Above view of large group of embraced people in nature.

Recognizing the Person, Not the Disability

Anna Wafula Striker, author of In My Dreams I Dance, writes that, “When you have a disability, knowing that you are not defined by it is the sweetest feeling.”

How we phrase things is important and “people first” language should be used when describing someone with a disability: the child with autism, the boy with a hearing impairment, the woman with Down Syndrome—not the autistic child, the deaf boy or the Down Syndrome woman.  A person is not the disability.  The diagnosis of a disability should not rob anyone of their identity.

It should go without saying that it is never okay to use the word “retarded” as slang for something stupid or dumb, like “what you are doing is just retarded” or “that TV show is retarded.” The term, mental retardation, as a diagnosis is even outdated; although some states may still use the term to qualify individuals for some specific services.  Intellectual disability and developmental disability are the preferred terms.

So what falls under these categories? According to the American Association on Intellectual and Developmental Disabilities, “intellectual disability” is a disability that occurs before age 18 and causes significant limitations in intellectual functioning and adaptive behavior.  The term “developmental disability” includes intellectual disability but also is broader in scope to include other disabilities appearing in childhood. Intellectual and developmental disabilities are significant and chronic and often affect both cognitive and social skills, as well as activities of daily living.

Disabilities of all types can affect someone’s daily functioning. Attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD) and learning disabilities (LD) may not be easily detected but can still impact the person’s educational progress and quality of life.

The  LSU Health Shreveport School of Allied Health’s Children’s Center has a diagnostic team that works with families and school systems to make such determinations and help ensure students with these disabilities receive the assistance they need to achieve better outcomes in school and daily life.   The Children’s Center diagnosed and made recommendations for assistance for 78 children with ADD or ADHD and 22 students with LD, as well as 145 more students who had other types of developmental issues in 2013.

Perhaps the most important takeaway from Intellectual and Developmental Disability Awareness Month can be summed up as “Recognize my disabilities, but emphasize my possibilities.” As we encounter persons with disabilities in our daily lives, remember that all of us have gifts and talents that we can offer, which makes the world a better place to live.

Aufpassen: Baby will mit Putzmittel spielen

The Importance of Poison Centers

Each year the third week of March is designated as National Poison Prevention Week in the U.S.   The nation’s 55 poison centers work extra hard during this time to make people aware of what a poison center is and how a call to the experts working in poison centers can save a life or prevent injury and harm.

Here are some interesting facts you might not be aware of:

  • Louisiana has the only poison center that closed, and then reopened after the effects of no longer having poison center services available were realized.
  • The people who answer the emergency hotlines are pharmacists, nurses and physicians who are highly trained in clinical toxicology to provide the best care available to those who call us for assistance.
  • The 55 U.S. Poison Centers collectively receive over 4 million calls each year.  That’s 1 call every 8 seconds of every day all year long.  The Louisiana Poison Center responds to over 87,000 calls each year from within Louisiana.
  • 22 percent of the calls to the Louisiana Poison Center every day come from emergency departments and intensive care units in hospitals across the state.
  • We are able to safely manage almost 90% of patients in a non-healthcare setting (usually at home), reducing the burden on our healthcare system and reducing healthcare expenditures.
  • For every dollar spent on poison center services, latest studies estimate that at least 36 dollars are saved by preventing unnecessary utilization of healthcare services.

When we think of poison control centers, most people think of children and things like drinking bleach, drinking too much cough syrup or eating plant fertilizer.  After 21 years of working in a poison center, I can tell you if you can imagine it we have probably had a call about it.  It’s true that exposures in kids under six make up almost 70% of the calls we receive.   But they aren’t just swallowing perfume or chewing on plants anymore.  The majority of the exposures in children now involve medications.  And the ingestion of medications are requiring more children to be evaluated and treated in a hospital setting.

The #1 cause of injury related hospitalization and death for children 18-36 months old in the U.S. is poisoning.  Poisoning is the #2 cause of unintentional death in the U.S.   Those are sobering facts and why we work so hard to educate about poison safety and prevention.  If you ever need us, don’t hesitate.  Call immediately.  If you just have a question, please call. We would much rather prevent a poisoning than have to deal with the effects later.

The national poison center hotline number is 1-800-222-1222.   Write it down and program it in your phone.

We love what we do.  We help people in time of need.  What’s better than that?

Kid with iPad

Screening Media Use in Kids

How much time does your child spend watching TV or playing on a phone each day? It may be as much as eight or eleven hours.

