Post #48 Coronavirus COVID-19 Pandemic Update
Well before news of COVID-19 wreaked havoc on our borders, travels, news cycle, and hand sanitizer supplies, influenza was quietly going about its yearly routine business with minimal hubbub from the media.To put things in perspective, consider that for the 2019-20 flu season, there have been an estimated 20,000 - 52,000 deaths thus far per the Center for Disease Control in the United States alone. That is just one country.In contrast, there have been approximately 3,600 deaths from COVID-19 worldwide. More deaths are sure to follow, and quite possibly, the final tally may far outstrip that of the seasonal flu.An unkn...
Source: A Pediatrician's Blog - March 8, 2020 Category: Pediatrics Source Type: blogs

Post #47 How to Optimally Utilize Tamiflu
Every year in the United States, the CDC estimates that influenza results in between 9 million – 45 million illnesses, between 140,000 – 810,000 hospitalizations, and between 12,000 – 61,000 deaths (approximately 100  – 200 being pediatric fatalities). In the United States, the immense disease burden of the flu is unparalleled with any other pathogen, but fortunately there is a vaccine and antiviral medications which help to mitigate the yearly morbidity and mortality wrought by influenza.Because the flu changes its shape every year by a process called antigenic shift&n...
Source: A Pediatrician's Blog - February 22, 2020 Category: Pediatrics Source Type: blogs

Post #45 How to be Optimally Measles Immunized
Measles is a highly contagious disease caused by a virus. It spreads through the air when an infected person coughs or sneezes – the kicker is this can happen 2 hours AFTER said person has left the room. Measles starts with a fever; soon after, it causes a cough, runny nose, and red eyes. Then a rash of tiny, red spots breaks out which starts at the head and spreads to the rest of the body.It is important to recognize that fever and rash are extremely common in children and the vast majority of fever/rash cases will not be Measles.Unless you are reading about local cases of Measles in the news – it is high...
Source: A Pediatrician's Blog - April 30, 2019 Category: Pediatrics Source Type: blogs

Post #44 Transitioning Babies to Solid Foods
This is an unedited excerpt from my 2nd book, "What to Know Before Having Your Baby" - coming out in February of 2017.Because infants begin their life on breast milk, parents often think that milk is essential for their child’s diet even beyond the first year of life.  While milk is absolutely important for the first few months of life, once babies can start eating solids, the value of milk (breast, formula, or cow’s) quickly diminishes.  Milk’s main purpose is for humans (and animals) to provide an easy source of nutrition to their babies until they are ready for solid foods – w...
Source: A Pediatrician's Blog - June 3, 2016 Category: Pediatrics Source Type: blogs

Post #43 My Father the Pediatrician
I recently wrote a new book geared to help parents have more meaningful conversations with their pediatrician and which will hopefully save them a copay or two as well!  As I reflect back on the five year journey in writing this book, I wanted to highlight the contributions of my biggest influence – my dad.In the summer of 1973, my father, thirty years at the time, boarded a plane with his best friend to fly overseas for the very first time in his life.  Having recently finished medical school and his mandatory army training in South Korea, he was headed to the United States to begin his residency in P...
Source: A Pediatrician's Blog - December 10, 2015 Category: Pediatrics Source Type: blogs

#43 My Father the Pediatrician
I recently wrote a new book geared to help parents have more meaningful conversations with their pediatrician and which will hopefully save them a copay or two as well!  As I reflect back on the five year journey in writing this book, I wanted to highlight the contributions of my biggest influence – my dad.In the summer of 1973, my father, thirty years at the time, boarded a plane with his best friend to fly overseas for the very first time in his life.  Having recently finished medical school and his mandatory army training in South Korea, he was headed to the United States to begin his residency in P...
Source: A Pediatrician's Blog - December 10, 2015 Category: Pediatrics Source Type: blogs

