIES OVERREACT TO INSECT BITES?

CAN PARENTS DO ANYTHING FOR PREVENTION OF THE HYPERSENSITIVITY?

WHEN SHOULD PARENTS CALL ABOUT MOSQUITO BITES?

LACERATIONS ARE UP NEXT.  ONE OF THE BIG QUESTIONS PARENTS HAVE IS “WHEN SHOULD I COME IN AND GET STITCHES”?

BURNS ARE ALSO TOUGH TO EVALUATE AND TO KNOW WHAT TO DO WITH THEM.  WHEN SHOULD PARENTS COME IN WITH BURNS?

WHAT IS THE MOST COMMON BURN YOU SEE?

What is your management for MINOR BURNS?

ARE THERE ANY BURNS THAT NEED TO GO TO SPECIALISTS?

LAST IS SLIVERS OR OTHER FOREIGN BODIES.

THIS WRAPS UP OUR EPISODE ON SKIN INFECTION AND TRAUMA.  NEXT WILL BE OUR EPISODE REVIEWING BABY SKIN.

SKIN PODCAST

SKIN VISITS

ONE OF THE MORE FREQUENT REASONS YOU HAVE FOR PATIENT ENCOUNTERS IS SKIN CONCERNS.

WE ARE GOING TO BREAK UP SKIN CONCERNS INTO THREE EPISODES 

WE HAVE SO MANY TOPICS TO DISCUSS THAT WE WANT TO BREAK THEM UP INTO EASIER TO FIND SEGMENTS.  

LET’S START OFF WITH ECZEMA

WHY IS IT SO COMMON IN UTAH?

WHEN IS ECZEMA THE WORST?

DOES IT GET BETTER WITH AGE?

WHAT ARE THE WAYS TO PREVENT ECZEMA?

WHAT SKIN CARE PRODUCTS CAN FAMILIES USE?  PARENTS ALWAYS GET FUN LAVENDER AND BABY-SCENTED PRODUCTS FOR BABY SHOWERS BUT THOSE ARE PROBLEMATIC FOR BABY SKIN.

WHAT ABOUT OTHER PRODUCTS THAT TOUCH SKIN?

HOW DO PARENTS MANAGE FLARE-UPS?

SPEAKING OF PREVENTING BLEEDING.  WHAT ABOUT MEDICATION PREVENTION WHEN SKIN IS DOING WELL?

WHAT IF THEY DO ALL THESE THINGS AND STILL HAVE PROBLEMS?

ONE OF THE COMPLICATIONS OF ECZEMA IS THE TENDENCY TO GET SOME SECONDARY INFECTIONS.

SOUNDS KIND OF LIKE A SPELL NAME FROM HARRY POTTER—mol-LUS-CUM con-TAGE-E-OSUM AND POOF —A BAD RASH

WHY DO KIDS WITH ECZEMA GET IT MORE OFTEN?

WHAT ARE TREATMENT OPTIONS?

THE LESIONS SOMETIMES GET REALLY INFLAMED AND INFECTED APPEARING

ARE THERE OTHER MORE AGGRESSIVE TREATMENT OPTIONS?

HOW ABOUT A COMMON SKIN CONDITION KERATOSIS (KARA-TOSIS) PILARIS (PIE-LAIR-US) THAT PEOPLE OFTEN CONFUSE WITH ECZEMA

AND IT OCCURS IN VERY CONSISTENT LOCATIONS

AND IT IS NORMAL ON SKIN, LIKE SOMEONE HAVING FRECKLES

IF IT BOTHERS SOMEONE ARE THERE OPTIONS TO HELP MANAGE IT?

LET’S MOVE TO EVERYONE’S FAVORITE—ACNE.  WE DO HAVE A COUPLE ITEMS IN THIS PART ONE THAT ARE INFECTIONS LIKE MOLLUSCUM AND ACNE

SO AFTER GOOD SKIN HYGIENE WITH ANY NUMBER OF SKIN CLEANING PRODUCTS, WHAT ARE YOUR RECOMMENDED STEPS IN THE HIERARCHY  FOR ACNE TREATMENT?

I THINK THEY GOT THE MESSAGE THAT EACH STEP REQUIRES 6 WEEKS OF  PATIENCE.  ONE CHALLENGE IS DOING A GOOD JOB WITH EACH STEP—THE MEDICINES DON’T WORK WELL IF THEY DON’T GET USED.

