‘travel’

All Articles tagged ‘travel’

On Motion Sickness

I really love this TEDEd video explaining motion sickness. What I find most helpful is the admission that we humans still know very little about motion sickness, why gender differences exist (women get motion disturbance more often than men), and how to put a stop to it. No question children get motion sickness well before they’re old enough to tell us exactly how they feel. Often it’s screaming or fussing only in the car or a series of vomiting episodes that clues us in. A few tips for families, planning that last-minute summer road trip, to help support children who are prone to get sick in the car, on the train, at the park, or up in the air during a bumpy ride.

Motion Sickness In Children

  • Disconnect: Know that motion sickness comes about when there is a disconnect between what our eyes see, what the fluid in our inner ears knows about our position and direction, what our skin senses, and what our muscles feel while we’re positioned wherever we are. This disconnect in all these sensors around our body leaves the brain “confused” and for unknown reasons we’re left feeling nauseated, uneasy or achy. This can happen quickly and can happen even on a swing at the park. It really doesn’t take a jet airplane or an automobile driving quickly on a curvy road to elicit this unease and malaise. This can happen in the back yard! There’s often another disconnect, for those who don’t get motion sickness there is often little insight into how horrible a child or adult can feel while experiencing this. This reality, of course, only increases the displeasure for the person ill. But know this, some experts observe that everyone, given enough mismatch and motion–say a group of people in a life-raft in turbulent seas–will get sick from motion.
  • Common: Motion sickness is fairly common with most reports stating that 1/4 to 1/3 of adults may experience it. In school-age children, a recent European study found the prevalence of motion sickness was 43.4 % in car, 43.2 % on bus, 11.7 % on park swing, and 11.6 % on Ferris wheel. Like adults, most children report dizziness, nausea, or headache when their body is triggered by motion. And although some research claims motion sickness doesn’t start until age 2, I’ve certainly learned from parents that some young children don’t love riding in the car and show it. More preventing and treating it:

Read full post »

Hepatitis A Outbreak: A Vaccine For That

frozen smoothie berriesThe CDC declared an outbreak of Hepatitis A over the weekend that has affected over 30 people in 5 states. Preliminary information confirms the source of the outbreak stems from organic frozen berries that were sold at Costco stores (including stores in Washington) yet sickened people thus far are in Colorado, New Mexico, Arizona, Nevada, and California. No cases have been reported in Washington to date. The berries: Townsend Farms Organic Anti-Oxidant Blend, a frozen berry and pomegranate seed mix, have now been pulled from shelves and people who purchased these berries from February through May are being contacted.

The amazing thing about this outbreak: there’s been no reported cases of Hep A in children under age 18.

In the United States, Hepatitis A typically spreads through contaminated food handled by someone with the infection. Rates of Hepatitis A infection tops 5,000-10,000 cases annually in the US while they are far higher in the developing world because city water sources can get contaminated (see below). Hepatitis A vaccine is recommended before international travel.

The lack of children with infections from this outbreak is logical and potentially illustrative.

Read full post »

Your Friend’s Pool: Drowning Risk

New research shows that there is a 6-fold increased risk for drowning when at the pool of a friend or relative.* Something about being at the home of a friend or relative may change the way we supervise our children. In the Florida study, 79% of patients that were seen in an ER for drowning accidents were at a home pool.

We also know that young children under age 5 drown more in home swimming pools than anywhere else. Anyone can drown in any body of water. But more than anything else I can say, know that children are more vulnerable to drowning due to their size, maturity level, insatiable curiosity, swimming skill level, familiarity with water, and communication skills. Babies and children can drown in any collection of water over 2 inches deep. The Florida research also shows that where we are and who we’re around while swimming may change levels of supervision and distraction.

Plan Ahead When Children Swim in Pools:

  1. Never let anyone swim alone.
  2. When swimming, young children need constant eyes-on, non-distracted supervision. Put down the book, put down the cell phone, and put down the alcohol. As best you can, focus only on your children. There are too many tragic stories of quick phone calls and book chapters that have left children unprotected. If you’re at a party, designate one adult to provide constant supervision.
  3. Know about safety equipment present at the pool, watch for risks from entrapment around drains, pool covers and pool equipment, and have a phone nearby. Call 911 immediately if you’re concerned about a potential drowning accident — seconds matter.
  4. Enroll your children in swimming lessons and update their skills every single year. However, never trust swimming lessons to be protective for drowning. Your supervision is paramount. I’ll post more on this next week.

Drowning injuries and deaths are preventable but often silent and quick. Young children under age 5 drown more than any other group, but nearly 1000 children die annually from drowning.

 Resources on Drowning Prevention

*When I say “drowning victims” in the video, I didn’t mean to imply all those patients in the study died. Of the 100 study subjects with drowning accidents, only 10% had life-ending drowning accidents. Fortunately, 90% of the patients that presented to the ER after a drowning accident survived and had full neurologic recovery.

