Inside This Issue ...
2
Page Home safety checkup
Good and healthy pizza
Page
3
Seven Steps to a Healthier School Year
Page Protect teens with meningitis vaccine
Know symptoms of sports-related concussions
Page
7
6
It’s almost back-to-school time — the perfect time to set up healthier school-day routines at home. Consider these your “New School Year Resolutions” for minimizing stress and maximizing well-being. Here are a few strategies to try: Organize the night before. A mad morning rush starts everyone’s day off stressfully. Skip the drama by taking a few unhurried minutes in the evening to load backpacks and lay out school clothes and shoes. Are there forms to be signed? Do snacks or lunches need packing? Set a bedtime and stick to it. School children need nine to 11 hours of sleep. Kids who don’t wake easily, often seem irritable and lack daytime energy need more sleep. “Getting enough sleep is important for so many things, from overall growth to learning and concentration at school,” says Amanda Haiman, M.D., a clinical instructor at Stanford University Medical Center. Help kids wind down before lights-out. Make time for breakfast. “If your child hasn’t eaten since dinner the night before, there’s no energy to draw from — the gas tank is empty,” says Los Angeles Children’s Hospital pediatrician Michele Roland, M.D. Kids learn better with food in their stomachs. What’s
1 2
3
more, she says, “Breakfast eaters are leaner because they’re not as likely to snack on highcalorie, low-nutrient foods later in the day.” Learn what’s up. Ask open-ended questions, such as “What were the best and the hardest parts about today?” or “What things stress you out?” Then listen to the answers. Kids are more apt to open up about problems if you show interest. When following up with a teacher or principal, take a problem-solving approach. Teach safety. Think through your child’s day from the moment she leaves for school to the time she arrives back home. How can she stay safe — from wearing a bicycle helmet to avoiding conversation with strangers to keeping doors locked at home? Spell out expectations. Discuss classroom behavior, a homework policy, balancing social time and schoolwork, and realistic goals for grades. “Set the path for them, and they’ll know when they’re on track,” Dr. Roland says. Practice relaxation. “It’s important for everybody to have some downtime, even children,” notes Dr. Haiman. Dr. Roland adds: “When signing kids up for sports or classes ask, ‘Whose needs is this meeting — mine or the child’s?’”
4 5 6 7
Check Out Your Home’s Safety Keeping children safe requires common sense and awareness of threats More than 2,000 children ages 14 and younger die each year in home accidents, University of North Carolina researchers estimate, and millions more are injured. Fires, burns, suffocation and drowning are the key culprits. “There’s no doubt that the typical family home can be a hazardous place,” says pediatrician Mark D. Widome, M.D., a Penn State University professor and safety activist. “But you can reduce your family’s risk of injury tenfold, simply by taking the right attitude about safety.” Here are some tips to help head off threats: Fire and burns ♦ Install smoke detectors on each level of your home, outside bedrooms, and in the basement and garage. ♦ If you smoke, don’t smoke in bed or when drowsy. ♦ Keep working fire extinguishers in the kitchen, garage and basement. 2 kidbits
♦ Plan a fire escape route and practice it twice a year. ♦ Plug portable heaters directly into wall sockets, not extension cords. Unplug them when they’re not in use and you’re not in the room. ♦ Don’t overload electrical outlets. ♦ Keep electric cords and plugs in good repair. ♦ Never leave a child with a fireplace or woodburning stove that’s in use. ♦ Keep hot liquids or food out of children’s reach. Poisoning ♦ Never leave children alone with cleaning, cosmetic or medical products. ♦ Store alcohol and tobacco products out of reach. ♦ Keep medications, vitamins and herbal remedies out of sight and reach. ♦ Handle, mix, store and dispose of hazardous materials safely. ♦ Install carbon-monoxide detectors on every floor and outside bedrooms.
♦ Make sure fuel-burning appliances are installed and maintained properly. ♦ Never use a gas range or oven to heat a room. ♦ Never leave a car running in a garage. Suffocation and drowning ♦ Never leave a child alone in a bathtub, wading pool or other body of water. ♦ Never leave small objects within a baby’s reach. ♦ Buy age-appropriate toys that are too large to swallow. ♦ Put your baby to sleep face up to prevent suffocation. Falls ♦ Never leave an infant alone on a changing table, bed or sofa. ♦ Use gates on stairways and install window guards above the first floor as soon as your baby can crawl. ♦ Place adhesive covers on the corners of sharp-edged furniture.
