Category Archives: Health tips

8 tips to prevent poisoning

With one of the busiest pediatric emergency medicine programs in the nation and more than 90,000 emergency department visits annually for a variety of reasons, you can trust we’ve treated just about everything. We love kids here at Children’s, but we’d rather see them safe at home.

In recognition of Poison Prevention Awareness Week (March 15-21), we’ve gathered tips from our experts. Share these tips with your kids and print them to share at their schools or with your friends. Together, we can make safe simple.

Keep all potential poisons up high and out of the reach of children — in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze. (iStock photo / Getty Images)

What is Poison Prevention Week?

National Poison Prevention Week was established by Congress in 1961 for annual, national recognition. The goal of the week is to educate the public about poisoning risks and what to do to prevent poisonings.

What you should know

Did you know that injuries are a leading cause of death in children? Each year, 5,000 kids die and another 6 million are hurt as a result of unintentional injuries. One in 4 children is hurt seriously enough to need medical attention. Most childhood injuries occur at home, and many of these injuries, including poisoning, could be prevented.

Facts about poisoning

  • More than 1 million accidental poisonings per year occur in children younger than 6 years old.
  • Approximately 1 in 10 poisonings involves cleaning products.
  • Approximately 1 in 10 poisonings involves indoor and outdoor plants.
  • Approximately 1 in 20 poisonings are caused by cosmetic and personal-care products.

Tips to prevent poisoning

  • Review the poison prevention home checklist from the Minnesota Regional Poison Center.
  • Keep all potential poisons up high and out of the reach of children — preferably in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze.
  • Keep medications and vitamins out of the reach of children. Never call medicine “candy.”
  • Keep foods and household products separated.
  • Keep products in original containers. Do not use food storage containers to store poisonous substances (i.e. plant food in a drink bottle).
  • Destroy old medications.
  • Identify all household plants to determine if poisonous.
  • Post the Poison Center phone number, 1 (800) 222-1222, near each phone in the home.

subscribe_blogWhat do you do if you suspect someone has been poisoned?

  • Swallowed poison: Remove anything remaining in the mouth. If a person is able to swallow, give about 2 ounces of water to drink.
  • Poison in the eye: Gently flush the eye for 10 minutes using medium-warm water.
  • Poison on the skin: Remove any contaminated clothing and rinse skin with large amounts of water for 10 minutes.
  • Inhaled poison: Get fresh air as soon as possible.
  • Call the Poison Center, 1 (800) 222-1222, immediately.
CROSSWORD PUZZLE: Poison Search

Cognitive-behavioral therapy for insomnia an option for kids with sleep trouble

Cognitive-behavioral therapy for insomnia (CBT-I) requires regular visits with a sleep provider who will work with you and your child to help change the way he or she sleeps. (iStock photo)

Cognitive-behavioral therapy for insomnia (CBT-I) requires regular visits with a sleep provider who will work with you and your child to help change the way he or she sleeps. (iStock photo)

Terese Amble, PsyD, LP

Insomnia is broadly defined as difficulty falling asleep, staying asleep and/or subjective, poor-quality (“non-restorative”) sleep.

Everyone has problems sleeping at times; however, a diagnosis of insomnia is made if sleep problems persist for more than one month and result in some degree of daytime impairment. Untreated insomnia can result in chronic sleep loss that can cause excessive daytime sleepiness and impact daytime functioning, which may range from fatigue, moodiness/irritability or mild cognitive or behavioral problems (difficulties with concentration/attention, hyperactivity) to significant effects on mood, behavior or school performance. Chronic insomnia also increases the risk of physical and mental illness.

Given the negative impact of chronic poor sleep, it is important to have sleep problems evaluated and treated. Behavioral treatments are the first line treatment for insomnia and involve improving sleep without the use of medications, as there are no medications that are FDA-approved for the treatment of insomnia in youth. Cognitive-behavioral therapy for insomnia, commonly referred to as CBT-I, is a safe and effective treatment that aims to help children and adolescents identify and replace thoughts and behaviors that cause or worsen sleep problems with thoughts and behaviors that promote sound sleep.

