Ask Emily

29 03 2012

Why does our hair thin out as we age? My aunt lost hair in unexpected places as she closed in on her 80th year.

The reasons for hair thinning as we age range from benign but perhaps unwanted processes to serious disease. One reason your hair may seem thinner as you get older is that each individual hair is itself literally thinner because the hair follicle narrows with age. The result is hair with less volume than you may have had before, which seems like thinning. Because thinner also means “breaks more easily,” you may see more hair in your hairbrush or after a shower, but that doesn’t mean your hair is actually falling out.

If your hair is really falling out, the usual cause is an inherited susceptibility to androgens. The official name is androgenetic alopecia (“androgenetic” refers to an inherited susceptibility to androgenic hormones and “alopecia” means hair loss). Most people are aware that men develop this form of hair loss, which we know of more colloquially as “male pattern baldness.” Men and women exhibit different patterns of baldness when these androgens kick in with age, and women tend to lose their hair over the front part of the scalp and have thinning all over. This loss in women also may be related to changes at menopause, and some research suggests that estrogen decline in addition to androgen activity could be involved. A recent study also found that malfunctions in the source cells for hair follicles may also be part of the pathway that leads to androgenetic alopecia.

While the loss itself is not harmful, the appearance that results can be particularly difficult for women, as most people don’t expect it to happen in women, in spite of how common it is. Treatments for androgenetic alopecia in women include use of compounds that block androgens or a compound called minoxidil that circumvents androgen activity and promotes hair growth.

While these common causes of hair thinning are relatively benign in health terms, thinning can also signal something more dire. One common health-related cause of hair loss is thyroid dysfunction. Emotional or physical stress, such as childbirth, major surgery, or severe infection can also elicit a widespread loss of hair weeks or even months after the episode occurs. The loss eventually slows.

Some infectious diseases can cause hair loss, including syphilis, while autoimmune diseases like lupus can also be to blame, although some forms of lupus and associated hair loss may actually improve with age and after menopause. In elderly women, causes of hair loss include pulling out the hair themselves in some cases, known as trichotillomania. Another potential cause of hair loss is giant cell arteritis, which is inflammation of the arteries in the upper body, head, and neck. If a person whose hair is thinning also has been diagnosed with cancer, any hair loss should be closely investigated for the possibility that the cancer has metastasized or migrated to the scalp.

The bottom line with hair loss is that any hair loss that is sudden, occurs in an odd pattern, or that you simply find worrisome justifies a call to a medical professional. As one scientific abstract noted, hair loss particularly in postmenopausal women “warrants close inspection.”

Do you have a question for Emily? Send it to:

By Emily Willingham

Image courtesy of  Wikimedia Commons

Facebook Timeline

26 03 2012

If your Facebook page doesn’t look like this (see below), you better get ready, because it will change over automatically to the new layout on 30 March.

That giant image at the top, called the Cover Image, is a significant change. Now, last week, we were helping to promote World Water Day, so we loaned our cover image space to Normally, we have something PKIDs-related up there. You will want something that relates to your organization’s work in that space.

The cover image dimensions are 851 pixels wide x 315 pixels high.

Open your picture editor and choose “new” to create a new image. Set the image size at the pixels stated and then just lay it out as you like.  Keep in mind that your profile picture (see our big purple P above) juts up into your cover image, so don’t put anything critical in that space when designing the cover.

Some Facebook rules about the cover image are:

  • All covers are public. This means that anyone who visits your Page will be able to see your cover. Covers can’t be deceptive, misleading, or infringe on anyone else’s copyright. You may not encourage people to upload your cover to their personal timelines.
  • Covers may not include:
    • price or purchase information, such as “40% off” or “Download it on”;
    • contact information such as a website address, email, mailing address, or information that should go in your Page’s “About” section;
    • references to Facebook features or actions, such as “Like” or “Share” or an arrow pointing from the cover photo to any of these features; or
    • calls to action, such as “Get it now” or “Tell your friends.”

Facebook has removed your automatic landing tab, if you had one, and given you this space instead. 

If you want new visitors (those who haven’t “liked” your page yet) to first land on a tab that encourages them to “like” your page, you can still do that. Create the tab, copy the URL for that tab, and use that URL in all of your hyperlinks that point to your Facebook Page. When they click on that hyperlink, they’ll be taken to your custom landing page.

You can have up to 12 tabs/apps. Four are viewable at any one time, and when folks click the down arrow, the rest appear for viewing. These are located under the cover image to the right of the About paragraph. You can move them around so that certain apps are part of the four that are viewable all the time. Put your page in edit, hover over the app icon and click on the edit pencil. At the top of the dropdown box it says, ‘swap position with’ and you just click the name of the app or tab you want to swap.

You can also change out the thumbnail image of each app/tab by clicking on the ‘edit settings’ and choosing Custom Tab Image: Change.