Plan A Vacation STAT

As Memorial Day weekend slips into the rear-view mirror, we set our sights on summertime. Often that includes a camping trip or vacation away from home. When it comes to travel, there’s a bit of data supporting how to do summertime right. The short version: plan a vacation today. Stop whatever you’re doing, take a Magic marker to the calendar and block off some time for your family. Trust me, it may make you happy. Right now.

Being happy, chasing happy, and achieving/experiencing happiness is often a motivator (or an excuse) for the decisions we make. Despite the ubiquitous quest for happiness, it eludes many of us. When reading about happiness, we often hear about mindfulness, the focus on the present and doing our best to live in the moment in which we live. It seems that if we just stopped planning and thinking about the future or worrying with regret about the past, we’d find ourselves entirely aware and entirely much happier. When it comes to summer vacations, the data is different.

A 2010 Dutch study found that planning for the vacation, not the vacation itself, makes you happy. We really must focus on anticipation (vacation planning) if we’re going to get the best out of our trips and travels! Positive effects of vacations don’t last long. Previous work finds that those of us who suffer from burnout return to our pre-vacation levels of stress and overwhelm just 3 to 4 weeks after the vacation ends. Therefore the Dutch study can guide us in really making the most of our limited time away… Read full post »

Idaho: Vaccine Safety, A Desert, And A Networked Community

I’ve just returned from a week in Idaho where I had the privilege to do a series of talks for the Idaho Department of Health (DOH) about using social media to communicate about vaccines. The best part of the week was all of the education I received. I traveled around the state (see those photos!), witnessed the DOH at work, connected with Idaho physicians & politicians & advocates & volunteers, and talked with many Idahoans about changing the understanding of vaccine science. Three times I heard Dr Melinda Wharton from the CDC present on vaccine safety. And more, in a matter of 4 days we talked with a clinician, nurse, or medical assistant from every single office in the state that provides vaccines to children. I mean, that’s a wow–a sincerely networked community circa 2012.

If all states had the opportunity to convene like they do in Idaho we’d really improve understanding, communication, and opportunities in health care surrounding vaccine safety and decision-making.

After arriving home to my boys, I’m compelled to share 3 things I learned in Idaho:

ONE:

I think it’s essential that we talk about the risks associated with vaccines when we give them–each and every time. Dr Wharton discussed known risks to vaccines and the science to support those risks. She also talked about inferred risks that aren’t backed up with science (autism, for example).

Take fainting: we know teens faint after shots sometimes. Read full post »

Flying With Toddlers: Tips For Distraction, Tips For Tantrums

Flying with toddlers is far more difficult than flying with an infant in my opinion. It’s the need to get up, run the aisles, move around, have another snack, read a different book, take an abbreviated nap, go pee, and that minute-attention span that makes it not only exhausting but nerve-racking for most of us. Although the challenge is real, success comes with having a good plan, allowing extra time, and packing the right snacks, toys, and books to keep your toddler occupied. That 3,000 mile flight at 30,000 feet can be a ton of fun! The above tip came from a friend years ago. Prepare for the worst and expect the best when flying with toddlers–hopefully this blue tape idea sticks. (ha)

Now dealing with tantrums while up in the air is another challenge in and of itself. Many of us heard about the toddler kicked off an airplane, and have also heard about the opinion for commercial airline children-free flights. Although I wholeheartedly disagree that we should segregate flights by age, I do think these stories in the news media elevate our anxiety for flying with our children. Don’t let it. You’re always the best one to support and help your child on the ground or up in the air. Don’t let the public shake that truth. My tips for dealing with tantrums at 35,000 feet aren’t very different from those on the ground: provide consistency, provide distraction, and provide comfort. But more, set yourself up for success by clearing the tension with passengers sitting next to you ahead of time. Acknowledge the challenge. I’ve found it not only decreases my own anxiety, it allows for a much better reception when things don’t go as planned.  Click to read full post for my additional 1-minute video explanation and a few ideas. What are yours? Read full post »

When Is It Okay To Fly With My Newborn Baby?

I think it’s okay to fly with your newborn baby straight away. After 1 week of age the Federal Aviation Association (FAA) says it’s okay, as does the AAP, but always recommends a separate seat for your infant whenever possible.

The biggest risk flying with a healthy newborn is exposure to infection. So, like any decision in life, you have to weigh the risks and benefits of a decision. Because we take fever very seriously in babies under 3 months of age, we want to avoid infections when possible. Take precautions, wash your hands frequently, and wipe down seat backs, tray tables, and seatbelts on board.

