Dr Gwenn Is In

Being Healthy Means Living Healthy, Not Spending Bucks

ideas@pediatricsnow.com (Dr. Gwenn) — Mon, 02 Nov 2009 14:07:00 +0000

I opened a fortune cookie the other day, expecting it to say something relatively nonsensical or meaningless, only to have it read:

“Money is not everything. You can buy a doctor but not heath.”

This fortune tells the story of more people than most of us can count, including most of us at times. All too often we fall into trap of thinking that the more we spend on health the healthier we will become. Not true. In fact, good health is a state of mind and need not cost more than time for exercise, time to give ourselves the R&R we need to nurture our souls, the price of food to eat for proper weight and overall good health, and the occasional co-pay for our primary care physician and needed prescriptions.

We can toss money at vitamins, pricey health clubs, personal trainers, diets, alternative health treatments, doctors, second opinions, medications, prescription and nonprescription, as many people do, but those things can’t get us healthy. More times than not, they only produce the facade of good health.

Think about it like this. The bikes and treadmills at the YMCA are the same as at the pricey gyms. The food at the large grocery store chains is just as nutritious and much more affordable than the chains claiming to be “natural” and “organic”. The big vats of vitamins that many people are costly and not needed if people eat an overall well balanced daily diet.

So, take a look at what you are doing “to be healthy”. I bet if you make a few tweaks you’ll find there are easier ways to achieve your goal and you’ll find you’ll start saving more than a few pennies in the process, too.

Also, next time you come across some fortune cookies, open them up. The words of wisdom may actually be useful, cost effective, and health promoting!

H1N1, Swine Flu...Dispelling Myths

ideas@pediatricsnow.com (Dr. Gwenn) — Fri, 30 Oct 2009 12:46:00 +0000

Yesterday, New England Cable News hosted a 2 hour prime time special on H1N1. I was honored to be invited on air as the pediatric health expert along with the area's top health professionals in emergency medicine, OB/GYN, public health and infectious disease. We covered a great deal of ground in the 2 hours including clearing up the popular myths circulating around:

Vitamins, Diet and the H1N1:

NECN: H1N1 What you Need to Know Resource Page

Flu Update

Teens need less homework and more free time!

ideas@pediatricsnow.com (Dr. Gwenn) — Wed, 28 Oct 2009 11:42:00 +0000

“Hey mom”, my 15 year old said as she walked in the living room with that ‘I’ve been thinking about my life look’ that teens get once they enter high school. “How much homework did you have when you were my age?”

“This could potentially be a trap”, I thought. “Answer carefully”, I told myself.

“Well…,” I began cautiously, trying to read the look on her face – trying to see if she was just curious or about to have a HUGE stress out moment because of having too much homework that night.

“It does seem like you have more homework than Daddy and I had when we were in High School. But…our afterschool lives were also not quite as full.”

She gave me a blank look before responding.

“I think we have too much homework and we need more time to be kids. You and Daddy tell me that you and your friends used to do things and have time to hang out on weekends and stuff. My friends and I don’t have that. We even have tons of homework on weekends. THIS – IS – JUST –WRONG!!”

Then she added: “THEY…”, she pointed to her book bag, “ are stealing are childhood!”

I didn’t say anything in response just yet.

“So”, she continued. “Do you think we have too much homework? Do you think our childhoods have been stolen?”

I didn’t want to freak her out, but the truth is I did think she was right and knew the data supported her observation. So, I simply replied. “Times are different today but I have to agree the homework seems excessive. Perhaps there’s a way you and your friends can look into this and see if so much homework is needed.”

“That’s a great idea! Our Principal seems like a really cool guy. We’ll do some research.”

With that, she left, seeming more at ease.

In truth, our kids have much more homework than we had, as well as more overloaded afterschool lives. How much more homework? About 50% more!

Kids need a balance of education, extracurricular activities and free time. Since we were kids, so much attention has focused on programming their lives that no room has been left for our kids to water their own childhoods and to grow them in the direction of their choosing.

We live in a time of excess and the concept of moderation has flown out the window. Our kids can’t keep having every aspect of their lives pushed to the max: homework, afterschool activities, school sports.

TIME Magazine ran a very interesting article on The Myth About Homework that not only echoes my daughter’s concerns but tosses out some intriguing solutions, such as homework limits. The article points out what I’m seeing in my daughter, her friends and teens nationwide: the push on homework is actually backfiring – our kids are getting burned out and turned off to learning.

So, it’s time we support the movement my daughter and so many other teens nationwide are demanding in their lives. This is their childhood and they deserve time to explore more than just books and word problems.

BTW, the data is on the side of the teens with this one. More free time is exactly what their lives need for better learning…and better health!

Do your tweens and teens feel their childhoods are under attack either from too much homework or too many activities…or any other reason? I’d love to know!

On Line Health Forms Should Be For Patients, Not Health Professionals!

ideas@pediatricsnow.com (Dr. Gwenn) — Tue, 27 Oct 2009 12:42:00 +0000

We had an interesting experience today.

My husband is scheduled for a routine test tomorrow and was notified by letter that he had to register ahead of time for the test. The test is going to take place at our local hospital. The letter clear had instructions with the name of the test and department name as well as two ways to register: phone or internet. My husband opted for the internet route assuming that was the more straight forward option.

Now, as background, he’s a fairly medically savvy guy. Even without having experienced second hand my residency, he’s incredibly well read and very health and computer literate. And, he knows his way around the insurance system. We assumed this would take all of 5 minutes and be a snap. Read on!

