Travel in Good Health – Part 2 of 3

3 02 2010

All the prep and stress of getting out your front door is over. Now it’s fun, sun, and bugs.

Wait. What?

Oh yes, wherever your journeys take you, you can be sure that pesky critters will be flying or crawling around, biting, stinging and more…so much more.

Some bugs carry certain diseases, such as West Nile virus, malaria, dengue and others. Whether you’re in Napa Valley, the Sahara or the Alps, there are steps you can take to avoid infection.

  • Use an insect repellent on exposed skin to repel mosquitoes, ticks, fleas and other arthropods. EPA-registered repellents include products containing DEET (N,N-diethylmetatoluamide) and picaridin (KBR 3023). DEET concentrations of 30% to 50% are effective for several hours. Picaridin, available at 7% and 15 % concentrations, needs more frequent application.
  • DEET formulations as high as 50% are recommended for both adults and children over 2 months of age. Protect infants less than 2 months of age by using a carrier draped with mosquito netting with an elastic edge for a tight fit. There are DEET-free solutions available, but check with the pediatrician for a final recommendation. Protection against mosquito bites is the goal.
  • When using sunscreen, apply sunscreen first and then repellent. Repellent should be washed off at the end of the day before going to bed. Put repellent only on exposed skin and/or clothing and don’t apply repellent to open or irritated skin. Don’t let children handle the repellent. Rather than spraying it directly on children, adults should apply it to their own hands then rub it on the children. Don’t get it near a child’s mouth, eyes or hands and don’t use much around a child’s ears.
  • Wear long-sleeved shirts which should be tucked in, long pants, and hats to cover exposed skin. When you visit areas with ticks and fleas, wear boots, not sandals, and tuck your pants into your socks.
  • Inspect your body and clothing for ticks during outdoor activity and at the end of the day. Wear light-colored or white clothing so ticks can be more easily seen. Removing ticks right away can prevent some infections.
  • Apply permethrin-containing (e.g., Permanone) or other insect repellents to clothing, shoes, tents, mosquito nets, and other gear for greater protection. Permethrin is not labeled for use directly on skin. Check label for use around children. Most repellent is generally removed from clothing and gear by a single washing, but permethrin-treated clothing is effective for up to 5 washings.
  • Be aware that mosquitoes that transmit malaria are most active during twilight periods (dawn and dusk or in the evening). Stay in air-conditioned or well-screened housing, and/ or sleep under an insecticide-treated bed net. Bed nets should be tucked under mattresses and can be sprayed with a repellent if not already treated with an insecticide.
  • Keep baby carriers covered with a mosquito net.
  • Daytime biters include mosquitoes that transmit dengue and chikungunya viruses, and sand flies that transmit leishmaniasis.

Don’t forget to come back for Part 3, where we talk about more fun times for traveling parents.

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Travel in Good Health – Part 1 of 3

1 02 2010

Traveling with children, no matter their age, can be a joyful, tiring, exciting, and exhausting endeavor. Traveling with children who get sick on the trip is just plain exhausting and, sometimes, exciting in a way that we don’t want to experience.

Although dealing with illness in the midst of a family trip isn’t ideal, you can take steps to prevent illness before traveling and equip yourself with supplies to make the treatment of illness easier and more comforting.

Prevention is key, and no one does that better than the CDC. This article captures some tips for traveling families from CDC’s website, and a few other places.

If anyone in your travel group has an existing condition that may affect his or her health, it’s important to discuss travel health safety with a healthcare provider.

If you’re traveling outside the United States and you love detail, download a copy of CDC’s Yellow Book . It’s written for healthcare providers, but many people find it useful. Wherever you’re traveling, these suggestions may help you and yours avoid infectious diseases on the road.

There are steps you can take prior to departure that will protect you and your kids, and many things you can do while traveling. First, the pre-departure list:

Time Zones and Rest

If you’re changing time zones, spend a few days just before travel adjusting your sleep/wake periods to match the destination’s time zones. When you arrive, get out during the sunny periods so that you body realizes it’s time to be awake. Good sleep is critical to good health. Make sure everyone gets lots of rest a few days before and then during the trip.