The image size for a thumbnail is 111 pixels x 74 pixels.

You can hover over the Liked button on a page and see a few options, one of which is to unlike the page. The Interests list is also located here. You should try it out to get an idea of what it is. It’s a way of bookmarking pages or people on Facebook and listing them under whatever list name you choose. You can make those lists viewable by all, some, or no one but your page admins.

I haven’t gotten into it yet, other than to create a list to see how to do it. I’m not sure if this is something that will be useful or not. But, because one’s newsfeed quickly fills up each day, being able to check out a list of interest to see what they’re up to—for instance, a list of vaccine advocates—would be a way to drill down through the mass of information you get each day.

There are a couple of things you can do to posts. Hover over one and click the star. That post will be highlighted and spread across both columns. Try it and see, you can always click the star again to unhighlight a post.

You can also ‘pin’ a post to the top of the wall for a week or just a day or two, whatever you want. If it’s something you really want everyone to see, try it. Experimenting is fine! To pin a post, click on the edit pencil of a post and choose ‘pin to top.’ You can always reverse your actions to unpin it.

There are a few more gewgaws to the new Facebook layout, but we’ll get into those later. You know enough to get set up. Don’t be afraid to experiment. And, if you have any suggestions for others, we’d all love to hear them!

By Trish Parnell


22 03 2012

My daughters and I took showers last night. I make the youngest go last because she’s a water baby and loves to play in the shower. If she goes first, the rest of us have to wait 40 minutes for her to exit the shower, and 30 minutes after that for the hot water heater to do its thing.

I drank tap water yesterday. It’s what I usually drink, unless it’s morning and then I drink carafes of coffee, which I make with tap water, but it seems like I’m drinking something else entirely since it’s coffee-flavored.

My kids drink tea- or juice-flavored water—there’s always a glass full of liquid near them. I wish they’d drink milk, but that battle was lost before it began.

All of this daily drinking, not to mention the platters of food we consume, sends us trotting down the hall throughout the day to use the toilet

It’s convenient to have a toilet, or better, several toilets in the house. They always flush our waste through the pipes, unless someone gets carried away with the toilet paper, and then it’s mom to the rescue with the plunger.

The dogs love cold, fresh tap water. Since their water bowl is three steps from the kitchen tap and the kitchen is a popular place, they get water whenever they want it.

Speaking of the kitchen, we have an appliance called a dishwasher. I put our dirty dishes in it, push a button on the front, and hot water swishes and rinses until the dishes are clean. The same thing happens to our clothes when I put them in the clothes washer.

Using water is one of the things we do best at our spot on earth. We fill pots and cook pasta, wash off the roof and sometimes the house, porch, deck, sidewalk and driveway, wash the cars, wash tubs and sinks and countertops and floors, pour it on plants and, when we had a hot tub, we put water in it. We even fill plastic guns and have water fights. We do lots of things with water.

We just turn a faucet, and we have water. is trying to do something for the one billion humans who don’t have access to clean water. And the whopping 2.5 billion who have no access to a toilet.

Take time today to check out their website and read about the lives of those affected by lack of water. If you’re so moved, make a donation. They’re turning on faucets all over the world.

Happy Water Day.

By Trish Parnell

Image courtesy of Bob West

Spring Break!

19 03 2012

Health tips from our friends at CDC:

Going to another country for spring break? Follow these tips to reduce your risk of illness or injury abroad.

Spring break means an escape from the daily grind. For high school and college students, it can be a rite of passage or an annual tradition. This is your time. It is all about you, and YOU are in charge of your health, safety, and well-being.

Getting ready for spring break is more than just picking a destination.

While you’re choosing among an exotic island getaway, a ski vacation, or just a short ride down the highway, follow these steps to ensure you have a healthy and safe spring break trip.

For those Going Abroad

Vaccination before vacation. Before you go abroad, find out about vaccines and any health concerns at your destination. Check with the local health department or a travel medicine specialist 6 to 8 weeks before you leave the United States.

It’s still flu season, and vaccines are the most important tool we have for preventing the flu. Talk with your doctor about getting a flu shot.

Travel health insurance. Consider health insurance if you’re traveling outside the United States, because your regular carrier might not cover expenses. Coverage for emergency medical evacuation can be useful, particularly if you do extreme sports, such as mountain climbing or heli-skiing.

Active vacations. Whether your sport is ice climbing or reef diving, depend on reliable outfitters for success. When making reservations, ask questions to make sure you will be with properly trained guides and will be using well-maintained equipment. Don’t take chances that might cause injuries—or worse.

You are what you eat. Tempted to indulge in the local cuisine? Food can be the best or the worst part of your international trip. In developing countries, eat only food that has been fully cooked and served hot. Avoid eating fresh vegetables and fruits, unless you can peel them yourself. Drink only bottled, sealed beverages, and steer clear of ice—it was probably made with tap water.

