Category Archives: Health Tips

Influenza is now widespread in Minnesota. Here’s what you need to know.

By Patsy Stinchfield, MS, CPNP

Patsy is a pediatric nurse practitioner in infectious disease and the director of infection prevention and The Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota.

Update

Influenza is now “widespread” in 35 states, including Minnesota.

There is still time to get vaccinated if you and your family have not yet done so.

To learn more about how Children’s is helping prevent the spread of influenza in the community, click on over to www.childrensMN.org/flu.

This post originally appeared on the Mighty Blog on Jan. 2.

As of Jan. 2, 2014, the Minnesota Department of Health has declared influenza “widespread” across the state, the highest designation level. Over the past two weeks, influenza cases at Children’s have more than doubled, however they still remain below where they were at this time last year. Now that influenza has arrived, it’s likely that it will remain in full swing in Minnesota for the next two months.

So what can you do? The No. 1 way to prevent the flu is to get vaccinated. And it’s not too late. Anyone 6 months of age and older who has not received their flu vaccine should do so now. Most clinics and pharmacies are still vaccinating and have a good supply of vaccine. The most common influenza strain we’re seeing is the H1N1 strain which is contained in this year’s vaccine. In addition to getting the vaccine, we also recommend frequent hand washing and avoiding touching your eyes, nose or mouth prior to washing your hands to help prevent the spread of illness.

If the flu has already reached your house, here are few helpful tips for caring for your child while they’re ill.

What’s the difference between the cold and the flu and how can I tell?

Sometimes it’s hard to know whether a child has a cold or the flu because she may cough, have a runny nose, sore throat and fatigue with both. However with the flu, a child tends to have a high fever which comes on more suddenly and may include severe fatigue and body aches. Colds tend to come on more gradually, and many kids may feel well enough to keep playing and going to school with a cold. Clinics may use a rapid nose swab test to determine if someone has influenza.

What should I do if I suspect influenza?

Most cases of influenza are mild and can be managed at home with rest, plenty of fluids, and fever-reducing medicines. Tender-loving care is good medicine, too. Most over-the-counter “cough and cold” medicines do not help a sick child get better faster and won’t have much effect on influenza. Sometimes, the flu can make a child very ill and a visit to the clinic or emergency room is necessary.

When should I take my child to the emergency department?

Take your child to be checked if they have difficulty breathing (fast, grunt-sounding, noisy breathing or small breaths), if their color looks bad (pale or bluish), if they aren’t drinking fluids often or urinating at least once every eight hours, or if they just aren’t themselves and you’re worried. Signs of dehydration are dry lips, sunken eyes, sleepiness or crankiness. Children who seem like they’re getting better and then suddenly get worse should be taken to the Emergency Department immediately. This could mean they have another infection such as pneumonia in addition to the flu.

What are the best ways to get my child’s fever down when she has the flu?

Fever is one of the tools our immune system uses to kill germs. However, children with high fever can feel quite miserable, get crabby, have trouble waking up and may drink less fluids causing dehydration. If you can’t keep the fever down with a fever-reducing medicine such as Tylenol or ibuprofen, then the child should be taken to the clinic or emergency department.

Is there anything else I can do to help make my child more comfortable?

You can keep your child home from day care, school, sports or other activities and have them rest early in their illness until they show signs of getting back to “their normal.” If your child doesn’t want to eat regular meals, don’t insist, but do make sure they drink small amounts of fluids every hour to prevent dehydration.

Is there anything I can do to help my child recover more quickly?

There is an anti-viral medicine called Tamiflu that can be given to children as young as 2 weeks of age. This is used if the child is hospitalized with moderate or severe influenza or if the child is outpatient but at higher risk for complications from influenza. These would be children with immune system problems or neurological, pulmonary, or metabolic underlying conditions. Tamiflu works best if given in the first two days of illness which can cut the severity and number of days of illness in half.

How long will my child be contagious?

