Healthy Living

Steering Your Way Through Hospitalization

Updated 3 years ago

By Dr. Jonathan WoodSteering Your Way Through Hospitalization(Beware – – potentially rough waters ahead!)Being admitted to the hospital is often scary and traumatic… for the patient and for the patient’s family as well.Being critically ill, needing invasive procedures or having a hospitalized child all accentuate this feeling. The medical lingo is difficult to understand, the issues discussed often carry great importance, and there are often unanswered questions. What’s more, caretakers often seem to be overworked or in a hurry. Arrgghhhh!And then money is invariably an issue: missed work, inadequate insurance, childcare needs, day-to-day living away from home, etc. More stress.In the end, many people report a sense of “loss of control”. What can be done?While I cannot offer a fix for the sometime beleaguered state of modern medicine, I will suggest one central thing that can help with all the above: improved communication. And much of it is within your control.Some suggestions:• Learn the system (i.e. who are all these people?)Hospitals depend upon a complex system of personnel that is often very confusing and very difficult to understand. Examples:o Primary Care docs (e.g. Internist, Family Practitioner, Pediatrician)o Inpatient Specialists (e.g. Hospitalist, Intensivist)o Specialists (e.g. Surgeon, Psychiatrist, OB-Gyn)o Sub-Specialists (e.g. Cardiologist, Neurologist, Orthopedic surgeon)o Midlevel Providers (e.g. Nurse Practitioner, Physician Assistant)o Nurses (e.g. bedside nurse, charge nurse)o Ancillary Personnel (e.g. Respiratory Therapy, Physical Therapy, Occupational Therapy, Nutritionists, Social Workers, Care Managers)o Trainees (e.g. residents, nursing students, medical students)• Ask questionso Who are you? Insist that people introduce themselves and explain their role in your care. Where do they fit in the lists above?o Why are we doing this? Insist on understanding why tests are being done and what is going to happen with the information.o May I speak with my doctor? Ideally there is one doctor orchestrating all of your care. Ideally there is excellent communication between doctors and amongst all the participants in the care team. Insist on a team and a good leader.• Tell your caretakers your worries – don’t be afraid to tell people what concerns you or what would make you more comfortable. Nothing is off limits!• Leave your biases at homeo Believe in the system – Much of believing is understanding. Work to understand the system (see above) and increased confidence will follow. o Don’t worry about offending – Doctors are people – – you can talk to them like you talk to anyone. Sometimes people feel intimidated, but it is important to move beyond this. Be yourself. Remember: you are the consumer. Be polite and expect the same in return.o Gender – The days of female nurses and male doctors are long over. Do not make assumptions based on gender and treat all your caretakers with respect. Insist on the same in return.o Teaching Hospitals – Much of the best care in the US is delivered in teaching hospitals. No one is experimenting on you. On the contrary, these are often very concerned, very smart, and often less busy students or residents who can be very helpful in you quest for quality healthcare. Take advantage of the opportunity!o Culture Differences – Maine attracts caregivers from all cultures. These people are invariably well trained and very caring. Treat them with respect and expect the same in reverse. If accents are difficult to understand, be frank, polite, and patient.• Know what is expected of you and your family when you are dischargedo Ask questionso Get to know your “care manager” or “discharge planner”o Be sure you understand your medications and doses (including changes from when your arrived)o Have instructions repeated as many times as it take to understando Know who you need to see after leaving and where and when.While these suggestions won’t make being hospitalized fun, they may take some of the unnecessary fear and anxiety out of the process. In the end, remember… communication is the key!

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Healthy Living: Dementia or Depression- How to Tell the Difference?

Updated 3 years ago

By- Dr. David PrescottDefining Dementia and Depression: Two common health concerns for seniors are dementia and depression. The relationship between these two conditions is complex and usually requires a careful assessment by a health or mental health professional. However, knowing some of the common similarities and differences can help seniors and their family members know when to ask for help. Dementia refers to significant problems with memory and at least one other cognitive ability such as language or reasoning. As noted by the American Psychological Association‘s Help Center, dementia can be caused by Alzheimer’s disease or other age-related problems such as stroke or Parkinson’s disease. Dementia is not an inevitable consequence of aging, although it is age-related and doubles in prevalence from a low rate in 60-64 age group to 40-50% of those older than 85.Depression is primarily a mood disorder, but depression is also marked by difficulties with concentration and short term memory. In fact, concentration and memory difficulties are often the most treatment resistant symptoms of depression in the elderly. In addition to problems with memory or concentration, elderly people often first report signs of depression as physical complaints, such as lack of energy, poor sleep, or increase in minor pain and discomfort. How to Differentiate Dementia from Depression: As mentioned previously, sorting out whether changes in mood and memory are due to depression, dementia, or both usually requires a health or mental health professional. However, certain situations are commonly associated with depression. The following are questions which may help you identify whether or not depression is the underlying factor. 1. Are memory problems brief and variable? Occasional lapses in attention and short term memory, such as forgetting where you put something or forgetting someone’s name, are common and not usually cause for concern about dementia. These types of problems may become more common when a person is depressed. 2. Was the onset of memory problems associated with a loss or other difficult event? Depression is often associated with a loss of a loved one, a job, or loss of physical functioning. Sometimes the losses are gradual, sometimes sudden. In many cases, if memory problems are associated with some type of loss, they are symptoms of depression rather than dementia. 3. Does the person have persistent hopelessness, discouragement, or sadness? Persistent hopelessness or sadness is a hallmark of depression. If these mood symptoms are present, there is a strong chance of a mood disorder like depression. What Can I Do? Perhaps the biggest common misconception about either depression or memory problems is that there is nothing you can do about it. While there are certainly limitations to treatment, particularly with severe forms of dementia, there are many ways that you can help both your memory and your mood. 1. Engage in mentally stimulating activities: While the exact impact of keeping your mind active is still being researched, there is widespread agreement that staying mentally active helps both your mood and your memory. 2. Find ways to be independent: Independence in the elderly may be different than independence of younger adults, due to physical limitations or general life circumstances. But, finding ways to respect the preferences and self-worth of our senior citizens is a good way to combat depression, and to keep their mind active. 3. Make sure you work closely with health and mental health professionals: The reasons for changes in mood or changes in memory are often complex with seniors, and may involve medications, physical changes, or environmental and social changes. It takes time, and usually professional help, to sort them out. 4. Don’t keep it all to yourself: Neither depression or dementia are inevitable consequences of aging. There are things you can do to cope with depressed mood or mile memory loss. Don’t think you have to go it alone!Additional Resources: American Psychological Association Psychology Topics: National Institute of Mental Health: www.nih/

