Archive for July 2011

Monthly Archive

Varicella Vaccine: It Works

I don’t diagnose Chickenpox often. I’ve seen patients with Chickenpox only a handful of times since I started medical school in 1998. Auspiciously, there simply haven’t been many children to serve as my teachers. Varicella virus causes Chickenpox and there’s a vaccine for that. So, like Smallpox or Polio, I’ve been forced to learn a lot about Chickenpox in textbooks. My strongest professor in the Chickenpox department is my own memory; I had Varicella between the age of 5 and 6 years. It was the one week of my childhood where I remember being really babied– my mom gave me a small gift or craft every day while I was home from school. I got to watch TV on the couch. I must have looked pretty awful…But it wasn’t so bad and I was lucky. I was a healthy 5 year old girl who had a case of chicken pox that was “run of the mill”: lots of spots, lots of itching, a week of fever and feeling crummy. Then poof, I scabbed over and got better. The only remaining trace (besides the virus that may live in my nerves) is the scar on my L forehead. You seen it?

The big trouble with Chickenpox is you can’t predict which child will have a serious complication (a brain infection, an overgrowth of flesh eating bacteria in the sores, or a life-threatening pneumonia).

While I was finishing up college, the Varicella vaccination was introduced into the United States. At that time, over 150 people died every year from Chickenpox and over 11,000 people were hospitalized annually. This created a huge economic toll (from missed work to health care costs).

So my apparent lack of clinical opportunity with Chickenpox reflects reality. A study published this week found that over the last 12 years there has been a 97% reduction in deaths from Chickenpox in children and adolescents younger than 20 years of age. There’s been an 88% reduction of Chickenpox deaths over all (kids plus adults). These are staggering statistics. Read full post »

Protecting Infants From The Sun: Seattle Mama Doc 101

Here’s why to avoid sunscreen for babies under 6 months (when you can) and ways to protect babies from the sun.

For more on protecting your baby and children from the sun read:

First Movie With My 4 Year Old

I’ve had media on my mind lately. And Finn McMissile, I’ve got my eye on you.

We took F (age 4 1/2 years) to his first movie about a month ago. It is something we’ve been talking about for over a year. He’d built up a sense of anticipation that we could have bottled. F is a focused boy. The only movie he has chosen to watch from start to finish his entire life is the original Cars. So with the news of Cars 2 coming to the big screen, we plotted our first big family trip to the cinema. F lost sleep with anticipation. He studied (and slept with) the New York Times synopsis. The NYT review, we didn’t share with him…

What age did you first take your child to a movie? Did you go because of a certain film or because the timing was right?

I’m asking because I think although there is no perfect answer (3, 4, 5, or 6), I wish our first movie had gone better. All in all, our experience was a great success in the eyes of my son, but Pixar let me down. As did Finn McMissile.

McMissile, why the unnecessary ammo? Read full post »

Partnerships In Health Care

I got a parking ticket today. It was worth every penny. The logistics behind why I was in the wrong spot don’t matter (do they??). What does matter is the fact that I made a conscious decision at 10:30am that I was happy to pay the fee that was going to be coming my way if I didn’t exit the building.

I was able to attend a portion of the Pediatric Bioethics conference entitled “Who’s Responsible for the Children” this morning. I was planning to return to other work after a couple of talks. But I couldn’t pull myself away. In perfect form, bioethics’ discussions draw a feisty and varied crowd. In keeping with this, I sat between a lawyer and a nurse, behind a pediatrician, and in front of a philosopher. For someone who has studied bioethics, this is a little bit of nirvana.

Did you know that recent data finds that 40% of children in the US have Medicaid and/or no health insurance?

