New OHSAA Pre-participation Sports Form

     The Ohio High School Athletic Association has a new Pre-Participation Physical Evaluation form that for the 2012-2013 school year, it will be the preferred form. We will soon have it up on our website here. It is also available at the OHSAA website here. We have copies in the office also if your child is here for a checkup and needs the form completed. By the way: it is six pages long now.

Butterbur for migraine prevention

     I am a long-term migraine sufferer and can empathize with my patients that have migraines. I have been on a number of treatment and preventative medications and know that it can be difficult to deal with migraines. It has taken me a long time to figure out my triggers (journaling about my headaches helped).
     I am open minded about recommending different preventative measures if they have been scientifically tested. One herbal supplement that has been scientifically tested is butterbur. A purified form without PAs (pyrrolizidine alkaloids) and 8mg total petasin called Petadolex(r) is the one I would recommend over alternatives. Side effects are considered minimal and include belching, itchy eyes, diarrhea, and headache(!). Butterbur should not be taken by those with ragweed allergy or a history of liver problems.
     For migraine prevention, the starting dose is 50mg capsule twice a day. The dose can be increased to 75mg twice a day if needed. One average, there were less headaches and less severe headaches, a decrease by about half. It has studied in children down to 6 years of age with success.
     If your child has migraine headaches, discuss with your pediatrician whether this may be something to try.

The choking game

     A recent study published in Pediatrics April 2012 issue showed that 6% (one in 16) 8th graders had played "the choking game". This involves applying pressure to the neck to limit oxygen and blood flow in the hopes of experiencing a "high" or "rush" feeling once the pressure is released and blood and oxygen rush back to the brain. Scary! In 18 years of practice, I have had only a few pre-teens or teens where this came up, but I am shocked how high the percentage is in this study of kids in Oregon.
     I suspect kids would deny it or say they had not done it very often, but 1 out of 4 of these Oregon kids said they had done it more than 5 times. Some of these kids may briefly lose consciousness and faint. It is possible someone would become injured with this -- hitting their head, getting a cut or laceration, and possible other injuries. The numbers of boys and girls involved with the "choking game" was the same in this study. These 6% of the 8th graders were also more likely to be involved with sexual activity, drug abuse, poor nutrition, and gambling.
     If you hear your children speak about this, see odd bumps or scrapes on the head or face, or see unusual marks or bruises on the neck, ask your child about it. If you are suspicious but your child will not further discuss it you, contact your pediatrician's office to further discuss it.
     A good website for more information and support is Games Adolescents Shouldn't Play (GASP).

Movie and video game ratings

     Every parent struggles with picking or approving of movies and video games for their children. This can be difficult. I personally have had struggles with this issue with my three children. Each family will have their own comfort level with different material. Many times, one scene in a movie or some occasional inappropriate language will tip the balance towards "not right for my child". I think one of things that make a good parent is being able to say "no" to your child when they want to watch or play something when you do not approve of it. Many adults can recall having nightmares from a frightening scene in a movie. Children are especially vulnerable to nightmares from frightening scenes. Exposure to violence, sexuality, and inappropriate language at a young age can make them more accepting of it -- not a good thing at a young age. Children do NOT need to grow up too quick.
     The Entertainment Software Rating Board at www.esrb.org provides the information on the package of video games but many parents will tell you it is inadequate in helping you decide if it is right for your child and family. There are two good websites that can give you more information so that you can make a more informed decision. One of them is Kids In Mind. This site thoroughly covers many parts of the movie and gives you more information to make an informed choice. The other site is Common Sense Media, which gives information about both games and movies.
     Stay involved in your children's choices about television programs, movies, and games. I hope these websites help you make informed decisions.

Poisonous plant rashes

     Our poison ivy season seems to be shaping up to be a bad one!  The combination of the warmer weather and damp late winter and early spring seem to have turned the outdoors green very quickly. This has apparently helped the poison ivy grow and we have seen quite a few cases in the office.
     The best treatment with any poisonous plant rash is PREVENTION. It can be helpful to Google search images of "poison ivy" if your child is prone to the rash to help try and avoid the plant. If you think you did get exposed, take a warm soapy shower or bath as soon as you can to wash the oil from the plant off your skin.
     A couple points: 1. You CANNOT tell which of the poisonous plants that caused the rash by looking at the rash -- they all cause the same rashy issues. 2. There is a lot of poison ivy (80% of the rashes we see) and poison oak (about 15% of the rashes we see) in Ohio, but almost no poison sumac -- that is a more Southern plant.
     Please see our website handout about treatment and prevention here.

Websites that are good resources for parents.

     There is so much information on the internet that it can be intimidating to try and figure out what information to trust. I will list some websites that consistently are good, reliable resources of information.
     The American Academy of Pediatrics, the major national organization of pediatricians, has a wonderful website called Healthy Children. It is a wonderful resource for many topics. I would rate it the top, reliable website for information on children's health.
     Another helpful website is Kids Health. It is run by a large nonprofit organization: Nemours. They cover many topics and has excellent information.
     If you are looking for information about a specific illness or about specific information about health risks in a specific country, the Centers for Disease Control and Prevention website is very helpful. Their information is top notch.
     One of top children's hospital in North America is Toronto's The Hospital for Sick Children. Their website at this link is comprehensive and helpful.
     Our local hospital, Nationwide Children's Hospital, has a very nice website that has some good information.
     I hope these are helpful!