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Back-to-School Parenting: Addressing Common Ailments

It’s that time of year again, when prepared parents get a head start on supply shopping while our children eagerly pick out new backpacks in anticipation of the rapidly approaching return to school. As both a parent and a pediatrician, I’ve found that this is the time when it’s also useful to arm oneself with information about some of the more common ailments and health-related challenges of the season.

What first comes to mind, in addition to the annual scramble to get school physicals and sports forms signed (a necessary and important pre-requisite for getting the school year off to a good start), are the not-so-eagerly anticipated maladies that predictably show up each fall. While children predictably share everything from strep throat, pinkeye, and common cold viruses to dreaded head lice – I’ve found that it’s the back-to-school headaches and stomach aches that have a way of leaving parents scratching their heads wondering which ones warrant being taken seriously.

When it comes to stomachaches, parents often find it difficult to determine which ones are “real,” and which are simply the result of not wanting to go to school. By “real,” most parents are thinking of the stomach-flu type illnesses that often cause symptoms like fever, vomiting and/or diarrhea. It’s important for parents to understand, however, that stomach aches not attributable to a virus or other medical cause can still be quite real. Stress-related stomachaches in school-age children are actually quite common and often said to be the equivalent of headaches in adults. Even if the underlying cause is due to a child’s stress or desire not to attend school, very “real” symptoms (such as vomiting and diarrhea, but not fever) can result, and it’s worthwhile trying to identify and address the underlying cause(s).

Similarly, the appearance of headaches can often cause parents to question whether they are serious or simply related to new school year nerves. When it comes to getting a head start on school-year headaches, as well as stomachaches, it’s always important to consider when they first start (after the first day of school? or during the family’s eagerly anticipated summer vacation?), when they occur (first thing in the morning? Or after a long day of reading and/or computer use?), how bad are they (do they make your child stop doing even those things they really enjoy? Or only get in the way of chores and going to school?) And what makes them better or worse.

There are common medical explanations – the eye strain and/or the yet-identified need for glasses, or the onset of seasonal allergies, for example – but it’s equally important to enlist your child’s doctor if you need help sorting out stress-related causes of headaches and/or stomach aches, as the resulting symptoms can be just as “real,” and addressing them just as important.

Getting a handle on these school-time ailments, as well remembering to help ensure your children get a good night’s sleep and eat a good breakfast, will go a very long ways towards making this a more enjoyable and productive school year.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Top reasons people visit the doctor during the summer

As my children finish out another school year and the whole family settles in to our summer routine, I can’t help but be reminded of how nice it is to have made it through another winter of cold and flu season. After a winter of spending significantly more time indoors and in closer quarters with other people – the characteristic of winter which inevitably leads to more effective sharing of illness-causing germs and more frequent trips to see the doctor – I routinely find myself welcoming the sunshine, the swimming, and all of the other outdoor activities that summer brings.

As I buy my summer supply of sunscreen, fill prescriptions for allergy meds and remind my teenagers that they are still expected to wear their bicycle helmets, however, I am also reminded that stepping into summer fun and sun is not without its own set of reasons to visit the doctor. After all, this warmly welcomed season comes with its own set of most common illnesses, ailments and injuries.

Seasonal Allergies. For millions of allergy sufferers, some of the sure signs of summer – freshly cut grass, pollen and weeds to name a few – also serve to bring about itchy eyes and runny noses. Allergy symptoms that often start in the spring can and often do persist throughout the summer and into the fall, and can range from annoying eyes, nose and skin irritations to more serious sinus infections and difficulties with breathing and wheezing – all of which may warrant a trip to the doctor for diagnosis and/or treatment.

Bites. Need I say more? Spider bites. Mosquito bites. Tick bites. These too are the signs of the season, and in some cases warrant a trip to the doctor – in some cases for identification, because of increasing pain, redness, swelling, or the appearance of a rash, or for symptomatic treatment.

Broken Bones. Along with the welcoming outdoor weather and increased physical activity of the summertime comes a noticeable increase in injuries which, in addition to the common bumps, bruises, and skinned knees characteristic of the season comes the increased likelihood of broken bones. While necessitating a trip to the doctor, the good news about broken bones is that despite the temporary pain and limitations, children’s bones actually heal incredibly well.

Diarrhea. Not only do summer viruses have the distinct ability to cause some less-than-desirable effects when it comes to vomiting and diarrhea, but so do several bacteria known for contaminating food and summertime fun. That means that in addition to recognizing and regularly acting on the importance of hand washing when dirty, when in contact with germy hands or surfaces, or when exposed to someone who is sick, remember to heed.