CBT-I requires regular (usually weekly or biweekly) visits with a sleep provider who will work with you and your child to help change the way he or she sleeps. The frequency of treatment may vary from as few as two sessions to as many as eight of more sessions, depending on the specific sleep concerns and progress. At the beginning of treatment, a comprehensive sleep evaluation will be conducted to determine factors that are underlying or contributing to sleep difficulties and to help develop an effective treatment plan. As part of this initial evaluation, you will be asked to keep a sleep log of your child’s sleep patterns for one to two weeks and your child may be asked to wear an actigraph, a portable wristwatch-like device which records and stores more objective information about body movements and sleep-wake patterns.

subscribe_blogAfter this initial evaluation, treatment is individualized and each session is focused on learning specific cognitive and behavioral strategies to improve sleep. The cognitive part of CBT-I involves teaching your child techniques to quiet his or her busy mind at night to relax and fall asleep. Your child will learn strategies to recognize, modify or eliminate unhelpful/negative thoughts or worries that interfere with his or her ability to sleep, including unrealistic beliefs and attitudes about sleep and the possible daytime consequences of poor sleep (e.g. “I’ll never be able to fall asleep tonight,” “If I can’t fall asleep, I won’t be able to get up in the morning and I’ll miss my test”).

The behavioral part of CBT-I involves identifying and changing behaviors that may keep your child from sleeping well and developing good sleep habits to promote quality sleep. Treatment is tailored to each child or adolescent and may include some combination of the following techniques:

  • Sleep restriction: This strategy involves temporarily restricting the total time in bed to current amount of sleep each night to decrease the amount of time spent in bed awake. Being extra-sleepy can help your child fall asleep quickly and stay asleep. Once sleep has improved, the amount of time in bed is gradually increased until desired bedtime is reached.
  • Stimulus control: This technique involves eliminating any activities in bed that are not conducive to sleeping to disrupt the association between being in bed and wakefulness (and strengthen the association between being in bed and sleepiness). Stimulus control instructions often include only going to bed when sleepy, leaving the bed (and possibly bedroom) to engage in a quiet activity if not asleep within 15-20 minutes and only using the bed for sleeping both during the day and at night (not watching TV, doing homework, worrying, etc.).
  • Sleep hygiene: This involves learning positive sleep practices and habits that are important for getting sound sleep, such as establishing an optimal sleep environment, implementing a developmentally appropriate and consistent bedtime and wakeup time (no matter how much sleep you got the night before!), avoiding naps, establishing a calming, consistent bedtime routine, decreasing stimulation near bedtime (caffeine, physical activity, conflict/stress) and removing electronics from the bedroom.
  • Relaxation training: Increased mental activity at night (such as worrying or not being able to “switch off” an active, busy mind) or stress about not being able to fall asleep leads to increased activity and tension in the body, which further interferes with the ability to unwind and fall asleep. Relaxation strategies, such as deep breathing, visual imagery, progressive muscle relaxation, autogenics, meditation and mindfulness can be used to help quiet the mind and calm the body at night and improve sleep.

Given the potential negative consequences of chronic sleep loss, it’s important to actively treat sleep problems. CBT-I is a safe and effective way to treat insomnia in children and adolescents without the use of medications. CBT-I is generally short term, but the skills learned during this treatment can lead to lasting, improved sleep if positive habits are maintained.

Terese Amble, PsyD, LP, is a pediatric psychologist in the sleep center at Children’s Hospitals and Clinics of Minnesota.

“Children’s Pedcast,” Episode 2: Dr. Keith Cavanaugh on sleep health

subscribe_blogDr. Keith Cavanaugh and Karen Johnson, APRN, of the Children’s Sleep Center in St. Paul talk about healthy sleep habits for kids from newborns to teens.

They cover children and schedules, sleep apnea, daylight saving time, teens and technology, and other sleep habits, both good and bad, providing information for parents and kids.

Listen to “Children’s Pedcast” on Podbean, iTunesStitcherYouTube and Vimeo.