Vaccinations

You and your kids should be up-to-date on currently recommended vaccines in the U.S.

If you’re traveling outside the United States, you need to check the destination country for recommended vaccines for you and your children, and if you have special health concerns, you need to determine which vaccines to get and which you should not have. Not all vaccines recommended for international travel are licensed for children.

Health Notices

If you’re traveling outside the U.S., read the CDC’s Health Notices first to get the latest updates on infectious diseases in various areas of the world. What you learn may affect your travel plans.

First Aid Kits

Prepare a first aid kit for the trip or purchase one from a commercial vendor. This is a sample list, as not all destinations require the same things.

  • 1% hydrocortisone cream
  • Ace wrap
  • Acetaminophen, aspirin, ibuprofen, or other medication for pain or fever
  • Address and phone numbers of area hospitals or clinics
  • Adhesive bandages
  • Aloe gel for sunburns
  • Antacid
  • Anti-anxiety medication
  • Antibacterial hand wipes (including child-safe) or alcohol-based hand sanitizer containing at least 60% alcohol
  • Antibacterial soap
  • Antibiotic for general use or travelers’ diarrhea (azithromycin, cefixime)
  • Antidiarrheal medication (e.g., bismuth subsalicylate, loperamide)
  • Antifungal and antibacterial ointments or creams
  • Antihistamine (such as Benadryl)
  • Antimalarial medications, if applicable
  • Anti-motion sickness medication
  • Commercial suture/syringe kits (to be used by local health-care provider with a letter from your prescribing physician on letterhead stationery)
  • Cotton-tipped applicators (such as Q-tips)
  • Cough suppressant/expectorant
  • Decongestant, alone or in combination with antihistamine
  • Diaper rash ointment
  • Digital thermometer
  • Epinephrine auto-injector (e.g., EpiPen), especially if anyone has a history of severe allergic reaction. Also available in smaller-dose package for children.
  • First aid quick reference card
  • Gauze
  • Ground sheet (water- and insect-proof)
  • High-altitude preventive medication
  • Insect repellent containing DEET (up to 50%)
  • Latex condoms
  • Laxative (mild)
  • Lice treatment (topical)
  • Lubricating eye drops
  • Malaria prophylaxis and standby treatment, as required by itinerary
  • Medications that the child has used in the past year
  • Moleskin for blisters
  • Mosquito netting, if applicable
  • Oral rehydration solution (ORS) packets
  • Personal prescription medications in their original containers (carry copies of all prescriptions, including the generic names for medications, and a note from the prescribing physician on letterhead stationery for controlled substances and injectable medications)
  • Safe water
  • Scabies topical ointment
  • Sedative (mild) or other sleep aid
  • Snacks
  • Sunscreen (preferably SPF 15 or greater)
  • Throat lozenges
  • Tweezers
  • Water purification tablets

Discuss with your family’s pediatrician any special needs your children might have that require you to prepare beyond this basic list. Also, your pediatrician may be able to give you sample sizes of antibiotics and other meds that may be useful for your kit.

Health Insurance

Before traveling, check your health insurance policy to see what it pays for. It will probable reimburse you for most of the cost of emergency medical care abroad, excluding any deductible or co-payment. For non-emergency care overseas, you may be covered, but check with your health plan about this before you leave home. Failure to get authorization may mean denial of reimbursement.

Travel Regulations

Check travel regulations and carry what you can onboard the plane, particularly prescription medication. Put the rest in your checked baggage. Put your first aid kit in a fanny pack or backpack that you take with you everywhere you go. There’s no sense bringing the kit if you don’t have it when you need it.

Now that you’ve done your pre-departure prep, stay tuned for Part 2 for some tips on problems you may encounter on the road.

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Kids and Nutrition

25 01 2010

Nurse Mary Beth tells us what works and what doesn’t when it comes to the foods our kids eat.

Listen now!

Right-click here to download podcast (5mb, 10min)


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Love Those Critters, But Oh Those Germs.

22 01 2010

We love our pets. They give us unconditional love, cuddle when we want (and sometimes when we don’t), and make us laugh.

