Archive for January 2015

Monthly Archive

“I’m A Kid Like Everyone Else”


We all hope our children will get along with each other. Most of us also just want them to get the chance to be a kid amid a world of increased access, evolving speed, and constant digital communication. Immersed in the rigors of growing up right next to someone else, siblings can forge deep connection and of course deep divides. The connection part is gold…especially when it’s analog.

To foster this connection we can read Siblings Without Rivalry but we can also absorb the examples laid out by sibling units in our focus and in our own periphery.

Thankfully every once and a while something easy and authentic pops on YouTube in that periphery. For me, this week it’s the brother and sister, Nathan and Eva Leach, viral video from 2013. When I first watched it earlier this week it had 1M views, now it’s nearing 5M. Something works here. A set of siblings partnering to throw out a duet to the world. I mean in it they just LOOK like siblings! A regular kitchen in a regular life with glances to each other like everyday, regular kin. In typical YouTube form the familiarity, authenticity, and surprisingly beautiful strike is overwhelmingly refreshing in an over-marketed world. My favorite moment comes with the surprise about 2 minutes 45 seconds in and when Eva sings the line:

Baby I need some protection. I’m a kid like everyone else.

We’re all always hoping for a little harmony between our children, The Leach children hit it out of the park here. Although I am reminded this is just a tiny sliver into their lives, I’m thankful for its lesson and its reminders today. Happy Friday.

Legal Doesn’t Mean Safe: Marijuana

Legal never has meant “safe” but the two words may at times overlap in our minds. When it comes to marijuana I’d suggest there is quite a bit of confusion right now about safety, recreational and medicinal use, and the effects of use on our population. In general, as laws change and access to marijuana increases we have a responsibility to be clear about what is known.

The adverse effects of marijuana in children and teens have been well-documented. Marijuana use can impair memory, decrease concentration, and change problem-solving capacity. It’s not good for the lungs nor long-term health; teens who use pot have a higher likelihood of drug addiction later on in life, the risks increase the earlier they start using. Research also finds that teens who use marijuana are less likely to finish high school, are more likely to use other (illicit) drugs, and have an increase in suicide attempts compared to those who don’t. The more they use, the more the effect. I can’t help but think about what a mom to a teen said to me recently in clinic, “marijuana is everywhere now.”

One in 5 high school students says they have used marijuana in the last month and up to 1 in every 16 students says they use it every single day. Who are we if we ignore these numbers?

As legal may mean “safe” to some a strong statement from pediatricians everywhere from The American Academy of Pediatrics (AAP) was released today to set the record straight. The two things to know:

  1. Research has found marijuana has adverse effects on teen health. It’s now known that the brain isn’t fully developed until the mid-20’s raising real concerns about what the drug does while the brain is still forming. The effects of marijuana change how teens think in school, how safe they are on the road, and potentially how they act for a lifetime (lifelong addiction risks increase with use, teens who use are less likely to finish high school, teens who use have higher suicide risk).
  2. Use Coupled With Criminalization Can Change Lives For Good: Legalization for medical and recreational use may imply marijuana is benign; for children and teens this is untrue. History shows that teens, especially those of racial minority groups, are incarcerated at higher rates secondary to possession or use of marijuana. A criminal record can have lifelong negative effects — the AAP is advocating to decrease marijuana crimes from felonies to misdemeanors, study effects of legalization in states like WA or Colorado, Alaska or in DC, and strictly limit access to and marketing of marijuana to youth. The big concern here as well is that policies that lead to more adult use will likely lead to more adolescent use. Decriminalization is especially important in states where recreational use is legal for those over 21 years of age.

Read full post »

Friends And Bacon

At dinner tonight we had breakfast for dinner (genius meal when you’re stumped by an unending need to create something “new”). At the end of the meal we were all discussing our love for bacon. Without a beat this came from the 6 year-old in our midst:

“Mama, could I live a long time and still have a piece of bacon everyday?”

I thought about it. Yes, it seems, yes. Yes, every day with bacon!

“Yes, I said, “I think you can have bacon but only if you exercise everyday and if you have really great friends. The kind of friends that make you feel alive.”

I launched into some sort of summary of the art of moderation with bacon, pouring out facts about fats, cholesterol, and diverse food choices – the essential need to balance bacon with things that grow in the ground. As I waxed on with a macronutrient-level discussion the 6 year-old in front of me just kept moving with his idea. Turned out he wanted concrete responses for his life with bacon. He pushed into the friendship part.

Screenshot 2015-01-22 20.20.23A long life with bacon goes something like this: of course you need to eat a lot of other goodnesses with your bacon. We can borrow wisdom from the Mediterranean diet and reduce the red meat we eat, put fish on the table twice a week, eat lots of seeds and nuts and ensure fruits and veggies show up on every plate we serve. Debates will wage on about the magic foods we eat, today it was the complexities to the value of an orange over OJ so we always have to put food advice in the context of life. I told my 6 year-old tonight he’d have to exercise every day and get outside, twirl around without a ceiling, take a lot of steps, and be connected with nature.

