A spoonful of honey – treating children’s coughs

honey and lemon2

‘Tis the season, coughs and snotty noses abound. A nasty cold or cough is uncomfortable for all, but for infants and very young children, unable to express themselves or understand what is happening, it can be particularly difficult. Before you go out and get an over-the-counter medication to soothe your child’s throat be aware of the warnings against using over the counter cough and cold medications.

In 2007 a number of children’s cough medications were withdrawn from the market. The American Academy of Pediatrics (AAP) advised parents and physicians not to give young children cough and cold syrups.

A growing body of evidence suggested that non-prescription medications for cough and cold actually did little to aid recovery. These medications also pose risks with regard to a rare adverse reaction due to unintentional overdosing. The Food and Drug Administration issued an advisory recommending that parents do not give these products to children under the age of 2 because of the risk of serious and potentially life-threatening side effects.

What to do when we want to ease our children’s discomfort.

(Information posted here does not constitute medical advice and should not be used to replace seeking a health care professional’s expert advice.)

It is important to understand that most coughs and colds are the result of contracting a virus and do not respond to antibiotics. Inappropriate use of antibiotics can result in an allergic reaction or antibiotic side effects, such as nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics may also kill beneficial bacteria and encourage the development of dangerous antibiotic-resistant bacteria. The best way to treat cold and coughs is with prevention.  Teaching and modeling proper and frequent hand-washing is important. See this post on RSV for more prevention tips.

Here are several suggestions:

Honey and lemon

A favorite in our home, among those over one year old, is a cup of hot water with honey and lemon slices. There have been multiple studies that have shown that honey is effective in easing a cough(1).

 Honey is not to be given to children under one year of age as it carries a risk of infant botulism which can be life-threatening.

Fluids

You can also encourage your child to drink more fluids. Being hydrated whether by broths, water, or juices helps loosen the mucus making it easier for your child to cough or blow their nose. Another plus of keeping hydrated – liquids can sooth an irritated throat.

Positioning

Elevating your child’s head while they sleep can ease a cough.

Saline and suction

If your child is having trouble breathing or drinking because of nasal congestion, you can clear their nasal passages with a little saline solution drops or spray followed by proper use of a suction bulb. (2)

Moisture

Close the bathroom door, run the shower to get the bathroom steamy and then sit with your child in the bathroom. (Young children should not be left in any room with standing water that they can access.) The moist air can help clear upper respiratory passages.

Keep warm, safe and healthy this holiday season.

(1)Warren, M.D., Pont, S.J., Barkin, S.L., Callahan, S.T., Caples, T.L, Carroll, K.N., Plemmons, G.S., Swan, R.R., Cooper, W.O., The Effect of Honey on Nocturnal Cough and Sleep Quality for Children and Their Parents Arch Pediatr Adolesc Med. 2007;161(12):1149-1153 FULL TEXT Accessed 12-7-2011

(2) Child and Colds, Healthy Children Blog, American Academy of Pediatrics FULL TEXT Accessed 12-7-2011

Reducing stress during the holidays

family and friends eating dinnerThe holidays can be full of friends, families and festivities.

They can also bring stress.

We talked previously about the importance of putting aside a desire for perfection.  But there’s another potential pitfall to avoid: saying yes to so many requests that you find yourself overextended.

…A friend invites you to an annual holiday brunch.

…The family wants to go to the annual holiday movie outing.

…Work has its standard office party. Colleagues are hoping to go out for nibbles and drinks separately as well.

…Your aunt is hoping you can join her for a holiday fundraiser for one of her favorite charities.

They all sound great.

And even if they don’t sound great, you often don’t want to disappoint others, so you end up saying yes.  The next thing you know, your calendar is way too full; your errand list is way too long and your bank account way too thin.

When it comes to scaling back, the first person you have to convince is yourself. It’s OK to slow things down. And if you won’t do it for yourself, think of it this way: Showing up a frazzled, less attentive, less-engaged version of yourself could shortchange others around you.

