Monthly Archive for June, 2010

Running for Fun

This last weekend I was supposed to run the Rock and Roll Marathon in Seattle as I have done quite a few marathons over the years. Things did not work out as planned because about two months ago I developed an overuse injury that is slowly getting better. Having learned the lesson the hard way that my mind is stronger than my body on more than one occasion, like tearing muscles, for the first time I actually made the decision to let my body rest and not put it to that level of stress. It was the right decision.

This can be a hard thing for the teen athlete as well as there is so much pressure to compete. Often athletes can play through mild injuries but if things are getting worse then at some point rest is often the solution along with a hard look at what got them to that injury in the first place.

My wife and I both get out and exercise often as it helps to set an example for our children. They both enjoy going “jogging” around the block or taking walks. Our children see us both being active and want to engage in the activity as well. We also try to find activities to do as a family to get us all moving. Our latest new family activity is geocaching. Basically we use our GPS device to walk around parks and find little hidden treasures put there by other players. The kids really enjoy it.

Keep Learning Going While Having Fun Over the Summer



School is out and summer is here. This means lots of fun play time for the kids but it also means finding things for them to do that stimulate continued learning during the summer months. My family has already made its first trip of many to the Redmond library to check out some books for my daughter to read and for us grown ups to read to my son. My daughter was very excited to learn about the summer reading program at the King County Libraries and is progressing along well in the goal for  summer reading.

As difficult as it can be, we do try to find time every day to sit down and either read to them our encourage them to read on their own. It was not that surprising to me a few days ago when my daughter came and asked me to help her with her “math homework” which is really something she just wanted to learn more about on her own initiative.

Most of us want to raise children that can satisfy their own desires. Many children will say they are bored and no matter what idea we throw out there, none are sufficient. These days my answer to our daughter is that “we raised a bright child and I am sure you can find something constructive to occupy your time.”

There are lots of other creative ways that I am sure many of you use to help your children learn while having fun this summer. I would love to hear them.

Start Kids Early with Good Oral Hygiene

As a pediatrician and a parent, I realize that it can be challenging to get some children to brush their teeth. It was a big battle in our household for both of my children when they were younger as they would kick and scream. This is one battle that is worth the fight as there are long term consequences of losing.

Oral disease is the single most common chronic childhood disease — Continue reading ‘Start Kids Early with Good Oral Hygiene’

Father’s Day Reflection

Father’s day is this weekend and it represents a time for my family to get together with all of our relatives and celebrate. It also is a time of reflection for me.

It has been fantastic being a dad. It has made me become more patient and helped focus my priorities about life. Certainly the dynamics of my relationship with my wife have changed as we have gone from the pre-kid days to now, but I love her more every day that goes by. It is a journey that we both are on as we watch these amazing and challenging little beings grow. She has helped me become a better father and husband.

Last night as my son went upstairs to bed with both of us marching like a penguin, I just watched him from behind and took in the moment realizing that there will come a day when the silly little things like that quit happening. I also took extra notice of the usual bedtime ritual of “a kiss, nose to nose rub, and head bonk” as that will not last forever as well. All of these moments will be replaced by new ones that I am sure will be equally satisfying.

Taking the time to slow down and appreciate things today is important. I know I will not be a father that 20 years from now wishes he had spent more time with the people that are important to me. That time is now.

Happy Fathers Day.

Picking up on the Positive

It’s so easy to notice, and comment, when your child is behaving badly. It seems we are all programmed to point out when someone does something wrong, but we ignore the good. So actively look for those times when your child is being good, and praise them for it.

My wife and I use star charts to help us remember to compliment our daughter when she’s doing the right thing in a consistent way. We make a chart with goals marked on it (like getting dressed on time) and place it at kid’s-eye level. Every time she meets the goal Continue reading ‘Picking up on the Positive’

Water Fun, Water Safety

Summer is approaching and, for most parts of the country, this usually means warm weather and time to play in the water. I was shocked last weekend when I saw people swimming in Lake Whatcom. I can only imagine how cold the water must be right now, as at least for me, here in the Puget Sound area, it is not quite swimsuit time yet. I know the time is coming, though.

For most children, playing in the water is one of the most enjoyable and free-spirited of summer activities. It’s also great exercise. That’s why it’s so important to teach kids about water safety and how to swim. Without question, it’s one of the most important skills they’ll ever learn. Swiftly moving rivers pose obvious hazards, but parents don’t always realize that children can drown in the shallow end of a backyard pool, even in a few inches of water. Never leave a toddler or non-swimmer alone near water. This includes wading pools, buckets of water, or the decorative pond at a friend’s house.

