Rx For Parenting Today

Eating Disorders in Kids

I  have had far too many kids with eating disorders as patients.  These were not only mostly girls with anorexia, but kids who would eat only certain foods. These were not foods they were allergic to but foods they just did not like. Once in a while I had to ask for help from a psychologist, but generally I solved the problems in a simple way. I asked the parents just to give the patient the same food that everyone else had and not offer special foods the kids would eat. Snacks were not permitted, so of the patients got hungry enough they started eating what the family did.

I think these problems started when special foods were provided and then the problem  would get worse and worse. The family could not go out to dinner unless the particular foods were available. One mother was a physician and I think it was just easier for her to provide the special foods rather than call it a problem. That particular youth did need some counseling and for him I think a lot of it was attention-getting. He seldom saw his mother, never saw his father and was seeking attention. Gradually he became happier as the parents paid more attention to him. So for some food was certainly an attention-getting mechanism. 

Pediatric Care in the U.S.

I am often amazed at what parents tell me about the  pediatric care their children are receiving or not receiving in the U.S. One mother told me  her daughter's pediatrician had never looked below the child's waist. I was appalled. I have found many abnormal things by doing a complete physical exam once a year on kids. 

When I ask parents if yearly urinalysis are done, the answer is usually "no".  Every child, even little ones, should have a yearly urinalysis done. I have been amazed at the many problems I  have found by doing this. One teenager was not feeling well when I examined her, but I was unable to find anything wrong. I did check a urine, but it was O.K. I asked the girl's mother to bring her daughter back the next day.  Once again, there was nothing specific I could find wrong. I asked for another urine and the mother said, "but you did one yesterday." I told  her I would not charge for doing it, but did want another urine. The girl brought back a urine specimen that was brown. I knew immediately she had pyelonephritis. This can be extremely dangerous and I started her on antibiotics. The mother was very grateful and subsequently referred many other kids to me.  I saw the teenager many years later in San Francisco when I was doing a book signing and was delighted that she looked so happy and healthy. So parents please insist  a yearly urinalysis be checked on your children. A lot of problems could be found and helped.

Teenagers and Social Media

It is hard to watch the news and hear statistics about teens, who because they are active on social media,  may do harm to themselves. It  got me to thinking about what I would do if I was the parent of a teenager. I would certainly find a lot of fun activities the kids could become involved in, jobs they could do, or ways they could volunteer to help others. What are parents thinking if they allow a teen to spend hours on a computer being involved on social media sites? Don't parents have any  control of what their kids are doing these days? What about chores, helping around the house? Do teens these days learn to cook, sew, knit, iron, have music or art lessons, or have homework to do? I started working when I was 12 and later on worked as a waitress after school and on weekends. Money was tight for us as a family, even though my father was a college professor. 

Both of my children had sports activities and music lessons, and my son became very involved in theater.  My daughter volunteered at a school for children of  low income parents.  Then  later, after college she started a  program in San Francisco to help kids with disabilities find jobs and my son became a physician. If you are going to  be a parent, it is a hard job, but very rewarding if you take the job seriously. Are parents too involved with their social life, their jobs, shopping, or themselves? Something is very wrong if a child thinks suicide or hurting himself or herself is the answer. One of the reason I sold my much loved pediatric practice was  either I was going to  have to adopt some of the children who were in such pain or  open an orphanage.  

Raising Children with Manners and Morals

It must be hard to raise a child today with both good manners and good morals. With all the anger, division, and craziness in the world today, what can parents do? I think the answer is to go back to the basics of good  parenting. Children want and need to know their parents are in charge. Parents are also role models for their children. If you cheat, are unkind to people, and think money is the more important than anything else, how do your children know what is right?

I have seen all kinds of parents as a pediatrician. Some were wonderful parents, some were terrible parents, and some were essentially absent parents. When a child is raised by a nanny, a grandparent, or someone else, how do they know how to parent when they have children of their own? Some parents today just want to be friends with their children and are afraid if they ever say "No" that their child or children will not love them. I do not know where that concept came from or when it started, but it is just plain wrong. Children have much more respect for a parent who is in charge and from whom they can learn both good morals and good manners. It is a lucky child who has this kind of parent.

Keeping Babies Safe from Falling.

Now that the days are so difficult parents have to be particularly careful to not let their stress keep them from being vigilant about the safely of their children.

I remember one patient I had where the mother laid a baby on a bed while she did something else. It did not occur to her that the child might roll over onto the floor. But that is what happened. The baby did O.K. but we all worried for several hours. Now it has been reported by the CDC that there are about 2.8 emergency room visits a year because of falls by infants when the doorbell rings or a parent or caretaker needs to use a bathroom or do something else. Also remember that babies should always sleep alone and on their backs. I shudder when a grandparent tells me that a grandchild sleeps with the parents. Do the parents have any idea how risky that can be?  It is very tiring to care for infants  or little children, but a single mistake can  have a life-long effect.

With this awful pandemic, I worry about  all the babies being born and wonder if they will survive their parents' stress level. This is a particular problem if there are other children in the family and they have either not been  immunized or not yet able to go to school. I am certainly thankful that my children and grandchildren are adults. It is very important that parents find ways to take time off, have a little fun and relaxation. Parenting is  hard work and it never over, but the rewards are immense.