Mindfulness a technique to relieve stress

Many teachers of mindfulness suggest visualizing thoughts as leaves floating down a stream or as clouds drifting by in the sky. (iStock photo / Getty Images)

subscribe_blogLeslie Partin

Whether you’re a busy, working parent or a teen trying to balance a full social calendar and school, life can be stressful at times. Mindfulness, otherwise known as mindful meditation or mindfulness-based stress reduction (MSBR), is a tool any one of us can use as we navigate through the demands of our days.

The basic tenet of mindfulness is paying attention to the present moment. So much of the time we’re thinking ahead to the next task or mulling over something that happened in the past. For example, have you ever driven past the exit you intended to take, only to realize you missed it because you were thinking of something else? When we are caught up in our thoughts, we miss what is happening around us like that missed freeway exit.

Our minds are powerful, and we can harness that power to help us manage difficult experiences and distressing (or afflictive) emotions. When we are in the midst of a strong emotion or physical sensation like anger, sadness, disappointment or physical pain, it can feel like things will never get better. But if we’re able to step back and observe our distress, we may notice that it changes, ebbs and flows. Noticing and recognizing that the intensity varies, whether it’s an emotion or physical sensation, offers hope and reassurance that it won’t always be so hard. And when we focus on what we’re experiencing right now, instead of what’s going to happen — “I don’t want to have a headache at the dance,” “I don’t want to be stressed out at my child’s game,” etc. — then we don’t add the additional suffering of anticipation or worry. We suffer when we focus too much attention on what may happen in the future.

Mindfulness doesn’t mean trying not to think or making one’s mind blank. Instead, mindfulness teaches us to watch our thoughts, observe them while not attaching to them. Many teachers suggest visualizing thoughts as leaves floating down a stream or as clouds drifting by in the sky. Practitioners of meditation say that having a regular “practice” — a time set aside to practice meditation — allows us to develop our capability to be mindful in times of distress. It’s like building our mental muscles in the same way we build physical muscles by lifting weights or working out. Committing to a meditation or mindfulness practice helps us develop those muscles so we have the ability to use them when we need them most.

Neuroscience studies show us that the brain develops neuro-pathways as a result of our thinking habits and patterns. Similar to the way a trail through the woods is developed by animals and people following the same path over and over, our neuro-pathways, or thought habits, are made as we repeatedly take the same path of worry, fear, joy, happiness, etc. Mindfulness is one technique we can use to help form new neuro-pathways or mental habits. When we practice mindfulness we increase awareness of all of our thoughts and emotions, the positive as well as the afflictive ones. We then can choose which thoughts, emotions and sensations we want to focus on and nurture, and of which ones we want to let go. Remembering that we have this choice can help us cope when we hit stressful times.

If you’re interested in learning more about mindfulness, here are few links that can help you and your family get started (the first six links are centers that are located in the Twin Cities):

The Kiran Stordalen and Horst Rechelbacher Pediatric Pain, Palliative and Integrative Medicine Clinic at Children’s – Minneapolis has medical providers that work with children to teach relaxation techniques that can include the use of mindfulness. These strategies are helpful for chronic conditions such headaches and abdominal pain or problems with sleep and anxiety.


[1] Jon Kabat-Zinn developed Mindfulness Based Stress Reduction programs in Massachusetts and has several books and CDs, which provide a good starting point. “Everyday Blessings” is his book on mindful parenting, with Myla Kabat-Zinn.

Leslie Partin is a social worker at Children’s Hospitals and Clinics of Minnesota.

Preparing yourself for your child’s surgery

Visiting the hospital ahead of time gives everyone a chance to learn more about what to expect and what’s helpful to do ahead of time or bring with you when you come to the hospital. (2013 file photo)

Jeri Kayser

When a child needs surgery, the focus of preparation usually is with the child.

That makes sense.

We want our kids to understand what’s about to happen so they aren’t overwhelmed or traumatized by the event. They’re kids, after all, and we adults have to deal with it, right? Or, perhaps, wrong.

After more than 30 years as a child life specialist, 20 of those in surgery, I have observed that the first person to be well-prepared should be the parent. Children respond most directly to how their parents are reacting emotionally to the event to gauge their own response.

