Breastfeeding – 10 ways you can support the new mama in your life

10 ways dads can help with breastfeedingThere was a time when in the first fresh days and weeks of a baby’s life, a new mom would be surrounded by the women of her family and community. They would provide her support and guide her through breastfeeding and caring for her new child. Today, that is often not the case. A new mom may find herself without that sisterhood to draw upon. Breastfeeding support groups, lactation consultants and postpartum doulas provide valuable resources, but for day-to-day the support of dad or partner is critical in determining whether breastfeeding is successful.

TMC for Women Lactation Consultant, Susan Dennis IBCLC, shares these ten tips to help dads and partners help the new mom in their lives:

How to provide breastfeeding support to your partner:

  1. Before baby arrives attend a Breastfeeding Class with the expectant mom.
  2.  Tell the new Mom that she is doing a great job- encouragement is a key building block to success.
  3. Help recognize when the baby is showing feeding cues and help give mom private time to feed without distractions from other visitors.
  4. Place pillows under mom’s arms, back, legs to help support her in comfortable positions while feeding.
  5. Watch how staff at the hospital or birth center help the baby start a feeding and do the same when mom needs help.
  6. Hold baby skin to skin after feedings while mom takes a nap. This is a great bonding time for you and baby.
  7. Bring water and snacks whenever mom feels hungry.
  8. Be the mom’s sounding board when she feels frustrated. Sometimes she just needs to talk.
  9. Burp baby, change diaper and cuddle baby in between feedings so you get a chance to know the baby.
  10. Babies are only small for short time. When they cry they need to be held. This builds trust and later independence.

Know there are outside resources to help mama with breastfeeding, we provide outpatient consultations with certified lactation consultants as well as a weekly support group.

Resources

Pisacane, A., Continisio GI., Aldinucci, M., D’Amora, S., Continisio, P., A controlled trial of the father’s role in breastfeeding promotion Pediatrics. 2005 Oct;116(4):e494-8. [Accessed 6/13/2014]

Flu season, like winter, is coming. Is your family ready?

Are you ready for flu seasonFrom cooler temperatures to pumpkin pie, we welcome many things that come with the fall season, but the flu is not one of them. Dr. Katherine Leitner, a TMCOne provider at TMC Rincon Health Campus, provides some important pointers to best prepare families for flu season.

How should a family prepare for flu season?

The most effective preventative measure is a flu vaccination. Everyone in the family should get a flu shot.

If experiencing flu-like symptoms:

  • cover your mouth when coughing
  • avoid touching your face
  • wash your hands with soap and water frequently
  • disinfect surfaces you come in contact with
  • and stay at home for at least 24 hours

When should you get a flu shot?

The Centers for Disease Control recommends receiving a flu vaccine in October. Even if you did not receive the flu shot in October, it is still beneficial to obtain one throughout the flu season which can run through January or later. It is also important that everyone get the flu shot yearly, because the flu strain changes from year to year.

What about vitamin C and a healthy diet?

Studies have shown that supplementing with vitamin C during a cold does not actually improve the outcome or decrease the duration of illness. However, it is always important to stick to a healthy diet so you can build a good immune system for when you do get sick. During an illness, drinking lots of fluids and staying hydrated is very important.

What should you do if a child is showing flu symptoms?

Make an appointment with your child’s health care provider right away. The provider can test for the flu and treat it with a medication if caught early. To prevent the spread of illness, keep your child out of school until he or she is feeling better.

Who should get the flu shot?

Dr. Robert Jacobson, a pediatrician with Mayo Clinic, says, “The latest recommendations from the CDC reaffirm that all of us are at risk for catching and spreading the flu, and all of us should get our flu shot this fall. Very few of us cannot get the vaccine. Our getting the vaccines protects them, too.”

The CDC continues to recommend vaccination for all people aged 6 months and older without contraindications, preferably by the end of October. For those aged 65 and older, the CDC says standard-dose or high-dose vaccine is acceptable.

For information on how to protect infants under 6 months from the flu see this TMC for Children post.

Asthma shouldn’t keep a kid from being a kid – Dispelling myths

asthma mythsWhen your child experiences an asthma attack it can be terrifying for both your child and for you.

Understandably, you want to take the precautions to prevent asthma attacks, but there are many myths about asthma. Some of these myths can lead parents to overly limit a child’s activities and negatively impact your child’s health.

Dr. Jamie Ruderfer, a pediatric pulmonologist with Pediatric Pulmonary Associates, sets the record straight and explains how parents should take the appropriate precautions that build strong health because, as she says, “asthma shouldn’t keep a kid from being a kid.”

MYTH ONE: Allergies and exercise are the most common asthma triggers

Actually, the most common trigger of pediatric asthma is the rhinovirus, or common cold. The flu is right behind the cold as a significant asthma trigger.

I strongly agree with the American Academy of Pediatrics that every child should receive a flu vaccine, and it is even more important for asthmatic children.

Does that mean allergies and exercise aren’t triggers?

Allergies and exercise can be serious triggers, they just aren’t the most common triggers of asthma-related difficulties.

Every child who experiences asthma will have unique triggers. Some will be triggered more by allergies or exercise. Some will be triggered more by viral colds. This is where proper expert advice on management comes in.

Before taking extreme precautions, an evaluation by a pediatric pulmonologist can determine your child’s your child’s unique experiences with asthma and create a management plan that fits your child’s needs and lifestyle.

Should parents take extra precautions to keep their child from getting a cold?

When it comes to colds, asthmatic children cannot realistically take different precautions than a child who does not have asthma.

Parents need to work, and children need to go to school and daycare. I’m a mom, too, and I understand that preventing a child from catching a cold is nearly impossible. We should still take precautions, but reasonable and effective ones – like a flu shot, hand washing/sanitizing, a healthy diet and good sleep.

If an asthmatic child catches a cold (which they will), it does not mean that an acute asthmatic episode is certain – it means that parents should be more alert for signs and symptoms. Again, management is key. Your child should have an individualized asthma action plan developed by their pediatrician or pediatric pulmonologist for when they get the sniffles.

MYTH TWO: Asthma symptoms only involve wheezing, right?

Wheezing (both breathing in and out) is a symptom, but there are other symptoms and signs that parents should be aware of.

Symptoms the child may have an escalating issue include:

  • Chest tightness
  • Chronic cough
  • Respiratory infection
  • Shortness of breath
  • Waking in the night with breathing difficulty

Acute symptoms that require immediate treatment involve:

  • Severe wheezing
  • Rapid and/or labored breathing
  • Coughing that doesn’t stop
  • Pressure and pain in the neck and chest
  • Difficulty talking due to shortness of breath
  • Blue lips or fingernails

If your child is experiencing any of these acute symptoms, go to the nearest emergency department or call 911 immediately.

MYTH THREE: My child hasn’t had symptoms for a long time – so I don’t have to be as aware?

Children can go for long periods without asthma being triggered. Asthma is a serious condition and while parents don’t need to be overly cautious, they should regularly visit a health-care provider, stick to the asthma management plan and always be alert to symptoms.

MYTH FOUR: To prevent asthma just cut out sports

I’m just so afraid of an asthma attack – should I just cut out sports entirely?

An asthma diagnosis should not keep a kid from being a kid. Having a solid, ongoing management plan will make it possible for your child to safely enjoy sports and other physical activity.

Dr. Ruderfer graduated from the University of California, Irvine Cum Laude and Phi Beta Kappa with a B.S. in biological sciences with emphasis in cell biology. She received her medical degree from St. George’s University School of Medicine, and completed her 3-year residency in pediatrics at Winthrop University Hospital and a 3-year fellowship in pediatric pulmonary at Baylor College of Medicine/Texas Children’s Hospital. She is a member of the American Academy of Pediatrics. Dr. Ruderfer is married to Dr. Daniel Ruderfer (TMCOne pediatric infectious disease) and has two sons, Ethan and Josh, ages 3 and 6.

 

 

 

 

Back to School: Know the warning signs of bullying

For many children, the start of a new school year can be stressful, especially if they’ve been victims of bullying in the past. Mayo Clinic Children’s Center psychologist Dr. Bridget Biggs says parents and caregivers should know the warning signs. “If your child is reluctant to go to school, stressed after spending time online or avoids social situations, he or she may be being bullied.”

What is bullying?

Dr.Biggs defines bullying as “any form of aggression that is repeated.” This can be physical, verbal, social (excluding victims from activities, starting rumors about them) and increasingly electronic. It can happen not just at school, but anywhere a group of children congregate, whether on the playground, in school or on social media.

Bullying differs from fighting or teasing because there is a power differential between the bully and the victim. The bully has power over the other child and tries to control them using fear over and over again.

Additional warning signs your child is being bullied:

From www.stopbullying.gov

  • Unexplainable injuries
  • Lost or destroyed clothing, books, electronics, or jewelry
  • Frequent headaches or stomach aches, feeling sick or faking illness
  • Changes in eating habits, like suddenly skipping meals or binge eating. Kids may come home from school hungry because they did not eat lunch.
  • Difficulty sleeping or frequent nightmares
  • Declining grades, loss of interest in schoolwork, or not wanting to go to school
  • Sudden loss of friends or avoidance of social situations
  • Feelings of helplessness or decreased self esteem
  • Self-destructive behaviors such as running away from home, harming themselves, or talking about suicide

Dr. Biggs points out that consequences of bullying can be serious. She says victims are at increased risk of depressionanxietysleep problemsself-harm, poor grades and in rare cases, suicide. She encourages parents and caregivers to directly ask their child if they have thought about self-harm. If a child knows that their parent or caregiver is open to discussing feelings about self-harm it can be a relief to the child and can open up lines of communication.

Dr. Biggs shares these tips for parents and caregivers on how to help children who are victims of bullying:

  • Talk it out – Ask your child about concerns.
  • Learn – Get information from your child about what’s happening.
  • Take notes – Record details of bullying events.
  • Discuss and practice how to respond – Walk away. Get help from trusted adult or peer.
  • Talk about technology – Before cyberbullying occurs set some ground rules including letting your child knows their electronic privileges will not be removed if they share that they have been cyberbullied.
  • Build self-esteem – Encourage your child to get involved in positive activities.
  • Team up – Reach out to teachers.

Watch: Dr. Bridget Biggs discusses warning signs of bullying.