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Healthy Living: Teens & Sleep

Updated 3 years ago

By- Dr. Anthony NgOne of the most talked about topics in teen health has been the issue of sleep. According to the National Sleep Foundation, their recommended guideline for sleep for teens is nine hours and fifteen minutes per night in order to function at their highest level. Other past studies have suggested children between ages seven to 12 needed 11 hours of sleep. Insufficient sleep for teens has been linked to poor academic performance, as well as health changes and mood issues as well as other task performances such as driving. However, according to a recent study that came out of Brigham Young University, their results seem to highlight that perhaps teens do not need as much sleep as previously thought to see the same level of academic performance on standardized testing. The researchers studied 1,724 primary and secondary school students across the U.S., assessing how much sleep they got and how they scored in standardized tests. In this latest study, the authors noted that in terms of testing best in exams, for age 10, nine to 9.5 hours of sleep is needed: for age 12, eight to 8.5 hours of sleeps is needed and for age 16, seven hours of sleep is needed. What is important about sleep is not how much but more the quality of sleep. Teens may perform better academically if they cut down on lie-ins. Pupils also do better in exams if they have a regular sleeping pattern. While this recent finding highlights that the amount of sleep that teens need to maintain good academic performance is slightly lower than previously thought, additional studies are likely needed to fully assess quality of sleep, rather than duration, how sleep actually affect performance and what variables may affect teen sleep. The amount of sleep needed may be a range instead of a hard number. Also, teens’ lives are busy between school attendance, home work, extracurricular activities, house chores or even paid work. There is significant pressure from parents and society for teens to do well both in and out of school. Such pressure can be extremely stressful. Teen sleep may be compromised as a result. It is important that sleep hygiene or habits are practiced earlier on especially in the teen years. Sleep hygiene include adherent to a regular of schedule of sleep. Avoid long day time naps that can affect one’s sleep at night. The use of stimulants, such as caffeine and nicotine, during the day and especially toward evening should be limited. Teen should try to have some down time for the mind to slow down before sleep. Technology can greatly influence negatively teen sleep. Avoid watching TV, texting or staying on the computer prior to sleep as this may provide ongoing stimulus that may impact sleep. Relaxation techniques such as deep breathing may be helpful. It is also important that teen should not get into a habit of taking sleep medication, both over the counter or prescribed to achieve sleep, as regular use of sleep aids may adversely affect the quality of sleep, thus resulting in not feeling refresh despite the length of sleep. Most importantly, the use of illicit substances such as alcohol or taking sleep medications not prescribed to them is a must to avoid.A take home message is that sleep is important to teens. It is important not only related to school performance but with adequate good quality sleep, teens health can be remarkably improved. Additionally, practicing good sleep habits as a teen will help them continue such habits as adults, thus reducing the potential impact of stress later in life. The Acadia Hospital in The Youth Services Sleep Hygiene Project will be sponsoring Sleep Awareness Month in April. For more information, please contact Sally Carlisle at 207-973-6016.

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Healthy Living: Mind Body Connection; Obesity & Mental Health

Updated 3 years ago

By- Dr. David PrescottHow is Your New Year’s Resolution Coming Along? A little more than a month into the new year, and for many of us our New Year’s Resolution is becoming a distant memory. The most common types of New Year’s Resolutions are those to improve our health, lose weight and exercise more. So why is this so difficult for many of us?Obesity and the Complexity of the Mind-Body Connection: The relationship between our minds and our bodies is important, but complex. In terms of obesity, psychologists have identified several psychological and emotional factors which play an important role in people’s struggle with obesity. • Obesity and Depression: Depression can be both a cause and a result of being overweight. Particularly with women, the risk of having clinical depression (major depression) increases nearly 40% with obesity. For many people, depression has become such a significant obstacle in their life that they need to address it first before they are able to adopt a successful weight management program. • Obesity and Eating Disorders: Many fad diets encourage people to avoid food, rather than simply reduce portions. Many experts believe that trying to skip meals actually increases a person’s risk for engaging in binge eating, where large quantities of food is consumed in a short period of time. Binge eating is often present in diagnosed eating disorders such as bulimia or anorexia. • Obesity and Stress: Stress refers to general feelings of anxiety, chronic worry, and feeling run down. It is very difficult to address obesity while your stress level remains at high levels. Many people hope that if they lose weight they will feel less stressed, but this is rarely the case. Rather, working to balance and reduce life stress is the first step, and then focusing on healthier eating and exercise is the second step. The Psychology of Overeating: Two Potential Factors: Experts in the mind-body relationship and obesity have identified some important factors in the psychology of overeating. Identifying whether any of these factors are important in your own life can be the first step in finding a better way. 1. Not recognizing our own eating patterns: Many, many of our behaviors fall into recognizable patterns. However, in the bustle of everyday life we may fail to recognize these patterns. In terms of eating for example, many people overeat at the end of the day when they are trying to relax and unwind. Others eat reasonable portions at home but oversize portions when eating out. Writing down everything you eat and studying this for patterns helps you determine your own psychology around eating. 2. Recognizing your patterns but not wanting to change: Psychologists have recently started focusing on the strength of our drives to eat palatable food. Said another way, many people who struggle with obesity know their own eating patterns, but simple don’t feel compelled to change them. Psychological theories about why we make certain choices and how we decide between two competing goals offer some direction in cases like this. Psychological Tips for Addressing Obesity (from• Think about what you eat and why. Track your eating habits by writing down everything you eat, including time of day and amount of food. Also record what was going through your mind at the time. Were you sad or upset with something? Or, had you just finished a stressful experience and felt the need for “comfort food?”• Cut down on portions while eating the same foods. Along with making dieting feel less depriving, you’ll soon find that the smaller portions are just as satisfying. This will also give you a platform to safely curb your appetite even more.• Losing weight is always easier when you have the support of friends and family. Try to enlist the entire household in eating a healthier diet. Many hospitals and schools also sponsor support groups made up of people who offer each other valuable encouragement and support. Research shows that people who participate in such groups lose more weight than going it alone.• Use the “buddy system.” Ask a friend or family member to be “on-call” for moral support when you’re tempted to stray from your new lifestyle. Just be sure you’re not competing with this person to lose weight.• Don’t obsess over “bad days” when you can’t help eating more. This is often a problem for women who tend to be overly hard on themselves for losing discipline. Look at what thoughts or feelings caused you to eat more on a particular day, and how you can deal with them in ways other than binge eating. For More Information: American Psychological Association: Maine Medical Center:

