The number of entertainment options available to kids these days is mind-boggling. Playstation, X-Box, Nintendo DS, personal DVD players, the internet, iPods, cell phones–all of these compete for a child’s attention, taking away time otherwise spent in physical activity and family functions. We all know the result of decreased physical activity. Childhood obesity is on the rise, bringing with it an increased number of kids with hypertension, elevated cholesterol, and type II diabetes. But what you may not have considered is the impact these electronic devices have on family time.

It’s not just the kids’ fault. Technology distracts many parents from family time as well. Moms and Dads can watch movies every night, thanks to home-delivered DVD services, like Netflix. They comfortably surf the internet hour upon hour with lightening fast broadband connections and they bring laptops home from the office to work on next week’s presentation. And while these innovations are not inherently bad, sometimes we forget to temper our craving for technology with sensible moderation.

So the kids play their X-Box while their parents watch a movie or surf the net in a different room. How often does this scene play out in your house? You’re not alone. We do it too. And why not? Everyone is happy. Nobody is arguing–well, maybe the kid’s are arguing over the video game, but that’s a discussion for a different day. The point is that it doesn’t seem so wrong, really. And yet the family unit is weakened by a lack of good old fashioned bonding.

So what can we do about this? Well, spending more time as a family will certainly help. And I don’t mean time spent watching the same DVD together. I’m talking about family activities. I’m talking about interaction and communication. Physical activities are good–touch football in the backyard, bowling on the local lanes, a round of miniature golf at the fun center.

Or you could revive one of my favorite childhood activities: family game night. Does anyone do this anymore? Give yourselves a good three or four hours, pop a big bowl of popcorn, and everyone choose a board game–no electronic ones please.

The old standards, games like Monopoly and Clue and Life, are still around. You can find updated versions that provide variety (Haunted Mansion Clue and Pirate Life for example), while others are packaged with vintage pieces in collectible tins. Dominoes are fun. Card games work. You could even try a lively game of charades or Pictionary.

Maybe you have a quirky game from your childhood collecting dust in the closet. The quirkiest one I remember was a board game called Fat-so. Each player had a big hollow plastic fat guy that snapped together at the belt line. His mouth was an open hole, just the right size to insert little wooden tokens that represented food. Players raced around the board, eating out at pizza places, ice cream stands, and doughnut shops. At the end of the game, whoever had eaten the most, won. See, I told you it was quirky. And while I certainly don’t advocate this game as a lifestyle choice, I challenge you to find a quirky game that is as memorable. And that’s what we’re talking about–making memories.

I think the key to a successful family game night is to plan at least one a week. If you don’t plan it, it won’t happen. You forget. I forget. We all forget. But it’s important, and I bet your kids, even if their first reaction is to complain about a family game night, will remember the event fondly in their adulthood. Why? Because interaction stands out. Sitting in a chair, staring at a screen for two hours, does not.

So the next time you’re at the store, look through the game aisle and find something new. Schedule your night. Fix a special snack. Get everybody jazzed up for the event. Don’t worry if there are grumblings in the beginning. You can bet as the weeks pass, with family game night entrenched as a regular occurrence, the grumblings will cease. Everyone will forget about their tech toys, at least for this one night. Your family will grow as a unit, and fond memories will be burned into each person’s heart. So what are you waiting for? Go on. Give family game night a try!

COPYRIGHT 2006 MIKE PATRICK JR

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Your one-year-old is unresponsive. Her eyes roll back. Her arms and legs stiffen. She begins to jerk and twitch. You are suddenly shaky yourself as panic and fear grab hold. You snatch her up in your arms and discover her skin is hot to the touch. You don’t understand. She hadn’t been sick–until now. You rush to the phone, but aren’t sure who to call–911, the doctor, your husband, your mother? By this time, the twitching has stopped, her muscles have relaxed, and her eyes have closed. Like a spring tornado, the convulsive episode came and went in a flash, leaving you with an unarousable child and a whole lot of questions, the first of which is, “What do I do now?”

Witnessing a febrile seizure is a frightening experience. As a parent, you are helpless to control the unfolding situation. I am reminded of my daughter’s seizure several years ago. We had packed everything in the apartment and were preparing to move into our first house the following day. Excitement filled the air. Our daughter was 15-months old at the time and she felt a little warm. But we couldn’t take her temperature or give her Tylenol because when I say everything was packed, I mean everything was packed.

The dinner hour beckoned, so my wife volunteered to swing by the drug store on her way to KFC. That was fine by me. Katie wasn’t exactly what you’d call a cuddly baby. The low-grade fever had relaxed her temperament, and I took advantage of the situation, rocking her to sleep in my arms.

While waiting for my wife and the chicken to return, Katie woke up. But her eyes weren’t looking at me. Instead, they were forced high up in the sockets as if she were inspecting the hairs on her brow. Her tiny body became stiff and started to twitch, and I realized she wasn’t really awake at all. I remember her body suddenly burning like fire and I remember feeling helpless to do much of anything about her fever or the seizure.

Typical of most febrile seizures, the episode passed quickly, but it left me with a lasting impression of the experience. I understand why fever, and the prospect of a resulting seizure, scares parents.

Yet, you really shouldn’t be afraid. Fever is a normal function of our body, aiding in the elimination of infection. It should prompt you to seek a medical opinion regarding the source of the fever, but it shouldn’t scare you. And why not?

Well, only 4% of the population will ever have a febrile seizure. That means your child has a 96% chance of never having a fever seizure, even with temperatures in the 104-105 degree range. The chances, however, do increase slightly if other children in the extended family have a history of seizing with fever.