The American Academy of Pediatrics recently changed their policy about swim lessons for children. The prior statement discouraged lessons for children under four years of age. This never really resonated well with my practice as even with my own daughter, we started swim classes much earlier than this. The new statement says “new evidence shows that children ages one to four may be less likely to drown if they have had formal swimming instruction. The studies are small, and they don’t define what type of lessons work best.” So the AAP is not recommending mandatory swim lessons for all children ages one to four at this time, but they ask you as a parent to consider whether to enroll your child in swim lessons based on your child’s frequency of exposure to water, emotional development, physical abilities, and certain health concerns related to pool water infections and pool chemicals.

The Frightened Toddler
Lots of kids are afraid of water at first, and some carry that fear longer than others. Telling them to “be brave” or “act grown up,” forcing them to jump into the water, certainly won’t help. The answer is trust. Talk with your child about what will make them feel safe in the water, and don’t press them before you’ve earned their trust.

Boats Afloat
If you plan on boating this summer, remember that Coast Guard-approved life jackets are not just a smart idea, they’re required by law. Your child’s jacket should be snug, but not constricting. Keep the straps fastened at all times.

If your older child wants to try water -skiing or tubing, be absolutely certain you have the safety equipment, keep a sharp eye out, and use good judgment at all times. It takes only a second of inattention or carelessness for disaster to strike.
Keep in mind that every child has different strengths and levels of coordination and that children of similar age and build may have completely different abilities.

My Tummy Hurts

These last few weeks I have seen quite a few children with a stomach bug otherwise known as gastroenteritis. This may surprise many parents because one would think we are just getting out of cold and flu season and it should be smooth sailing form here, right? This is not the case.

Late spring and summer is a common time for some of the viruses that cause intestinal symptoms. The symptoms typically consist of vomiting, diarrhea, abdominal pain, fever, and sometimes rashes.

It is never fun to see your child throw up. I recall one such episode last year when my daughter proceeded to burst into our room at 2 a.m. to declare she just threw up. When I went to investigate, I quickly realized that she must have been running down the hallway with her mouth open as there was quite a bit of cleaning that needed to get done after we took care of her.

Gastroenteritis is generally self-limiting, meaning that it will go away on its own without treatment or medication, but the symptoms can range from a few days to longer sometimes, especially if we are talking about resolution of the diarrhea.  It is also very infectious, as most of the viral causes can live on surfaces for quite a long time. Good hygiene is critical.

Foodborne illnesses are a different entity that can cause similar symptoms. Most are also self-limiting. As a general rule with foodborne illnesses, many people tend to get sick in a very short time period after ingesting something. The symptoms are often quick to resolve as well.

The treatment for both tends to be supportive care, which means keeping your child hydrated. Us pediatricians always tend to recommend Pedialyte but it seems that many children just won’t drink it, so half strength Gatorade or other sports drink can serve as a substitute. Slow and steady is a good guiding principle as putting too much into the stomach at once can lead to not so pleasant results. As your child feels better it is reasonable to have them try to eat some solids.

Historically we use to recommend the BRAT diet to help with diarrhea (consisting of bananas, rice, applesauce, and toast) but evidence based medicine does not support this as it is unnecessarily restrictive.

The new recommendation is for the child’s usual age appropriate diet realizing that giving lots of fruits or fruit juice may exacerbate the problem. Giving lactobacillus can also be helpful to help speed up the resolution of  diarrhea as this is the good bacteria that lives inside of our intestinal tract. By all means, if something does not seem right with your child or they are not urinating at a reasonable interval, something is wrong and they need to be seen.

Visiting My Youngest Patients

This week I am on Nursery rounds at Overlake Hospital, which means I get to see all the newborn babies. The joy and excitement in the parents’ eyes is very obvious as I make my rounds. You can also sense the trepidation of those first time parents who quickly realize that they are going to be allowed to take this brand new baby home and often times feel suddenly unprepared for what comes next …

Some parents have only a few questions, others ask a countless number. There is so much information thrown at them prior to leaving the hospital. The nurses do a tremendous job of teaching these parents the basic skills necessary—aiding them in things to look for and when to worry.

We work as a team and I could not do this without their support. When it comes time to go home, that maternal and paternal instinct takes over. Ultimately the parent’s job can be broken down to nurturing a helpless infant who will one day grow up and become a good-hearted person.

For those of you who might say that my wife must love having a “pediatrician for a husband” as he can give advice, that is not always the case. It is like any other relationship in that sometimes we do not want to listen to our significant other even though they may have some extra knowledge on a topic. Often times my wife teaches me something that will make me a better father and better doctor.

All Parents—Enjoy your child now, no matter what age or stage they are, as they grow all too quickly.

Does it Help to Start Kids Early or Hold Them Back?

It seems that every year about this time, the question of whether to have their toddler start school early comes up from parents who have children who have a birthday that misses the school cut off for the next fall enrollment. This is a complex question, and there is no one-size-fits-all answer. There’s so much more involved in this decision than the child’s cognitive ability. Having a good confidence building experience can lay the foundation for future success at school. Where that child is at developmentally and socially also needs to be factored into the equation.

With my daughter, Continue reading ‘Does it Help to Start Kids Early or Hold Them Back?’