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Healthy Living: Snowmobile Safety

Updated 3 years ago

By- Dr. Amy MoviusFor many, snowmobiling is an important part of wintertime in Maine. The deaths and injuries from snowmobiles this past weekend are a sober reminder that care and planning is essential and may be lifesaving for people using these large and powerful machines. Some snowmobiling statistics follow: 1. Victims of snowmobiling injuries or deaths are often young: a. 35% are less than 25 yrs. of age. i. 25% are 15-24 year-olds, ii. 10% in children less than 15yrs. 2. Males outnumber females three to one 3. Head injuries are the leading cause of injury or death, usually from hitting a fixed object such as a tree. 4. Children less than 16yrs are frequently injured from falling off snowmobiles or having them roll over onto them. Children less than 8 yrs of age who are injured or killed are usually passengers or being towed behind snowmobiles. 5. For persons over 16yrs, drowning from falling through ice is a major factor.6. Operator error, speeding, use on inappropriate terrain, snowmobiling at night, and alcohol use are all contributing to snowmobile injuries and deaths 7. Non-accident risks include frostbite, hypothermia, hearing loss, and white finger syndrome.If you want to snowmobile, please do so responsibly. Consideration of the following guidelines can keep you and your family safe, while having fun. 1. Please don’t let anyone less than 16yrs old drive a snowmobile! Though this is not a law, the American Academy of Pediatrics urges you to think of operating a snowmobile as you would driving a car. It requires not only strength and skill, but maturity as well.1 Completion of an instruction and safety course is best. 2. Children less than 6 years should not ride as passengers on snowmobiles because of inadequate strength and stamina.3. A “graduated license” approach is recommended for new operators. This means new operators are limited to snowmobile use during daylight hours and on groomed trails only. Use of a speed limiting governor (limits maximum speed) is also recommended for new operators.24. NEVER use alcohol or drugs before/during snowmobiling.5. Protective clothing is needed. This includes goggles, a waterproof snowmobiling suit, gloves, rubber-bottomed boots and an approved helmet.36. Carry emergency supplies including a first aid kit, a survival kit (that includes flares), and a cellular phone.7. Don’t snowmobile alone.8. Avoid ice is there is any uncertainty about its condition. Conditions can be checked at 9. Carry a maximum of 1 passenger.10. Use headlights and taillights at all times. 11. Never tow or pull someone behind a snowmobile (ex = in saucer, tube, sled, skis) for amusement.References1. Snowmobiling Hazards. American Academy of Pediatrics, Committee on Injury and Poison Prevention. Pediatrics Vol. 106 No. 5 November 2000. Statement of Reaffirmation 2010. www.aap.org2. Maine Snowmobile Laws 2008-09 3. (for current conditions)Footnotes1. Maine state law allows children 10yrs and older to operate snowmobiles without adult supervision and children 14yrs and older to cross public ways on snowmobiles.2. The effect of graduated licensing for teenage snowmobilers has not been determined. However, graduated licensing for teenage drivers has reduced the number of motor vehicle-related deaths in this age group.3. Maine law currently requires persons less than 18yrs to wear protective headgear on snowmobiles being used on public trails funded by the Department of Conservation, Bureau of Public Lands. This applies to both operators and passengers.

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Healthy Living: Binge Drinking IS a Big Deal

Updated 3 years ago

By- Dr. Anthony Ng“It is no big deal.” This is often a statement that one may hear when one tells a friend or family member who drinks too much on occasions. This drinking excessively is known as Binge Drinking. Binge drinking is essentially defined as four or more drinks for women and five or more for men over a period of few hours. However, drinking in such excessive amount can be a big deal. In fact, according to a new data from the Center for Disease Control (CDC), a survey of more than 450,000 adults showed adults in the United States binge drink more frequently than previously suspected and they consume more drinks when they do. The CDC data also showed that more than 38 million U.S. adults binge drink an average of four times a month and the most drinks they consume on average is eight. Binge drinking is more common among young adults ages 18–34 and of those ages 65 and older who report binge drinking, they do so more often – an average of five to six times a month. Binge drinking is more common among populations in the northern states, those with household incomes of $75,000 or more, but the largest number of drinks consumed per occasion is significantly higher among binge drinkers with household incomes of less than $25,000 – an average of eight to nine drinks, the report said. In Maine, about one in five binge drinks, as compared to one in six nationally. Mainers drink an average of eight alcoholic drinks when they binge drink. It is suspected that much of this data may be an underestimate.The occasional heavy drinking as some may characterize binge drinking is widely accepted, especially in youth population. It is part of youth passage into adulthood as some perceive it. There may also be stigma attached to binge drinking which deters someone from seeking help. There may also be concerns about legal consequences, especially when underage teens are involved. However, alcohol is still among one of the most common drug of choice to abuse. People who binge drink may not be dependent or alcoholics but binge drinking can lead to a variety of public health concerns. When individual binge drink, they often become impaired and with that impairment, bad choices are made. Such choices may include driving while intoxicated, engaging in unsafe sex, risk taking behaviors resulting in injuries or deaths. Drinking too much, including binge drinking, causes more than 80,000 deaths in the United States each year, making it the third leading preventable cause of death, and was responsible for more than $223.5 billion in economic costs in 2006. Over half of these deaths result from injuries that disproportionately involve young people. The most important intervention to binge drinking is education. Communities, and in particular vulnerable populations such as teens and college age adults, are a prime target for such education. People should be informed of the potential for binge drinking and its consequences. Such education can also help empower individuals who are what is called bystanders, parents, teachers, peers, who can help remind individuals who may binge drink. For the individual who binge drinks, they should seek help if they find that their frequency or the amount of alcohol consumes are increasing. They have increased difficulties with school or work because of their drinking. Their moods are altered significantly, with possible depression, mood irritability and anxiety. Help should also be obtained when relationships with friends, families and coworkers become strained because of their drinking. A great resource for individuals is Alcoholic Anonymous. Professional substance abuse counseling may be helpful and in some instances, medication may be helpful to stop binge drinking behavior. So in response to the person who says it is no big deal when they binge drink, you can now tell them that binge drinking IS a big deal.References:CDC Fact Sheets. Binge drinking is bigger problem than previously thought. Accessed online January 13, 2012., J. CDC: 1 in 5 Mainers binge drink. Bangor Daily News. Accessed online January 13, 2012.

