Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

A mom, a pediatrician, and her insights about keeping your kids healthy.

Introducing Seattle Mama Doc 101

Pile On The Paperwork: Vaccine Exemption In WA State

I’m happy about a new pile of paperwork coming my way. To be clear, I’ve never said this before. But I’m serious. Instead of stewing controversy, I suspect a new bill around here could open up lines of communication. I’m not living under a rock; I understand that some feel this new bill requiring signatures for vaccine exemption is heavy handed. I wholeheartedly disagree.

Yesterday Governor Gregoire signed a new bill into law that will demand families talk with a health care worker about the risks when exempting from immunizations. It turns out, WA state lags in their vaccination rates compared to national averages. In the last 10 years there has been a doubling in the number of students with exemptions for vaccinations in our schools. The biggest reason may be a convenience factor. The state suggests that 95% of exemptions are not for a medical reason, but one for convenience. Seems like you’d never opt out of immunizations for convenience putting your child or another child at risk. Right? But then think about how nuts your life is, how chaotic it is to raise children, and work, and pay bills and and and….

Imagine this: you’re a busy mom/dad, your child is about to start Kindergarten or 6th grade. The records you have for their immunizations are incomplete. You didn’t keep the book and like me and everyone else, your paper work isn’t filed perfectly. You’re pretty sure your child is “up to date.” You’re standing at registration at the school. You’ve been waiting in line and your left heel hurts. Come to think of it, your head hurts, too. Your daughter just tugged on your pant leg; she’s hungry. Quickly, when you realize you’ve got an incomplete record, you call your daughter’s doctor office while still in line. No one picks up when you call and you’re put in a queue waiting to talk with someone in medical records. You have a choice, would you rather just sign your name, exempting your child from vaccines, or go on a hunt for the records to ensure your child truly is up to date? Sure, the answer for most any parent is clear.

You sign your name. Read full post »

Location, Location, Location: Where You Get A Pediatric CT Matters

After I saw reports of the 5-fold increase in CT scans in children, I asked for “The Husband’s” take. I worry about a rise in the use of pediatric CT scans in the US because when a child gets scanned, they are being exposed to radiation. A CT scan is a series of x-rays taken in quick succession that form a more composite view of the body. Although x-rays and CT scans save lives and improve diagnosis, the radiation given to children when obtaining these studies must be minimized. Children are more sensitive to radiation than adults; their bodies are still developing. And as the Society for Pediatric Radiology reminds, “What we do now lasts their lifetimes.” Here’s a post about why it may matter where your child gets a CT scan by Dr. Jonathan Swanson:

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Pardon the interruption…I’m chiming in again on a similar topic as my last guest post (I am kind of a one trick pony) – radiation exposure in children. SMD has asked me to talk about a recent radiology-based study and what it might mean for how we take care of our children.  My take:

If it were my child, and F or O needed to go to an emergency room, I would go to the nearest children’s hospital…to spare my children unnecessarily high radiation exposure. Bias alert, I am a pediatric radiologist working at a children’s hospital. However, I think the literature supports my position. Read full post »

Happy Mother’s Day

 

 

 

 

 

 

 

 

Happy Mother’s Day. If anything, holidays like today place a stamp on this day amidst the irrevocable march of time. Photos, cards, gifts, mentions, and memories..a moment or day where we reflect, compare, and remember with those from the past. Last year on Mother’s Day it was sunny, my family had a picnic on a hill with fried chicken, and neither of my children were old enough/able to make a homemade card. We played airplanes (the kind where kids fly on your legs), drank sparkling water, and I celebrated my mom’s health amidst a cycle of chemotherapy. It was a good day; I felt love and loved, simultaneously. Sandwiched in the best way I know. Read full post »

Finding Friends Online

As I work to encourage more physicians and health care workers to join me in social media, I stopped yesterday, to reflect on how much I enjoy and have grown personally and professionally because of my online community. Social media tools certainly aren’t just about what I say–my community online is far more about what I learn. I have made some real friends via social networks and Twitter. This virtual space is very real to me. My patients and families in clinic tell me this often, too. I have a whole new set of comprehensions, friendships, and perspectives because of these friends (and foes). Social spaces are important to me. Although I’m constantly out of balance and need to find more time to unplug, I wouldn’t ever want to leave this cyber space. I’d simply miss my friends. Many of them live far away; I can’t invite them over to dinner.

Last week I tweeted about a dream I had about Dooce. She’s the queen bee of mommy bloggers. I’ve never met her (would love to, clearly) and thus my thoughts metamorphosed into a dream. I’m a big teller of dreams. Haven’t you had a vivid dream about someone, run into them the following day, and felt you knew them much better? All fictional, maybe, but relevant to your reality. I usually out myself and share my dream. Foolish maybe. Most others, it appears, worry about the vulnerability of doing so. So recently it was a treat to check my email amidst a very busy day when… Read full post »

Pull Ups and Potty Training

My take on Pull Ups: get out of them as soon as possible! Easier said than done, of course.
Bed wetting is a common challenge for children (and their families). If your child is wetting the bed you certainly know that may be the understatement of the week. You’re not alone in your struggle to help your child stay dry at night, even if it feels that way at times. Know this, I talk about bed wetting every single week in clinic.