Imagine you are 3 years old and about to get your tonsils out. This is scary because it’s hard to understand what’s about to happen and frustrating you can’t control it. Age-appropriate information and a supportive staff are helpful, but if you notice your mom or dad is anxious, nothing else matters. You got the message: You should be anxious, too, especially if your parents are trying to suppress their emotions – that is even scarier to a child. You can tell that they are upset, but you don’t know why, so you imagine the worst. If you’re a teenager, you might pick up on the message that we don’t talk about this and it will upset your mom if you bring it up to her. It’s hard to deal with the unspoken stress of your family as well as your own fears and concerns.

When I’ve observed kids coping successfully with the challenges of a health care experience, I have noticed that their families have prepared themselves with some or all of the following techniques:

Seek information

Find out what is happening and why. What are the expected outcomes?  What types of things can you as a family plan on doing to foster your child’s healing?

Attend a pre-admission tour

On our hospital’s website there is helpful information about surgery and how to sign up for a tour. Visiting the hospital ahead of time gives everyone a chance to learn more about what to expect and what’s helpful to do ahead of time or bring with you when you come to the hospital.

Make a list

Write down a list of questions to bring to meetings with health care providers. I remember one family kept an ongoing list in their kitchen for anyone to write down questions, and they all contributed, even the siblings. Everyone had a say, and the questions helped everyone feel a part of the event. Knowledge helps you be in control and having specific tasks you can do to support your child in his or her recovery provides focus and direction.

subscribe_blogBe honest with your emotions

As a parent, our job is to love and protect our kids and guide them towards being an independent adult. It can be overwhelming to have to make decisions for your child that includes any potential discomfort since we so desperately want to keep him or her safe from life’s struggles, but learning to deal with life’s struggles is what helps kids learn to be independent. We also carry with us our own memories and experiences with health care that may help or cloud our emotional response to our child’s experience. It helps to pay attention to where your emotions about surgery differ from your child’s. You each get to own your own perspective.

Kids do best when we are honest with them. When you label your emotions and show your child what you’re doing to help yourself, your child gets to experience some phenomenal role modeling on how to cope with challenging situations.

“I am sad that your tonsils need to come out, but I am glad that the doctors can fix this and soon you will be able to breathe better at night when you’re sleeping,” a parent can say. “Let’s think of some fun things to do while you are healing!”

Take care of yourself

You know yourself best. Helping your child through the experience of surgery can be exhausting. Think about what will help you be in your best place. Whom can you call on for support? Even small favors like having someone else pick up your other kids from school can be a great stress reducer.

Plan on something nice you can do for yourself while waiting for your child’s surgery to be done or when you get home. This also can help you and your child focus forward and be reminded of the time-limiting nature of the experience. It won’t last forever, and soon you’ll be looking back on this adventure.

Cut yourself some slack. There is no perfect person, so there can be no perfect parent. Your effort is what your child will notice and appreciate.

We grow as individuals and we grow as a family when we figure out what works best for us to deal with life’s challenges. This knowledge is precious and affirming and gives us all the more strength to deal with the next adventure.

Jeri Kayser is a child life specialist at Children’s Hospitals and Clinics of Minnesota.

Taking fear out of food-allergy diagnoses

(iStock photo)

(iStock photo)

Dealing with a food allergy diagnosis can feel daunting, especially for the uninitiated, due to its serious nature. But it doesn’t have to be — no parent or child has to face the new reality alone. There are doctors who specialize in food allergies, and there are groups and programs to educate and assist with how to live with food allergies.

The Food Allergy Support Group of Minnesota, founded in 2003, provides support to more than 650 members and is committed to guiding people through the confusion and fear that can come with a food-allergy diagnosis. Its mission is to empower families affected by food allergies by providing support, education and a community to build personal connections.

For the newly diagnosed, finding a board-certified allergist and learning what medications are commonly prescribed for food allergies are at the top of the list. Other actions include: knowing how to read food-ingredient labels, organize the kitchen and recipes, eat safely at restaurants, travel with food allergies, and partner with your child’s school.

All parents should know

It’s important for all parents and teachers to know about potential dangers and how to practice food safety, too. Kids with food allergies may encounter unsafe food or treats brought to school for lunch or holidays such as Valentine’s Day. Or a child’s friend visiting as a house guest may have a food allergy that requires consideration.

