Archive for January 2018

Monthly Archive

What I’m Doing Now – January 2018

It’s still (barely) January of 2018 and I’m doing my best to try to new things, take breaks from old things, be more strategic, practice tiny habits, and spend time with my sweet boys and family. I’ve even committed to a weekly early morning swim with a dear friend to just ritualize something beautiful for the year.

(added 2/1/18: Check out this palliative care physician’s twitter status update [read the whole thread — amazing] for any reminder for why we should just be with our babies when we can and why we should tell more stories, read more books, and perhaps, eat more ice cream!)

Many of you are familiar with my Seattle Mama Doc podcast which typically features parenting advice and pediatric experts sharing ideas for particular health topics. But I’m often asked about all the different hats I wear: mom, doctor, Chief of Digital Innovation at Seattle Children’s Hospital, Chief Medical Officer at Before Brands, reporter at KING5 News and more. So, this is my first attempt at detailing what I’m working on each month — the juggle — why I’m doing it and how it all feels. It was an idea inspired by my dear friend, Susannah Fox who updates her work list publicly, on her blog monthly. I recorded an ad lib take on the podcast (embedded below).

Tell me what you think, share ideas, offer advice or partner with our digital health team if you can!

Power on, People. Thank goodness, here comes February!! Maybe some sunnier days? Think weather and think metaphor, too.

Widespread Influenza in US: Ways To Protect Your Family

It’s flu season, no doubt about it, with widespread influenza infections all over the United States (see the CDC updated maps with high-levels of ILI [Influenza-like illness]). Influenza is a virus (there are many types or “strains”) that cause terrible fever, cough, respiratory distress, pneumonia, ear infections, and sometimes hospitalization and death. As you’ve likely heard from the media blitz the last week or so, it’s shaping up to be a pretty nasty year – and some public health workers are concerned not only about this surge or “peak” of flu season coming early, but that it may be bigger and more dangerous than we expected. Washington is still bracing (we have lower levels) but many areas are inundated and hospitals and ERs are full. Any Google search on “flu” will give you headlines like this: Hospitals Face a War Zone, Flu Season is Bad But Might Get Worse (which is true, it might), and this with the data update this week: Flu Season Has Killed 30 Children (which is also true and dreadful).

5 Simple Things To Do During Flu Season To Help Your Family

Read full post »

How To Treat Lice And When To Ask for A Prescription

This is a follow up post to my recent post on treating head lice. It’s all just a major inconvenience. And worse than having lice is having lice again and again. And even worse than your child getting re-infested may be treating lice with an ineffective therapy. Enter…..”super lice.” Ewwwww. Although please know that their name exceeds their actual scariness. These lice are only different (aka “super”) in that some lice may have developed gene mutations that indicate they are developing resistance to a common class of over-the-counter (OTC) treatments (permethrin).

A 2016 study in The Journal of Entomology that got a bunch of media coverage found resistant lice all over the United States. Lice were sampled from 48 states at well over 100 different centers to evaluate their patterns of mutations that may render them resistant to OTC medications. Do note that the study was funded in part by the pharmaceutical company that makes one of the prescriptions, but nonetheless did find that lice are becoming harder to treat, coast to coast.

Do you have a super lice? It may be hard to know. If you’ve treated your child several times exactly according to directions and aren’t having success, you should explore prescription medications that may work better. But REMEMBER though, that sometimes you child is just getting re-infested from someone at school.  It is sometimes hard to decipher if the OTC medication is ineffective, or if your child has been re-exposed. Working with your school and with others where your child may have been exposed is always a part of this when a child continues to have lice after a treatment. There are some medicines (see section below) that may help if the OTC meds are not working. The chart below shows where the resistant bugs were detected (red is fully resistant, orange shows intermediate resistance, and green showed no resistance to OTC meds). Read full post »

How To Treat Head Lice

As parents, many of us have been there. You’re going about your day and BAM…fear and anxiety start creeping in as soon as you read the email, that perhaps again, there’s an outbreak of lice. Someone in your child’s school has lice and your child may have been exposed…blah, blah, blah. Nothing about this ever feels benign, even though it always is. Lice just feels a gross inconvenience. This post details the lice life cycle, the ways lice spread, and ways you can treat lice with both OTC or prescription medicines.

