Author Archive

Simplifying Health Care

StrikeWe all want simple solutions to living a healthy life.

It feels like I was born at just the right time for my work in health care. I completed my medical training just as social tools were percolating out to the masses. Motherhood and my practice of pediatrics auspiciously coincided with the bounty of information that technology has distributed, offered up, and shared unlike ever before.

I can search and learn about health wherever I am –  at the park or in the walls of my own clinic or home. For me, using my phone, Twitter, my blog, apps, Facebook, activity tracker, and patient online communities to provide health care, consume it, and engage in it is my new reality. It turns out, amidst all the clutter and stress of health care reform and our reduced time with our own doctors I can see clearly that intuitive ways of learning about science wed with thoughtful technology will let us care, cure, and prevent illness and injury like never before.

A survey published today finds that more that 3/4 of moms search online for symptoms. The majority of mothers in the US also look up information regarding their child’s development online, read about a medicine, or track their pregnancy with online tools. I’ve done, or do, all of those things. Don’t you?

I’ve just started a new job in the hospital overseeing a group in Digital Health. Our goal is to rapidly improve the way we serve children and their family’s unique needs in the hospital, clinical setting, and community. I want to help facilitate elegant communication between parents, patients, families, and their clinicians & surgeons when they are outside the hospital or clinic. Reason is: it seems to me that the luxury of our time is the one-to-many communication we have in our pockets. Over 60% of all American adults have a smartphone in their pocket and  crowd-sourcing happens at virtual water coolers (ie Facebook) every day. Over 40% of Americans log onto Facebook everyday to listen, lurk, snoop, learn, and vet ideas. Read full post »

Yes, Vaccines Are Naturopathic!

Dr. Mary Alison HigiThis is a guest blog from Dr. Mary Alison Higi. Dr. Higi is a naturopathic physician in her final year of residency at Cascade Natural Medicine specializing in pediatrics under Dr. Candace Aasan. She studied at Bastyr University where she earned her Doctor of Naturopathic Medicine. She emphasizes the importance of the physician’s role in preventative medicine and public health. Dr. Higi has a special interest in implementing Naturopathic Medicine programs for under-served communities. 

I’m publishing this post because I think there is significant confusion about naturopathic physicians’ support of vaccines. I’m hoping this sheds a little light. Would love to learn more from you all about your experiences with naturopathic medical care and vaccines. Please leave comments!

 

 

I have frequently heard from parents, “You give vaccines? I thought you were a naturopath!” I can only reply, “Vaccination follows three of our most important guiding principles”

1. Premum non Nocere — First do no harm; weigh out risks and benefits and follow the least harmful path.
2. Docere – A physician should be a teacher to her patients.
3. Preventir – Practice preventative medicine.

By providing routine vaccinations to my patients I have the opportunity to help them weigh risks and benefits of vaccine preventable disease versus costly, painful and the often dangerous consequences of preventable infections.

When I counsel and give vaccines I get to teach about disease prevention and public health; I get to help patients prevent some truly life threatening diseases. So yes, vaccines are naturopathic! In that light, following our naturopathic principles, there are a few vaccination myths that I’ve heard so often, I feel compelled to dispel them:

Read full post »

Engage With Grace Today

Engage with Grace

Engage With Grace is a movement started by brilliant and thoughtful Alex Drane and Matthew Holt. The movement is an opportunity to come together at Thanksgiving and have discussions, even just for 2 minutes, about preferences in life and preferences you have for the end of life. Even if you’re unsure of your answers, take the time and live courageously enough to talk about this. If you’re healthy, youthful, full of verve, swishy and wrinkle-free—this is the perfect time to have this conversation with those you love.

If you need inspiration for why this is worth your time, read Za’s story. Parenthood makes this all the more relevant and essential. More thoughts on this from 2011 and 2012 but basically it’s this: print this out and do your best to engage with grace this weekend. So will I.

Happy Thanksgiving

Inspiring Gratitude

Gratitude — appreciating the positive aspects of life — may not be an innate, spontaneous daily emotion to you or your children.  Rather, appreciating what we have is a skill we cultivate, practice, and maintain. There is research that shows gratitude is far more than just a touchy-feely pop-psych term. In fact, people who practice gratitude have less anxiety and depression, better sleep, decreased levels of stress, better outlooks on life and kinder behavior.  Sign me up!