You can say “no” while still sounding open and friendly. Here are some suggestions:

  • I would love to get together, but my calendar is really full with the holidays approaching. Can we schedule a time when things slow down so we don’t have to rush and I can give you my undivided attention?”
  • “I’m looking forward to seeing you, but a formal dinner is really beyond my capacity right now. Any chance you have time to grab a cup of coffee in the coming week or so?”
  • “Thank you for the invitation to join you at the charity event. It sounds like a great cause, but I’ve already agreed to help meet several other needs this season. Thanks for sharing it with me, though. It’s nice to know about options for future years.”

You don’t have to give a reason, either. Try a simple: “Thank you for thinking of me, and I’m sure I’d enjoy it, but I have a prior commitment and I won’t be able to attend.”

While it’s important to maintain balance, it’s also important to recognize if you’re pulling back from social engagements because of depression or other behavioral health issues. Isolating at holiday time has the potential to increase symptoms like appetite, sleep and mood disturbance.

Holidays can also bring memories of times past that can make us sad if we have lost loved ones or have loved ones who are ill. It’s important to honor the authenticity of your feelings and seek help when you need it.

Try to hold close the spirit of the holidays. The winter holidays are all about peace and love. Allowing others to help can bring joy and purpose to them just as you felt joy to all the “Yesses” you were able to say this year.

Try to savor the positives in your life and create new holiday memories that keep you healthy and happy. Sit back, enjoy some egg nog with a good holiday movie and honor yourself for finding balance in an ever changing world. You deserve it. Happy Holidays to All!


Terri Waldman MSW was the director of the TMC Geropsychiatric Center at Handmaker and now is the administrator at Copper Canyon Alzheimer’s Special Care Center

Keep the Sparkle in Your Celebrations – Firework safety

Firework safety - tips from our Safe Kids CoordinatorIt’s time to hoist the flag and celebrate our independence from the British Empire. And what would Independence Day be without fireworks? But before you break out the sparklers and the Roman candles here are some important considerations to make sure you keep it safe for everyone in your family.

Fireworks are spectacular, but also very dangerous.

Last year 12,900 firework-related injuries were treated in hospital emergency rooms across our nation. The vast majority of those injuries, some 8,700, occurred around July 4th, according to a report from Consumer Products Safety Commission and National Electronic Injury Surveillance System.

Are fireworks legal in Tucson?

There was a time when you had to travel to legally purchase fireworks, but in 2014 Senate Bill 1158 required Pima and Maricopa cities and towns to allow the sale and use of ground fireworks around July 4th and New Year’s Day. So yes, fireworks can be legally bought and used in Tucson, but with significant limitations. Check this informational sheet to make sure you know which fireworks are legal here in Tucson. Did you know that while you might be able to buy bottle rockets, Roman candles and the like, anything that shoots into the air and detonates is not legal in Arizona? Check out the sheet linked above from the city of Tucson to find out what you can and can’t use within the city limits.

Firework Safety Tips

We asked Jessica Mitchell, coordinator for Safe Kids Pima County, for her firework safety tips this Independence Day.

“We know fireworks are fun and young kids look adorable holding those sparklers. Unfortunately, fireworks can cause serious injuries to children, including devastating burns and other injuries. The best way to keep your children safe is to not use any fireworks at home. Attend public fireworks displays and leave the lighting to the professionals. If you plan to use fireworks, make sure to follow the tips below to keep your kids as safe as possible.”

  1. Leave Fireworks to the Professionals

The best way to protect your family is to not use any fireworks at home. Instead, attend public fireworks displays and leave the lighting to the professionals.

  1. Be Extra Careful With Sparklers

Yes they’re legal, but little arms are too short to hold sparklers, which can heat up to 1,800 degrees! Instead, let your young children use glow sticks. They can be just as fun but they don’t burn at a temperature hot enough to melt glass.