Next week we will discuss cyberbulling, how to recognize it, react to it and prevent it.

As a member of the Mayo Clinic Care Network, Tucson Medical Center works directly with Mayo Clinic, the nation’s No.1 hospital according to U.S. News & World Report. Our doctors get access to Mayo Clinic knowledge and resources, and you get the best care, close to home.

Oh no, I think my child has heatstroke, what should I do?

girl heatstrokeIt’s a difficult balance during summers in Tucson. I don’t want my boys inside all day so we try to get out early in the morning or in the evening, but the 100 degree days seem to start earlier and earlier and last longer. Along with dehydration, I worry about heat exhaustion and, worse still, heatstroke during these hot summer months. While we often think of heatstroke as what happens when children are left in a hot car, it can also happen when they’re just playing outside in the heat.

Because children have smaller bodies, they are more susceptible than adults to heat exhaustion and heatstroke, so it’s important to know the symptoms and what to do in case heatstroke strikes.

What is Heatstroke?

Heatstroke is when the body becomes overheated and fails to regulate its own temperature. Body temperatures rise, and may even get up to 105°F (40.6°C) or higher.

Heatstroke is a medical emergency, it can be life-threatening and requires immediate medical attention.

Here are some symptoms to look out for:

  • Skin is flushed, red and dry
  • Little or no sweating
  • Deep breathing
  • Dizziness, headache, fatigue or a combination of these
  • Less urine is produced, and it is of a dark yellowish color
  • Loss of consciousness

What to do if you suspect heatstroke:

  • Move your child out of the heat immediately and take your child to the hospital or doctor as soon as possible
  • If for some reason you cannot get your child to a hospital or physician, quickly move your child immediately out of the heat and place in a cool bath (although not less than 60 degrees, you don’t want to constrict the blood vessels)
  • When your child is in the bath, massage the skin to increase circulation, get them to a hospital or doctor as quickly as possible

What is heat exhaustion?

Heat exhaustion is not as severe as heatstroke, but is a result of the body overheating. It still requires careful monitoring and can be a precursor to heatstroke.

Heat exhaustion can take a while to develop especially with prolonged exercise.

Here are some symptoms of heat exhaustion to look out for:

  • Goosebumps and cool skin
  • Excessive sweating
  • Faintness and or dizziness especially upon standing (low blood pressure)
  • Complains of being tired
  • Pulse becomes rapid
  • Complaints of cramps, nausea or headache

When to do if you suspect heat exhaustion:

  • Stop all activity and rest
  • Move your child to a cooler place
  • Encourage your child to drink cool water or sports drinks
  • Contact your child’s pediatrician if signs or symptoms worsen or if they don’t improve within one hour. Seek immediate medical attention if your child becomes confused or agitated, loses consciousness or is unable to drink.

What can we do to prevent heat exhaustion and heat stroke?

  1. If your child is in camp or daycare, check to make sure the camp or child care provider has procedures in place to prevent dehydration and excessive heat exposure.
  2. Make sure your child stays hydrated.
  3. Incorporate water play into outdoor time. Whether it is swimming, a splash pad or sprinklers in the backyard, water play can make the outside bearable. Don’t forget sunscreen, swim shirts and hats though!
  4. Stop and rest. Children and adults alike tend to become exhausted in the heat. Build in rest time.
  5. Dress for the heat. Light-colored and light-weight clothing is best
  6. Check out some cool air-conditioned space for a change of pace from the house. Pima County libraries provide lots of activities year-round and are free. The Children’s Museum of Tucson provides an opportunity for active play.
  7. If possible for your family’s schedule, incorporate a siesta, or nap, into the hottest part of the day and then let the kids stay up later to enjoy cooler nighttime temperatures. Reid Park Zoo, Tucson Botanical Gardens and the Arizona Sonoran Desert Museum all have summer schedules that allow early morning or evening visits.

Keep cool in the Old Pueblo this summer,

Melissa

Melissa HodgesPediatric Emergency Notes from Melissa
Melissa Hodges is a pediatric emergency room RN and mom to two young boys. Melissa has been at Tucson Medical Center for 10 years. She is a knitting ninja apprentice who makes a mean chili and enjoys spending time with her family and friends in beautiful Tucson, Arizona.

Avoid these common mistakes to protect your child from the sun

sunscreen mistakesWe asked Dr. Gerald N. Goldberg of Pima Dermatology for advice on how best to protect our children from the blazing Arizona sun. Dr. Goldberg is board certified in both pediatrics and dermatology. 

1. Not applying sunscreen in spring, fall and winter

Really is there any time of year where sunscreen isn’t necessary at this latitude for you or your children?

Ideally, we are providing examples and modeling of good sun safe behaviors for our children from a young age. Daily application of a broad-spectrum, water-resistant sunscreen of SPF 30 or higher is ideal. This latitude provides tremendously intense ultraviolet exposure for much of the year. Worst times are late spring through early fall and midday from 10 a.m. to 3 p.m. when the UVB (“burning rays”) are most intense.

2. Assuming the shade will be enough to protect from the sun

Shade is not totally protective since there often are considerable reflected rays and filtered rays through partial shade. The same is true for cloudy days where filtered UVB light can still cause sunburn.

3. Using any old sunscreen

Not really. It’s best to look at labeling when considering if your sunscreen is up to snuff.

Broad-Spectrum: Blocks the UVA (“aging, wrinkling rays”) and UVB (“burning rays”).

Water-Resistant: Retains blocking power for 40 minutes of water immersion or “very water-resistant” if it retains protective effects after 80 minutes of being in the water.

An SPF (“sun protective factor”) of 30 or better is recommended. The FDA no longer allows “number chasing.” No sunscreen can be rated higher than SPF 50 or simply 50+. The SPF factor means that if it takes 15 minutes to burn in the June midday sun without sunscreen, with a sunscreen of SPF 10, it takes 15×10 or 150 minutes to burn with sunscreen SPF 10 in place. The FDA also no longer allows “sunblock,” “sweat-proof” or “waterproof” on labels.

Remember to check for the expiry date on your sunscreen too, old sunscreen won’t do!

Contrary to some written statements, sunscreens are relatively safe when applied properly. Zinc oxide and titanium dioxide are some of the best sunscreens since they truly reflect dangerous rays of both the UVB and UVA types. There are no substantiated claims of problems with toxicity or absorption of nanoparticles leading to a danger to health. Vitamin A, at reasonable doses, has been used for years to boost the immune system and to protect against cancer development. The more complex question is Vitamin D. Some modest amount of sunlight exposure (a few minutes a day unprotected) is probably fine on modest body surface areas to maintain good vitamin D health. If levels are low, the recommendation is to take a vitamin D oral supplement daily, and not to seek more sunlight to improve one’s vitamin D status.

4. Not using enough sunscreen

The most common error is inadequate application. Studies show that the average person puts on about 25-30 percent of the quantity necessary to achieve the stated SPF rating. A shot glass full of sunscreen is a fairly reasonable amount to apply for full-body protection. This is the other reason why SPF 30 or more is recommended – because of “sloppy” application.

5. Not allowing enough time

The next most important issue is taking time to apply sunscreen before activity. The sunscreen needs to bind to the skin to be effective, so try applying it 10 to 15 minutes before activity. Also, when using many products in the morning, apply sunscreen first to bind to the skin whenever possible.

6. Not reapplying sunscreen

Have you applied sunscreen again after swimming, hiking or just hanging out? Failure to reapply after being in the water or sweating; both can wash off sunscreen. Always reapply after water immersion or activity with significant perspiring.

What are the top three things parents can do to protect children from sun exposure?

ABCs:

A= Avoid the sun midday from 10 a.m. to 2 p.m.

B= Block the sun with sunscreen

C= Cover up with sun-protective hats and clothing (including swim shirts when in the pool)

 

 

When big breathing problems trouble little ones – Pediatric pulmonologists provide expert care

Asthma- when to see the pediatric pulmonologistStruggling to breathe can be terrifying, especially for children – and their parents. Acute and chronic respiratory challenges including asthma need specialized care to keep airways open – enter the pediatric pulmonologist.

Chiarina Galvez, M.D., explains when a child with asthma symptoms should see a pediatric pulmonology specialist.

What is pediatric pulmonology?

Pediatric pulmonology is a medical specialty that focuses on the care of infants, children and teenagers with disorders of the lung and airways, and those with sleep-related breathing problems.

If a child has moderate-to-severe asthma, should the child see a pediatric pulmonologist?

Children with moderate-to-severe persistent asthma may benefit from a consultation with a pulmonologist. Asthma guidelines recommend seeing a specialist for children ages 0 to 4 years who need daily controller therapy.

These recommendations are made because several studies have shown that patients who received specialized care had better outcomes, which included improvements in asthma symptoms, as well as fewer hospitalizations and emergency department visits.

If the asthma diagnosis is uncertain, or if there are difficulties maintaining asthma control, then pulmonology referral should be strongly considered.

Asthma is not as common in Arizona because the climate is hot and dry – right?

Unfortunately, we’ve learned over the years that asthma is prevalent in the state. In 2014, it was estimated that the prevalence of asthma in Arizona children aged 17 years and younger was higher than the national average (10.9 percent vs 9.2 percent).

Asthma is a complex condition, and it is likely that genetics and multiple environmental factors interact to trigger the disease.

The right environment depends on the individual’s triggers. A climate that might be good for one child’s asthma, might be terrible for another. Achieving good asthma control requires working with a specialist to identify and avoid triggers, medication adherence and regular follow-up visits to optimize therapy.

What respiratory symptoms should a parent of a child with asthma be mindful of?

In children, symptoms of respiratory problems are often varied and may be subtle. If a child is experiencing any of the following symptoms, a pediatric pulmonologist may be able to help.

  • Cough for more than four weeks and is not improving
  • Two (or more) episodes of pneumonia in one year
  • Chronic wet cough
  • Pauses or stops breathing while awake or asleep
  • Fast or labored breathing on a frequent basis
  • Frequent or recurrent brassy or honking cough
  • Gets a cough after he or she choked on food or another object, even if he or she choked on the object days or weeks ago

It may also be helpful to see a pediatric pulmonologist if a child has received treatment due to a respiratory illness.

