9
Apr

E-Cigarette Cancer & Juuling in Teens

What Are E-Cigarettes (E-Cigs)?

E-Cigarette Cancer Increased in Teens unsafe

E-Cigarette Cancer Increased in Teens

E-cigarette cancer chemicals have increased in teens.  Before we get into the details, let's review the background of E-cigarettes.  E-cigs are electronic cigarettes that have liquids that contain many chemicals including nicotine, and fruity and other flavors.  They are battery-powered and mimic cigarettes, but don't have the smell of smoke.  The liquid changes into a vapor due to the heat in an e-cig.  Hence, it’s also called “vaping.”

 

What is Juuling?

There is a new teen trend called “Juuling.”  Juuling is an e-cig that is thin, looks like a flash drive, and charge in a USB port.  A juul produces less smoke which disappears more quickly. Hence, teens are able to juul at school and home without parents’ knowledge.  In comparison to smoking cigarettes, one juul pod (cartridge) has as much nicotine as a pack of cigarettes.

 

What are the Signs if Your Teen is Juuling?

The signs of e-cigarette smoking & juuling are:

  •     Increased thirst
  •     Sore throat
  •     Caffeine sensitivity - they decrease their caffeine intake.
  •     Nosebleeds
  •     Higher rates of pneumonia

 

E-Cigarette Cancer Causing Chemicals

Juul Looks Like a Flashdrive

Juul Looks Like a Flashdrive

They’ve been advertised as a safe alternative to cigarettes.  They’ve also been advertised as an aid to stopping smoking.  Since e-cigs don't burn tobacco, they don't burn the same amounts of tar ans carbon monoxide.  However, e-cigarettes are unsafe, contain high levels of nicotine, and do not help in smoking cessation.  E-cigs and juuls have many cancer-causing chemicals (acrylonitrile, acrolein, acrylamide, benzene and ethylene and propylene oxide, and crotonaldehyde).

 

Study Showed E-Cigarette Cancer Chemicals Increased in Teens

 

In a recent study of 100 teens from the San Francisco Bay area by the University of California-San Francisco study: 67 teens used e-cigs only, 16 used both e-cigs and conventional cigs and 20 didn't smoke or vape at all.  Urine and salivary gland fluids tested positive for cancer-causing chemicals in teen smokers.  It revealed that teens who used e-cigs and cigarettes had three (3) times higher amounts of these e-cigarette cancer causing chemicals in their body fluids as compared to the teens that used only e-cigs.  It revealed that the teens that used e-cigs only had three (3) times higher amounts of these e-cigarette cancer causing chemicals in their body fluids as compared to the teens that didn't smoke at all.  Lastly, the study also showed that teens who used fruit-flavored e-cigarettes had significantly elevated levels of acrylonitrile as compared with those who used other flavors, such as menthol. 

 

Is Advertising Increasing E-Cig Usage by Teens?

The CDC has reported that teens view ads for e-cigarettes more than before; the exposure increased from about 69% in 2014 to about 78% in 2016.  Retail stores have exposed teens to e-cigs the most in comparison to other ads like those found on TV, internet, or magazines.  Since studies show that ads for tobacco products show increased use by teens, it is very likely that ads for e-cigs are also increasing use among teens.

 

FDA Sued for Delay in E-Cig Regulations

The American Academy of Pediatrics (AAP) and its Maryland chapter, the Campaign for Tobacco-Free Kids, four other public health groups and five pediatricians filed a lawsuit against the FDA for delaying submission product-review applications for cigars and e-cigarettes until August 2021 and August 2022, respectively. This leaves children at increased risk of cancer and other negative side effects from e-cigs.

 

Learn & Talk About the Risks of E-Cigarettes with Your Kids

 

It is important to learn all about the signs, symptoms, and risks associated with e-cigarettes.  The U.S. Surgeon General has created a website with lots of information about e-cigs and how to talk to your kids about this.  Remind them to respect their bodies and care for themselves.  Positivity goes a long way.  Talk to them today about e-cigarette cancer in teens. 

4
Nov

Suicide Youth ADD/ADHD & Depression

Suicide in Youth with ADD/ADHD



Suicide Risk in Youth with ADD/ADHD

Suicide in Youth with ADD/ADHD

Of those children who committed suicide, 5 – 11 year olds were more likely to have Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD), as revealed in a recent study in Pediatrics revealed that.  Teenagers 12 – 14 year olds, were more likely to suffer from depression or dysthymia, and one third (1/3) of children had a mental illness.  In order to determine the cause of suicide of children 5 to 14 years old, the study reviewed data from the National Violent Death Reporting System from 2003 to 2012.