(The U.S. Consumer Product Safety Commission’s stats from Fourth of July festivities in 2014 indicated sparklers were involved in a majority of fireworks-related injuries sustained by children under 5 years of age.)

  1. Take Necessary Precautions

  • Always have a bucket of water, hose and/or fire extinguisher nearby. Know how to operate the fire extinguisher properly.
  • Do not wear loose clothing while using fireworks and protect your eyes with safety googles.
  • Never light fireworks indoors or near dry grass.
  • Point fireworks away from homes, and keep away from brush, leaves and flammable substances (at this time of year and considering how dry it is, this should dissuade most of us.)
  1. Be Prepared for an Accident or Injury

  • Stand several feet away from lit fireworks. If a device does not go off, do not stand over it to investigate it. Put it out with water and dispose of it.
  • Always have a bucket of water and/or a fire extinguisher nearby. Know how to operate the fire extinguisher properly.
  • If a child is injured by fireworks, immediately go to a doctor or hospital. If an eye injury occurs, don’t allow your child to touch or rub it, as this may cause even more damage.

For more information on fire safety and more visit Safe Kids WorldWide. 

 

TMC volunteer shares two best tools that helped her lose 48 pounds

DonnStairs.jpgDonn Corder has battled extra pounds for most of her life. So when she decided to fight back, she turned to two tools: Measuring cups and a food scale.

Corder, 59, who has volunteered in pastoral services at TMC for two years, was attending a lunch & learn session for volunteers when she learned about TMC’s weight management program. “I knew I needed to do something,” Corder explained. “My weight was creeping up and no matter what I seemed to do, it wasn’t going away. I also knew I didn’t want surgery and I also didn’t want a ‘system.’ I wanted to eat real food and not something out of a box.”

Corder met with registered dietitian Laurie Ledford, who went over her blood work to determine any risk factors. Corder was borderline on cholesterol and she comes from a long line of family members with diabetes.

Corder was surprised when she left the visit without a food plan to follow. Instead, she left with a food log, instructed to write down everything she ate for a week.

They discovered her servings were too large. The average serving for cereal is one cup. She had been just filling her bowl, and the result was twice that.

“I eat fast, so I didn’t realize how much I was eating. I started measuring and weighing everything,” she said. And she started to be more conscious of what she was eating.

Take cheese – a food Corder is particularly fond of. Ledford asked if she could really taste it in her salad, for example. And the answer was: Not especially. So the two of them agreed: Corder should eat her cheese, but she should have a chunk of it as a snack and really savor it.

Same with ice cream. Come on: Who eats half a cup of ice cream? But now, if Corder has a craving, she buys those individual servings at the grocery store to help her manage the portion size.

She made other little changes. Two percent milk dropped to one percent. She makes her own salad dressing. She makes snack bags of trail mix she’s made herself with just mixed nuts and raisins, since the ones at the store often have additional candy in them. She even put two weeks of snack bags in her carry on luggage when she took a two week trip.

With the help of the program’s physical activity counseling, she also added in more activity, whether it’s walking the hallways at TMC, jumping on the elliptical machine in the living room or walking up stairs instead of taking the elevator.

“It’s worked for me because I don’t feel deprived because I still have my favorite things.”

The only downside? A shopper she is not, and she now needs new clothes.

“You’re not going to be perfect every day, but it’s a question of whether you can make progress overall. It’s made a huge difference for me because I feel better, I sleep better and I have more energy.”

