Newsymails sent out in 2015
Children can have symptoms of stinging when they urinate. It is called
Dysuria and can be a sign of infection. But 90% of the time it is just
irritation caused by soaps and/or poor hygiene. The kids become potty
trained and want to go to the restroom by themselves. Then they do not wipe
or wrong direction. You will go in there and they did not flush and there
is no paper in the toilet. The girls will have a little odor and periodic
chafing which will cause occasional stinging when they urinate. But the
next time they urinate it does not. That is not an infection. A urine
infection will cause all day long burning, frequency and accidents. There
can be some white cells in the urinalysis from irritation but the culture is
what will prove infection. Do not accept a urinalysis to diagnose urine
infections… request a culture. Also cleaning their private area too
vigorously with chemical wipes can cause irritation. Swimming a lot in the
summer and riding trikes or bikes with the sweat and friction can cause
irritation also. Past 2 years old I do not recommend baby soaps, fragrance
soaps, or any products that causes bubbles on the surface of the water.
They remove the protective mucous lining of their privates. Use Dove or
Oil of Olay unscented bar of soap. Put Vaseline or A&D ointment down there
if it becomes chafed and if it is getting irritated every week, then put a
thin coating of ointment down there after every bath. It will be several
years until they take better care of that area. Males can be irritated also
and especially if not circumcised. Plus it is hard to potty train them if
it hurts. There is no therapy for the symptom but the ointment or warm tub
bath. If it is all day symptoms then see the doctor.
I am sure you heard
about the outbreak of Measles from the Disney Theme park. Most cases were
unimmunized people. The vaccine does not work in 100% of people but if 90%
are immune then we do not see an outbreak of illness. There is a thing
called herd immunity.
Herd immunity theory
proposes that, in contagious diseases that are transmitted from individual
to individual, chains of infection are likely to be disrupted when large
numbers of a population are immune to the disease. The greater the
proportion of individuals who are resistant, the smaller the probability
that a susceptible individual will come into contact with an infectious
For most diseases if 85% are immune to a disease then there are no major
outbreaks of the illness.
chart below shows the number of cases of Measles over the last 13 years.
There was a huge increase last year. The Philippines is experiencing a
large, ongoing measles outbreak then and many of the cases in the U.S. in
2014 have been associated with cases brought in from the Philippines. In
2011, more than 30 countries in the WHO European Region reported an increase
in measles, and France was experiencing a large outbreak. Most of the cases
in America that year were brought in from France. The increase in cases in
2008 was the result of spread in communities with groups of unvaccinated
people. So those who do not vaccinate are risking their children and
endangering our infants below 1 yr old who have not had their MMR.
about “M” diseases…. What about Mono! Infectious Mononucleosis is more
frequent than you might think. We used to say it was strictly teenager
kissing disease (altho most are from sharing drinks). Our old fashioned
blood test was not very accurate and about 15-20 years ago we got a more
accurate one. By 5 yr old 50% of kids have had mono. It is very mild and
not diagnosed often. By 26 yr old, 90% have had it. Probably most of the
other 10% will get it later. So I will see a patient with a horrible throat
and start antibiotics. But I warn the mother it also could be mono and if
they are not well in 24-36 hours… it is viral and probably mono. There
aren’t any strep resistant to penicillin/amoxicillin. 5% of kids carry the
strep all year and they can have a viral sore throat with a positive throat
culture. The Strep was not the cause of the sore throat. So when not
better in 2 days the doctor changes the antibiotic thinking it is resistant
and starts a different antibiotic. The viral sore throat finally gets
better and everyone thinks it is a result of the new antibiotic.
preferences can change food preferences. A study showed bitterness in food
triggers an inborn aversion to certain foods that is responsible for dietary
choices in children and adults. Unpleasant taste such as bitter or sour
evolved to detect potentially lethal compounds such as plant metabolites or
toxins. Salty taste developed to ensure ion and water balance. Good taste
such as sweets and meats elicited by energetic compounds with carbohydrates
and proteins supplied more safe energy. Certain tastes are detected by the
four different taste buds on the tongue and receptors on the palate. Sweet
and bitter are recognized by protein receptors and Salty and sour are
detected by ion channels. Some people are hypersensitive to bitter or to
wide spectrum of flavors. They tend to have more restricted diets compared
to those with less sensitivity. These receptors also decrease as we get
older and we broaden our diets as we get older. Definitely children’s diet
is different than adults. Some kids like vegetables from birth and some
like sweets from birth. There is a debate whether one can get used to those
tastes that we naturally dislike. Many kids start out liking vegetables but
as they get to school age then prefer meat and potatoes. Can you give
vegetables starting at 6 months and keep giving it to the child every day so
they get used to that taste???? I don’t know. But definitely there are
people who have their preferred tastes and it changes with age. See my
article on Picky Eaters at the web site.
difference between broccoli and buggers? Kids will eat their buggers.