... And Hold the Pepperoni! Pizza as a healthy meal? It just takes some imagination You can toss together a homemade pizza in the time it takes to order a delivery. “Use your imagination and creativity to make a healthy pizza,” says Patricia Vasconcellos, R.D., a Massachusetts spokeswoman for the American Dietetic Association. “Pizza can be a balanced entree because it includes starch, protein, vegetables or fruit, and dairy.” Pizza is child-friendly as a meal or snack. You can set up a pizza toppings bar — heavy on the veggies — and let the kids make their own, says Ms. Vasconcellos. A few slices of advice: ♦ You don’t have to make your own dough. Refrigerated crust is easy to find. Alreadybaked pizza crusts come in several sizes and whole-wheat varieties. ♦ Low-moisture, part-skim mozzarella is the first choice for cheese. But you can be creative with cheddar, feta or other types. ♦ Fresh tomato slices and sun-dried tomatoes add flavor without salt. You can also buy no-salt-added sauces. ♦ Make sausage and pepperoni very occasional treats. Instead, “hide” veggies under the cheese.
One pitfall of pizza: It tastes so good you might eat too much. Ms. Vasconcellos suggest serving your pizza with a big salad.
Shrimp-Scampi Pizza Cooking spray 1 13.8-ounce package refrigerated pizza dough 1 tablespoon cornmeal 1
/2 cup fat-free ricotta cheese
1 pound cooked and peeled shrimp, sliced lengthwise 6 cloves roasted* garlic, sliced 8 ounces part-skim mozzarella cheese (about 2 cups) 1 tablespoon crushed basil *If you don’t have time to slow roast garlic in a 325-degree oven for an hour, microwave on high for about 30 seconds to soften cloves. Preheat oven to 400 degrees. Lightly spray 101/2 by 151/2-inch baking pan with cooking
spray. Sprinkle cornmeal evenly over pan. Stretch refrigerated pizza dough across pan. Bake dough for eight minutes. Spread ricotta over pizza base. Put a layer of shrimp and sliced garlic. Cover pizza with mozzarella and sprinkle with basil. Bake on the bottom rack of an oven heated to 400 degrees for about 12 minutes, until cheese is bubbling. Cut into 12 pieces and serve immediately. Each piece contains about 175 calories, 14 grams protein, 5 grams fat, 69.5 milligrams cholesterol, 18 grams carbohydrate, less than a gram of fiber and 448 milligrams of sodium.
Growing Pains Are for Real If pain persists or other symptoms occur, visit your doctor Does growing hurt? “There’s no proof that growing bones cause pain, but most doctors agree that ‘growing pains’ are all too real,” says Patrice Knight, M.D., pediatrician at UAB and Huntsville Hospital for
Women & Children. “In fact, they’re pretty common.” A recent Australian study published by the Journal of Pediatrics found that 37 percent of children ages 4 to 6 years had leg pain associated with growth. It’s not clear just what causes the pain. Some doctors think it may be due to a bout of intense physical activity. “Growing pains often occur deep in the leg muscles — not the joints — usually late in the day or in the middle of the night,” says Dr. Knight. “The pain can be bad enough to wake a sleeping child, but it’s usually gone in the morning.” There’s no test for growing pains, but doctors like to rule out other possible problems that can be more serious. Some of the symptoms that seem to signal growing pains can come from ailments like juvenile arthritis, chronic fatigue, joint infections, musculoskeletal problems or tumors. “But there’s a big difference: Children with growing pains feel fine the next day,” says Dr. Knight. If your child complains about leg pain with
any other symptoms — a fever, a limp, swelling — call your doctor. The doctor will consider all the possibilities and may run some tests to make sure it’s not something besides growing pains. It’s also important to call your doctor if the pain persists or worsens. The true cure for growing pains is time. Most kids leave the problem behind by age 8.
If the doctor says your child has growing pains, you can take steps to help: ♦ Reassure your child that the pain won’t last. ♦ Massage the legs gently for 10 to 15 minutes. ♦ Apply heat or give your child a warm bath. ♦ Give your child ibuprofen or acetaminophen (but not aspirin).