With insurance card and letter from the local hospital in hand, my husband goes to the hospital website and clicks “register for test”.

So far, so good.

He’s then asked to enter his insurance information and notices the the information fields don’t quite match up with the information on his insurance cards. One field asks for information not on his card: group name or number. We took a stab in the dark that it would be his company’s name and since the system accepted the information and moved to the next screen, we assumed we were likely right.

The next screen was the actual test registration screen.

This screen asked him to choose the name of the test and department name from drop down menus. Neither his test nor the department the test will occur in were on the menus, and this is one very common test in one of the most popular departments of the hospital!! Perplexing and surprising. So, he opted to enter the information in the “other” box, which the system seemed just as happy with.

This experience left us scratching our heads. Clearly someone didn’t do their homework. It seemed to us that the insurance aspect of the program was out of step with the information we are actually given, and that the test and department information was not patient friendly. It should have matched the letter sent out verbatim.

I was very disappointed to discover that the biggest community hospital in our area, the one claiming to care for people from all walks of life, didn’t have in place a registration system that met the literacy needs of the average patient.

This isn’t unique to our hospital or our area. This is the problem with Health 2.0 systems.

If we are going to go high tech, someone must pay attention to literacy and it has to follow through on all levels, from the letters sent home to the technology we are asked to use.

Again, I’m very disappointed, but not surprised. Just another symptom of our broken health care world.

Strollers Are Not Designed for Escalators!

ideas@pediatricsnow.com (Dr. Gwenn) — Mon, 26 Oct 2009 13:41:00 +0000

There’s an epidemic at our malls: parents taking their small children up and down escalators in strollers of all sorts of sizes and shapes. I ended up behind one such parent yesterday and found strollers heading up and down all afternoon. Some were small, some large. Some had bags dangling off of them, others not. Sometimes parents had both hands on the handles, other times they were balancing the stroller and a drink or cell phone.

Some escalators have signage to indicate “no strollers” but this mall didn’t have any visible. But, do we need signage for common sense? Given what I witnessed, perhaps we do!! Plus, the statistics reveal a story of danger for young children that most parents don’t realize with escalators, on foot or in a stroller.

Before I share with you the statistics, check out this YouTube Video to see one scenario that could have occurred:

Or, this one:

Scary, huh?

Coupled with these images, we have compelling data to support how dangerous escalators are to young kids if we don’t use them with more common sense.

A 2006 study from Pediatrics looked at escalator injuries from 1990-2002 and concluded that there were a “disproportionate amount of escalator related injuries in children who were younger that 5 years of age.”

51% of the injuries were falls, 36.5% of the injuries were entrapment in this age group (such as a hand being caught in the side). 6% of injuries in this age group were from a stroller, usually from falling out of the stroller.

In the under 5 age group, the hand was the most common body part injured and entrapped due to escalator accidents. Of all the injuries seen, lacerations, some severe enough to cause amputation and avulsion, were the the injury most common in the under 5 age group.

It’s time we all start using transportation devices the way they were designed and stop playing Russian Roulette with our children’s safety. So, next time you are at the mall, give your self the extra time and use the elevator if you have a child in a stroller. Just think about the future ER visit you’ll be saving.

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Pediatricians stand united on importance of Swine Flu vaccination!

ideas@pediatricsnow.com (Dr. Gwenn) — Wed, 21 Oct 2009 11:30:00 +0000

At last weekend's American Academy of Pediatrics meeting, a few of us were asked to comment to Good Morning American Weekend about our feelings about H1N1 (Swine Flu) and the vaccine, in particular.

None of us were privy to the comments each other made and I think you'll find the consistency of what we all had to say incredibly reassuring: Pediatricians on Swine Flu Confusion

Yesterday, GMA ran a segment on "The Scramble for Swine Flu Shots" which includes advice from me and other experts about the delay in the H1N1 vaccine. This segment does a nice job putting the entire situation in a very healthy perspective.

And, just to clarify, my entire family will be receiving the H1N1 vaccination when it becomes available in our area. That's how comfortable I am with it!

How do you feel about public cell phone talking?

ideas@pediatricsnow.com (Dr. Gwenn) — Tue, 20 Oct 2009 17:28:00 +0000

During my recent travels to DC, I was privy to conversations about teenagers, business transaction, child care arrangements, marital issues, gossip, among other things!

These conversations have occurred while someone I didn’t know was on a cell phone yabbering away in a variety of settings: the mall, supermarket, airport (waiting areas, on the plane, restaurants), coffee shops, restaurants, on the street, at one of my kids’ schools. to name a few!

Having run into more cell phone “talkers and walkers” than I could count on my last few business trips, I found this poll done recently by USA Today and published in its October 16, 2009 print issue, quite intriguing. Asked if they find “public cell phone conversations rude”, 51% answered ‘yes’, 37% ‘no’ and only 12% replied they were ‘unsure’.

It’s one thing to use our cell phones publically for emergencies but for other conversations, time to pull in the reins and grab back some old fashioned discretion.

Part of this issue is setting a good example for our children. If we want them to adopt good phone manners and social skills, we need to follow good phone manners and social skills ourselves.

So, next time you are at the airport, read a book or magazine…don’t hop on the phone and conduct business. You should be considering that confidential and those of us around you really don’t want to hear your private details.

Think about how much quieter, and more polite, our days could be if we all followed this good cell phone etiquette!