Parents come in and complain that their child is stubborn, shy, not speak to
strangers, or has a temper. Every child has a different personality from
birth. Look at your own brothers or sisters… totally different even though
same parents and family. And sister or brother who was stubborn as a child,
still is! We as parents modify them but not change their inborn
temperament. The shy child will eventually come out from behind mother’s
skirts and be more active. They will do it at their own pace. You have not
changed your wife or husband. You look for a person to marry who has the
personality you like. But when you have a child, God gave you that child
with that personality. So it is important as parents to accept what God
gave you and not be so bent on changing them. They will get better as they
get older and with your guidance and wise advice, they will be less stubborn
and make great adults as we did. But you will not make a pessimist into an
optimist. I know there will be those of you who do not agree but think
about it. By the way, this concept is true of pets like cats and dogs.
Roger Knapp MD
You know, the advice of my parents come back to be every week. They died
many years go but their sage comments are in me and still guide me. So the
comments and wise advice you give your kids is in there but you will not see
it for 20 years. So keep telling them your sage advice even though you
swear they don’t listen to you.
Most girls get their first period (menarche) between the ages of 10 and 15,
but some get it earlier and some later. If not by 16 yr it still may be fine
but see your doctor. Premature puberty and you need to see your doctor if
they start before 7 in girls and 9 in boys. No it is not the hormones in
food or milk. It has been getting younger over the last 2-3 hundred years.
I like the American Girl Book on puberty for girls. They will have full
development, growth, and then the cycles start. Then they will grow only
2-3 inches more. Boys can keep growing and even into college years ….
Because they never mature. At least I don’t plan on growing up! LOL
The number of days of a cycle is a 28-day cycle it varies from 24 to 34. It
frequently is variable or even skipping months for the first year and a
While irregular periods are common among teenage girls, an underlying
hormonal disorder may be to blame if this problem persists. Polycystic
Ovarian Syndrome (PCOS) is an endocrine disorder that is characterized by an
excess of androgens or male hormones in the body. The imbalance of hormones
interferes with the growth and release of eggs from the ovaries, which can
prevent ovulation and menstruation. PCOS can be overlooked because irregular
periods are normal in teens but if erratic menstrual cycles persist later
into the teen years, girls should see a specialist to determine if something
else might be causing this issue." Other symptoms associated with PCOS can
include weight gain, hair growth on the body and face, thinning of the hair
on the head, acne and infertility. Women with PCOS are at risk for high
blood pressure, high cholesterol, endometrial cancer and tend to become
resistant to insulin.
Sometimes we and the GYN docs will cycle them with hormones and that is safe
in teens. They will also give them hormones if their periods are horrible
and flooding or if severe acne.
Hope you had a good Valentines.
Silicosis is lung damage from breathing in fine dust from silica. Silica is
from sand and is used to make many glass objects.
A silica-based aerogel was used in the Stardust spacecraft to collect
extraterrestrial particles. Silica is also used in the extraction of DNA
and RNA due to its ability to bind to the nucleic acids
A statistically significant decline in silicosis death rates was observed
during 2001–2010 but some deaths still occurred among persons aged 15–44
years. It is now rare but OSHA continues to educate at-risk workers and
their employers regarding the exposure. Approximately 2 million U.S.
workers remain potentially exposed to breathable crystalline silica
HOWEVER crystalline silica is used in hydraulic fracturing in the production
of underground tight oil and shale gas, a use which presents a health
hazard to workers. In 2013 OSHA announced tightened restrictions on the
amount of crystalline silica which could be present and required "green
completion" of fracked wells to reduce exposure. So we now have to worry
about earthquakes and toxic fumes from these well. All for cheaper gas.
Roger Knapp MD
Flonase ... a nasal spray with steroid is now over the counter. Hopefully a
generic soon. It helps nasal allergies and the trees are starting to bloom
now. Also Zaditor eye drops for allergies.
silly report in the press. “Washing dishes by hand will cause fewer
WHAT!! Get real. This study was done in Sweden on 7-8 year olds. Those
families who did dishes by hand had 23% eczema compared to 38% of those with
dish washing machines. But it did not change the incidence of other allergy
problems like asthma. These families were also in lower socioeconomic class
and higher number of immigrants who are also linked to fewer allergies.
