Whooping Cough: California’s Preventable Epidemic

30 06 2010

Recent news reports warn that California stands to “…suffer the most illnesses and deaths due to pertussis, also known as whooping cough, in 50 years.”  At least 5 infants have died of whooping cough with another 600 suspected cases currently under investigation.  Public health officials have labeled it an epidemic.

It’s easy to forget that before the vaccine was made available, pertussis killed thousands of people and infected hundreds of thousands each year.  Once a vaccine was developed, cases dropped by 99 percent, but the numbers haven’t stayed that low. In 2008, there were more than 13,000 infections and several deaths.

It is estimated that a rising number of families in California are choosing to avoid vaccinating their children through the use of a “personal belief exemption.”  Given this trend, it’s no surprise that we’re seeing a resurgence in infectious diseases like pertussis.

Some basic facts about pertussis:

  1. Whooping cough is a highly contagious bacterial disease that infects the respiratory system.  Symptoms can appear mild at first, including a runny nose and a mild cough. When in doubt, take your child to the doctor right away.
  2. Infants can become gravely ill very quickly.
  3. Symptoms may progress to rapid coughing (sounds like a “whoop” in young children) coupled with difficulty breathing. Infants can turn blue from lack of oxygen.
  4. Left untreated, pertussis can lead to bacterial pneumonia and, especially in infants, seizure, encephalopathy, or death.

How to protect your child from pertussis

  1. The best way to protect infants from pertussis  is to vaccinate them according to the recommended schedule.
  2. Immunity from pertussis begins to fade by the time we reach our teens, so it’s critical that adolescents and adults get the one-time pertussis booster in order to cocoon the infants and others in their lives who are not able to be fully vaccinated.
  3. Keep anyone with a cough away from your child.
  4. Wash your hands and your child’s hands regularly.

Protect your children by talking to your provider to see what vaccines are right for your family. To read more about pertussis, go here.


Sunscreen or no? Flip a Coin!

28 06 2010

Have you bought sunscreen lately? From what the advertising claims, we wouldn’t get sunburned even if Scotty accidently beamed us a kajillion miles closer to the sun.

Sunscreens have never been on our list of things to watch.  They basically do one thing, and the higher the SPF rating, the more protected we are. Right?

Well, before we squirt goo from that bottle or mist ourselves, here’s something to think about. The Environmental Working Group studied 500 sunscreens and ended up recommending only 8 percent of those studied.

The problems they found were:

The Personal Care Products Council, an association representing sunscreen manufacturers and others, basically says it isn’t so.  They claim to do all the necessary testing and follow FDA guidelines.

Who should we believe? Wish we had an answer. More studies need to be done by various groups before we can be certain.



25 06 2010

When we’re in an Intensive Care Unit (ICU), either as a patient or as the caregiver of a loved one, we’re pretty scared and looking for all the help we can get.

Next time you find yourself headed to an ICU, ask for the Intensivist, or critical care specialist for the unit.

Intensivists are big picture people who review all available information and then develop a diagnosis and course of treatment for the critically ill patient. The plan they devise for the patient may change daily or hourly, because they stay on top of details and adjust the course as new information emerges—an essential element of high quality care.

Intensivists relish thinking outside the box, and their methods work. The survival rate of patients with an Intensivist running the ICU is greater than for those in an ICU without one.

Though qualifications and experience levels vary, these specialists are game-changers and often are the difference between successful and unsuccessful outcomes for critically ill patients.

An Intensivist gets information from many sources, including the patient and  the caregiver. If he or she starts asking you questions, don’t leave out even the smallest details. This is NOT the time to keep secrets.  You might be asked if your loved one has a substance abuse problem, or if the patient is supplemented with concoctions not on the “official list of medications.”  Share everything you know, as it’s impossible to say what might have bearing on the diagnosis and treatment of the patient.

An Intensivist usually has a specific time when he or she makes rounds. If you can manage to be there during that time, it’ll help you become part of the decision-making team.

Some tips for surviving the ICU:

  • Try not to be afraid.  The sights and sounds in the ICU are intense.
  • Use hand sanitizer or soap and water every time you enter and exit the area.
  • Don’t be afraid to touch and talk to your loved one.  And watch what you say, they can hear you.
  • Be considerate of the privacy of others, and obey the rules.
  • Ask questions of your doctors and nurses.  They have a lot of information to offer.
  • Rest when you can. You will be advised if you should NOT go home.  Keep a spare change of clothes and toiletries, if the circumstance warrants it.  Things can change quickly when someone is in ICU


5 Quick Tips for Nonprofit Facebook Success

23 06 2010

Social media (user- generated and interactive web content such as Facebook and Twitter), works incredibly well for companies like Starbucks and Coca-Cola, but did you know it can be powerful for nonprofits?