All that being said, I flew with O when he was just 6 weeks old. It was important for us to travel to see family in California for the holidays. I took precautions, loaded up on hand sanitzer, and backed extra diapers. It was a wonderful Christmas…

For more on traveling with children, check out:

TSA Tips For Traveling With Children

Is Air Travel Safe For an Infant (the short answer is “yes”)

The View: 5 Truths WhenTraveling With Children

We arrived home late in the day Monday from Central America (hence the near silence around here). My family traveled to Costa Rica where we visited my father, old friends, my family’s ecolodge, and had some real honest-to-goodness time together. I remained essentially unplugged for the 10 days (except for a few brief moments online). Wondrous. Life really feels different without an iPhone in my pocket and a diaper in my purse while on the way to preschool. I didn’t have the iconic stethoscope along either. In the absence of routine and my typical tools, I was reminded that travel and how you deal with it is often about perspective. And optimism.

Time brushes your body differently when you’re out of the country, as if it attains a new temperature. Startling news like the shooting rampage in Arizona or the deeper disappointment in Andrew Wakefield hit me differently than I would have expected. Sometimes what we infer really depends on the view. When sitting in a country without an army, surrounded by family and wide open spaces, priorities came into focus, minutia disappeared, the resume of my life diminished in importance, and tragic news penetrated less deeply. For me, travel was a break from responsibility but also a break from the internet, the demands of the constant worry we can feel when taking care of others or bearing witness to the hydrant stream of ideas and news in the (social) media. While I was in Costa Rica, I really felt like a mom. Singularly at times. We were devoid of deadlines and while in the middle of the rain forest, the distance from technology was vast. Big trees, humid thick breeze, and the bazillions of bugs reminded me that there really was a time before my iPhone, Twitter, and e-mail. There can be time that is slow and uninterrupted.

Let me be clear, travel with children isn’t all rosy and relaxed. Travel with children is just that, travel. It’s not technically vacation. There remains little “down-time.” The diapers still get filled, the tantrums remain rampant, the sicknesses can still appear, and the room is usually crammed. And although travel through the eyes of children enlightens, it also exhausts. Which leads me to these 5 things. Read full post »

Wednesday Before Thanksgiving

Be safe today. With travel defining many of our days, this is a day I think about safety every year. Now more than ever because of my kids. Motor vehicle injuries are the leading cause of death for children in the United States. The CDC statistics on child passenger safety state that child safety seats reduce the risk of death in passenger cars by 71% for infants and 54% of toddlers age 1 to  4 year of age. Car and booster seats are an awesome way to protect our kids.

Wednesday before Thanksgiving was changed for me forever while training in pediatrics.

Wait, a warning: this is a slightly morbid thought. So if it will do you no good, don’t read on. I share this only to show you how and why pediatric training and the profession of caring for ill children shapes how and why we pediatricians believe so strongly in preventing illness and injury. Terrible stories are instructive.

One year in residency, I rotated into the pediatric ICU during November. I was on-call the Wednesday before Thanksgiving until middle of the day Thursday. I was taking care of critically ill patients, some who were on the transplant list waiting for organs. I remember as colleagues left for the day on Wednesday afternoon and evening, one doctor mentioned she wasn’t worried. She knew the patients in the ICU were going to get the organs they needed shortly. It was the biggest travel day of the year, she explained, and organs were going to be much more available.

Entirely morbid, and then entirely hopeful, too. Yes, the organs did arrive over the weekend…

The memory of that conversation really stuck with me. I don’t know if it’s true that more organs are available soon after the Wednesday before Thanksgiving (biggest travel day defined) because of travel related accidents, but it comes into my head every year. Makes me double check the car seats, re-examine the buckles, and drive a bit more slowly.

Be safe today, all. Don’t take risks you don’t need to take, and buckle up. Ensure the carseats are properly installed, particularly if you’re putting a seat in a relative’s or a rented car while you travel away from home.

I like this USA Today article with tips about traveling with infants and children, too.

And here’s my take on why I don’t recommend using Benadryl on the plane if you were thinking about throwing it in the travel bag.

Be well. Enjoy time with friends, family, and your Thanksgiving traditions. I am so thankful for all of you…

Protecting Children In The Sun: What To Use & Why

It’s cloudy and cold in Seattle. The rest of the northern hemisphere is starting to grill, swim at the beach, and play in the sun. Here in Seattle we’re shivering (literally) under raincoats and fleece. It’s pouring. My space heater is running. Think rain, space needle, cold. It’s not always like this, though. And in the great hope that the clouds will clear and the ball of fire will reappear in the sky, I’ve been thinking about sunscreen and ways to prevent melanoma.

Every season we hear that cancer of the skin related to sun exposure (and tanning bed use) is rising, even in children. This post covers my thoughts, the off-the-cuff thoughts of 2 dermatologists and 1 environmental health expert/pediatrician. We’re all still learning. But we do know a few things that may help.

Although melanoma is rare in children, sun exposure is more dangerous for children than adults. Here’s why: the more sun exposure children have, the more moles they make in their first few decades. The more moles, the bigger the risk of a mole turning into a melanoma. So, here’s how to stop being scared of the sun and enjoy it safely. Sunscreen is what most parents reach for when they worry about the sun, yet when it comes to infants and toddlers, long sleeved UV suits, hats and sunglasses are far easier. And maybe cheaper depending on how many times you use them.

Read full post »