PROBABLY ANOTHER FAVORITE FOR PARENTS IS WARTS.  HERE WE HAVE ANOTHER COMMON PROBLEM THAT IS ALSO A VIRAL INFECTION.

AND WARTS ALSO GO AWAY 100 PERCENT OF THE TIME—EVENTUALLY.

IF PARENTS WANT TO ACTIVELY TREAT, WHAT ARE THE OPTIONS?  THERE ARE SOME CREATIVE ONES LIKE USING DUCT TAPE.

WHAT ABOUT THE OVER THE COUNTER FREEZING AGENTS?

ANY OTHER OPTIONS INCLUDING FREEZING IN THE OFFICE?

AND WHO SHOULD MAYBE GO DOWN THE PATHWAY OF HAVING WARTS FROZEN?

ARE THERE ANY WARTS THAT YOU REFER TO SPECIALISTS?

LET’S MOVE ON TO MOLES.  THESE ARE ALWAYS TRICKY—WHEN DO I GET A MOLE CUT OUT VS LEAVE IT ALONE?  MANY FAMILIES HAD A HISTORY OF SKIN CANCER AND WORRY ABOUT MOLES.

MAYBE WALK US THROUGH THE A-B-C-D-E MNEMONIC FOR MOLES

AND THEY CAN FIND REFERENCES FOR THIS ONLINE

AND WHILE WE ARE STILL IN THE SPACE WHERE PEOPLE MIGHT BE CONCERNED ABOUT CANCER—MANY CHILDREN COME IN WITH UNUSUAL LUMPS.  I THINK THAT MOM’S IN PARTICULAR ARE ATTUNED THAT UNUSUAL LUMPS ARE BAD.

AND WE HAVE SAVED THE MOST FUN FOR LAST—HYPERHIDROSIS—EXCESSIVE SWEATING.

WHAT TREATMENT OPTIONS ARE OUT THERE?

THIS WRAPS UP PART ONE OF THE SKIN PODCASTS.  NEXT WILL BE MORE ABOUT SKIN INFECTIONS AND SKIN TRAUMA.

SUMMERTIME BUGS--GERMS AND INSECTS; PLUS THE ALLERGIES THAT WE KNOW AND LOVE!

IT’S A LITTLE LATE IN THE SPRING/SUMMER SEASON, BUT WE WANTED TO COVER PROBLEMS THAT ARISE WHEN THE WEATHER WARMS UP

WHAT DOES THE WARMER WEATHER BRING BESIDES AN INCREASE IN INJURIES?

LET’S COVER ALLERGIES AND INSECTS FIRST AND THEN MOVE INTO THE SEASONAL ILLNESSES LIKE INTESTINAL VIRUSES AND HAND-FOOT-AND MOUTH DISEASE.

ALLERGIES ARE THE BIGGEST ITEM WHEN IT GETS WARM AND THINGS START BLOOMING.

WHAT IS THE CYCLE OF ALLERGENS?

WHEN DO YOU RECOMMEND TESTING FOR ALLERGIES?

WHAT NON-MEDICATION STEPS CAN PARENTS TAKE TO PREVENT ALLERGIES?

WHAT IS FIRST-LINE MEDICATION HELP?

HOW DO YOU STEP UP TREATMENT IF NOSE OR EYE SYMPTOMS ARE ESPECIALLY BAD?

INSECT BITES AND STINGS ARE A BIG PART OF KID PROBLEMS IN THE WARMER MONTHS.  HOW DO YOU MANAGE THESE?

CAN WE DO ANYTHING TO PREVENT THE SWELLING REACTIONS TO MOSQUITO BITES?

WHEN TO PARENTS NEED TO COME IN?

WHAT IS YOUR BUG SPRAY ADVICE?

ANY COMMENTS ABOUT BEE STINGS?

WHAT ARE THE MOST TYPICAL ILLNESSES WE SEE IN THE SPRING AND SUMMER?

SO A LOT MORE OF THE INTESTINAL VIRUSES THAT WE HEAR ABOUT ON CRUISE SHIPS ARE HAPPENING NOW?

HOW DO INTESTINAL ILLNESSES PRESENT?

WHAT MAKES DIARRHEA COMPLICATED IN KIDS?