When it comes to communicating messages widely and effectively, Facebook has the potential to benefit most nonprofit groups regardless of size or budgets. And in terms of reach (number of people who use it), Facebook recently surpassed Google. This dominance is good news for organizations that learn to use it effectively.

If your nonprofit wants to broadcast information to a widening group of people, Facebook is the tool for you.  Like all social media tools, your success is linked to your ability to utilize it efficiently and effectively.

Once you’ve set up your Facebook page,  these 5 quick tips will help insure your success:

1. Build your fan base. Inviting your existing Facebook and email contacts to Like your page is time well spent.  It’s also effective to search out and “Like” other pages on Facebook that relate to your work, as you’ll often attract their audience to your page. Once you get your page “fans” to 20-30, you’ll be on your way. You should also participate in other page communities by leaving comments and notes regarding their links and news. If you want fans, you need to be a fan.  (Although the term “fans” is no longer prominent on Facebook, it indicates the frequenters of your page.)

2. Communicate with your fans. Fans are members of your page and have joined because they’re interested in what you’re saying and doing. Your Facebook page allows you to email your fans directly about timely matters such as upcoming events, celebrations, or contests (see point #3). The key to successful fan communication is to not spam people. Once a month is about right, unless there is something pressing or timely such as a call to action or an event.

3. Hold a Contest. Page contests allow you to inject some fun into your Facebook community and increase participation in and enthusiasm for your work. Some popular ideas include caption contests, guess the story behind the picture, or name our [fill in the blank] (fundraiser, new office space, new employee title). Contests can be fun, and are a great way to boost your page fan base.

4. Update page daily with news, links, and shares.  By updating your page with organizational news and views from around the web, you’ll help your fans stay plugged into your mission and message.

5. Put a Facebook badge on your website. Facebook makes it easy to create a badge promoting your Facebook page, which you can add onto an existing web page. If you take the time to create one and ask your fans to place it on their site as well, you’ll soon see a jump in your fan base. Don’t forget to put one on your blog!

For a nonprofit, sharing your mission through page communications will strengthen your work in the long run.  For more nonprofit-related tips on using social media, check out PKIDs’ Communications Made Easy program.


Improving Health Literacy

21 06 2010

Nearly 9 out of 10 adults have problems understanding and using basic health information.

Insufficient health literacy (a person’s ability to understand health information) is not limited to a select group.  It cuts across all cultures, levels of education and income, and all age groups.

We need to be educated to improve our health literacy, so that we can make optimal health-related choices.

Toward this end, the Department of Health and Human Services, led by Howard K. Koh, M.D., M.P.H., Assistant Secretary for Health, has developed the National Action Plan to Improve Health Literacy.

The plan does a good job of outlining the barriers to health literacy, identifying goals, and providing some steps to reach those goals:

  • Develop and disseminate health and safety information that is accurate, accessible, and actionable
  • Promote changes in the health care system that improve health information, communication, informed decisionmaking, and access to health services
  • Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in childcare and education through the university level
  • Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community
  • Build partnerships, develop guidance, and change policies
  • Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy
  • Increase the dissemination and use of evidence-based health literacy practices and interventions

The American Medical Association (AMA) Foundation has done a lot of work over the years toward improving health literacy, providing helpful tips and tools to physicians to improve communication and understanding between patients and providers.

In fact, lots of groups are working on health literacy.  If you search the term on the Internet, you’ll get half a million results or more.

If so many people are working on it, why is it still a problem?

It’s a tough nut to crack. Low literacy is a key factor in non-compliance with healthcare recommendations. For example, if the directions for taking medication are complicated, or the instructions for recovery from surgery are hard to understand, chances are patients will be reluctant to ask for help in deciphering the language and therefore they will not be able to follow the directions. In other words, they become non-compliant.

Unfortunately, many healthcare professionals don’t always know why a patient is not responding to treatment.  They may not know that there’s a non-compliance issue and that it’s connected to low health literacy.

Low health literacy plays a significant role in:

For the health of our population, we as educators need to become better at finding ways to improve health literacy. Perhaps Dr. Koh’s plan will blaze some trails.


