Dr. Thompson's Blog

Holiday Safety Tips for Parents and Grandparents

December usually becomes a very busy month for parents and grandparents with entertaining, baking, buying gifts, and trying to follow family traditions. Because the days can get pretty chaotic, it is important to  keep children's safety uppermost in your minds. One thing to be particularly careful about is toys.  Remember that some many toys have detachable pieces which if swallowed can lodge in a child's throat.  I would also check  for sharp edges. Remember, too, that magnets in toys are a problem because they can cause perforations or blockages in the intestines, if they are swallowed.

If you are decorating with Christmas or holiday plants, remember that the poinsettia and some holly and mistletoe plants are  poisonous. Candles can be beautiful, but you want to be sure that they are in a safe location and not near anything inflammable. If you forget and leave a candle burning, big trouble could result. Holiday lights should be checked for safety and turned off when you leave the house. 

Children need plenty of rest and routines, especially during the holidays. This is particularly true of those who fit into the autism spectrum. Hiring a baby sitter to help when you are stressed or overworked could make the difference in your life and your child's or grandchild's. A meltdown in the middle of shopping or entertaining can ruin things for everyone. Planning ahead for some extra help or trading childcare with a friend can help greatly.

If you have questions about the safety of toys or other gifts you are buying for children, the Consumer Product Safety Website can be checked at  www.cpsc.gov. Also, it is wise to always have the 800 number for the Poison Control Center posted. It is 1-800-222-1222. There is also a Web site at www.poisonprevention,org.

Happy Holidays!

Drug Companies and Their Outrageous Charges

Drug companies, such as Mylan, try to explain their outrageous prices by saying they have to charge so much for their drugs because of all the research and development they do. The truth is that European drug companies do just as much research and development but their charges are much less. Also, unlike our government, the governments control the prices drug companies can charge. European companies are not allowed to have the drug ads that we see in the U.S. and the U.S. and New Zealand are the only countries that allow drug ads on TV or radio. 

One statistic is that 4.8 billion dollars are spent annually by U.S. drug companies on advertising. That is just wrong and should not be allowed. In addition, drug companies pay millions of dollars to lobbyists and on mailings to doctors' offices. 

There just has to be a way for the new Congress to do something about companies like Mylan that makes Epipens for allergic people, but I am not optimistic anything will be done. However, if the American public starts protesting, perhaps a miracle could happen. Many people have to decide whether to pay for medicine or food. In this wealthy country that is just wrong. 

Medical Errors in Popular Novels

I have always enjoyed reading and find a good novel to be relaxing. However,recently I am finding more and more medical errors in books published by major publishing companies. I am puzzled why the editors don't have someone with a medical background check that the details are correct when a medical problem plays a major role in a novel. Not only are these errors annoying, but I think they can also cause problems. Recently, I started reading a novel where one of the children had been diagnosed as having Asperger's Syndrome. Not only was the syndrome misspelled throughout the book, but many of the details were incorrect. The child was put on a gluten-free diet, not at a doctor's recommendation,, but from a source on the Internet. There has not been any acceptable medical research finding that this diet can help. Instead, it can cause harm because some necessary nutrients will be missing from the diet. If a child has Celiac disease, a gluten-free diet is needed, but not otherwise. 

Another novel was even more upsetting, because the author had a boy in a wheelchair at age eight with the diagnosis of Duchenne muscular dystrophy. She also called it a disease and made several statements that were totally inaccurate. No boy with this disorder should ever be in a wheelchair at age eight. I have been the physician for countless youths with Duchenne muscular dystrophy and with appropriate physical therapy, night braces, stretching,orthopedic surgery and prednisone have kept many of the boys walking into their teens. I cannot imagine being the parent of a boy with this type of muscular dystrophy and reading all the inaccurate statements in this novel. That would be very upsetting. 