Post #42 A book review - Being Mortal: Medicine and What Matters in the End by Atul Gawande
In his breathtaking book, Being Mortal: Medicine and What Matters in the End, Atul Gawande (one of my favorite authors) elegantly describes three different modalities of patient counseling that doctors employ.  The first is the oldest and most traditional approach, a paternalistic relationship.  The doctor not only has the knowledge to guide the patient, but also possesses the experience and wisdom to make decisions on their behalf.  The second type of relationship is termed "informative."  Here the doctor informs you about the facts and figures related to your medical problem, along the lines...
Source: A Pediatrician's Blog - August 10, 2015 Category: Pediatrics Source Type: blogs

Post #41 Update on the 2014-15 Flu Vaccine
The main circulating flu this year is a recently mutated H3N2 strain (91% in one sample).  Because of this new mutation, the vaccine currently used is not a great match for this particular strain. In my medical opinion, this paradoxically makes it even MORE IMPORTANT to get the flu vaccine. Mainly, because the worse protection the flu vaccine offers, the more widespread the flu will be this year, and this increases the likelihood that a large percentage of people, both immunized and unimmunized, will contract the flu. However, those who are unimmunized will be at an even greater risk of catching the flu. Ess...
Source: A Pediatrician's Blog - December 5, 2014 Category: Pediatrics Source Type: blogs

Post #40 Flu Vaccine Update 2013-2014 (Quadrivalent vs Trivalent)
How is the flu vaccine formulated?Flu viruses are always changing. Each year, experts study thousands of flu virus samples from around the world to figure out which viruses are making people sick and how these viruses are changing. With this information, they forecast which viruses are most likely to make the most people sick during the next flu season. These strains are then used to make the flu vaccine for the next flu season. The 2013-14 U.S. trivalent influenza vaccines will contain: *an A/California/7/2009 (H1N1)pdm09-like virus *an A/Victoria/361/2011 (H3N2)-like virus *a B/Massachusetts/2/2012-like virusThe newer qu...
Source: A Pediatrician's Blog - August 17, 2013 Category: Pediatricians Source Type: blogs

Post #40 Flu Shot Update 2013-2014
How is the flu vaccine formulated?Flu viruses are always changing. Each year, experts study thousands of flu virus samples from around the world to figure out which viruses are making people sick and how these viruses are changing. With this information, they forecast which viruses are most likely to make the most people sick during the next flu season. These strains are then used to make the flu vaccine for the next flu season. The 2013-14 U.S. trivalent influenza vaccines will contain: *an A/California/7/2009 (H1N1)pdm09-like virus *an A/Victoria/361/2011 (H3N2)-like virus *a B/Massachusetts/2/2012-like virusThe newer qu...
Source: A Pediatrician's Blog - August 17, 2013 Category: Pediatricians Source Type: blogs

Post #39 Vomiting and Diarrhea (Gastroenteritis) in Children: A Practical Guide
It certainly looks, sounds and smells awful, but vomiting and diarrhea are rarely dangerous.Vomiting, not to be confused with spitting up, is the expulsion of food from the stomach.  Spitting up is more of a laundry problem than a medical problem, and kids who spit up do not become dehydrated.  Diarrhea is a little harder to define, because watery stools are fairly common and most healthy individuals will experience it from time to time for reasons which do not qualify as diarrhea.Frequent stools can be normal too, especially in breast-fed babies, who might dirty the diaper every time they feed, up to 12 times a ...
Source: A Pediatrician's Blog - July 13, 2013 Category: Pediatricians Source Type: blogs

Post #38 The Common Cold
It's been around for centuries, and there is no cure. Millions of people every year are miserable because of it, but there is no vaccine. It is the common cold.Back in the 16th century, folks dubbed it a "cold" because symptoms seemed to pop up in conjunction with exposure to cold weather.Today, science has identified more than 200 different types of cold viruses that are specific to humans.Most children will catch six to 12 colds per year, typically in rapid succession and usually in the wintertime – and this is actually quite normal.Kids with colds can be quite miserable, leaving parents desperate for rel...
Source: A Pediatrician's Blog - May 15, 2013 Category: Pediatricians Source Type: blogs