Summer 2005 3
4 kidbits
Annual Statistics for Huntsville Hospital for Women & Children ★
Pediatric Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . .450 admissions ★ Pediatric floor . . . . . . . . . . . . . . . .3,900 admissions ★
Regional Neonatal Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . .830 admissions
★
Labor and Delivery
★
Pediatric Emergency Room
★
Outpatient
. . . . . . . . . . . . . . . . .4,100 births . . . . .31,500 visits
. . . . . . . . . . . . . . . . . . . . . . . . . . .30,000 visits
Specialized Services Include ★
Pediatric/neonatal critical care transport
★
Pediatric general surgeon
★
Pediatric Intensive Care Unit
★
Regional Neonatal Intensive Care Unit
★
Pediatric Therapy
★
Pediatric Radiology
Summer 2005 5
New Meningitis Vaccine Can Protect Adolescents Federal authorities recommend a new meningococcal vaccine for 11- and 12-year-olds, teens entering high school and college freshmen who live in dormitories. Though relatively rare, meningitis can be devastating. Caused by bacteria that infect the bloodstream, brain lining and spinal cord, it kills one out of 10 victims — up to 300 Americans a year. One in five survivors may face permanent disabilities. That’s why most infants get the Hib and pneumococcal conjugate vaccines, which protect against this contagious disease. Most meningitis patients are less than a year old, but the disease rate peaks again in adolescence and early adulthood. “More deaths actually occur in teenagers,” says Paul A. Offit, M.D., chief of the Division of Infectious Diseases at Children’s Hospital of Philadelphia. The federal Advisory Committee on Immunization Practices (ACIP) has long suggested meningitis vaccinations for new college freshmen — especially those living in dormitories’ close quarters. But early this year the U.S. Food and Drug Administration approved a new vaccine, Menactra, for protection against meningococcal disease. In contrast to the older vaccine, it’s recommended for adolescents and lasts longer. “The advantage of Menactra is that one shot protects you, arguably, for the rest of your life,” says Dr. Offit, a member of an ACIP panel that
Meningitis Symptoms
drew up recommendations for Menactra’s use. “And it also makes you less able to transmit the bacteria to someone else.” The new vaccine protects against four of the five bacteria groups that cause meningococcal infection. “That means it protects you against about 70 percent of the meningococcal cases,” says Dr. Offit. He plans to vaccinate his own two children, ages 12 and 10, with the new vaccine. “The risk is small, but I’d rather they get the vaccine than the disease, which can cause permanent harm and death,” he says.
Meningitis at first looks like the flu or a migraine and progresses quickly, says the National Meningitis Association (NMA). Symptoms include: ♦ A headache, which may seem like the worst you’ve ever had ♦ A fever (perhaps very high) that doesn’t respond to a tepid bath or medication ♦ Vomiting ♦ Numbness, cold or loss of feeling in extremities ♦ Stiff neck ♦ Avoiding light ♦ Disorientation or confusion ♦ Seizures ♦ A rash or purple spots Just one or two symptoms may appear. The NMA suggests you call your doctor or go to an emergency room. Antibiotics treat bacterial meningitis. People who have been in close contact with the patient may receive an oral antibiotic to protect them and limit the disease’s spread.
Help Teens Embrace Self-Care Inform and involve children as young as possible Before teens leave home, you need to teach them to make their own health care decisions. How? By giving them information and involving them in their own self-care from an early age. “It’s just like any form of development — one learns to take care of one’s body, especially when given opportunities to learn about health,” says Susan B. Dickey, Ph.D., R.N., an associate professor of nursing at Temple University in Philadelphia. “And studies have shown that some adolescents ages 13 to 16 are able to make health care decisions as well as adults when given enough information.” It may be hard for you to give up control out of concern for your child’s safety. But Dr. Dickey says adolescents’ skills in coping with responsibility are enhanced by your willingness to support them as they make choices and face challenges. “By involving teens as full participants in their self-care, they’re more likely to choose healthy behaviors throughout their lives,” she says. 6 kidbits
To help your teen move toward health care independence: ♦ Be a good role model. Take medications as directed, follow doctors’ instructions, eat nutritious foods, exercise and make other healthful choices. ♦ Don’t smoke, abuse alcohol or take illegal drugs. That sends a powerful message that these activities jeopardize health and well-being. ♦ Encourage your child’s independent thought and expression. Your child will gain a healthy sense of self and a greater ability to resist peer pressure. ♦ Make sure your teen knows the facts on reproductive health. That will help lead to informed, responsible decisions on safe sex, for instance. ♦ Work with your child’s doctors. Together, the teen and doctors can make age-appropriate decisions about treatment. “The teen years are a good time to foster an
independent relationship between your children and their doctors,” says Dr. Dickey. “To do so, make sure they have time at each appointment to talk to the doctor alone.” Chronic conditions If your teen has a chronic illness, such as diabetes or asthma, help the child learn as much as possible about managing the condition. “Knowledge is empowering,” says Dr. Dickey. “It can help your youngster feel more in control. It’s critical for parents to help their children accept appropriate responsibility for caring for themselves.”