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Healthy Living: Flu Season

Updated 3 years ago

Don’t get fooled by the relatively warm weather. It’s still flu season.TV 5 Health Advisor Dr. Erik Steele spoke on TV 5’s News at 5 with Jim Morris on being pro-active.

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Healthy Living- Early Recognition and Intervention: One Key to Good Mental Health

Updated 3 years ago

By- Dr. David PrescottThe Tragedy of Lost Time: It would be almost unimaginable to think about breaking your leg and then waiting two years before you went to get it fixed. Yet, two years is the average amount of time that elapses before a person showing clear signs of psychosis receives any type of mental health treatment. Similarly, people diagnosed with bipolar disorder report that 9-11 years passed before they first experienced clinically significant mood swings, and the time they were appropriately diagnosed. Increasingly, the need for early intervention in treating mental health disorders is recognized as critical in minimizing the impact of severe mental illness. Here, we will examine early warning signs for three disorders that typically begin in mid to late adolescence: schizophrenia, bipolar disorder, and alcohol dependence. As with any health problem, if you are in doubt, talk to a psychologist, mental health professional, or your family doctor. Early Signs of Schizophrenia or Psychotic Illnesses: The onset of schizophrenia, a mental disorder characterized by disorganization in thinking, excessive suspiciousness or paranoia, or in some cases hallucinations, is typically in the late teens or early twenties. However, warning signs are often present long before the formal onset. These include: • Withdrawal from friends or family • Difficulty concentrating, confusion, jumbled thinking • Suspiciousness, fearfulness or mistrust of others • Changes in the way things look or sound, seeing or hearing things that aren’t there • Odd thinking or behavior: feeling odd, like something is wrongEarly Signs of Bipolar Disorder: Bipolar disorder, or manic-depression, is characterized by repeated extreme mood swings. During a manic phase, people have excessive energy, grandiose idea, and elevated mood. These manic phases are often followed by sudden onset of depression, characterized by sadness, lack of motivation, and in some cases thoughts of suicide. While distinguishing normal from abnormal mood swings in teenagers is difficult, early warning signs may include: • History of biological relative with bipolar disorder. • Abrupt mood swings lasting from several hours to several days. • Explosive, lengthy periods of rage. • Hyperactivity, agitation, or distractibilityEarly Signs of Drug or Alcohol Dependence: Often, drug or alcohol dependence begins as recreational drinking or drug use. Early signs of drug and alcohol abuse or dependence include: • Frequent episodes of binge drinking (4 or more drinks for women, 5 or more for men)• Missing school or work due to drug or alcohol use or feeling hungover. • Spend increasing amounts of time using substances or with people that drink/use drugs with you. How do I seek help? Seeing a qualified mental health professional, like a psychologist, psychiatrist, psychiatric nurse, or licensed social worker is a good start. Help may include counseling, medication, or a combination of the two. If you don’t know a mental health professional, your primary care doctor is often able to make a recommendation. For More Help: Acadia Hospital www.acadiahospital.orgIn Maine: Dial 2-1-1 for agencies that provide counseling.

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Healthy Living: Realistic Resolutions

Updated 3 years ago

By- Dr. Joan Marie PellegriniMost of us start thinking about our New Year’s resolution about this time of year. Common resolutions are to lose weight, eat more healthfully, get more organized, etc. The problem with many of these resolutions is that they are too vague and the goals are too lofty. Thus we set ourselves up for disappointment. This year I thought I would compile a list of resolutions that are easy to accomplish.Easy New Year’s resolutions:Advanced directives: On New Year’s day, set a date that you can sit down and address this issue. You will need to decide what you would want done medically if you were unable to make decisions. You will also need to decide who would make decisions for you in that situation. You should address whether you would want to donate organs and tissues if appropriate. You should discuss your decisions and concerns with your doctor at your next doctor’s appointment.Wear a seat belt: If you often forget, New Year’s Day is a good time to put a reminder note on your dashboard.Check smoke alarms: Set aside time on New Year’s Day to do this.Drive more politely: stop when a pedestrian is trying to cross the road. Stop at red lights. Give pedestrians and cyclists plenty of room. If you need a reminder, New Year’s Day would be a good time to put something on your dashboard that would serve as a reminder.Stretch: This cannot be done just on New Year’s Day but it doesn’t require a lot of work. Everyday, either before going to bed or maybe even at work you should do some gentle stretching. Being more limber will help prevent injury and help with chronic back pain.Buy a good pair of shoes: This may require consultation with a shoe sales person who can recommend the right shoe. Poor arch support and lack of appropriate orthotics can contribute to poor posture and back pain.Read my companies safety policies: If you have a job that puts you in danger on occassion, it is always a good idea to brush up on injury prevention.Go through medicine cabinet and throw out old medications: This will help prevent taking the wrong medication or the wrong dose.Update your list of medications: Make sure you have a copy in your wallet in case you need to go to another physician or the Emergency Room. Keep the name and number of your pharmacy on this list also.Check your blood pressure, cholesterol, make appt for checkup: When is the last time you had a health check up?Get vaccines updated for you and your children. This includes the Flu vaccine.Buy and read Unclutter Your Life In One Week: Or, read one motivational book.Go to church this weekend: for some people this can be a stress reliever.Sleep more: Most of us do not get enough sleep. Make sure you get quality sleep. Being well rested leads to bet productivity at work and healthier lives.Be nicer: Studies show that “nice” people are more relaxed and have better performance in their jobs. Being relaxed will help with any health issues also.Eat something healthy each day : I think this is easier than giving up something.Teach children brushing/ flossing: Make is a family routine to have better dental care.Buy a fiber supplement and take it daily: It is easy to remember if it is near your toothbrush or morning coffee. Most of us have inadequate fiber intake. Higher fiber diets help prevent many medical conditions.Take a vitamin supplement: Your physician can help you decide which one is best depending on your other medical conditions. As we head into winter, many of us could benefit from some extra vitamin D.These are just a few ideas. I am sure there are many other good ideas that can be accomplished in just a few days or less.