Gratitude is the emotion of friendship   ~  Dr Michael McCollough told the New York Times in 2011

5 Tips For Inspiring Gratitude In Your Family

  • Make lists: Researchers describe making lists as the “classic” intervention to practice gratefulness. Making a list can be as simple as a weekly journal entry where you list that for which you’re thankful. It can be more intensive and involve daily writing and reviewing of lists, too. Regardless, the research shows that keeping these lists is easier than other interventions for improving mood, more likely to turn into a habit, and one that can improve your outlook, mood, and health. I’ve taken to jotting down things I’m thankful for on post-its and sticking them onto the bottom of my computer screen.
  • Plan a visit: Dr Martin Seligman, one of the founders of positive psychology, studies interventions that improve happiness. He suggests planning a gratitude visit. Here’s how: Read full post »

Get Smart: 5 Reasons To Avoid Antibiotics

Smiling babyResearch shows that about 1 in every 5 pediatric visits for “sick visits” results in an antibiotic prescription. Now not all of those antibiotics are taken; many pediatricians now use the Rx pad for “wait and see” or “delayed prescribing” antibiotics. They give a prescription and allow the family to watch and wait — if a child is not getting better, they advise parents to start taking them. However, in total there are nearly 50 million antibiotic prescriptions written annually in the US. It’s not uncommon that prescriptions for antibiotics are written when children have “colds” or upper respiratory tract infections from a virus. That’s where we all have an opportunity to improve our children’s health. Nearly all of us know it’s good to avoid antibiotics when unnecessary. It’s the end of Get Smart About Antibiotics Week.

Studies indicate that nearly 50% of antimicrobial use in hospitals is unnecessary or inappropriate. ~CDC

In my experience, this issue really isn’t a tug-of-war between parents wanting drugs and doctors wanting to restrict them. Most parents I talk with in clinic don’t want an antibiotic if they can avoid it. However, recent survey data on adults found that 38% expressed a desire for antibiotics when seeking health care for the common cold. Determining when antibiotics are necessary is the tough part. This week, a clinical report was published to help pediatricians and parents know when they can avoid antibiotics given unnecessarily. Some of the data from the report included here:

5 Reasons To Avoid Antibiotics When Unnecessary

  1. Antibiotics can cause side effects. The reason: while you may be giving antibiotics to treat a possible ear infection, once ingested the antibiotics go to every organ in your body thus killing off some of the “good bacteria” living there. Some new research even suggests that bacteria that live in our gut affect our brain activity, mood, and behavior.
  2. Bacteria do good. Throughout our lifetime we accumulate a lot of bacteria to the point that of all the cells in and on our body, 90% of our cells are bacterial! These bacteria help keep our bodies happy – assisting in digestion and keeping a good balance of colonies for healthy skin and intestines.
  3. Every dose of antibiotics changes us. Each dose of antibiotics kills the normal bacteria that live in our body. The risk of taking antibiotics is not only the side effects (diarrhea, rash, or upset stomach, for example) but the risk that each dose changes who we are. Previous research from 2012 found that antibiotics, particularly when given to infants, may increase risk for chronic disease later on (inflammatory bowel disease). Read full post »

Smokeout

Screen Shot 2013-11-21 at 10.31.00 AMToday is the Great American Smokeout. A national day for quitting for all ages. Of course quitting smoking, even for a day, is an awesome step forward for health. Clearly finger-wagging and guilt-tripping really don’t help smokers quit. I remember as a child lying on the floor when around a family member who was smoking saying, “Smoke rises….I’ll stay down here.”  Fairly ineffective, I’m certain. Anecdotally, the family member is still a smoker. Nicotine is really addictive.

Cigarette smoking remains the number one cause of preventable death and premature birth in this country. And the risk of cigarette-related health problems start with the very first cigarette. That being said, recently I was talking with a colleague about her exposure to second-hand smoke as a child. She was joking that it was either all the diet soda she was drinking or her exposures to her parents’ smoking in the car that would kill her.

I got to tell her the great news. Health benefits for smokers who quit start almost immediately. Don’t underestimate the joy children exposed to second-hand smoke get when the air clears…

Benefits Of Quitting:

Health benefits to a smoker and their family start immediately. Not just the cosmetic benefits (smoking is kind of ugly) and olfactory ones (smoking stinks). Within 20 minutes of quitting heart rate and blood pressure drop. In the first day after quitting a smoker’s carbon monoxide level in blood returns to normal and within weeks to months their lung function improves. For smokers it only takes a few months for coughing and shortness of breath to improve as well. There is great reward if smokers can get support to decrease their craving and addiction to nicotine to succeed in quitting. Other astounding benefits from American Cancer Society:

  • 1 Year After Quitting: the risk of heart disease is ½ that of someone who keeps on smoking.
  • 5 Years After Quitting: risks of cancer of mouth, throat, esophagus, and bladder are ½ of what they were while smoking. For smokers of any age, stroke risk can fall to that of a non-smoker after only 2-5 years!
  • 10 Years Out: the risk of dying from lung cancer is ½ that of someone still smoking.
  • 15 Years Out: the risk of heart disease for smokers who have quit is that of a non-smoker’s ! Seriously rewarding especially as heart disease remains the number one killer for both men and women in America.

If you or someone you know if thinking of quitting, I suggest framing the opportunity positively. Even posting one of the above factoids on your Facebook page today may help encourage a smoker to seek support. Secondhand smoke can also be a huge motivator: Read full post »

Arriving Early: World Prematurity Day

Screen Shot 2013-11-13 at 10.03.17 PM

I think about the essay Welcome to Holland by Emily Perl Kingsley a lot. Her explanation of what it’s like to raise a child with a disability helps approximate (for me) the unexpected realities that ensue for families who encounter significant pediatric health challenges. Although her essay is not about prematurity and it’s not new, when I sat down to write about World Prematurity Day I couldn’t help but think back to her words and her metaphor. What’s marvelous, of course, is that her essay is built of love so all of us have a chance to understand it.