Several other studies have linked lifestyle factors like having pets and
living on farms to lower allergies. So hand washing your dishes is not
going to help your hay fever.
Now they are
talking about peanuts. It is true earlier introduction of these allergenic
foods can decrease allergies. Even eating peanuts in pregnancy can lower
their risks of peanut allergy. I have recommended for many years starting
allergenic foods like peanut butter or eggs starting at 6 months…. just make
sure it is in a safe condition where they cannot choke on it. We used to
wait until 2 years to start them on the allergenic foods and they had higher
risks of the allergies. That is why you hear about so many people allergic
to peanut butter is because we waited later. Giving it younger caused them
to identify the protein as self-proteins rather than foreign proteins.
There is now a patch with peanut protein in it that is worn and causes you
to be able to eat it. Awesome!
I think I am
allergic to the cold… I am ready for Spring. I’m just not crazy about the
In 2012, a study was reported involving 2358 children with radiographic
evidence of pneumonia. 21% required intensive care, and 3 (<1%) died. Tests
were run to determine the cause of the pneumonia.
A viral or bacterial pathogen was detected in 1802 (81%),
one or more viruses in 66%,
bacteria in 8%,
and both bacterial and viral pathogens in 7%.
The x-ray only shows mucous or congestion in the lung but does not
differentiate between viral chest cold, allergy asthma, or bacterial
The annual incidence of pneumonia was 15.7 cases per 10,000 children with
the highest rate among children admitted to the hospital were younger than 2
years of age.
Respiratory syncytial virus was more common among children younger than 5
years of age (37%) than among older children (8%),
adenovirus 15% vs. 3% in older
and metapneumovirus 15% vs. 8% in older.
Mycoplasma pneumoniae (Walking pneumonia) was more common among children 5 years of
age or older (19%) vs younger children (3%).
30 years ago there would have been mostly bacterial pneumonia but with the
HIB and Prevnar vaccines, it now is only 15% bacterial pneumonia. Vaccines
prevent pneumonia and meningitis.
So the x-ray will be read out as “pneumonia” meaning there is some white
stuff in the lung field of the x-ray. But what is it? Generally kids get
a lung injury from asthma attack, or viral chest infection, or smoke
inhalation or some insult to the lung. Then the bacteria infect the mucous
and it generally starts with fever the second week of the cough or cold.
Fever the first week is usually the viral chest cold or flu. Watch for
fever the second week of your child’s cough/cold. It still is very uncommon
if you vaccinate your children.
Burger King Quietly Drops Sugary Soft Drinks From Kids’ Menu
I love it. There is the same amount roughly of sugar Fructose in both soft
drinks and apple juice. Sounds healthy or “natural”… NOT. Same thing.
Like my brother-in-law always says: “It is not the deal you get but the deal
you think you get!” So true. See this web site for a discussion and
Fruit Juice Vs. Soda? Both Beverages Pack In Sugar, Health Risks
When mothers do not or cannot make enough breast milk,
some have purchased breast milk on the internet. (really?) There is a
regulated breast milk bank in America which pasteurizes it to kill viruses
and bacteria, and it is tested for bad diseases like Hepatitis C, Hep. B,
CMV, and HIV aides. However, one study found 21 % of privately sold breast
milk on the internet had CMV. Giving someone else’s breast milk is like
giving the other person’s blood to drink. I am a big breast man
J but the pros and cons of breast
vs formula is not that huge. My recommendation: if you can’t breast feed,
then feed them formula. I and the American Academy of Pediatrics do not
recommend purchasing internet breast milk.
weather is getting better and better. So are the pollens. Use
antihistamines like Zyrtec and Allegra. Also there is Nasonex and Flonase
over the counter nasal sprays. For the eyes I like Zaditor eye drops.
to use sunscreen. See:
that are UV protecting are even better.
The CDC has made some fairly good “parenting” videos”:
Swimming season is getting close. I am already seeing some swimmer’s ear
infections. You can usually tell it is swimmer’s ear instead of inner ear
infections by grabbing the ear lobe where it connects to the head and moving
it. That will cause pain. Once it is infected the over the counter
medications will not cure it and you need to call the doctor for a
prevent this infection in two ways. Put a few drops of solution ½ alcohol ½
white vinegar after they swim. The ENT doctors found that it was not as
much the wetness as the water changed the pH from normal acid to basic and
the germs grow. The over the counter “Swim Ear” preparations only have
alcohol so make your own. Or if you have some of those drops, pour out
enough to add 50% vinegar. The other way to prevent it is by putting a few
drops of olive oil in the ear before swimming.