 
Of those children who committed suicide,young school aged children were more likely to have family or friend relationship problems.  In contrast, teenagers were more likely to have boyfriends or girlfriend relationship problems.  The study also revealed that there was a higher rate of suicides among black youth than young of other races.  In addition, 29% of young children and teenagers told someone about their intention to commit suicide before they attempted to do so. 
 

Suicide Warning Signs

 

Warning signs include, but are not limited to increased seclusion and alone time, increased time spent in their room alone, decreased time spent with friends, decreased time spent in school activities, poor grades or a drop in grades, poor communication, discussion of a desire to commit suicide, increased temper, increased frustration.

 
 

National Suicide Prevention Line

 
An excellent resource is The National Suicide Prevention Line.  There are many tools available on their website, suicidepreventionlifeline.org.  In addition, their Lifeline is 1-800-273-TALK (8255).  Online Chat is also available.  If Chat is unavailable, then please call the Lifeline, as help is available 24/7.  It is anonymous and confidential.  
 

Positivity during depression can be helpful, so that the child at risk does not feel so helpless and alone.  For older children, they can call the hotline.  They can text HOME to the Crisis Text Line at 741741.  Also, consider having a professional and/or you do affirmation work with your child.  Daily affirmations can be one of many tools that help.  Lastly, a professional psychologist and/or psychiatrist may be beneficial as well.

  

Summary

 

It is important to (1) know the warning signs for suicide among young children and teens, (2) be aware that ADD, ADHD and depression place these children at a higher suicide risk, and (3) know where to call for help.

 

3
Nov

Electronics and Sleep Problems

electronics-before-bed-sleep-problems-in-childrenChildren develop sleep problems when they use portable media devices, such as tablets or smartphones, before bed.  They have more difficulty falling asleep, staying asleep, are more sleepy during the daytime, and are twice more likely to sleep less than children without access to their devices before bedtime.  A JAMA Pediatrics review (reut.rs/2fkjL1j) of 20 studies that involved children using these portable media devices. The review excluded their use of PCs and TVs before bed.  It included over 125,000 children between the ages of 6 and 19 years old.
 
 Even more interesting, is the fact that sleep problems are also more likely in children who had their portable media device near them at bedtime, even if they didn’t use it before bedtime.  If they receive texts or use social media, then they are more likely to check their devices throughout the night.  Before you know it, after checking the texts, Facebook, Twitter, Snapchat & other social media, several hours of precious  sleep may have been lost.
 
So many of us are guilty of using out smartphones in the middle of the night.  We’ve commonly woken up, after a deep sleep REM cycle, checked our smartphone, and interrupted our sleep.  A good amount of sleep for most children is 10 hours per night, for teens it lowers to 9 hours per night.  For a child, this has a huge impact on their education the next day as well.  If sleep problems exist, learning difficulties are more likely to occur when they are sleepy during the daytime. 
 
Next time you use your smartphone before bed, think about how it could negatively impact your own sleep.  Poor sleep is linked to many potential negative health consequences, including dementia.
 
Please consider protecting your child’s sleep by making sure they don’t use their smartphones or tablets before bedtime, turn them off or remove them from their bedroom at night.
21
Jul

Concussions in Football and Children

imageedit_4_8211374059 - concussions in football and childrenChildren in Football and Other High Impact Sports

In the July 7, 2014 issue of People magazine, there was an article called, "6-Year-Old Football Players, Too Young to Tackle?" The article discusses the Tri-County Titans, a competitive tackle football team in the Texas Youth Football Association.  What makes the Tri-County Titans so unique? They are a team comprised of 6 year olds.  They were highlighted on Friday Night Tykes, a TV show on Esquire Network.  There's been a lot of controversy regarding these elementary kids playing football.  So what's wrong with 6 year olds playing football?  Nothing, except, these young kids are playing tackle football.  While the article discusses the potentially negative impact of competitive football among elementary school kids, I would like to focus on an important issue, concussions in football and children.
 