WHAT PROBLEMS ARE CREATED BY NOT PROCESSING LACTOSE APPROPRIATELY?

HOW DO WE MANAGE THE TEMPORARY LACTOSE INTOLERANCE?

WHAT ABOUT HELPING THE GUT FLORA?

ARE THERE DEHYDRATION CONCERNS?

WHEN SHOULD PARENTS BE CALLING FOR HELP?

SPEAKING OF LONGER-LASTING INTESTINAL SYMPTOMS, AREN’T SOME OF THESE INTESTINAL ILLNESSES CAUSED BY OTHER PATHOGENS BESIDES VIRUSES?  WE TALK ABOUT THE WEBER WATER HERE IN DAVIS COUNTY.

ARE THERE RASH COMPLICATIONS OF INTESTINAL ILLNESSES?

WHAT DO WE NOT WANT TO MISS?

LET’S TALK ABOUT HAND-FOOT-MOUTH DISEASE

WHAT DOES THE RASH LOOK LIKE WITH HAND FOOT AND MOUTH

HOW LONG IS IT CONTAGIOUS AND HOW DO WE CARE FOR THE KIDS?

YOU MENTIONED VIRAL MENINGITIS AS WELL

WITH PLAYING OUTSIDE, KIDS GET LOTS OF CUTS AND SCRAPES THAT GET INFECTED.

IS IT FINE TO USE NEOSPORIN INSTEAD OF A PRESCRIPTION TOPICAL ANTIBIOTIC?

AND LAST IS THE CLASSIC SWIMMER’S EAR.

HOW ABOUT PREVENTION FOR SWIMMER’S EAR?

THIS WRAPS UP OUR DISCUSSION OF WARM WEATHER INFECTIONS AND MEDICAL PROBLEMS.  REMEMBER TO APPLY YOUR SUN BLOCK.

PICKY EATERS—MY KID ONLY EATS 5 THINGS

TODAY WE ARE TALKING ABOUT PICKY EATERS.

WHY IS THIS SUCH A HARD TOPIC?

WE HAVE THIS DISSONANCE—A GAP BETWEEN WHAT PARENTS WANT FOR THEIR KIDS AND WHAT THE KIDS ARE CHOOSING

IT IS ONE THING TO HAVE SOME TOUGH LOVE OVER CLEANING ROOMS AND DOING CHORES AND QUITE ANOTHER TO HAVE POWER STRUGGLES OVER WHAT THEY EAT.

WHY DO YOU THINK THE ISSUE OF BEING A PICKY EATER IS SO VISCERAL AS PARENTS—WHY THEY WANT SO HARD TO GET IT RIGHT?

WHERE DOES THIS VIEW ORIGINATE FROM?

WHERE THE MOM CUTS THE ENDS OFF THE ROAST AND THE DAD ASKS “WHY” AND THE QUESTION WORKS IT’S WAY BACK TO HER MOTHER AND THEN EVENTUALLY HER GRANDMOTHER WHO CUT THE ENDS OFF THE ROAST BECAUSE THAT IS HOW IT FIT IN HER LITTLE OVEN.

BECAUSE GRANDMA OR FURTHER BACK CAME FROM A DEPRESSION-ERA INFLUENCE WHERE THEY HAD FOOD SCARCITY AND UNCERTAINTY, THE VALUES PASSED DOWN AROUND EATING ARE MUCH MORE STOIC IN HAVING TO EAT WHAT IS FRONT OF YOU BECAUSE THERE WERE NO CHOICES

BUT ISN’T IT IMPORTANT TO HELP KIDS EXPAND THEIR PALATE TO INCLUDE A WIDE VARIETY OF FOODS TO HELP THEM BE HEALTHY?

HOW DO WE MAKE A PARADIGM SHIFT?

HOW DO WE HELP A MOTHER WHO FEELS PRESSURE TO KEEP UP THE BATTLE?

WHAT ARE THE PROBLEMS WITH BATTLES OVER FOOD?

HOW DO WE KEEP THEM HEALTHY?

Start with making your only rule—No tears at the table.

NICE MOTTO, BUT WHAT IS THE METHOD TO HELPING PICKY EATERS BE HEALTHY?

