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Do healthy young adults need a yearly physical?

Ezekiel J. Emanuel, M.D., an oncologist and vice provost at the University of Pennsylvania, recently wrote an op-ed piece for the New York Times called “Skip Your Annual Physical.” He stated his new year’s resolution was to skip his check-up with his primary care provider. He said it was one small way he could help reduce health care costs – because, from a health perspective, the exam was “basically worthless.”

That’s a pretty bold statement – one which might cause head scratching and confusion among the general population. After all, it goes against everything we’ve been told. And while his article makes some valid points, I don’t agree with his assessment that there’s no value in regular visits with your primary care provider unless you have a medical issue or complaint.

Tips for parents dealing with toddler’s diarrhea

Toddlerhood is a time when children are going through a lot of changes.  Children enter pre-school, toilet-training begins, diets change, and sometimes stooling patterns become different as well.  The latter issue often leads to parental worry.   One of the most common changes that parents of toddlers bring up during visits with me is that their toddler’s stools seem very loose or watery (“diarrhea”).  More often than not, the diagnosis ends up being “toddler’s diarrhea”, a harmless type of diarrhea that generally starts after a child is weaned.  (Other names for this condition include “functional diarrhea of childhood” or “chronic non-specific diarrhea of childhood”.)

Toddler’s diarrhea occurs due to a relative immaturity of the intestinal tract of young children.  Relatively speaking, sugars and some fluid get poorly absorbed.  The stools often contain undigested food particles (carrots and corn being the most commonly noticed).  The key differentiating factor that sets toddler’s diarrhea apart from other causes of diarrhea at this age is that except for loose stools, there are no other symptoms.  There is no malabsorption of nutrients, so children with toddler’s diarrhea have normal growth and weight gain.  Otherwise, they are perfectly healthy.  There won’t be anything abnormal found during their physical exam.  Tests are not generally needed, because those, too, will be normal.

Even though toddler’s diarrhea resolves on its own, I often tell families to follow the “4 Fs” as a guide to treatment:

Visiting Your Hospitalized Child

When your child is hospitalized, it’s understandable that family and friends will want to visit. This is often a help to both the patient and the parent at the bedside. To maximize the benefit of this support, keep the following guidelines in mind:

  • Visiting hours: Check with your nurse for the visiting hours and let your nurse know when you are able to visit. If there are extenuating circumstances for your family’s situation (e.g., a parent works night or swing shift and can only visit before or after), let the nursing staff know.

  • Security ...

Seattle rain? You can still play inside!

In the last few years, I’ve taken note of various national campaigns encouraging improved health and wellness in children. Some aim to inspire at least an hour of play daily. Others focus on movement in conjunction with eating nutritious food to help fight childhood obesity. All of these campaigns share a common important message: regular physical activity improves a child’s overall health.

With the winter months upon us, my patients and families are concerned how to maintain activity levels when it’s cold, rainy, and gets dark outside too early. Even in the warmest months, there may be reasons a child might be inside more than out – including safety concerns. Fortunately, there are many fun ways children CAN stay active indoors when playgrounds are cold, ball fields are icy, yards are soggy, or the sun goes down too early.

Here are some ways kids can play inside while also working on strength, balance, flexibility, or coordination:

Frequently asked questions about pelvic health

I recently participated in a live chat with Swedish to answer questions that women had on urine leakage, bladder control treatments, pelvic floor disorders, and other pelvic health topics.

Click here to read through the archive of the chat. I also wanted to answer a few other questions I get asked, but didn't come up in the chat:

Having a healthy road to pregnancy

If you’ve been thinking about getting pregnant, here are some steps to take before your pregnancy to ensure a healthy and successful journey to becoming a mom.

  1. Start taking prenatal vitamins at least a month before conceiving. The folic acid in these vitamins (usually between 400 and 800 micrograms) will help decrease risk of a neural tube defect, like spina bifida. The spinal cord forms and closes by four weeks gestation, before many women even know that they are pregnant, so it’s important to get on this early.

  2. Starting pregnancy at a healthy weight decreases your risk of complications of pregnancy like high blood pressure and gestational diabetes. Good control of chronic medical problems will also help a future pregnancy go much more smoothly.

  3. Consider  ...

A year of personal medicine as a physician

I’m fortunate enough to have lived most of my life with hardly a worry in the world when it came to personal health issues. However, this year changed my outlook. Firmly into the fourth decade of my life, it became necessary to schedule some basic preventative health care screens for the first time. This then led me down to what seemed like a never-ending path of scheduling and completing test after test, followed by even more appointments. As the year progressed, I also became involved in a serious health care issue affecting a very close family member which led to learning how to navigate the maze of international health care!

As 2014 finally rolls to an end, I reflect on some valuable lessons learned, having experienced medicine from the perspective of a consumer rather than a provider.
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