“Chronic Fatigue Syndrome” Gets a Make-Over

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by Dr. Jennifer Caudle, Family Medicine

Chronic Fatigue Syndrome, a condition that has long been difficult to diagnose and treat, is now getting a make-over. The Institute of Medicine (IOM) estimates that between 800,00 and 2.5 million Americans suffer from Chronic Fatigue Syndrome which is characterized by fatigued, trouble carrying out daily activities, sleep difficulties and cognitive problems.

As a physician, I have to admit that I didn’t learn a lot about Chronic Fatigue Syndrome, or how to treat it, in medical school or residency. I’m not alone, however, as many physicians lack appropriate knowledge about this condition. Furthermore, biases about “Chronic Fatigue Syndrome” do exist and some feel the condition is fake or non-existent.

These biases as well as the lack of knowledge about the condition make it very difficult for patients to get help and physicians to make the diagnosis. To this end, the Institute of Medicine examined the medical literature that exists for Chronic Fatigue Syndrome. As a result of this in-depth analysis, the IOM committee proposes to change the name of “Chronic Fatigue Syndrome” to “SEID- Systemic Exertion Intolerance Disease.” The committee also proposes new diagnostic criteria to help doctors and patients with diagnosis.

I have always enjoyed appearing on the Dr. Oz Show and have been on the show a number of times but I wanted to discuss this topic in particular because of the new changes proposed by the Institute of Medicine. Tune in to the Dr. Oz Show on Thursday, March 5th as I discuss the ‘make-over” and new criteria proposed for SEID- Systemic Exertion Intolerance Disease. Check your local listings for air times.

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Dr. Jennifer Caudle is a Family Physician and Asst. Professor in the Department of Medicine at Rowan School of Osteopathic Medicine. She appears regularly on CNN, The Dr. Oz Show, CBS Philly, Fox and others. Please visit her at http://www.jennifercaudle.com and on Instagram and Twitter at @drjencaudle.

The Key to the Kiss: 5 Tips for the Best Lips Ever

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by Dr. Jennifer Caudle, Family Physician

This is the season for love and romance! As a physician, I know that love and affection are not only healthy for the heart, but the mind as well. One of the classic ways to show affection is through the kiss. What part of the anatomy is crucial to the kiss? The LIPS!

Too often, the lips are a forgotten part of the body. We often take care of our skin, are joints and muscles, brain and other body parts…but we forget the lips. It’s important to tend to our lips- this will keep them healthy and soft- keys to a great KISS! Here are 5 tips to having the best lips (and kiss) ever:

1) Stay moisturized. Wear lip balm or moisturizing lipstick to keep your lips supple and soft- SOFT lips are important! Tell me, who wants to kiss dry, cracked lips? Exactly. No one. Keep ‘em moisturized- and this goes for you too, men. Moisturized lips will lead to soft lips!

2) Wear SPF on your Lips. Make sure your lip balm has a broad spectrum sunscreen in it; this is important because skin cancers can occur on the lips. In addition, the sun can cause or exacerbate chapped lips.(If you are unclear about the problems with chapped or cracked lips, see #1)

3) Don’t lick your lips. Do you lick your lips excessively? When you get nervous, stumped, or excited?? If you do, it’s time to stop. Licking your lips can cause them to get dry and cause chapping. Fight the habit!

4) Embrace Humidity. Winter air can be drying, which in turn, can cause dry skin and dry lips. Keep the air in your home slightly humid (use a humidifier, for example) – this will add moisture and help keep your skin and lips hydrated.

5) Protect your lips! Remember, your lips are just as important as every other body part! Keep your lips protected- especially in this harsh winter weather (windy, cold days)- by covering your lips with a scarf to avoid getting damaged!

Take the poll, and tell me what factors you think makes a great kiss!

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Dr. Caudle is a board-certified Family Physician and Assistant Professor in the Department of Family Medicine at Rowan University School of Osteopathic Medicine. She appears regularly on television as a media expert and appears regularly on CBS Philadelphia News, Fox News, CNN, The Dr. Oz Show, HuffPostLive, Doctors Radio (Sirius) and others. Visit at www.jennifercaudle.com, and follow her on twitter/Instagram at @drjencaudle. She believes in soft lips and good kisses.