They also can be good for our health by reducing stress, improving moods, and lowering blood pressure.

But, our critters can infect us with some nasties – H1N1 is just one (huge) example of that.

To give an idea of what germs may lurk in our pets:

  • There are certain bacteria that live in animals’ guts that can cause infections that bring on diarrhea, abdominal pain, and fever in humans.
  • There is an infection that’s caused by worms that live in dog and cat intestines. People can get these worms by coming into contact with the worms’ eggs in an animal’s infected feces. This is where good hand cleaning can make a big difference in preventing infection. If the eggs get in your mouth and gut, you can get sick with fever, swollen glands, muscle pain, headache, cough, sore throat and rash.
  • A certain parasite is sometimes found in cat feces that can cause an infection that is particularly dangerous to pregnant woman because of the harmful effects to the baby she is carrying.
  • Cat scratch disease (a.k.a. cat scratch fever), tapeworms, and ringworm are also diseases that can be caught from cats and/or dogs.
  • Let’s not forget our avian friends–even those we keep in a cage. You can be exposed to some diseases by inhaling the fungus from bird droppings, ending up with serious problems like brain inflammation and pneumonia.  Parrot fever is transmitted by coming into contact with infected bird poop or dust in bird cages, causing cough, fever and chills. And, let’s not forget avian flu, although that would normally come from outdoor birds.
  • Salmonella can be caught from pets such as lizards, snakes, turtles and frogs.  Most reptiles and amphibians carry Salmonella in their digestive system and feces, and they can also carry it on their skin. People can get sick with Salmonella just from touching the animal or cleaning the cage.
  • Rodent pets such as hamsters, gerbils, and guinea pigs can carry diseases such as rabies and rabbit fever.  Rabies may be transmitted when an infected animal bites you. For rabbit fever and other diseases, you must come into contact with the animal’s urine or feces to get infected.

We need to protect ourselves and our kids from infections. After touching, feeding, or cleaning up a pet’s waste, we should always wash our hands. A good way to protect ourselves is by wearing gloves when we clean the cat’s litter box or a pet’s cage. And, we shouldn’t feed our critters raw meat or let them drink water from the toilet. Doing so can make them sick and they can pass that along to us.

Finally, make sure the pets have all their vaccines!

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Kids Bring Home the Darndest Things!

6 01 2010

Nurse Mary Beth explains how to identify and treat pink eye and head lice – oh my!

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Right-click here to download podcast (5mb, 10min)


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Vitamin D – Gotta Have It!

20 11 2009

High blood pressure, heart disease, diabetes, and cancer. Kids with low levels of vitamin D may be at risk for some or all of these health problems. If not now, then as they get into their 20s and 30s. In case you were thinking this doesn’t apply to your children, you might want to reconsider: 70% of kids in the U.S. do not get enough vitamin D.

Why is this? Scientists tell us that spending 10 or 15 minutes in the sun without using sunscreen lets the body make the amount needed.  And vitamin D, which helps bones absorb calcium that makes them stronger, can also be found in milk and in multivitamins.

Talk to your child’s healthcare provider about the amount of sun, supplements, and milk your child should receive each day to achieve and maintain healthy levels of vitamin D.

Ask your provider about your vitamin D levels and what you can do to improve them.  Parents sometimes forget that they need to be taken care of, too.

Check out AAP’s article on vitamin D deficiency for more info.

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Five-Second Rule!

16 11 2009

Nurse Mary Beth confirms that yes, we can scarf down what we dropped on the floor (most of the time).

Listen now!

Right-click here to download podcast (2mb, 4min)


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Teaching 911 Basics

30 10 2009

iStock_000004171601XSmallTeaching our kids to call 911 can be as important to their health and the health of others as teaching them the importance of good nutrition and how to stop-drop-and-roll. And just like stop-drop-and-roll, we must teach them not just the ‘when’, but the ‘how’ of it, until it becomes second nature.

Consider teaching a 911 mini-class to your kids at least once a day for three days, then quizzing every other day, then quizzing about once a week.  By that time, the routine should be stuck in their heads.

