Degree of illness, not fever, is what harms children

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

Is fever good or bad? Fever is the result of inflammatory process of the body’s immune system.

The inflammatory process may be cause by infection or autoimmune diseases such as rheumatoid arthritis.

Fever is one of the main reasons that children are brought to the clinic or the emergency room.

Many mistaken beliefs about fever have persisted for decades.

In 1980, Dr. Schmitt coined the term “fever phobia” to help explain the unrealistic concerns about fever and how it can hurt children.

He found that 52 percent of parents bringing their children to the clinic with a fever of 104 degrees or less thought that the fever itself could cause serious neurological consequences.

Twenty years later, Dr. Crocetti and associates found that fever phobia still existed with 21 percent of parents thought brain damage was the primary harmful effect of fever and 14 percent listed death as a harmful effect. Continue reading

Miracles happen in medicine

Dr. Victor Sierpina

Dr. Victor Sierpina

Editor’s note: This is the first of a two-part series.

The other day, a lovely 81-year-old patient, let’s call her Edna, an active community volunteer, came in to see me after a bad fall.

The swelling and lack of mobility in her upper arm made me suspect that she had broken her humerus, the big bone in the upper arm. I based this nearly certain assessment on my many years of primary care and emergency room practice.

Since I don’t have X-ray eyes, I ordered an X-ray while our hardworking staff simultaneously arranged for a visit to orthopedics for the requisite splinting.

Imagine my surprise and relief later that morning to find the X-rays were normal. No fracture at all.

When I called Edna to report this happy outcome, she told me she had prayed fervently on the way to Radiology and was quite sure this prayer had had its desired effect, that things would be normal.

Of course, I could have dismissed her personal miracle, but I chose instead to reflect on this story and share it with you. Every doctor knows his or her fallibility, the limits of both our art and science. We can always be wrong though we constantly study and try not to be. Continue reading

Researchers develop new insulin delivery system

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Diabetes is a life-changing diagnosis that can mean several injections of insulin and several tests of blood glucose levels every day.

Some people with diabetes say they feel like a pin cushion, and children with Type 1 diabetes often find it particularly challenging.

However, there may be some relief in sight thanks to nanoparticles.

Nanoparticles range in size from one to 2,500 nanometers. For an idea, the width of a strand of human hair is 100,000 nanometers.

Researchers have developed a new insulin delivery system that involves a network of nanoparticles. Once injected, the nanoparticles release insulin in response to increases in blood sugar levels for up to a week.

They have been tested in mice and if they perform similarly in people, this may be a better solution to managing diabetes than multiple daily injections. Continue reading

Researchers: Parental smoking, childhood ear infections are linked

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

Here is more information on ear infections and smoking in children’s living space.

Ear infections are common in children. They include acute otitis media, which is an infection in the middle ear space associated with pain and fever. There an estimated 5 million ear infections each year in the United States.

There also is otitis media with effusion. Children with otitis media with effusion have extra fluid in the middle ear, so symptoms might include feeling like the ear is plugged or difficulty hearing.

Even if these infections are common, they can have consequences. Sometimes they require surgery and they might make the children at risk for hearing loss and delayed speech development.

A recent review in the Achieves of Pediatrics and Adolescent Medicine showed that having a family member who smoked raised the risk of ear infections in the children who shared their living space. Continue reading

Planning to live and die

Dr. Victor Sierpina

Dr. Victor Sierpina

A strange story was in the news last week that I have been using as a talking point about end-of-life planning.

A deer hunter in his 40s fell 16 feet out of a tree and broke his neck. As a result, he could not breathe on his own and was placed on a ventilator. The doctors told the family he would be dependent on this device for the rest of his life. The family knew he likely would not make this choice if given the option.

So, he was awakened from his sedated state and presented with the situation. He ultimately decided that he did not want to live hooked up to a ventilator for the rest of his life, asked that it be disconnected and died a few hours later. I might have made the same choice.

This true story brings to focus the importance of having patients and their families consider, discuss and sign advance directives, medical power of attorney, and out-of-hospital do-not-resuscitate orders. Continue reading

A real tricorder for your smartphone

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Many people may soon have a piece of “Star Trek” sitting at home in their own medicine cabinets. It’s not a Captain Kirk costume, Spock ears or a model of the Starship Enterprise, but a real-life tricorder.

When “Star Trek” began in 1967, the character Dr. Leonard “Bones” McCoy used this medical device in his work. Now, the Scanadu company has brought this fictional tool to life and called it the Scout.

To use it, a person holds the round, palm-sized tricorder to his or her temple, and it measures temperature, heart rate, respiratory rate, systolic and diastolic blood pressure, blood oxygen saturation and stress level and performs an electrocardiogram.

It does all this with optical sensors in 10 seconds with 99 percent accuracy. It sends the readings via Bluetooth to a smartphone, where apps track and analyze the data. Continue reading

Use antibiotics judiciously to preserve power to heal your child

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

Despite a growing concern in the medical community over antibiotic resistance, parents still request that pediatricians prescribe such medications for their children even when the antibiotics are unnecessary, according to a study published by the American Academy of Pediatrics.

Researchers surveyed 400 parents and 61 pediatricians and found that 18 percent of parents give their children antibiotics without consulting a physician.

Nine out of 10 parents thought antibiotics were needed for ear infections, eight out of 10 thought antibiotics were needed for throat infections and six out of 10 thought antibiotics were needed for cough and fever.

On the other hand, the physicians surveyed felt like the medication was not needed in most cases. Most coughs, ear infections and sore throats are caused by viruses. Continue reading

Staving Off Dementia

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

“When I was younger, I could remember anything, whether it had happened or not; but my faculties are decaying now and soon I shall be so I cannot remember any but the things that never happened.”

While American novelist Mark Twain can invariably add his iconic sense of humor to any situation, it is no laughing matter when patients lose their memories and cognitive function to dementia. And for their family members, there is hardly anything harder than caring for a loved one who can no longer remember them or any shared experiences. But lowering a person’s risk of dementia may be as simple as changing his or her lifestyle.

The incidence of dementia increases with age. As the average age of Americans increases, the number of people with dementia also increases. In 2010, more than 30 million people worldwide had dementia, and this figure is estimated to more than triple by 2050. Continue reading

How to make the most of a doctor visit

Dr. Victor Sierpina

Dr. Victor Sierpina

If you have an ear infection, a laceration, broken bone or other acute problem, the answer to this question is easy. You expect and likely will receive immediate, competent and focused care of your condition.

However, in the primary care arena in which I work, these kinds of visit are a relatively minor, simple part of our daily work. Much more time and effort is dedicated to the management of chronic diseases, doing annual physicals and attending to preventive and screening issues. Trying to manage these larger issues is not usually possible during an acute care visit so another appointment generally needs to be scheduled.

So how do you make best use of these more complicated visits? In the words of the Boy Scout motto, “Be prepared.” Continue reading

Choose which health insurance plan is best for your family

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

The American Academy of Pediatrics recently reported in their Parent Plus column some information about the Affordable Health Insurance Act.

Starting Jan. 1, almost all Americans must have health insurance. If you do not have health insurance, you may have to pay a fee.

Now is a good time to see what health insurance benefits are best for your family and whether you qualify for a lower cost plan.

If your family already has health insurance through an employer, there is no need to change anything. Children 26 and younger can be covered on their parents’ health plan.

If you do not have health insurance, you can find options through your state’s Health Insurance Marketplace. You can sign up for an insurance plan during the open enrollment period through March 31. Continue reading