Is it worth the risk? The phrase “what happens on spring break stays on spring break” can imply that it is okay—even expected—to engage in risky behaviors that you would not normally consider in your daily life, but you should take your healthy behaviors on vacation with you:

  • Use latex condoms if you have sex (see Sexually Transmitted Diseases).
  • To prevent infections such as HIV and hepatitis B, don’t get tattoos or piercings.
  • Drink alcohol responsibly and be sure to have a designated driver.
  • Remember the basics of safe driving: wear seatbelts, maintain the speed limit, and avoid distractions such as talking on the phone or texting while driving. (Using a cell phone while driving is illegal in many countries.)

Travel wise. Here are a few other reminders to ensure smart traveling:

  • Wear sunscreen. Avoid overexposure to the sun by wearing protective clothing and limit time in the sun during the hottest part of the day, 10 am–4 pm.
  • Swim in safe places. Before jumping in, ask about bacterial contamination, water depth, and other hazards, such as sharp rocks or coral, riptides, and dangerous sea animals.
  • Pack smart and remember that prevention can be travel-sized. Carry your own stash of first-aid supplies and medications. Insect repellent and antidiarrheal medicine are musts.

Politics, politics. The US Department of State website,, helps travelers gauge the political climate of unstable countries.

You have been busy, you have worked hard, so now relax and have a good time—you deserve it!

More Information:
CDC Travelers’ Health

Here’s to Clean Hands

15 03 2012

It’s no secret that clean hands are one of our most effective weapons against infections. At PKIDs, we’re big on handwashing. One of our first projects as an organization was the development of a handwashing video for young kids. It still gets used today:

Several years later, PKIDs and students from the Art Institute of Portland developed a handwashing cartoon that’s perfect for middle school or high school students. It’s a flash program and can be played from a computer.

We also have a handwashing poster that can be downloaded from our site. There are two versions—one with PKIDs’ brand on it and one that’s unbranded, should you want to put your own contact info on it.

Yep, we think clean hands are a big deal in the fight against infections. If you know of any resources health educators can use, just put them in the comments section. Thanks!

Telling the School About Your Child’s Infection

12 03 2012

[Ed. note: One of our parents hired an attorney to write a letter to the preschool her daughter will be attending. She chose to inform the school of her daughter’s illness, but wanted to do so in a way that would best protect her daughter’s rights. She kindly offered to share the letter in case others would like to use it. We’ve edited it to make it generic, but PKIDs does not take responsibility for the contents of this letter or any person’s use of this letter, nor does the mom who provided it. Consider it a form letter for your adaptation. Please contact an attorney to review any documents you prepare.]

Please be advised that this firm has been retained by Mr. and Mrs. Smith. Mr. and Mrs. Smith are the parents of Jane Smith, a (number) year old girl who was recently enrolled in the ABC School.

The purpose of this correspondence is to address a situation that is of great concern to Mr. and Mrs. Smith, that is, the health and well-being of their daughter and those who care for her. The Smith’s daughter is a carrier of the hepatitis [B or C, whatever is true for you] virus.

Although there is no legal or ethical duty for my clients to inform you or the school of the specific health status of their daughter, the Smiths, in their personal discretion and out of an abundance of caution, have chosen to share this very private and confidential fact with you. In fact, the Centers for Disease Control do not advocate that parents of children with hepatitis [B or C] routinely inform day care providers of the hepatitis [B or C] status of their children.

Under normal conditions, a child with hepatitis [B or C] poses no threat to other children or to day care staff. Please bear in mind that the hepatitis [B or C] virus (hereinafter “HBV or HCV”) is not transmitted casually: it can be, for example, transmitted through blood, sexual relations, needles and mothers who carry [HBV or HCV] to their newborn child.

There is no data to demonstrate that hepatitis [B or C] is transmitted through feces or urine, nor is it transmitted by stool contamination of food or beverages, or casual contact. Changing diapers or helping children with “accidents” associated with potty-training generally do not place one at risk of contracting [HBV or HCV].

[This next paragraph is only for HBV kids in some states:] In addition, since the State of [your state] requires children to have a series of immunizations against HBV, it is highly likely that Jane’s classmates are already protected from any potential transmission of HBV. The medical information record required of children admitted to the ABC school indicates that such inoculations are mandatory for enrollees. I assume your day care staff have had such vaccinations and are similarly protected.

Regardless of any minimal risk a carrier of [HBV or HCV] pose to others, my clients and I assume that proper, standard precautions are taken when dealing with the bodily fluids of any child in the ABC school. You have been made aware of Jane’s condition, but you may not be aware of other children who may carry blood-borne pathogens as well, not just [HBV or HCV].