To find out more about TMC’s weight management program please contact TMC Wellness, (520) 324-4163 or Wellness@tmcaz.com

 

Enjoying the Season While Avoiding Stress – Tips from Mary Atkinson, Director of Wellness

Tips for keeping the stress at bay this holiday season
Do you have a love-hate relationship with this time of year? You love the vision of family and friends brought together to celebrate and the fantasy shown on Pinterest or in magazines, but you hate the pressure you feel to create some idyllic experience? Our director of Wellness, Mary Atkinson, has these suggestions to reduce the stress and up your enjoyment of the season:
  1. Review your calendar
    It’s easy to fill up your calendar with events and gatherings and feel rushed at every one. Sit down with your family and discuss which events are actually truly loved and which have just become routine. Perhaps the annual potato latke cook-off is a must do for the whole family, but the bike ride around Winterhaven lights is no longer top of everyone’s list. Remember those quiet moments with loved ones where you’re not doing anything but lighting candles together and savoring the moment can be the most precious.
  2. Celebrate the season
    Don’t focus on one day. We can get hung up on creating the ‘perfect day’ pinning too many hopes on one day. Refocus on the little moments of beauty, kindness and community that you experience throughout the month.
  3. Ask for help and delegate
    Whether it’s sharing the responsibilities of a fancy meal for a horde of family and friends, sending cards to the family or wrapping gifts for all ask for help. Perhaps make the feast more potluck and the cards can be written and addressed by other members of the household? Working together can be memory-building in itself.
  4. Indulge with balance
    Tis the season of festive gatherings and indulgent eating. Nutritionally speaking, this is a tough time of year. We don’t want to give up delicious holiday dishes; however, we would rather not wreck our health through weeks of unhealthy eating. Fortunately, with a few modifications and a little moderation, we don’t have to do either. Check out registered dietitian Laurie Ledford’s suggestions here. Remember to take time to breathe and to take a walk after dinner or a hike with the family.
  5. Recognize and remember
    During holidays loss and estrangement can feel particularly hard. Terri Waldman, former director of the TMC Geropsychiatric Center, shared these wise words, “Your heart has no obligation to be jolly. Take the time to celebrate cherished memories but be open to new rituals. If you find you are having a hard time coping and can’t shake the sadness, though, don’t try to tough it out. It may be time to see a primary care physician.”
  6. Learn to say no
    Saying yes when you should say no can leave you resentful and overwhelmed. Friends and colleagues will understand if you can’t participate in every project or activity.
 
No matter whether your house will be full to the gills or quiet this holiday season, we hope the season is healthy and full of hope.
From our family to yours best wishes,
Mary Atkinson
Mary Atkinson is a registered dietitian and TMC’s Director of Wellness. You can find out more about the programs that the Wellness Department offers the Tucson Community here.

Walk this way – Walk to School

Safe Kids Pima County and FedEx volunteers will join students from Whitmore Elementary and around the county to celebrate International Walk to School Day on October 4. International Walk to School Day raises community awareness about walking safety and promoting healthy behavior.

Did you know unintentional pedestrian injuries are the fifth leading cause of injury-related death in the United States for children ages 5 to 19? Teenagers are now at greatest risk with a death rate twice that of younger children and account for half of all child pedestrian deaths.

Whether or not your child’s school is participating, Jessica Mitchell, Safe Kids Pima County program coordinator, provides these suggestions for parents:

Teaching kids how to walk safely:

  1. Teach kids at an early age to look left, right and left again before crossing the street. Then remind them to continue looking until safely across. Teach them to never run or dart out into the street or cross between parked cars.
  2. Teach kids to put phones, headphones and devices down when crossing the street. It is particularly important to reinforce this message with teenagers. Parents, let your actions speak as loudly as your words.
  3. Encourage your children to be aware of others who may be distracted and speak up when they see someone who is in danger.
  4. It’s always best to walk on sidewalks or paths and cross at street corners, using traffic signals and crosswalks. If there are no sidewalks, walk facing traffic as far to the left as possible.
  5. Children under 10 need to cross the street with an adult. Every child is different, but developmentally, most kids are unable to judge the speed and distance of oncoming cars until age 10.
  6. Remind kids to make eye contact with drivers before crossing in front of them and to watch out for cars that are turning or backing up.
  7. It’s always best to walk on sidewalks or paths. If there are no sidewalks, walk facing traffic as far to the left as possible.
  8. Cross streets at corners, using traffic signals and crosswalks. Most injuries happen mid-block or someplace other than intersections.