Sorry I’ve been MIA…but I’ve been home sick!

ideas@pediatricsnow.com (Dr. Gwenn) — Thu, 15 Oct 2009 12:40:00 +0000

Yes, even doc-mom bloggers get sick! It hit me last week out of the blue like a Mack truck that decloacked on a superhighway with out warning. So, I suspect it was one of the flu viruses that have been on our minds recently.

I thought about attempting to blog, even fired up the computer at one point to give it a whirl, but my mind was too foggy and I just didn’t have the oomph. So, I took the advice I give out so many times during the flu season to others: I rested!

This was no ordinary rest, though. I found myself in bed for the entire long weekend and for most of that time I actually slept, which is unusual for me with a bug of any kind.

That’s how I know I likely had one of the flu bugs. I just don’t get sick like that.

Luckily, I had received my seasonal flu vaccine earlier in the month. So, while it could have been seasonal influenza, more likely I suspect I had H1N1. I’ll never know…but as it’s going around and I haven’t yet received that vaccine yet, it’s a safe bet!

Regardless of whether I had H1N1 or one of the many other viruses that circulate with the flu viruses this time of year, I did what I was supposed to do: I stayed away from other people and rested!

To go a step further, let me give you a sense of some other steps I took to get back on my feet and help contain the spread of whatever I had in my home and community:

1. I called my doctor. I have a form of inflammatory arthritis so I know a simple cold or virus in me can become a big deal. But, even without an underlying condition, I felt lousy enough that this wasn’t the time to be patient and doctor to myself!

2. I called out sick. I missed not only a clinical shift but stayed away from some media work, too. I didn’t want to expose others, health or sick, to what I had.

3. We went to plan B for our kids’ schedules. My husband did some kid running and we actually cancelled some things.

4. Early in my illness we stocked up on anything I would need at home – sports drinks, soup, crackers, etc. The key was making sure I didn’t have to leave home!

5. One of our daughter’s came home from school last Friday with a fever so over the weekend we did a mini isolation. My husband kept our healthy daughter busy while I took care of our sick daughter, with his help when needed. The feeling was, I already had the bug!

6. We made sure we had tissue, hand sanitizer, fever control medication and a functional thermometer as soon as we realized I was sick…and stocked up in case illness recurred later in the flu season.

7. We talked about a plan of attack should one of us get sick later in the flu season. Who would get the kids to their activities? What if both of us get sick at the same time? Do we each have all the doctor’s number programmed into our phones? Good to catch up on all those details…and be sure all the grownups in the home have all those details!

By the end of Columbus Day, we were all healthy again!

Had we not been so aggressive in resting and letting our illnesses run their course, we may not have been so luck with how brief and uncomplicated our illnesses ended up being.

Illness this time of year packs a punch on families logistically and financially. If parents don’t work, paychecks don’t come in. If parents are not healthy, kids don’t get where they need to be after school.

As parents, we don’t hesitate to keep our children home from school when they are sick but not so great in staying home when we are sick. Your body will recover much faster if you don’t force it to work when it’s battling a war against an illness. You are essentially burning the candle at both ends by doing so and your illness will last longer that way.

I hope my family’s recent dip in the illness pond will give you a bit of a road map should illness enter your home this flu season. If you get sick this flu season, don’t feel a bit of guilt for caring for yourself. Feel empowered that you are taking the responsible path not just for your health but for the health of the people you care about the most and who count on you each and every day…your family, friends and co-workers.

H1N1 Vaccine Hysteria: A Look At The Facts

ideas@pediatricsnow.com (Dr. Gwenn) — Wed, 07 Oct 2009 11:36:00 +0000

There’s a disturbing statistic floating about parents’ view of H1N1. According to a recent survey by CS Mott Children’s Hospital, only 40% of parents plan to get their kids the H1N1 shot. The reason: “they are not worried about H1N1”.

This statistic completely stuns me given the amazing amount of coverage and data on H1N1. As a parent and a pediatrician, I’m floored that more parents are unable to see just how serious H1N1 is and why they need to immunize their children for this flu season.

Let’s tease through the facts so you have a better understanding why H1N1 isn’t a virus to take lightly, or for granted:

1. There are two influenza flu seasons occurring at once this year each requiring its own flu shot: seasonal flu and H1N1.

2. Each flu shot is specific for the flu season it is designed to protect against. In other words, the seasonal flu shot will not protect you or your kids against H1N1 and the H1N1 shot will not protect you or your kids against the seasonal flu.

3. The neither flu is not a mild illness. H1N1 is often described as being less intense than the seasonal flu but that does not make it less significant or potentially deadly.

In fact, H1N1 hits people under 24 the hardest with a preference for small kids. For a more visual picture of how H1N1 infects people and causes it’s complications check out these charts from the CDC:

(This chart shows infection rate by age. Not only is the under 24 age group is the group at risk from H1N1 infection by a wide margin but the 0-4 age group is one of the groups at particular risk.)

(Hospitalization rates parallel infection rates with H1N1..under 24 at highest risk with 0-4 most vulnerable.)

(This is the chart we don’t want to consider – the death rate from H1N1. Note that there are documented deaths in all ages with the 0-24 group accounting for close to 20% of the total deaths from this virus.)

The data really speaks for itself. Our healthy kids and young adults are at more risk than other groups from infection and complications from H1N1. As parents, our job is to protect our kids from things they can’t protect themselves from. We can’t keep them from being exposed to H1N1 but we can give their bodies a way to battle it once they come into contact with it. It’s not a matter of if they will be exposed, but when.