Constantly checking phones or leaving TVs on in the background of course isn’t a trend that is unique to kids, but childhood is a crucial time for development and habit formation. Plus, as the American Academy of Pediatrics (AAP) concluded recently, parents are by and large not regulating media use in their kids—and should be.

The AAP is calling for more research on how media affects youth. We already know that excessive screen time can cut into sleep and lead to obesity and problems at school with concentration and behavior. We all share a role in teaching kids how to most appropriately use media.

Parents should set a good example with their own habits, while setting limits for kids. Is your TV on while you eat dinner? Are you constantly checking your phone? A maximum of two hours in front of a tablet or TV a day is reasonable, and it’s best to leave TVs out of kids’ rooms altogether.

What about babies? TVs and other “screen time” should be avoided all together for little ones under the age of two. Interaction is an integral part of a child’s brain development in these early years and watching TV is a one-way street.

As pediatricians, we too can step up our role. A good place to start is asking about media use at clinic visits.

It isn’t all bad news though with emerging technology—a lot of good educational programs can be found electronically. The key is to be smart with the content and how long kids spend in front of a screen. The time honored tradition of playing outside with friends is still very important and should be encouraged for both the social and physical benefits.

The AAP’s revised policy statement, “Children, Adolescents and the Media” was in November’s Pediatrics’ Journal. More tips and information can be found on their website.

Headshaving 51

Why I Shaved My Head (and Beard)

Today, a medical student shaved my head and beard, which have been part of my identity for over 40 years. Why? For two very good reasons:

The first is in solidarity with our patients. As an oncologist, I get to know and treat patients who are fighting for their life. Many lose their hair from chemotherapy.  They give up so much fighting for what others take for granted; life itself.

The second compelling reason to go bald is to support our medical students. Amidst classes and studying, they are motivated to make a difference.  They find the time and energy to put together a program such as the Geaux Bald organization and work tirelessly to make it successful.  I am proud to serve as one of their faculty members, but I am even more proud to consider them as colleagues.

My patients and my students keep me inspired!

On Friday, March 14 from 2 to 6 pm in the BRI Atrium, many other students, faculty and community members will shave their heads. All of funds raised go toward pediatric cancer research. If you want to help, join a team or consider donating by going to the LSU Health event page on St. Baldrick’s website. Or, visit the “Geaux Bald” Facebook page.

sad

Shining Light on the Winter Blues

Shorter days and dreary weather can bring on the “winter blues” for some people. It is a real condition called Seasonal Affective Disorder or SAD.  The farther someone lives from the equator, the more likely they are to develop SAD. The most difficult months for SAD sufferers seem to be January and February, but the condition can occur in summer as well. SAD may begin at any age, but frequently shows up between 18 and 55 years of age. It is more common in women and those with a family history of it or personal history of psychiatric illness.

Norman E. Rosenthal, a South African scientist and psychiatrist, first described the problem and pioneered the use of light therapy for its treatment. He became interested in the idea when he emigrated from the mild climate of South Africa to the northeastern US. He noticed that he was more energetic and productive during the long days of summer versus the shorter darker days of the winter. He found himself feeling better by exposing himself to more light during winters.

Lack of sunlight is believed to be the major reason for SAD and it affects people who have a genetic vulnerability to the condition. Lack of light may upset your sleep-wake cycle and other circadian rhythms. It may cause problems with a brain chemical called serotonin that affects mood.  Melatonin, a sleep-related hormone, released by the body in the dark has also been associated with SAD.

Symptoms of SAD are similar to those of clinical depression and include:

  • Feeling sad and hopeless
  • Loss of interest in things you enjoy
  • Decreased energy level
  • Feeling of heaviness in arms and legs
  • Difficulty concentrating
  • Appetite changes including craving for foods high in carbohydrates
  • Over sleeping
  • Social withdrawal

Severe cases can lead to hallucinations or even suicidal ideations. It is very important to get treatment especially if the symptoms are severe. SAD that presents during summer presents with more anxiety, irritability, insomnia and weight loss.

While medications are available, the best treatment for classic winter onset SAD is exposure to light—either sunlight or bright artificial light from a light box. The results seen with light therapy, which could be within one week are much faster than antidepressant medications that may take up to a few weeks to start working. It is advisable to try light therapy first, but keep in mind that the effect is reversible, so you need to keep it going throughout the season. If that doesn’t work, you can move on to medication.

Exercise has known to have mood elevating properties and can be helpful. Cognitive behavioral therapy is another treatment option for those that want to stay away from medications.

silhoutte

A Growing Waistline & the Need for Thicker Skin

People are just so excited for you when you’re visibly pregnant that the normal boundaries of what’s acceptable to comment on disappear. Or that’s what I tell myself in the spirit of assuming people always mean the best, which can be particularly challenging in the face of comments like “you’re spreading fast!”