THERE WILL BE SOME OVERLAP BETWEEN THEIR CIRCLES THAT MIGHT BE COMPROMISE FOODS LIKE CHICKEN NUGGETS, PEANUT BUTTER AND HONEY SANDWICHES, MAC AND CHEESE AND YOGURT

SO YOU HAVE TACOS FOR DINNER, THE CHILD HATES TACOS, WHAT DO YOU DO?  ARE YOU ASKING PARENTS TO MAKE DIFFERENT MEALS FOR EACH CHILD?

THEN THEY ALL SIT DOWN AS A FAMILY TO EAT TOGETHER—MOST WITH THEIR TACOS AND ONE WITH HIS PEANUT BUTTER SANDWICH.

WHICH BRINGS UP A GOOD POINT: WILL GIVING LATITUDE TO ONE CHILD AFFECT OTHER KIDS?

DO YOU TELL PEOPLE TO EVEN FORCE KIDS TO TRY ONE BITE OF SOMETHING?

WILL THEY EVENTUALLY GET BETTER?

THEY WILL EAT MORE FOODS SOONER IF YOU DON’T FIGHT ABOUT IT.

WHAT ARE THE MINIMAL GOALS FOR EATING?  YOU TALK ABOUT MILK, MEAT, AND MULTIVITAMINS REGULARLY

ANY COMMENT ABOUT EATING FREQUENCY

IS THIS HARD TO DO AT SCHOOL

DO YOU GET MUCH PUSHBACK ON THIS

ANY GOOD BOOKS ON THIS TOPIC

Jessica Seinfeld: Deceptively Delicious—getting your children to eat wholesome food

CONSTIPATION

• WHY IS CONSTIPATION SO PROBLEMATIC?
• HOW DO WE DEFINE CONSTIPATION?
• WILL KIDS REALLY GO DAYS OR WEEKS BETWEEN NORMAL BOWEL MOVEMENTS?
• CAN A CHILD STOOL DAILY AND STILL BE CONSTIPATED?
• IS THERE  A TARGET AGE FOR THIS PROBLEM?
• IS THERE A REASON FOR THAT IN THIS AGE?
• YOU TALK ABOUT CONSTIPATION BEING A CYCLE.  HOW DOES THIS CYCLE GET OUT OF HAND?
• AND THAT’S WHAT MAKES THIS A SNEAKY PROBLEM—CHILD IS ACTUALLY APPEARING OKAY FOR LONG STRETCHES BECAUSE THEY CAN HOLD A LOT OF STOOL IN A DISTENDED COLON OVER MONTHS AND YEARS…
• WHAT IS NORMAL STOOLING FOR INFANTS?
• HOW DO WE TREAT CONSTIPATION FOR INFANTS?
• WHAT IS A MUSHER?
• AND WHAT IS A PUSHER?
• HOW DO YOU USE MUSHERS AND PUSHERS FOR INFANTS?
• WHAT IS NORMAL STOOLING FOR OLDER KIDS?
• LET’S TALK ABOUT TREATING CONSTIPATION IN OLDER KIDS.  THERE ARE THREE STEPS TO THIS: 
  • A COLON CLEAN-OUT, 
  • DAILY MEDICATION AND THEN 
  • RETRAINING THE BODY.
• CLEAN-OUT FIRST.  IS THIS LIKE A COLONOSCOPY CLEAN-OUT?
• NEXT COMES OUR DAILY MEDICATIONS FOR MAINTENANCE
• HOW DO YOU USE MUSHERS AND PUSHERS HERE? 
• SIDE QUESTION: HOW SUCCESSFUL IS INCREASING FRUITS AND VEGETABLE CONSUMPTION IN PICKY KIDS? 
• LAST BUT MOST IMPORTANT IS THE TACTICAL POOP
• WHO DOESN’T WANT TO WATCH A VIDEO ABOUT POOPING?
• MENTIONED BEFORE, BUT HOW LONG SHOULD WE PLAN TO TREAT?
• ARE THERE THINGS THAT LOOK LIKE CONSTIPATION BUT AREN’T?
• WHAT IS THE PROCESS FOR JOURNALING PAIN?
• WHAT IS IT ABOUT JOURNALING THAT IS HELPFUL? 
• AND THIS HELPS TO REALLY NARROW DOWN THE DIFFERENTIAL OF PROBLEMS TO AVOID EXCESSIVE TESTING LIKE BLOOD TESTS AND IMAGING STUDIES.