  • Hospitalization
  • More than one visit to an emergency department
  • Received more than two courses of oral steroids in the past year
  • Has complicating conditions (e.g., chronic lung disease of prematurity)

Dr. Galvez - pediatric pulmonologistWhat motivated Dr. Galvez to become a pediatric pulmonologist?

It has been my life’s calling to care for children who are acutely ill and admitted to the hospital. But what makes pediatric pulmonology so special to me is the opportunity to see patients over the long term – I build relationships with the children and their families. It’s why I chose this field.

In addition to completing medical school and a pediatric residency, Dr. Chiarina Galvez completed her pediatric pulmonary fellowship – a three-year, specialized training in the treatment and management of pediatric, respiratory illnesses.

What are the most common illnesses you treat?

Conditions we frequently treat include asthma, bronchopulmonary dysplasia (breathing problems related to prematurity), chronic cough, recurrent pneumonia and sleep apnea. We also take care of patients who are technology dependent, such as those with tracheostomies and on home ventilators and oxygen.

Dr. Galvez is a pediatric pulmonologist at TMCOne. Call (520) 324-7200 for more information.

 

 

 

 

 

Incredible reward at no cost – How cord blood donations are changing lives at TMC

Cord Blood Kristen Wilt

Cord blood donations can enhance and save lives, and do even more – providing donors and their families with the uplifting benefit of knowing their cord blood gift will have a positive impact for years to come.

“My brother-in-law passed away from a rare blood disorder when he was just 19,” said Stephanie Babcock, a mom who recently donated the cord blood from her baby Midori at TMC. “It’s so rewarding to know our donation can save someone like my brother-in-law – we know what it means to that person and their family.”

What is cord blood?

What exactly is cord blood and why is it so beneficial?

“Cord blood is the blood that is left inside the umbilical cord and placenta after a baby is born,” said Kristen Wilt, cord blood coordinator at TMC. “It is so important because it contains blood-forming stem cells that can be used in blood transfusions to heal or repair damaged cells that cause serious diseases.”

Saving and improving lives

Wilt explained cord blood stem cells are used to treat more than 80 life-threatening diseases, which include many forms of cancer, as well as immune and genetic disorders. “Acute myeloid leukemia, Hodgkin’s lymphoma and sickle cell anemia to name just a few,” Wilt said.

Cord Blood 4Blood transplants can have a significant and permanent effect for individuals facing specific debilitating and severe health challenges, she explained. “By and large, the treatments can cure many diseases or have a significant impact that dramatically improves the quality of life for the recipient.”

How donation works

Wilt said the process is quick, easy, and it is free. “At TMC the mom and family are asked if they would like to donate the cord blood immediately after birth,” explained Wilt. “There is one simple consent form to sign and a health history questionnaire to review and you’re done – you’ve just created a life-saving possibility for someone.”

Participation in the Arizona Public Cord Blood Program is growing, but currently available only in a few Arizona hospitals. “It made a great impression on us that TMC was the only hospital in Southern Arizona who offers cord blood donation,” said donor Babcock. “It can seem like a small thing but has such an incredible impact.”

Cord blood donations from TMC have gone to help patients all over the United States and as far away as Australia.

Safety and anonymity

Donating cord blood poses no risk to the baby or mom because the cord blood is collected after the birth, when the placenta and umbilical cord are no longer needed.

The hospital assigns a number to each donation so that it is received and tracked by the public cord blood bank anonymously.

“We did our research,” said Babcock. “We had no concerns about safety or privacy – TMC made it a simple, easy part of the birthing experience.”

Cord Blood 3

Where it goes and how it helps

For the past four years, TMC has worked with the Arizona Public Cord Blood Program and has provided almost 5,000 cord blood donations.

“Within 48 hours, the cord blood is delivered to the University of Colorado Cord Blood Bank (an FDA-licensed facility), where it is cryopreserved in liquid nitrogen tanks,” said Wilt. “This process conserves the stem cells in the blood for a very long time – donations have been used after 20-25 years.”

The donation becomes part of the national registry managed by NMDP/Be the Match registry. “Worldwide, patients of all ages who are in need can work with the registry to determine if they are a match,” Wilt said.

Why your donation matters, for others and for you

Some moms and families decide to save and privately store their baby’s cord blood. However, the cryopreservation process and on-going storage fees can be cost-prohibitive. “If cord blood is not donated, it is disposed of as medical waste – and it is truly a waste,” said Wilt.

Donating cord blood has such significance because finding a match can be very difficult. “About 70 percent of people in need are not able to find a match from their family,” Wilt said. “More cord blood donations means a greater chance that someone in need will find a match.”

For Babcock, making the donation was more than a fulfilling gesture. “It’s not a big sacrifice, and it changes your life just knowing that you could save an adult or child who is fighting a deadly disease.”

Cord Blood 1For more information about cord blood donations, contact Kristen Wilt at (520) 324-6210 or visit the Save the Cord Foundation website.

Patients, families enjoy afternoon of pampering thanks to generous volunteers

PFAC3.jpgEdmundo Zevallos knows all too well the stress of having a child in the newborn intensive care unit.

In 1993, his premature baby spent five months recovering in the NICU at Tucson Medical Center. His son is now a healthy 25-year-old, but back then, Zevallos remembers around-the-clock vigilance, being tethered to a pager that would summon him to the hospital from work in an emergency, and the struggles with managing heart monitors and other medical equipment when his baby finally came home.

Zevallos, who serves on the Patient and Family Advisory Council at TMC, helped coordinate Family Day, designed to support the parents of children recovering in the hospital.

PFAC1.jpg“It is important that the family or support unit of the patient take care of their own well-being. The patient will need them to be strong and healthy for the journey ahead. They shouldn’t try to tough it out. We want them to know we understand and support them, and that we are here to help them,” Zevallos said.

The event served about 20 parents, relatives and patients of TMC for Children and TMC for Women. Each visitor received a bag filled with small gifts, discount coupons and a fresh flower.

The day wouldn’t have been possible without the support of about a dozen different vendors.

“It’s just a nice way to give back,” said Andrea McCully, from ANR Massage, who provided massage services to patients. “When you learn more about what other people experience, it’s really gets you to think outside of yourself.”

Those sentiments were echoed by Kashmir Crossley, of Salon Kashmir, and Casey Reminder, of Z.E.N. Studio. Fellow stylist Silviya Warren said she used to paint the fingernails of a 6-year-old who was struggling with cancer treatment. “She made me fall in love with her,” she said. “She survived, but I know how hard it can be on families. I thought of her and said of course I would help.”

PFAC2Lory Sullivan, a beauty consultant with Mary Kay, remembers how it felt when her granddaughter, now a healthy 15-year-old, was born prematurely. “I know parents have to be stressed and be scared when their child is ill, so if I can help them take that moment to relax and take a deep breath, I’m grateful for that opportunity.”

Amy Clemans, an acupuncturist with Mountain Waters Acupuncture, who shared a Chinese body work practice, said as a parent of a special needs child, she wanted to give back. “I know how important it is for parents to do self-care,” she said.

Also in attendance were Mary and Jim Harvey from BioPhotonic Therapy Solutions, Lisa Westerwick from Serenity Holistic Touch and Kim Adair from Women Under the Sun. The Basket Butler provided gift baskets, the Flower Shop on 4th Avenue provided flowers, and Epic Café, in conjunction with Women Under the Sun, donated the pastries.

The Patient and Family Advisory Council shares information with TMC on how to better serve parents and families by creating a family-centered environment.

Some of their projects have included assisting in the layout of pediatric areas of the hospital, creating child-friendly words for specialty procedures and providing input on the KidSpeak mobile app that helps children become more familiar with the hospital and medical terminology through virtual tours and a digital whiteboard. Click to learn more about serving on the Patient and Family Advisory Council.

Do I need a fence for the inflatable above-ground pool? Pediatric Emergency Notes

Do I need a fence for our above ground pool? Drowning prevention,We don’t have a built-in pool at our home, but we often use a little splash pool which got me to thinking about the safety of above-ground pools — you know, the sort that just go up for the summer, whether rigid sides or inflatable, and come down when school is back in session.

As a pediatric emergency department nurse I’ve seen my fill of child drowning victims and so I tend to be hypervigilant around pools. The absolutely crushing part about drownings is that they are nearly always preventable.

I asked Jessica Mitchell, Safe Kids Pima County coordinator, what the rules are regarding fencing and general safety practices around temporary above-ground pool structures.

“The law…oh the law on pools! It can be so confusing. Pretty much, if you have a pool that is taller than 18 inches and wider than 8 feet intended for swimming, it requires a fence/barrier that is at least 5 feet tall with a self-closing or self-latching gate. The entire law for pools can be found on the Arizona government pages“ Jessica shares.

“Mesh fencing is a great option for those with above-ground temporary pools because when the pool comes down, the mesh fence can also come down. There is one exception to having to put up a pool fence, and that is if everyone in the household is 6 years or older, no safety measures need to be in place. This doesn’t mean this is the safest option. Not everyone over the age of 6 can swim, and even swimmers can get into difficulty in a pool.

“If you decide to get a temporary above-ground pool make sure you have a fence at least 5 feet tall with a self-latching gate. Make sure your child cannot use a chair or other item to climb over the barrier or to unlatch the gate. And emphasize to all kids and adults that the gate is not to be propped open.”

Also, we worry most about pool mishaps in the summer, but be vigilant all year for drowing hazards. Empty the cooler of melted ice water; dispose of the bucket of mop water; drain the bathtub (and never leave your toddler or pre-schooler in the tub unsupervised). Unfortunately, we see all these drowning scenarios in the emergency department.

Whether it’s in the pool, the ocean or the bathtub, you will not hear a child drowing. Drowning is silent … keep your eyes on your child.

This summer we’re going to follow all the advice above as well as the ABCs of pool safety whether it’s a splash pool or a regular pool:

“A” is for Adult Supervision

Always have an adult watching the pool, not reading, not looking at their phone, not taking an afternoon siesta – just watching the kids in the pool. Go ahead and take turns if it’s a social gathering, but make sure that the designated adult knows the rules. Better yet, consider hiring a trained lifeguard. While it seems like the more adults who around, the better. But the reality is that it seems to be the opposite – everyone thinks someone else is wathcing. Make hiring a lifeguard a part of your pool-party budget.

Jessica also wanted to remind folks that floaties are toys and not safety devices. If you have a life vest, they need to be the right size, and they are not a substitute for adult supervision.

