Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

E-Cigarettes

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6235a6.htm

Ever Electronic Cigarette Use ~ National Use Tobacco Survey, 2011-2012

Grim news out today. E-cigarette use in teens has doubled in a year. The CDC reports that 1 in 10 high school students admitted to ever using an e-cigarette in 2012. The rate of use doubled for middle school students as well. Although I’m not surprised, I remember just weeks ago tweeting about my dismay with Jenny McCarthy’s new job– advertising e-cigarettes. I took flak. Some advocates for e-cigs felt I was shortsighted and not valuing the potential benefits of these electronic nicotine-laden vapor tubes. All I could think of was her image, the lure she may create for teens, and the likelihood that teens would peek in on e-cigs with greater fervor.

Just a month ago we learned that smokeless tobacco use is steady with teens (5%) and many teens are now turning to novel sources of nicotine (dissolvable tobacco, snuff, snus) in addition to tobacco cigarettes. I consider myself fairly up to date, and until the AAP report came out in August I’d never once heard of snus. You?

Some people are wed to the concept that e-cigs may reduce the burden of illness and smoking-related morbidity from tobacco cigarettes. Even if you believe in harm-reduction for adults (switching from tobacco cigarettes to e-cigs to reduce use or quit) this is an entirely different issue for our middle and high-school students. A nice summary of the data for e-cigs from pediatrician, Dr Aaron E Carroll, with numerous associated comments helps frame the issue.

I wish I could remain agnostic about these devices, but I can’t. This is pretty easy to say:

I don’t recommend e-cigarettes for a teen.

Compare two stats: One in five adults who smoke has used an e-cig with one in ten of ALL high school students have tried an e-cig. Teens aren’t wired to conceptualize the power of nicotine addiction.

The e-cig really does feel like the gateway to the gateway drug.

There is still a lot of unknowns about e-cigarettes. More research will come out and the FDA is likely to regulate e-cig use shortly.

In the meantime, check in with your teens, look around, and I urge your to support regulation of e-cigs and advertising of e-cigs to teens. This just can’t be good.

Your Phone And Your Life


I love it when I forget my phone. Especially if I’m with the boys. But I admit it’s gotten more complicated for most of us to leave the phone at home. It’s harder and harder to function without our online resources and phone connection to those we love.

Watch the 2-minute video and read the 3 tips for making unplugging a weekly habit (below).

The Pew Research Center confirms that more than 9 out of 10 adults in the US have a cell phone. More than 1/2 of adults (56%) are now using a smartphone and rates for cell phone adoption start at earlier ages. Teens between 12 and 17 are rapidly acquiring cell phones of their own: more than 75% of teens have their own cell and 1/3 of teens have a smartphone in their pocket. We spend more time with our phones than our friends, it seems. Although sometimes we’re just looking at the bus schedule or our work email, The New York Times reported this summer that Facebook claims 40% of Americans are on Facebook every day. Every flipping day! So it’s not surprising perhaps that although I meant to take the month of August primarily offline I was mostly unsuccessful. It wasn’t until August 29th that I officially unplugged from all my inboxes and stayed off all apps and mail for 4 days. Read full post »

First Day Of School: Quick Reminders

first day first gradeIt’s the first day of school for us today. This time of year is momentous.

The photostream on Facebook this morning is striking: children in pressed shirts with clean backpacks. It’s obvious the cameraman for each photo is smiling, just so much pride… There is something clearly resonant with we adults about a clean slate, a new day, a first moment of each new grade level. We have our memories tucked neatly into our pockets (yes, I know my 1st grade teacher’s name) and this first day often represents an important line in the sand. First day of school is clean, hopeful, and sincerely wondrous for most. I told someone yesterday I’d move a mountain to be present for first day drop-off.

I know today is also complicated for some parents. Not everyone can get time away from work for the drop-off at school or the bus pick-up. Some parents have doctor’s appointments or illness that prevents an easy morning and send-off. Nearly 1 out of 10 children are living with their grandparents. So today isn’t all white-picket-fence-two-parents-at-the-door perfect for all children in the US. But for most, it’s a very exciting transition.

I also know amidst the sparkle of the fresh start  today we have to remember that the beginning of anything does come with significant anxiety for many children and teens (and their parents). The rapid ramp-up to full speed this week required by early start times and homework schedules with afternoon +/- sports practice can incite anxiety and real fatigue for children, especially those with social phobia, underlying anxiety, depression, or learning challenges. Here are a few quick reminders that may ease the September transition for us all.

4 Tips When Starting School

Sleep is essential. 

