Dr. Thompson's Blog

Keeping Children Safe

Most parents are aware of things they can do to keep their children safe. By looking for frayed electric cords, having covers for outlets and putting safety gates at the top and bottom of stairs can all make a great difference. A playpen can be life-saving when you are cooking, working at your desk, talking on the phone, or getting your mail. Covering or making a barrier in front of a wall heater, so it is not accessible to a child is important. Keeping medicines up high and not in bedside tables, not having dishwasher soap or chemicals under the sink can  keep children fro getting into them. I've had patients hurt by all of these things.

Having adequate carbon monoxide and smoke detectors is a must.  I had a teenage patient who was having a lot of headaches. For some reason I asked about wall heaters. The parents were great and immediately had them checked when they got home. The heaters were defective and once they were repaired the youth's headaches went away. 

Most garages have lots of dangerous things a child can get into. A backyard can also be a source of problems. If you have a swimming pool, a fence around the pool is essential. Pool covers can be a problem because a small child can slip underneath one and drown. Fences and windows should be secure, particularly if a child is on the autism spectrum and likes to slip away.

One thing I always did before I went to bed was to walk around the house to be sure there was nothing my little children could get into if they got up very early. This is especially important if you have had a party or visitors. I had a small patient who drank from  left-over wine glasses and another  who swallowed cigarette butts. Both had to be hospitalized. As parents you always have to be on the lookout for problems and teach any older  children to watch out for  younger brothers and sisters.

Senior Medical Care When Traveling in the U.S.

If you are traveling in the U.S.by yourself or other seniors there are some precautions to take. As an older person, you want to be sure you carry a prescription for your glasses if you need them. Glasses do get broken. You also want to be sure you have refills  for any prescriptions you take. If you become ill on an airplane there may not be a physician on board. The airlines are somewhat better in the past about training their staff about what to do if someone becomes ill. I hope they are better, too, about having more medications available for physicians to use than they did in the past. I have responded to calls for a physician several times when I was flying.  One time it was necessary for me to have the pilots land the airplane mid-way across the country because there was no medication I could use to stop a man from  having seizures. From his luggage, we decided that he was using a stimulant and had been traveling for several days. I was accustomed to treating seizures in children, but there was nothing in the airplane medical chest  I could use. 

Most, and I hope all airlines  have defibrillators on board. I am told the staff are trained to use these. I  have found that some of the flight attendants in the past were quite difficult. One flight attendant insisted I show her my medical license. Would she had done that for a male doctor? Another one asked me if I wanted a glass of wine as I was listening to a person's chest and taking his blood pressure. Amazing!

My other concern, if you are traveling by car or bus, and become ill is about using urgent care facilities. Not all have a physician on-call. I have seen seen some grave mistakes happen when a non-physician tries to treat a patient. One teenager who had muscular dystrophy, was told he had diabetes and the nurse wanted to give him insulin. The parents called me and traveled for several hours so I could see the youth. A chest X-ray showed he had lobar pneumonia! He did well with the right antibiotics.

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.

Summer Safety for Children

Summertime can offers some difficult challenges for parents as they look forward to vacations and yet know their usual routines will be interrupted. If vacations are being taken near the beach, the sun can present a major problem. As global warming is a definite fact, despite denial by the Republicans, children's eyes and skin are at risk unless proper measures are taken. I live in a beach town and am astounded to see parents who have on hats and sunglasses and yet their chi ldren have neither.  I always wonder if they even use sunblock on the older children. The Amerian Academy of Pediatrics advises sunblock use after the age of six months, but not before. Before that a child should be covered as much as possible and if they are at the beach, they should be under big beach umbrellas and have on hats.

Sunglasses are also important and a recent article in our local paper stressed that "half of a person's lifetime exposure to ultraviolet radiation takes place by age 18." Overexposure to UV light can cause a condition called photokeratitis  which may cause lifetime problems. The Web site baby banz.com offers sunglassses for all ages, even small children.

Camping is enjoyed by many, but once again there are several precautions: insect bites, ticks, snakes, food safety, and even big animals have to be considered. Knowing what to do in each case should be carefully thought out before a camping trip is undertaken.  A first-aid kit is a must, as well as carrying extra needed medications and an Epi-pen for anyone with severe allergies

Hotels should be checked for windows that open without screens and cribs that are unsafe.

Safety for Children in Strollers

I have always worried aobut the strollers I see American parents using for their little children. It bothers me that the adult pushing the stroller is blocked from seeing the child. Generally, I find adult caretakers either talking on a cell phone or drinking coffee. The strollers that have a cup holder are particularly worrisome. If you have had to care for a burned child, as I have as a physician, you would never have a cup of hot coffee or tea sitting above a child's head.

I was delighted to see a German mother and grandmother the other day  pushing a small, cute baby in a strolller that had no cup holders. The baby was in a seat facing the adults. Both women were talking to the  child and he was loving it. We know when parents talk with their babies right from infancy that the children's vocabulary is much better than those babies who are ignored or are in a house where the TV is always on.

Not only  have I seen  parents totally ignoring their little children when they are in a stroller, but I  have even seen children with a drape or cloth over their faces. If a child had a convulsion, was choking, or  had another medical emergency, how would the caretaker know?

Automobile Safety for Children

An article in the 2/11/14 New York Times noted that "In 2011, 33 percent of children who died in car accidents were not buckled in." Also, twenty-percent of children under age one who died in car accidents were not buckled in and in proper car seats. The age and weight of a child should determine what kind of car seat or seat belt is required. There are several places parents can check to be sure they are using the proper car seats and restraints for their children. The National Auto Safety Hotline can be called at 1-800-424-9393. There is also a Web site at www.nhtsa.dot.gov that can be viewed. No child should ever die or be injured in a car accident because parents or caretakers or grandparents did not have the proper car seats and restraints.

