Tuesday, May 31, 2011

Cell phones linked to brain cancer!

There has been speculation about cell phones and increase risk of brain cancer for a while now.  Today, the World Health Organization (WHO) has announced that radiation from cell phones can possibly cause cancer.  You can click here to read more.  It seems as if the risk is worse for younger children and for those who use the device for a long time.  Even though the studies have been inconsistent, some European countries have already taken precautionary measures mostly aimed at children.

Here is an excerpt from the article that I read that summarizes the bottom line:

Jonathan Samet, MD, chairman of the working group, notes that "the evidence, while still accumulating, is strong enough to support a conclusion and the 2B classification.
"The conclusion means that there could be some risk, and therefore we need to keep a close watch for a link between cell phones and cancer risk," he said in a news release.
A full report summarizing the main conclusions and evaluations of the IARC Working Group is slated to be published online soon in The Lancet Oncology and in print in its July 1 issue.

So what does this mean to me?

  • Will try to limit cell phone use in my kids who are both under 4 - they already have this fascination with cell phones and play with pretend or inactivated cell phones that we have around the house all the time.  Every now and then I'd let them talk to grandparents or grandparents would let them talk to me on the cell phone... if I'm going to do it, will set it on speaker mode so the phone itself is farther away from the head
  • Will try to use headset or speaker mode more for myself - especially since I take calls from patients when our office is closed, I'm on the phone almost all the time!  Hey even if the research is not conclusive yet.. why not take whatever precaution possible to avoid such risk...

Friday, May 20, 2011

Preventive Cervical Screen

So here's an interesting article I recently read about the recommended frequency of the dreaded pap smear.  For the longest time, women have been told to get annual pap smears.  Few years ago, new guidelines allow screens to be spaced out to every 2-3 years for women over 30 and who have had 3 normal pap smears in a row and who test negative for both the pap smear and high risk hpv.  

This article reports on a study of over 300,000 women confirming the validity of these new guidelines.  So even though the guidelines came out a few years ago, many practitioners and patients have been tentative in following the spaced out schedule.  For me personally, I gladly will follow these more spaced out guidelines (who has time with little ones around... and it is not the most pleasant screen).  I also feel a lot more confident about advocating this to my patients.

Why do we test for cervical cancer anyway?  Here are some interesting facts:

Top Causes of Death in Women:

  • Heart Disease
  • Cancer
  • Stroke
Top Causes of Cancer Deaths in Women (worldwide and not counting skin):
  • Breast
  • Lung
  • Cervical

Wednesday, May 18, 2011


I just wanted to share a link to a pretty funny christian article I read on parenting.  You'll especially get a kick out of this if you are familiar with Tedd Tripp's Shepherding A Child's Heart.  Click here to read the article.

Monday, May 16, 2011

Using au pairs for childcare

So how many of you folks out there have used or are using au pairs for childcare?

With baby #3 entering our world soon, we've been looking for more help around the house.  Although the time I spend at work add up to about 25 hours/week, I feel I still need help around the house even when I am home.  Otherwise,  I just can not get any chores or important phone calls in.

We've never used an au pair agency before and we're entering this somewhat tentatively but some of the factors that drew us to try this include:
  • Cross cultural experience :  I would love my kids to be fluent in Mandarin Chinese and this is the age where they can soak it up easily and it will probably stick for the rest of their lives.  Plus, I'm also excited about the idea of sharing life here in the States with someone who grew up in a different culture and country.
  • Availability:  Advantage of a live-in caregiver is that I don't have to worry about someone cancelling on me if there is a snow day (and we had a lot of those this past winter).  Plus, there is also the advantage of being able to sneak out after the kids are asleep late at night because someone is home with them.
  • Economic financially :  Using an au pair comes out to about $7.50 per hour.   That is practically impossible to beat especially if you are asking someone to watch 3 kids under the age of 4!
There is a small part of me that feels I should be able to do it all and why do I need to get so much help when there are other moms out there doing it all by themselves without any help.  Well... for the sanity of my family, I'm giving in and realizing to just accept help and use help if available.  I will always fall short of my own expectations.  So we'll see how it goes!

