Doctors' Diaries

Dr. Bob Sears Offers Advice in March 21st New York Times Health Section on Vaccine Choices Parents Make

2008-03-27T11:28:00.000-07:00

The recent measles outbreak (if you can call it that) in San Diego last month, in which twelve children came down with the illness after an unvaccinated family brought the disease back with them from Switzerland, raises awareness of a growing trend among families to decline certain vaccines.

This article raises the question, should parents have the right to decline vaccines when doing so may put the health and safety of other children at risk? In twenty states of our free nation, parents are allowed to decline vaccine for personal reasons. But in 28 states they must have a religious reason, and two states (West Virginia and Mississippi) don’t allow parents to decline them for any reason.

I believe our nation can tolerate a certain percentage of unvaccinated children without risking the overall public health in any significant way. Since most children are vaccinated, our nation has enough “herd immunity” to contain outbreaks like this one. However, in the San Diego case, some infants caught measles before they were old enough to even be vaccinated. Fortunately, all cases passed without complications, as is usually the case with measles.

So the question is, are unvaccinated parents putting the rest of our children at risk? Maybe a little. But in my opinion parents SHOULD have the right to make health care choices for their children. They should not be forced into vaccinating if they feel strongly against it.

Click here to read the whole New York Times story.

Dr. Bob

Shutdown at Starbucks

2008-01-15T16:42:00.000-08:00

I like to sit at Starbucks and work on writing books on my laptop anytime I have a couple hours to kill during the work week. A cup of coffee, a maple oat nut scone, and the brilliant words just flow right onto the screen. People come and go in front of me, the soothing calls of “Venti non-fat no-whip 160 degree carmel mocha frappe cappa latte chino” in the background, and the sweet aroma of coffee are the perfect setting for me.

But today, chaos broke loose at the local Starbucks, and the entire city practically shut down. One of the little ovens they use to heat up their breakfast sandwiches began to smoke and we were calmly evacuated. I could see the stricken looks of helplessness on the faces around me as we calmly stumbled out. I’m sure my face mirrored theirs, and I probably wasn’t the only one thinking, “Is it really smoking that bad? Are the fumes really dangerous? Can’t we stay inside and take the risk if we want to?”

So I grabbed a table outside, but it just wasn’t the same. No aroma, no background Starbucks music, and nothing brilliant seemed to flow onto the computer screen anymore. But I had it easy. I already had MY coffee and scone. I wasn’t prepared to witness the devastation that was to follow. Over the next hour, hundreds . . . nay, thousands of people drove up, parked, got out of their cars, and as they walked toward the door I could see confusion turn to bewilderment turn to sudden panic as realization dawned on them. The green-aproned gentleman standing at the door wasn’t there to open it for them to let them in. I don’t know how many hundreds of times the feeble and apologetic explanation went from his lips to stricken ears. Some people didn’t even leave their cars. They would watch others try to sneak, bribe, and even push their way inside, only to be turned away. They’d drive away dejected.

I could see some of them looking at me, then at my coffee, then back at me. I knew what they were thinking. “How much would he sell his coffee for?” “Maybe a few of us can gang up and rush him . . . he doesn’t look that tough.” I quickly guzzled down my remaining café Verona, savoring the delicious coffee grounds at the bottom. I didn’t throw my cup away; I left it perched on the edge of the table, just to tempt and tease anyone else who came by. I know it was cruel, but it was fun.

I’m sure more of those people just went back home instead of going on to work. Their boss would understand. Without Starbucks, you just can’t start the day. I don’t know how many millions of dollars of productivity were lost that day, not just at the Starbucks, but throughout town. And I know what most of you are wondering. Why didn’t people just go to the next block and hit the Starbucks there? Well, I know you’ll find this hard to imagine, but this was the only Starbucks within a seven minute drive. We have it rough in our little town of San Clemente.

What does this story have to do with parenting or pediatrics? Nothing . . . and everything.