Constipation in Older Individuals

A friend, who is in his late sixties, called me the other day saying he was having problems with constipation and did I have any ideas. He was away from his home and was unable or unwilling to reach his regular doctor. I told him that as people get older the movement or motility or the bowel slows down. Then as seniors get less exercise and often gain weight that can cause addition problems. The problem got so bad that the man went to an Urgent Care place near where he was staying. The young woman doctor neither did a rectal examination or ask him about his diet. Both of these are unacceptable and just bad medicine.I wonder if medical schools are even teaching their students to do rectal examinations these days. I have picked up quite a few unusual problems by insisting on doing a rectal examination when I did a regular physical examination or if there was a bowel problem. The young doctor suggested that the man eat flax seeds and something else I had never heard of. Obviously, her interest was in holistic or alternative medicine. I went over the man's diet with him and suggested adding prunes, more fiber, a stool softener, and if necessary a mild laxative, such as Puralax. (This also goes by other names.) Some people find Metamucil works, but I have not found this to be helpful for patients. I suggested the man drink lots of water and get more exercise. Also, I reminded him that bananas and apples are constipating, as is rice. Sadly, few doctors discuss diet with patients, I have found, so if you have an elderly family member in trouble with constipation, do ask what the individual is eating

The Terrible Tragedy of American Health Care if the Republicans Take Over

I have great concerns about what will happen to our American healthcare if Mr. Trump and Paul Ryan take over the government in November. Twenty million people will lose their healthcare, as the Affordable Healthcare Act is eliminated. So far, I have heard nothing from the Republicans about anything else that would replace healthcare for these twenty million people. Medicare would be placed on a voucher system that would be a disaster and Medicaid or Medi-Cal in California would all but be destroyed.  People with disabilities and low incomes would be in serious trouble. Having cared for hundreds of people with disabilities, I know what a terrible problem that would be. Seniors would be in real trouble if Social Security benefits were decreased. I do not understand why Mr. Trump and Paul Ryan care so little about people, who don't have their money, their education, or their good health. What has happened to compassion? When I was growing up in a small college town, we didn't have a lot of money, but we knew everyone and people took care of each other. I can remember my mother fixing a meal for someone in trouble and seeing that the individual received it, often as he sat on the steps at our back door. At Christmastime, we helped make neighborhood gifts that were delivered to many. As kids, we all had jobs, baby-sitting, doing errands for neighbors, and as teens waiting table or working in the college kitchens. I cannot imagine many of the rich Republicans doing these kinds of jobs. Many rich people believe if they made it, so can anyone, but what about a good education, family support and good health? Compassion seems to be a lost commodity with many politicians or perhaps they never had it? 

Problems with Nursing Home Care for the Elderly

I have visited nursing homes that were good and some that were pretty awful. Now that people are living longer and many doctors have problems with letting elderly patients die, nursing homes are BIG business. I did not realize until I read an article in the 11/15/15 New York Times that nursing homes receive more money if they feed elderly patients with feeding tubes. Many of these patients have multiple medical problems, plus dementia and yet have feeding tubes to keep them alive. A living patient means more money for the nursing homes. I believe this is immoral and no doctor should authorize it. Of course, some families want their elderly relatives kept alive at any cost,  but since many or probably most of these patients are on Medicare, the families are not paying for their care, but instead taxpayers are paying. 

One problem also is that doctors are taught to keep people healthy and alive. Few doctors do well with dying patients, because many feel a death is a mark against them. Dying should be a part of living and if a person has multiple medical problems and dementia, they  have no decent quality of life. There is a statement I have long remembered that when the pain of life outweighs the pleasure, something needs to change.

I have cared for many babies, little children, and older ones with severe, degenerative neuromuscular diseases. The most important thing I always tried to do was to support and  communicate daily with the parents and talk openly with the children who were old enough to know their disorder was slowly getting much worse. Usually the one question the older patients  asked was "Would they be in pain?" I always assured them that pain would be controlled if there was any and that I would be there. Only one Duchenne muscular dystrophy patient, who was developmentally delayed, ever asked to be put on life support machines. The others refused this kind of care to prolong their lives. One 22-year-old left a wonderful letter to be given to me after he died. He told me  how much he appreciated my helping him to have as normal a life as possible. He was a remarkable young man who left a wealth of friends and a wonderful family behind.

Rx for Summer Medical Problems

Most people look forward to summer as a time to relax, have a vacation, and some fun. Without careful planning and awareness and anticipation of possible medical problems, summer plans can be greatly disrupted. In thinking about the medical problems I have treated and those that friends have had, I have some suggestions.  Because our weather is getting warmer and warmer, sunblock is very  important for those who spend time outdoors. The only exception is babies under six months of age. Unfortunately, some dermatologists disregard this about infants, despite the urging of the American Academy of Pediatrics.

Walking on the beach can be a problem if someone has left a broken bottle or there is some other sharp object. A first-aid kit is always wise to carry. Swimming precautions are important, particularly about diving into shallow water or not being aware of strong ocean currents.