Here’s some suggested text for your lesson plan:

If there is an emergency, dial 9-1-1 from a telephone. An emergency is when a person is badly hurt or in danger ‘right now.’ An emergency is if you see a crime happening, like a person hurting another person or someone breaking into someone’s house, or a fire somewhere a fire shouldn’t be. An emergency is if someone is suddenly very sick, having a hard time speaking or breathing.

An emergency isn’t something like forgetting your homework or arguing with a brother or sister.

Go to a safe place to call. If there’s a fire, leave the building first. Get away from the person hurting you or someone else, then call 911.

It’s normal to feel afraid or nervous about it, grownups often feel the same way. Call anyway. The people answering the phone will understand.

It’s OK to make a mistake. If you call 911, stay on the line and tell them why you called. It’s OK to tell them you think it might not be an emergency after all. If you start the call, but hang up before someone has a chance to answer, the 911 operators might think you are still in danger.

*****

Help them prepare. Teach them their address and phone number and explain what to expect when the operator picks up the phone, and that they should stay on the phone until the operator tells them it’s time to hang up.

Role-play the scenario with them so that the first time they call 911 won’t necessarily feel like the first time. The 911 dispatcher will ask these questions:

  • What is the emergency?
  • What happened?
  • Where are you?
  • Who needs help?
  • Are you safe where you are?

When you role-play, give your children a turn both as the caller and the 911 operator. Practicing these skills with your children will help them be more confident, feel safer and be safer.

 

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Two Sisters, One Virus (H1N1)

21 10 2009

My teenage daughter is recovering from H1N1. For weeks, I’ve pressed an ear against her thin, little chest (No, dear, I don’t mean “little” in that way) listening for the slightest gurgle or wheeze.

I’ve hovered countless times, peering into her eyes, looking for the slightest hesitation, and asked, “Are you having any trouble breathing?”

She has, so far, answered no.

Younger days

Younger days

She coughs phlegmatically, yet produces little phlegm.  She sniffs, but no longer wants to blow her sore, red nose.  Her fever, aches, diarrhea, chills, fatigue, and sore throat have all gone away.

She’s…fine.  Yet, I still hover and query as she grows more impatient with my ministration.

I can’t help it.  I’m her mom.

My 10-year-old remained healthy throughout her sister’s bout with H1N1, but I had to get her vaccinated.  We’re big on vaccines in this house.  We prefer a poke in the arm or spray up the nose to days or weeks of feeling miserable.

When my teen became infected, the H1N1 vaccine had just come out but couldn’t be found in our area.  I was determined to track it down for my youngest.  The county health department wasn’t much help.  The pediatric clinic my girls go to, the largest in our town, said it had not received any and didn’t know when they would.

A couple of days ago, I realized that I had failed to ask the clinic if they knew who did have the vaccine.  I called and was told they’d received a surprise shipment that morning from the health department.  They were vaccinating for that one day only and would stop at 4pm.  It was 3:10 and my daughter was somewhere close, on her way home, bouncing on the back seat of the school bus because that’s where fifth graders get to sit.

She finally got home and we jumped in the car, arriving at the clinic about 3:30 p.m.  Because the parking lot was full in front, we had to park in the back forty, hike to the building, and climb through some bushes to get to an entry.  Which we did–in a hurry–with me pushing or pulling her the entire way.

The line at the pediatric desk was long and slow.  I kept glancing at the clock while shifting from foot to foot.  The line was not moving.

In a loud voice, I asked if the H1N1 clinic was in this office and if it was really closing at 4 p.m.  Whispered conferences were held behind the desk and someone said the clinic was two floors up, but they were out of vaccine.  Being a mom, I shouldered my way to the front of the line and explained that this couldn’t possibly be because the woman on the phone told me they would be vaccinating until 4 p.m. and we had another 20 minutes.

The whisperers disappeared into the back.  Mutterings were heard, but not deciphered.

After four minutes, a head appeared around the corner and said they were still vaccinating in room 330.

We rushed to the elevators.  I just stopped myself from butting in front of a woman who was slowly moving forward with the aid of her walker.

Shortly after, and with five minutes to spare, I watched my youngest get vaccine sprayed up her nose.

I know that some parents are worried about the vaccine.