Dr. Bob

Dr Sears' 4 Tips to Fight Cold and Flu

2007-10-16T09:04:00.000-07:00

Cold and flu season is kicking into high gear, and Americans will get more than one billion colds this year. However, there are simple tips parents can follow to help protect their families from getting sick:

Be healthy to stay healthy. Maintain a healthy diet, packed with vitamins and nutrients to keep your immune system strong and healthy. Immune-boosting foods, such as fish, citrus fruits and leafy vegetables, help prevent illness in the first place. My book, The Healthiest Kid in the Neighborhood, further identifies foods and eating habits that can counter or prevent many common illnesses.
Wash hands often and properly. You can't avoid all germs, so wash your hands frequently to help kill the viruses and bacteria that you may have collected. According to the Centers for Disease Control & Prevention (CDC), hand washing is the most effective way to help stay healthy. Use regular soap and warm water to scrub your hands - including the back of your hands, in between fingers and under nails - for 20 seconds (long enough to sing "Happy Birthday" twice). Use an alcohol gel if soap and water are not available.
Disinfect to protect. In a recent study by The Hygiene Council, only five percent (5%) of people identified the home as the place where kids are most likely to catch an infection. However, the home is one of the germiest places for families; germs can survive on surfaces such as bathtubs, doorknobs, remotes and railings for hours. You can help protect family members from picking up these germs on their hands by cleaning surfaces with a disinfectant spray or wipe, like those made by Lysol. Regular disinfection will help kill cold and flu causing viruses and bacteria found on commonly touched objects and surfaces.
Prepare in advance. If you can't avoid flu symptoms, you can at least avoid last minute trips to the pharmacy. Stock up on items such as tissues, vitamin C, fever reducing medicine, hand sanitizer and portable disinfectant. Keep them in one handy place to make illness prevention even easier.

For more information feel free to visit http://www.lysol.com

Sugar Bugs

2007-10-09T16:53:00.000-07:00

With Halloween fast approaching, I got to thinking about an interesting recent encounter I had with a child and her parent in our office. Parents are constantly worried about their child's dental health, and rightly so. This parent was telling me, "Doctor I just can't seem to give my child anything other than juice in her sippy cup." "She refuses to go to sleep without a bottle full of juice and I know this is ruining her teeth." This three year old had several cavities that her dentist had rightly attributed to sucking on a sippy cup or bottle full of juice all day long. The mother lamented, "She refuses to drink only water!"

I sized up the situation and thought of a good answer. I squatted down to the child's eye level and said, "Juice, candy and other foods can have lots of sugar." "When we eat or drink too much sugar, tiny little sugar bugs can grow on our teeth and give us cavities." The little girl was astonished that she had been feeding these "sugar bugs" on her teeth with the juice from her sippy cup. Several weeks later, the (very happy) mom came to me and said, "She is now drinking much more water and doesn't require going to bed with a bottle full of juice anymore!" The girl had become fascinated with keeping the "sugar bugs" away!

This may be a helpful tool for all you parents this time of year to keep your kids aware of how too much sugar can hurt their teeth. Tell them (in a non-threatening manner) that if they eat too much sugar and don't brush their teeth, the "sugar bugs" will stop by and munch on all the sugar on their teeth. I have given this advice quite a bit in my office, and all the children really seem to grasp the concept - and none of them have been scared by the idea. Hope this helps, and have a happy Halloween!!

Dr. Pete

On the Road Again

2007-07-24T14:06:00.000-07:00

With summer in full swing, I thought a few quick tips for a safe and fun family trip would be in order. Most of this advice is geared toward travel outside of the U.S. Have fun!!!

Airplanes and little ears. Infants and young children often have problems with equalizing their ears on planes. Have them nurse or suck on a bottle during take-off and landing. Infant's Motrin can also help with the discomfort caused by equalizing. The air on planes is very dry, bring saline spray and squirt a little in their nose every hour or so. This may help prevent nasal irritation and sinus problems. Teach older kids how to clear their ears by chewing gum or yawning.

Passports for everyone! In the past, a birth certificate was enough for kids under two. With today's heightened security, many countries (including the U.S., Canada and Mexico) require EVERYONE to have a passport - even infants! I remember laughing when I took my four-month-old son, Thomas, to get his passport photo for a trip to Mexico last year! It looks nothing like him now!!

Safe Eating.
-Only drink bottled water and other drinks. Use a straw when drinking from glass bottles.
-Carefully wash produce with soap and water. Always peel your own fruits.
-Avoid eating food from roadside vendors in areas where proper sanitation is a concern (too bad because these spots can be so yummy - this is from personal experience!)
-Encourage frequent hand washing, especially before meals. Carry hand sanitizer with you.