Swimmer’s ear is more likely to occur with swimming in lake, river, gulf or
ocean and less if in swimming pool. Also it is more common if prolong
swimming rather than an hour or so.
do not recommend “swimming lessons” with babies below 1 year old. Also
watch out for low body temperature in small infants and children. The
minute the shiver, get out and warm them up.
Ivy is around every summer. If you are allergic to it then it will cause a
blistery itchy rash a few days later. If you get around it and come in
right away, take a sudsy bath and put the clothes in the washer, then you
will not break out much. If you do get a rash, it is not contagious.
Studies ran experiments where we tried to spread it and could not. We
thought it spread because one area broke out in 1 day, another in 3days, and
another 5 days later. Or the person got out and came into contact with it
again. We thought we were spreading it but didn’t. There are 10 plants
out there that can give you the allergic rash but Poison Ivy is the most
common. Treat the rash with hydrocortisone. If worse then get a stronger
prescription steroid cream from the doctor. If all over and on the face,
then call to get oral steroids. Swimming is OK with poison ivy rash and can
help heal it. Attached are pictures of the rash and the plant.
children is so very difficult. It requires hard decisions and lots of worry
“are we doing it right?” You will make decisions that you hope are the best
and we always make them thinking what is the best for our child. Sometimes
we make one that did not turn out so good but we were trying to do the best
for our child and not what is convenient for us. Our parents also were not
perfect and some of their actions did not turn out so good. But they meant
no evil… they were just trying the best they could to be a good parent. If
your mom &/or dad were decent parents and are still alive, write them a
letter tonight. Hand written.. not email. Tell them how much you
appreciate their love, sweat and efforts raising you. Now that you have
kids of your own you realize how hard it is. And how much you love them and
thank them. You can’t tell them in person because you breakdown and cry.
If you can, then do it in person. It is hard to do this when they are
dying. Do it tonight or you will forget.
think about writing a letter to your children when they graduate from high
school or turn legal age of 21. My Dad did and there is a copy at my web
site. It is a neat thing to do.
Well I diagnosed a case
of Pertussis (or whooping cough) this week. The vaccine has been out for
decades. First described in the 16th century, the
organism was first isolated in 1906. Before 1900, 5 out of every 1000
children died of Pertussis. From all diseases, 10% of all children died the
first year and only half made it to adulthood. The average life span was 35
years. Before the availability of pertussis vaccine in the 1940s, more than
200,000 cases of pertussis were reported annually. In America in 1976
vaccines had decreased the number of cases to 1,010 but now it is around
Pertussis remains a major health problem among children in developing
countries, with worldwide 300,000 deaths resulting from the disease yearly.
83% of the deaths are in infants less than 3 months old because it is more
deadly below one year of age.
was developed in 1914 and the wide spread use of it in the 1940’s. The
first vaccine was called Whole Cell since the whole germ was used. It
contained 80 some odd protein antigens and had a lot of side effects. The
kids would run high fevers and not walk for a day with red swollen leg
muscles. Then in 1996 an acellular version of the vaccine was developed and
it only contained 3-4 protein antigens. Since then the reactions are
minimal with no fever and minimal soreness. But it did not stimulate very
good and long lasting immunity like the whole cell vaccines. That is why we
are seeing an increase in the disease… plus the idiots out there that do not
vaccinate their children.
study published in the Journal of Pediatrics reported the effectiveness of
the new acellular vaccine given to 12 year olds. It said it was 73% after 1
year and only 34% after 2-4 years from the booster TDaP. (whole cell
vaccine was called DPT and the acellular used the “a” before the P.) I am
not sure what the specialists are going to recommend in the future. Maybe
give some of the doses with the whole cell vaccine? Who knows? If your
child has severe hard coughing and especially if rapid fire coughing 5-8
times, and sometimes vomit at the end of it, you might want to get tested
for it. Most patients do not make a whoop with it. Croup is a seal bark
cough outward. Whooping cough sounds like a whoop breathing in after the
rapid fire coughing. Most will not have fever. It is not very dangerous in
older kids but we need to diagnose it to protect others.
Disney world???? We love it. Get two apps for your visit.
Also go to
Hoop Dee Doo Review show… lots of fun, songs, skits, jokes, and buckets of
food and drinks. Best thing there.