Influenza is most contagious the day before symptoms present through about day four of illness. Your child should stay home from school during this time. After viral illnesses, kids can have lingering muscle or body aches and really do need time to rest and recover before rushing back to school. They can often pick up other viruses easily and may have a lingering cough as their airway heals. Depending on the severity of the flu, this may be a few days to a few weeks. Most kids recover within a week. Remember that many schools require that your child be fever-free (without the help of medicines) for one to two days before returning to school or day care.

Can Christmas trees cause an allergic reaction?

Dr. Molly Martyn

By Molly Martyn, MD

While the sight and smell of a live Christmas tree is part of the holiday season for many, trees can also trigger allergies.  Common symptoms include sneezing, sniffling, itchy nose and eyes, and dry cough.

Pine, fir, and spruce allergies are relatively uncommon, but do exist.  More frequently, people react to the dust and mold that live Christmas trees carry.

For children with pine/fir or mold allergies, a live indoor Christmas tree is not a good option.  Instead, families may choose to decorate an outdoor tree or to buy an artificial Christmas tree.

Artificial trees should be wiped down with a damp cloth prior to use as they can accumulate dust and mold during storage.  If your family decorates a live tree, give it a good shake outdoors prior to bringing it into your home to help dislodge dust and mold spores (some tree lots will do this for you).  In drier climates, trees can be hosed down and allowed to dry prior to bringing them indoors, something harder to do in cold, snowy Minnesota.

If you are concerned that your child is experiencing allergy symptoms related to a Christmas tree, talk to their primary care provider. They can help discuss next steps in diagnosis and management.

For more information about winter and holiday-related allergies, the American Academy of Asthma, Allergy, and Immunology is a great resource.

Traveling with kids during the holidays

Dr. Molly Martyn

By Molly Martyn, MD

With the holiday season coming, many families are making plans to travel to see family and friends.  Airline travel with infants and young children can be both joyful and stressful.  Travel is often unpredictable, but advance preparation can go a long way when it comes to traveling as a family.

The Travel Security Administration (TSA) and Federal Aviation Administration (FAA) both have tips on their websites for safe airline travel with children.  Below are some ideas and information to help your trip go more smoothly.

PLANNING AND PACKING

1.  Many families find it helpful to use a checklist for packing, something you can use for the next time you travel.  Keep a pencil and piece of paper nearby while you go through your daily routine with your child and make notes of things that you will need to remember to pack.  In general, the less gear you have to tote around the better, but having an extra pacifier or a favorite comfort object with you will help make life easier for everyone.

2.  For older children, talk with them in the week prior to your trip about what they can expect at the airport and the new things they will get to explore and experience with a trip to the airport, an airplane ride, and at their destination.

3.   Check with your airline ahead of time regarding checking car seats and strollers.  If you bring a car seat or booster seat, they can often be checked as an extra piece of luggage without additional fees.  Most airlines will allow you to check a stroller at the gate, which is helpful because it means you can use your stroller to go through security and navigate the airport.

4.  Pack more food in your carry-on bag than you think you will need in case your travel is delayed or you find yourself waiting on a runway.  If you are traveling with an infant who drinks formula, bring extra.  If you are traveling with young children, pack plenty of nutritious, filling, familiar snacks that do not need to be refrigerated.

5.  Baby formula, breast milk, and jarred baby foods are allowed through security, but must be presented to a TSA officer.  Pack them separately from your other liquids or aerosols.  You can read more on the TSA website.

6.  Bundle diapers, wipes, a changing mat, and a few plastic bags together so that they are easy to access for diaper changes.  Pack extra clothes in your carry-on.  Footed pajamas are a good option because it is only one item of clothing to change in case of an accident, spit-up, etc.

SAFETY TIPS

1.  Children less than 2 years of age can legally travel in a parent or guardian’s lap, which is what most families opt for given the cost savings.  The American Academy of Pediatrics recommends that children travel in their own airplane seat, restrained in a car seat appropriate for their size and age.  A car seat that can be used in an airplane will carry a label stating that it is certified for use in both motor vehicles and airplanes.  Once children are 40 pounds, they can use the aircraft seatbelt.  Unlike in cars, booster seats are not routinely used for airline travel.