Bed wetting is familial and fortunately, often improves simply with time. Watch the video for more information, but the cliff notes: although Pull Ups are convenient, at times they may hinder and prolong bed wetting. If your child is potty trained but wears a Pulls Up/diaper at night, never having tried a night without them, there may be less incentive to potty train. Achieving nighttime dryness demands connecting their brain with their bladder. If there is a diaper on, there may be less motivation to form this connection.

Of course, achieving full potty training success is a huge milestone in every child’s life. It’s a big one for most parents, too. Remember, bed wetting is seen in up to 40% of 3 year-olds, 20% of 5 year-olds and even 10% of 6 year-olds. Watch the above video for my take on Pull Ups and ways to support your child, when ready, to ditch them.

Potty Training and Pull Ups, DO:

  • Try to get out of the Pull Up from time to time. Don’t force it, but if you child is interested in giving it a try without one, do it!
  • Set your child up for success: limit fluids after bedtime, consider waking them to pee at 10 or 11pm, and light the path to the potty so they know how to get there in a hurry.
  • Tell your child it’s not their fault for wetting the bed.
  • Tell your child if one of their parents was a bed wetter. Chances are, they were! Provide them support.
  • Celebrate success whenever it happens (any dry nap, dry night, less pee than usual, getting from the bed to the potty in the middle of the night).

Potty Training and Pull Ups: DON’T:

  • Don’t punish a child for wetting the bed. Even when you’re uber frustrated cleaning the sheets for the one hundredth time, to do your best to hide disappointment when your child wets the bed. This will only increase your child’s anxiety and frustration.
  • Don’t assume your child can’t make it through the night without a Pull Up. If they are dry during the day and dry during naps, I’d certainly give it a try without them.
  • Don’t force your child out of diapers or Pull-Ups if they resist. If resistance arises, back off and try again in a few weeks or month’s time.

Why The Pony Doesn’t Win

I was reminded one week ago why the pony doesn’t win. When I was finished with bedtime stories, I sat on the edge of F’s bed. He’s nearly 4 1/2 years old now (he’s counting the days), full of ideas but also still busting with thoughtfulness. We’d had a day out of a story book. Really. It started with an Easter party (with chocolate!) at a neighbor’s home, an Easter egg hunt at our local park, a spotting of the Easter Bunny, a balloon artist, and A PONY RIDE. A pony ride! By the end of the day, the sun was out and I was full, satiated, calm, and feeling very connected to my boys.  The husband was on call, so I had the boys primarily to myself for the majority of the day. As we readied for a night of sleep,we snuggled in. Mindful of the day and noting the space, I finished reading the book and asked him a question.  I wouldn’t have thought to tell you the next part, but you’ll need to know more to understand his answer. Read full post »

Lunch (Time) With Alison Singer, Advances in Autism Research

Tomorrow I have the privilege to give opening remarks and introduce Alison Singer. Ms Singer is the founder and president of the Autism Science Foundation. She’ll speak about advances in autism research in honor of National Infant Immunization Week. Ms Singer has a daughter with autism as well as a brother with autism and has worked for both Austism Speaks and with the Interagency Autism Coordinating Committee to provide leadership on strategic goals for autism research at the national level. She’ll speak about her belief that immunizations do not cause autism while highlighting goals for ongoing research and education efforts to support families with autism. Everyone is welcome; please join us! Read full post »

Read The Data On Bouncy Houses

I was forwarded a case series that captured a bit of data about injuries in bouncy houses and inflatables. It’s not a large study (only 21 families injured in a bouncy house were interviewed) but it sheds light on 2 things. One, orthopedists worried enough about bouncy houses that they set out to determine the risk, and two, bouncy houses do pose a real risk for fractures. Their suspicion alone doesn’t confer a problem, of course. But, validate my worry? Maybe. Change my decision? I don’t know…

The post I wrote last week about hating the bouncy house was more about negotiating my experience of parenthood than it was about the bouncer itself. What I mean is, I was writing about the internal wrestle I have with wanting to do things one way but feeling compelled (in my gut) to go in the opposite direction. You know what I mean, the parenting dynamic in which we set out to do one thing, then being tugged by instinct, we find ourselves in yet another spot. It feels typical, maybe expected, and entirely normal. For example, I set out not to use the pacifier with my first son. At hour 2 of crying, on about day of life 6, we grabbed onto that pacifier and gave it to F. Parents in my clinic will state that they meant to wait until 6 months to introduce solid foods, but once their darling 4 month-old started staring at their spoon with each bite, they gave in and grabbed the carrots. I set out not to use any television in our home. But after the second baby arrived, showing Sesame Street to the 2 year-old allowed me to take a shower. The list goes on and on and on. The ideas of how we’re going to parent and how we implement our choice are not always aligned much less overlapping. Like I said, this is normal. Being a parent helped me “get this.” Read full post »

Happy Earth Day: 1 Thing To Do Today

One thing you can do for Earth Day; a gift for your kids…