“B” is for Barrier

Yes, even with an above-ground temporary pool that you picked up for $75 you want a barrier. It can be mesh; it just has to be at least 5 feet tall and have a self-latching gate. Even if your kids are over the age of 6, what about the neighbors or the grandkids? Make sure the barrier isn’t compromised – there aren’t any chairs or trash cans that can be dragged over to act as a ladder, and that nobody props open the gate.

“C” is for Classes

Tucson has lots of great options for swim classes including Vest it Up!  TMC for Children and Credit Unions for Kids offer FREE year-round swim lessons at dates, times and locations that meet the needs of busy families. These free lessons are at local YMCA locations and include a free personal flatation device, or PFD. This U.S. Coast Guard-approved life vest for kids is provided to kids completing swim classes. The free classes are available to the first 400 kids each year between 4-17 years old.  Register here for Vest it Up!

I have a few additional thoughts:

Having a party? Hire a lifeguard.

It seems like the more adults are around to watch the better right? But in reality it seems to work in the opposite way. Everyone thinks someone else is watching. Make hiring a lifeguard part of your pool party budget.

It’s not just pools and it’s not just summer time

We worry especially in the summer when kids are in the pool, but be vigilant all year. Empty the cooler of melted ice water, dispose of the bucket of mop water, drain the bathtub (and never leave your baby, toddler or preschooler in the bathtub unsupervised.) Unfortunately, we see all these drowning scenarios in the emergency department.

Eyes peeled

Whether it is in the pool, the ocean or the bathtub you will not hear your child drowning. Drowning is a silent affair…keep your eyes on your child.

Hope your summer is splashing good fun.

Stay safe,
Melissa

P.S. Did you know that the Drowning Prevention Coalition of Arizona provides pool safety checks? Request one here 

Melissa HodgesPediatric Emergency Notes from Melissa
Melissa Hodges is a pediatric emergency room RN and mom to two young boys. Melissa has been at Tucson Medical Center for 10 years. She is a knitting ninja apprentice who makes a mean chili and enjoys spending time with her family and friends in beautiful Tucson, Arizona.

Dehydration and kids – what you need to know

Dehydration and kids what you need to knowWhile standing on the sidelines cheering my eldest on at his soccer game is enough to get me reaching for my water bottle, my kindergartener with the flushed face needs a little reminding to hydrate. As temperatures soar it becomes especially important to make sure our children are hydrated – dehydration and heat stroke are all too common in the region and in the emergency department. And children are more prone to dehydration and heat stroke than adults.

Your kids are more susceptible to heat than you are!

As kids have a smaller mass-to-surface-area ratio, they can lose fluid more quickly than adults and become dehydrated more rapidly. Children also have a higher metabolic rate, so their bodies use more water, too. Add to that their kidneys do not conserve water as well as an adult’s and kids often may not drink or eat when they are not feeling well, and you have a recipe for a dehydration disaster! Luckily dehydration is easily preventable. Given the average temperatures here in the desert, we need to be aware year round and teach our children how to prevent dehydration.

To encourage my 5 year old to make a habit of hydrating, I follow two pieces of advice:

    1. Encourage constant sipping over infrequent large gulps
    2. Let him pick out an insulated water bottle that would keep the water cool

Remember: be a good role model -drink sips of water often. Throw a slice of fruit in your child’s water, or a silly straw, or perhaps fun colored ice cube shapes – anything that will encourage constant sipping.

The advice below is not a substitute for seeing a physician.

Is my child dehydrated?

  • Does the child seem sluggish?
  • When crying are there few or no tears?
  • Are there complaints about a dry mouth?
  • Is the child more cranky, irritable or fussy than usual?
  • Is urine darker than usual?
  • If child is an infant, is urination less frequent (fewer than six wet diapers a day)?
  • Is the child constipated?*
  • Is the child’s skin particularly dry and lacking its normal elasticity? Maybe even wrinkled?
  • Do the eyes appear sunken?
  • If your child is an infant is the soft spots (fontanel) sunken?

*Sometimes your child may be dehydrated due to diarrhea. Don’t forget to treat the dehydration.

“Yes” to any of the above may indicate that your child is dehydrated. If it is fairly mild you may be able to address this at home, but check with your physician if you have any questions.

What should I do if my child seems dehydrated?

For children older than 1 and less than 11:

  • If your child is dehydrated use an oral rehydration solution, such as Pedialyte. If your child is eating food, plain water may be used to replace lost fluids. But if the child isn’t eating, plain water doesn’t provide essential electrolytes, so an oral rehydration solution is needed. Avoid sodas, caffeinated beverages or gelatins, which don’t relieve dehydration and may make symptoms worse.
  • Make sure your child is drinking small amounts, frequently.
  • Rehydration may take a few hours, so keep your child in a cool, shaded area and sipping fluids frequently
  • Allow your child to drink as much fluid as he or she wants. Encourage your child to drink extra fluids or suck on flavored ice pops, such as Popsicles. Children ages 4 to 10 should drink at least six to 10 glasses of liquids to replace lost fluids.
  • Call your doctor if symptoms do not improve or if they worsen

How can I prevent my child my child getting dehydrated?

  1. Hydrate, hydrate, hydrate.

Insist on your children taking plenty of breaks to drink fluids while playing outside, especially if playing sports or engaged in vigorous physical activity. Perhaps set up a timer as a reminder. Also, hydrate before, during and after time in the heat.

  1. Stay indoors

We’re all about getting kids out and physically active, BUT when the heat is high, avoid spending time outdoors. In Tucson summers this means stay indoors any time after 9 a.m. into early evening.

Our suggestion: wake early to play outside, take a siesta in the afternoon and then venture out in the evening.

  1. Never leave a child in a parked car at ANY TIME, NOT EVEN FOR A MINUTE

Even if the windows are open, temperatures can rise to shocking temperatures in minutes.

  1. Keep it light and wear a hat

Have children wear light, loose-fitting clothes when they’re outside. Breathable fabrics like cotton are best.

Stay cool this summer,

Melissa

Melissa HodgesMelissa Hodges is a pediatric emergency room RN and mom to two young boys. Melissa has been at Tucson Medical Center for ten years. She is a knitting ninja apprentice, who makes a mean chili and enjoys spending time with her family and friends in beautiful Tucson, Arizona.

This advice does not substitute for that of a medical professional. If you are concerned that you or your children may have heat stroke or moderate to severe dehydration please seek in person medical advice.

Tucson youngster collects books for rite of passage to share with pediatric unit

IMG_2597Addison Braswell surprised her parents as a kindergartener when she decided to donate to pediatric cancer patients all of the contents from her piggy-bank that she had collected over the year from gifts and holidays.

She has done the same thing every year since, explaining that she feels badly for children who are sick and wished she lived in a world where sickness didn’t exist.

So when she celebrated her First Holy Communion this year, it was completely within character that the 9-year-old asked her friends and family members to purchase children’s books for donations to give to children recovering in the hospital.

“Sometimes, when I don’t feel well, stories help me imagine that I’m somewhere else,” explained Addison, who donated more than 20 books to TMC for Children.

Jamie Antrim, a Child Life assistant at TMC, thanked Addison for her kind spirit. “Sometimes, when children spend the night in the hospital, they can feel a little sad because they miss their house and their pets or their friends, so we work hard to help them feel better,” she said. “Having a book to read can help make the hospital feel a little more relaxing and a little more like home.”

Not only does TMC for Children have a library for children, but every pediatric patient gets a coupon to pick out a brand-new book when leaving the hospital. Addison helped put her donations into the Book Nook, while little sister Avery looked on.

Addison’s mother, Anne-Marie Braswell, works for Golder Ranch Fire District, which is a partnering organization in Safe Kids Pima County, a coalition led by TMC that is working to prevent accidental childhood injury.

“I knew as a community hospital, TMC has a commitment to programs that cater to kids,” she said.

IMG_2600

Addison, who wants to be a veterinarian or a teacher someday, was satisfied about how she spent the first day of her summer vacation. “It made me feel good that I was going to be able to help a lot of people and maybe put a smile on someone’s face.”

For more information on TMC’s wish list for pediatric donations, please visit donating to TMC for Children.

Children’s Miracle Network Champion – Emma Martin

Nine-year old Emma Martin is spunky! No two ways about it, this little girl has a big personality, an infectious laugh and the kindest heart. Emma is also TMC for Children’s 2018 Children’s Miracle Network Champion.

Each year Children’s Miracle Network recognizes one child in southern Arizona who embodies bravery, spirit and hope and is a champion for every child who spends time in our hospitals. We are thrilled to announce that Emma has been recognized as Southern Arizona’s champion for 2018.

While Emma was still in the womb, several of her internal organs developed and fused together, meaning she was without a crucial organ to remove waste from her body. In addition, Emma was born with only one kidney, making it even more difficult for her body to process fluids. A triplet, Emma spent an extended time in the NICU with her sisters, but faced with additional complications went home months after her sisters had left.

Over the past nine years Emma has spent months in the hospital, had over 20 surgeries to address the original congenital issues and the subsequent developments. A fungal infection caused her bladder to be removed, and she lost a majority of her colon in 2016 to a dangerous form of colitis. Emma must use a colostomy and urostomy bag for the rest of her life.

Despite years of complex surgeries and painful symptoms, Emma is joyful, kind and has a giving heart. “She will help others before herself, even her sisters,” said Emma’s mother, Shannan Martin. “She is a special and amazing person who is so positive – she lights up any room she walks into.”

Through Emma was born with rare and daunting health challenges, she keeps an enthusiastic positivity that is nothing short of inspiring – she is a true champion.

Southern Arizona communities can look forward to seeing Emma out-and-about in 2018, sharing her story and advocating for the courageous families and kids who are receiving care at TMC for Children.

You can support Emma’s efforts by contributing to TMC for Children/Children’s Miracle Network. Every dollar donated stays right here in Southern Arizona to support wellness programs, purchase life-saving equipment and provide vital health services to help children like Emma be as healthy as possible.

“TMC for Children has made an incredible difference for our amazing Emma,” said Martin. “We are grateful for the staff, technology and the continued services that have kept Emma alive and brought us all hope.”

Congratulations Emma and thank you for serving as the 2018 TMC for Children Champion!