Spider and snakes bites can be a problem in the desert or in canyons. I had to hospitalize one child,  a visitor, because of a bad brown recluse spider bite. Fortunately, he did well.

There are some summer viruses that cause fever, headaches, and diarrhea. Good hydration and treatment of the diarrhea is important. The Hepatitis A vaccine is important for all to have and those traveling overseas should always check the CDC website to see what they advise for overseas travel. Taking along an antibiotic and some medicine for diarrhea, as well as asperin or tylenol for kids is always wise. Remember that most hotels have an M.D. they can call, so asking for help may be a good idea with an illness.

College Students and Drinking

I heard a startling statistic today that 1825 college students die of alcohol ingestion each year.  This is a terrible tragedy. I cannot imagine sending a child off to college and having him or her die because of drinking. I guess I was fortunate being brought up in a college town where alcohol was not allowed within the city limits. My father-in-law was greatly upset when I was married in the beautiful Little Bridges Hall at Pomona College and no champagne was allowed at the reception. It was fine with me because my college professor father could not have afforded it anyway for all the guests.

Whne I attended Stanford, there was a fair amount of drinking at the fraternity parties, but I never saw anyone pass out from drinking. I can remember finding a potted plant at one party that was the recipient of most of any drink my date gave me. I have never been able to handle much in the way of alcohol and knew it right from the beginning. I think parents have to teach their children about drinking fairly early. The French probably have one answer and that is to start their  children early with sips of wine, teach them what a good wine is, and the kids then grow up appreciating wine and don't use it to get drunk.

Children even in grade school these days are starting to drink. When there is lots of alcohol at home and little food or parenteral supervision, it is understandable. This particularly true if the  parents drink excessively. I had to take care of one patient who was about three-years-old and was  thirsty early on a Sunday morning and so emptied the half-filled cocktail glasses. He was a most unhappy drunk!

 

Cheap Heatlh Insurance May = Poor Medical Care

I am always amazed  how many people put good medical care at the bottom of their priorities. Whenever I have moved to a new area, I have always made finding the best doctors  at the top of my list. Of course, you a have to be willing to pay for the best health insurance you can afford, because doctors who are on many HMO lists get by with offering as little care as possible.

A woman told me recently of calling her physician because she felt so ill and he said "get in a taxi and go to the hospital emergency room." A friend took her to a  nearby hospital and after an eight hour wait, she was told she had bronchities. Now the doctor does not even answer his phone!

The woman has always lived in nice apartments, taken fun trips, and put health insurance way down on her list of priorities. I  have given up trying to get her to change.  Now after being really ill, I hope she will re-think how she spends her money. Nice places to live and fun trips are important, but if you don't have good medical care, you may pay a high price for this.

When you  have seen people who had bad medical care and never recovered, you want to scream at our current medical system. Many HMO's are for profit and make their money by offering the least care possible. I cannot imagine being either an HMO patient or doctor. The doctors make more money  by not ordering tests and not referring to specialists. I don't know how any physician could tolerate that. I certainly could not.

 

Holiday Safety for Children

As I watched the mad black Friday scramble on TV, I wondered where  parents had left their children ? Are their days now going to be  filled  with getting, but not having family fun and giving? If each day is going to be a mad scramble of buying, baking, and  entertaining, how many children will end up in the emergency room because they were hungry and chewed on a left-over cigarette butt, drank some alcohol left over after a  party, or swallowed a magnet or detachable part of a toy?

Autistic children are prone to run away and with all the hustle and bustle of the holidays, how easy it would be for a child to slip away.  Lighted candles can be  a real fire hazard if they are easy  for children to reach. Do your children know the three rules of fire protection---Stop, Drop, and Roll? Knowing how to use fire extinguishers is also important for older children. Mistletoe and poinsettias are poisonous if ingested, as are some holly plants.

If your days become too hectic, it is wise to hire some extra help or a baby-sitter if you are not able to keep your eyes on the children. Kids can get into trouble very quickly and when they are bored and not getting much attention, it is amazing the trouble they can get into.

Old fashioned holiday fun is much  easier on children  then all the hype that now seems to go along with the holidays. I hope the image of people grabbing for merchandise sends a chill down most  parents'  and grandparents' backs and they find some simple holiday pleasures for their families to enjoy.