The Lyme disease
bacterium, Borrelia burgdorferi, is spread through the bite of
infected ticks. The blacklegged tick (or deer tick, Ixodes scapularis)
spreads the disease in the northeastern, mid-Atlantic, and north-central
United States. The western blacklegged tick (Ixodes pacificus)
spreads the disease on the Pacific Coast.
Ticks can attach
to any part of the human body but are often found in hard-to-see areas such
as the groin, armpits, and scalp. In most cases, the tick must be attached
for 36 to 48 hours or more before the Lyme disease bacterium can be
Most humans are
infected through the bites of immature ticks called nymphs. Nymphs are tiny
(less than 2 mm) and difficult to see; they feed during the spring and
summer months. Adult ticks can also transmit Lyme disease bacteria, but they
are much larger and are more likely to be discovered and removed before they
have had time to transmit the bacteria. Adult Ixodes ticks are most
active during the cooler months of the year.
yourself and your kids after outdoors in weeds and forest. Especially if
you are in areas Northeast of here.
are really concerned there is a test kit where you can test the tick for
Lyme disease called
Lymenator Instant Tick Test for Lyme Disease
pictures of the tick that carries lyme and the rash it can cause.
blocks 93 percent of UVB rays while SPF 30 blocks 97 percent of UVB rays and
above 30 is a sales gimmick. Water-resistant sunscreen helps a little
since regular sunscreen can rub off when the sun makes us sweat or while
swimming. Water-resistant sunscreen means it will stays effective after 40
minutes but it is not water proof and you still need to put more on every
fairly conservative in mediations and surgery. If you need it I will tell
you but to give medications and do surgery when not needed, it has
complications. Several studies have shown lower IQ and development with 1-3
surgeries below 4 years old. Another study was just reported in the
another study came out showing how
over-praising children can lead them to believe they are special people who
deserve special treatment all the time.
starting to see swimmer’s ear. You can tell because it hurts to touch or
move the outer ear lobe. See my web site on the treatment and prevention of
tough to raise kids these days. Do you send them to private school or
public? Do you let them watch which TV shows or movies? Cell phones and
when? Do you spank or not? There are too many gray areas of decisions in
raising kids. Our parents had some but we have many more these days. What
you do is get as much information about these decisions as you can. Talk to
your mother, spouse, friends, doctor, and of course the internet (Yeow).
You will never know if it was the right decision. You cannot go back and
replay life. You could think “maybe I should have married the other person”
but how do you know …. They might have turned out horrible. But the
decision you make will be the best one based on the information you have.
Even though you may look back and wonder. Sit back in an easy chair, close
your eyes and do what you think is best for your child at that time. That’s
God telling you what to do if you would just listen. The worst thing is
when you get talked into what you did not want to do with your child and you
kick yourself for years. Just try to make the best choices and move on.
Don’t waste energy worrying about the past. You will never know if it was
the best decision.
Excessive use of computer games among young people appears
to be taking an alarming turn and may have particular relevance for American
parents whose children spend many hours a day focused on electronic screens.
The documentary “Web
Junkie,” to be shown next Monday on PBS, highlights the tragic effects
on teenagers who become hooked on video games, playing for dozens of hours
at a time often without breaks to eat, sleep or even use the bathroom. Many
come to view the real world as fake.
While Internet addiction is not yet considered a clinical
diagnosis here, there’s no question that American youths(and adults!) are
plugged in and tuned out of “live” action for many more hours of the day
than experts consider healthy for normal development. And it starts early,
often with preverbal toddlers handed their parents’ cellphones and tablets
to entertain themselves when they should be observing the world around them
and interacting with their caregivers.
In its 2013 policy statement on “Children,
Adolescents, and the Media,” the American Academy of Pediatrics cited
these shocking statistics: The average 8- to 10-year-old spends nearly eight
hours a day with a variety of different media, and older children and
teenagers spend more than 11 hours per day.” Television, long a popular
“babysitter,” remains the dominant medium, but computers, tablets and
cellphones are gradually taking over.
“Many parents seem to have few rules about use of media by
their children and adolescents,” the academy stated, and two-thirds of those
questioned in the Kaiser study said their parents had no rules about how
much time the youngsters spent with media. Parents, grateful for ways to
calm disruptive children and keep them from interrupting their own screen
activities, seem to be unaware of the potential harm from so much time spent
in the virtual world.