Preparing and taking precautions are not as difficult as you may think. Make sure you have the child’s emergency medications nearby and ask to review their Allergy Action Plan from their doctor. Here are some important steps to take if someone is showing symptoms of a food-allergy reaction:

  • Watch for symptoms, which may include hives, coughing or a tight throat.
  • Identify their symptoms on their Allergy Action Plan and determine if they are having a minor or severe reaction.
  • Give emergency medicine as directed, such as an epinephrine autoinjector (ex. EpiPen).
  • Call 911 for medical assistance and head to the hospital in an ambulance.
  • If possible, bring a smartphone or tablet to entertain your child during the wait.
  • Bring safe snacks.

Food or foe?

subscribe_blogEight foods account for more than 90 percent of food allergies in the U.S., according to the Food Allergy Support Group of Minnesota.

  • Milk (all dairy)
  • Eggs
  • Fish
  • Peanuts
  • Shellfish
  • Soy
  • Tree nuts
  • Wheat

The Big Quack

The Food Allergy Support Group of Minnesota (FASGMN) is hosting the ninth annual Big Quack, a family-friendly, food-allergy-safe event at the Water Park of America, from 4-8 p.m. April 19. Attendees will enjoy shorter lines as the park will be closed to the general public during this event.

The Big Quack event is a fundraiser to help support families who manage food allergies by providing special support groups and programming. Admission is $15 per person (if purchased in advance), which is roughly half of the usual price at the water park. No food allergies? No problem. All are welcome! For complete details or to order tickets, please visit FoodAllergySupportMN.org.

Food Allergy Resource Fair

The Food Allergy Resource Fair, which takes place on Oct. 12 at the Eisenhower Community Center in Hopkins, is an event open to the public that features allergy-friendly products and services from the U.S. and Canada. There are products for adults to sample and a safe trick-or-treat experience for kids with food allergies (all candy is free of the top-eight food allergens).

Find the Food Allergy Support Group of Minnesota at foodallergysupportmn.org,  Facebook, or email [email protected].

The scoop on a good night’s sleep

Simple steps to a good night’s sleep include: sticking to a schedule, decreasing caffeinated beverages, keeping naps to a minimum, creating a calm environment, and knowing when to unplug from electronics. (iStock photo)

Simple steps to a good night’s sleep include: sticking to a schedule, decreasing caffeinated beverages, keeping naps to a minimum, creating a calm environment, and knowing when to unplug from electronics. (iStock photo)

Erin Fritz, CNP

The significance of good sleep habits often is overlooked. It seems so simple; when the hour is late and it’s dark outside, it’s time to get some rest. Unfortunately for millions of kids and young adults, it’s not that simple. With busy school schedules, after-school and weekend activities, and maximizing time with family and friends, sleep often is one of the first things to become compromised. Not only does lack of sleep make for a tired person, but it has a critical impact on many aspects of health, daytime function and cognitive development.

Snoozing significance

The direct effect that sleep has on health has been well-studied over the years and is known to lower a person’s resistance to illnesses. Decreased amounts of sleep alter immune function, making it more likely for illness to occur. For example, the Centers for Disease Control and Prevention shares evidence for a higher risk of getting the common cold, pneumonia and influenza when sleep deprivation is a factor. Once illness occurs, sleep is necessary to boost the immune system and fight off illness. Sleep is the body’s time to repair and rejuvenate itself.

Daytime function also is altered with sleep deprivation. The American Academy of Pediatrics has recently released recommendations for later start times in middle and high schools after noting an increased risk of automobile accidents and a decline in academic performance related to decreased amounts of sleep. Poor test scores, increased behavioral problems and children falling asleep in class have been highlighted as inhibited daytime functions directly related to sleep deprivation.



Sleep suggestions

Recommendations per the CDC:

Age Recommended amount of sleep
Newborns 16-18 hours a day
Preschool-aged children 11-12 hours a day
School-aged children At least 10 hours a day
Teens 9-10 hours a day
Adults (and elderly) 7-8 hours a day

Sleep solutions

subscribe_blogWhile it’s easy to perpetuate the cycle of being sleepy, it’s possible to make a conscious effort to improve this problem. Simple steps to a good night’s sleep include: sticking to a schedule, decreasing caffeinated beverages, keeping naps to a minimum, creating a calm environment, and knowing when to unplug from electronics.