Learn more about how TMC for Children/Children’s Miracle Network are making a difference, and how you can join the effort to provide life-saving equipment and health services for Southern Arizona children.

My child is in hospital – what are family-centered rounds and how can I make the most of them?

family centered roundsRounds are the discussions that happen every day between the medical staff and parents of a child at TMC for Children, about the child’s progress and plan of care. The family-centered rounds take place in the patient’s room and include the family and patient as a critical part of the health team.

“Parents know their children and know how they’re going to react to new situations. The physicians and medical staff know what the evidence-based care is appropriate for the child. Working together in family-centered rounds, parents and medical staff can develop a plan of care that is best for the child.” said Jordan Richardson, child life specialist. “When parents take an active role in the family-centered rounds, they feel more involved. It improves communication and outcomes when everyone is on the same page.”

What can parents do to capitalize on family-centered rounds?

Be present on rounds

Try to be at the rounds. We know that it can be difficult to be there, and particularly if you don’t have flexibility in work schedules. At TMC, rounds on the pediatric unit occur from 9 a.m. – noon every day. The order and the time of rounds is dependent upon how sick patients are and varies from day to day as acuity often changes.

Participate!

Listen on rounds. Ask questions about things you don’t understand. Don’t hesitate to speak up on rounds.

Know that longer conversations may have to happen later

Our staff spends time with each patient, but needs to see everybody by the end of the morning. Once the hospitalist sees all of the patients and develop plans to move everyone’s care forward, he or she can return in the afternoon to have more in-depth discussions.

Write your questions down on a piece of paper

If you think of questions after the doctor leaves, or in the middle of the night, write down the question on a piece of paper or on the whiteboard in the room.   “We will be happy to answer them on rounds in the morning.” Richardson says.

medical students

Be part of shaping doctors of the future

The attending physician often is working with physicians in training and medical students. The attending physician will allow the trainees to present your child in a formal format and then may do some quick bedside teaching.   The teaching is for you as well! Please listen in and participate. This is how we all learn.   Don’t be surprised if you find that you have something to teach our trainees; our families often have valuable insight.

Just with every team, everybody brings different strengths. You, as a parent are a key team player on family-centered rounds.   Do not hesitate to ask questions and express your concerns.   Our goal is to provide high-quality, effective care for your child while in the hospital, and the best way we can do that is with your involvement.

 

 

Hip Hop dancing with Type 1 – Brody’s got this!

Brody Coomler shares his insights on living with type 1 diabetesHip hop dancing can be tough for anyone, but not for Brody – a seventh-grader living with the challenges of Type 1 diabetes.

“Diabetes doesn’t change who I am,” said twelve-year-old Brody. “But it is a disease that I have to manage on a constant basis in order to stay safe.”

The moves? Brody’s practiced for years. The look? He’s got it on lock. The music? Please. So what happens when his insulin pump comes out during a performance? Brody’s got this.

Brody doesn’t miss a single beat – incorporating the pump wires into his routine.

The situation is a metaphor for Brody’s life. When Type 1 diabetes unexpectedly surfaced – he didn’t let it affect his dance, and Brody doesn’t let Type 1 stop him from playing basketball, gaming, learning to play the tuba or experiencing all life’s got to offer.

But Brody says it much better. “Don’t let type one diabetes stop you from doing anything!”

At four, Brody and his family learned his pancreas was creating little to no insulin – the hormone that regulates blood sugar. He was diagnosed with type 1 diabetes, a chronic and life-long condition that causes blood sugar to spike and fall unexpectedly.

Surging blood sugar levels are far more than a nuisance, they can lead to serious medical complications and death if not properly managed through insulin therapy.

“I have to check [my blood sugar] before meals and before bed,” Brody explained. “If I’m feeling like my blood sugar is too high or if I’m feeling like my blood sugar is too low I have to test. I am very active and so I have to test before I play any sports or any dancing. Monitoring my blood sugar is a big part of having diabetes.”

Even though this brave young-man doesn’t let Type 1 slow him down, he admits his life would be different if there was a cure.

“I would definitely be free from having to test my blood sugar, put on new insulin pump sites or wear a continuous glucose monitor – things like that,” Brody said. “I wouldn’t get sick as much as I get sick now. My mom wouldn’t call me as much.”

You can help kids like Brody by supporting Type 1 research through events like the JDRF Sip, Savor & Celebrate being held Friday, March 23 at La Encantada. Festivities start at 6 p.m. – enjoy live music, fantastic food and drink, and help move research closer to a cure.

Purchase tickets at www.celebratejdrf.com or call (520) 203-8084.

When should I tell my child about an upcoming surgery?

When should I tell my child about an upcoming surgery. When your child has an upcoming surgery or procedure, telling your child when they arrive at the hospital is generally a bad idea. So when to tell your child? Can it be too soon, too late? Amy Fregonese, child life specialist at TMC for Children, weighs in with some concrete advice on when and why to talk to your child about their surgery.

While talking about an upcoming surgery with your child may feel overwhelming, research has found that providing developmentally-appropriate preparation can help to decrease stress and anxiety before, during and after the experience.

When to tell your child:

Toddlers (1-3 years old)
Tell your child a day or two before. Toddlers are not able to understand the concept of time and may begin to worry if told too soon. It is normal for toddlers to become fussy and have behavioral changes before and after a procedure.

Preschoolers (3-5 years old)
Tell your child 3-5 days before the scheduled surgery. Too much time will allow fears and misconceptions to develop. Your child will be curious and will want to know what to expect.

Elementary school age (6-12 years old) 
Tell your child a week or two in advance. This will allow time to process the information and to develop and ask questions without allowing too much time for fears to develop. Your child needs details before, during and after the procedure.

Adolescents (12-18 years old)
Involve your teen in all aspects of planning for the surgery, including talks with the doctor. Allow teens to discuss and talk freely about their concerns. Allow them to maintain their independence and sense of control. Be supportive and honest.

What should I tell my child:

How much and when to tell your child will depend on age and developmental stage, personality, past health care experiences, and understanding of the illness or condition that is being treated.

You know your child best. Use your knowledge, along with the information you have gathered, to talk openly and honestly with your child. Focus on what your child will experience before and after the surgery. An expected stressor is less stressful than an unexpected stressor. Remember to ask your child what questions he or she has about surgery.

Finally, remember you child, no matter the age relies on cues from you. If you appear calm and confident, your child will be more relaxed.

A tour of the surgery area can help you and your child feel more comfortable and gain a better understanding of how things will proceed.

Amy Fregonese
Child Life Specialist

Surgery Tours

Our child life specialists can help your child understand surgery and what to expect. Pre-surgery and pre-admission tours are available. Most tours are geared for children ages 3 and up, but all ages and siblings are welcome. You can call (520) 324-1154 to set up a tour time that is best for your family.

Amy FregoneseAmy Fregonese, Child Life Specialist, specializes in supporting families as they prepare for and recover from surgery. Amy has been helping children and families at Tucson Medical Center for five years.

 

 

 

 

Gun Safety – Steps you can take today to protect your children

As I grieve for the families of the victims and survivors of the school shootings that continue to threaten our children’s safety, my thoughts turn to my own little boys. How can I help keep them and their classmates safe? Is there anything we can do? I don’t have the answers to these big questions, but it does make me think about things I can do in my own community to keep our children safer.

As a mom and as a pediatric emergency room nurse I know that it isn’t just school settings that we need to address when it comes to gun awareness and safety. Along with handguns and rifles, we also need to apply safety concerns to pellet and BB guns, and we need to start taking action.

We talked with Jessica Mitchell, Safe Kids Pima County coordinator, who shared the following about what parents can do to help prevent gun incidents with children:

“Did you know about two-thirds of students who used guns in violent acts at school got those guns from their home or at a relative’s house?

The first thing you can do is make sure that if you keep a gun in your home, it is kept unloaded and locked away. Make sure that the ammunition is stored separately from the gun in a locked container and make sure the keys are hidden away, too. If the gun is not in its lock box make sure it’s in your line of sight.

You can pick up gun locks at TMC Family Support Services located next to the Desert Cradle.”

The other thing we must do is talk to the adults in homes where our children spend time ‑ whether it’s with the grandparents, aunts and uncles, family friends or a play date – about the status of guns in the home. Don’t make assumptions about whether someone has a gun, or whether it is unloaded and locked away. Don’t assume the children in the house don’t know when the guns are kept – ask.

I know it feels uncomfortable, but what’s worse ‑ a few seconds of discomfort or the unthinkable?

How to ask the parent or guardian of your child’s play date whether there is a gun risk in their house

This would be so much easier if it was commonplace to ask on a first play date, so let’s make it commonplace. Be brave. Ask.

Offer information on the gun status at your house when children come to visit:

“Hey, we’re so excited for Lily to visit. I just want to check that she doesn’t have any food allergies and to assure you that while we have guns in our house they are not loaded and are in a locked gun safe that the kids can’t access. I know that it can be a concern especially given how curious kids are”

Prior to the first play date or if there is a new adult in the home, ask:
“Lucas is looking forward to hanging out with Omar after school today. It feels a little uncomfortable to ask this, but do you have unlocked guns in your house? Kids can be so curious even when we warn them about not messing around with guns.” If there are guns in the house, ask if they are stored unloaded and locked away where kids have no access. Remember to ask if a new adult joins the family or is staying. Whether it is grandpa visiting for an extended time or mom or dad has a new partner.

Uncomfortable asking in person or over the phone? Text 
Sandwich the question in between the usual questions, “Hi Tom, this is Melissa, Jack’s mom. Jack’s really looking forward to coming over after school today. What time should I pick him up? Also, weird question I know, but I’m trying to get in the practice of asking this given recent events. Do you have guns in your house? Just want to check that they’re unloaded and locked away from the ammunition. Thx”

Blame your pediatrician
Or at least deflect the origin of the query to your pediatrician. Our pediatrician asks us at every annual check-up whether there are guns in the house and if they are unloaded and locked away. Say something like, “Our pediatrician suggested that we ask about guns, even BB guns, just to check that they’re unloaded and locked away.”

Don’t assume that girls aren’t curious about guns 
Ask.

Don’t stop asking once your child is old enough to walk home alone or whether you will be at the house or not
Gun accidents happen whether the child is 4 or 13. Children can be impetuous when little and even more so when teens.