You can find out more information on the FAA’s website.

2.  Babies and small children can be carried through TSA screening (strollers and car seats have to go through the XRay machine).  TSA should not ask travelers to do anything that will separate them from their children.

3.  Have a plan with older children about what they would do in case you get separated while traveling (a place to meet, who they can safely ask for help, etc).

IN THE AIR

1.  Changes in altitude during take-off and landing can cause uncomfortable pressure and fullness in ears.  You can help keep infants comfortable by having them nurse or suck on a bottle (this mimics what older children and adults learn to do to “pop” their ears by yawning or chewing on gum).

2.  To occupy older children, pack a bag of “special treats” such as books/crayons/games to be used on the plane.

3.  Look forward to a safe arrival at your final destination!

Good luck and travel safely.  If you want to read more, here are some good sites and additional tips:

1.  TSA Policies: http://www.tsa.gov/traveler-information/traveling-children

2.  FAA Car Seat and Safe Travel Information:http://www.faa.gov/passengers/fly_children/crs/

3.  American Academy of Pediatrics Travel Tips:http://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/pages/Travel-Safety-Tips.aspx

Beat the flu, get vaccinated

By Patsy Stinchfield, MS, CPNP

Patsy is a pediatric nurse practitioner and the director of infection prevention and The Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota.

Last year, we learned that influenza is a complex, tricky virus that is nearly impossible to predict. It ended up being the widest season on record (earliest start and latest end).

We know that of the 174 kids who died from influenza last year, 90 percent of them had not been vaccinated. We know that pregnant women are more prone to influenza complications and are a high priority for getting vaccinated, but only half of pregnant women are actually protected.

The flu vaccination isn’t perfect, but it’s still our best defense against what can be a very serious infection at any age. It reduces your chance of getting sick. But, if you do become sick, it helps reduce the severity.

If not for yourself, vaccinate on behalf of babies who are too young to receive the vaccine (under 6 months of age), women and those with immunity problems or who are undergoing cancer treatment. When you get vaccinated, you protect yourselves and others.

My colleague recently told me that when her mom was undergoing cancer treatment, she got influenza and died from the infection. My colleague and her entire family were vaccinated that year before flu season and will never miss a chance to protect themselves against the disease that took their loved one.

 

Dr. Friedrichsdorf’s top 10 apps for pain management

By Stefan Friedrichsdorf, MD

State-of-the-art pain management in the 21st century demands that pharmacological management must be combined with supportive and integrative (non-pharmacological) 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 0-12 months), that we numb their skin with topical anesthesia (e.g. EMLA-patch, LMX 4% lidocaine patch, or J-tip) and use distraction, such as bubble blowing or blowing a pin wheel. Alternatives can be apps on your smartphone etc.

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 Chalkboard: Drawing on a realistic chalkboard with different color chalk – much more fun than it sounds. [$ 1.99]

 #9 Talking TomThis is a cat that repeats everything you say in a funny voice. You can then record and share videos and send them by eMail / YouTube / Facebook. Kids really enjoy that they can make Tom the cat say funny stuff… [free]

# 8 Simply BeingProvides relaxation, stress relief and benefits of meditation without prior experience. It allows the child/teenager to choose from 4 meditation times and gives them the option to listen to the guided meditation with or without music or nature sounds. Kids can also listen to the music or nature sounds alone. More for older children and teenagers. [$ 0.99]

 #7 Drums As the name implies, this is a drum kit. Great for kids with too much [or too little] energy. Rock on! [$ 0.99]

# 6 Tesla ToyTesla 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 (& adults) are often mesmerized by this app for a long time. [$ 1.99]

#5 Fruit NinjaA “juicy” action game with squishy, splatty and satisfying fruit carnage! [$ 0.99] 

 #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… [$ 0.99] 

#3 Easy Bake TreatsThis 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 very long time on this! [free]