But perhaps most essential to living a long life (with bacon), I repeated, is solid choices with whom he chooses to live his precious life. If you’re going to eat bacon every day you have to make great friends and forge partnerships with those who make the world feel possible. In my mind you need soul-fetching friends — the ones who literally make you feel like you can fly. We have to spend time with those who let us unpeel ourselves without judgment and urge us to take risks, help us take our time, and lend support to shelter whatever we consider dear. Read full post »

Influenza Hitting Hard: OTC Medications For Symptoms

Image courtesy: http://www.cdc.gov/flu/weekly/#S5

Image courtesy: CDC

Influenza is hitting hard this year thanks to a drifted influenza strain (H3N2) causing a more serious illness and one that is not included in our annual vaccine. Because of the hard hit, public health officials are reminding us to get high-risk patients into see physicians early if they have symptoms of “the flu” or influenza infections. Reason being, those at high-risk for complications may benefit from a prescription anti-viral medicine that can lessen the burden of illness and decrease risk for complications. Over-the-counter medicines you buy don’t fight influenza.

What Is “The Flu” And What Is Influenza

In general, in healthcare we use the term “the flu” when discussing an infection with influenza, a virus that causes widespread body aches, high fever, cough/cold symptoms, headache or even leg aches. Some children vomit with influenza infections as well (incidentally many patients with lab-confirmed influenza that I’ve seen this winter have also been vomiting) although in general influenza infections are upper and lower respiratory infections, and not the “stomach flu.” We worry about influenza as it’s in the list of top ten causes of death in the US and because it can cause severe symptoms, even in children. Infants and young children are at particular risk for serious infections as their bodies and their immune systems haven’t fought off influenza before.

High risk patients: 

  • Children 2 years & younger (their immune system not as robust and not as much “memory” to fight off severe influenza infections).
  • Adults age 65 year & older (their immune system is aging and not as robust fighting off severe influenza infections).
  • People with underlying health problems (including asthma) or other lung problems, other chronic health conditions (like diabetes, heart disease).
  • Pregnant moms or newly postpartum moms.
  • Those people immunosuppressed.

The Numbers So Far

According to the CDC, widespread influenza activity is being reported in 46 states. The most common strain is that drifted virus H3N2, accounting for over 90% of the more than 5,000 reported influenza-positive tests recorded last week (ending January 10). It’s still too soon to tell whether we’ve reached the peak of flu season, however there are early signs that the virus is lessening in parts of the country. So far, this year the influenza vaccine is estimated to be about 23% effective, clearly not as effective as usual but still providing some protection.

What Over-The-Counter Medicines Can Help With Influenza?

It’s important to remember that over-the-counter (OTC) medications cannot cure “the flu” nor shorten your suffering with symptoms. They’re designed simply to help you get through the illness and should be taken within the proper guidelines. In general children under 4 should not be given OTC cough and cold medicines. 

That being said, there are four types of medications that can make getting through the flu a little more bearable. Read full post »

Sleeping With A Smartphone

460297347Turns out small screens in the bedroom may be worse for sleep than a TV. Little screens enter the room without much effort, stealing away in a pocket or backpack without notice; smartphones also grab our attention in novel ways. The light emanating from small screens is really close to our face (potentially interfering with that lovely melatonin spike before bed in ways a TV across the room cannot) and small screens are often interactive, requiring us respond or type back, provoking alertness. The first study evaluating effects of smartphones and tablets on sleep in US children is out. While the news isn’t surprising it isn’t good either.

We may be raising a really tired generation of children.

I’ve been chatting for years about trying to keep TVs out of childrens’ bedrooms. Simply put, television adds little to a child’s life when viewed right before bed. In fact ,Seattle Children’s experts Dr Michelle Garrison and Dr Dimitri Christakis have shown consuming television just before bed can cause children to have more trouble falling asleep, more nightmares, and more awakenings during the night [here’s more info–> why no TV before bed is better]. Recently though, we learned what we all likely suspected: interactive, small screens may be even worse for a child’s sleep than the TV. Tablets, TVs, iPads, and smartphones are for most adults and kids a normal part of everyday life, even during infancy and toddlerhood. 2013 Common Sense Media data finds 45% of 5 to 8 year-olds have a TV in their bedroom and 72% of children from birth to 8 report using mobile devices during the day.

A study out this past week in Pediatrics shows small screens in the bedroom have a troubling effect on children’s sleep. Read full post »

Forgive Yourself In Advance

Our children will never be the sole judge of our job as parents of course. We are likely our own closest and most fastidious critic. And really it’s just us (and our partners) that can truthfully reflect and evaluate how it goes as we raise our children — what our hopes were when we started on the journey of raising another and where we find ourselves. And so, however radiant the peaks and successes seem, the anxiety of our choices in this high-stakes job will likely dominate. The angst with how this all goes as our children mature ties our feet together at times, and can feel a little like stuffing big rocks into our pocket as we jump off the dock into the lakes of our lives. We’re hard on ourselves. Sometimes this is good and motivating, centering or stabilizing, and at times it can even be useful when sorting priorities. But sometimes, it’s simply unkind. Some of the best advice I was given after my boys were born was this: Read full post »