Dr. Deb

Every morning I make 6 neat little piles of vitamins for my family. A multivitamin with calcium, omega 3’s and CoQ10 for each of us. A new study showed that supplements increased death rates in older women.  With over 50% of American taking supplements like we do, does this mean we should we stop? I’ll explain.

Does this new study show that we should stop taking vitamins?

This study was very limited in that only white women with an average age of 62 recalling what vitamins they were taking were studied. The study did not a have  “cause and effect’” design. They did look at 40,000 women, ages 55-69, over 19 years and found a 2.4% increase in death in those taking multivitamins. The most significant increase was seen in those taking iron with a 3.9% increase risk of death. What we don’t know is if those taking these supplements had underlying medical problems that may have influenced taking supplements. Only Calcium showed a decrease risk of death by 3.8%.

Dr. Deb’s Tips in Taking Supplements

1. Never take Iron supplements unless you are Anemic

Extra iron intake has been linked to heart disease, liver disease, diabetes and most recently Parkinson’s disease.

As little as 200mg of iron can cause poisoning in children.

Hemochromotosis is an iron storage disease that affects 1 in 250 people of European descent. Complications from this common disease can be prevented by frequent blood donation. In medical school I tested high for iron stores without having hemochromotosis so I do give blood frequently.

Unless you have a blood test that proves you are anemic, then do not take an iron supplement.

2. Consider a Calcium Supplement

This study did show a decrease in death with calcium supplements ans most are not meeting the daily recommended dose. Teenage girls are most likely to be deficient in Calcium and would therefore benefit.  Take a supplement if you are not getting 1200 mg calcium per day with 600iu of Vitamin D.

3. Less is More

The most important thing this study shows is too much of a good thing may be bad. Don’t take extra iron unless you need it and don’t take megavitamin doses. A study published in JAMA yesterday showed that high doses of Vitamin E may actually increase prostate cancer. Vitamin D was seen as the wonder drug a few years ago but excess Vitamin D can cause problems too. Vitamins and supplement are not regulated by the FDA but can have major health consequences. What the company says is on the bottle may not be the case. Consumer reports found great disparity in what was actually in many supplements and also found many “natural” supplements” to have health risks.

4. Make half your plate fruit and vegetables

The food pyramid was recently replaced with the food plate as study after study has shown the most health benefit is found in a diet rich in vegetables and fruits which are still lacking in the American diet as only 3% of Americans are following the food plate. This one simple rule may be the most beneficial to your health. The old adage an apple a day keeps the doctor away has more and more data to back it up with apples showing a decrease in cancer, diabetes and asthma while helping with weight loss. You can track your nutrition on this link.

5. Talk to your Doctor

Many patients neglect to tell their doctor what supplement they are taking but it is critical as supplements may interfere with other medications. Supplements are drugs with consequences both good and bad and need to be discussed with your health professional.

This study will not change my supplement routine yet but does reinforce that no supplement can replace proper nutrition.

I always wanted twins until I actually HAD them. It took about 18 months before I actually LOVED mothering twins, which I do now with a passion. The early months were all about survival and I savored the exersaucer time in front of the TV. 20 minutes of Smart Baby gave me the least bit of sanity and I was making them smart, right? Turns out those videos don’t really make your baby smart and television, especially for young children, may lead to several health risks.

SpongeBob SquarePants is the most-watched TV show among kids between the ages of 2 to 11 but a recent study showed that 4 year olds who watched only 9 minutes of the show were significantly impaired on tests of executive function or the ability to focus and not get distracted compared to kids that watched a PBS show Caillou or drew with crayons.

Sponge Bob is considered a fast-paced show with complete scene changes every 11 seconds compared with 34 seconds for the slower-paced program. These fast paced shows may over stimulate the brain and lead to deficits.

This is not the first study to show problems with television. Television watching is associated with higher blood pressure and obesity, because not only is it sedentary and noninteractive, but there are an estimated 10,000 unhealthy food commercials per year being viewed each year.

Watching too much television is unhealthy for even active people. A recent study of the National Cancer Institute showed adults age 50-71 who watched more than 5 hours of TV a day were twice as likely to die sooner. Even those who exercised at high levels but also watched a lot of TV were still at risk for early death.

What is a sleep deprived mother to do?

Dr. Deb’s Television Watching Recommendations

1. Limit Screens to less than 2 hours a Day

The American Academy of Pediatrics discourages TV altogether for children under the age of 2 so forget Smart Baby like programs. It is important to be active and interactive and television does neither. When you do have the TV, keep closed caption on. This had been shown to be a far better reading aid than any video or smart program.

2. No Television in the Bedroom

32% of 2-7 year olds and 65% of 8-18 year olds have a television set in their bedroom. Television creates sleep problems for both children and adults. Even watching TV too close too bedtime caused sleeping problems in 28% of preschoolers who watch TV or played video game at least 30 minutes after seven.

