Rx For Parenting Today

Thoughts about Charter Schools and the Pros and Cons

Our educational system in the United States leaves a lot to be desired, particularly in low income areas. There was an interesting  article recently in the New York Times by Eve Ewing. She is a former teacher and has interviewed and researched charter schools. I like one paragraph  where she notes that  "Although  charter schools  have  improved, they are "less effective than their non-charter peers". However, she says they are "more effective for low-income students and students of color than for white and affluent students."

I was raised in a college town that should  have had good public schools. However, when I went to Stanford the professors would said, "Oh you would  have had that in high school." They were not talking about the high  school I attended!

One of the smartest things I did when my two children were growing up was insist they go to private school. Our San Diego public schools were not good and certainly do not seem to have improved. Both children received wonderful educations for which I am very grateful. We did not have the money to send them to private school and were living in a small rented house , as we were both just  starting to practice medicine. 

I worry greatly about the education many students are receiving. I think we can see that in many kids need for constant entertainment, social media, and the lack of inner resources so evident during this pandemic. Kids knowledge of other countries, other cultures, and even the history of this country seems to be greatly lacking. 

I hope the Biden administration will push our schools to do a better job and all  children will get a good education, as kids seem to in Europe.

 

Pregant Teenagers

I worry about many of the teenage girls today. So many seem focused on dating, clothes, and their appearance. I was fortunate growing up in a town with several colleges and a college professor father. My main concern was to get out of high school and go away to college. The boys in our class were pleasant, but seemed more interested in sports than dating, although we did have class parties and I always had a date.

I had a good friend, who is no longer living, who told me her mother was 15 when she was born and that you never wanted to get near her father's right hand. She didn't ever talk about her family, but from just those two remarks and her adult life, it was not hard to figure out what her family life must have been like. She had two bad marriages, several pregnancies, and multiple affairs. Even with good friends, she was very closed and did not want to talk about her family life. 

As a pediatrician, I have cared for several teenage girls who became pregnant and all but one were able to get abortions. One mother insisted her daughter carry the baby to term because  she wanted a baby to raise. I don't have a follow-up on either the girl or her baby, but have a lot of concern about both of  them. Having a baby as a teenager will change a girl's life forever. I do not understand the stance many people take  against abortions. If they could see the tragedies I have seen in the girls' and their babies' lives, I hope they would re-think their stance against abortions. The say it is a religious stance, but I don't think any religion would want to inflict the pain I have seen in pregnant girls. We now have 450,000 foster children in the U.S. Many of the kids come from homes where they were not wanted or the parent or parents could not afford to care for them. I hope we can do a much better job of caring for our children in the future than we are doing now.  

Should Student Loan Debt be Cancelled?

There is a push by several of the members of Congress to have all student loan debt cancelled. I agree with that for students from low income families but I  have a real problem with that for students from affluent families. Students who have never had summer or part-time jobs while at school should not have their debts cancelled. There are many scholarships available for students and I was very lucky to have a colleague of my father's, who was also a college professor,  to establish a scholarship so I could attend Stanford as an undergraduate and then medical school. However, I still worked hard every summer and also had two part-time jobs while I was an undergraduate. A good friend worked 40 hours a week  even while attending medical school. 

I find that many young people these days are accustomed to using their parents as ATM machines and the idea of getting a summer job or a part-time job during school time is beyond their comprehension. You learn a great deal about people if you work as a waitress or have a job in other service professions. 

What a Child Eats Can Affect His or Her Health

I have always taken a diet history when I do a complete physical examination and have been told by many medical students and residents that I am the only doctor they have ever heard do that. It has paid off royally in my ability often to make a correct diagnosis. A good example was a little boy who a pediatrician sent me from quite a distance. He thought the child might have Duchenne muscular dystrophy because he seemed weak. When I examined the boy I could find no signs of a muscle disorder. His diet history was quite startling. The mother was a single parent and a busy executive. She had little household help and said she would pick up food from a fast-food place and did little cooking.  I asked her to send me a three-day list of what the family ate. It was quite unbelievable. I told her my answer to feeding my two children was to  make out menus on the weekend and do the necessary grocery shopping and cooking. Two weeks later she called me and said "You have changed our family's life. We all get along better and everyone seems to have more energy." I saw the little boy again and he was a different child. I had to laugh that I "cured muscular dystrophy with a better diet." The referring pediatrician was amazed.