Undoubtedly, there is much more to be done, but this…this we can do today.

Melissa

Melissa HodgesMelissa Hodges is a pediatric emergency room RN and mom to two young boys. Melissa has been at Tucson Medical Center for ten years. She is a knitting ninja apprentice, who makes a mean chili and enjoys spending time with her family and friends in beautiful Tucson, Arizona.

Pregnancy and the flu vaccine – Protection for you and your baby

Why you should get the flu shot if you're pregnant

Photo by Alex Pasarelu

“Babies can’t be given the flu vaccine until they are six months old, so the vaccine that you receive is for both of you,” explained Erin Sperry Schlueter, M.D. F.A.C.O.G., department chair of TMC OB/GYN.

With pregnant women on the short list of people with an increased risk of developing flu complications, understanding the facts about the flu vaccine is a top priority. According to the American College of Obstetrics and Gynecologists (ACOG), pregnant women can get the flu vaccination at any time in their pregnancy, but it is best to get one early in the flu season, October through May.

The vaccine can be given in two ways, a shot or a nasal mist. The mist is not recommended for pregnant women, although it’s safe for women who have just given birth and are breastfeeding.

Protecting yourself from the flu is only half of the benefit; the other half is the protection it gives your baby. The vaccine decreases your risk of getting the flu while you’re pregnant and then keeps your baby protected for the first six months of life. If you do happen to catch the flu after getting the flu shot, it is usually a much more mild sickness.

“The flu shot is critically important for pregnant women because they are at a much higher risk of life-threatening complications from the flu. We also recommend that all immediate caregivers such as partners and grandparents get themselves protected with a flu shot to provide a ‘cocoon’ of immunity around the new baby”, said Dr. Sperry Schlueter.

Don’t get caught by the flu, get your vaccination early. Mild side effects like a sore arm and a low fever for a few days are a minor annoyance when compared to the flu virus.

The Centers for Disease Control and Prevention has information on their website about the vaccination and pregnancy. https://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm.

If you haven’t already had your flu vaccine, get vaccinated. Even if it is late in the flu season the vaccine can still be beneficial. You can schedule an appointment to get the flu vaccine at the TMCOne Wyatt office by calling (520) 394-6619. A brief registration keeps you on schedule, the central location makes it easy and the friendly professionals provide the quality care your family expects from TMCOne. The flu shot is covered by insurance and only $25 for out of network plans.

 

Protecting your family against rabies

skunk rabiesRabies reports have been in the news lately. Tucson has had at least one confirmed case and one suspected case in the last month alone. Additionally, the recent death from rabies of a 6-year old Florida boy is a warning call for us all. Rabies is something as parents with curious and inquisitive children we need to be aware of. We connected with Tim Bohan, nurse practitioner in the TMC pediatric emergency department for a few words of advice to parents and caregivers regarding rabies.

This information is meant as a guide, but should not be used in place of medical advice from your health care provider.

Advice to parents and caregivers regarding rabies:

Thanks to widespread canine rabies vaccination, the disease has become a very rare disease in the United States, but awful situations such as the Florida incident still do happen.

Primarily, the risk is mainly from wild animals, especially bats such as in the Florida case, but raccoons, skunks, foxes, javelinas and coyotes are also sources. We just had a case of a rabid skunk found dead at Jesse Owens Park last month, and this week a suspected rabid gray fox bit a woman in Vail near Rancho del Lago. In total there were 77 cases of rabies identified in animals in 2017 just in Pima County.

What can I do to lower the risk of my child being exposed

  1. Teach your child to never handle wild or unfamiliar domestic animals even if they seem friendly.
  2. Vaccinate your dogs, cats AND ferrets against rabies AND keep up to date with vaccinations.
  3. Bat-proof your home and have those unwelcome lodgers evicted if they’ve already taken residence. Pima Animal Care Center has more information about bat-proofing

My child has been bitten or scratched by a bat/dog/feral cat/ferret/fill in the blank. What should I do?

  1. First thoroughly flush the wound with water and wash it with soap and water.
  2. Call Pima Animal Care Center for help if this animal can be captured, but do not attempt to capture a possibly rabid animal without the proper equipment and training.
  3. Call your pediatrician. Any bite by a wild animal should be considered a risk for rabies until proven otherwise. Exceptions: rabbits, hares, squirrels, rats, mice and other small rodents. Even if your domestic cat or dog has been immunized, if they bite your child they need to be watched for 10 days to make sure that they don’t develop symptoms.

What will the pediatrician do if there is suspicion the bite was from a rabid animal?

We examine the skin. If we think there is a high chance your child has been scratched or bitten by an animal with rabies, we must immediately immunize your child against rabies. The immunization is injected into the skin around the bite. Your child will also receive the rabies vaccination.

Even if we don’t suspect rabies we will often start oral antibiotics to ward off against infection from the bacteria in cat and dog saliva that can cause cellulitis.

My child is terrified of shots. Can we just wait and see?

No. Seek medical attention immediately, and have a professional assess the risk. Once the infection develops there is no sure treatment. Treating at the time of the bite is critical, if not rabies is almost always fatal.

We have bats in our house should I be worried?

Please have the bats removed and bat-proof your home. If the bats have been found in the areas where your child sleeps or plays, whether your child has been bitten or scratched or not – immediately report it to your regular pediatrician.

Tim Bohan NPTim Bohan
Nurse Practitioner
TMC Pediatric Emergency Department

 

Why children with diabetes need a pediatric endocrinologist

Why see a pediatric endocrinologist

Let’s face it: children are physically, cognitively and emotionally strikingly different from adults. When children have diabetes these differences affect how they communicate and understand symptoms and treatment of the disease.

The pediatric endocrinology team at TMCOne is comprised of specialist providers and educators who support our pediatric patients and their families with developmentally appropriate care. Pediatric endocrinologists treat children with diseases of the endocrine system, such as those with diabetes or growth disorders. We talked to the team about treating children with diabetes:

My child has been diagnosed with diabetes, why should we see a pediatric endocrinologist?

Both children and adults can experience similar symptoms of high and low blood sugars, but younger children might have trouble expressing their symptoms to their parents or caregivers. As physicians and educators, we take extra time to explain complicated medical details to a child in terms they can understand.

The difference between treating children and adults with diabetes isn’t just in how we communicate, but also because we are treating a condition that is affected by the ongoing physiological and hormonal changes associated with growth.

As children grow, develop and experience puberty, their insulin requirements change. Children with diabetes need to have regular monitoring throughout these changes to adjust treatment plans, educate, and help with any problems that have developed around diabetes. The pediatric endocrinology team helps your child and you master the skills and knowledge whether it is a young child newly diagnosed, or the teen who learning to manage diabetes independently of their parents.

Regardless of age, however, a person with diabetes needs a supportive network of family, friends and health care professionals to troubleshoot the everyday or emergent events that can occur with diabetes, whether it is type 1 or type 2.

What is the difference between Type 1 and Type 2 diabetes?

Diabetes is a broad term used to describe a number of disorders with different origins and impacts. What Type 1 and Type 2 diabetes have in common is a problem with the hormone insulin.

The primary purpose of insulin is to pull glucose into the body’s cells. Without insulin, or without a full insulin dose, glucose remains in the blood, raising blood sugar levels in the individual. Both those with Type 1 or Type 2 diabetes must monitor and manage their blood glucose carefully to avoid both short-term symptoms and long-term complications. Both forms of diabetes are serious conditions that require medical care.

Type 1 diabetes

Cells in the pancreas of people with Type 1 diabetes do not make insulin. People with Type 1 diabetes must take insulin to control their blood glucose levels. Insulin can be delivered by injections or pumps. It’s usually diagnosed in children or young adults

Type 2 diabetes

Type 2 diabetes is the form of diabetes that affects a large portion of our adult community, but is seen increasingly in young children. When a person has Type 2 diabetes, insulin is still produced by the pancreas, but it does not work as well as a person without diabetes.

Unlike Type 1 diabetes, Type 2 diabetes is often associated with excess weight. Families are encouraged to use diet and exercise to help weight loss and reduce the body’s resistance to insulin if their child has Type 2 diabetes. In addition, medication may be used to make the insulin more effective. When those treatments do not work, insulin may be used.

Which type of diabetes is more common in children?

New cases of Type 1 and Type 2 diabetes among children are on the rise. Type 1 diabetes is significantly more common in children than Type 2 diabetes. Type 2 diabetes is found predominantly in adults 40 years and older. It is found occasionally in teenagers.

In the last decade, children have been diagnosed with Type 2 diabetes at a higher rate than before. The following risk factors are linked to the higher rates of Type 2 diabetes in children:

  • increased sedentary lifestyle
  • higher body mass index
  • excess of availability of processed foods

Helping children exercise and eat a healthy, balanced diet can help drive down the rates of Type 2 diabetes, but it cannot affect those with Type 1 diabetes. Children with Type 1 diabetes cannot prevent nor treat their lack of insulin through diet and exercise.

Can children acquire both types of diabetes?

A child can get either Type 1 diabetes or Type 2 diabetes. In general, of all the children in Southern Arizona with diabetes, about 85-90 percent have Type 1 diabetes.

It’s important to note that Type 1 diabetes and Type 2 diabetes are managed differently. Type 1 does not become Type 2 diabetes nor does Type 2 become Type 1.

Check out our blog posts about Type 1 diabetes.

When your child is diagnosed with Type 1 diabetes

Dr. Priti Gupta Patel, pediatric endocrinologist

Dr. Chetanbabu M. Patel, pediatric endocrinologist

Dr. Chetanbabu M. Patel, pediatric endocrinologist

Flu season is here – when to bring your child to the emergency room

Over the past few weeks our pediatric and adult emergency rooms have swelled with patients with flu-like symptoms looking for relief.

While it is critical that some seek emergency help, the majority of patients with the flu do not need emergency medical care.

In the Pediatric Emergency Department we are seeing a lot of children with flu-like symptoms who have high fevers (103F-105F). As a mom to a toddler and a preschooler I know how worrying those high fevers and respiratory symptoms can be, and I have to remind myself that a fever is actually a sign of the body taking care of itself. So when should you bring your child to the emergency room and what can you do at home to relieve symptoms?

This information is meant as a guide, but should not be used in place of medical advice from your health care provider.