Before age 2, children should not be exposed to any
electronic media, the pediatrics academy maintains, because “a child’s brain
develops rapidly during these first years, and young children learn best by
interacting with people, not screens.” Older children and teenagers should
spend no more than one or two hours a day with entertainment media,
preferably with high-quality content, and spend more free time playing
outdoors, reading, doing hobbies and “using their imaginations in free
play,” the academy recommends.
Heavy use of electronic media can have significant negative
effects on children’s behavior, health and school performance. Those who
watch a lot of simulated violence, common in many popular video games, can
become immune to it, more inclined to act violently themselves and less
likely to behave empathetically, said Dimitri A. Christakis of the
Seattle Children’s Research Institute.
Teenagers who spend a lot of time playing violent video
games or watching violent shows on television have been found to be more
aggressive and more likely to fight with their peers and argue with their
teachers, according to a study in the Journal of
Youth and Adolescence.
Schoolwork can suffer when media time infringes on reading
and studying. And the sedentary nature of most electronic involvement —
along with televised ads for high-calorie fare — can foster the unhealthy
weights already epidemic among the nation’s youth.
A good rule to make: for every 2 minutes you read, you get 1
minute of screen time. I had one mother turn the sound off the TV and
turned on closed captions. She said everyone’s reading became better. You
can also purchase a
Automatic TV & Videogame Timer and it will
automatically turn on any device for so many hours on certain days.
Here are some teens having "fun" at DisneyWorld: all on their phones!!!!!
Due Largely to Diagnosis Patterns, Not Increase in Prevalence
The results of the study were published this week in The American Journal of
growth of autism diagnoses in the United States may not mean the condition
is becoming more prevalent, according to a new study. Rather, the increase
in autism rates appears to have more to do with changing diagnosis
I have told
many patients that Autism is not caused by vaccines and it is not
increased. There was an equal decrease in diagnoses of retardation (and
other similar conditions) as there is an increase in the autism diagnosis.
Plus other conditions with decrease development (like downs syndrome) have
been put into “autism spectrum”. In addition many children slow reading
have been labeled autistic to get extra help. So most of us do not think it
is truly increased.
Also: If you
have flown much, you may have occasionally gotten a “precheck” status. Then
you go through a short line, and do not have to take shoes off, or take
liquids or laptops out. Fast and easy and your kids can go with you. You
can get a permanent precheck by applying in Terminal D of DFW airport. It
is great and worth the money for the permanent precheck status. Here are
applicant must be a U.S. citizen or Lawful Permanent Resident (LPR) and
cannot have been convicted of certain crimes. If an applicant has a record
of any of the crimes identified in the eligibility requirements, they may
choose not to apply, as the application fee is nonrefundable. Interested
applicants must visit an application center to provide biographic
information that includes name, date of birth and address. An applicant will
be fingerprinted and will be required to provide valid required identity and
citizenship/immigration documentation. An applicant also has the option to
pre-enroll online to provide basic information and make an appointment
before visiting an application center. There is a nonrefundable application
processing fee of $85. After completing enrollment, successful applicants
will receive a Known Traveler Number (KTN) via U.S. mail approximately 2-3
weeks following the visit to the application center. Once approved as
eligible for TSA Pre✓®,
the enrollee must enter the provided KTN in the ‘Known Traveler Number’
field when booking travel reservations on any of the ten participating
airlines. The KTN also can be added when booking reservations online via a
participating airline website, via phone call to the airline reservation
center, or with the travel management company making reservations.
Additionally, the KTN can be entered in participating airline frequent flyer
profiles, where it will be stored for future reservations. Please make sure
the name used when applying for the TSA Pre✓®
application program matches the name used when booking travel. TSA Pre✓®
eligibility will be identified with a TSA Pre✓®
indicator on the boarding pass.”
I love it when the internet disseminates false
information. “Apple juice followed by olive oil to flush out your gall
stones.” WHATEVER? Cures for memory and bald heads. Amazing what you read
and most of it is a scam or just wrong. Use your common sense on most of
this. Research it on Google’s Scholar search engine. So now Coke is the most
horrible thing for your body…… “Coca-Cola Infographic”
Some whack-os talk about how bad coke is for our body.
Coke: 140 calories and Apple juice: 120. Get just as much sugar rush with
Caffeine in Coke: 23-35. Tea: 20-70. Coffee: 100-200.
Phosphoric acid “binds magnesium zinc and calcium”. Not enough to matter and
it is in fruit juice also.