Sometimes as parents we have to stop over thinking a situation and do what we have to in order to keep our children safe. I believe this is one of those situations. Instead of questioning data and acting out of fear, we need to start trusting the doctors and scientists working hard to keep our communities safe. After all, they have families and children, too.

My entire family is getting the H1N1 vaccine this year. I believe in this vaccine and it’s safety. Please consider doing the same for your kids.

(Addendum, 10/8/09: much thanks to Universal Hub for pointing out a typo in the last sentence than is now corrected! Dr. Gwenn)

For information on H1N1 and the new school year, click here.

What the new Autism Study Means for You

ideas@pediatricsnow.com (Dr. Gwenn) — Tue, 06 Oct 2009 18:08:00 +0000

This week's new Autism study in Pediatrics has created a great deal of conversation...and confusion!

I discussed the study today on Fox Boston to help shed some light on what this study is really about...and what we can learn about it's implications for the future of Autism:

For more information, check out

33 Charts
AAP's Autism Study Parenting Handout
The New Autism Study: why the fine print matters

The New Autism Study: Why The Fine Print Matters

ideas@pediatricsnow.com (Dr. Gwenn) — Mon, 05 Oct 2009 17:19:00 +0000

By now you’ve likely heard about the new Autism study out today in Pediatrics.

It’s a solid study that adds great value to the Autism landscape. To help clarify questions raised by the study, the American Academy of Pediatrics has put together a very comprehensive Q&A that is worth checking out.

What’s important to understand about this study is that it represents an evolving understanding of the entire field of Autism. Keep in mind that Autism is not just one condition but a spectrum of disorders. It can be very difficult to diagnose and the goal over the last few years has been to attempt to screen children as young as 18 months and intervene as early as possible with behavioral modalities. This is the type of condition where early identification and intervention does make a huge difference.

So, has there been a true increase in Autism, as the study suggests? Maybe, may be not. Because of our better understanding of Autism and our better screening tests, we are certainly picking up more kids at younger ages. Whether this is a true increase in rate we don’t know yet but we do know we are doing a better job in identifying kids who may have Autism, and that is very important.

And, it’s equally important we remember that not all children initially diagnosed with Autism actually have it. The study notes that 38% who are initially diagnosed with Autism “lose the diagnosis over time.” I can think of 2 reasons for this.

1. Our diagnostic criteria are constantly evolving so some kids stop meeting the criteria for Autism but are found to actually have other behavioral disorders.

2. Our screening tests for Autism are working as they should. A good screening test will always pull in kids who on further testing are found to not have the test they are screened for but have something else.

For either of this situations, this is still good news for these 38% of children because they are still identified as having a behavioral issue that needs pursuing and intervention. That’s significant even if the final diagnosis turns out not to be Autism.

More studies will need to be conducted to tease out where we truly are in numbers but studies like this help us see that we are making progress in a very confusing situation.

Are you ready for H1N1 and Seasonal Flu? Pediatrics Now is!

ideas@pediatricsnow.com (Dr. Gwenn) — Tue, 29 Sep 2009 21:35:00 +0000

The Pediatrics Now September update is live and has all the latest information on H1N1 and the Seasonal flu to help you stay informed and up to date.

This month's highlight's include:

New School Year, New Flu Season
H1N1 has sure made our lives more complicated, hasn’t it?As if one flu season wasn't enough now we have H1N1 to contend with. In this month's Dr. Gwenn Is In, I cover all the highlights of why this year's flu season is so unique and how you can get your family prepared to ward off the germs already lurking at all of our front doors.

Fox News appearances covering Flu Shot: Fact vs. Fiction and H1N1 Tips for Prevention.

Flu Season Activity Update Hot off the presses H1N1 and Seasonal Flu highlights for the top experts in the fields.

Don't forget to check out the home page for other updates to Ask Dr. Gwenn, Bug of the Month, and Fit Tips: Small Changes, Big Results.

If you don't see what you are looking for, let me know! I'll hunt down the info for you and put it in next month's update.

Swine Flu Vaccine: The Bottom Line

ideas@pediatricsnow.com (Dr. Gwenn) — Thu, 24 Sep 2009 12:00:00 +0000

If your a bit confused about the H1N1 vaccine recommendations, you are in good company! They are a bit confusing because this year's flu season is a bit confusing. To add insult to injury, the recommendations for H1N1 are just similar and dissimilar enough from "seasonal flu", Influenza A&B, that sorting it out can make your head spin and your tongue get tied.

Kim Carrigan and I attempted to clear the air about this challenging topic recently on Fox News Boston...as you'll see, I even got tripped up once, so don't feel badly if you're a bit confused!

Stay tuned! This is one story which is most certainly just beginning.

(Yes, I know I'm posting during Turn-Off Week but important breaking news has to get posted, even if you read it next week...which I hope is what you do. But, if you do need information this week, I want you to have it.)

Mission Turn Off Week...are you up for the task?

ideas@pediatricsnow.com (Dr. Gwenn) — Mon, 21 Sep 2009 14:55:00 +0000

This week is Turn Off Week, formerly TV Turn Off Week.

Your mission: keep all screens off in your home for the next week, for you and your kids.

There are events going on in just about every state this week so check out what's happening in your area.