Lice infestation is common for US children and has nothing to do with cleanliness. The Centers For Disease Control (CDC) estimate 6-12 million lice infestations a year in the United States, but something you cross your fingers doesn’t make its way into your home or hair.

How Lice Live And How Lice Spread

Head lice feed on tiny amounts of blood from the scalp and if they are not on a person’s scalp, they can usually only survive about a day. This is good news for remembering that lice won’t crawl around your home for days — ever. They just can’t. Lice lay their eggs close to the scalp and when on the head can live about 28 days. They can multiply quickly, laying up to 10 eggs a day. It only takes about 12 days for newly hatched eggs to reach adulthood. This cycle can repeat itself every 3 weeks if head lice are left untreated.

Remember that head lice usually only survive for less than 1 day away from the scalp at room temperature. Their eggs cannot hatch at room temperature lower than that near the scalp. So once they fall off a child’s head, lice pose very little threat. You don’t have to vacuum the carpet, sterilize the toys, wash the house top to bottom after your child has lice. I mean you can, but don’t do it for the lice :-).

Lice is typically passed through close person-to-person contact.  Lice crawl, they can’t hop or fly (phew!). Lice mainly move from head-to-head and less commonly move from one person to another on a hairbrush or hat or costume.

Lice At School – Why Kids Don’t Get Sent Home Anymore

The American Academy of Pediatrics and CDC have fought hard against “no nit” policies in schools, in the interest of reducing the school absence associated with head lice. When recurrent infestations occur this can be frustrating but no child really ever needs to miss school for lice. Schools are increasingly unlikely to exclude children for nits, but still, in some schools, the policies persist. The rationale for not sending kids home:

  • Many nits are more than ¼ inch from the scalp. Such nits are usually not viable and very unlikely to hatch to become crawling lice, or may in fact be empty shells, also known as ‘casings’.
  • Nits are cemented to hair shafts and are very unlikely to be transferred successfully to other people.
  • The burden of unnecessary absenteeism to the students, families and communities far outweighs the risks associated with head lice.
  • Misdiagnosis of nits is very common during nit checks conducted by non-medical personnel.

 

Over The Counter Lice Products


Most of the time the very best bet for lice are OTC, easy-to-use treatments. The FDA has approved over-the-counter (OTC) lice products as safe and effective when used according to the Drug Facts label instructions. There are 3 main ingredients used to treat lice: Permethrin, most commonly found in the OTC product Nix or Piperonyl Butoxide and Pyrethrum Extract, most commonly found in Pronto or Rid. Each product has different and specific treatment instructions, like if hair needs to be shampooed first or if dry hair is needed, the age a child has to be for these products to be used on their scalp and if and when a second treatment is recommended. If the thought of dealing with lice makes you light-headed, there are lice-removal services available. They’re not cheap (starting around $100 in the Seattle area), but some parents may find the expense well worth the piece of mind of getting rid of lice manually by professionals. Read full post »

MLK Day, The New Year And Tiny Habits

I’m quieted today by the profound example of Martin Luther King Jr. and one of his many enduring proclamations,

“Life’s most persistent and urgent question is, ‘What are you doing for others?”

The answer I often feel is “not enough.” While most of us spend portions of our everyday caring for or enriching the lives of others, the enough-ness and potency of feeling we’re doing enough, or giving back in satisfactory ways, can yo-yo.

There’s not a better moment than now to augment who you are and what you do with your days.

We’re halfway through the first month of 2018 and perhaps today is a beautiful moment to pause on what we do each day routinely and how we contribute. Even in the tiniest ways. Resolution season is dying down so I suggest we think less resolutions and more intentional habit formation. More intention for you and your life I believe will likely translate to more for others.

BJ Fogg, a behavioral psychologist and founder and director of the Stanford Persuasive Technology Lab, created a behavior model (see the graph below) that when dissected and simplified, details that making change in your life and forming a lasting habit is a blend of how much motivation you have for the change, the challenge of actually doing the behavior and the need for a triggering event to get the desired change habitualized. In some senses, if you have high motivation for a new habit or change, even if something is hard to do, you’ll do it with a proper trigger. If you have low motivation for the new habit, even if something is easy to do, you may not. But triggers and other barriers and thresholds can throw this all off. He recommends implementing “tiny habits” to drive change in your life by following 3 steps.

1. Start small. Make it teeny tiny. Read full post »