Rashes – in addition to bug bites, rashes such as heat rash, increasingly dry skin and eczema, sunburns, and contact rashes such as poison ivy all tend to make their appearances in summer. Generally, a trip to the doctor is warranted either to figure out what the rash is, and/or figure out how best to treat the often-associated discomforts.

Stings. Head outdoors in the summer and you’re sure to find bees. While I only just finished listening to a world-renowned bee expert give a TED talk on how crucial bees are to the world’s food supply, nevertheless as a physician when I hear “bees” I think bee stings. While a run-of-the-mill bee sting doesn’t typically necessitate a doctor visit, some people can have enough pain, swelling and even – in some instances, all-out allergic reaction that requires medical attention.

Sun-related. While sun may be one of the things we all look forward to most about summer, having a healthy respect for its ability to cause sunburn, dehydration and heat stroke – especially during the peak hours of 10a to 2p – can help keep your family out of the doctor’s office, as can making sure you stay well-hydrated and well-equipped with sunscreen.

Swimmer’s ear. Also referred to as “otitis externa,” this common ailment of summer occurs as the result of repeated exposure to water, and typically presents itself as an annoyingly itchy and often painful irritation of the ear canal. While the pain and redness are often alarming enough to bring people in to see their doctors, the good news is that simply drying out the ear canal and treating the infection work very well.

Viral illnesses. While we all tend to think of winter as the time for cold and flu viruses to lurk, there are still plenty of summertime viruses – most notably a group called enteroviruses – that can cause anything from vomiting and diarrhea to hand foot mouth, and/or croup-like illnesses. In most cases, what most determines the need for a trip to the doctor is the persistence of high fevers, dehydration, lethargy, accompanying rashes, or simply reassurance.

Well visits (for school). I would be remiss as a pediatrician if I did not remember to mention that while you may think of them as “school physicals”, summertime is actually a great time to beat the crowds of people who wait until just before school starts and take your school-age child in now for his/her annual well visit (not to mention camp physical, sports participation physical, etc).

Originally posted on Omaha World Herald’s Live Well Nebraska

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Signs of Spring: Recognizing, preventing and treating seasonal allergies

While most people welcome spring with open arms, an estimated 35 million new and seasoned allergy sufferers may not be so excited. These folks are generally the first to realize that spring is, quite literally, in the air. They’re faced with questions about how to recognize, understand, prevent and treat seasonal allergies. While it’s hard to believe with snow still on the ground, the fact is we’re fast approaching that predictable time of year when the runny noses of “cold season” are replaced by those provoked by pollen.

In general, think of allergies as the body’s over-reaction to something. That “something” being an allergen – certain foods, pet dander, dust, medicines, mold spores, pollen, etc.

Every person is different when it comes to whether their body reacts to allergens, which ones and how bad. Some people go through life with no allergies whatsoever. Others experience reactions ranging in severity – from a simple runny and/or itchy nose, eyes, mouth, throat and ears, to wheezing or worse.

These symptoms definitely have some overlap with those of the common cold. In fact, the runny/stuffy nose and sneezing offer little insight into whether a cold or an allergy is to blame. Coughs, on the other hand, are more likely to mean cold. And the presence of itchy eyes or nose points to allergies. There’s actually a term for that habitual upward nose-wiping gesture you often see kids doing. It’s called an “allergic” or “nasal salute.”

If you start seeing possible allergy symptoms in your kids, have a conversation with their pediatrician. Figuring out the cause of your child’s symptoms is going to determine how best to treat and prevent them. The ideal approach is to prevent exposure to the culprit allergen(s) altogether. In many instances, avoidance can be challenging but nevertheless doable – like peanuts or penicillin.

In contrast, spring’s molds and pollens literally make their way into the air we breath, making absolute avoidance much less realistic. A typical pollen season can run from March through October, and the amount of pollen in the air can vary from day to day depending on the weather (with hot, dry and windy days especially bad). Keeping windows closed, using an air conditioner, air purifier, humidifier or air filters, and staying indoors when pollen counts peak can certainly help.

There is also a wide range of medicines – antihistamines, nasal steroids, decongestants, and allergy shots – that help prevent allergic reactions or minimize symptoms once they appear.

Be sure to brush up on your allergy-prevention plan and treatment if your child has been diagnosed with seasonal allergies in years past, and check in with your pediatrician if you suspect them.

As we jump straight from the snow into spring, many little noses are likely to keep on running, so keep an eye out for the telltale signs of allergies vs. cold. And it’s not a bad idea to continue to keep a box of tissues on hand!

Originally posted on Omaha World Herald’s Live Well Nebraska