Sunday, May 26, 2013

Lawn Mower Safety

This time of year a lot of us must mow twice a week to keep the grass under control.

I have already seen kids in my neighborhood who are far too young to safely mow pushing the lawn mower. Each year I cringe at the sight of kids taking on this responsibility too soon! 

I often see a parent mowing with kids playing near by. 

Thousands of children are injured by lawn mowers each year. They lose limbs and life. This is entirely preventable.

Last week I drafted this picture to quickly show a few safety tips.  It was popular on our Facebook page, so I wanted a more "permanent home" for it. 

Please feel free to share!

For more tips, see the American Academy of Orthopedic Surgeon's page on Lawn Mower Safety.

Original picture altered from Shutterstock.

Wednesday, May 15, 2013

What kids need to be able to do to leave the nest...

photo source: Shutterstock
It's graduation season, which has me thinking of all the ways our kids grow over the years. They're born, then just a few years later they are in kindergarten. In just a blink of the eye they get a locker in middle school. Then high school is over. The world awaits...

Where does the time go?

I have one who will be starting high school next year, and have spent a lot of time reflecting about at all he's learned and what he needs to learn to be successful, independent, healthy and happy.

I have never really thought that school is about learning the actual subjects. It is more about learning how to learn. How to organize. How to be responsible. I have always told my kids I don't care what grade they get as long as they learn what they need to and do their best.

Home life is also a process of learning. We learn how to live healthily and respectfully with others. We learn to take care of ourselves. We learn to be responsible with money. Ideally we learn to argue a point without losing control of our emotions or being hurtful.

In all of this reflection, I came up with a list that I have shared with my kids, and I invite you to share it with yours.

Things you should be able to do independently before leaving home:

Good hygiene habits

  • Brush teeth twice daily. Floss once a day. 
  • Shower or bathe daily. Wash hair as needed for oil control. 
  • Wash hands often. 
  • Shave as needed. 
  • Flush.
  • Brush hair at least daily and get a hair cut regularly. 
  • Clip and groom nails regularly, fingers and toes. 
  • Use personal hygiene products correctly, including: deodorant, facial acne cleansers, etc. 
  • Wear clean clothes and change underclothing daily. 
Healthy habits
  • Get adequate sleep to wake fresh and ready for the day. Set an alarm and get up on your own. 
  • Eat healthy foods and limit junk food and sodas. Be able to prepare simple healthy meals. 
  • Take vitamins daily. 
  • Understand common over the counter medicine indications and how much to take.
  • Understand why you are taking medications (if you are), how to take them, and what is needed to get more -- is it over the counter or a prescription medicine?
  • Know your medical history, including any allergies and chronic health care problems.
  • Know how to take care of common injuries until they are healed. 
  • Exercise regularly, at least 3 times a week. 
  • Develop healthy strategies to handle stress. 
  • Journal 
  • Prayer or meditation 
  • Sketch or other artwork
  • Talk to someone openly—don’t hold bad feelings in! 
  • Take a long bath 
  • Think before speaking 
  • Deep breathing 
  • Laugh 
  • Exercise 
  • Schedule down time 
  • Think about the problem from different points of view 
  • Break big projects into small parts to be able to complete in parts 
  • List the good things going on and be positive 
  • Avoid overscheduling
  • Learn to say "no"
  • Enjoy social interactions as well as alone time. 
  • Exercise the brain by doing puzzles or reading.
Things to learn

  • How to cook a healthy, balanced meal. 
  • How to grocery shop on a budget to incorporate nutritional balance.
  • How to properly clean dishes and tidy up the kitchen after eating.
  • How to balance a check book, make a budget, and pay bills on time.
  • How to do easy repairs around the house.
  • Understand health insurance plans - how to get them, what they cover, what is excluded.
  • Basics of money investment, retirement planning, savings.
  • What to do in case of a road side emergency.
  • Important numbers (doctor, dentist, insurance, etc).
  • How to do laundry.
  • How to clean a bathroom, use a vacuum, and dust.
  • How to sew basic clothing repairs (buttons, hems, etc).
  • How to get help when needed.
  • How to apply for a job and build a resume.
  • Choose words carefully: they can build someone up or crush someone down. 
  • Drugs and alcohol should be treated with respect and used only with good judgment. This judgment should take into consideration laws and safety. Our brain does not fully develop until the early/mid 20s and early use of drugs or alcohol increases the risk of addiction.
Be a good friend and responsible family member

  • Be clear with plans: Look at the family calendar when making plans. Get permission from all parents involved; let family know where you will be and when you will be home. 
  • Keep a phone available to be able to call when needed. Answer calls/texts from parents! 
  • Treat everyone with respect: family, teachers, friends, and strangers. 
  • Require that others treat you with respect. 
  • Do random acts of kindness occasionally. 
  • Volunteer regularly.
  • If you feel unsafe, leave the situation. Tell a trusted adult as soon as possible. 
  • Do only things you and your parents will be proud of. 