Travel Vaccinations. First off, make sure you and your children are up to date on immunizations. Depending on which area of the world you are traveling to, it's a good idea to check out any additional vaccines that may be needed. Many local health departments have travel clinics that specialize in determining which shots and/or other medication treatments (such as malaria prevention) you and your family may need. A good website to check out is www.CDC.gov for more information.

Common Travel illnesses. Traveler's diarrhea and respiratory infection are the two most common illnesses one will encounter while abroad. The above precautions can help prevent these illnesses. In my practice, I often provide patients with a prescription of an antibiotic to have on hand "just in case". However, patients should not take antibiotics unless they develop symptoms.

Safe areas of the world. Be sure the area of the world you are traveling to is considered safe. The U.S. Embassy has information on safe and unsafe areas for travel.

Dr. Peter

A Band-aide is Everything

2007-07-17T12:21:00.000-07:00

Every year I get to go to my kid's summer camp for two weeks to be the camp doctor. It's two weeks of hiking, mountain biking, sailing, waterskiing and relaxing each evening around the campfire, with very little doctoring. This year was no exception. The doctoring took all of about 30 minutes each day. An ear infection here, a funny rash there. No big deal. The nurses did most of the work. They had almost a full-time job taking care of all the little things kids need while at camp.

Half way through the session, the nurses were getting a little tired, so they asked me if I would hang out in the clinic for a few hours while they went out boating. They deserved a break, so I said sure. How hard can it be? I could play nurse for a few hours. Those ended up being some of the funnest 3 hours of my time there. No one came in needing any "doctoring". It was all simple stuff - cuts, scrapes, splinters. Who ever though putting band-aides on cuts could be so fun!

And boy, when you put a band-aide on something, you've performed a miracle. The child looks at you like you've just cured her of cancer. Who cares about treating ear infections and diagnosing infectious diseases. The kids don't care about that. But if you can put a band-aide on it, Wow!

One kid came in while on her way to make home-made ice cream. She had a little cut on her leg, and she was VERY concerned that she would miss her ice cream social. After I used all of my hard-earned medical expertise to fix her boo-boo (with a band-aide, what else?) I told her she could still go make ice cream. A ray of sunshine came through the window, lighting up the room. A chorus of angels could be heard singing, and the little girl smiled at me like I had just saved her little kitten from drowning. I asked her if she could bring me back some ice cream, if there was any left over.

An hour later, I'm sitting there reading, and in walks the little girl. She tells me to close my eyes and hold out my hand. I obeyed, and she placed a huge bowl of ice cream (2 scoops, not 1!) with chocolate syrup all over. And behind that bowl was the proudest smile I'd ever seen on a little girl's face. She was bringing ice cream to the doctor who had saved her life!

After that, I started carrying band-aides around in my pocket, in case any other kids needed rescuing anywhere I went around camp. I couldn't let the nurses have all the fun!

Dr. Bob

Shaq's Big Challenge

2007-07-09T10:59:00.000-07:00

Have you all seen this show yet? What a great idea! Grab some unhealthy, over-weight kids and offer some lifestyle changes to whip them into shape. Actually this is very similar to one of the ideas that I have on my "To Do" list, so bravo to you Shaq for getting this done. I can't wait for the next few episodes to see how things turn out for the kids.

I enjoyed watching the first episode while the kids were getting the initial medical evaluation. First, it was interesting to see how difficult it was to find a doctor who specializes in childhood obesity; Shaq had to make many dead-end calls before finally getting was he was looking for. Not sure why I didn't get a call... maybe I had my ringer turned off!

The results of the medical evaluation were eye-opening. Some of the kids got an MRI scan of their torso which showed just how much extra fatty tissue was in their belly. The doctor told one of the kids, "You've got a whole extra person living in there!" Seeing the MRI images up on the screen really helped the kids realize just how serious their condition was. Next were the exercise stress tests - very disappointing. These kids could hardly tolerate even low levels of activity; their heart rates skyrocketing and one of the kids almost passed-out. This showed just how seriously the kid's health is affected by their obesity.