If you’re in need of a same day appointment check out TMCOne

When to bring your child with fever and flu symptoms to the emergency room

  1. Your child is struggling to breathe.
    If your child’s skin has a blueish tinge, is breathing fast or is struggling to breath
  2. Is not waking up
    It is normal when we’re sick to sleep or rest, but if you can’t get your child to wake during the day or the child is not interacting go to the emergency room.
  3. If your child has a high-risk condition, such as heart, lung or kidney disease, or an immune-system disease and is spiking a high fever (103F-105F) seek medical help.
  4. If your usually affectionate child is so irritable he or she doesn’t want to be held
  5. Has a fever AND rash
  6. If your infant has no tears when crying or has significantly fewer wet diapers for 8 to 10 hours.
  7. Any infant less than 2 months old who has a fever over 100.4F.

My child seems to be coming down with flu-like symptoms, but none of the above apply.

The kid is miserable and so am I should we come in?

If your child is at high risk of flu complications because of another condition, call your health care provider, otherwise you can probably avoid the emergency room. Try to make children as comfortable as possible at home.

  1. Let them rest
  2. Make sure that they are getting lots of fluids to avoid dehydration
  3. Let the fever do its job. However, if your child is uncomfortable try lowering the body temperature with a lukewarm bath (do not use ice packs or alcohol bath) or giving acetaminophen or ibuprofen. Make sure you give the right dose! Talk to your pediatrician or pharmacists for help in finding the right dose. Do not over bundle them.

What if my child has a fever over 103, should I bring them in?

My child’s temperature recently soared to 105.6 Fahrenheit, and he was uncomfortable so we brought the fever down by alternating doses of ibuprofen and acetaminophen, talk to your pediatrician before trying a combination approach. DO NOT GIVE THEM ASPIRIN – there has been an association with Reye’s syndrome. The medications won’t get rid of the flu, but they may help you and your child ride out the flu with less suffering. If the fever persists for more than three days or if your child develops any of the symptoms above contact your pediatrician.

What we can and can’t do in the emergency room

Make my kid better please!

There is nothing we would like more than to make your child feel better. It’s what we’ve dedicated our lives to. When it comes to the flu we are limited in what we can do. Because the flu is a virus, antibiotics like amoxicillin are USELESS. In fact, they are worse than useless and can be harmful if used when not needed.

FIND OUT MORE ABOUT ANTIBIOTIC MISUSE AND DRUG-RESISTANCE HERE.

While there are antiviral drugs like Tamiflu, there is a very small window at the beginning of the flu where they have limited effectiveness. Usually, by the time your child is exhibiting symptoms, it’s too late. What we can do in the emergency room is help if your child is dehydrated or struggling to breathe.

How can we stop the rest of the family from getting sick?

  1. Teach your children to cough into their elbows and model the behavior to help reduce the amount of germs flying through the air.
  2. Make sure everyone in the family practices good hand-washing technique and washes their hands frequently–after going to the bathroom, before eating or touching their face, etc.
  3. Use masks! Stop the droplets.
  4. Get the flu vaccine. I know, I know, this year’s flu vaccine isn’t as effective as usual, but it is stopping some of the flu variants, AND it may help reduce the length of time you’re affected.
  5. Eat well, get plenty of sleep and exercise.

Healthy wishes,
Melissa Hodges RN

Melissa Hodges is a pediatric emergency room RN and mom to two young boys. Melissa has been at Tucson Medical Center for ten years. She is a knitting ninja apprentice, who makes a mean chili and enjoys spending time with her family and friends in beautiful Tucson, Arizona.

When your child is diagnosed with Type 1 diabetes

type one diabetes diagnosed

“Our biggest goal in properly managing diabetes is to help the patient and family achieve a lifetime of good health.”

Dr. Priti and Chetanbabu M. Patel, TMCOne pediatric endocrinolgists

If your child has received a Type 1 diabetes diagnosis you may be feeling overwhelmed. While the condition develops gradually, the symptoms can seem to appear overnight.

Symptoms of Type 1 diabetes

  • Excessive thirst
  • Hunger or loss of appetite
  • Dry skin
  • Blurry vision
  • Numbness
  • Fruity breath
  • Excessive urination
  • Weight loss
  • Excessive sleeping
  • Irritability
  • Weakness
  • Delays in wound repair or infection control
  • Nausea and vomiting

Not all children will present with the same signs and symptoms. Some children may present with few or none of the above symptoms and some children may present with many.

Is there a cure for Type 1 diabetes?

While there isn’t a cure yet, the past decade and specifically since about 2014, leading-edge technology is helping the diabetes community.

Today some insulin pumps are capable of making micro adjustments to help the patient curb hyperglycemia (low blood sugar) and can turn off the insulin supply if the patient is experiencing hypoglycemia.

Continuous glucose monitors allow patients and families to glance at a screen at any moment to see glucose levels in real time. These advancements are without a doubt life-changing.

However, we still have not discovered the elusive cure. Until that time, it is imperative children with diabetes and their families feel supported and confident in their ability to control blood glucose levels. Please remember people with diabetes do incredible things every day. There are actors, Olympians, scientists and neurosurgeons with diabetes. People with diabetes can live long, productive and healthy lives!

Why is it so important that my child learns to manage Type 1 diabetes?

“We know that if we can help get the glucose (sugar) levels down in the first 5 years, those children will have a smaller number of complications than children who were not able to properly manage their diabetes,” said Dr. Patel. “The three main complications we try to prevent as an adult or older teenager are eye disease, kidney disease and nerve disease.”

Type 1 diabetes is a life-long condition with life-threatening implications if not under control. We know the habits children develop at an early age can stay with them for a lifetime. If children remain supported and encouraged to care for themselves early on, they can develop positive coping skills which can help keep them healthy and happy into adulthood.

What does it mean to ‘manage’ diabetes?

When people with Type 1 diabetes eat carbohydrates–whether whole wheat bread, pasta, fruit or candy–they must inject insulin into their body to help their body move the glucose out of the blood stream and into the cells. You must figure out just how much insulin to inject based upon the amount of carbohydrates consumed. As children’s bodies are constantly growing their insulin needs increase making this adjustment an ever changing target.

Learning how to count carbohydrates at every meal can be demanding for a family. Even families with the best routine can easily forget to cover carbohydrates at a busy family event or on a long road trip. The reality of it is that sometimes life gets in the way. Learning to plan, cope, organize and forgive yourself are some of the best tools for any new Type 1 diabetes family.

The child’s pediatric endocrinology team can be a support system to help the family understand how to safely manage changes in insulin requirements.

What should I do if I think my child may have Type 1 diabetes?

As noted earlier, some children present with few or none of the symptoms listed above, and some children may present with many.

Remember, children go through growth spurts and might ask for more water, might sleep a little more or might be constantly hungry. These symptoms might seem normal, but they could also be clues to a potential diabetes diagnosis.

If you’re concerned, don’t delay. Ask your child’s primary care provider for a glucose test. Depending on the result, the PCP may order additional tests, may start your child on insulin or have your child admitted to the hospital for close monitoring.

Don’t doubt your parental gut feeling! Untreated diabetes can escalate quickly to critical diagnoses like diabetes ketoacidosis or coma. If your child DOES have diabetes, TMC and TMCOne can form a team to help support your child to learn to care for this manageable chronic condition.

You can find the TMCOne pediatric endocrinologist contact information here.

“Diabetes doesn’t change who I am”

Brody Coomler shares his insights on living with type 1 diabetesTwelve year-old Brody Coomler refuses to let type 1 diabetes define him – he explains how a seventh grader balances a full schedule with the challenges of diabetes.  

He’s an avid basketball player, he’s a hip-hop dancer, he plays the tuba and he’s a gamer. Brody is an active and enthusiastic tween who doesn’t let diabetes keep him from doing the things he’s passionate about.

At four, Brody and his family learned his pancreas was creating little to no insulin – the hormone that regulates blood sugar. He was diagnosed with type 1 diabetes, a chronic and life-long condition that causes blood sugar to spike and fall unexpectedly.

Surging blood sugar levels are far more than a nuisance, they can lead to serious medical complications and death if not properly managed through insulin therapy.

Managing Type 1 diabetes can be demanding, especially for a young person. During National Diabetes Awareness Month, Brody shares how monitoring diabetes is part of his life, but hasn’t taken it over.

What does having Type 1 diabetes mean to you?

Diabetes doesn’t change who I am. But it is a disease that I have to manage on a constant basis in order to stay safe.

Do you have to check your blood sugar all the time?

Yes, I do! I have to check before meals and before bed. If I’m feeling like my blood sugar is too high or if I’m feeling like my blood sugar is too low I have to test. I am very active and so I have to test before I play any sports or any dancing. Monitoring my blood sugar is a big part of having diabetes.

Do you have a special diet?

No, I don’t have a special diet. But like anyone I have to watch what I eat. I count my carbohydrates so that I can dose my insulin based on what I’m eating.

Does diabetes ever get in the way of sports or hobbies?

It definitely does. When I have low blood sugar I have to sit out of a sport or not be able to participate. I have to make sure that my blood sugars are in good range so that not only am I safe but also so that I can perform.

What do you want people to know about having Type 1 diabetes?

Don’t let Type one diabetes stop you from doing anything!

How would things be different for you if there was a cure?

I don’t let diabetes hold me back, but I would definitely be more free from having to test my blood sugar, put on new insulin pump sites or wear a continuous glucose monitor – things like that. I wouldn’t get sick as much as I get sick now. My mom wouldn’t call me as much.

What would you tell a friend who just found out they have Type 1 diabetes?

I would suggest that they make other friends who have Type 1 diabetes so that they can help one another. My friends with diabetes are a good support to me. You can expect the unexpected. You get to have some fun times and meet people that you didn’t think that you would otherwise meet.

For more information about Type 1 diabetes and how you can support research for a cure, visit the JDRF website or call (800) 533-CURE (2873).

TMCOne provides adult and pediatric endocrinology services – for more call (520) 324-4900.

 

One foot at a time – Newborn screening

Electine Orido RN and Baby Cash

A quick pin prick to the heel of the foot, a small cry, a few drops of blood on card and you and your baby have taken an important step in keeping your child healthy – newborn screening.