As kids get older, they’re anxious for a little more freedom when walking to school or playing outside. But this is also a time when parents need to stress the importance of the little things big kids should do to stay safe.

Remember you are your child’s first role model. Lead by example:

  1. Be a good role model. Set a good example by putting your phone, headphones and devices down when walking around cars.
  2. When driving, put cell phones and other distractions in the back seat or out of sight until your final destination.
  3. Be especially alert and slow down when driving in residential neighborhoods and school zones. Be on the lookout for bikers, walkers or runners who may be distracted or may step into the street unexpectedly.
  4. Give pedestrians the right of way and look both ways when making a turn to spot any bikers, walkers or runners who may not be immediately visible.

For more resources to help keep your family safe
visit our website.

 

Developing rituals can help build balance

Terri Waldman on developing rituals to balance lifeTerri Waldman, the Director of TMC’s Geropsychiatric Center, was one of the experts interviewed for the Arizona Daily Star’s series on dementia, Hope and Help. Among the stories was one on finding hope. Here is her monthly column on the importance of building ritual.

Every morning, I go for a walk with my dog.

If I miss that walk for some reason, my day just feels a little off.

It’s one of my rituals, along with meditation, that gives shape to my day.

Ritual, which is increasingly recognized as important to our health and wellbeing, is more than merely everyday habit. But to be clear, it also does not have to be reserved for just the sacred and complicated.

Whether we are talking about rituals of religion, families or individuals, those intentional steps we take on a regular basis help remind us about what’s important and help us build a sense of stability in our lives.

When I was a child, bedtime meant my parents would tell each other and their children that they were loved. For me, regardless of family squabbles or anything else that happened during the day, it gave me that sense of continuity. No matter what else I faced, love was not a negotiation.

When you hear “ritual,” there are all kinds of ideas in our head about what that looks like, often involving ceremonial trappings and historical foundations. But it can be as simple as having dinner as a family – a ritual that is growing in importance all the time as we lose some of that precious time to busy lives and technology.

It can be having a cup of coffee on your patio to start your morning. It could be a cup of tea in the evening. It could be a prayer before bed.  It’s any time you carve out that feels good and centering and maybe even healing to you.

In the work I do, I’ve noticed that some people’s lives become imbalanced because they lack structure. Rituals have a way of grounding you. Even if you’re traveling, you can still have that morning coffee or that bedtime tea and feel a sense of structure. Ritual does not have to be rigid. And it doesn’t have to be something handed down through generations – it can be something you create.

If ritual is something you want to more fully develop in your life, you might look at your life to see what you have in it already.  You probably have more of it in your life than you think. If it isn’t obvious to you, you might ask a friend: What do you see in my life that brings me comfort?

You might just start with something simple: Finding 5 minutes of quiet time with your thoughts. It’s easy to click on the TV or the radio for a distraction, but learning to be present with oneself can be a gift. And it might just start with one, simple ritual.

Terri Waldman has more than 20 years of experience in providing services, advocacy and leadership in the field of aging in Pima County. Currently the Director of the TMC Geropsychiatric Center at Handmaker, Waldman received her Masters in Social Work at Arizona State University. She follows her father’s philosophy that five minutes of laughter every day leads to quality in life.

Pets, TV and Chocolate: Potential Sleep Scuttlers

Photo courtesy of N.C. Industrial Commission

You simply are not going to be able to reverse lost sleep by trying to cram it in on the weekends.

“It takes the average person three days to rebound from one night of sleep deprivation,” explained David Sholes, manager of Neurodiagnostics at Tucson Medical Center, which oversees the Sleep Laboratory.

Memorial Day weekend aside, he said, “There are not three days in a weekend, so you’re never going to recover at that rate. You’re better off just keeping a reasonable schedule so your sleep is more consistent.”

With May designated “Better Sleep Month,” Sholes shared some tips on how to get the restorative Zzzzzz’s you need.