  • Preschoolers: 10-12 hours of total sleep (night time sleep + naps). Most children naturally get tired and ready for bed between 7pm and 9pm at night. Most 4 year-old phase out their nap prior to turning 5.
  • School-age children: 10-11 hours total sleep. Most children get to bed around 8pm but as they near age 12, they may naturally “phase shift” later into the night. That means as they age and go through puberty, many tweens aren’t really tired until around 9pm or 10pm.  Puberty brings on changes to their sleep cycle and thus shifts them later.
  • 12 year-old to teens: 8 1/2-9 1/2 hours total sleep.  Read full post »

Savoring Versus Saving

dock calling me

If the world were merely seductive, that would be easy. If it were merely challenging, that would be no problem. But I arise in the morning, torn between a desire to save the world and a desire to savor the world. That makes it hard to plan the day.

E.B. White

It’s an entirely challenging task getting to live this     just     one     life.

E.B. White summarizes the dilemma as well as I can imagine when he describes the tension between wanting to savor and wanting to save. For most of us who are raising children there is a constant tug-o-war in our minds/hearts as we decipher how best to live each day, especially when making choices about how we work. Nothing better than savoring the delight of our children, though, most all of us agree on that. Sure my boys fight and squabble, they ignore me when I ask them to put on their shoes, they leave their room a mess, and they forget to say, “please” in front of Grandma. But not a cell in my body denies this: my boys are simply miraculous. I constantly remain awestruck while in the midst of my family. And yes, just like those ahead of me warn, it does feel as if their childhood is coming at lightening speed.

So as the torrid waves of “work-life-balance” perpetuate, I’m unplugging for a few weeks just as I’ve done the last 2 years.  A true believer that digital-free time is essential,  I’ll use this post to ensure I check-out of the Internet for a bit. After sundown Friday I’ll be off Twitter, Facebook, LinkedIn (maybe even Instagram), off the blog, and only sporadically into my email. I’ll still be at clinic and also on KING5 News. The rest of the time I’ll be with my family as we work to live mindfully, enjoy the end of summer, and prep for the onslaught of autumn.

Be well until September. In the meantime here’s some good reading:

Simply Not Factual

No-SymbolSimply not factual. That’s really all that needs to be said in response to Michael Edwards’ opinion piece entitled “Vaccine Side Effects and Why You Shouldn’t Vaccinate” published in Organic Lifestyle Magazine last week. This is clearly a non-peer reviewed, non-fact-checked online publication that Mr Edwards edits and owns. Fortunately, the magazine is reported to get about the same amount of traffic as my blog so it’s not exactly the Washington Post…

That being said, Edwards’ piece is so egregious I’m unable to hold my breath. Although I’m no watchdog, the dangerous writing demands physician attention partly because it’s been published amidst a noteworthy week in the world of vaccine misinformation:

  1. A segment aired last week by a local TV station in Las Vegas claimed doctors debating a need for vaccines. The TV station reported false information and misrepresented a chiropractor as a “holistic physician.” There was a noted uproar online, especially when original comments from physicians were, at first, taken down. Here’s more from news watchdog Gary Schwitzer, “Back To School Anti Vaccination Woo.”
  2. Mr. Edwards published false information claiming families shouldn’t vaccinate. More below.
  3. Jenny McCarthy’s credibility erodes further as it’s announced she is now advertising e-cigarettes. A pediatric colleague wrote a blog post entitled, “Jenny McCarthy continues tireless crusade to kill us all.”

Back to the piece in “Organic Lifestyle” though. What is so dangerous is not just Mr. Edwards’ misinformation but the way his article appears to the eye. Mr. Edwards published his vaccine opinion in a structure that misleads a reader to believe it’s based in fact. There are sections with headers, subtitles with supposed historical reference, and a list of resources at the end. All the while Mr Edwards warps truth and paints a picture of a fictitious world—one where those diseases now eradicated (small pox) or nearly so (polio) thanks to vaccines, aren’t.

Small pox has been eradicated by worldwide vaccination and thanks to vaccines married with a remarkable commitment from the Gates Foundation, polio is nearly gone too. Read full post »

Kids In Hot Cars

car seatUnthinkable really, leaving a child in a car and forgetting about them. But it happens more than a dozen times every single year here in the US. On average, over 30 children die from the consequences of heat stroke after being left or trapped in a hot car.

Children are particularly vulnerable to heat stroke because their bodies heat up 5 times faster than adults. The reason for their quicker warming stems from a child’s inferior ability to cool themselves (sweat) and their high surface-area-to-mass ratios.

A car heats up rapidly on a hot day. For example, if it’s 80 degrees outside your car can heat up to 123 degrees in an hour. Heatstroke can happen when it’s only 60-70 degrees outside and we all know from experience that in just 10 minutes, your car can rise 20 degrees in temperature.

Most people instantly feel that they could never forget their sleeping children in their car on the way to work. Read this incredible 2009 award-winning Washington Post article if you’re in doubt. Gene Weingarten chronicles the experience of a man on trial for murder after forgetting his child in the car. He weaves in details about the science of distraction. It’s a haunting and terribly difficult article to read but it’s wholly instructive: this could happen to any of us.