But, you don't have to participate in an organized event to accomplish this important mission in your home. All it takes is

1. turning off the screens
2. spending time as a family doing screen-less activities

What activities are screenless, you ask?

reading
puzzles
games
nature walks
talking together
family meals
making family meals
listening to music together...and talking about it
outdoor adventures
playing games outside
sports outside
going to the gym together
charades
organizing your child's room together
rearranging the family room together
organizing your child's toys together and giving old ones to charity
sorting your child's books and giving outgrown ones to charity
fall cleaning closets and finding all sorts of things for charity

I came up with this list and about 2 minutes and many of these items my family did this past weekend. Actually, we do these things a great deal as a matter of life style choice. Why? Because we find that too much screen time for any of us makes us sort of wonky. We all feel wired, not as social and our interactions as a family just don't seem as real.

The statistics on TV watching are incredibly interesting. Did you know that

BTW, what about work and homework? Just aim for less screens for those. We have to be realistic that we do have jobs to do that may involve screens so don't get fired over this mission and don't let your kids' get expelled from school. But, then shut the things off!!

So, give it a try this week. When you flip back on those screens next week, I predict you'll find you won't have missed 'em half as much you thought you would!!

Turn Off Week Tool Box:

Dr. Gwenn's Article: Why Turn Off Screens
Dr. Gwenn's tips on unplugged living
Dr. Gwenn's Media Diet FitTips
American Academy of Pediatrics Media Use Resources

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BTW, to help you not be enticed to turn on the computer, I'll do my part and not blog again until next week :)

Rosh Hashanah Musings: The Power of Traditions

ideas@pediatricsnow.com (Dr. Gwenn) — Fri, 18 Sep 2009 18:45:00 +0000

Traditions embody so much of Rosh Hashanah that it seems fitting I republish this post each fall, on this day. And, before you ask...yes! I do know where Nana's table cloth is this year :)

L'Shana Tova. ~ Dr. Gwenn

Today is Rosh Hashanah, the Jewish New Year. As today approached, I found myself quickly entering autopilot to prepare. Cooking, shopping, contemplating...comes with the holiday week.

The holiday actually starts the night before with a meal. Last year I discovered that it's not the meal that matters but the extra special things that go with the meal. During the meal preparations, I went to find a very special tablecloth given to me by my Nana, my mom's mom. This table cloth had to be on the table. It was a necessity in my mind. I went to the usually spot I keep it and was shocked to find it not there. Panic set in. I had no idea where it was.

I recall vividly when Nana gave me this tablecloth. It was about 15 years ago and I was expecting our oldest daughter. We were running our first sedar - a big deal for a Jewish woman but an especially major deal for me since I married "out of the faith". To give you a sense of my Nana, as traditional as you'd expect someone from her generation to be, she was my husband's first and biggest fan in the family. Nana came over with all sorts of stuff that day, including this tablecloth, and wanted us to keep it. It was clear a baton was being passed. Not a holiday went by from that day until the day she died that she didn't call with a tip or two about chicken soup or preparing a meal, and she always seemed so happy to hear that her tablecloth was on the table. So, I had to find it, and it had to be on our table.

The last time I recall it being used was on Passover at my Mom's house but Mom was certain it was not there. After tearing apart my home, including the attic, which is not at all where it would be since that contains Christmas stuff (but people look in strange places when special things go missing!), I called Mom again. "Are you sure? Can you check one more time? Otherwise, I think Nana's tablecloth is lost."

That was all Mom needed to hear - she was now on "Mission: Find The Tablecloth". An hour later the phone rings. It was my Mom. She has the tablecloth after all. Apparantely, she has put it somewhere safe after Passover and had to go through all her "safe spots" to figure out which one it was in. A wave of relief rippled over the entire family. The tablecloth will be on the New Year's table and on the Yom Kippur table next week, which is a good thing since Yom Kippur is the one day a year we are supposed to atone for our sins and I was fairly certain losing this very important family heirloom counted as a major sin. Slate clean for one more year!!

While the tablecloth was missing, I remember feeling horrible. I honestly could not imagine a holiday without that tablecloth. We all know the connection between emotions and health, but did you know there is similar science between spirituality and health? After my experience last year, I'd believe it!!

But, it makes sense. The more "well" we feel in our body, mind and soul the better our bodies work and that translates to our kids as well. If we can teach this to our kids and help them feel this as they get older, their bodies will also reap those benefits. I'm not talking about anything deeply religious, by the way. I'm just talking more about family traditions and foundations. Having something strong you all do and believe in that you do practice and repeat that your kids will learn to count on and understand. That's the fabric that makes your family what it is. That's what I think spirituality is and what makes up the spirituality in a family. You could actually interchange "tradition" or "culture" for "spirituality" and end up in the same place in my mind.

Despite our moaning and groaning at times over some of the holiday logistics, I can't knock the overall benefits to my kids for some of the perks they reap when we pull off some great family times when holidays roll by. We don't have to have a holiday to create this for our kids but holidays allow us to build in a pause to our craze lives to pull it off so I'll take it!

So, Nana's tablecloth is once again on our holiday table without becoming lost in some long lost closet. Her soup is made compliments of my Mom. And, the dessert baton torch has been passed to her great grand daughters - a tradition I know my Nana would have loved to have seen, and tasted! All in all, the New Year is off to a great start.

L'Shana Tova! (Have a sweet and great year!)

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Facebook Users Equal US Population. Is this a good thing?

ideas@pediatricsnow.com (Dr. Gwenn) — Thu, 17 Sep 2009 12:00:00 +0000

CNN posted today that "Facebook is as large as the US Population." That's a lot of computers connecting in a lot of homes and communities all over the world but at what cost?

None to Facebook. They announced today they are finally making money.

But what about to us and our kids? Are we paying a price for being so socially networked?

Certainly we all have to assess the degree we want to be connected to people we know well, don't know too well, or don't know at all. As our connectedness to people online grows, what will happen to our connectedness to people off line?