Children need a quiet soothing winding down ritual time before bed and reading a book is a great habit to get children into at an early age.

3. Aim for Educational & Nonviolent Television

Children have trouble discriminating fantasy from reality. 37% of children who were exposed to one hour or more of violent media had sleep problems compared to those who watched less than an hour or none at all. Not only does more media violence promote real life violence but teens that watch sexualized shows tend have earlier and more frequent sexual experiences.  Make sure they are watching quality and diverse television. The FCC has V chip guidelines for every show with age recommendations.

4. Watch TV with your kids to Find Teaching Moments

I don’t think you should ban every violent or sexual show but make sure you are watching these shows together to have teaching moments about the choices the characters have made. You can help clarify the fantasy versus the reality of real life.

5.  Turn TV off during Meals

Mealtime should be sacred. Families that eat together and share their day are more successful in school and in life. It is too easy to have television as the background noise so make all television viewing with a purpose.  Those that eat while watching TV consume far more calories than those sitting at a table together.

Do my kids enjoy Sponge Bob? Absolutely! Keep him in his target audience of 6-11 year olds and out of the younger kids eyes. You don’t have to ban TV but don’t make it your babysitter either.  Think about what kind of modeling you are doing for your kids too.

Have a great week and don’t forget, the new fall season starts soon!

Dr. Deb

Preventing Annoying Back to School Infections

There’s peace in my house as all the kids are back to school but the return to school also means the return of annoying school infections such as pink eye and lice. I want to share my tips to keep those infections out of your house this year.

1. ABCs: Allergies, Bacteria and Colds

These three account for the most common infections in children and can all be prevented with hand washing, covering mouths while coughing and not sharing drinks and utensils.

Just one lesson on hand hygiene where students ages 5-15 learned to clean hands 3xs during the school day decreased 4 or more sick days by 66 percent according to the American Journal of Infection Control.

Most importantly have kids wash their hands when they come home from school to keep germs out of the house. They should also wash their noses with normal saline spray to prevent allergy outbreaks. If they do become ill then wash their toothbrush in the dishwasher or replace it to prevent reinfection.

2. Pink Eye

Pink eye is conjunctivitis or inflammation (swelling) of the conjunctiva—the thin layer that lines the inside of the eyelid and covers the white part of the eye.

The most common causes of conjunctivitis are viruses, bacteria, and allergens.

Symptoms include red eyes, crusty eyelids in the morning, itchy eyes, tearing and blurred vision.

Is typically mild, with symptoms being the worst on days 3–5 of infection. The condition usually clears up in 7-14 days without treatment but may take 2-3 weeks.

Many cases improve without treatment but topical antibiotics are often prescribed.

Prevention:

Wash your hands often with soap and warm water or an alcohol-based hand gel, especially after applying eye ointment.

Avoid touching or rubbing your eyes.

Wash any discharge from around the eyes several times a day but use different cloths on each eye.

Wash pillowcases, sheets, washcloths, and towels in hot water and detergent.

Don’t share tissues, towels, washcloths, eye makeup or eye drops with other people.

When treating allergic conjunctivitis dust and vacuum often to reduce allergens in your home and close windows when the pollen count is high.

3. Head Lice

6 to 12 million cases of head lice infestation occur each year in the United States in children ages, 3 to 11 years, according to the Centers for Disease Control and Prevention. They are tiny parasitic bugs that don’t spread disease and spread mainly by direct head-to-head contact with a person who already has head lice. Lice don’t fly or jump; they move by crawling.

Every parent should check regularly for lice by parting the hair in several spots. Lice can move fast so use a magnifying glass and a bright light. Nits can look like dandruff, but stay firmly attached to the hair if you pull your fingernail across the hair while dandruff will come off easily.

Most important for lice treatment is to use a fine-toothed comb or special “nit comb” to remove dead lice and nits that can be used with or without chemical treatment.

Prevention:

Don’t share hairbrushes, combs, hair ornaments, scarves, bandanas, towels, or helmets.  Girls with long hair should keep their hair braided and pulled back. Avoid head-to-head contact during play or slumber parties

When your child returns from a sleep over put everything in the dryer on high heat for 10 minutes. This treatment will also kill bedbugs.

Treatment:

Machine wash and dry clothing, bed linens, and other items using hot water (130°F) and dry on high heat. Clothing and items that are not washable can be dry-cleaned or sealed in a plastic bag and stored for two weeks. Head lice survive less than one or two days if they fall off the scalp and cannot feed.

Vacuum the floor and furniture, particularly where the person with lice sat or lay.

Disinfest combs and brushes used by a person with head lice by soaking them in hot water (at least 130°F) for 5–10 minutes. After finishing treatment with lice medication, check everyone in your family for lice after one week.