Sunday, May 15, 2011

Q&A with Allergist!

We're in the midst of a crazy allergy season!  My poor older daughter is suffering pretty badly from it.  

Here are some commonly asked questions that I've posed to an Allergist/Immunologist.  Dr J has a private practice in Dallas, TX and is also a mom of a preschooler and a toddler.  Here is what she has to say:

*  At what point should my child be referred to see an allergist specialist?
 It depends. if there are food allergy concerns we can see very young (ie bad eczema)

Most kids don't start getting allergy symptoms, especially pollens, til about 3 yo, but those with more atopic family histories can have symptoms (dust mite, cat, dog) as young as 1 yo.  It depends on quality of life. if recurrent sinus/ear infections, bad asthma, then need to look at allergies as a trigger.

 *  How young do you typically start allergy shots?
Same thing, depends on severity of symptoms, quality of life, and maturity of the child.  I've started as young as 3 yo but that's because of fireant venom anaphylaxis, which are probably virtually nonexistent where you are. but with kids playing outdoors and high likelihood of exposure to fireant in Texas, then we can start that young.  Shots for environmentals is more rare, mainly because everyone wants to try meds first.  But if family loves their pets, then that's something to consider. Also, evidence shows that very atopic 3 yo who started shots did show a delay or reduction in severity of asthma developing, so that is often a decision maker for parents who suffered through allergies and asthma as young children and don't want their kids to go through that.  But "most" kids I have start around 7-8 yo, that's because they consciously know and can verbalize how tired they are of being sick, or they are now always on the football/soccer field, and want to keep playing.

 *  Typically how long does it take to complete treatment?
Evidence shows 3-5 years of allergy shots appear to help people for at least 10 years.  I usually tell people it's the closest to a "cure" we have.  There is still possibility of breakthrough symptoms when the pollen counts are high, but at least day to day quality of life is significantly improved.

 *  How soon can you expect the allergy shots to work?
Some as early as 4 months, I usually tell people let's try for a year, then you'll know when your typical allergy season comes around.  It works for about 90-95% of people who start allergy shots.

 *  I was treated with allergy shots before but I still need to take allergy
 medications.  Does this mean I need to go through another round of shots?
No, depends on severity of symptoms and complications.  if meds work and they are tired of the time commitment put into shots, then ok to just take meds.  But I always caution patients that allergy shots are effective for about 10 years, so yes, I see people in their 30s who recall childhood shots worked but now it's all coming back. Plus they may have received shots in another region of the US.

 *  What does it mean if all my allergy testing comes back normal but I still
 get allergy symptoms?
Could retest (ie skin testing, RAST testing). but their's 90-95% likelihood that negative means negative.  May need to look at nonallergic causes (ie irritants, wind) and especially chronic sinusitis.

*  Do you think brand name allergy medications work better than generic?
Not really.  That's depends upon the individual.

Wednesday, May 11, 2011

Marital strife can affect sleep pattern in toddlers!

I just read an interesting article on CNN.  Marital strife around the time an infant is 9 months old can affect his or her ability to stay asleep through the night at 18 months of age.  You can click here to read the article.

It makes sense that even at a young age infants can pick up on stress.  I just find it interesting that it can affect one's ability to sleep through the night later on.  I suppose adults have a hard time sleeping through the night when they are stressed so the same would hold true for little folks.

Hm.  Something to think about when applying the whole sleep training concept...

Thursday, May 5, 2011

Measles in Bucks County

I just received a Bucks County alert that there may be 3 cases of measles that could have exposed other people while infectious.  So if anyone out there is not immune or your kids are not immune... you may want to watch out or get vaccinated.  We may be seeing more of these alerts as more people refuse the vaccination.  See below for the press release.  Also for more information on measles you can click here.

Contact: Chris Edwards or Ann Machesic
The Bucks County Health Department has identified three probable cases of measles that could
have exposed other persons while infectious. For most people, measles is not a serious illness.
However, in some cases it can cause severe illness. Complications from measles can include ear
infection, diarrhea, pneumonia, and encephalitis. All three probable cases in Bucks County were
at least partially vaccinated.