#2 The Healing Buddies Comfort Kit™ app provides an interactive, virtual way for kids and teens to engage with the latest in integrative medicine techniques and activities to assist in the management of symptoms they may be experiencing. 
Kids and families are increasingly interested in options to improve health and wellness that involve taking fewer pills and that involve supporting their body’s natural, internal healing systems. -combining kid-friendly activities and pre-recorded audio exercises and instructions that teach self-care skills. The Healing Buddies Comfort Kit™ (mobile app for iPad, iPhone and iPod Touch platforms) 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 Healing Buddies Comfort Kit™ 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 mobile 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. The app leads kids through these various techniques and activities, plus, the Healing Buddies™ make it a fun and engaging experience.

Techniques that kids will learn that are included in the Healing Buddies Comfort Kit™ include:

-Mental Imagery/Visualization: in this technique kids/teens will learn to use the power of their imagination to effect changes in physical and emotional activity.

-Relaxation Exercises: with these breathing and muscle control techniques, kids/teens will learn to calm down and balance the body and the nervous system which helps to reduce symptoms of pain and nausea, improves sleep and can have a powerful effect on controlling & even eliminating worries

-Acupressure: acupressure is part of the ancient Chinese medical system and involves applying pressure to “special points” on the body which in turn releases helpful chemicals and induces nervous system changes that can help to reduce pain, nausea, and anxiety

-Aromatherapy: aromatherapy, which involves smelling oils made from plants, has been around in most cultures for thousands of years. Smelling certain kinds of scented oils offers another tool for kids/teens to use to control unwanted symptoms/feelings

-Positive Self-Talk: this involves learning to be a “self-coach” and harnesses the power of positive thinking. [Disclaimer:

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

and the winner is…

#1 Balloonimals Absolutely groovy – kids love it! 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.

Apps, which just did not make the list (but I still like them a lot): Art of Glow, Sand Garden, Build a Zoo, Naturespace, SkyView and Disney’s Small World

This post originally appeared here. You can also download Children’s app.

Preparing for school when your child has a food allergy

Missy Berggren’s preparation for her daughter’s upcoming entry into kindergarten started long before school supplies hit the shelves at Target.

Her daughter, 5, has severe food allergies to eggs, milk, peanuts, tree nuts and shellfish. Exposure can be deadly. So, Berggren, a parent advocate and board member of the Food Allergy Support Group of Minnesota, set out to safeguard her daughter beginning with researching school policies and practices before deciding on a school, and, then, partnering with the school administration and teacher.

“My goal is to empower my daughter to live as normal of a life as possible, with some extra planning to make sure she is safe and feels included. We always plan ahead to avoid a food allergy reaction but also need to be prepared if something happens,” Berggren said.

Berggren was most attracted to a school that does not use food in the curriculum and where there are wellness policies in place that limit or don’t allow treats on birthdays and holidays. Most schools in Minnesota still allow that, Berggren said. Her daughter will eat lunches packed at home at a peanut-free table, and will be reminded never to share food with other children.  

Berggren is working with the Kindergarten teacher to make sure classroom snacks are safe for her daughter. She also shared books from her personal library, such as the “Alexander the Elephant” series about food allergies, which the teacher plans to read to the class.

Her daughter recently spent four days at the school’s KinderKamp preparing for kindergarten. When Berggren dropped her off, she reviewed the allergy action plan and emergency medicines with the teacher. All the students washed their hands with soap and water when entering the classroom.

Before school begins in the fall, the family met with an allergist to review the child’s medical condition and to have the appropriate paperwork filled out for school. A special school meeting is planned with the principal, school nurse, teacher and other key staff to talk in detail about the child’s food allergies, how to spot and treat a reaction, and how to make sure she feels  physically and emotionally safe.

While food allergies are becoming more common — one in 13 kids has one, which equals about two kids per classroom – there is still the danger of being picked on or teased.

When other kids ask her about eating different food, she often says, matter-of-factly, that she has food allergies and needs her own food, Berggren said.