4. Molluscum Contagiosum

MC are pink, white or flesh-colored bumps caused by a type of poxvirus. It is common in kids ages 1 to 10 but many parents have never heard of it. Molluscum contagiosum is very contagious, mainly through skin-to-skin contact or contact with contaminated objects, such as clothing, towels or toys.

Once someone has the virus, the bumps can spread to other parts of their body by touching or scratching a bump and then touching another part of the body. Molluscum can also be spread by sexual contact. There has been a relationship of catching molluscum by shared swimming pools, baths, saunas, or other wet and warm environments, this has not been proven. Most likely sharing towels and other items around a pool or sauna than through the water spread the virus.

Prevention: Hand hygiene and not sharing personal items, including towels are the best ways to avoid this skin infection, which typically clears up without treatment in 6 to 12 months. Do not shave or have electrolysis on areas with bumps. If you have bumps in the genital area, avoid sexual activities until you see a health care provider.

To prevent the spread of molluscum to other areas of your body or to other people, it is important to keep every blister or bump covered either with clothing or with a watertight bandage

Treatment

There are many treatment options including Cryotherapy (freezing), Curettage (removes the fluid inside the bumps), Lasers and Creams that include certain chemicals (i.e., salicylic acid, podophyllin, tretinoin, and cantharidin). There is also a newer cream (imiquimod) that helps strengthen the skin’s immune system.

Mollusscum is tough to treat when it spreads and I have used imiquimod on my own children with great success.  It needs to be used every night, is expensive, may cause irritation but is safe.

A home remedy that may be worth trying is apple cider vinegar or ACV. There are several options but one is to soak a cotton ball with ACV and tape it to the MC overnight. There can be some irritation and stinging. Some have reported just soaking in a bath nightly with ½ cup of ACV will work too. Others advocate popping the MC with a sterilized needle then applying the ACV that is very similar to the curettage that we do in the office. I do not recommend popping at home as you may spread the infection or cause a bacterial infection but I would try the ACV nightly bandage option.

Being a parent is never easy. Here is hoping for a Happy Healthy School Year!

Dr. Deb

Kids are headed for college this week and while my last blog discussed the nuts and bolts health tips for BACK TO SCHOOL like vaccines and hygiene, this week I want to talk about what parents are really worried about: How will my child handle the smorgasbord of temptations without rules or limitations?

Here are Dr. Deb’s 5 College Health Tips.

1. Avoid the Freshman 15

Students often gain weight the first 2 years of college and most of it occurs during the first trimester of freshman year, but weight gain is not inevitable. It only takes an extra 150-175 calories a day to gain that weight so making a small change like cutting the midnight snack or drinking water instead of pop can mean the difference between weight gain or staying the same.

Critical to avoiding the weight gain, as well as stress relief, is REGULAR EXERCISE!

Don’t skip meals and be aware that everyone has a different metabolism. Avoid the mob mentality. Just because your skinny friend is chowing down on French fries and fast food after a night of drinking doesn’t mean you won’t gain weight if you do too. She may have a hidden eating disorder that is quite common on college campuses. Click her for more information on Eating disorders.

2. GET SOME ZZSs

Sleep is critical for all but especially dealing with the stress of college.  Try to get on a regular sleep schedule and avoid all nighters. You need at least 4 hours of sleep to perform well on a test but 7-9 regular hours is best for your health as well as your grades. Lack of sleep also contributes to that freshman 15 as hunger chemicals are released in times of low sleep. Stay away from energy drinks and avoid caffeine in the evening as it can take 8 hours to wear off.

3. Stress Relief

Depression and other mental illness usually start between ages 15 though the 20s. The stress of school and being away from home can trigger depression in children especially with a family history. Talk to your kids about warning signs and make sure they know where to get help. Regular sleep, a healthy diet and exercise are critical to keep all children feeling their best. Encourage joining a club to build social support, as college life can be very overwhelming.

Talk about warning signs and have them see a professional if the have:

Extreme mood swings

Feelings of sadness or hopelessness

A loss of interest in things they once loved

Loss of appetite or binging

Significant changes in sleep patterns.

4. Sex and Safety

College is different because they have not grown up with these kids or know their families so a healthy amount of caution is necessary. Don’t allow boys you just met to “walk you home” because predators come in all shapes. Almost every campus has a college escort service so make sure your kids know about it.

Sexual expectations may also be different in college and make sure they do not put themselves in situations they may not be used to. Have them discuss at the beginning of a date, what if any sexual expectations either of them have. Talk to them about keeping themselves safe as they are in a high-risk group for sexually transmitted diseases and what they would do if something they had not planned for were to happen like emergency contraception.

Take this Sexual Assertiveness Quiz and read about date rape prevention.