Post #36 Asthma: A Pedi Perspective - Part 4 of 5
Conundrum of causeAccording to a 2010 National Health Interview Survey by the Centers for Disease Control, more than 10 million U.S. children aged 17 years and under have ever been diagnosed with asthma, and 7 million still have it. The study shows that boys were more likely than girls to become diagnosed with asthma.Furthermore, asthma cases in children under 4-years-old increased by 160 percent between 1980 and 1994. And there's been a steady increase in the nearly two decades since then.An analysis by the U.S. Agency for Healthcare Research and Quality states that the percentage of children who use prescription medicati...
Source: A Pediatrician's Blog - February 16, 2013 Category: Pediatricians Source Type: blogs

Post #37 Asthma: A Pedi Perspective - Part 5 of 5
Frequently Asked Questions: I have asthma. Does this mean my child will have it too?There is definitely a genetic component to asthma, but how big a role genes play is unclear. While there isn't a specific asthma gene, it is more likely that your child will inherit the tendency to develop asthma. Why does asthma seem to come and go?Asthma is inflammatory in nature, and there are certain things (triggers) that can cause a flare up. I don't like the thought of my child being on daily medication. I also worry about the medication losing its effectiveness, and then not working when we really need it to.  Can't he jus...
Source: A Pediatrician's Blog - February 16, 2013 Category: Pediatricians Source Type: blogs

Post #34 Asthma: A Pedi Perspective - Part 2 of 5
Diagnosis is in the details Asthma is a disease that is diagnosed by history.  In other words, one cannot make a diagnosis of asthma the very first time a child wheezes.  It's like your friend who show up late to your home for dinner; it would be premature to label them "tardy" after one episode, but if they come late multiple dinners in a row, they are likely "tardy" friends.  With every subsequent wheezing episode, the more likely these are not one time events but a sign that there is underlying asthma.If asthma is suspected, your child may be referred to a lung specialist for a series ...
Source: A Pediatrician's Blog - February 16, 2013 Category: Pediatricians Source Type: blogs

Post #35 Asthma: A Pedi Perspective - Part 3 of 5
Tenets of treatment Inhaled medications are the mainstay of therapy, and are delivered two different ways. The first is a nebulizer, which is a machine that emits humidified air combined with medication. The child inhales the air through a mask.The other way to receive inhaled medication is through "Metered Dose Inhalers." MDIs are the puffers that most people are familiar with. Medication is sprayed directly into the mouth, but a contraption called a "spacer" helps make sure the medication goes directly into the lungs. Using an MDI without a spacer leads to half of the medication missing its mark &ndas...
Source: A Pediatrician's Blog - February 16, 2013 Category: Pediatricians Source Type: blogs

Post #33 Asthma: A Pedi Perspective - Part 1 of 5
It's difficult to diagnose, can attack without warning, and unfortunately we don't know exactly what causes it.It's said to be the most common chronic medical problem in children, fortunately it's manageable with medication.Asthma is a lung disease that causes inflammation and narrowing of the airways, making it hard to breathe.While it affects people of all ages, it most often starts in childhood. According to the American Academy of Pediatrics, between 80 to 90 percent of people with asthma develop symptoms by the age of 4 or 5.Parents tend to worry at the first sign of a cough or wheeze, but in reality, a one-time episo...
Source: A Pediatrician's Blog - February 16, 2013 Category: Pediatricians Source Type: blogs

Post #23 Assessing the Risk of Cell Phones to Children's Health
Recently, our local elementary school allowed a cellular company to hoist a cell phone tower next to the cafeteria. Apparently, the school district will receive some monetary subsidy in exchange for allowing the tower to be built. I am unaware of the politics, legislation and deal-making that allowed this to happen; however, as a local pediatrician (with one child and many patients who attend this school) I felt compelled to do some cursory research into the potential health hazards (if any) regarding long term exposure to a cell tower. As I am not an expert in epidemiology, radiation, cellular technology or cancer, I hav...
Source: A Pediatrician's Blog - March 24, 2011 Category: Pediatrics Source Type: blogs