Possible measles exposures could have occurred at the following times and locations:
  • Saturday night, April 30, at the Murder Mystery Dinner at the Cock and Bull Restaurant in Peddler’s Village, Lahaska;
  • Saturday, April 30, between the hours of 11 a.m. and noon at the Parx Casino blackjack tables.

If you attended one of these locations during the time specified, and are susceptible to the virus,
you are asked to watch out for symptoms of measles between now and May 17. What should you
do if you develop symptoms of measles? If you develop a rash and/or fever, do not attend public
places (such as work, school, childcare, shopping or public transportation until you see a doctor
and are sure you don’t have measles). If you suspect you have measles, call your physician
before you go and let him/her know that you may have been exposed to measles.

Most people in the United States are immune to measles, either because they received the
Measles Mumps Rubella (MMR) vaccine in childhood, or because they were exposed to measles
in the pre-vaccine era (before 1957). Infants less than one year of age are too young to have
received the MMR vaccine.

The public should be aware that measles is caused by a highly contagious virus. Symptoms will
begin one to two weeks after exposure and include a runny nose, watery eyes, cough and a high
fever. After four days, a raised, red rash starts to spread on the face, down the body and out to
the arms and legs. The rash usually lasts four to seven (4-7) days. An individual with measles can
spread the virus to others for four days before and four days after the rash begins.
The probable cases here in Bucks County were exposed to French foreign exchange students
who were symptomatic for measles, but returned to their native country prior to testing. There
is currently a major measles outbreak in France. The probable cases live in the Council Rock
School District, and the affected schools and their students are being notified. Children who have
not been vaccinated will be removed from the schools until the possible incubation period of
illness is over.

Dr. David Damsker, director of the Bucks County Department of Health, notes that this
situation “shows more than ever the importance of vaccinating your family. Diseases that are rare in the U.S. are
still circulating around the world, and are only a plane flight away. This is another reminder to
check with your physician and make sure you and members of your family are up-to-date on their

Commissioners’ Office of Public Information * 55 East Court Street, Doylestown PA 18901
215-348-6415 * www.BucksCounty.org
County Commissioners
Charles H. Martin, Chairman
Robert G. Loughery, Vice-Chairman
Diane M. Ellis-Marseglia, LCSW

Wednesday, May 4, 2011


Spring time means warmer weather but for a lot of folks, it also means seasonal allergies.  I grew up getting allergies mostly in the fall.  However, the symptoms are similar.  Some may have all or some of these with varying severity:  

-  sneezing
-  itchy eyes
-  runny nose
-  congestion
-  throat clearing (from post nasal drip)
-  scratchy throat (from post nasal drip)
-  annoying cough
-  overall malaise

I'm beginning to suspect that my three year old may have some spring allergies.  Sometimes it is tough to differentiate between allergy symptoms and cold symptoms.  When in doubt, always check with your physician, but in general colds will have certain characteristics you don't typically find in allergies like:

-  fever
-  yellow/green mucous

So what do you do when you have allergies?  It helps to know what you are allergic to avoid the triggers as much as possible.  Most people just take general measures to decrease allergy symptoms such as:

-  staying indoors and keeping windows/doors shut (especially if the triggers are outdoors)
-  change your clothes and shower after coming in from outside
-  washing bedsheets at least weekly in hot water (needs to be > 130 degrees to kill dust mites)
-  keep pets away from bedrooms (may need to not have pets if allergic to them)
-  dust/vacuum often and avoid rugs/carpets if possible

Most folks can take over the counter allergy medication with relief such as claritin, zyrtec, or allegra.  However, if the symptoms are more severe one may need prescription allergy medication and may also get added benefit from prescribed nasal steroid inhalers and/or an antihistamine inhaler.  These are especially helpful if one has postnasal drip causing a cough.  Eye drops may also be prescribed to help with itchy, watery eyes.

In addition, one may get referred to an allergist for more specific testing and for potential allergy shots.