Here in Arizona the newborn screening looks for 31 core disorders. In addition, we conduct a screening for hearing loss , for critical congenital heart defects and for jaundice. The list continues to expand as medical understanding grows.

Find out more about the Arizona Newborn Screening Panel

In July 2017, the State of Arizona Health Department added severe combined immunodeficiency, or SCID, to the list of conditions screened. While you may never have heard of SCID, a rare disorder affecting about one in 50,000 to 100,000 babies in the United States, you may have heard of the “Boy in the Bubble.” A young boy, David Vetter, brought this disease to notice when he survived for 12 years living in a plastic enclosure that excluded the everyday germs that generally kill affected infants in the first year of life. Generally, infants appear healthy at birth, but the lack of a functioning immune system makes them vulnerable to even everyday germs. Today, survival rates for children affected by SCID are much higher due to improved screening and treatment. If an infant receives a bone or cord blood transplant in the first three and half months of life prior to active infections, the survival rate can be as high as 94 percent.

But my baby looks healthy … Why every newborn needs newborn screening

We screen all babies because ALL babies are at risk, even if they look healthy. Most babies who are identified through screening have no family history of a disorder. The sooner a disorder is identified the quicker treatment can begin, which can prevent disability and even death.

What is involved in newborn screening?

Kassandra and baby Cash

1. Blood Test

At about 24 hours after birth, we start newborn screening with what is often called the heel-stick test.

Your baby’s heel will be cleaned and warmed. A quick pin prick allows five drops, yes just five drops, from your baby’s heel to be dropped onto a card with special filter paper to absorb the blood.

Once your baby’s details and your contact information are collected on the card it is sent off to the Arizona State Laboratory for testing.

Your child’s healthcare provider will be informed of normal or abnormal results. Be sure to ask your child’s provider for the test results if they do not volunteer them.

2. Pulse Oximetry

By using a sensor to detect low oxygen levels in the blood, we can identify babies who may have severe heart defects known as critical congenital heart disease. The pulse oximetry test is quick, easy and painless. We usually perform this screening test about 24 hours after birth. If a newborn’s oxygen level is below normal, your baby may need to have an ultrasound of the heart (echocardiogram). Unfortunately, the pulse oximetry screening is limited in that it won’t find all heart conditions.

3. Bilirubinometer

We assess all babies for jaundice using a special light meter, which calculates the level of bilirubin by analyzing how the light reflects off the skin. Because bilirubin levels, which cause the yellowing of the skin, peak between the second and fourth day after birth, your newborn’s health care provider should check for jaundice after release from the hospital. If jaundice is suspected, the level of bilirubin in the blood will be assessed too.

4. Newborn hearing screening

This is a simple, non-invasive hearing screening. If your baby appears to have a hearing issue during the initial screening the baby will be referred for auditory brainstem response and otoacoustic emissions testing. Your baby will be asleep during the ABR testing, and if the infant sleeps well, we usually give the results of the testing immediately following the test.

Whether you deliver with a midwife or obstetrician at TMC for Women we will take care of these critical newborn screenings. To find out more about our maternity services check out the free maternity services tour.

Find out more: FREE maternity services tour.

Halloween Safety Tips from Jessica Mitchell, Safe Kids Pima County

I love celebrating Halloween with my family, but I must admit I feel like I’m holding my breath all evening. Like many Tucson neighborhoods, ours has few street lights and on Oct. 31, kids are EVERYWHERE, often in dark costumes, often zigzagging across the roads to trick or treat. It’s a safety nightmare! Did you know that children are more than twice as likely to be hit by a car and killed on Halloween than on any other day of the year?

We try to watch where we are going, watch where our little ones are and watch for cars all at the same time. It can be really tough. I give my kids glow sticks to help them be seen by others, including drivers of cars. An added bonus, they think glow sticks are the coolest things ever!

What can you do to make Halloween safer this year for your children?

  1. When selecting a costume make sure it is the right size to prevent trips and falls.
  2. Decorate costumes and bags with reflective tape or stickers and, if possible, choose light colors.
  3. Since masks can sometimes obstruct a child’s vision, try nontoxic face paint and makeup whenever possible.
  4. Have kids use glow sticks or flashlights to help them see and be seen by drivers.
  5. Children under the age of 12 should not be alone at night without adult supervision. If kids are mature enough to be out without supervision, remind them to stick to familiar areas that are well lit and trick-or-treat in groups.
  6. Popular trick-or-treating hours are 5:30 p.m. to 9:30 p.m. so be especially alert for kids during those hours.

Plan ahead and keep your little ghouls and goblins safe and sound this Halloween,

Jessica

Jessica Mitchell is the Safe Kids Pima County program coordinator. Safe Kids Pima County is a network of organizations whose mission is to prevent accidental childhood injury, a leading killer of children aged 19 and under. Spearheaded by Tucson Medical Center, the local coalition is part of Safe Kids Worldwide, a global network of more than 600 coalitions in 23 countries bringing together health and safety experts, educators, corporations, foundations, governments and volunteers to educate and protect families.

These halloween revelers need a few glow sticks and then theyll really be shining.

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.

 

Dr. Patel returns to Tucson, providing pediatric endocrinology at TMCOne

Patel C PhotoDr. Chetanbabu Patel returned to Tucson in June and joined the TMCOne location on 2380 N. Ferguson, across the street from the TMC main campus.

While there are many great reasons for moving to Tucson, Dr. Patel summed it with just one. “The best care for the children we are treating,” he said. “This was a unique opportunity to be a part of a comprehensive program involving specially trained staff who communicates frequently and openly with families – that’s why I chose TMCOne.”

Dr. Patel and his team provide care for children ages 0 to 18 who are experiencing a wide range of endocrine related illnesses, including diabetes, thyroid disorders, adrenal and pituitary disorders, metabolic challenges, and much more.

“Chronic endocrine issues are complex and require a team working together to best help children achieve strong health,” the doctor explained. The team involves the coordinated efforts of specialists at the TMCOne clinic and Tucson Medical Center. The specialists include clinical dieticians, social workers, certified diabetic educators and several others.

Why the certified educators? “The importance of communication cannot be overstated – we want parents to feel comfortable and confident working with us because they are the most important part of the treatment team.”

Peds Endocrinology Care Flyer JPEGEach endocrine challenge is as unique as each human body and what works for one child may not work for another, which can frustrate parents and the patient. Dr. Patel says empathy is an important part of the care provided at his clinic.

“I try and place myself in the parent’s shoes, and understand what is happening with respect to the family dynamics as well as with happening with that particular child. I give them my undivided attention and spend enough time so that they understand why I want them to get labs or to consider one of the treatment options.”

Dr. Patel has dedicated his career to learning as much as possible about pediatric endocrine illness, and he is a devoted advocate for children and their families.

“I always dreamed of becoming a doctor to help others,” he said. “I enjoy working with the parents as well as the babies and teenagers to help them achieve optimum health.”

In addition to his medical practice, Dr. Patel has held many respected positions, including director of diabetes education at the Steele Research Center, chief of pediatric endocrinology at Texas Tech University and assistant professor of pediatric endocrinology at the University of Arizona.

His immediate and extended family also reside in Arizona, and Dr. Patel has always felt that Tucson is his home. While basketball, tennis and reading are his favorite hobbies, he most enjoys spending time with his family.

Dr. Patel is currently accepting new patients. Please call (520) 324-1010 to schedule.

 

 

Temps are rising and the pool is beckoning – do you know your water safety?

Pool Safety 3Is it hot enough yet? With Tucson temperatures exceeding 115 degrees for three straight days, many families will be heading for the pool this weekend.

It’s no surprise why swimming is a summer favorite. Parents get a chance to cool-off, kids max out on fun and families make memories.

With the summertime exuberance of visiting, splashing and playing, it can be easy for all to forget important safety rules. This is serious because Arizona has the second highest number of child drownings in the United States.

Child drowning is tragic but preventable. Safe Kids Pima County Coordinator Jessica Mitchell works with community partners to provide helpful tips and education to prevent childhood drowning. She provided us important water safety standards every
parent should know.

It’s as easy as ABC

A = Adult supervision B = Barriers around pools, spas and hot tubs C = Coast Guard approved life vest and life-saving CPR classes

My kids love playing in the pool – what are the things to watch out for?

  • Active supervision is a must. Provide active supervision without any distractions – even if other adults are present and many kids are in the pool. They call drowning the “silent killer” because a drowning child can’t call for help.
  • Infants and toddlers should stay within an arm’s reach of an adult.
  • Don’t rely on swimming aids such as water wings and pool noodles. They are fun, but may not prevent drowning.
  • When finished, remove all toys from the pool. This can tempt children to go for the toys later, increasing the risk of them falling in and drowning.
  • Barriers should be in place to keep children from entering the pool on their own. Alarms on doors and pool fences with self-closing gates also helps to keep kids safe.
  • Always keep a phone nearby so that you can call 911 in the case of an emergency.
  • Empty kiddie pools and turn them upside down when finished. Tragedies have happened in just a few inches of water.

Pool Safety 2
What swimming rules should I set for my children?

  • Only swim if an adult is a present.
  • Do not dive in shallow areas of the pool (or the entire pool if it is not deep enough for diving).
  • Don’t push or jump on others.
  • Don’t go swimming during thunder/lightning storms.

My kids have already taken swimming lessons, so I probably don’t need to watch them as much, right?

While we encourage swimming lessons, children should not be swimming alone even if they are good swimmers. It takes multiple lessons before a child learns how to swim effectively and even then, there should still be active supervision by an adult.

How do I rescue a child I think might be drowning?

  • Take the child out of the water
  • If you are alone, call 911 and begin CPR. Starting CPR immediately is the most important thing you can do to prevent a child from dying.
  • If you are not alone, begin CPR and ask someone to call 911.
  • Check for breathing and responsiveness. Place your ear near the child’s mouth and nose to see if you feel air on your cheek? Determine if the child’s chest is moving and call the child’s name to see if he or she responds.

Should I be CPR certified?

Anyone who routinely supervises children around water should get CPR certified. The certification courses are provided by many community organizations, including the American Red Cross.

It sounds like there is a lot to prepare for – can the water still be safe and fun for my family?

Absolutely! Swimming can be great family fun. Make sure you take the necessary precautions, always supervise swimming children and that someone in the family has taken CPR classes.

Visit our website for more safety tips and information.

 

 


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