The show ended with the kids getting busted for not taking their exercise regimens seriously. Instead of using their treadmills and exercise bikes, the kids' work-out routine had disintegrated into a game of dodge-ball. The kids got the wrath of Shaq for this, but I think it just shows how important it is for exercise to be fun. When I travel, I try to use the treadmills at the hotel gym, but I find it very difficult to keep this up for more than 15 minutes - it gets very boring. I thought, "Heck, let the kids play dodge-ball", at least their burning energy. It might be better for these kids to stay active in other ways. One thought would be some sort of building project. If these kids spent most of the day building a playhouse or playground - digging, carrying, lifting, hammering, and sawing - they would probably burn more calories than they would on the treadmills. And, they would be having fun! Everybody wins.

I'm going to stay tuned.

Dr. Jim

Child Lonesome for Military Dad

2007-07-03T23:51:00.000-07:00

The other day a military mom related to me a cute thing her three-year-old daughter did. Dad is in the military and he frequently sends home videos of himself so mom and his daughter can watch daddy. One day while playing the video of dad talking to the three year old, the child went over and stuck her bottom against the TV screen. Astonished, mom asked, "Suzy, what on earth are you doing?" She responded with, "Mommy, I'm just sitting on daddy's lap." It's important for traveling parents to stay connected to their children by frequent phone calls, videotapes, emails, or whatever modern-day technological gadget you have access to. Call it electronic bonding, if you wish, but as this little child demonstrated, the message gets through to your child that you really care.

Dr. Bill

Ten Tips for Safe Teen Drivers

2007-06-29T16:40:00.001-07:00

Now that summer is here, schools have set teenagers free much to the worry of concerned parents who want their young adult to be safe. This is a normal parental concern and a well-founded one. Car crashes and other traffic accidents account for 44% of all teen deaths. Most teenagers spend more time on the road during the summer, and the peak for fatal teen car crashes is in July and August.

Here are 10 tips to help keep your precious cargo safe this time of year:

1. SEATBELTS, SEATBELTS, SEATBELTS -- Enough said. Talk to your teen about NEVER getting into a car without operating seatbelts. If they are driving, they shouldn't start the car until everyone has buckled-up.

2. Certain vehicles just aren't safe for young adults who think they are invincible. Talk with them about staying out of small roadsters, jeeps with open tops, and large SUVs that are rollover hazards. SUVs have a reputation of being very safe, but can roll easily. Research safety ratings of any car or truck your teen’s friends drive, and of course any vehicle you are thinking of purchasing for your teen.

3. Teach your teenager how to be a good driver. In my opinion, it is too easy to get a driver’s license in this country. Driver’s training and driver’s education are not enough. YOU have to take responsibility to teach them the finer points, such as:

• Driving in various weather conditions (snow, rain, fog, wind, etc.)

• How to change a tire

• Basics of under-the-hood components (may need to brush up on this yourself!)

• Driving at night

• Safe freeway and highway driving

• Quiz them yourself on various driving situations

4. Make sure they know the people whose car they are getting into -- and the people that get in theirs.

5. Talk to them about the dangers of drinking alcohol and using drugs.

6. Discuss avoiding distracting activities while driving. Talking (and texting believe it or not) on cell phones, eating/drinking, and changing CD’s are common causes of accidents.

7. Be informed if they are planning a long-distance trip.

8. Stress the importance of always having a way to contact your child, and make yourself reachable as well.

9. Avoid an overcrowded vehicle. Death rates increase for each additional passenger.

10. Talk with them in an open, non-judgmental fashion. They will respond more if they sense that you can trust them with this great responsibility. Becoming a driver is a critical stage in the development of an independent, responsible young adult.

Dr. Pete

The Music Man

2007-06-21T15:26:00.001-07:00

Well, many of my patients have wondered where I’ve been for the last three weeks. Well, a few times a year, I disappear for a while and pursue one of my other passions – live musical theater! I just finished acting in a production of The Music Man – and I played the lead – Professor Harold Hill!

I started this “hobby” about 5 years ago when I joined a production that my daughter was doing. This has been a great time for some much needed father-daughter bonding. Some of the shows that we’ve done together are: The Wizard of Oz, Annie, Joseph and the Technicolor Dreamcoat, Oliver!, Fiddler on the Roof and several others. There is nothing like the challenges of live theater to help foster a strong mutual respect between my daughter and I. This is something that I cherish – especially since she is entering the “crazy years” of high school.

Many of our shows are during the daytime, and are heavily attended by local school fieldtrips. Almost everyday, at least one of my patients is surprised to see their doctor up on the stage. I love to see the looks on their faces as they try to figure out why I look so familiar.