The teenage girls that I cared for who had anorexia and bulimia also gave me unbelievable lists of what they ate or didn't eat. I  don't remember having to hospitalize any of the girls.  By working with them and having a good psychiatrist follow them was what they needed. 

Allergies in Children

I am always amazed when I am asked to see a child with allergies that the parents have not been referred to a pediatric allergist. In small babies, cow's milk is usually the problem. Breast fed babies are lucky not be exposed to cows' milk if they are completely breast fed. A pediatric allergist should be seen as soon as parents suspect a problem. If a baby or child has eczema, a pediatric dermatologist should be seen.

The usual problem causes of food allergies are milk, fish, eggs, and chocolate. Some children become very allergic to dust, others to dog dander, grasses, weeds, mold, oak, elm, pecan and maple trees. In Rochester, New York, when we lived there,  schools were often delayed in opening if the pollen count was too high. The  pollen count was published daily in the local newspaper. Often children outgrow their allergies and allergy shots can make a real difference. If a child  has severe allergies, an Epipen should always been within reach, in the house, the car, at school and with relatives, or close friends. 

Air conditioners or dehumidifiers can  make a difference and special allergy-free mattresses, pillows and cotton blankets can help. Keeping the house as dust-free as possible is important.

Arthritis in Children

A friend called the other day to ask me what her grandchild's parents should do about the joint pain their five-year-old was having. The pediatrician didn't have any answers. The family live near the good Washington D.C. Children's Hospital, so I said they should make and appoint with a rheumatologist there. They also needed to make an appointment with a pediatric ophthalmologist and have a slit lamp examination done. The eyes can be affected in this disorder. When I was running a program for children with disabilities at Oakland Children's Hospital I stared an arthritis clinic and had a rheumatologist come down from UC Davis Medical Center to consult. She taught me a lot. I remember we had one teenager who was blind because her eyes had not been taken care of. She had fairly severe JRA. Unfortunately, the blood tests for JRA can be negative, so you have to be sure and  take a good history and  do a good physical examination. 

When I was working in the neuromuscular unit at USC, the  director asked me to see a child who was referred for a work-up. The child was  having hip pain at night and had no muscle weakness. My diagnosis was JRA and a year later the director told me my diagnosis was correct even though they had done a complete neuromuscular work-up. Sadly, this is not one of those disorders that is often taught to medical students and residents, so a good rheumatologist is usually needed

Finding Good Childcare

Leaving your child or children with a babysitter can be a scary experience even though you have done all you could to check the individual's references. I've had a couple of frightening experiences with babysitters myself when my children were small. Fortunately, everything turned out O.K. One thing I did to make sure the children were safe when I hired a  new baby sitter was to have a friend or neighbor stop by to leave something or bring back a dish they had borrowed. On one occasion my upstairs neighbor called my office and said "I think you need to come home right now." I ran to my car and was home quickly. The babysitter seemed groggy and I suspected she had taken some medicine or perhaps had had a seizure or convulsion. My neighbor watched the children while I took the woman to a friend's house. She refused to see a doctor and I found out later that she did not believe in doctors. Her references it turned out to be from people from her same religious sect. I was amazed when several days later she called and wanted to come back to work!

Good places to get referrals are childcare agencies, your family doctor or pediatrician, good friends, or employment services.  It is important to leave your child's doctor's name and telephone number, the number of the local poison center, police, fire department, and close relatives or neighbors who could help. Also leave the location of fire extinguishers, first aid kit, and your child's general routine, plus any special food allergies or food instructions. You can never be to careful when a child's life is at stake.