“In her mind, she’s a normal kid and she doesn’t want the emphasis to be on her food allergies and neither do I,” Berggren said. “I work really hard to make sure she feels included and that at this age, 5, she doesn’t feel treated differently.”

Here are some tips on how to navigate school with food allergies. Here are more age-specific tools to teach kids about food allergies. Here are suggestions on how to navigate the holidays with food allergies.

This post also appeared in the Star Tribune‘s kids’ health section.

Reminders to prevent flu at the Minnesota State Fair

With the Minnesota State Fair in full swing, we gathered information from the Minnesota Department Health to share reminders with fair-goers about preventing swine flu. Pigs are commonly infected with swine influenza (variant flu) viruses that are usually different from human influenza viruses. While rare, the flu can still spread from pigs to people and vice versa.

What you should know:

• Swine influenza viruses do not normally infect humans. However, sporadic human infections with influenza viruses that normally circulate in swine and not people have occurred. When this happens, these viruses are called “variant viruses.” Variant viruses are very different from human seasonal influenza viruses. Examples include H3N2v and H1N2v.

• Most commonly, human infections with H3N2v and H1N2v occur in people with direct or indirect exposure to infected pigs.

• H3N2v and H1N2v are not transmissible by eating properly handled and prepared pork (pig meat) or other products derived from pigs.

How to prevent it:

• Never eat, drink or put things in your mouth in animal areas. Don’t take food or drink into animal areas. Never take toys, pacifiers, spill-proof cups, baby bottles, strollers or similar items into animal areas. Avoid touching your eyes, nose or mouth.

• Persons at high risk for influenza complications should avoid swine exposure. Persons at high risk include: children younger than 5 years, people 65 years or older, pregnant women, and people with certain  chronic medical conditions (such asthma, diabetes, heart disease, weakened immune systems, and neurological or neurodevelopmental conditions).

• Avoid close contact with pigs that look or act ill.

• Wash your hands frequently with soap and running water before and after exposure to animals. If soap and water are not available, use an alcohol-based hand rub. Always wash hands thoroughly after contact with farm animals, pets, animal feces, and animal environments.

Mosquitoes, ticks, and bees…oh my! Learn how to prevent and treat bites and stings

By Erin Dobie, CNP

Minnesota summers bring warm weather and opportunities for our kids to go outside exploring and playing in nature. Pesky insects often irritate or interrupt summer fun.  Learn how to prevent insect bites, treat bites when they do occur, remove ticks, and how to know when you should seek medical attention for your child.

How to treat bites

Insect bites and bee stings react because of venom injected into the skin. The severity of reaction depends on your child’s sensitivity to the venom. Most reactions are mild causing redness, local swelling, and irritation or itching. These will usually go away in two to three days. Calamine lotion or any anti-itch gel or cream may help soothe the itching.

Bee stings cause immediate pain and a red bump, but usually the discomfort lessens within 15 minutes. More than 10 bee stings at once (very rare) may cause a more severe reaction with vomiting, diarrhea and headache. Allergic reactions to bee stings can be severe and quickly get worse. These reactions include difficulty breathing, swelling of the lips, tongue or throat, or confusion. Children who have a severe reaction need immediate medical attention, and you should call 911. If the child has a known bee allergy and an Epi-pen is available, the Epi-pen should be administered in addition to calling 911. If a stinger is present, try to rub it off with something flat such as the edge of a credit card. Do not try to squeeze the stinger out or try to dig it out. If it does not come out easily, soak the area in water and leave it alone to come out on its own.

Tick bites don’t often cause much of a local reaction. They’re primarily concerning because they can transmit infectious diseases. Ticks are very prevalent in Minnesota. They’re generally found on the ground in wooded or heavily bushy areas. Ticks can’t jump or fly. Generally they climb grass and climb onto someone to attach as we brush up against them. Ticks are most active during the spring and summer months.