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Healthy Living: Avoiding Dangerous Toys

Updated 3 years ago

By- Dr. Amy MoviusKids love toys! And who doesn’t love seeing the excitement and joy of a child playing with a well loved one? Anyone with a child on their holiday list has probably noticed there is a seemingly endless array of toy choices these days. Not surprising when you consider there are an estimated 3 billion toys sold yearly in the United States.Toys aren’t all fun and games, however. Despite mandatory and voluntary safety standards, not all toys are created (literally) equal. In 2009, at least 12 children died from toy-related causes, and more than 250,000 – a quarter of a million – were treated in emergency rooms for toy-related injuries. WATCH (World Against Toys Causing Harm) is an organization devoted to raising awareness and providing information for consumers to use when purchasing toys. They also publish a “Top 10 Worst Toys” list yearly. This list is by no means inclusive, but it does illustrate many hazards of currently available toys which unfortunately, are not new. These include (1) choking from small parts (2) strangulation from ropes/cords (3) impact or puncture injuries from rigid/plastic parts (4) electrical injuries and (5) items marketed as toys that shouldn’t be. Some examples follow:1. Choking Hazards 16 of the toys recalled by the CPSC in the last year were because of choking risk related to easily detachable small parts or affixed small parts that easily break. The children most at risk are quite young because they are very oral in their behavior. However these detachable or affixed pieces are not necessarily considered “small parts” by the toy industry and so may not be labeled as such. 2. Strangulation HazardsThese can result from necklaces, cords, ribbons, etc that can be wrapped around a child’s neck, including items such as guitar straps. The industry standard for maximum cord length for toys designed for cribs or playpens is 12 inches. However there are pull toys (including one of the 10 worst list) marketed for these same very young children with much longer cords.3. Impact/Puncture injuries from rigid partsOne of the toys on the “worst” list illustrates this point very well. It is a popular movie figure holding a 4 ½ inch rigid plastic sword that activates when a lever is pushed. It is marketed to children over 3 and there is a warning of small parts, but no mention of the (obvious) risk of eye/impact injury.4. Electrocution. Sometimes electronic toys, with heating elements, are labeled for children as young as 8 5. Toys that Aren’t ToysAir powered rifles are the prime example. They are actually weapons and not recommended for anyone less than 16yrs. Warning labels, while useful, are not a sole reliable means for determining a toy’s safety. Some warning labels consist of removable sticker labels and others omit some risks or contain warnings that are impossible for the marketed child to adhere to. Examples include:1. A foam bow and arrow, for ages 8 and up, whose warning states bow should not be pulled back at “more that half strength” and “anyone at close distance to the target should be alerted”.2. A trampoline, for age 3 and up, whose “only function is for controlled bounce (exercise) in young children.3. An action figure, for ages 4 and up, with a flip open blade up to 2 feet that warns “do not aim toy at anyone…do not hit anyone with toy…do not poke anyone with toy…do not swing toy at anyone”. How exactly do they envision these toys being used? In some instances, the marketing seems solely targeted at protecting the manufacturer, not the children using it.Likewise, toy recalls are too little, too late. They occur after a marketed toy has been shown to cause harm – i.e. children have already been hurt. Many consumers are never aware a recall notice has been issued for a toy that is in their home. In the past year, there have been at least 28 toy recalls, accounting for over 3.8 MILLION dangerous toys in circulation in the US alone. There are no particularly safe brands or stores either. A quick scan of the CPSC’s list of recalled toys includes items found on the shelves of big-box stores, specialty stores, and dollar stores alike. In the end, families and friends must carefully examine the toys we buy for children, considering the specific toy as well as the nature and maturity of the child for whom it is intended. It is always the season for safety.References1. ToyList.shtml2.

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Healthy Living: Holiday Stress

Updated 3 years ago

By- Dr. Anthony NgChristmas holidays are upon us. It is filled with joy, celebration, anticipation of getting together with friends and families. For also many, it is a time of enormous stress, thinking about what to do for the holidays, who to buy gifts for, where do I go to get those gifts, online or waiting in long lines in bad weather as many did for Black Friday. If one is not careful, the stress of the holidays can quickly overwhelm folks and in turn make this holiday season not very fun and enjoyable.First of all, we need to understand what is meant by stress. Whenever we hear the word stress, we only think of negative aspects of it, such as too much to do at work, too many obligations at home, relationship issues, etc., but there are other positive aspects of life that can be “stressful”, such as holidays, getting a raise or promotion, going on a first date, or getting married. As joyful and exciting as these events, they are still causing what have been described as positive stress. It is stress that is sustained, uncontrollable and overwhelming, where people can’t figure out options to solve their problems, that is damaging.When a person experiences stress in whatever forms, they may have anxiety, frustrations, happiness and joy or anger. We often tried to cope by various things such as relaxation, reading a book, exercises, spirituality, seeking support from friends and families to name a few. And for those who faces constant stress, they may develop potential negative coping strategies that may include overworking, arguing more with families, friends and colleagues, smoking more, drinking and in some instances using illicit drugs. We process stress in three ways, how we feel emotionally, how we feel physically and how we think. This falls back on the basic principles that human, like all animals, are born with, the “Fright or Flight” response. When an animal sees a threat from a predator, the brain processes the threat. The brain then attaches an emotion to that threat, such as fear or anger for example. The body then reacts to the threat, either by running away or by fighting it. We humans have evolved enough to now have threats or stresses that are not as visible. Nonetheless, we still behave in a way how our body is genetically imprinted with. We experience a stress. We then interpret the threat in a variety of manners. We then attach emotions to that stress and then our brain instructs our body to respond accordingly. Our body would respond for example by increasing more adrenal hormones to prepare the body for its responses, such as increased heart rate, breathing, muscle tensing to name a few.Our body is designed to handle short bursts of these stresses. We have chemical and hormonal changes to deal with stress. A well know chemical is the stress hormone cortisol which is increased and it leads to an increase of another chemical, adrenaline. The body gears up immediately in the face of stressful stimuli. It goes to our energy stores, and releases glucose and insulin so that our muscles have the energy to deal with the stress.These body chemicals are sustained at high rates to compensate for the stress, and as such, they can impact the body adversely over time. Additionally, the choices we make to handle this stress can influence how those stress hormones affect us. Drugs like alcohol, nicotine and cocaine, and also high-fat, high-calorie comfort foods, are powerful modifiers of the stress system. They will change our stress pathways and affect the way your body is able to control our stress response. And so, after a period of bingeing, our body’s stress response system eventually wears out. However, folks will continue to take those drugs and alcohol to compensate a weakened system. This is often what we see in addiction. Research shows that childhood stress can hardwire the brain for a lifetime of higher stress levels. Early traumatic experiences can increase children’s susceptibility to a range of high-risk behavior, such as tobacco use, binge eating, and earlier onset of alcohol consumption. It is important to keep in mind that children who see their parents stressed out during the holidays will inherently respond with their own stress and mimic parental stress responses, both good and bad ones.Does that mean we cannot revitalize our stress responses such as the adrenals? In fact, our body is forgiving and they can recover when we take away those toxins. What is not clear is how long that process takes. The problem, though, is that while your adrenals are still recovering, you are more likely to be stressed. And stress affects abstinence and increases chances of a relapse. So then we are caught in a vicious cycle of quickly degenerating health because both the stress and the substances are working together to wear down our body systems and our stress axis, our liver, kidney, heart, blood pressure. All this can also lead to certain types of cancer.We don’t really know which comes first, but we do know that these are all complex multi-factoral diseases. That means they don’t have one single factor that leads to the disease state. And there are factors that can make a person even more vulnerable to stress-related diseases and addiction: early trauma suffered in childhood, cumulative adversity, socio-economic status, education and also things like genetics and personality traits.In addition to the holidays, we live in a society where there are multiple demands on us almost all the time. We need to put greater emphasis on protective factors like sitting down with the family or exercising or putting away all the electronic devices. We also need to focus on mindfulness which we all do in some form or another. Having hobbies is one as well as relaxation. They all provide healthy distractions on stress and allow us to focus on oneself.So as you struggle to find the best bargains, what meals to prepare and who to invite for the holidays, you should take a moment to remember what the holidays is about. It is to share joy with friends, families and others. Make sure you take breathers in your busy schedules to practice stress reductions techniques, such as sitting down at the mall and taking a breather and to relax. Prioritize what you need is an efficient and healthy way to cope. Drink alcohol in moderate amounts. Don’t forget to continue your hobbies and exercises. Remember, your families and friends want you around for many more holidays to share the joy. Happy holidays !!! Reference: CNN Blog: The Vicious Physiology of Stress by Amanda Enayati 11/26/11WedMD Feature: Tips for Overcoming Holidays Anxiety and Stress by R. Morgan Griffin 12/5/2011