My concern is we have fostered a culture obsessed with online connections that we forget that the world of living is offline. We see this played out almost daily as people cavalierly unfriend or unfollow people on their Facebook and Twitter feeds and then puzzle over the backlash, have forgotten that real relationships when severed have emotional consequences, even if based online.

This is one situation we can learn a great deal from our kids. As many researchers have already pointed out, teens use social networking sites to enhance and deepen the relationships they already have. They don't feel the need to reach beyond those relationships online and use the social networking tools as a way to foster a richness of their offline lives. As note in the Future of Children:

"...most adolescents use social networking sites to reinforce existing relationships, rather than make new friends....Instant messaging, Facebook, and MySpace...allow teens to share personal information and communicate with their friends and existing social networks."

I see this play out daily with my high school daughter who uses her Facebook network to enhance her offline time. For she and her friends, time on Facebook is a continuation of the day's socializing, not something disconnected from it. She's not trying to fill a need when she goes onto Facebook that she doesn't already have but continue conversations that were already begun.

Adults, on the other hand, use Facebook very differently and many times we have people on our lists we don't know as well. And, even the people we have on our lists are often people we are not heavily invested in socially day to day. The best description of Facebook that I've heard in a long while is from a psychiatrist I know who told me that he thinks of it like "a school reunion that never ends - it feeds our need to connect and not much else."

It's time we embrace what our teens already know - it's the offline world that matters and the online world is supposed to help us make those connections more meaningful. If your not using Facebook that way, perhaps your not using it the right way.

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Celebrity Behavior Out of Control: Williams and West UnPlugged

ideas@pediatricsnow.com (Dr. Gwenn) — Mon, 14 Sep 2009 11:00:00 +0000

Did you see these recent celebrity outbursts?

First, Serena Williams on the court of of the US Open showing one of the worst displays of poor sportsmanship ever displayed by an elite athlete in a very, very long time:

Second, Kanye West at last night's VMA awards attempting to steal Taylor Swift's thunder (only to have it backfire the entire evening):

William's refuses to apologize, making matters much worse for her. She was fined $10,000 but has not apologized for her behavior. Elite athlete or not, she has to play by the same rules as every one else, especially in the arena of sportsmanship and decorum. If nothing else, just as a role model, would she want a young tennis player to behave as she did and not be remoreseful for it? Clearly the loss of money didn't leave enough of an impression on Williams. Perhaps a stiffer penalty, not playing in the next high profile match or being banned from the game she loves, is the only way to teach her that everyone, including her, must play by the same rules.

West later did apologize, but likely to save face as he was asked to leave the hall and received huge backlash from the audience in and out of the theatre who made it clear they disaproved of his continued poor behavior.

As the Guardian pointed out,

"It's not the first time West has rushed the stage at an awards ceremony to protest over an award's recipient. During the MTV Europe Music awards in 2006, the rapper lost it after Justice v Simian's We Are Your Friends scooped best video instead of his own Touch the Sky. Just as he did last night, West grabbed the mic and said: "Oh hell no, you guys already won. This video cost a million dollars and Pamela Anderson was in it.""
It wasn't clear during the show whether West was asked to leave but we hoped he had been. His past behavior had not gone unnoticed in my family and what he did to Taylor Swift was unexcusable, in very poor taste and such a statement of his continued in ability to understand the spirit of these awared shows that he has no business being part of them any more.

It's important that our kids understand that even celebrities, with their money, glitz and glam, need to be held to the same standards as everyone else.

My hat goes off to Beyonce who gave up her own moment in the spotlight last night to regroup from the debacle West created. That's true class. In case you missed it, Beyonce accepted her award by saying:

"This is amazing. I remember being 17-years-old, up for my first MTV award with Destiny’s Child and it was one of the most exciting moments of my life, so I would like for Taylor to come out and have her moment."

If only everyone could have such grace and class!

Keep in mind that we control two important things that all celebrities need in their lives: the TV remote control and our wallets. These folks owe us more than many of them give and it's time we remind them of that by pulling the plug on their fame and fortune when they don't act they way they should. So, remind your kids that it's never ok to behave as these folks do and that other role models are better ones to have. In other words, take Serena Williams and Kanye West off the A list...time to move on.

Networked Families: Connecting With Digital Teens

ideas@pediatricsnow.com (Dr. Gwenn) — Fri, 11 Sep 2009 12:17:00 +0000

Do you use digital media to connect with your kids? I do?

Here's a snapshot of my family's story as told to PBS's Digital Nation:

I'd love to know how you connect with your digital natives...aka tweens and teens! Leave your stories in the comments or email me the details.

Are we barking up the wrong tree with health care reform?

ideas@pediatricsnow.com (Dr. Gwenn) — Thu, 10 Sep 2009 12:45:00 +0000

In a recent interview with Dr. Oz on Good Morning America, Dr. Oz told Diane Sawyer that he doesn’t think any of the proposed health care plans will work. Why? As Dr. Oz told Diane:

"What we haven't done is get to the very root reality of the flaws we have in the health care system. True health care reform cannot happen in Washington. It has to happen in our kitchens, in our homes, in our communities. All health care is personal."

Dr. Oz pointed out that the United States has twice the disease that is found in Europe. He believes that we have to find it impossible for Americans to not embrace good health. According to Dr. Oz:

"If I make your workplace conducive to walking at lunch, or working out at some time during the day, or I get people to use the stairs more by creating incentives to do such, then people will start doing it naturally.”