Children and the Pandemic

Children are becoming ill and far too many (450) are dying from the virus. Are they being exposed by family members, friends or teachers? Now 29% of the Covid cases are children. I do not understand how any adult could be so SELFISH as to say they will not get the vaccine. Tucker Carlson and his counterparts are certainly responsible for much misinformation. It is hard to believe that Tucker Carlson grew up in the same  small community where I now live and went to Country Day where my children went. Does he just care about the money he makes and the power he has? That is selfish and completely wrong. Of course, he and his family have had the vaccine. 

I am so very glad that I don't have school-age children. No, I would not send a child to school unless I could be assured that every adult and all the children age 12 and up had been vaccinated. If I were a school board member or a Principal or in charge of several schools I would mandate that everyone be vaccinated. That should not be a choice. I wish pediatricians and family doctors would be more out-spoken about the need for everyone to be vaccinated. I have not seen that. Nor have I seen anything from the AMA or other large medical groups about the importance of vaccinations.  

 

Hospitalizations for Children

As more and more children are being admitted to hospitals for the Covid 19 virus, parents and relatives need to be very sure  a child is getting the best possible care. This is a difficult time with doctors and nurses and other personnel tired and being pushed hard to care for all the patients. I do not understand why any adult would not have the vaccine. That is selfish and can cause a relative, friend or child to die. 

If I had a child admitted to a hospital I would want a parent or relative to be by the child's bed at all times. There is a lot that can go wrong and a child will be frightened and lonely. I am not sure a special, much loved stuffed animal will be allowed, but I would ask. There may be restrictions about parents not being allowed to be near a child, but if they have been vaccinated and wear a mask they should be allowed to be by their child's bedside. Parents and relatives can take shifts, so there is always a familiar face for a child to see. It is also important that parents take care of themselves during these difficult times, particularly if  a child is hospitalized.

In general you would want the child's doctor to talk to you each day, but these are difficult times, so I am not sure that will always be possible. It is important to get to know the nursing staff and call them by name. They work hard and a good nurse is worth his or her weight in gold. 

Checking that your insurance covers the hospitalization is important and after a child is hopefully discharged, you need to check the bill very carefully. Lots of mistakes can be made.

 

Choosing Health Care

I am always amazed at how even people with advanced degrees don't seem to be able to find good health care and settle for care that is not only bad, but could be dangerous. When children are involved that is even a greater concern. The man who was instrumental in starting the concept of HMOs finally admitted  it was a very bad idea when he himself had care from an HMO.

A friend asked me to check on a doctor she was to see for severe back pain. Not only had he gone to a poor medical school, but he was not even an orthopedist with training in back problems. Before I would see any doctor whether it is for yourself, a family member, or a child, I would look on the Internet and check his or her training, how long the doctor had been in practice, comments about the doctor and if he or she has been in practice for more than a few years.  You also want to be sure the doctor is board-certified in his or her particular specialty.  I am sure there are good young doctors, but I would only go to a doctor who has been practicing for a while and also has had good training. 

If you decide to use an HMO, be aware that there are many restrictions, Also, they use many nurse practitioners who do not have MDs supervising them. They may also have restrictions on what specialists can be seen, conditions that are excluded and  out of state emergencies not covered.

Before you sign anything, read the fine print very carefully. It could save your life or that of a family member. 

 

The Possible Tragic Effects of the New Texas Law

If the new Texas law is allowed to stand, I fear there will be terrible consequences. If teenagers and women can not get abortions, the number of foster, abandoned, and abused children will increase greatly. I don't think people understand that when a woman or teenager is raped and cannot get an abortion, they will try every possible way to get rid of it. This could result in more children with disabilities. What if a woman cannot afford to raise another child or she has been deserted by the father of the child? I saw one mother who had a boy with Duchenne muscular dystrophy and knew she was a carrier of the gene. Her husband insisted she keep on having children, but once another boy was born with dystrophy, he left. Thus she had little money, two boys with this fatal disorder and sadly a doctor who had no idea of the best care for the youths. I spent a lot of time with her and was able to give the boys the care they needed, but it was a struggle for both of us. Children will be abandoned, abused and if they are put in the foster system, they are often used as servants or abused. 

I do not believe that any religion would want children to be abandoned, abused, or live lives that have little future. As a former Sunday school teacher I do not understand how people who base their dislike of abortions say this is because of their religion. That makes little sense to me. If you love children, as I do, you want them to have loving parents and homes. 

Parenting Teenagers

Teenagers who have compassion and interest in others are easy to parent and a real joy. I think parents have to be role models for kids to develop these characteristics. I was probably lucky because when I had my pediatric practice, my two teenagers got to know some of my patients with disabilities. They realized that life was not always fair. One boy in particular made a difference, I think. He was a large teenager and because he could get unruly and quite difficult, my nurse would give immunizations to him in the family car parked right outside my office. I'm not sure how Jennifer and Geoffrey knew about him or saw him but I know he made a big impression. They also went with me to the County hospital at Christmas-time and took gifts to some of the kids in beds there. That too, made an impression. My daughter started an agency, when she was out of college, to find jobs for kids with disabilities and my son  became an M.D. 

If teenagers see parents interested just in bridge, golf, shopping or similar pursuits, how do they realize  that many of their peers and others may have serious problems, are poor, or have parents in trouble, maybe even in jail? There are lots of opportunities for parents to  teach their  children about real life, but if they are given a car at age 16, a credit card, and are never expected to do chores or look for a  ways to help others how do the children learn about real life?