It’s important to keep in mind that sleep deprivation might not seem like a big deal, but it can have serious consequences. Incorporate healthy sleep habits to promote an overall healthy lifestyle.

Sleep well!

Erin Fritz is a certified nurse practitioner at Children’s Hospitals and Clinics of Minnesota.

Q&A with Team Superstars coach Antonio Vega

Coach Antonio Vega of Zoom Performance will guide Team Superstars with an online training plan, weekly training tips and two group runs and presentations. (Photo courtesy of Antonio Vega)

Coach Antonio Vega of Zoom Performance will guide Team Superstars with an online training plan, weekly training tips and two group runs and presentations. (Photo courtesy of Antonio Vega)

“Anybody can be a runner. We were meant to move. We were meant to run. It’s the easiest sport.” — Bill Rodgers, four-time Boston Marathon champion

In 2015, you have the opportunity to move for kids by running on behalf of Children’s Team Superstars in one of the Medtronic Twin Cities Marathon weekend events and fundraising. Whether you’ve been considering your first race or have been logging miles for years, you can do it.

__________

RELATED: Add a Children’s event to your race calendar

__________

If you need further proof that you can do it, keep reading. Coach Antonio Vega of Zoom Performance will guide the team with an online training plan, weekly training tips and two group runs and presentations. He has a bachelor’s degree in kinesiology from the University of Minnesota. As a former member of Team USA Minnesota, he holds a 2-hour, 13-minute marathon personal record and a 61:54 half-marathon PR. We asked him a few questions about training, his philosophy on running and his own running career.

Q: Is it true? Can anyone run?

A: Absolutely, everyone can run. When I think about all of the great experiences and friends that I have made during my running career, I would not change that for the world. I think anyone who does not get out and run is missing out on such a great part of life.

subscribe_blogQ: I’m just getting started as a runner. Do you have a few tips?

A: The best thing any new runner can do is ease into his or her new running routine. It can take a good month for running to become enjoyable and something that you look forward to on a daily basis. Don’t be afraid to take walking breaks when you are first starting out, and keep the pace nice and easy and enjoy the sights and sounds of being outdoors while exercising. The beauty of running is that you are competing against yourself, so there is no need to worry about how fast you are running.

Q: How do you conquer fear of signing up for a race, whether it’s your first 5K or marathon

A: Being prepared for any race that you are doing is one way of conquering your fear of signing up for a race. Following a training plan or working with a running group is a great way to feel prepared before any competition. Also having a friend or a family member that will cheer you on at the race or will run with you will also help to minimize any fear that you might have about signing up for a new race distance.

Q: What should I expect training with Team Superstars and Coach Vega?

A: The training plans that I have put together for Team Superstars are meant to challenge athletes of all ability levels. Whether your goal is to finish your first marathon or run a PR in the 10-mile, there will be a plan to help you accomplish your goals. You can rest assured that all of the guess work that comes with training for any race has been decided for you. Every plan is meant to get you to the starting line ready to run your best race.

Q: What’s your trick for staying motivated to “go the extra mile”?

A: For me, getting out the door is always the hardest part about any run. Once I have my shoes on and I am out the door, I never turn around. I find that mixing my training up helps to keep me motivated, whether that is running with a friend, changing my running route or taking my dog out on a run with me. All of these things help me to stay motivated to continue to train.

I always tell myself you never regret going for a run, but I always regret not running.

Q: What is your coaching style?

A: I tend to be a very hands-on type of coach. I know how much time and work my athletes put into training, so I always become personally invested in their racing and training goals. When I know one of my athletes has a tough workout coming up or a big race, I am constantly checking their training plan to make sure they are well-rested going into their workout or race, and then I find myself eagerly waiting for them to update me in how the workout or race went.

Q: When you reflect on your running career, what are you most proud of?