Also keep in mind that there’s little you can do to prevent a febrile seizure. This is because most of them occur at the very onset of an illness, with the first temperature spike. In these cases, the seizure is the first sign your child has a problem.

When febrile seizures occur, they tend to be brief (a few minutes that seem like an eternity) and uncomplicated. Your child may be sleepier than usual for an hour or so after the episode. Also, having a febrile seizure increases the odds of having another one sometime in the next few years–about one-third of kids with a febrile seizure will have a repeat episode. Will your child go on to develop epilepsy (seizure without fever)? It’s unlikely. Only one in one-hundred kids with febrile seizures will go on to have a lifelong seizure disorder.

How about brain damage? Nope. Neither high fevers nor febrile seizures cause brain damage. However, brain damage can lead to fever and seizure.

So back to the question on every parent’s mind: What do I do during and after a febrile seizure. During the seizure, you want to make sure your child is in a safe place and breathing fine. If there are breathing difficulties, call 911. Start rescue breathing if your child is apneic or blue (a CPR course through the American Red Cross is a good idea for any parent). But realize this situation is extremely rare.

After the seizure, you should call your child’s doctor. He may have you go to the emergency room or might see you in the office.

Witnessing a febrile seizure is scary–take it from me, a Dad and Pediatrician who lived through one. But in the overwhelming majority of cases, all is well in the end. Sure, we treat fevers in kids, but our primary goal is making your child more comfortable, not preventing a seizure. God made fevers for a reason. They have a purpose. Since seizures are a rare occurrence with fever, and since they are generally brief and without complication when they do occur, you should respect your child’s fever, but please don’t fear it.

Mike is an American pediatrician. Read more at http://www.pediascribe.com

COPYRIGHT 2006 - MIKE PATRICK JR, MD

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The kids are out of school for the summer. The backyard pool is open and clean. The pH and chlorine levels are just right. Don’t have a backyard pool? No problem. Maybe it’s the Y or city pool or beach club. Wherever your kids swim this summer, they are likely to have an unwelcomed guest join them: swimmer’s ear.

Each summer, thousands of children visit their doctor for this painful condition. Are these visits necessary? They usually are. While it’s true most cases of swimmer’s ear will resolve on their own, most kids experience quicker relief with a prescription medication. Of course, it’s best to prevent swimmer’s ear in the first place. To understand how to prevent it, let’s first take a look at the factors that cause it.

Understanding swimmer’s ear boils down to two facts. First, our skin is crawling with bacteria. I know, it’s not the most pleasant thought in the world, but these little critters are a normal part of our lives. You can’t get rid of them, at least not permanently. The second important fact is that prolonged water exposure leads to a breakdown in the skin of your ear canal. Think about what happens to fingers and toes when you swim or bathe too long. They get wrinkly, right? The same thing happens in your ears. And some kid’s are more prone than others. The quality of our protective ear wax can make a big difference. Those with a moderate coating of wax throughout the canal tend to get fewer cases of swimmer’s ear than those with no wax or thick clumps of wax.

Now let’s combine our two basic facts: Bacteria is crawling over broken down skin. The bacteria get inside the skin, causing infection. Your immune system recognizes the bacteria as foreign invaders and attacks them. White blood cells come to the rescue, but they cause pain, swelling, and inflammation in the course of their fight.

Knowing this, preventive strategy becomes easy to understand. You must decrease the number of skin bacteria and limit prolonged water exposure. But what if your child is a fish? What then? Well, if they are also prone to swimmer’s ear, they’ll need to take more frequent breaks to allow the ears to dry. Applying a few drops of rubbing alcohol in the ear will facilitate drying and will kill off much of the skin bacteria (temporarily).

Ear plugs will also keep the ears dry. These are most useful for competitive swimmer’s who can’t take frequent breaks and for children with surgically-placed ear tubes. Most ENT specialists can make custom plugs, but the price is often high and kids lose them easily. An inexpensive alternative is Silly Putty. Simply break off a large piece, roll it into a ball, and mold it into the outermost ear opening (not the little hole going into the ear). If you have trouble creating a seal, try coating the Silly Putty with a thin layer of Vaseline.

Sometimes the best efforts of prevention fail. If your little swimmer complains of a persistent earache, it’s time to see your doctor. Although swimmer’s ear is likely, there are other possibilities such as middle ear infection and tonsillitis. Because we treat these things differently than swimmer’s ear, it’s best to have your doctor take a look.

Okay, so let’s say it is swimmer’s ear after all. What next? Well, your doctor will likely prescribe a combination ear drop. One ingredient of this medicine is a steroid. It’s job is to reduce the pain, swelling, and inflammation. The other component is an antibiotic. You can guess its job, right? We want to help the immune system kill off the invading bacteria.

No question about it–kids and swimming are a great combination. Supervised swimming is great exercise and is certainly better for your child than an afternoon in front of the TV playing X-Box games. But if your child is prone to swimmer’s ear, you and your child may have reservations about taking a dip. Go ahead and get in. The water is fine. Just be sure to take frequent breaks to allow the ears to dry, consider using ear plugs, and treat the ear with a few drops of rubbing alcohol when you get out.

A final word on pool safety is required: Always supervise your children when they are swimming, even if you consider them to be outstanding swimmers.

Accidents happen when you least expect them, and when accidents happen in an unsupervised pool, the results are all too often deadly. Look for more information on pool safety in an upcoming installment of Pediascribe.

Mike is an American pediatrician. Read more at http://www.pediascribe.com

COPYRIGHT 2006 Mike Patrick Jr, MD

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