This production was a ton of fun, but also very stressful. Three long weeks of little sleep, fast food, stale air and the anxiety of a major lead character… it’s a miracle that I didn’t get sick! That was actually a major concern of mine, since there were actors all around me that were dropping like flies. There were coughs, sore throats, hoarse voices, upset tummies all over the place! Many times, between shows, I was asked to be a doctor again and help keep the cast healthy – I’m always prepared with my doctor bag. I really had to look out for myself, though. After a few nights of a fast food dinner, I said, “Enough of that”, and started to pack some healthy sandwiches instead. I was also very careful to wash my hands, and take extra nutritional supplements.

I didn’t invite too many friends and family to the show because it just makes me nervous. I prefer to be on stage and not know who is in the audience. Well, my wife had secretly invited a ton of people and I was very surprised to see a huge group of my family and friends after the show. I will never forget the look on their faces – they were blown away by how good the show was! I hate to brag, but they were right! We use a full Broadway quality set and many of my co-stars are professional quality actors – even though we are all moms and dads of kids in the show. It is so rewarding to be performing right along with our kids! If you live in Southern California, check out CTExperience.com for information on our next show: School House Rock in November, then A Christmas Carol in December.

I’m sure our theater will do Music Man again in the next few years. Next time I’ll be sure to let you all know!

Dr. Jim

Swimmer's Ear Prevention

2007-06-15T13:22:00.001-07:00

The summer season is here, and with it come trips to the beach, the local pool and family excursions to the lake. Unfortunately, along with these frequent dips can come swimmer's ear -- also known as otitis externa, which is an infection of the outer ear canal. This occurs when the canal is constantly exposed to water, which creates a nice breeding ground for bacteria, or very rarely, a fungus.

The main symptom of swimmer's ear is pain, which is usually more painful than an inner ear infection. The pain is often made worse by pulling on the ear. Occasionally, swelling and redness of the ear can occur. The good news is swimmer's ear is usually easily treated with prescription antibacterial ear drops, sometimes a steroid is added to help ease pain. Even better, swimmer's ear can be prevented altogether, without needing to stay out of the pool! Here are some tips:

Note: The following is for swimmer's ear prevention only. If your child experiences pain or tenderness of the ear, contact your health provider immediately.

Swimmer's ear prevention drops can be purchased over-the-counter. However, I like my own homemade concoction. Mix equal parts white vinegar and rubbing alcohol and place a few drops in each ear after getting out of the water. If you do this consistently, you can often prevent swimmer's ear from putting a damper on the family vacation!!

The main cause of swimmer's ear is constant dampness of the ear canal. A way to help avoid this is to use a hairdryer on the LOWEST setting and place an inch from the ear for a few minutes. You can also purchase specially designed ear dryers over the counter. They look like a doctor's ear light, but they emit a warm air to dry out the ear canal. Combining this technique along with my above mixture is a great way to avoid swimmer's ear.

Some physicians feel earplugs can help prevent swimmer's ear, but others think they can actually cause it. If your child gets recurrent swimmer's ear, talk to your doctor.

Avoid swimming in water exposed to sewage or in other bodies of water which may be dirty. Make sure any pools used are maintained at the proper chlorine and pH balance.

Earwax is a good thing! It helps protect against swimmer's ear. NEVER stick Q-tips or other objects inside the ear to remove wax.

After swimming, gently tap or pull on the ears to help drain the canals.

If left untreated, swimmer's ear can get worse. The earlier it is treated, the better. Contact your healthcare provider for further information or if your child gets recurrent swimmer's ear infections. Here's to a safe and wet summer vacation!

Doctor, Do You Remember...?

2007-06-11T20:59:00.001-07:00

Patients always seem to have a much better memory than I do. I guess that's because they only have to remember everything that happens to only ONE child. I have to try to remember a couple thousand. Plus, that one child happens to belong to the parents genetically, so I suppose that helps too. But I always find it funny how parents EXPECT me to remember everything that's happened with their child in the past. I want to come across as a good doctor, and one who remembers everything about every precious little child. But of course that's next to impossible. So I'm left with two choices when a parent says, "Remember last time when I showed you little Johnny's rash and you said . . . ?" Who cares if it was 3 years ago; that mom is going to expect me to remember. So what do I do? Do I pretend I DO remember and play along? That's a risky step, because a smart parent will catch me at it every time.