Five Things to Do Before Your Gynecology Visit: What Your Gyn Wants You to Know

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by Dr. Kalinda Woods

 

  1. Pretend we are your Therapist: Tell ALL!

Think of your gynecologist as the Oprah of the medical realm. Have a bump ‘down there’ that you’re stressed about? Odds are excellent that your doctor has seen that before, knows how to treat it, and will reassure you that it’s not the end of the world. You’ll get the most out of your visit by being as honest and forthcoming as possible. Be assured that your doctor is well trained to deal with whatever is ailing you and there is little you can say or show her that will startle or offend. As physicians, our goal is to make you better, never to judge or chastise. It’s okay to cry in the stirrups. That’s why there’s a box of tissues right next to your head and a picture of kittens on the ceiling.

  1. Wear clean socks.

Most women worry about the smell or appearance of their vaginas at their pap smear, but the truth is, vaginas are not as offensive as people would have us believe. Feet, however can be nasal insults unto themselves. During an exam, the part of your body closest to your doctors nose is…think about it…your feet. A word to the wise is sufficient.

  1. Check your calendar

When was your last menstrual period? This information is important for docs to know. We make many types of women’s health decisions based on this info: from when to advise you to stop/ start contraception, to when to have sex if you are trying to conceive to whether you are going into menopause. Your doctor can also use this information to time certain laboratory and diagnostic tests. Always remember: the quality of the information you give your doctor can make all the difference in performing an accurate work up and making a timely diagnosis. So, when your doctor asks you this question, please be able to shout out the date! This will save time and provide a wealth of information for your doctor.

  1. Know your medications

Your gynecologist needs to know what meds you are taking- especially if they will be prescribing other medications. Don’t assume that because you say you have high blood pressure your doctor knows what medicine you take. And saying, “high blood pressure pill” is not acceptable. If you’re not sure, that’s okay, just call the office when you get home with your medication list so your doctor can update your chart.

  1. Your doc doesn’t know Insurance

Your doctor is a very simple creature. She spent many years studying the science, perfecting the technical skills, and learning the unteachable art of medicine that only comes with experience and having the privilege and the pressure of caring for the health of another. Does she know copays and deductibles? Not so much. Call the number on the back of your insurance card and chat with them about your questions- that’s what those folks are trained to sort out. If you don’t have a card, hope your doc has someone in her office with a fancy title like “Financial Advisor” who can assist with cost and billing concerns.
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Kalinda Woods, MD, FACOG, is an Assistant Professor of Gynecology and Obstetrics at Emory University School of Medicine.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

Post-Partum Depression: A Different Kind of Fairy Tale….

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by Dr. Kecia Gaither, MD

A new mom and depressed? These seem like two realities which radically contradict each other. However, given the fact that you have just delivered a child, and are feeling sad and overwhelmed—your feelings are not uncommon and entirely understandable. While pregnancy has always been seen as a happy time in a woman’s life – a time she can reflect on her own well- being and her status change to “mother,” —for many time is not a fairy tale.

Let’s pull back the cover on some basic issues—pregnancy and the postpartum are a phase where, not only are there biological changes, but psychological ones as well. For some women, these two factors alone can constitute a difficult time: feelings of inadequacy ( I can’t do this), poor self esteem ( I’m not good enough to be a mom), or ambivalence ( this is not what I thought it would be) may erupt and create a situation where there becomes an inability to care for yourself and your newborn as well.  According to ACOG ( American College of Obstetrics and Gynecology) at least, 14-23% of all women in the U.S. experience some degree of depression during pregnancy and the postpartum period. As an Ob/Gyn who specializes in high risk pregnancies, I have seen and dealt with many moms in your situation.

What’s most important is that you know the signs of depression and if you are experiencing any of these symptoms, you discuss them with your doctor. If you are unable to care for yourself, you will not be able to be the fabulous mom you were born to be for your child. So let’s talk about some of the common symptoms of depression– loss of energy, concentration difficulties, eating/sleeping (either too much or too little), low self esteem , denial, guilt, suicidal thoughts, and lack of pleasure. These symptoms are generally present daily and last for more than two weeks. If these symptoms are left untreated, there can be negative complications including:

  • Poor mother-child bonding
  • High incidence of postpartum psychosis
  • Increased risk of substance/child abuse

It is essential to treat your depression during this time to protect both you and your baby. Medication and psychotherapy are typically the first line treatment modalities recommended.   If anti-depressive medications are chosen, your doctor should help weigh the benefits and risks of taking these medications, particularly should you desire to breastfeed.