Health Effects of the Oil Spill

18 06 2010

Oil spill—say those two words in a group of people and you’ll likely see responses ranging from anger to confusion to despair. The worst environmental disaster of our age is difficult to comprehend much less address in any real way. The extent of the damage to air, water, and soil quality won’t be understood for a long time, though they are being monitored very closely by CDC, EPA, and other organizations.

As parents, our first concern is the potential impact of the oil spill on our children’s health. Since the spill is happening now, data isn’t yet available to help us understand the health challenges the people of the Gulf Coast region, and more specifically the children in that area, will face. And what of those children already living with health challenges such as chronic infections? How will the spill impact their quality of life? No one knows.

According to former CDC Director John Howard, even the long-term impacts of the Exxon Valdez spill aren’t fully understood, noting that “One of the deficiencies there is that we were able to ascertain some acute effects but we didn’t follow through for chronic effects,” he said. “To be able to identify chronic effects, you have to start very early.”

While anecdotal evidence indicates the clean-up crew who worked the 1989 Valdez spill suffer from the Valdez Crud, no studies were conducted addressing the health dangers posed to Alaskan children by that spill.

Dr. Gina Solomon says that clean-up crew who worked more than “20 days in highly polluted areas, performing 3 or more tasks, having skin contact with oil, or eating while in contact with oil” were more likely to suffer dizziness, nausea, sore throats, and itchy eyes.

Environmental impacts are being felt by those living in the Gulf Coast states of Louisiana, Florida, Mississippi, and Alabama. There are no definitive estimates about the eventual range of the spill, nor are there any estimates about the date of containment. To stay current with the potential health impacts of the spill, check with CDC’s Health Surveillance.

Food – Seafood safety is particularly concerning during this spill. Though Louisiana has closed some areas of the coastline for seafood harvesting, other areas remain open. Both the NOAA (National Oceanic and Atmospheric Association) and the FDA are charged with public notification if or when seafood becomes contaminated. Currently, the FDA assures people that seafood is still safe to eat.

Air – The EPA is monitoring air quality using mobile labs along the coastlines of Alabama, Louisiana, Mississippi, and Florida.  As of 16 June, these labs have not detected levels of toxins such as propylene glycol high enough to cause health effects.  However, the dispersants used to clean up the spill do pose a risk to those working in clean-up efforts and those near these efforts.

Water – According to the EPA, drinking water should not be impacted by the spill. However, water used for recreation and industries such as fishing is obviously impacted. Each of the four states offer state-specific information via the CDC website.

Protecting the health of our children during an environmental disaster requires special care, patience, and persistence. As the potential health effects of the Gulf oil spill become known, more specific actions will be required.

What We can Do Now to Protect Our Family’s Health

  1. Monitor air quality and stay indoors if air quality becomes too poor
  2. Stay current with the CDC health updates
  3. Call the Environmental Hotline/Community Information Line with specific health questions- 866.448.5816
  4. Before heading to a specific beach, check the status of the spill in that area
  5. Exposure to crude oil, even in small amounts, can lead to dizziness, nausea, and blurred vision, and if your child is near a contaminated beach and complains of any of these symptoms, immediately take him or her to the doctor
  6. If your child is exposed to oil or oil residue, wash the area immediately using soap and water, or an oil-removing cleanser. For children with respiratory problems, the effect of the spill on air quality in and around Gulf Coast beaches will be exacerbated for them

What You Can Do to Help:

  1. If you live in the region, report any oiled wildlife
  2. Volunteer your time to help clean-up efforts
  3. Add the EPA oil spill widget to your Facebook page or website in order to inform more people about actions they can take in the wake of the spill.


Dr. Mary Beth Explains Fifth Disease

16 06 2010

Dr. Mary Beth, PKIDs’ advice nurse, tells us what Fifth disease is and that we can’t really prevent it! But, we can manage symptoms.

Listen now!

Right-click here to download podcast (9min/4.5mb)

Medical Info on the Internet. Reliable?

14 06 2010

When we or our loved ones are diagnosed with a condition, many of us turn to the Internet for information.

Last year, 61 % of Americans used the Internet to research health topics.

The question is, how do we know if the medical information we find online is worth the time spent looking it up?

The National Library of Medicine has a 16 minute tutorial in both English and Spanish that helps users distinguish between reputable sites and those that may not be credible.

When faced with a potentially catastrophic diagnosis, we want to believe the hopeful sites that promise a cure, no matter who the authors may be, but we’re better served in the end by paying attention to details that tell us if a website is trustworthy.