All you have to do is walk around any place USA compared to anywhere else around the globe to know this is true. Or, just note our friends from around the world who are visiting our country on vacation. Striking how much healthier our friends from other parts of the world appear – and act. They seem more vibrant, have more energy.

For these reasons, Dr. Oz isn’t hopeful any of the healthcare reform plans will work. He feels that until people start living more healthy, how the health care system is paid for is really moot. In his words: "The big debate right now in Washington is health care finance. It's how are you going to pay for it. I don't care which program we pick. I'll tell you why. Because none of them are going to work."

The sad truth is, he’s right. Americans have shown themselves to be very untrustworthy on the health care front with heeding doctors warnings about healthy living. Until that changes, until we find a way to make healthy living more appealing, how the system is paid for isn’t the path to reform.

After listening to President Obama last night, where does that leave us? No where useful. Sure…he talked a good talk about the insurance changes needed for the economics of the system to work but that has nothing at all to do with the true reforms needed in our system for not only personal health care but the actual ability to practice medicine, a topic the President barely covered last night.

I felt President Obama did an adequate job calming the waters of the misconceptions of the bill he is trying to put forward but let’s not mistaken that bill for the type of true health reform our country will need in the end. That type of reform, as Dr. Oz, pointed out, has to come from within each of us and the start of that may be as simple as looking in the mirror and accepting more individual responsibility for our own bodies and what happens to them.

What about savings, you ask? If we all care for our bodies better, we’ll all save by saving ourselves the time and expense of doctor’s visits, prescriptions, procedures, operations, and treatments of all kinds. Those savings will not only be in dollars to our bank account but years to our lives. Doesn’t sound too bad, huh?

Juggling Back to School Schedules Sanely!!

ideas@pediatricsnow.com (Dr. Gwenn) — Tue, 08 Sep 2009 17:20:00 +0000

Feeling frantic with the back to school frenzy already? You are in good company!

I just returned from My Fox Boston where Kim Carrigan and I talked about a potpourri of topics on all of our minds this week from juggling schedules to finding time for family meals to how to keep our kids active and eating healthy with such crazy schedules. We're both in this with you and are facing these exact issues with our families this week, too. Not easy stuff!

Check out what we talked about:

The key to sanity really is the family meal. If you don't have time to gather around your dinner table each and every night, you're all doing too much - parents and kids. The benefits of the family meal will pay forward for all of you in health, sanity and family life so give it a try - and make it a priority.

BTW, if you have tips you find useful this time of year, drop them in the comments section for the benefit of all of us!!

Thank You, Nurse Practitioners, For Recognizing Pediatric Health Blogs!

ideas@pediatricsnow.com (Dr. Gwenn) — Mon, 07 Sep 2009 14:00:00 +0000

Thank you to the Nurse Practitioners for taking the time to create the "100 Pediatric Health Blogs Every Mom Should read" list, and for including Dr. Gwenn Is In among such wonderful doctor bloggers, who do so many amazing things for the health and well being of children and families on and off line.

It's a very comprehensive list and covers a wide gamut of pediatric and child health blogs. Nancy Shute put it best on her US News and World Report blog when she wrote:

"...this list is chock-full of terrific blogs of all flavors and is well worth a browse, whether you're looking for information on a particular topic or just for a good excuse to procrastinate a bit."

(BTW, thank you, Nancy, for your kind words about me and Dr. Gwenn Is In!!)

I have actually read the vast majority of the blogs on the Nurse Practitioner list and they are all truly amazing in unique ways. As I wrote on Nancy's blog, find a few that "sing" to you, but that you can read in the time it takes to have a cup of coffee. The honest truth is the online world is really just your guide to the offline world. It's easy to forget that sometimes with so much great stuff online now...so use "Dr. Gwenn's cup o'jo blog reading rule" and you'll always be efficient with your online hunts and the time you need where it matters most - offline with your family and friends!

Loud Kids Don’t Belong In Waiting Rooms

ideas@pediatricsnow.com (Dr. Gwenn) — Thu, 03 Sep 2009 12:02:00 +0000

Just wanted to share a great story with you. I was at a doctor’s appointment the other day when I noticed a family waiting for one of the parents to be called. The mom was called in and the dad sat there for a moment looking at these 2 very young and rambunctious kids.

I looked over and noticed he didn’t have a backpack or any books with him to distract them. He tried to get them to site and just chat but that lasted about 10 seconds. After another 10 seconds, the dad stood up and said “Ok, you two come and let me tie your sneakers. You have too much energy for this room…we’re taking a walk.”

Even had he come prepared with books and other distraction toys, that was one excellent dad move!

Sometimes kids can’t be contained in places you think they can be. Waiting rooms are called that because the are places of waiting. The one thing we know for sure is kids don’t do waiting well, at any age, but especially when young.

If I can offer you one word of advice…leave young kids home if you can when you have a doctor’s appointment. If you can’t and come with an ally such as your spouse or friend, remember this story and be willing to take the kids out of the waiting room. They are just being kids…looking to explore and have fun…if plan A fails, improvise and just walk.

Swine Flu and Back to School: Focus on Prevention

ideas@pediatricsnow.com (Dr. Gwenn) — Tue, 01 Sep 2009 17:59:00 +0000

It used to be that we'd get all our kids settled back to school and then enjoy a bit of a pause before the other shoe fell with the inevitable concern over another flu season. With Swine Flu, Influenza H1N1 not taking a summer vacation and showing no signs of letting up, we didn't have that luxury this year.