Here are my recommendations:

  1. It’s ok to seek the comfort and counsel of others.
  2. Align yourself with a support group of moms who are also experiencing the same situation as you—they can appraise you of any potential impact on your work life, the potential interactions that may occur with the other children/family members in the house, and how it may impact your relationship with the baby’s father. This is important, because if depression persists , your may not be able to provide the best nurturing for the infant– which in turn may further exacerbate your depression.
  3. It is important to continue with your postpartum care.
  4. Take home message? Remember you are not alone. Being able to care for you and your baby well after birth means being concerned with you first, in the here and now.

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Kecia Gaither, MD MPH FACOG is the Director of Perinatal Outreach, Montefiore Medical Center, Albert Einstein College of Medicine. Follow her on twitter @KeciaGaitherMD.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

Can TV Shows Help Kids? A Neurologist’s View

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by Dr. Heidi Moawad, Neurologist

Television has been scientifically proven to produce many harmful effects on children and adults.1,2 From setting the stage for unrealistic expectations linked to low self-esteem and eating disorders to advertising unhealthy food and presenting unethical behavior as the norm, television can have many undesirable effects.

But some television shows provide entertainment while actually cultivating intellectual or emotional maturity. Some characteristics of these shows teach kids aspects of the real world that can help them understand how to interact with others in a positive way.

The following is a list of popular television shows that, in my observation, help develop a variety of valuable emotional, interpersonal and practical skills for growing children while providing wholesome family entertainment.

Love it or List it

Each episode of this program centers on a different couple – homeowners who are dissatisfied with their home. One homeowner wants to move to avoid making extensive repairs while the other wants to stay because of loved features of the home. The couple agrees to a remodeling and a new home budget while a real estate agent and a home remodeler compete to see who can provide the couple with the best living option. 

There are many great lessons to be learned from this program. The couple agrees to come to a compromise after they each list their wants in a home. They are encouraged to be considerate and compromise with each other. The couple sets a realistic budget, not an extravagant price, thus setting the stage for compromises. The real estate agent and the remodeler compete in a good-natured but genuine competition and accept loss graciously once the couple make a decision at the end. Lessons learned include compromise, good-natured competition and setting a budget.

The Middle

This is a comedy about a working class family with 3 kids ranging in age from grade school to college age. The plots are humorous and often touching, usually highlighting the message that the characters are imperfect but generally honest and kind. The show, unlike most television shows directed towards kids, does not focus on extravagant wealth or superstar kids or superpowers but instead on ordinary kids who lack more talents than they have. The benefits of watching this program include exposure to normal expectations and watching a family work through some typical problems within a half-hour episode.

Chopped / Cupcake Wars

The cooking challenges in this show focuses on the swift creation of a tasty and attractive meals using unusual ingredients. Contestants have to think on their feet, work well with their team, and use constructive criticism to improve as the show progresses through each round. There is some occasional crying but the show teaches poise under pressure, creativity, and compassion for the loser, who is always presented as very human. Many contestants return even after having been eliminated on past episodes, emphasizing the importance of persistence. 

Shark Tank 

This reality show features fledgling entrepreneurs with business ideas that they want to take to the mass market. A panel of potential investors offer varying levels of financing and partnership in the young businesses. Unlike most reality show competitions, every contestant on the show can win. Business offers are made quickly and clearly which emphasizes the importance of strong math skills. Business ideas are praised, criticized and questioned, teaching the importance of self-confidence as well as the importance of keeping an open mind to constructive criticism.  

The Voice 

This show is about talented vocalists who compete for voice coaching and mentorship by celebrity judges. While there is certainly an emphasis on entertainment, this show emphasizes the importance of coaching and reveals that even talented people need to work hard to improve. At the core, this show also demonstrates the tough reality that great raw talent can’t progress to the professional level unless it is packaged for general consumption similar to the message of Shark Tank. 