There are a few different infectious diseases that can be transmitted by ticks, but the most common one found in the Minnesota-Wisconsin area is Lyme’s Disease (Borrelia borgdorferi). To infect a person, a tick typically must be attached to the skin for at least 36 hours. The incubation period, the time from infection to being symptomatic, is anytime between three and 30 days.

Lyme’s Disease can present in many different stages. Early localized stage often includes a red ring-like rash (or may resemble a “bull’s eye” target) that slowly expands bigger. Other symptoms include headache, fever, joint or muscle aches, and overall not feeling well or excessively tired. If your child develops these symptoms within a few days to weeks after tick exposure you should seek medical attention to evaluate for Lyme’s Disease. Lyme’s Disease is evaluated by medical history, physical examination, and sometimes a blood test. It may take the body several weeks to develop antibodies and the blood test may not show up positive early in the disease. Most cases of Lyme’s Disease are easily and successfully treated with a few weeks of antibiotics.

How to prevent a bite

Prevention is the key to avoiding insect bites. I recommend insect repellent that contains at least 20 percent DEET. The higher concentration of DEET does not indicate better repellent; it just means that the repellant will last longer. Most repellents can be used on infants and children greater than 2 months of age. Other effective repellants contain permethrin, picaridin, oil of lemon eucalyptus, and IR3535.  Permethrin-treated clothing is also an option if the child will be camping or on wooded hikes. Finally, showering or bathing soon after exposure to tick areas is important to check for and remove ticks. Parents should pay close attention and check children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair on their scalp! Dogs should be treated for ticks, but also checked as the ticks can ride into the home on the dogs then attach to a person later.

How to remove a tick

If you find a tick attached to your child’s skin, there is no need to panic!

  1. Use a fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure. Do not twist or jerk the tick, as this can often cause the tick’s mouth to break off and remain in the skin. If the mouth does break off: try to remove it, but if it cannot be removed easily do not dig it out, just wash and allow it to fall out on its own.
  3. After removing the tick, clean the skin with soap and water or rubbing alcohol.

Why you should protect your son or daughter against HPV

By Patsy Stinchfield, MS, CPNP

Patsy is a pediatric nurse practitioner and the director of infectious disease/immunology and infection prevention at Children’s Hospitals and Clinics of Minnesota.

The Centers for Disease Control and Prevention released a new report indicating that only about half of adolescent girls – and far fewer boys – received the first dose of the recommended HPV vaccine and only about a third  have completed the three-dose series.

As a parent and a practicing clinician, the fact that many of our children are missing an opportunity to get protected against HPV, short for the human papillomavirus (a common sexually transmitted disease) and related cancers concerns me. Since the introduction of the HPV vaccine, the number of HPV cases which leads to cervical cancer cases has been cut in half. In half. That’s monumental. We know this vaccine works, and we need to use it to the fullest extent possible.

The vaccine is safe, as well.  In the more than 56 million doses given thus far, no serious safety events have occurred.  The most commonly reported event is fainting, which happens with other vaccines given to teens, as well, leading to our usual practice of having teens sit for 15 minutes after vaccination.

HPV infects about 79 million Americans, 14 million of whom become infected each year. About 21,000 women are affected by cancer linked with HPV, and cervical cancer is the most common. More than 4,000 women, usually in child –bearing years, die of cervical cancer. It’s also associated with other cancers, such as those that affect the throat, tongue and tonsils, in men.  But, the infection that causes these cancers can be prevented with the vaccine series. What parent wouldn’t want his or her child to be protected against cancer?

The HPV vaccines are given as a series of three shots over six months to protect against HPV infection and the health problems the infection can cause, according to the CDC. Two (Cervarix and Gardasil) protect against cervical cancers in women. One (Gardasil) also protects against genital warts and cancers of the anus, vagina and vulva. Both vaccines are available for girls. Only Gardasil is available for boys.

I recommend to families that children – both boys and girls – get the vaccine well before they’re sexually active to offer the best protection. Typically, we suggest 11 or 12.  And, the full series – all three shots – need to be taken in order to be truly effective.