Concussions & Concussion Symptoms

A concussion is a type of traumatic brain injury that typically occurs when there is a sudden movement of the brain due to an injury such as a blow to the head, a jarring of the head, or a fall.  Concussion symptoms can be various and linger.  Symptoms may include disordered thinking, memory loss, dizziness, headaches, blurred vision, tiredness, nausea, vomiting, difficulty sleeping, and more.  There are new guidelines for returning to sports after a concussion.  These serve to promote brain healing and  prevent additional injury.
 

Concussions in Children

Concussions and other injuries are more likely to occur with tackle football than flag football.  Concussions have a huge impact for children.  The reality is that once someone has had a concussion, they are more likely to have additional concussions. Repeated concussions are repeated brain injuries.  What does that mean for the brain?  It increases the likelihood of chronic lifelong brain damage.  What does that mean to our youth?  The younger the child has a concussion, the more likely they are to have more concussions in their sports lifetime.  The growing brain in the child with repeated concussions is uniquely susceptible to brain damage with prolonged effects, especially if the family and child are planning a life with many years of football or high-impact sports participation.
 

Traumatic Brain Injury

Concussions have come to public attention in recent years due to all of the attention received by concussions in the NFL.  Many NFL players have lifelong effects from repeated concussions.  In 2013, there was a  "$765 million settlement over concussion-related brain injuries among its 18,000 retired players, agreeing to compensate victims, pay for medical exams and underwrite research."   Repeated concussions can cause a degenerative brain disease called Chronic Traumatic Encephalopathy (CTE).  CTE can manifest as Alzheimer's, dementia, and Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's Disease.  Measures are being taken in the medical and school communities to help prevent our children from getting concussions during all sports, not just football. Doctors, coaches, and parents are also more aware of concussion symptoms.
 

Support & Resources

If your child suffers a sports related injury, make sure to go to his or her doctor.  Also, make sure your child receives an extra exam that clears him or her to return to their sport.  More importantly,even before a potential injury occurs, make sure you know the facts about concussions.  Make sure your children's school and coaches know the facts as well.  The CDC has many concussion education resources available, such as "Concussion Fact Sheet for Teachers, Counselors, and School Professionals."  They've even created an "Heads Up" app to help parents identify concussion or traumatic brain injury symptoms.  For more support and resources about concussions, concussion symptoms, and treatment, please refer to the  CDC concussion support website.
9
Jul

Child Sexual and Physical Abuse

It is never easy to see a child who has possibly been sexually abused. It's especially not easy when the family tells you that no one other than family members have every been with, cared for, or babysat the child.  As a pediatrician, I have had to see the pain on a mother's face that not only does she need to consider her child may have been abused, but also it may have been by someone close to her, someone she loves.  It's heart wrenching for everyone involved. Such was the case today.  It moved me to write this, as many people need help or information.

 
Unfortunately, child abuse is common.  The news frequently has reports about sexual and physical abuse.  We often don't think someone we love could hurt our children.  Unfortunately, they can and they do.  The reasons why are complex.  The reasons don't really matter.   The reality is that families are under a great deal of stress.  In addition, children often have special needs.  This puts children at an even higher risk of abuse.  Counseling may be helpful for some families or children.  However, it's important to know the warning signs. Because even if you are not a family with stress, you undoubtedly have people in your life that are dealing with stressful events in their lives.  This may impact you if they have access to your children.  Protect your children at all costs possible.
 
What matters is that you prevent it from happening in any way, shape, or form.  Although we constantly hear about horrendous child abuse, we don't hear or discuss the just as potentially paralyzing cases of emotional and verbal abuse, or even neglect.  Whether it is your child or not, if you see or even think you know of a possible case of child abuse, consider calling in a report.  Even if you are not sure, it will not be held against you.  Chances are you could save a life.  It is anonymous.  You will not be tracked in any way.  Every state has an emergency abuse hotline. In Florida, it is 1-800-FL-ABUSE.  As a pediatrician, I am under a legal and ethical obligation to report any possible child abuse.  Yet, if each of us were more involved with what we see around us, we could help protect all of our children.
 
The American Academy of Pediatrics has some very helpful information titled, "What to Know About Child Abuse" http://bit.ly/12BdNf7 and "Child Abuse: What Evry Parent Should Know." http://bit.ly/1aW8IGs
13
Nov

Injury in Children | Swallow Magnets

 
The U. S. Consumer Product Safety Commission (CPSC) has released a warning regarding magnets and children.  Much care should be taken when considering giving children toys that have mini-magnets.  If these magnets become dislodged or if children swallow them during play, then injury and death can occur.  If two (2) or more of these magnets are swallowed, they may not pass in the stools.  They can attach to each other in the gastrointestinal tract.  As a result, various injuries can occur, including perforation, twisting, and blockage of the intestines.  In addition, the magnets can cause infection, blood poisoning, and death.
 