The Biggest Loser 

This reality show features obese contestants who need to lose weight. An emphasis on health, making positive changes, looking towards the future and not being ashamed of admitting the you need to work on self-improvement are central to the concept. Most importantly for kids, while there is a prize for the winner, the benefits for all contestants lies in the process itself – emphasizing the importance of working hard in daily life. For example, if a student is not number 1 academically or in sports or other extracurricular activities, participation is still beneficial. 

Television, like anything in life, can be harmful, but an also be beneficial if used mindfully. Kids can get some valuable advantages from some television shows that teach realistic and useful life lessons.

 

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Heidi Moawad MD is a Neurologist and a medical writer. Dr. Moawad is a graduate of Case Western Reserve school of Medicine and trained at University of Chicago Hospitals. Dr. Moawad is the author of “Careers Beyond Clinical Medicine” and she teaches human physiology and global health at John Carroll University in Cleveland, Ohio.
http://nonclinicaldoctors.webs.com/ 

 

Sources:

http://www.ncbi.nlm.nih.gov/pubmed/24639016

Early childhood electronic media use as a predictor of poorer well-being: a prospective cohort study, Hinkley T, Verbestel V, Ahrens W, Lissner L, Molnár D, Moreno LA, Pigeot I, Pohlabeln H, Reisch LA, Russo P, Veidebaum T, Tornaritis M, Williams G, De Henauw S, De Bourdeaudhuij I , JAMA Pediatrics, May 2014

http://www.ncbi.nlm.nih.gov/pubmed/25230366

“I Think My Child is Being Bullied: What Can I do?”

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by Dr. Jennifer Caudle, Family Physician

Over the years I have spoken with over 50,000 children, parents and youth about Bullying. This is a topic that I am not only passionate about, but dedicated to helping prevent. In this issue of The Physicians Blog, I wanted to honor “Bullying Prevention Month” (October) by answering your most commonly asked questions about bullying:

1) What are the warning signs that would let me know that my child is bullied?

The following situations should prompt you to ask questions about what your child might be experiencing:

  • If your child has changes in habits, including eating habits (skipping meals), sleeping habits (problems sleeping), or activities (decreased interest in activities)
  • If you notice injuries that cannot be explained
  • If your child has frequent health issues such as headaches, stomach aches, and generally not feeling well
  • If your child has experienced achange in grades (decline), not wanting to go to school or skipping school
  • If he/she has had a change in friendships or avoidance of certain social situations
  • If there is decreased self esteem
  • If your child exhibits sadness or talks about suicide

Any of the above are signs that your child might be involved in bullying behaviors. If any of them occur you should talk with your child. At times (such as in the case of suicide, etc), you should discuss these symptoms with your child and their health care provider as soon as possible.

2) How do I talk with my child about being bullied? Especially if they feel threatened or scared to talk- How do I break the silence? And, what are some tools to help them?

The following are tips to help you talk with your children about bullying and help them:

  1. Ask specific and open-ended questions
  2. Find out what is happening to your child by showing interest
  3. Understand that your child may feel fear or shame about the situation
  4. Talk with your child’s school officials-  including bus drivers, school counselors, teachers and administrator
  5. Encourage your child to get involved in activities they might enjoy-  this can actually be protective for children who are bullied. Encourage your child to spend time with others who have similar interests.
  6. Role play solutions at home
  7. Educate your child about bullying and cyberbullying and monitor online behaviors by following your kids on Facebook, Twitter and Instagram!
  8. Model good behaviors at home
  9. Discuss your child’s feelings and experiences with your child’s physician

3) Is it bullying, or just kids being kids? When will I know that it is bullying and when should I intervene?

Bullying behaviors should ALWAYS be intervened!

The definition of bullying is:

  1. Behaviors intended to hurt or harm someone
  2. There is a perceived imbalance of power between the parties involved
  3. The behavior is repetitive

Research has shown us that children who are bullied or who are bullies often have long-lasting consequences that may be psychological (increased risk of depression and anxiety), behavioral (problems with violence or substance use) or include other health consequences such as headaches, stomach pains, fatigue, etc. Bullying is a health problem that can affect many aspects of a child’s health and intervening should always be a priority!

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Dr. Jennifer Caudle is a board-certified Family Physician. She is an Assistant Professor in the Department of Family Medicine at Rowan School of Osteopathic Medicine. Dr. Jen is the author of “Bullying Among Today’s Youth: The Important Role of the Primary Care Provider” http://www.osteopathicfamilyphysician.org/article/S1877-573X%2813%2900041-5/abstract.