Following are some things to note when determining a site’s credibility:

  • Who sponsors the website and are they easy to identify?
  • Is the sponsor’s contact information easy to find?
  • Who are the sites’ authors?
  • Who reviews the text?
  • Is it easy to determine when something was written?
  • Is there a privacy policy?
  • Does the information sound too good to be true?

The Internet can provide real assistance to us as we work to become team members in our own health care.

One benefit to having access to new technology is we can arrive at our doctor’s office better prepared for the visit. Given that doctor/patient visits last on average only eight to10 minutes, this is good news.

The more we understand walking in the door, the more time we’ll have to get the information that only comes from our healthcare professionals.

Bottom line is, we shouldn’t believe everything we read on the Internet, but if we become discerning in our online research, we’ll be more effective health advocates for ourselves and those we love.


Labor Inductions Lead to Earlier Births

11 06 2010

It is my personal belief that pregnant women who are less than 6 feet tall should not be allowed to carry twins. Not literally, of course, but as a 5’3” pregnant woman carrying twins, I more or less cried with relief when my OB recommended an induction at 39 weeks.

Given a recent study which associates an increased rate of induction with lower birth weight and earlier birth, I ought to have paused a bit before submitting to the induction.

In the study, researchers found a correlation between the increased rate of induced labor in the U.S. (48% between 1993 and 2003) and earlier births, as well as lower birth weight.

Circumstances which merit an induction are hotly debated, with some decrying most inductions as invasive and unnecessary while others maintain that better technologies allow for more medically appropriate interventions.

Possible reasons for an induction include:

• Fetal distress

• Uterine infection

• 10 days past estimated due date

• Maternal medical condition

The reasons for the increased rate of induction were not investigated as part of this study, but the resulting earlier births and lower birth weights are of concern because of their correlation with complications such as respiratory infections and related illnesses. And the increased usage of labor induction could be a bellwether of further complications for newborns.

Most traditional healthcare providers will recommend against inducing labor unless it’s deemed medically necessary. Despite the temptation to push labor along using various “natural” methods, the Mayo Clinic recommends instead that you:

1. Stay in touch with your healthcare provider

2. Turn on your answering machine/voicemail

3. Relax and let nature take its course.

(Rachael Brownell is the statuesque mother of three adorable munchkins, and PKIDs’ Director of Outreach.)


Piercing? Stay Safe!

9 06 2010

Thousands of years ago, Egyptians loved to pierce their ears and wear jewelry as symbols of their status. However, only the Pharaoh was allowed to pierce his navel, and if others were caught doing so, they were put to death.

Mayans pierced their tongues for spiritual reasons, and the Roman centurions had their nipples pierced to hold their capes (ouch!), and to demonstrate loyalty to the emperor.

If you’re thinking of piercing, or even if you’ve done it but want more piercings, let’s talk safety.

The mall:

  • Piercing “staff” are often young and inexperienced.
  • The piercing gun is usually not a single-use device, and cannot be adequately cleanedInfections can come with piercings, if the staff don’t sterilize as they should, or if they reuse equipment. Some of those infections can be serious—hepatitis, tetanus or even TB.

The doctor’s office:

  • The healthcare provider that pierces your ears will do so with a sterile, single-use device, all while following standard precautions, which will significantly decrease the odds of infection.
  • Your provider might lack experience, so there’s no telling how the job will turn out, but it beats living with a disease for the rest of your life. Still, you may not be thrilled if you end up with lopsided earrings.

Your BFF’s house:

  • Tools and supplies may be purchased by anyone.  This does not mean your BFF, or her mom, is qualified to pierce your ears.  Due to lack of experience and the high probability that standard precautions will not be followed adequately, you’re going to want to rethink this option.

A professional shop:

  • Make sure that the piercer is a professional, follows standard precautions, and runs a clean shop. He should wear disposable gloves and change them between customers.
  • The piercer should be trained to avoid cross-contamination.
  • A sterile, single-use, long, smooth, hollow needle with a razor sharp tip, applied using a sterile mechanical device into a single-use sterile cork is likely the safest way to have your ears or other parts pierced.
  • Talk to your healthcare provider about any medical information that might be pertinent to your procedure.  Depending on the piercing, you might require prophylactic antibiotics, or the procedure might not be recommended at all.

A special note on tongue piercings and splitting: it’s important to read the warnings put out by the American Dental Association. It’s risky and the damage can be significant—and permanent.