Sholes said the brain is built on a circadian rhythm – think of it as your internal body clock. By keeping a regular routine, it knows what time to go to sleep and what time to wake up, and is more likely to transition through the necessary four stages of sleep without interruption. Furthermore, obtaining adequate levels of each stage of sleep is important for restorative sleep.

Other tips include avoiding alcohol and caffeine, including choclate, within five hours of bedtime. Avoid going to bed on an empty stomach and finish exercising at least three hours before bedtime.

A cooler room often improves sleep. And if you can’t fall asleep after 15 to 20 minutes, get up and do some other relaxing activity instead of stewing over your inability to sleep.

Sholes said among his least popular tips: Make sure that your television stays off during sleep time. At the very least, he suggested, set the sleep timer so that it turns off within 20 minutes instead of letting it stay on the entire night. Televisions have fluctuating volumes and lighting, which can cause microarousals without the patient completely waking up. This can make it difficult for patients to transition to deeper stages of sleep or get back to sleep all together.

Also, don’t think sharing the bedroom with your pet will necessarily help with quality sleep. Although many are convinced their pets bring them comfort, Sholes said if the animal is moving around every few hours, it could interrupt the cycle of sleep stages and may do more harm than good.

Sholes suggests keeping a sleep diary for two weeks with the pet, then starting a new diary cycle without the pet to see if any difference is evident. By noting your energy level and the way you feel at wake time and half way through the next day, it will soon become apparent if the pet is significantly disturbing your sleep, he said.

As anyone pulling an all-nighter can attest, bad sleep can impede on quality of life. “It can cause an inability to stay awake during the day, which decreases productivity and can interfere with the lifestyle you want to live. Maybe your friends are going on a hike, but you’re just too tired. Maybe you have some personal goals you want to accomplish, but you can’t seem to motivate yourself,” Sholes said.

Sleep disorders, such as sleep apnea, can also have significant health impacts, he said, from high blood pressure to diabetes and heart problems.

Tucson Medical Center offers a diagnostic sleep lab with spacious, overnight accommodations to help patients get to the root of their sleeping problems.

Sholes said people tend to diminish the importance of sleep. “It’s entirely under-rated. People think it’s more of an inconvenience than a true health concern, which is alarming,” he said. “Here at TMC, we are trying to educate the community that it can really put your health at risk and prevent you from getting out of life all that you want to get out of it.”

For more information about the Sleep Diagnostic program at TMC, call 324-3318.

Laughter Might Indeed Be the Best Medicine

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Although children laugh unabashedly all day long, adults might be lucky to laugh a dozen times a day.

But those belly laughs might be just what the doctor ordered to relieve the stress of a demanding profession such as nursing.

Cardiothoracic surgeon Gulshan Sethi led an early morning round of laughter therapy Tuesday in honor of National Nurses Week.

While nurses are vital to patient care, Dr. Sethi said, they do face a number of challenges, from dealing with the emotional needs of patients and families to juggling so many tasks that they almost need an extra set of arms.

Noting prolonged exposure to stress can lead to a state of mental and physical exhaustion, the doctor warned that too many nurses opt to leave the profession.

Armed with the knowledge they are in a profession at high-risk for burnout, Dr. Sethi urged the standing-room-only group to learn self-calming techniques. “You need to give yourself time to relax,” he said.

Those techniques can take many forms, from meditation to guided imagery, progressive muscle relaxation and reciting mantras.

It might include making a conscious effort to breathe. “Most of us don’t know how to breathe right. We do not pay attention to our breath and we take it for granted,” Sethi said, adding most people tend to breathe shallow and fast when they should breathe deeply and quietly.

Meanwhile, he noted, laughing boosts the immune system, relieves tension and helps relax the body. Even faking laughter has therapeutic benefits, since it often prompts the real thing.

“As we get older, there’s so much going on in our brains that we stop laughing,” Dr. Sethi said. “I believe we have to do something to help us laugh again like children.”

Maybe one more reason to dig out those old family photo albums.


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461