I went onto My Fox Boston this morning and talked with Keba Arnold about this very unique flu season with 2 influenza strains traveling among us and offered some practical tips to not only prevent the flu but be ready should it impact your town's schools:

Don't try and absorb everything at once. Focus on prevention today and I'll help keep you informed as we learn more about the flu shots your family will need, when they will be available, and any breaking CDC alerts that are important for your family's well being during the flu season.

Please Note: “No Cell Phones” signs are for everyone…even you!

ideas@pediatricsnow.com (Dr. Gwenn) — Wed, 26 Aug 2009 12:11:00 +0000

I have a new pet peeve. It’s called the “willful violation of posted no cell phone zone” callers. It drives me completely bonkers!

I thought about it the other day when I was waiting in a big down town Boston physician’s office waiting room. All the waiting rooms in this facility are very nicely appointed with comfortable chairs, magazines, and water bubblers. They have quiet, all-ages music piped in overhead at a reasonable level. On the walls are the following signs:

check in and check out reminders
“this is a non-smoking facility”
“No-cell phone zone”…depicted in words and with this symbol: (it was really hard to miss!)
- The sign also had this text: “This waiting room has been designated a quiet zone. Thank you for not using your cell phones for calls.”
- These signs were placed every couple of feet so each wall had a few…clearly this was an important policy!

My daughter called, not knowing about the sign. I answered and whispered “is this an emergency?” She said “no” and I quickly explained the situation and told her to use text to communicate with me while at the doctor’s appointment. I apologized to the one person in the waiting room with me who waved it off but I felt I at least needed to acknowledge the sign and respect it. In fact, I should have warned my girls as these policies are standard in all medical facilities these days.

The waiting room filled up fast. Everyone who came in noticed the cell phone signs – they were hard to miss as the most visible ones were near the check in desk. Most people kept their phones in their bags. A couple took calls and did what I did because they had kids at home and hadn’t warned them not to call.

One lady, however, just ignored the sign altogether. She pulled out her phone and made a call and started talking about neighborhood gossip. This went on for about 15 minutes.

These policies are not meant to block out emergency calls or calls to tell people, like teens at home alone or a babysitter, that we are running late. These policies are meant to block out the loud and obnoxious cell phone user…like this lady became.

It’s a turn for the better that we’re seeing more cell phone boundaries become created in our society but until we find a way to collectively enforce these ad hoc policies, the rude behavior will just continue to spiral out of control. Since self regulation has failed, perhaps facilities should consider fines…like the equivalent of parking tickets!

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Teen desire living healthy but are we helping enough?

ideas@pediatricsnow.com (Dr. Gwenn) — Tue, 25 Aug 2009 12:26:00 +0000

Nielson Wire yesterday posted a summary of a Scarborough Research study that may surprise you. According to the study, teens actually know what “being healthy” means. As reported by Nielson Wire, “92 percent percent of teens aged 13-17 say that health and a healthy lifestyle are important and when asked to give themselves a “health report card,” 76 percent of teens gave a grade of B- or higher.”

Also of interest in the report is where teens get their health information. As opposed to using social networking, as we’d expect them to do given how important a role it plays in their lives, teens turn to parents first and then true internet searches second.

(source: Nielson Wire as seen in Scarborough Research report)

I don’t doubt that on some level our teens know they need to live a healthier lifestyle and desire to do so. But, all we have to do is look around any of our towns to know the majority of our teens are not living they healthy life…not yet. So, why the discrepancy? What needs to happen to help teens live the healthy life they desire?

The discrepancy may have a few root causes:

1. unhealthy families: many of these kids have parents with weight issues…the apple doesn’t fall too far from the tree so they may not be getting the encouragement to “live healthy”.
2. lack of time for true exercise – while many teens are in sports, sports participation isn’t the same as true exercise and many kids don’t burn the calories many parents think they are burning.
3. Not knowing how to be more healthy.
4. the hurried child syndrome where childhood has become so busy there isn’t time for proper meals.
5. Not understanding their own bodies unique nutritional needs. The needs of a growing teen are different than they were when they were younger kids, especially as growth slows down. Our teens need help learning to eat more like adults and to eat in moderation and with the concept of “balance”. This will only happen if we lead by example and also have open conversations with them about food. This will also only happen if we serve food they enjoy eating!

How can we help our teens live the healthy life they desire?

1. Talk to your teen and really listen! Find out how your teen wants to eat and exercise. A friendly world of warning…it may differ from your own views but if that is how your teen wants to be healthy, help your teen with that goal because the teen years are the start of the eating and exercise paths for life.
2. Lead by example. Look honestly at how you eat and exercise and do what you need to to be more healthy.
3. Slow down the pace of the family week so there is time for family dinner each and every day.
4. Get every one in the kitchen cooking. I’ll be writing a lot more on this as the year goes on but I can tell you that a family who cooks together, becomes more healthy together!
5. Have your teen help you with the weekly family menu planning.
6. Consider a gym if you can afford it…teens love working with trainers and joining classes. Most communities have programs that are very affordable as do the local YMCAs.
7. Don’t by the junk if your teen asks you not to…that’s like having cigarette packs on the table when someone is trying to quit smoking.
8. Keep healthy snacks around such as fruit, veggie sticks, granola bars.
9. Talk to your pediatrician and address any medical issues if there are any that may be interfering with becoming more active.
10. Be encouraging!

The teenage years are when our teens are supposed to spread their wings and amaze us. If good health is where their wings are trying to take them, then our job is to hop on that path and tackle any obstacle in their way.