Today I saw a little one year old and as I was examining his diaper area the mom said, "See, his scrotum isn't swollen anymore. Remember how big it used to be?" Of course I didn't, and I immediately confessed to this fact. I was worried that I had let this mom down, that I had failed to remember this crucial fact about her precious little boy. But she let me off the hook easy. She laughed, hit me on the arm and said, "Duh, of course you don't remember. What am I thinking, with all your thousands of patients!" Whew.

So the next patient I saw was a little kid with a sore throat. The mom starts telling me about her OTHER child's arm and how thankful she was that I'd sent her to an orthopedic doctor for a cast. Apparently I'd called her 3 times to try to get in touch with her to have her go. The arm healed very fast and she was glad I'd caught the tiny fracture. Did I remember all this? Not right away. But she seemed like it had been such a big deal that I really ought to have remembered. So, I immediately started nodding and playing along (shame on me!), because I figured I'd catch on soon enough. And sure enough, after about 3 minutes of talking, viola! I did remember! The trick was that I had to make it look like I remembered, and then hide any sign of sudden realization when I actually DID remember! Boy, that was a tough few minutes.

I think from now on, I'll just stick with the excuse that I'm getting old and my memory is going and confess to my ignorance right away. Hey, you can never go wrong with honesty!

Dr. Bob

Funny Things Kids Say on the Way to Weaning

2007-06-08T15:05:00.001-07:00

One of the most exciting bits of medical news in the past few years - which savvy mothers have known for a long time - is that many medical studies show that the longer babies are breastfed the smarter and healthier they tend to be. Four-year-old Jason must have heard of this new research. I have been counseling Jason's mother, Tracy, on trying to wean her four year old who doesn't want to relinquish one of his favorite pastimes to his new sibling. The other day Tracy called and told me, "Jason came to me saying, 'Mommy, I have money. I pay you to nurse'." He then added a second incentive: "Mommy, I give you treat..." Of course, Tracy couldn't resist her little entrepreneur's offer.

I'm excited to see how mothers and medical professionals have picked up on this new research and are now thinking about breastfeeding in terms of years instead of months. The World Health Organization (WHO) now recommends three years; the American Academy of Pediatrics recommends at least one year.

Many Fortune 500 companies, especially Google, have set-up lactation lounges to make it easier for working mothers to express their milk while at work. This is not only good health, it's good business sense. These companies have found that mothers who continue breastfeeding after returning to work actually become more satisfied employees and miss fewer days of work because their babies are not sick as often.

Consider breastmilk as baby's best immunization. The incidence of just about every illness you don't want your child to get - from heart disease, diabetes, and multiple sclerosis - is lower in breastfed babies.

An eighteen year follow-up study from Australia showed that breastfed babies enjoy a higher I.Q., and that difference is proportional to the frequency and duration of breastfeeding. The brain-building and health-promoting effects of long-term nursing seem to be due to the smarter fats in breastmilk, namely DHA, an omega-3 fatty acid. Brain growth in babies is essentially helping the developing nerves make the right connections. A baby's developing brain is like miles of unconnected electrical wires. DHA is the prime structural component of the insulation of these wires, which allows nerve traffic to flow more efficiently.

Martha had a quip when someone chided her for still nursing three-year-old Matthew (just graduating as a pre-med student at the University of California, Irvine) with that phrase mothers hate to hear: "What, you're still nursing!" Martha replied, "I'm just being a specialist in early childhood education!"

Friendly Conversation!

2007-05-17T20:33:00.000-07:00

So I walk into a room to see a sick kid, but before I can get a word out the mom asks me “How’s your summer going?”

Now it was a pretty busy day, and I had my skates on (this is the term my staff uses when I’m in hurry mode), so I wasn’t really in the mood to chat. I wanted to find out why the child was here, what was wrong, look at his ears so I could make a diagnosis and get out of there to see the next patient waiting in line (and a very long line it was). Usually when I’m skating the first thing out of my mouth when I glide into a room is “What brings you in here today” or “What seems to be wrong with little Johnny” or something like that to get the ball rolling.

So when this mom beat me to the punch by asking me the first question, I was momentarily stunned. I didn’t know what to say. If I’d actually had real skates on I would have probably tripped. Why was this mom asking me such a casual question? Aren’t I the one who’s supposed to be doing the asking? Didn’t she notice the waiting room full of sick kids? Can’t she see I’m wearing roller skates?