Sunday, World Prematurity Day, is a day to think cautiously, bravely, and empathetically about the opportunity to improve the lives of children born prematurely, all around the world. When a child arrives early there are obviously significant health challenges not only to survival but to a long life thereafter, sometimes with significant disability. Parents all over world suffer and learn to thrive with and after prematurity every single day. In fact,

Prematurity is the leading cause of death in newborns. Although some risk factors are known for preterm birth, we don’t know very much about the cause.

None of us will really ever know what it’s like to survive and thrive in someone else’s experience. So we share stories, quotes, photos, and moments as best we can to help others understand. As I’ve met and been invited to help care for parents, families and children who are born prematurely, one thing is certain — it’s a journey. It starts often with surprise and evolves individually. The essay by Kingsley is clearly about the journey, not about the diagnosis of prematurity at the time of birth.

Here’s what a colleague and friend, Kim, shared with me about her experience with her twin daughters who were born over three months early: Read full post »

PG-13 Movies


PG-13 movies now have more gun violence than R-rated ones.

I was in fourth grade when Red Dawn debuted as the first PG-13 rated movie back in 1985. At the time Red Dawn was released, it was considered one of the most violent films by The National Coalition on Television Violence, with a rate of 134 acts of violence per hour, or 2.23 per minute. And although not every PG-13 movie has had significant violence (think Pretty in Pink) it turns out PG-13 and gun violence have become close bedfellows over the last 28 years.

New research out today in Pediatrics finds that gun violence is becoming a more common thread in the movies. Researchers sampled 945 films (all from the top 30 grossing films annually) since 1950, coding and evaluating 5-minute violent sequences in those films. The results proved unsurprising but unsettling: overall gun-violent sequences more than doubled in the sixty years from 1950 to 2012. When looking specifically at PG-13 movies researchers saw a tripling in gun violence since the rating was created in 1985. The trend for violence in these PG-13 movies has grown so rapidly it’s created a new reality. Over the past 30 years, R-rated movies have shown no change in the amount of gun violence sequences while PG-13 have soared making gun violence more prominent in PG-13 movies than in R-rated movies. Stunning when you think of it — gun imagery densely populating the movies targeting our teens. Yes, violence sells.

Read full post »

Birthdays

Stomp rocket jumpingSomething amazing about birthdays. Just a day of celebration in our child’s life, perhaps, but something altogether different for we parents. It seems to me that birthdays serve up quite vivid moments for reflection.They offer up a day to assess progress, loss, growth, and quite easily acknowledge the annual tick of time. Earlier this fall a 70+ year-old man at a conference said to me (I’m paraphrasing), “Well, life as a parent is simply a blur. It’s a hazy smattering of years of frenetic events peppered with poignant traditions–all you can do is look back and remember the holidays and birthdays in a sea of years that go by.” He may be right. All the more reason these birthdays carry so much meaning.

Our youngest just turned five. And although it was quite a wonderful day of celebration (see evidence in that photo), I couldn’t suppress the ever-rising pit in my stomach. I have vivid memories of my own 5th birthday and it’s clear that time really is flying by. “The days can seem like years and the years like days,” yes of course, but on birthdays I think we parents experience complex emotions. It’s easy to suggest we should just celebrate and rejoice. “Consider the alternative!” you could say. I’d suggest we do celebrate and we do rejoice; it’s a settling and lovely thing to watch our children soak up their birthday. I’m uncertain though that’s enough of a description of these days for most parents.

Like so many other friends and parents have shared, I’m really starting to want things to slow down. I can’t help thinking about the reality that I can barely carry my 6 year-old anymore and there are mornings when he beats me to the kitchen and pours his own bowl of cereal. I know soon the days will close when O wants to eat dinner sitting on my lap. This grace of intimacy in parenting young children is for me the treasure of life. And I’m mindful, thankful, present, and proud but I can’t help hurting as I witness the sunset on this time.

I love these boys more and more and more every day I know them and I enjoy parenting them more and more and more each day too. I know it will only get better as so many ahead of me suggest. It doesn’t mean though, that it doesn’t hurt to see the candles multiply on top the cake.

Numbers For You On Flu

It’s time for flu shots. Winter respiratory season is on its way and, “The single best way to protect against flu is to be vaccinated every year.” Ideally your child (and you) will have had the flu shot at least 2 weeks prior to any exposure to the virus. If your infant, child, or teen hasn’t yet had their flu shot call today for an appointment. Waiting provides no added benefit and only increases the time a child is more susceptible to getting influenza this season.

Listen to the video for information on quadrivalent versus trivalent flu shots, options for nasal flu spray (NO POKES!), and new viruses included in this year’s flu shot.

Information For Parents Online: Protection from Flu Shots