Things to do to show you are getting ready to leave the nest...
  • Complete assigned homework and chores without reminders or nagging. 
  • Keep your room picked up and clothes off the floor. 
  • Hang your towel to allow it to dry between uses. 
  • Clear dishes from the table. 
  • Clean up after projects or play. Return all things to their proper place after using them. 
  • Throw all trash in the trashcan. Recycle things that are recyclable. 
  • Responsible use of cell phone, computer, and other electronics. Turn off before bedtime to allow uninterrupted sleep. 
  • Spend and save money responsibly. Never spend more than you can afford. Use credit cards wisely.
  • Take pride in your work: schoolwork, chores, job, and helping others. Do it to the best of your ability and ask nicely for help as needed. Recognize that work is not always fun, but necessary. Doing tasks with a good attitude will help. 
  • Time organization skills: Do not procrastinate until the last minute. Plan ahead and do big projects in small steps. Be prepared with all materials you will need for a project and ask in advance if you need help acquiring items. Use tools (apps, calendar, check lists). 
  • Take care of your things. Keep them in proper working order, clean, and put away. 
  • Drive responsibly. 
  • Accept consequences with grace. 
  • Earn trust. 
  • Know when to trust and follow others and when to take your own path. Make independent decisions based on your own morals. Have the courage to say "no" if something goes against your beliefs.

Saturday, May 11, 2013

It's [Sports, School, Camp, Yearly] Physical Time!

It's that time of year when school aged children and teens need physicals for school or camp entry or to participate in sports. Parents often want to work in a last minute "quick physical" for a form to be signed before a sport season starts or a child goes to a new school. Plan ahead so you can get an appointment at your preferred time!

Unfortunately some parents calling at the last minute are unable to get an appointment that fits their needs so they decide to go to a walk in clinic to just get the form signed. Keep reading to learn why this isn't a good substitute for a yearly physical in your child's medical home (AKA regular doctor's office).

Some parents don't think a yearly physical is important, and if not required to present a form to a school, sport, or camp, they simply don't do them. Their kids miss out on the benefits of a yearly physical.

Even when you think your child is healthy, there are several things that should be discussed, reviewed, and evaluated during the physical, so the visit isn't quick and it should be done in your child's medical home. If your child's regular physician is not available, there is still benefit to scheduling with another provider at your doctor's office as allowed by their policies. Past records are available to be able to compare current height to past growth. We can review vaccines and update as needed. We can update your child's record as needed since the last visit with new family medical history, changes in the home or school, and with your child's overall health.

Over the years I have "cleared" many student athletes by signing a pre-participation form required for high school sports or camps. On occasion I have not been able to sign the form, and this can lead to frustration for the athlete and his/her family.  If a physician or other licensed medical provider does not feel requriements have been met to "clear" an athlete for safe participation in sports, parents and their athlete often do not understand the "why" behind the need for further evaluation or treatment.

Common reasons to not clear an athlete for participation include recent concussion or a history of passing out that hasn't been fully evaluated.  I had one patient upset that I wouldn't sign the form because of a current broken bone... you can't play a sport in a cast! From the mother's perspective, she just wanted the form done today because the physical was today. From my perspective, the form can be signed when the child is able to play. I can't in good conscience say the student is able to play today if he is not. You don't want me as your child's pediatrician if I am able to attest to something I know is not true.

Please don't go to an urgent care or chiropractor to get the form signed when your regular doctor refuses due to a medical concern. I have seen parents do this -- omitting the fact that their child has passed out and needs further testing or had a concussion. That undermines the reason for the form in the first place! It is for your child's safety!

A glance at the Kansas Pre-Participation Physical Evaluation form's first page highlights many of the important topics to investigate. It would be impossible to completely cover every recommended topic at every physical, but standard recommendations include:

  • Review of health history, including chronic conditions (such as asthma, diabetes, learning disabilities etc), hospitalizations, surgeries
  • Review of family medical history
  • Height, weight, Body Mass Index (BMI), vital signs (blood pressure, pulse, respiratory rate) - comparison to previous values is most helpful
  • Puberty status
  • Nutrition, exercise, and weight management issues - including performance-enhancing substances
  • Sleep
  • Risk factors (safety, smoke exposure, violence, alcohol use, screen time, internet safety, and more)
  • Mental health (depression screening, drug/alcohol use, bullying)
  • Physical exam (special attention to cardiac system, musculoskeletal, neurologic and other sport's preventing problems)
  • Update vaccines as needed
  • Laboratory evaluation as needed: cholesterol screening, anemia screening, and other risk-based testing
Not included in this list is following up chronic conditions, addressing the issues raised at the physical, refilling all medicines, etc. There are times that addressing one or two specific issues is appropriate, but often there isn't enough time to adequately address all concerns. A separate visit may be needed to be able to devote appropriate attention to each issue. Please don't save up a year's worth of concerns to discuss at one visit each year. 

A well visit is recommended every year for all children over the age of 3 years (more for younger children). If your child hasn't had a well visit in the past year, call today or request a physical through our portal! Don't wait until the last minute... summer physicals book quickly.

The yearly well visit can be used to address all sports and camp physical forms that need to be done. Please bring them to your visit with the appropriate sections pre-filled out to save time in the office.