A: The highlight of my running career would be winning the 2010 US Half Marathon Championship in Houston. Before running the Houston Half Marathon, Minnesota had experienced one of the worst winters that I can remember. I was unable to train outside during my build up to Houston. I ended up logging 120 miles a week for 12 weeks straight all on a treadmill. The day before the race was the first time that I had run outside in three months. Winning the Houston Half Marathon proved to me that when you put in the hard work day in and day out you can accomplish just about anything.

Q: What is your favorite distance and why?

A: Hands down my favorite race distance is the marathon; I love the amount of work and preparation that goes into training for 26.2 miles. Whatever your goal is, just finishing a marathon is always such a great accomplishment.

Support your favorite Superstar’s fundraising efforts by giving today.

 

Top 10 apps for pain management

Mobile apps can be used to help distract children dealing with pain. (iStock photo)

Mobile apps can be used to help distract children dealing with pain. (iStock photo)

Stefan Friedrichsdorf, MD

Stefan Friedrichsdorf, MD

Stefan Friedrichsdorf, MD

State-of-the-art pain management in the 21st century demands that pharmacological management must be combined with supportive and integrative (nonpharmacological) therapies to manage a child’s pain. At Children’s, we are using physical methods (e.g. cuddle/hug, massage, comfort positioning, heat, cold, TENS), cognitive behavioral techniques (e.g. guided imagery, hypnosis, abdominal breathing, distraction, biofeedback), as well as acupressure and aromatherapy.

For “needle pokes” (vaccinations, blood draws, etc.), for instance, we expect that kids are sitting upright (use sucrose in the age group birth to 12 months), so we numb their skin with topical anesthesia (e.g. EMLA-patch, LMX 4 percent lidocaine patch, or J-tip) and use distraction such as bubble blowing or blowing a pin wheel. Alternatives can be applications on your smartphone or tablet.

My personal favorite technique remains teaching children in self-hypnosis. However, in addition, I’m increasingly using apps on my iPhone or iPad with patients. Here are my top apps for pain and symptom management in kids:

10. Real ChalkBoard: Drawing on a realistic chalkboard with different-color chalk — much more fun than it sounds. ($1.99)

9. Talking Tom CatThis is a cat that repeats everything you say in a funny voice. You then can record and share videos and send them by email, YouTube and Facebook. Kids really enjoy that they can make Tom the cat say funny stuff. (free)

8. Simply Being – Guided Meditation for Relaxation and PresenceProvides relaxation, stress relief and benefits of meditation without prior experience. It allows the child/teenager to choose from four meditation times and gives them the option to listen to the guided meditation with or without music or nature sounds. Kids also can listen to the music or nature sounds alone; more for older children and teenagers. (99 cents)

7. Drums! – A studio-quality drum kit in your pocket As the name implies, this is a drum kit. Great for kids with too much (or too little) energy. Rock on! (99 cents)

subscribe_blog6. Tesla Toy: “Tesla Toy” is a fun, interactive “particle toy.” When the fingers touch the screen, they generate what looks like a powerful electrical field that makes the thousands of particles react beautifully. 
Kids (and adults) often are mesmerized by this app for a long time. ($ 1.99)

5. Fruit NinjaA “juicy” action game with squishy, splatty and satisfying fruit carnage! (99 cents) 

4. Koi PondOne is gazing into a pond of crystal-clear water with fish, turtles and more. Kids run their fingers across the cool surface of the pond and water ripples away from their touch.
The koi fish, disturbed, dart away… only to quickly forget and swim close once more. (99 cents)

3. Easy-Bake Treats!This is a highly recommended app; it let’s children make, bake, decorate, eat and share virtual cakes, cupcakes, cookies, cake pops and pizza. They pick their mix, fill the pan with batter and water, mix it all together and slide the pan into the virtual oven to cook. Then they can add candles to their cakes and cupcakes, too! Candles can be lit and re-lit for even more fun! 
Once they’ve baked and decorated their treats, kids can show off and share their delicious virtual creations with family and friends via email or Facebook. Highly addictive – kids can spend a long time on this app. (free)