Dr. Jen serves as an on-air health expert for local and national news networks including CNN, The Dr. Oz Show, FOX News, CBS Philly 3 News, The Tom Joyner Morning Show and many others. She is also the creator of The Physicians Blog. Follow her on twitter @drjencaudle and visit her at www.jennifercaudle.com.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

“Oh, My Aching Back:” Causes and Treatments of Low Back Pain

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by Dr. D’Wan Carpenter

Low back pain is a common stated complaint in most doctors’ offices. Low back pain is in the top 3 list for reasons people miss work in America. So what should you know?

For starters, low back pain has many causes. It can be from a muscular sprain/strain, myofascial pain (tightness and spasm of muscles), facet joints, sacroiliac joints, protruding discs compressing spinal nerves (which give radiating pain down one or both legs), or spinal stenosis (narrowing of the spinal canal which puts pressure on the spinal cord). If you have sudden or rapidly progressing leg weakness, new bowel or bladder incontinence, numbness in the genital area you need to be evaluated immediately by a healthcare professional as this can be the signs of an emergency.

While this list is not all inclusive, it represents the most common causes. The good news is most acute back pain, occurring 3 months or less, gets better on its own in almost 90% of cases although recurrence is possible. The other 10% of cases become chronic and are generally causes by one of three sources:

  1. Intervertebral disc-the disc in between two vertebral bodies in the spine
  2. Zygopophyseal joint (facet joint)-the joint created by the bottom of one vertebra and the top of the next vertebra below
  3. Sacroiliac joint (SI joint)-the joint created by the sacrum (the bottom of the spine) and the ilium (upper part of the pelvic bone)

Low back pain, whether acute or chronic, can limit your function with daily activities, interfere with sleep, and work performance.

Everyone wants to know, what can be done about this pesky back pain?

In most cases, pain medications such as non-steroidal anti-inflammatories (NSAIDs) like ibuprofen can relieve much of the pain. In conjunction, physical therapy for stretches, body mechanics training, and home exercises are often helpful. Osteopathic manipulative treatment (OMT) by an osteopathic physician can help restore the body’s overall function and help promote self-healing. Injections can be indicated particularly in the three main chronic causes. (To find a DO near you http://www.osteopathic.org/osteopathic-health/Pages/find-a-do-search.aspx) Epidural steroid injections (injections into the spinal canal with anesthetic solution and corticosteroid solution) can help relieve the inflammation caused by a protruding disc. SI joint injections are both diagnostic and therapeutic. Zygopophyseal/facet joint nerve block is diagnostic and can be followed by radio-frequency ablation (procedure where radio-frequency waves create heat that burn the identified pain causing nerves around the facet joint)of the nerve for long-term pain relief. Surgery may be indicated if all of the above measures fail, but keep in mind this should be last resort as surgery comes with its own risks.

Take home message:

  1. Remember when lifting heavy items particularly up from the floor, use the leg muscles and not the back to avoid injuries related to improper lifting
  2. Numbness in the genital area, back of legs and buttocks, bowel or bladder dysfunction, and leg weakness can be signs of an emergency and requires immediate evaluation.
  3. Avoid bed rest, but instead modify activities and decrease activity if necessary as complete bed rest can cause weakness of muscles which may exacerbate the condition.
  4. A thorough exam by your doctor is the best way to diagnose the cause of low back pain. Schedule a visit with your doctor especially if your low back pain is not getting better so that you can get the appropriate treatment you need.

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D’Wan Carpenter, DO is a graduate of University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine (now Rutgers School of Medicine) in Stratford, NJ in 2010. Dr. Carpenter is currently finishing her last year of residency in Physical Medicine and Rehabilitation in Taylor, MI with plans to focus on outpatient medicine to include treatment of joint pain, back pain, and neck pain with use of ultrasound injections, physical therapy, and manipulative techniques.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

5 Ways To Help Your Child Have a Healthy “Back-To-School”

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by Pediatrician, LaKesha Davison, MD

 

Are you and your children ready for another school year?  Here are 5 tips for a smooth transition:

1. See your pediatrician. If you haven’t already had your child’s annual exam, now is a perfect time to do so. Your child will be screened for obesity, learning disorders, vision problems and several other common problems. Teenagers will also be screened for depression, anemia and scoliosis and can be screened for sexually transmitted diseases. Your pediatrician will be able to fill out any forms needed for school at this time. Health is wealth and your child may have trouble performing well in school if his or her health care needs are not being addressed.
2. Insist on participation in organized activities. Several studies have shown that children and teens who play sports have higher self-esteem and lower rates of obesity. This is especially true for girls, with the additional benefit of lower rates of teenage pregnancy. If your child can not participate in sports, or has other interests, encourage him or her to work on the school yearbook committee, or debate club, or band or chorus. These all provide a sense of achievement for the children and teach them about responsibility to others. These activities also decrease idle time, which is the time when trouble finds kids.
3. Decrease screen time. Children should have two hours or less of screen time once they get home. This includes tablets, TV, smart phones and computers. Their time should be spent interacting with siblings and parents, active play, reading, eating as a family and sleeping. Children in middle school and high school may need to use the computer for school work, but afterwards, they should take a break from the screen as well. Children who have difficulty falling asleep and are hard to wake up in the morning should not be allowed to take electronic devices to bed. These gadgets often stimulate the children and keep them awake instead of helping them to wind down in preparation for bedtime.
4. Encourage healthy habits. Limit sugary drinks, including juice, to less than 8 ounces a day. Encourage your children to drink water. Remind your children to wash hands after using the bathroom, even if they just went “number 1”. Your children should also wash hands after touching their mouths, after sneezing, and after using school computers. If they can’t get to a sink, pack hand sanitizer in their backpacks to help reduce the spread of germs. The beginning of the school year is when we see a huge number of outbreaks of strep throat, colds, stomach flu and other infections.
5. Be Nosey. This may be the most important thing you can do for your children. They should expect you to know about almost everything in their lives. Ask questions about what they learned in school, about what homework they have, about their friends’ names, about their favorite teacher, about how they feel about their body’s changes as they go through puberty and more. You should also know how they spend their free time and time between classes. There are several dangerous games that kids are playing, including lighting themselves on fire and hyperventilating until they pass out. Middle schoolers are especially at-risk as they are trying to learn some independence but lack insight. This is also the time that many children are first exposed to drugs, alcohol and sexual images/conversation. If your child knows that you are aware of or will quickly find out what they are up to, they are less likely to engage in dangerous activities. In addition, if your children know that you are interested in their lives, they are more likely to talk with you before making important decisions such as whether to use drugs, when to engage in sexual activity and what they will do with their lives after graduation. You will be your child’s greatest advocate. Your children might not realize it, but they need you. Don’t let mood swings or perceived disinterest dissuade you from giving them the attention they require to help them successfully navigate the challenges of obtaining their high school diploma. Always remember that your pediatrician is around to help you through this time as well. Good luck!
Dr Lakesha Davison
LaKesha M. Davison, MD, FAAP
Pediatrician
Decatur Pediatric Group, PA
Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

“The Last Kiss. Saying Goodbye:” Thoughts Of A Doctor/Mom After The Death Of Her Son

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by Dr. Joyce Scott, Family Physician

 

“Death is going to be an awful big adventure,” Peter Pan.

And just like that the one you love is gone.
The only ones that know about death are those in the grave and they are not talking. There is a sense of mystery and wonder about death. Like death, grief is a personal and individual experience. The very moment that you experience the death of a loved one, and the grief that follows, will forever be etched in your heart and mind. Years may pass marking another anniversary of their death, but the memory is as fresh as the day it happened.

At the tender age of 19 years my son died. While sitting at his bedside the noise of the ventilator and medical equipment broke the silence of fear. I would talk to him and whisper “I love you.” I probably prayed more during those two days than all the rest of my life combined. I found hope and comfort in other families in the waiting room that were experiencing similar problems. Strange but the doctors never gave us hope. The first time that I met the neurosurgeon he shook my hand and then told me, “Your son has zero chances.” Once when I saw a tear fall from my son’s eye I became overwhelmed and said, “He heard me.” The nurse scowled at me, “That is not a tear. That is fluid from where his brain is swelling. He can’t hear you.” I gently wiped the tear from his eye and whispered, “Rawlin, it’s mom. I love you.”