If the proper restraints are used, a child has twenty-eight percent less chance to be killed in an auto accident. "Infants should be kept in a rear-facing car seat until they are twenty pounds and one  year of age." Booster seats should be used with proper seat belts or restraints until a child is four feet-nine inches tall. 

I hope that family doctors and pediatricians still ask about car seats, as I did when I was in general pediatric practice. I can remember a young, new mother with newborn twins that I saw as the  last patients in the morning. I carried one twin to the car and was horrified to find no proper infant carriers. We cared for the babies until the mother came back with two infant car carriers. The father was in the military and the mother had little money and no real support.

Medical Care When Traveling Overseas

I talked with a woman a few days ago about her plans to go on a long trip to Asia. She and her husband were in their seventies and he had had heart surgery a year ago. They planned to travel to some high altitudes and I asked if his doctor had said this was O.K. She said they had checked, but I wondered if the doctor had really listened to their question. The woman said they had had all the necessary injections, so I asked what medicines she was taking. She said they had pills for diarrhea and pain. When I asked about antibiotics, she said "Oh we can get those along the way if we need them." I  didn't think anything I said would make a difference, but knew she was making a mistake. I was remembering a good friend who I sent off to India with some antibiotics and he said I probably saved his life. He  had become desperately ill in a small poor village that had no doctor or place to buy medicine. Being prepared when you travel can make all the difference in the world. It is always wise to see if you can  get a doctor's name in an area where you might be traveling and also to have travel insurance. That way you can be air-lifted back to the U.S. if need be. You can check the Internet to buy travel insurance. One site is www.insuremytrip.com and another is www.totaltravelinsurance.com.

Be sure you don't start a new medicine just before a trip and carry extra glasses and drug prescriptions. I always carry an ace bandage which once came in handy when a friend and I attended a medical conference and she sprained her ankle when we were walking to dinner. So being prepared is always wise becasue a vacation should be fun and not a time of stress, pain, and worry.

Summer Safety for Children

I was buying some sunscreen the other day and was amazed at the number of sunscreens on the shelf said to be for infants. The American Academy of Pediatrics repeatedly says that infants from birth to six months should not have sunscreen put on their skin. I don't understand what the manufacturers are doing, so parents have to be aware of this caution. All children and babies need hats to protect them from the summer sun and to be under big umbrellas, if they are playing in the sand at the beach. I often see parents with hats on, while the kids go unprotected. A first-aid kit is wise to have when you are away from home or traveling, particu larly if a child touches a hot grill.

Drowning is a particular concern in the summer months, whether it is in a swimming pool, lake, or the ocean. Children can drown very quickly, so an adult should always be in charge and not reading a magazine or have their eyes closed. I've  had to take care of several children who drowned or half-drowned and were left brain damaged. All children should be taught about water safety and learn to swim, as soon as possible.

Hot dogs are fun for older chidlren at picnics, but little ones can easily choke. Pieces of cheese, raw carrots, other raw vegetables, and hard candies can also cause a little child to choke. Now there is a concern about the small magnets in many toys. Children swallow these and they burn a hole in the esophagus or feeding tube and deaths have resulted.  

So with some wise precautions, your chlldren should have a safe and fun summer.

Safety for Children in Parking Lots and Public Garages

I was sitting in a busy parking lot yesterday drinking a cup of coffee. Looking out, I saw a mother and two beautiful twin girls, probably about three years old, coming out of a ballet studio. The little girls were dressed in cute pink ballet dresses and the mother was carrying a small child. The mother opened the back of her big van and started putting the small child in the car. One of the twins started walking around to the back of the car and then to the other side. The mother was paying absolutely no attention to her when suddenly a car on the right started to back out. I was too far away to help in case the driver didn't see the little girl. Fortunately, the child then went to the left side of the car and was safe. I have been in this parking lot before and the last time kept a little child from wandering out into the busy driveway by blocking his way with my arms. Neither mother had any idea that their children had been in danger.

Having cared for many post-accident children, I am always amazed at some parents' total disregard for a child's safety. How easy it would have been for the poor driver to miss seeing the cute little girl and taking her life. He would have had a major lawsuit on his hands, when the mother was the one at fault.

One grandmother had her three-year-old by the hand in a parking lot going to her car when the lttile boy burst away and started running. Suddenly, a car came screeching around toward the child, but the grandmother had had hip surgery and couldn't run. She yelled at her grandson, but he didn't listen. A man getting out of his car saw the danger and scooped up the child, saving his life.

Be Aware that Regular Measles (Rubeola) is Spreading

A new article in the current Pediatric News caught my eye with a picture of a child with a wide spread rash on his face. I had no question that it was the measles having seen my own children and patients with the disease. (This was before a vaccination was available.) The child who was pictured had traveled to France with his parents for a vacation. Ten days after he returned home, the boy became quite ill with a fever, cough, and wide spread rash. His parents had not had the boy vaccinated.

The article states that in 2011, there were about 14,000 cases of measles just in France. This included cases of measles encephalitis and even deaths. In the United States, 217 cases were reported in 2011. If you have seen a child with measles that goes on to encephalitis, you would have, as I do, a hard time understanding why any parent would risk this serious illness happening to one of their children. They are also risking a possible death.

Now that we have many visitors coming from other countries and American citizens traveling all over the world, the risk of  exposure to an infectious disease or having one brought to the U.S. is very high. Dr. Wakefield's destructive article about immunizations causing autism has been completely refuted and he has lost his license to practice medicine in Britain.

I hope any parent who has not allowed their child or children to be immunized will realize that they could be causing their child's death or permanent disability.