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Healthy Living: Asthma and Acetaminophen

Updated 3 years ago

Should children with asthma avoid acetaminophen? (Tylenol)By- Dr. Jonathan WoodThe incidence of pediatric asthma increased dramatically between 1980 and 2000. During that same time period, the association between aspirin and the severe neurologic disease, Reye’s Syndrome, became apparent. Consequently, the use of acetaminophen, a non-aspirin pain reliever/fever reliever, increased dramatically.Increased incidence of asthma and increased use of acetaminophen – – is there an association? Perhaps. We, as yet, have no satisfactory explanation for why pediatric asthma incidence has risen and then seemed to level off. The leveling off, by the way, coincides with the leveling off and acceptance of acetaminophen as the primary analgesic/antipyretic in children by the mid-late 1990’s.This coming month, in the journal Pediatrics, John McBride MD, a prominent pediatric lung specialist and researcher has pulled together this data and many other alluring studies to make a strong case that the use of acetaminophen (1) may well be responsible for the increased incidence of asthma and (2) may correlate with increased severity of asthma. The argument is strong and comes from a valid and respected source.For example:· An enormous worldwide epidemiologic study looked at more than 500,000 children with asthma and concluded the following:o Children 6-7 yr old using acetaminophen monthly had more than 3-fold increase in asthmao For 13-14 yr olds, it was close 2.5 times the incidenceo For less frequent use (less than monthly, but at least yearly) the increases were still 1.6 and 1.4 times respectively.· Other studies have corroborated this data in a variety of cultural, socioeconomic, and geographically diverse settings.· Several adult studies apparently demonstrate similar findings These are associations, not proof of causation. Nonetheless, they are worth consideration.And what about asthma severity? Prospective studies have been done comparing acetaminophen (Tylenol) and ibuprofen (Advil) in the context of asthma severity. Again, these suggest an association between more severe pediatric asthma and acetaminophen use: those kids using actaminophen had more severe disease than those using ibuprofen. Unfortunately, no study has ever looked at this with a placebo control, the good standard. Still, while we wait for that, the current data is alluring.What if we could reduce the use of something that would, if eliminated reduce asthma incidence in the population by 35-45 percent? Would we act on this? Yes. How simple would it be for children with asthma to avoid acetaminophen whenever possible? Easy. Are there viable alternatives for most circumstances? Yes. Ibuprofen is one.Would there still be times when the use of acetaminophen is warranted? Yes.My advice? 1 – Keep your eyes open. This issue is going to be discussed more and more.2 – Consider limiting or eliminating acetaminophen use if you or your child has asthmaFever? 1 – Why are we worrying so much about fever anyway? Fever is generally not a bad thing.2 – Review “The Truth About Fever” in the Healthy Living archive.

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Healthy Living: Two types of Diabetes; Know the difference