“In a concussion, the brain bounces against the skull, interrupting normal brain signals. If concussions aren’t given time to heal properly, they can cause serious problems years later.” —Kevin Olson, M.D., medical director of the Pediatric ER at Huntsville Hospital for Women & Children
Recognizing Sports-Related Concussions If your child takes part in contact sports, you should know the risks and symptoms of concussions. High school athletes in contact sports suffer more than 62,000 concussions a year, studies show. Many take place in football, with one out of five high school players suffering a brain injury in a given season. “In a concussion, the brain bounces against the skull, interrupting normal brain signals,” says Kevin Olson, M.D., medical director of the Pediatric ER at Huntsville Hospital for Women & Children. “If concussions aren’t given time to heal properly, they can cause serious problems years later.” Younger athletes take longer to recover than older athletes, says the National Athletic Trainers Association (NATA). Damage to a young athlete’s developing brain “can be catastrophic,” says NATA, which urges its members to take young athletes’ concussions seriously. Suffering a second concussion while still
having symptoms from the first one can be fatal. Protective equipment, like helmets, can limit the risk. So can proper training. Football coaches, for instance, should tell players not to tackle or block with their heads or run headdown with the ball. “Because the brain needs time to heal, rest is the only treatment for a concussion,” Dr. Olson says. “A doctor or trainer should evaluate the athlete immediately after the injury. Boys or girls with any signs of concussion, such as headache or dizziness, shouldn’t return to the game.” “No athlete should play again until all the symptoms have been gone for a few days,” says Dr. Olson. A recent study by the University of Pittsburgh Medical Center showed high school athletes weren’t fully recovered seven days after suffering concussions. If there’s memory loss or loss of consciousness, the player may not be able to return for a month. And if this wasn’t the first concussion, return to play may take longer.
Concussion Symptoms Someone with a concussion will have some, but not all, of these symptoms: ♦ Vacant or befuddled expression ♦ Slow response to simple questions ♦ Slow response if asked to move an arm or leg ♦ Confused and easily distracted ♦ Disoriented — unaware of the time, date and place ♦ Slurred, disjointed or incoherent speech ♦ Uncoordinated or stumbling; unable to walk a straight line ♦ Memory problems, repeatedly asking a question that has been answered ♦ Loss of consciousness (not present in most cases) The athlete should be watched closely for 24 to 48 hours because some signs of a concussion develop later. These symptoms may include headache, dizziness, vertigo, lack of awareness, nausea, vomiting, convulsions and poor concentration. Summer 2005 7
Children’s Hospitals Work to Insure America’s Children Insuring America’s children is a top public policy priority for children’s hospitals. Children with a consistent source of health insurance receive routine checkups and stay healthier than children without coverage. That’s why the National Association of Children’s Hospitals, the public policy affiliate of NACHRI, advocates strengthening Medicaid and the State Children’s Health Insurance Program (SCHIP) for children. Two-thirds of the 8 million uninsured children in the United States are eligible but not yet enrolled in these programs. Introduced 40 years ago, Medicaid insures roughly one out of every four children — making it the country’s largest children’s health coverage program. It provides 22 million low-income and disabled children with
NACHRI National Association of Children’s Hospitals and Related Institutions
essential health care benefits. Children reliant on Medicaid come from working families who do not have access to health insurance through their employers. In 1997, Congress enacted SCHIP. The program allows states to expand Medicaid to uninsured children of low-income families, create alternative insurance programs for them or both. All states have now implemented SCHIP. For family friendly information on Medicaid and SCHIP, visit http://coveringkidsandfamilies.org. Even for privately insured families, Medicaid is important because it plays a critical role in the ability of children’s hospitals to care for all children. Children’s hospitals benefit all children by providing clinical care, training the nation’s pediatricians, conducting pediatric research and advocating public health protections. On average, 40 to 50 percent of children’s hospitals’ revenues comes from Medicaid. Without Medicaid, children’s hospitals cannot fulfill their mission to serve all children.
To Learn More To learn more about the importance of Medicaid and SCHIP to children’s health and children’s hospitals, visit www.childrenshospitals.net or contact your local children’s hospital.
Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date information. But no publication can replace the care and advice of medical professionals, and readers are cautioned to seek such help for personal problems. ©2005 Health Ink Communications, 780 Township Line Road, Yardley, PA 19067, 267-685-2800. Some images in this publication may be provided by ©2005 PhotoDisc, Inc. All models used for illustrative purposes only. Some illustrations in this publication may be provided by ©2005 The Staywell Company; all rights reserved. (305)
Quick Phone Reference Administration ..............256-265-7061 Angels for Women & Children ......256-265-8077 Class registration ..........256-265-7440 Main number ................256-265-1000 RN4U ................................256-265-7648 Pediatric surgery tours information ....................256-265-7969 Wellness Center ............256-265-WELL
Huntsville Hospital for Women & Children 101 Sivley Rd. Huntsville, AL 35801
Nonprofit Organization U.S. Postage PAID HSV, AL Permit No. 807