I was prepared to get bigger during pregnancy—you’re supposed to. I was not prepared, however, for so many people to comment on the changes to my body. Throughout it all, the most important focus of course was on the growing baby’s health, but most pregnant people—including me– would be lying if they said that they didn’t worry about how they looked. Women may succeed at not thinking about their expanding waistline at times (which seems so trivial in the big picture of bringing a human life into this world), but frequent comments, both good and bad, only reinforce the fixation on how it looks to carry a baby.

I’m a very open person who, when asked, will answer the question of how much weight I’ve gained for instance. But many women will likely feel violated with such personal questions. If you are thinking of becoming pregnant, prepare mentally for well-meaning people to remark on your belly and its size. Think about how you’ll respond to questions, whether with honesty, brevity or making a joke to change the subject.

We all should think about how we would feel if roles were reversed before commenting. One friend said she had gotten several remarks along the lines of “that’s going to be one big baby!” A good-sized, healthy baby is the goal, but people don’t know the results of your growth anatomy scan. They are commenting based on your size, and that statement does more than make an implication about her stomach’s size.

I enjoyed the “definitely pregnant” look that the third trimester brings. By feeling good and having a positive body image, it’s easier to take everything in stride better. In the second trimester, though, I felt more unsure about the in-between stage of looking somewhat pregnant or just like I packed on the pounds. I also was scared of swelling and how much weight I would gain in total. If someone is already feeling down about the number of the scale on top of perhaps not feeling well physically, one offhanded remark could add to their blue feelings. On the other hand, a compliment along the lines of “you look great!” can boost spirits.

I am certainly more aware about what to say to an expectant mom from being blessed with this experience in all of its glory and not-so-glamorous stages.

apple

Can Apple Juice Make You Sick?

Every year, news headlines appear questioning if apple juice is safe to drink because it contains arsenic. With apple cider now lining grocery store shelves, let’s take a closer look at this infamous chemical element.

A Dark Past

Arsenic, historically known as the ‘King of Poisons’ and the ‘Poison of Kings,’ has often been used to break up love triangles and get rid of political opponents throughout human history.  In some ways it is the perfect poison because it has no odor, taste or smell. Arsenic trioxide could easily be mistaken for sugar and used to kill when stirred into drinks or mixed into food. But in today’s modern CSI society, it has fallen out of favor as a murder weapon beware because it does not break down quickly and is easily measured in all body parts.

The Arsenic Basics

Arsenic is a heavy metal that is a natural component of the earth’s crust and so is widely distributed throughout the environment in the air, water and land.  People can be exposed to elevated levels of inorganic arsenic through drinking water, which can occur naturally in certain parts of the world including the western US.  For this reason, the EPA has set a level of 10 parts per billion (ppb) as the standard for chronic exposure in drinking water.

Arsenic persists in the soil for a long time after it has been applied to crops as a pesticide or fertilizer.  Plants can mistake it for essential nutrients and take it up from the soil.  Thus ingestion of vegetables, fruits and other food crops (rice) can be a common source for arsenic.  Note that this includes tobacco!!

Should We Be Worried About Consuming Arsenic?

Because it is in water and soil, arsenic is probably found in all foods that we eat, just at small levels that would not normally be of concern – the key point is that the “dose makes the poison,” meaning only an elevated amount would be of health concern.

Recent investigations have found arsenic in rice and apple juice. One recent study (Consumer Reports) showed 9 of 88 samples of store-bought apple and grape juices had more arsenic than the EPA allows in drinking water (10 ppb), although they were less than what the FDA allows in juice products (23 ppb). The difference is because people normally drink more water than they do apple juice.  In another study, researchers reported that eating half a cup of certain types of rice a day could expose someone to just as much arsenic as a quart of water at the government’s maximum allowable limit.

Normal consumption (food in moderation as your mother told you) should not be of concern, especially because of the positive food benefits from such products as apple juice and rice. If you’re concerned you may have been exposed to arsenic in food or water, laboratories can test for arsenic in your blood, urine, or fingernails.  Also, regarding arsenic from well water, you can test the well and use water filters to remove the arsenic from your drinking water. (Arsenic is regulated in city water systems).

Though rare, acute arsenic overdose and long-term exposure does carry health risks; but don’t hesitate to keep apple juice and rice in moderate levels in your normal rotation!

walking blog

Another Reason to Get Moving

We know exercise is good for our waistline, heart health and the quality of our sleep. Based on research being done at LSU Health Shreveport, we can now add reversing the Parkinson-like slowing of movement to the list of why exercise is important for people of all ages.