I’m left reeling, my head spinning webs of thoughts and streams of information together that make me want to do more, speak out, stand on a table and improve health care for children. I’m somewhat humbled and intimidated by the brilliant thinkers I heard. So until all that settles, there’s one thing that came up, and often does, that I must write about. It seems it’s a theme. Read full post »

A View Into Driving With Grandma

Grandma shouldn’t get such a bad rap. A study published this week found that kids were safer riding in a car with a grandparent behind the wheel than with Mom or Dad. Researchers evaluated data from crashes that occurred between Jan 2003 to November 2007. What they found defies my intuition: children were injured less with a grandparent-driver than with a parent-driver. The why behind the surprising finding may be harder to elucidate than the data itself. Researchers reviewed data collected on over 11,000 children involved in crashes with either a parent or a grandparent behind the wheel. Here’s what these prominent safety researchers found:

  • Children involved in crashes were driven by grandparents nearly 10% (9.5%) of the time. Yet those crashes resulted in only 6.6% of the injuries. Read full post »

Seattle Mama Doc 101: Teething and Fever

My take on teething & fever in the above video. What is your baby’s favorite thing to chew on? Do you have any advice for parents with teething babies?

And, do you disagree with the data–do you think your baby has/had fever from teething?

More information on FDA recalls:

Potty Training: Reward Chart Glory

Maaaaaaajor milestone in our house today. O filled up his first reward chart for potting training. Even bigger, last night just before he went to bed, O and I discussed that he only had two spaces left on the chart. Once filled, he gets a special trip to the toy store. Although seemingly unclear about the rules and benefits of the chart last night, he told me he would wait until morning to pee.

Thing is, he did.

He awoke with a dry diaper. We felt like lottery winners! O went to the bathroom, peed in the toilet, and then came to find me this morning. His 4 1/2 year old brother did the reporting:

“O peed much more than we thought he could this morning, Mommy.”

I was astonished. I went to the toilet to see the evidence. Dark yellow bowl of pee. Immense pride….I think my heart pushed out a double-beat. Read full post »

A Single Moment

Consider this an intermission. A moment where I have no wisdom to share, no knowledge or research I’m compelled to report, and no breaking news I feel I have to detail. This is a day where those words don’t come easily for me and thus I’ll give you a brief intermission. The reason? I’ve heard terrible news today about children going missing, children who have been hurt and children who have been killed. It’s left me a bit breathless. I’ve found myself unable to finish 5 posts that I’ve started. This past weekend I flew out to Minnesota for a 24 hour visit to support a dear friend who just lost her father. It’s Wednesday now and I’m still a bit consumed by it. And more, I’ve been sick for the last 7 days, feeling fairly miserable. As I wring myself out and attempt to stand back up after a long week for me personally, I acknowledge this: often we lack control of all that we’d like. Everything from our own health, our family’s health, the safety and vulnerability of our friends and loved ones, and even our own future.

Yet the saving grace can be that our lives can feel entirely whole in a single moment. A single moment of simplicity amidst a slanted sun. The bare bones moments away from technology and away from a clock– those moment surrounded by those we love. Those moments that define and then refine who and what we cherish most. Read full post »

Seattle Mama Doc 101: 3 Month Developmental Milestones

For more information:

Please leave additional topic ideas and suggestions for the Seattle Mama Doc video series as comments at Seattle Mama Doc 101: Introduction.

Thrilled To Be in Primary Care

Being a primary care doctor is an utter privilege. Think of this post as part proclamation and part journal entry.

Yesterday afternoon I sent out this tweet:

It was a spontaneous tweet in the middle of my 15 minute “lunch break” when I realized I still had hours to go in my clinical day. The motive was incredulity, not remorse or a need for pity. I was in a good spot–my frame of mind and perspective sharpened twice this week.

First, I’d had a discussion with clinic  leaders where we noodled around the upcoming fall where I will be traveling heavily and unfortunately away from clinic. We were discussing how to meet the needs of my patients while simultaneously meeting my need to contribute nationally. I reminded them how I’m unwavering in my adoration for my panel of patients and my commitment to caring for them. They nodded. You see, they know….. Read full post »