2. The Healing Buddies Comfort Kit“The Healing Buddies Comfort Kit” offers an interactive, virtual way for kids and teens at home, in a doctor’s office or in the hospital to learn and immediately benefit from self-care techniques to manage common symptoms like pain, worries, nausea, fatigue and trouble sleeping. 
The app contains several integrative medicine techniques adapted for use by children and teens that are quick and effective for symptom control so kids can get back to doing what they like to do – and need to do each day. The techniques included in this app are designed by leaders in the field of pediatric integrative medicine (physicians, nurses, psychologists and child life specialists) and have been tested for years in several leading children’s hospitals and clinics. (99 cents)

Disclaimer:

The creation of the mobile app has been a collaborative effort of my department at Children’s Hospitals and Clinics of Minnesota with Ridgeview Medical Center and DesignWise Medical.

1. Balloonimals Absolutely groovy; kids love it! This is my favorite app to distract a child in pain or discomfort. Beautifully rendered balloon animals spring to life when you blow into the microphone on your iPhone/iPad or swipe with your iPod Touch. Watch the balloon inflate and then give your phone a shake to start constructing your balloon animal. With each shake, your animal takes greater shape until… voila! Your balloon animal appears and is ready to play. Pet your “balloonimal” to see what tricks it can do. ($1.99)

Apps, which didn’t make the list but I still like a lot: “Art of Glow,” “Sand Garden,” “Build a Zoo,” “Naturespace,” “SkyView” and “Disney’s Small World”

Stefan Friedrichsdorf, MD, is medical director of the Kiran Stordalen and Horst Rechelbacher Pediatric Pain, Palliative and Integrative Medicine Clinic at Children’s – Minneapolis. This post originally appeared at NoNeedlessPain.org. Download the Children’s Hospitals and Clinics of Minnesota app.

Ensuring kids get enough exercise in every season

Games like hide and seek, building forts and even cleaning the house can get kids active and exercising. (iStock photo)

Games like hide and seek, building forts and even cleaning the house can get kids active and exercising. (iStock photo)

Samara Postuma

We all know that kids need exercise, but how much exercise should kids be getting? And how do we ensure they’re getting enough when those too-cold- (or too hot) to-play-outside days come around? Julie Boman, MD, a Children’s pediatrician, has some tips and ideas to share on making sure kids are getting the full 60 minutes a day of the exercise they need.

It’s important to note that while all kids need 60 minutes of exercise, the way that looks for your preschooler and the way that looks for your middle-schooler might be different.

“Younger kids need frequent bursts of activity versus an hour of activity straight, where an older child can get their exercise by being active for an hour,” said Dr. Boman.

So what about those days — those miserably cold days — where it’s deemed unsafe for kids to play outside? Or, as we dream of warmer days, those hot summer days where the heat index is so high it’s dangerously hot for kids to be outside?

subscribe_blogWell, according to Dr. Boman, it’s time to get creative.

Some of the more obvious options to get your kids active would be indoor parks, community centers, YMCAs and parks and recreation centers, most of which will offer special extended hours on the days that outside play might be limited.

“Younger kids just need a space to run,” Dr. Boman said, noting that this is when an unfinished basement can come in handy.

You don’t have to get too crazy to get kids active, though — games like hide and seek, building forts and even cleaning the house can get kids active and exercising.

The only time you’ll hear Dr. Boman suggest video games is when it comes to moving your body versus your thumbs, and there are plenty of games out there that do just that.

“Dancing games on the (Nintendo) Wii (or Wii U) are a good workout, even for adults,” she said.

Another more creative way to get kids active is by looking for active apps or videos such as the IronKids App, which was developed by the American Academy of Pediatrics and is available for iPhone or iPad for $3.99. The app has several different workouts for cardio and core, and kids can follow the app for five-minute bursts of circuit training and weightlifting using household items.

Don’t have a smartphone or tablet? No problem. A simple YouTube search will bring you thousands of workout videos for kids and adults.

“It’s all about exploring ways to keep kids interested,” Dr. Boman said.

What are your tried-and-true ways to keep kids active and exercising all year round?

For more information about Children’s childhood obesity efforts, contact Anna Youngerman at [email protected].

Read Samara Postuma’s blog Simplicity in the Suburbs, and follow her on Twitter.