Mr. and Mrs. Smith wish to convey to you their desire to keep the lines of communication open and fully cooperate with the ABC School and its staff regarding this situation. Mrs. Smith has provided me with written materials that she has collected about [HBV or HCV]. If you would like copies of this literature to help educate staff members about [HBV or HCV], please contact me and I will provide you copies of this material. If you have further concerns, my clients are also willing to participate in any meetings you may wish to have with them, or you may discuss this situation with a health care professional of your choice.

Although Mr. and Mrs. Smith have chosen to disclose private, confidential information about their daughter to your organization, it is of the utmost importance that no one other than officials at the ABC school are to be informed about Jane’s health status. In fact, my clients would prefer that you limit disclosure of Jane’s [HBV or HCV] status to your staff members on a “need to know” basis and that as few people as possible be told this information.

Additionally, anyone so informed should be cautioned that this information is highly confidential and extremely private, it is not to be disclosed to other persons, particularly parents of other children in Jane’s class.
As you may imagine, my clients are very concerned that, should information be leaked to other parents, Jane may suffer retaliation, discrimination or be socially ostracized by other children or their parents.

There are a number of laws and statutes which protect the confidentiality of private information, including both health and educational records. For example, the Family Educational Rights and Privacy Act of 1974, 20 U.S.C.123g (the Buckley Amendment) mandates that any institution which receives federal funds is prohibited from releasing a student’s records to any one other than school officials who have been determined to have a legitimate interest in the child. There are also protections for privacy of a student’s medical records under the Americans with Disabilities Act, 42 U. S. C. 12101, et seq.

Mr. and Mrs. Smith have only sought my assistance because this subject is of such personal importance, they felt that a disinterested, objective person might be able to more effectively convey their concerns.

My clients and I trust that all of the parties involved in this situation will cooperate and work toward a positive solution to the concerns of my clients, as well as those of the school. Mr. and Mrs. Smith also hope that this fall is the first of many happy semesters Jane will spend at the ABC school.

If you have any comments or concerns, please feel free to contact me by 4:00 p.m. on (day/month/year), as Jane is scheduled to begin school the following day.

If I do not hear from you, I will assume that there will be no problem with her attending this school and/or you have encountered this situation before and are well-versed in issues of this nature. Thank you for your attention to this important matter.

Parents, Encourage Physical Activity!

8 03 2012

Spring and summer approach, and we begin to see the winter coats and boots come off and a new appreciation for summer activities blossom.

I am thankful to reside in the lovely “Aloha” state of Hawaii, where beautiful weather conditions grace us daily, although in any locality, it is difficult at times to keep our kids excited about their fitness and encouraged to stay healthy and active.

According to Duane Alexander, M.D., Director of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), “Lack of physical activity in childhood raises the risk for obesity and its attendant health problems later in life.”

As parents, we cringe at the thought of our children dealing with the long-term life health issues related to obesity, so what can we do to offer a healthy lifestyle? Lead by example.

The Weight Control Information Networks asserts, “Parents have an effect on children’s physical activity habits as well. You can set a good example by going for a walk or bike ride after dinner instead of watching TV. Playing ball or jumping rope with your children shows them that being active is fun.”

These activities can start at nearly any age. My daughter recently turned one year old. After work each day our favorite moments together are playing in the park. We practice “running” (as well as a toddler can), crawling up a steep hill, jumping, climbing, etc. Everything I do, she copies. It is a fun game for both of us!

The same can be done with elementary-age kids. I remember my dad teaching my sister and I how to play baseball. It was the biggest excitement of my day! He would play with us as a reward after we patiently waited for his personal workout to be complete. He encouraged us to play in the same general area as he was exercising to show that he felt physical fitness was important. Years later we competed in 5k races together laughing along the way. He showed me that exercise can be fun, and I enjoy it to this day.

Take the time to enjoy physical activity with your children; it will benefit their lives into adulthood and beyond!

Alexander, D. (2008, July 15). Children’s physical activity drops from age 9 to 15, NIH study indicates.
U.S. Department of Health and Human Services. (2010, April 07). How can I help my child be more active?  

By Melissa Parnell – Melissa will appear as an occasional guest blogger on this site. She is working on a graduate degree in Human Services with a concentration in health and wellness. She minored in health and wellness in college and is an AFAA (Aerobics and Fitness Association of America) certified personal trainer.

Image courtesy of Melissa Parnell

Pregnant Women and Vaccination

5 03 2012

Dr. Mary Beth Koslap-Petraco, PKIDs’ advice nurse practitioner, talks about the vaccines pregnant women need.

Listen now!

Right-click here to download podcast (8 min/4 mb)

Rotavirus At Any Age

1 03 2012

Dr. Mary Beth Koslap-Petraco, PKIDs’ advice nurse practitioner, fills us in on the reach of rotavirus. Any of us can be at risk.

Listen Now!

Right-click here to download podcast (7 min/3.5 mb)