But it didn’t end there. She kept asking questions. “How’s Cheryl (my wife and office manager) doing? You guys going anywhere this summer? How are the kids? How’s Joshua?” She asked them so fast I could barely keep up. I think I said things like, “Oh she’s fine. Yes we’re going to Florida. The kids are fine.” You know, the kind of brief answers you give when you don’t really feel like talking, like when your mother-in-law calls or something. I normally love to talk to patients about my personal life, when I have the time and it’s not a super busy day.

And then it hit me. Maybe this mom was just genuinely interested in how I was doing. Maybe she actually cared about me as a person. Not just whether or not I was a good doctor, but how I was doing as a father and husband. Maybe some people like to have a nice friendship with their pediatrician, instead of it just being all business. Maybe she noticed I was stressed out and moving too fast, and she just wanted to give me a little breather.

So I decided to take a little break and enjoy some nice adult conversation. I answered her questions again, but this time I gave her real answers. My wife is great, but overworked and underappreciated. She works harder than I do. We’ve got a great summer planned. I’m going to be a camp doctor at my teenager’s summer camp for a week. That should be nice and relaxing. Then it’s off to Disney World for a fun filled week of all play and no rest, then a week at the beach to recover. The kids are a joy. I love playing guitar with my teenager, and the early teen years really aren’t as bad as everyone says they should be. I’m having a lot of fun with my 10-year-old doing sports and mountain biking. And my little Joshua, he’s as cute as ever and demands (and gets!) every second of my attention when I’m at home.

Ahhhhh . . . Deep breath . . . I could feel the stress of the day melting away . . .

Then I looked at the kid’s ear, said he’s fine, and left to move on to my next patient.

So, sorry to any of you who were there that day and had to wait an extra 5 minutes while this mom and I chatted. But it sure was nice to just sit down for a few minutes and enjoy a little peace and quiet. We all probably get too busy in our daily jobs and don’t stop to smell the roses once and a while. And it was really nice to know that this patient thinks of me not just as her doctor, but as a friend whom she is genuinely interested in how things are going. I should do that more often. Feel free to engage me in conversation if you ever see me overworked and overstressed in the office. I’ll appreciate it (although the patients still waiting after you may not!).

Dr. Bob

Teenagers . . . Gotta Love 'Em

2007-05-17T20:05:00.000-07:00

I saw a teenage girl and her mom in the office today. The mom told me her daughter had high fevers and a cough, since about 10 days ago. She was really worried that something serious might be going on. I was a little worried too. Anyone with a cough as bad as the mom described, not to mention high fevers for 10 days, would probably need antibiotics. But when I looked at the girl, she was sitting there as happy as can be. No cough. No fever. She didn’t look sick at all. Could this even be the same girl?

I started asking the girl some questions, and sure enough, she had fevers that started about ten days ago, and over this past weekend her cough had gotten really bad. I examined her, but everything looked and sounded just fine. I thought I might just put her on antibiotics just to cover what must be some sort of infection somewhere (although I really hate doing that), but I decided to ask her just one more question:

“Exactly when was your last fever?”
“Oh, it was last Tuesday.”
“You mean, like seven days ago Tuesday?”
“Yup.”
“So your fever started about ten days ago, like you said before, but it only lasted 3 days?”
“Yup, but it was really high.”
“And how bad was your cough last night and this morning?”
“Oh, it’s much better now. But it WAS really bad before.”
“Is there anything in particular that is still bothering you now?”
“Not really.”

My first thought, as I put my prescription pad away, was “So why are you even here?” My next thought was “I’m so glad I don’t have to write another unnecessary prescription for antibiotics.”

My third thought was, “Wow. Is MY teenager just as difficult to get a clear answer out of?”

My last thought, after not saying any of my first three thoughts out loud, was “I’m not just here to see really sick kids. I’m also here to offer reassurance when parents are worried. And it’s actually a wonderful thing that most “sick” kids that I see really aren’t very sick.”

So I offered my most sincere reassurance to both mom and child, and told them what things to watch out for over the next week that should prompt a call back to us. No need to tell her what was really going through my mind. She never needs to know. Hmmm, I wonder if she ever visits our website. If she does, hopefully she will cherish the thought that my teenager, and almost everyone else’s, is just like hers. You gotta love ‘em.

Dr. Bob