 
Hope is personal, providing comfort and softening the blow for bad news to follow. Taking away someone’s hope is like a thief in the night stealing a precious treasure. People look to the sky and search for a loved one. Somehow that sense of a Heaven above is where we might find them. Someone said to me “Rawlin is in a better place.” I looked at her, stretched out my arms and replied, “What better place for a child than in the arms of his mother that loves him.” Longing to see, feel, touch or just to sense their presence one more time lingers. I still believe my son heard me. Even if he didn’t, I would still want the last words that I spoke to my son to be “I love you Rawlin.”

 
I often heard phrases “time heals all pain”, “you will get over it,” and “you have two other children to take his place”. Once I replied, “Time does not help. It only reinforces that Rawlin is not coming back. You can get over a fence but you will not ‘get over “a death”. “No one, not even one of my other children will replace Rawlin.” To suggest that he can be replaced is to say in essence that he really didn’t matter anyway, his life was of little value, with no purpose because another can take his place. As the mother of three, each child occupies their own space and place in my heart and the family. People have said, “I know just how you feel.”  But, how can anyone ‘know’ another person’s thoughts and feelings? I’ve also heard, “It could have been worse.” I find it strange that during grief we have to imagine some horrible incident that could be worse so that death doesn’t seem so bad after all.

 
In this day of mass communications, internet frenzies, viral sensation, most trending events, tweeting, blogging, and even Facebook it is easy to get swept away in a cloud of confusion. We feel the pressure to say something. “I am sorry” or “I am sorry that this has happened to you” are simple ways to convey sympathy. Often, a gentle caress, sincere hug and even a tearful gaze from another can comfort and show compassion and sympathy. Sometimes you say it best when you say nothing at all.

 

“And all the king’s horses and all the King’s men couldn’t put Humpty Dumpty together again.” Powerless over death. We hear phrases like, “I would drown saving my child. I would die saving my child.” All of my medical training and education could not save my own child’s life. It is difficult to not feel like a failure. I did not swim fast enough to save my son. “No man is an island, we are all a part of the main.” Death and grief changes who we are. I told my daughter, “I will never be the woman that I was before Rawlin died.” My daughter now had two mothers: the mother she knew before Rawlin died and the mother she lives with now after he died.

 
I heard this advice, “Stop living in the past.”  That is where my son is….in the past. The only way that I can be with him is to return to the past. Move on.


How can we ease the pain and try to assemble the pieces to our shattered heart and life after the death of our loved one? Is there hope and peace beyond the grave? The answer is yes. It may take more effort and energy than required by Atlas while holding up the weight of the world, but it is doable.

 
1. Throw away all the misconceptions and misinformation from standardized grief processes. Avoid getting caught up in rules, steps to climb, stages to successfully pass through. The path of grief is a long and winding road that takes us on a journey for the broken heart.
2. Thrown down your armor and weapon along with your shield from pain. Loss makes us vulnerable. Realize that it is okay to be sad. It is okay to cry. One sincere listener can ease much pain. Allow the sympathizing heart of others to share the sorrow. It may be becoming weak that we survive to be strong.
3. Find strength in others while making time for being alone. Sometimes it is normal to seek our own solitude and quiet in order to appreciate the relationship shared with the lost loved one. As a mother I am reminded that I was not the only one that lost a son. My husband did also. My other children lost their brother.
4. Allow yourself to have freedom from pain without feeling guilty. It is okay to smile again; to laugh again; to rejoin life again.
5. Take care of yourself. Maintain nutrition and sleep. Try to get some form of physical exercise such as walking. Often our physical body suffers along with our emotional self.
6. If the time continues without going toward a healing process, there are professionals which can be instrumental. Counseling provides a safe time to ventilate feelings while receiving a sense of trust and unconditional caring support.
7. Although there is no such thing as a ‘miracle pill’ or remedy, there are many new medications available which also have added benefits to assist through emotional turmoil and situations. Symptoms of sleeplessness, anxiety, sadness, and lack of motivation for routine daily living can be improved with medication. Speak to a healthcare provider with concerns and possible prescription medication.