THIS HAS BEEN A FUN AND HELPFUL JOURNEY THROUGH THE WORLD OF CONSTIPATION.

CONSTIPATION AND HOME BOWEL PROGRAM FROM PRIMARY CHILDREN'S HOSPITAL:

https://intermountainhealthcare.org/ckr-ext/Dcmnt?ncid=520408179

PCMC Video:

https://youtu.be/pNagQup0Upg

In this episode we discuss depression--when a child's sadness rises to the level of creating problems for them.

• WHAT IS DEPRESSION? 
  • sadness that rises to the level of depression as these thoughts, feelings and experiences become incapacitating or debilitating
• DOES DEPRESSION ALSO EXIST ON A SPECTRUM LIKE ANXIETY?

• DOES DEPRESSION LOOK DIFFERENT AT DIFFERENT TIMES OF LIFE?

• WHAT PROBLEMS CAN LOOK LIKE DEPRESSION?
   
• DO OTHER MENTAL HEALTH PROBLEMS HAPPEN ALONG WITH DEPRESSION?
   
• HOW MUCH IS NATURE VS NURTURE  WITH DEPRESSION?
   
• WHAT IS THE EVALUATION PROCESS FOR DIAGNOSING DEPRESSION?

• WHAT OUTSIDE HELP DO YOU BRING IN FOR DIAGNOSING DEPRESSION? 

• WHAT ABOUT SUICIDE THOUGHTS?  HOW DO WE MANAGE THOSE?
  
  
• WHAT IF THERE IS A CRISIS—A PARENT IS AFRAID FOR THEIR CHILD’S SAFETY RIGHT NOW?

• WHAT ARE THE NON-MEDICATION TREATMENT OPTIONS FOR DEPRESSION?
   
• SHOULD EVERYONE USE COUNSELING?

• HOW DOES A PARENT CHOOSE A GOOD COUNSELOR FOR THEIR CHILD?
  • 4 items to choose a counselor paragraph. Right insurance  right age right problem right fit 
  • I recommend counseling through therapist covered by your insurance.  Call or check on website to see: 1, who is covered; 2, the counselor who works primarily with patient's age group; 3, they help with the concern we have; and 4, they are a good fit for the patient--hobbies, interests, so they have something in common--best chance for a good therapeutic relationship
• ARE THERE COMPLIMENTARY THERAPY OPTIONS?

• WHAT ABOUT THE BASICS—SLEEP, EXERCISE?

• ANY BOOKS OR APPS THAT ARE AVAILABLE?
  • Stem 4 Apps
    • Move Mood—manage low mood and depression
    • Calm Harm—track and resist self harm
    • Worth Warrior—self-worth and eating issues
    • Calm Fear—help to manage anxiety
    • SafeUT--Safe Utah app super critical for being able to report concerns as well as get help
  • Books—books that utilize counseling therapy principles
    • Happiness Trap
    • Mind Over Mood
    •  Don’t Let Your Emotions Ruin Your Life
    •  Beyond the Blues
    • Think Good, Feel Good
• WHAT ABOUT NEW TECHNIQUES LIKE TMS (TRANSCRANIAL MAGNET STIMULATION) AND KETAMINE THERAPY

• WHO NEEDS MEDICATION?

• WHAT ARE THE MEDICATION OPTIONS FOR TREATING DEPRESSION?

• WHAT IF A PATIENT WON’T GO TO COUNSELING BUT WILL TAKE MEDICATION?  WILL YOU STILL PRESCRIBE FOR THEM?

• MANY PARENTS HAVE HEARD ABOUT GENETIC TESTING FOR PRESCRIBING—TELL US MORE ABOUT THAT.

• ARE THERE ANY SIDE EFFECTS OF TREATING WITH MEDICATION?

•   SHOULD PARENTS BE AFRAID OF SIDE EFFECTS WITH LONG-TERM USE?

• PARENTS MAY HAVE HEARD ABOUT A WARNING THAT ANTI-DEPRESSANTS INCREASE SUICIDE THOUGHTS.

• WHAT ARE THE CONSEQUENCES OF NOT TREATING?

• WHAT SHOULD PARENTS EXPECT FOR FOLLOW-UP  ONCE TREATMENT IS STARTED?

• ANY PARTING THOUGHTS ON TREATING DEPRESSION?