Avoiding or limiting alcohol is critical for college health and safety. 1/3 of college students abuse alcohol, which contributes to the 3 most common causes of death in teenagers, accidental injury, homicides and suicides. Alcohol also plays a role in most sexual transgressions and sexual assaults.

5. Set them Free

Don’t be a helicopter parent and try to micromanage every grade or class. College is the time for kids to learn to be an adult and if you don’t want them back at home after graduation then have fight their own battles. Set limits on texts or phone calls to what is reasonable for you both.

Kick Ball games may be replaced by beer pong but arming your kids with the information and confidence is the best way to keep them healthy and safe at college.

Happy New School Year!

Dr. Deb

The first week of August is always a little depressing because summer feels over when fall sport practices start and some kids are even back to school.   Where did summer go? While buying backpacks and pencils don’t forget a tune up on your child’s health.

Dr. Deb’s Back to School Health Tips

1. Don’t Wait to Vaccinate
Each year, about 50,000 adults die from diseases that can be prevented by vaccinations. Children in closed in classrooms or living in dorms are particularly prone to infections. Check here to know your child’s requirements but the following are important vaccinations before college.
Tetanus-diphtheria-acellular pertussis vaccine (Tdap)
Meningococcal vaccine (MCV4)
Human papillomavirus (HPV) vaccine series

Flu

Tdap booster added pertussis protection to tetanus and diphtheria starting in 2005 to prevent whooping cough that has skyrocketed. Most children will be required to have this vaccine before starting 7^th grade but children going off to college should be certain that they received it prior to as they have missed that cut off. Td should be repeated every 10 years if Tdap has already been given.

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College freshman living in dorms are at particular risk for Meningococcal disease and that is why the MCV4 is mandated by many states. 1 in 10 people who get the disease will die from it. Check your state to see its requirements.

HPV is rampant affecting 80% of sexually active people and may lead to genital warts and several types of cancer of the skin, vulva, anus, penis and cervix.

Many adults are not up to date on vaccines so click here for more information about vaccines the importance of adult vaccines.

Take this quiz to see take a quiz to find out what vaccinations you might need.

2) Clearly, a Professional Vision Screen

Vision is always changing so have your child’s vision screened annually but have a professional vision evaluation by an eye specialist before starting preschool, middle school, high school and college. Between 2% and 5% of the population is legally blind in one eye and your child may not realize that they are only using one eye. Vision correction can prevent headaches, fatigue and improve classroom performance

3) Keep the Personal Personal
Washing hands with soap and water or 60% alcohol hand sanitizer and covering mouths are still the most important steps to prevent all infections. Remind your Wear flip-flops in the shower to prevent fungal infections and don’t share towels, combs, razors or bed sheets. Locker room infections caused by MRSA (methicillin resistant staph aurues) have even caused death in college athletes. Click here to learn more about MRSA prevention.

4) Mental Health Boost
Depression and other mental illness usually start between ages 15 though the 20s. The stress of school and being away from home can trigger depression in children especially with a family history. Talk to your kids about warning signs and click here to learn more. Regular sleep, a healthy diet and exercise are critical to keep all students feeling their best. LIMIT SCREEN TIME to 2 hours per day as recommended by the Academy of Pediatrics but minimally take phones and laptops after a certain hour so they get enough sleep. Teach kids to segregate study vs. social time so they focus on homework exclusively then take a social media break and not study, facebook, text, and watch TV all at the same time. Forget the all nighters, studies show that your need sleep to perform your best.

Here is a wonderful Family Media pledge to keep media under control

Talk about warning signs and have them see a professional if the have:

Extreme mood swings

Feelings of sadness or hopelessness,

A loss of interest in things they once loved,

Loss of appetite or binging

Significant changes in sleep patterns.

5) Sex, Drugs & Alcohol

Talking about the consequences of sex, drugs and alcohol should be an ongoing conversation from a young age. Start with the dangers but more importantly come up with a plan for when (not if) they will encounter a situation where they do not feel comfortable.

Have a secret sentence or text that they can send to you when they want to be picked up at a party but do not want to be embarrassed or pressured. (How is Grandpa feeling?)

Remind your kids to make sure they see who pours the drinks (even non alcoholic) as they can be spiked with rohypnol or the date rape drug.

Use college escort service.

Sexual expectations may also be different in college and make sure they do not put themselves in vulnerable situations. Have them discuss at the beginning of a date, what, if any sexual expectations either of them have. Talk to them about keeping themselves safe as they are in a high-risk group for sexually transmitted diseases and what they would do if something they had not planned for were to happen like emergency contraception.

Take this Sexual Assertiveness Quiz and read about date rape prevention.

Alcohol contributes to the 3 most common causes of death in teenagers, accidental injury, homicides and suicides. Learn more about substance abuse prevention at the Minnesota Institute of Public Health.

Enjoy the rest of summer and always keep the conversation going with your kids to keep them safe and healthy this school year!

Dr. Deb