Joyce E. Scott, D.O.
Board Certified Family Practice,  author and motivational speaker

Twitter:  @JoyceEScott1

http://www.drjoycescott.com/
https://www.facebook.com/joycees1

 

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

“Don’t Eat the Alfredo, Sweetheart.” How to Prevent Food Poisoning

doctor and stomach vector icon

by Dr. Lenny Powell

The evening of July 31, 2011 was lovely – my wife and I went to an Italian restaurant for dinner. She ordered pasta with marinara sauce, and I had the fettuccini Alfredo. We were sitting outside and the temperature was a balmy 95 degrees. We took our time eating our meals, picking at them while we gabbed and laughed about our day.

Then, it hit me – a grumbling and gurgling in my stomach about an hour after I finished my meal. “Hmm, that’s odd.” I thought. My stomach didn’t really hurt but it felt kind of annoying. I excused myself to the bathroom and came back a few minutes later, feeling somewhat better. Then it happened again- not cramps, but stomach pangs. I thought to myself, “this isn’t going to be a fun night.” By the time I got home I realized that I had food poisoning!

Foodborne illnesses strike about 1 in 6 Americans (48 million) every year; 128,000 people are hospitalized, and 3,000 people die from complications. Food poisoning can be caused by bacteria, viruses, toxins, or chemicals. Foods most commonly associated with foodborne illnesses include raw foods such as meat, poultry, milk, shellfish, eggs, and raw fruits and vegetables (1).

Food poisoning is caused by eating foods that are contaminated with bacteria or other pathogens. The good news is that most of these infections are largely preventable, and there are simple steps that can be taken to minimize exposure to these pathogens.

Safe food preparation is a key to avoiding foodborne illness. According to the CDC (1), it’s important to “Cook, Separate, Chill, and Clean” foods to prevent food poisoning:

Cook meat, eggs, and poultry thoroughly. Use a food thermometer to make sure you meat is cooked properly and use this chart as a guide: http://www.foodsafety.gov/keep/charts/mintemp.html. Make sure your eggs are cooked until the yolk is firm.

Separate foods so that they do not cross-contaminate one another. Keep produce separate from meat, poultry, seafood and eggs. Use separate cutting boards and plates and keep these foods separate in the refrigerator as well.

Chill promptly fruits, vegetables, milk, eggs, and meats. Bacteria can start to grow as quickly as after one hour unless foods are refrigerated. A cooler in the car with ice may be a temporary fix but the best thing to do is to get your food home, especially on a hot day, and into the refrigerator. It is also important to thaw or marinate foods in the refrigerator and never on the counter or in the sink.

Clean your hands, your surfaces, your utensils, and your fruits and vegetables. Clean your hands for at least 20 seconds with soap and warm water, your utensils and small cutting boards with soap and hot water, and surfaces as well as larger cutting boards with a bleach/water mixture. Wash fruits and vegetables before peeling to prevent bacteria from creeping inside and causing contamination.

Those who are most at risk from foodborne illnesses include pregnant women, the elderly, and those with weakened immune systems. Additionally, bottle-fed infants should be provided with clean and disinfected bottles with each feeding.

Symptoms of food poisoning include abdominal pain, nausea and vomiting, diarrhea, and fever. You should see your doctor if these symptoms progress to any of the following (1):

• Diarrhea, particularly if you notice blood, that lasts longer than 3 days
• Persistent abdominal cramping or pain
• Nausea and vomiting that is prolonged and such that you cannot keep liquids down
• Fever (greater than 100.4 ºF, measured orally)
• Decreased urination

Symptoms can range depending on the cause of the food poisoning. The goal of treatment is to replace fluids and, if warranted, provide antibiotic therapy. Not all foodborne illnesses require antibiotic therapy, as many diarrheal illnesses are viral in nature and will not be affected by antibiotic therapy. In some cases antibiotics may be more harmful than helpful.

“Don’t eat the Alfredo, sweetheart,” my mother warned me sternly at an outdoor wedding we attended shortly after this episode, “you don’t want to go through all that again!” I nodded in agreement, realizing that food safety and handling is of paramount importance and that with appropriate measures, illness can effectively be prevented.

Dr. Powell

Dr. Lenny Powell is a third-year Family Medicine resident at Rowan University School of Osteopathic Medicine. He presently has the pleasure of rotating with Dr. Jennifer Caudle (@drjencaudle) on a Medicine in Media rotation exploring the media communicates health information to the public. Follow Dr. Powell on Twitter @drlennypowell.

Reference 1:  http://www.cdc.gov

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

 

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