I agree that too much sugar is bad and does cause rebound low sugar if not
taken with other foods. Everything in moderation…. Video games, sugar,
picky eaters might have more mental health woes
Picky Eating Tied to Anxiety
Kids who are
picky eaters might develop depression, anxiety
started with 4520 children
they would allow their children’s eating to be screened
screened high and 2490 were not picky
more screening the researchers ended up with 693 normal 222 picky eaters.
judgement of how picky was based only on what mom’s said their impression of
how their child eats. And it was how the child eats for the mother and not
for other people and daycare.
Statistics were based on few numbers. For example:
refusal normal 0.8%(N=2) Moderate Picky 1.1%(N=6) Severe Picky 3.5%(N=3)
were only able to show differences statistically by running statistics on
the differences and not the actual numbers.
Number of anxiety and emotional problems in the mothers “
picky= 16% Picky = 32% had psychiatric problems
picky=21% Picky = 42% had anxiety issues.
= 9% Picky = 22% were drug users.
studies have shown emotional problems in moms rubs off on the child.
looked at several psychiatric diagnoses in these normal and picky eaters:
Separation anxiety disorder
Generalized anxiety disorder
Oppositional defiant disorder
some statistical differences in the differences for 1,2, and 4.
the follow up 2 years later, there were no differences in any of these
researchers have an agenda for or against something and try to prove it in a
very poor study. Then the news reads the summary and broadcasts this. I do
think picky eaters tend to be a bit more stubborn. See my web site on the
article and video on picky eaters.
Football season is here and many kids are suiting up to play several
sports. The coaches as well as the players are wanting the kids to train
hard and make more muscle. There are many “natural” over the counter
products promising more muscle, run faster, more energy, etc. Most are
usless, and some can be harmful. The muscle milk and protein drinks DO NOT
MAKE MORE MUSCLE. But the coaches and some players are fooled into this
propaganda. The average diet has plenty of muscle and too much protein can
have harmful effects. The only product proven to help make more muscle and
is safe is Creatine. Keep at the recommended dosage of 5 gm a day …. more
will not help and again cause side effects. Just lift weights, take normal
multiple vitamins, and eat healthy. Beware of adds for products to make
more muscle. Most are lying and scams just like the products that claim to
grow more hair, improve your memory, make you feel younger and stop aging,
Remember my advice on injuries which is at my web site. Fist wrap the
injured area in tape and leave on for 24 hours. Ice is the last thing you
put on it. The Dallas Cowboys wrap their joints in tape before they play
knowing they will get hurt. When a player comes off the field in a lot of
pain, immediately wrap the area with tape since it will swell in minutes.
The recovery time in most cases is cut in half if you can keep it from
Earlier this year, the Dietary Guidelines Advisory Committee (DGAC) released
a report stating that up to five cups of coffee per day, or up to 400 mg of
caffeine, is not associated with long-term health risks. Not only that, they
highlighted observational evidence that coffee consumption is associated
with reduced risk for several diseases, including type 2 diabetes,
cardiovascular disease (CVD), and neurodegenerative disorders. The body of
data suggesting that moderate coffee—and, in all likelihood, tea—consumption
is safe and beneficial in a variety of mental and medical conditions is
A substance known to increase blood pressure might actually be good for the
cardiovascular system. Caffeine consumption can cause a short-lived increase
in blood pressure. However, when caffeine is ingested via coffee, enduring
blood pressure elevations are small and cardiovascular risks may be balanced
by protective properties. Coffee beans contain antioxidant compounds that
reduce oxidation of low-density lipoprotein (LDL) cholesterol, and coffee
consumption has been associated with reduced concentrations of inflammatory
markers. Moderate coffee intake is associated with a lower risk
for coronary heart disease as far out as 10 years, and data
suggest that an average of two cups per day protects against heart failure.
Finally, a study presented during a poster session at the Heart
Rhythm Society 2015 Scientific Sessions counters the long-held dogma that
patients with arrhythmias should avoid caffeine, finding no association
between the compound and premature atrial or ventricular contractions.
According to a 2011 meta-analysis, consuming between one and six cups per
day reportedly cut stroke risk by 17%.
The steamy brew appears to confer benefits to the "metabolic syndrome," the
dangerous cluster of hypertension, hyperglycemia, abnormal lipid levels, and
increased body fat. Numerous studies have linked regular coffee drinking
with improved glucose metabolism, insulin secretion, and a significantly
reduced risk for diabetes.