We have to create reminders and habits that prevent the possible mistakes of leaving an infant or child in a hot car (see below).

Parents may leave children in a car that can overheat by accident after forgetting to drop them at school in the morning. Mr Weingarten writes: Read full post »

Alex’s Lemonade Stand

Alex and MomThis is a guest post from Liz Scott, mom to Alex, Patrick, Eddie and Joey. She’s looking for support and in doing so she is sharing her story. She talks about instincts and love, commitment and courage. Here’s more on how you may be able to help:

Some of you may be familiar with my place of work, Alex’s Lemonade Stand Foundation, a nonprofit dedicated to finding cures for all kids with cancer, where I am the Co-Executive Director alongside my husband Jay. If you are still reading this, you may be wondering why exactly I’m telling you all of this? The reason is simple, because like your very own Seattle Mama Doc, I too am a mother, and my daughter Alexandra “Alex” Scott battled childhood cancer from before her first birthday until the time of her death at the age of 8 in 2004.

I am hoping that through sharing her story with you, and my part in it, that you will join me in an initiative, The Million Mile Run, this September to raise the profile of National Childhood Cancer Awareness Month. Alex was my second child, born only a few short years after my husband Jay and I welcomed our first child, a son, Patrick. To say that we were experienced parents during Alex’s first year of life would be a gross overstatement, but something I learned quickly was to trust my instincts. Read full post »

Swimming Across The Pool

Splash

Our 4 year-old swam across the pool this past weekend for the first time. After years of swimming lessons this was a reason to celebrate: big throw! I hate to admit it but I’ve really disliked doing swimming lessons. Both boys often brought more tantrum and tears than tangible joy to the pool deck. After a day at work I would often leave evening swim lessons embarrassed, exhausted, or somewhat disappointed. They felt like #fails. So when we got across the pool this past weekend, we were all delighted. Finally the big win.

Swimming across the pool doesn’t mean I’m off the hook, of course.

I will say, however, that eating those veggies has paid off. Now that we’re finally swimming I’m thrilled we did lessons early. There is a lot more both our boys still need to learn about water safety and skills they’ll both need to be strong swimmers. For example it’s much harder for them to swim in the lake than the pool secondary to the waves and distractions. They still don’t understand risks of the water. So we have years of swimming lessons ahead but I’m feeling optimistic with the epic win last Sunday.

New data published in the last few years encourages swimming lessons earlier, as early as age 1 to 4 years. Data finds early swimming lessons reduce drowning risk in those children most at risk–toddlers (especially boys). Although swim lessons are never a replacement for close supervision, there may be some protection against drowning when children get started early. The American Academy of Pediatrics (AAP) says this about early swim lessons: Read full post »

Your Social Network, Your Kids’ Vaccines

network

We live in a profoundly different time today when it comes to caregiving, parenting, and gaining health care/advice than we did even 5 or 10 years ago. The internet has changed things dramatically. During an interview recently a reporter asked, “You were raised on digital media, yes?”  Well, no. I didn’t started using email until late 1995 just prior to leaving college, didn’t get a cell phone until I was teaching, didn’t have a working computer in my apartment until I started my master’s degree (after med school), and didn’t join social media until 2008. It was bedrest with my second pregnancy that urged the establishment of a profile on Facebook. That online community changed everything.

I’m no digital native but I may act like one.

My husband, my friends, and the doctors I’ve chosen to help me raise my boys certainly do color my belief about the world. So do the things I read and watch online.

There has been 3 measles cases in Seattle this July and 58 cases of measles in Brooklyn, NY since March. Measles is preventable with a very effective vaccine. The vaccine is so good that after 2 doses of the MMR shot, over 99% of people are protected against measles for life. However, often our community shapes our decisions to vaccinate…

An insightful Pediatrics study and accompanying editorial published earlier this year illuminate the reality that social networks carry big weight for parents making decisions about immunizations. We do make decisions in the context of our lives and the social network we choose to use as a sounding board really does help us determine what to do in moments of confusion. Read full post »

Measles In Seattle

There is a report of more measles here in Seattle. Measles is a highly contagious and potentially severe infection that causes fever, rash, cough, and red, watery eyes. It is mainly spread through the air after a person with measles coughs or sneezes. King County Public Health released information today detailing new cases and potential places for public exposure to measles infections between July 9th & July 15th. These two new cases are unrelated to the measles case earlier this month in a traveler at the Sea-Tac airport. Much of the information here is thanks to the public health department.

Local public health officials have confirmed measles infections in two siblings, an adult and a child, who were in several public locations during the time that they were contagious. The siblings have been visiting from out of state and public health officials believe that they acquired measles outside of Washington State.

Locations where possible exposures may have occurred:

Screen Shot 2013-07-17 at 11.19.58 PM

Read full post »