It was made quickly, and that makes parents wonder.  I had some questions for a few scientists when the vaccine came out, which they answered, and I realized that, although the vaccine was made quickly, it did go through clinical trials.  It was made the same way the seasonal influenza vaccine is made each year.  It’s effective and it’s safe.

I’ve seen both sides of this rotten H1N1–one child infected, the other protected.  There is no doubt as to which I prefer.

(This personal account was provided by Trish Parnell, a very relieved mom.)

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To Veg Or Not To Veg

22 09 2009

Vegans rule!If my teenager told me, her pork-lovin’ mama, that she was a vegan, I’d slam my sausage down and tell her to glue her fanny to a chair until I got a dictionary.

Turns out vegans don’t consume animal food – not even dairy products.  They don’t even wear leather shoes.

OK, first thing any involved parent will think about is: How is this going to affect my life?  Will I have to cook two meals, one vegan and one for regular people?  Just how much of a pain is this going to be and when is she moving out?

Oh, and how healthy is this lifestyle choice anyway?  (Yes, I eventually got there.)

If your teen is exploring vegetarianism or even veganism, here’s some animal-free food for thought.

The American Dietetic Association says that vegetarian and vegan diets can be healthy for people of any age, even for children. These diets are generally low in saturated fats, lower in cholesterol, and higher in fiber. These factors put vegetarians and vegans at much lower risk of obesity, heart disease, and type II diabetes than most meat lovers.

Vegetarians usually omit meat, poultry, and seafood from their diets, while vegans eliminate all animal products, including eggs and dairy, although there are vegetarians who eat fish and poultry and vegans who love their egg whites.  Apparently there’s room for personal choice.

Teens, whether meat-eating or not, are infamous for poor eating habits. Vegetarian and vegan teens, like all teens, need parental support in making healthy food choices. The key to a healthy vegetarian diet, like any diet, is variety. Parents should be aware of the vitamins and minerals that may be lacking in a vegetarian diet, particularly if variety is sparse.

Vitamin B12 is important in the formation of red blood cells and maintaining a healthy nervous system, and it’s essential for proper growth. A B12 deficiency can cause irreversible nervous system damage. Naturally, this vitamin is only found in meat, eggs, and dairy products, so look for fortified soymilk, cereals, or nutritional yeast if your child is vegan. Many meat-substitute products also contain B12.

Calcium is an essential mineral for many body functions. Blood clotting, muscle function, and the nervous system require calcium. When the body lacks calcium for these functions, it draws on calcium stored in the bones, leading to decreased bone density and possible fractures. Besides dairy sources, calcium is found in soymilk, calcium-fortified juice, soybeans, tofu, broccoli, and many other vegetables.

Vitamin D plays a vital role in regulating many organ systems and endocrine functions, as well as maintaining bone structure. Fish, eggs, and milk are great sources of vitamin D. As little as fifteen minutes of sun a day on the skin can provide some vitamin D. Fortified soymilk, juices, and cereals provide vitamin D, but a supplement for vegans is probably a good idea, especially in the winter months.

Iron is essential for oxygen transport in the body, as well as for the production and survival of all cells in the body. Green leafy vegetables, tofu, beans, fortified cereals, and meat-substitutes contain iron. The problem is that the body does not absorb iron from these sources as readily as it does from animal sources. Menstruating females and other teens may benefit from an iron supplement.

Zinc has numerous functions in the body and plays a role in nervous system function and reproductive organ growth. Red meats contain a lot of zinc, but it’s also found in wheat, beans and many seeds. Too much zinc can be harmful, so use care when considering a zinc supplement.

Proteins are made of amino acids that are essential for almost every body function. Surprisingly, nearly all vegetarians get enough protein. A vegetarian or vegan teen should eat a balance of legumes, nuts and seeds, vegetables, and whole grains every day. Eggs and dairy provide plenty of protein, if that’s part of their food plan.

If your teen announces he’s become a vegan, then yes, it’s going to mean more work for you.  But, with a little help from you, his doting parent, he’ll be eating foods that are good for him and, bonus, you don’t have to fork out the bucks for leather anything anymore!

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