The CPSC has stated that it is aware of at least 53 children who have suffered after having ingested magnets: 33 were injured, 19 required surgery, and one died.
 
So what precautions can you take with your child?  Injury prevention is the key.  Carefully decide which toys your child can play with & what toys you even allow into your home.  Regularly check any toys that have magnets for missing pieces.  These magnets can either be a part of toys or they can be the toy itself.  A building set of mini-magnets is a perfect example of a toy that although advertised for children, should not be used without strict constant direct one-on-one supervision.
 
Lastly, if you think you child has swallowed magnets, contact your doctor immediately.  Signs and symptoms of a problem can include nausea, vomiting, diarrhea, and/or abdominal pain.
 
To listen to an audio regarding injury in children who swallowed magnets by accident, please go to http://bit.ly/sLFGxR.
7
Nov

Asthma In Single Parent Family

Asthma Wrose in Single Parent Family Homes

Asthma Worse in Single Parent Family Homes

Single Parent Family Homes

Asthma is worse in single parent family homes.  This past Saturday, the Cincinnati Children's Hospital Medical Center presented a study that revealed that children in single parent families are 50% more likely to return for hospital care of their asthma than children in two parent homes.  The American College of Allergy, Asthma and Immunology (ACAAI) annual meeting in Boston had a presentation regarding tis finding. 

The study also revealed that children were more likely to return for hospital care for their asthma, if their family's annual income was less than $60,000 a year.

 

Children with Asthma Need Family Support

This study, presented at the ACAAI annual meeting, has not yet been published in a peer-reviewed journal.  Therefore, this is a preliminary report.  However, pediatricians see this every day; there is a definite socioeconomic impact on childhood disease.  In general, single-parent families are more overwhelmed and have less of an income than two-parent families.  Who is there to take turns when it comes to missing work, administering medications, and catching up on much needed sleep when caring for a sick child?  This is yet another reminder that single parent families need more support.  Support can come from other family members, friends, and in some cases the employer.  Inevitably, where there is more parental support, the child with a chronic disease is healthier.

For more information, go to http://bit.ly/rF1NGI & on single-parent families, go to http://bit.ly/toBaiG.

24
Jul

Sports | Children in Fencing

Two weeks ago, I had the opportunity to visit an dear friend of mine.  We've been friends for almost 20 years.  Alex and I became friends when we were fencing in college.  He and his wife own the Peekskill Fencing Center in Peekskill, NY (http://www.peekskillfencing.com/)..  It's a lovely facility doing wonderful things for children. 

When I reminisce on fencing, I am filled with joyous memories.  Fencing was wonderful.  It gave me so much; confidence, camaraderie, friendship, physical activity, and so much more.  Little did I know that years later, the family would have a fencing club.  I am so proud of them for taking a chance to run a business and help children in the process.  It is difficult to be in business for oneself.  And they are succeeding, despite the current economy.  And after spending time at the Center with Alex, I can see why.  Children need to believe in themselves.  Fencing offers them that.  This small club does so in particular.

I had never really seen a child fence before.  A student of his came to practice.  It was amazing to see this 7 year old fence.  He had skill & grace.  He has much to learn in fencing & in life.  And it showed, in the best way ever.  He was a bit cocky before practice started.  He told me how easy it was.  This little boy further explained that he had already won a competition.  Then, practice started.  The layers peeled away.  Alex was gentle & a gentle and excellent teacher.  At the end of the short lesson, the little boy took off his mask.  His tired face revealed it all to me.  It wasn't easy; it was false bravado.  At 7 years old, he already has to keep up a front.  The amazing thing is that fencing is teaching him little by little to break down the protective wall and build a solid foundation within.  He doesn't even know it yet, but that is what he's doing.  And that is the gift of all sports for children - physical & psychological strengthening.  I never realized how important that was until that moment ... mask off & all.

The benefit of fencing is that small clubs all over the country offer the intimacy that other large sports may not.  They offer one on one attention.  Consider fencing for your child.  It offers so much.  It's cool.  And it's really, really fun!

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