About 15% of adults ages 65 and over and more than half of adults 85 and above suffer from bradykinesia, the slowing of movement. It’s not just inconvenient—it is also responsible for many falls, a leading cause of mortality.

In our lab, we analyzed data from elderly rats. After 12 consecutive days of a using a treadmill, we found that the rats’ mobility was greatly improved.

What’s responsible for the connection? Perhaps dopamine, a brain chemical that helps to regulate movement in addition to controlling the brain’s reward and pleasure centers. Exercise increases dopamine levels and thus can increase movement.

We hope that the results could help our burgeoning aging “boomer” population continue to perform their daily activities into old age and greatly reduce disability and injury. Additionally, it could help middle-aged people devise lifetime habits to prevent decreased mobility as they age.

High in fat

Trimming the Trans Fat

In a bold move, the US Food and Drug Administration (FDA) announced today that they will require the food industry to gradually eliminate trans fat from all food consumed in America due to their harmful effects of our health.

This stand comes after the FDA looked at partially hydrogenated plant oils, the primary dietary source of artificial trans fat in processed foods, and found that they are no longer “generally recognized as safe” for use in food because consumption can lead to heart disease and other health problems. Trans fats will raise “bad” cholesterol levels while lowering “good “cholesterol levels. In addition, trans fats offer no nutritional value whatsoever.  Its primary use is in processed food to increase shelf life and reduce the need for refrigeration.

So this is good news, right?

Yes and no. Reducing trans fats in the American diet is a big step in the right direction. The Centers for Disease Control estimates that a ban could prevent 20,000 heart attacks and 7,000 deaths each year. Past bans seem to have produced favorable effects. New York was the first city to do so in 2007, and studies have since shown that New Yorkers do consume fewer trans fats now than before. Beware though– there are many food items that contain this fat and even though some packages say “No Trans Fat,” they can still contain a small percentage (a product with less than half a gram of trans fat can list zero trans fat on its label).

Trans fat most commonly lurks in sources such as fast food, snack food, fried food and baked goods.  Many processed foods require very hot temperatures that are only available in industrial food ovens. This is because it takes a high temperature to make the fat dissolve in the food and not clump.

So, the (scary) question is: how will the food industry offset this move? What other chemical will be swapped in to preserve shelf life?  Currently some fast food providers are using palm oil instead of trans fat; however, this substitute is also associated with heart disease.

It’s best to eat as many unprocessed foods, like fruits and vegetables, as possible. The American Heart Association, along with other nutritional related organizations, recommends total fat consumption to be about 30% of all calories eaten. This 30% fat should contain no trans fat.

The FDA proposal is now open for comments. A timeline for the phase-out will be released after the commenting period ends.

Children in halloween costumes

Taking the Fright Out of Halloween Night

Everyone loves a good scare on Halloween, but not when it comes to child safety. There are several easy and effective behaviors that parents can share with kids to help reduce their risk of injury.

On average, 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.

Top Tips

  • When selecting a costume, make sure it is the right size to prevent trips and falls.
  • Decorate costumes and bags with reflective tape or stickers and, if possible, choose light colors. Since masks can sometimes obstruct a child’s vision, try non-toxic face paint and makeup whenever possible.
  • Have kids use glow sticks or flashlights to help them see and be seen by drivers.
  • 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, they should stick to familiar areas that are well lit and trick-or-treat in groups.
  • Cross the street at corners, using traffic signals and crosswalks. Guardians should remind children to be mindful of cars backing up or turning. Children should be taught to make eye contact with drivers when crossing the street.
  • Look left, right and left again when crossing and keep looking as you cross.
  • Put electronic devices down and keep heads up and walk, don’t run, across the street.
  • Teach children to make eye contact with drivers before crossing in front of them.
  • Always walk on sidewalks or paths. If there are no sidewalks, walk facing traffic as far to the left as possible. Children should walk on direct routes with the fewest street crossings.
  • Watch for cars that are turning or backing up.
  • Teach children to never dart out into the street or cross between parked cars
  • Popular trick-or-treating hours are 5:30 to 9:30 pm so be especially alert for kids during those hours.

Where to Find Visibility Gear

  • Places like Target and Walmart carry glow sticks.
  • Sporting goods stores sell retroreflective gear.
  • You can find retroreflective tape and wristbands online at Amazon and other sites.

See more at: http://www.safekids.org/halloween