According to a recent blog post from CNN about the study:

“We don’t wait for exposure to occur before we vaccinate with any other routinely recommended vaccine,” CDC Director Dr. Thomas Frieden has said in the past.

I sometimes hear from parents that they’re worried their son or daughter will be encouraged to have sexual relations because they’ve been vaccinated. While I understand their concern, there is no link between getting vaccinated and increased sexual activity.

Unfortunately, I’ve seen first-hand the devastation that vaccine-preventable diseases cause in children who haven’t been immunized. Let’s work together to take HPV-associated cancers off that list. It’s the right thing to do.

Five Question Friday: Michael Scribner-O’Pray

Meet Michael Scribner-O’Pray, an RN in the Emergency Department at Children’s Hospitals and Clinics of Minnesota.

Michael Scribner O'Pray and his daughter, Grace

How long have you worked at Children’s? I started working at Children’s as an Emergency Medical Technician in the Emergency Department in 1998 while I was going to nursing school.  After graduating in 2000, I worked as a nurse on the float team for a year before coming back home to the Emergency Department in 2001.

What drew you to pediatrics? When our daughter, Grace, was admitted to Children’s as a toddler, I experienced, first-hand, what a difference great nursing care can make for a family. We were frightened by how sick our daughter had become and struggled to make sense of the storm of new information and emotions swirling around us in the Emergency Department.

Thankfully, the care providers we encountered (most memorably, Marie Koldberg, RN) were calm, confident and remarkably skilled.  They not only engaged our daughter directly, as the patient, they treated us, her parents, as the principal members of Grace’s health care team. During our four-day stay at Children’s, I realized that great nursing requires its practitioners to engage their entire selves – emotionally, intellectually, physically and spiritually.

What do you enjoy most about working in the Emergency Department? What could be better than getting paid to meet remarkable families every day and help alleviate suffering?

We have opportunities every day to build bridges with people from vastly different life experiences from our own. What a joy it is to see the look of surprise on people’s faces when they are greeted and asked genuinely about how they are feeling in their family’s own language! (Collectively, our staff can do this in at least 15 different languages: Amharic, Arabic, Cantonese, French, Haitian Creole, Hebrew, Italian, Mandarin, Ojibwe, Oromo, Polish, Russian, Somali, Spanish and Vietnamese)

Kids and their parents often arrive in the Emergency Department hurt and scared, and we get to play a role in helping them find relief. Sometimes our interventions are as simple as offering a kind word or warm blanket, and sometimes what we do is as complex and carefully rehearsed as a major theater production.  Although we encounter plenty to go home and cry about, more often than not, we also get to witness the transformation of pain and fear into relief and joy, of suspicion and anger into trust and understanding, of grief and powerlessness into hope and constructive action.

Do you have a favorite memory from working at Children’s? For more than a decade now, Mindy Teele, a a child life specialist in the department, has been encouraging us to find creative ways to make frightening procedures like laceration repairs and IV starts more child-friendly.

Many of my favorite memories are of times that we’ve succeeded in surpassing everyone’s expectations:  the 2-year-old with a 3-inch gash in her forehead who sat happily in her mother’s lap playing playdough and coloring with her dad while we put 30 stitches in her forehead…. the 1-year-old whose mother sang her to sleep in her arms while we closed a cut right next to her eye….  the 4-year-old boy who “never sits still” who sat up by himself in bed playing with water toys while we stitched up the back of his head…. all the times each week that kids (and parents) have left our Emergency Department feeling stronger, happier and more capable than they did when they arrived — these are my favorite memories.

How do you spend your time outside of work? My schedule working weekends in the Emergency Department allows me to do some extra things during the week including driving our teenagers around town, helping to provide in-home care for my mother-in-law who has Alzheimers, and volunteering one day each week as a farm hand on a small family dairy farm near Red Wing, Minn.

I also enjoy growing food, building and fixing things, canoeing, and learning primitive skills such as basketry and weaving, birchbark canoe building, hide tanning, bow building, and foraging for wild edibles.