Updated 3 years ago

By- Dr. Jonathan WoodMy work with children and teens with Type I Diabetes Mellitus and its life-threatening acute complications has led me to realize there is quite a bit of confusion about what diabetes is and what the differences are between the two main types. This is important stuff.The confusion is understandable. We use the same word to describe 2 different diseases. Related, yes, but really quite different. Type II or Adult Onset diabetes used to be a disease of older people and generally of overweight people. While it was always a fairly common disease, it has become much much more common in recent years. Many debate the reason for the increased incidence of Type II diabetes, but certainly it is related to some degree to the increased incidence of obesity in the US. And, as we see more and more young obese people, including many children, Type II diabetes has started to occur in younger and younger people. You see where I’m going here – – the terms Juvenile Onset and Adult Onset no longer apply and the crossover has fueled the confusion.Both Type I and Type II diabetes result in high blood glucose or blood “sugar”. That said, the way this happens and the consequences of this is somewhat different in the two diseases.What are the underlying problems in these 2 diseases?Type I Diabetes: lack of insulin. The pancreas stops making insulin. Insulin is critical to the body’s ability to manage and use the fuel glucose. Without insulin, paradoxically, the body tissues can’t “see” all the glucose accumulating in the bloodstream. They therefore turn to different pathways to produce fuel, which causes acute and often severe illness.Type II Diabetes: resistance to insulin. There is insulin, but the body doesn’t recognize it.The body makes insulin, but the tissues can’t “see” the insulin properly. The tissues are partially resistant to the effect of insulin and hence the blood sugar rises.The long-term consequences of high blood glucose (sugar) are largely the same in both diseases. (e.g. eyesight problems, kidney problems, peripheral nerve problems, increased infections)But, additionally, the complete absence of insulin in the Type I diabetics creates a scenario for life-threatening acute problems if day-to-day insulin management isn’t well understood and maintained carefully. This is generally not the case in Type II diabetes.If you have diabetes or a family member with diabetes, learn about their type of diabetes. If you have a young child or teen or grandchild or niece or nephew with diabetes, it is probably Type I. It needs to be well understood to safely provide for that child or teenager.If someone has Type I Diabetes, they need to have insulin given to them at all times. Learn about this! Most of the insulin given is to allow them to handle ingested foods, but a common misconception is that “if they don’t eat anything, they don’t need insulin”. This is a dangerous misconception. Yes, if they are sick or vomiting and not eating, a Type I diabetic needs less insulin, but they still need insulin. To give none is to risk the life-threatening complication of ketoacidosis. The rules governing this important situation are called “sick day rules” – – learn about them.Type I diabetics can lead full and productive lives. They can do all the things that other children can do, but they need to be safe and have family members that understand their disease.A good online review of all this can be found on Wikipedia:

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Healthy Living: Screening for Prostate Cancer

Updated 3 years ago

American men have about a one in six chance of getting prostate cancer and are especially vulnerable as they get older. But a panel commissioned by the U.S. Government recommends against screening for it. TV5 Health Advisor Dr. Erik Steele joined Jim Morris on TV5 News at 5 to talk about it.

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Healthy Living: Whooping Cough

Updated 3 years ago

Uncontrollable, violent coughing is one of the key symptoms of whooping cough. It’s highly contagious, also highly preventable. TV5 Health Advisor Dr. Jonathan Wood joined Jim Morris on TV5 News at 5 to help out.

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Healthy Living: Vaccines and Side Effects

Updated 3 years ago

By- Dr. Amy MoviusThere has been a lot of attention in the press lately regarding a certain vaccine. Unfortunately, what should be a cut and dried health issue can be politicized and otherwise distorted: bluntly stated, politicians and newscasters are probably not the best dispensers of medical advice (sorry WABI!).In approaching the subject of vaccinations, I opted to start with what I believe to be 2 undisputed truths:1. We all want what is best for the children in our lives.2. Doctors and other health providers come from a variety of political, religious and cultural backgrounds.Starting from these two assumptions, there is really very little controversy among medical professionals about the benefit and safety of vaccines. A quick look back in time illustrates the benefits. For example, before vaccine availability in the United States in the 1940s, there was an average of 175,000 cases/year of pertussis (whooping cough) or 150 cases/100,000 population. In the 1980s, there was an average of 2,900 cases per year or 1 case/100,000. In 2008 this was up to 13,278 cases. This is in part due to decreased vaccination rates. Unfortunately, in this example, the youngest among us suffer the most from severe illness and even death. Of the 181 pertussis deaths from 2000-2008, 166 were in children less than 6 months of age. All infants of this age are vulnerable to pertussis as vaccine immunity is not fully established until after 6 months of age (vaccine given at 2, 4, and 6 months). These most fragile among us must rely on not being exposed to avoid disease, which in turn depends on the immunity and vaccination status of the population at large. This does not mean that side effects from vaccines don’t exist. They do, and fortunately most of them are mild (pain/swelling at site). Also, some health problems coincidentally overlap with receiving a vaccination – they are unrelated except in time. However, in the US it is not expected that we vaccinate our children on faith alone. There is an organization that REQUIRES reporting of all possible adverse vaccine effects by health professionals and vaccine manufacturers. However, ANYONE can choose to make a report, including a patient (or a parent). Also, the results are public, so EVERYONE can access this information. The sole function of this organization, VAERS (Vaccine Adverse Events Reporting System), is to constantly process and analyze this data for the purpose of public safety. Because of this process, in 1999 the rotavirus vaccine was removed and then replaced. VAERS receives about 30,000 reports every year: 85% involve mild symptoms, 15% of the reports are more serious. Both of these numbers reflect possible vaccine related events, NOT definite vaccine caused events.Vaccinating yourself and your family is not a small matter. It can be very confusing with all the information – and misinformation –available. Consider discussing it with a health provider you know and trust. The goals you share should be simple: to keep you and your family happy and

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Healthy Living: Understanding Post-Traumatic Stress Disorder

Updated 3 years ago

By- Dr. David PrescottAbout 1 in 30 people experience Post Traumatic Stress Disorder (or PTSD) in a given year. That risk increases over a lifetime, with 1 in 10 women, and 1 in 20 men, experiencing PTSD at some point in their life. Sadly, many events the past decade have provided psychologists and other mental health professionals with a number of opportunities to learn more about the causes and treatments for post-traumatic stress disorder, or PTSD. More optimistically, knowledge of how to more effectively understand and treat Post Traumatic Stress Disorder has also improved. How is PTSD Diagnosed? While many people feel temporarily depressed or anxious after a very upsetting or traumatic event, Post-Traumatic Stress Disorder involves a number of characteristic behaviors and experiences. First, the trauma must be outside the realm of normal stressful events. Examples would include being exposed to a situation with a true threat of death or serious injury, or a serious violation of a person’s space and body. Symptoms of Post-Traumatic Stress Disorder are typically grouped into 3 categories: 1. Re-experiencing symptoms: Examples of these symptoms include flashbacks, bad dreams, or intrusive frightening thoughts. Words, objects, or situations that are reminders of the event can trigger re-experiencing.2. Avoidance symptoms: Avoidance symptoms include staying away from places or events that are reminders of the experience, feeling emotionally numb, having trouble remembering the dangerous event, or losing interest in activities which used to be enjoyable. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.3. Hyperarousal symptoms: People with PTSD are easily startled, feel tense or ‘on edge’, and often have difficulty sleeping or have angry outbursts. In all cases, to be diagnosed with PTSD the symptoms must persist for more than one month after the traumatic event. Does Everyone Exposed to a Traumatic Event Develop Post-Traumatic Stress Disorder?It is difficult, if not impossible to specifically identify which people exposed to a traumatic event will develop PTSD. What we have learned is that the determining factors in the development of PTSD include some factors which increase the risk, and protective factors which decrease the risk. Protective, or Resilience Factors, Include: • Seeking out support from other people, such as friends and family • Finding a support group after a traumatic event • Feeling good about one’s own actions in the face of danger • Having a coping strategy, or a way of getting through the bad event and learning from it • Being able to act and respond effectively despite feeling fear.Factors Which Increase PTSD Risk Include: • Having a history of mental illness • Getting hurt • Seeing people hurt or killed • Feeling horror, helplessness, or extreme fear • Having little or no social support after the event • Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.What Treatments Are Available for Post-Traumatic Stress Disorder? Many, although not all, people who receive treatment for Post-Traumatic Stress Disorder experience some improvement. Statistically, about half the people with PTSD no longer qualify for the diagnosis after one year. There are both short term and long term strategies for coping with PTSD. Short Term Strategies: Short term strategies, immediately after a traumatic event, are really designed to prevent symptoms of PTSD from occurring in the long run. These strategies include: • Getting immediate support from friends or family. • Finding a support with others who had the same or similar experiences. • Finding a way to learn from the event. Longer Term Strategies: • Counseling: Focused counseling on managing anxiety and changing thinking patterns which increase or perpetuate fear often help. This type of therapy is often termed Cognitive-Behavioral Therapy. • Medication: Medications are often used to reduce the symptoms of depression and anxiety that go along with PTSD. • Group Therapy and Support Groups: Particularly after a traumatic event, being with other people who went through the same thing helps reduce the risk of long term problems. MORE INFORMATION: American Psychological Association: Institute of Mental Health: Alliance for the Mentally Ill:

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Healthy Living: National Salt Reduction Initiative

Updated 3 years ago

By- Dr. Joan Marie PellegriniAmericans consume about twice the amount of salt that is recommended in our diets. This is approximately a doubling of the amount we consumed forty years ago. We cannot live without salt. Salt contains sodium which is vital to many cellular functions. However, eating more salt than we need can lead to high blood pressure (hypertension). Hypertension is known as the silent killer because there are rarely any symptoms. Also, we do not check our blood pressure except when we visit a doctor. Over time, hypertension can cause heart disease, stroke, and kidney failure among other problems. It is estimated that even a small reduction in our salt intake will dramatically reduce our risk of these diseases.The New York City Department of Health and Mental Hygiene is coordinating a national effort to prevent stroke and heart attack by reducing the amount of salt in packaged and restaurant foods. Only about 10% of our daily salt intake comes from our salt shaker. About 80% comes in processed foods. The American Heart Association and the American Medical Association are also fully supportive of this national effort and have guidelines for salt reduction. The good news is that many large national companies have signed on to the initiative and have pledged to reduce the amount of salt in their products. What should you do to decrease your salt intake? Most of us can name the obvious offenders: potato chips, salted nuts, soy sauce, etc. Unfortunately, there are hidden sources in the foods we buy. A quick visit to the sodium chart from the USDA will show you that one slice of wheat bread from a national chain may contain almost 10% of your daily allowance. That means that the most important thing we can do is look at labels in the grocery store. Buy the brand of food that has the least amount of salt if you can. There are some items that will have a lot of salt no matter what brand you buy: canned soup or dry soup comes instantly to mind. In general, you should aim for a maximum of 2000 mg of sodium a day. If you are eating out, you will not be able to know which food has the lower salt content unless you ask the chef or wait staff. Even then, they may not know. This is why the national initiative would like restaurants to list sodium content on their menus and also to reduce sodium in their offerings.Even though sodium is ubiquitous and hidden in our foods, the good news is that even a small reduction in our intake will give us benefit. The other good news is that there is a national initiative for food manufacturers to decrease the amount of salt in their products and to provide labels to help us know how much salt we are consuming.References:,8599,1884864,00.html Time Magazine printed this article in March 2009 and it is an easy read. It also has the link for the Sodium chart from the USDA. This site has links for Institute of Medicine report on public health priorities to control hypertension. It also has the link for the journal article that is heavily referenced in the Time Magazine article (Bibbins-Domingo K, et al. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease in NEJM 1010: 362.)

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Healthy Living

Updated 3 years ago

TV5 Health Advisor Dr. Erik Steele joined Carolyn Callahan on TV5 News at 5 to talk about “Nerve: Poise Under Pressure.” A book written by Taylor Clark focusing on anxiety.

Healthy Living: Teething

Updated 3 years ago

Teething: Not a source of fever and not an explanation for symptoms of illnessBy- Dr. Jonathan WoodTeething continues to be offered as an explanation for fever or as a reason for a variety of symptoms in infants and young children. An important study published in the September 2011 issue of Pediatrics elegantly dispels this misunderstanding. Researchers (pediatric dentists) visited non-daycare infants repeatedly in their homes and gathered data: symptoms reported by mothers, oral exams, and infant temperatures. This was an excellent study for a variety of reasons: the oral exams were performed by experts, the temperatures were taken by the examiner by two different methods, the exams occurred daily over a period of weeks to months and therefore generated detailed data around the eruption of multiple teeth in each child and over 230 teeth overall.The conclusions:· Teething does NOT cause fever (before, during, or after tooth eruption)· Minor increases in temperature (less than 0.3 degree F) occur on the day of and the day after eruption, but it is negligible and occurs within the range of normal temperature variation· Minor symptoms – sleep disturbance, irritability, increased saliva, rash, loss of appetite, diarrhea – can occur in the day of and day following eruption. But again, these symptoms are not of a severe nature.Why is this important?· Doctors and parents should not invoke teething as an explanation for fever, even low-grade fever. · Nor should they invoke teething as an explanation for severe changes in activity or behavior. · When teething is used as an explanation for these findings, parents and doctors alike can delay the diagnosis of a more serious illness. In young infants especially, this is important: a true fever can be the only signal that a severe illness is developing and the immature immune system of the infant makes prompt diagnosis and treatment particularly important.What can be done about teething?· “Teething tablets” and anesthetic gels are not recommended. Parents can inadvertently deliver toxic amounts of the active ingredients and should avoid these products. They have also never been shown to be effective.· Teething rings have been shown to be useful and effective.· Gently massaging an infants gums often helps and satisfies the infants urge to chew on somethingFor more information of teething and care for a child’s early teeth, visit the American Academy of Pediatrics’ “Healthy Children” website It requires a free registration, but is full of much useful information for parents.

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