With so many foods thought to increase cancer risk—soda, alcohol, and
grilled meats among them—at least we can rest easy when it comes to coffee
according to recent data. Evidence suggests that moderate to heavy coffee
consumption can reduce the risk for numerous cancers, including endometrial
(> 4 cups/day), prostate (6 cups/day), head and neck (4 cups/day), basal
cell carcinoma (> 3 cups/day), melanoma, and breast cancer (> 5 cups/day).
Beyond the short-term mental boost it provides, coffee also appears to
benefit longer-term cognitive well-being. A 2012 study reported that
patients with mild cognitive impairment and plasma caffeine levels of > 1200
ng/mL—courtesy of approximately three to five cups of coffee per day—avoided
progression to dementia over the following 2-4 years.
A 2011 study suggests that a boost in coffee consumption might also benefit
our mental health. Women who drank two to three cups of coffee per day had
a 15% decreased risk for depression compared with those who drank less than
one cup per week. A 20% decreased risk was seen in those who drank four cups
or more per day.
The liver might help break down coffee, but coffee might protect the liver
in some cases. Evidence suggests that coffee consumption slows disease
progression in patients with alcoholic cirrhosis and hepatitis C, and
reduces the risk of developing liver carcinoma.
As is often the case, with benefits come risks, and coffee consumption
certainly has negative medical and psychiatric effects to consider. Besides
the aforementioned potential increase in blood pressure, coffee can incite
or worsen anxiety, insomnia, and tremor and potentially elevate glaucoma
risk. Also, given the potential severity of symptoms, caffeine
withdrawal syndrome is included as a diagnosis in the DSM-5.
One must assess and balance the potential benefits and drawbacks of coffee
consumption. But mounting evidence suggests that going back for a second cup
might not necessarily be a bad decision.
I would not have made it through Texas A&M without coffee.
See web site for caffeine content in drinks:
Halloween is a fun time of year to dress up and go around and get candy. It
is more of a costume party than any evil worship event. And every one likes
to be scared. Look at the many movies with scare in them. Monsters Inc.
How about Beauty and the Beast? Around 41 million children trick or treat
every year. Most authorities recommend supervising your children until 12
years old. But one study in 2011 found that 12% of the children under the
age of 5 were not chaperoned and only 35% of the parents talked to their
children about safety. There are hazards to Halloween so let’s talk about
Tampered Candy: The fear of candy that has been tampered with is
media-driven(not surprising). Last poll showed 24% of parents of children
below 12 yr old worried about poisoned treats. To date only 5 deaths have
been linked to Halloween candy. Two in the 1970s that later were attributed
to the direct actions of family members. One was a heroin stash that was
hidden in the candy, and the other murdered his son with cyanide to get the
insurance. Other fatalities in 1978 and 1990 were determined to be caused
by cardiac disease and natural causes. In 2001 a 4 yr old died in Vancouver
Canada the day after eating candy. The police ordered everyone to throw
away their candy but it was later found out he died of streptococcal disease
and not the candy. One child died of Halloween candy in California because
a worker found marijuana-packed snickers bars in the post office and gave
them out unknowingly.
there are sharp objects in the candy. 80 such cases have been reported but
almost all have been determined to be hoaxes. The only valid case in 2000
when a teenage who bit into candy that had a needle in it. Nothing became
of that incident. Towns who have x-rayed candy have not found any sharps in
the packages. Again a media scare.
Physical assaults: There are no increases in assaults on children reported
on Halloween than any other time of year.
the real danger on Halloween night? It is pedestrian injuries. Halloween
is the number one day of the year for child pedestrian accidents with an
average 5.5 deaths vs 2.6 for the rest of the year. 32% are 12-18yr and 23%
are 5-8 yr old. And not surprisingly the drivers of the vehicles were
mostly 15-25 yr old. Most accidents occurred between 5 and 9PM with the
highest hour 6-7PM. We give out glow sticks along with a piece of candy at
our house and it really looks good when all the children on the side of the
street leaving our house are lit up with glow sticks. They love them and it
is a good safety practice. I also recommend letting them pig out on candy
for 24 hours and then throw them in the trash. Supervise children below 12
yr of age but that needs to be based on a case by case…. determined by the
child’s personality. Have a safe and fun Halloween. And parents… you can
dress up too!!!!
HOMEWORK. It drives kids and parents crazy. One could also argue if it is
even worthwhile in improving your child’s overall learning. But most schools
will give homework so we are stuck with it.
kids just don’t want to do it and if asked whether or not they have
homework, they will say NO and get a zero or low grade. So the question is
“does the parent find out what homework the child has and make them do
it?” Some would say let them fail and that will show them they need to do
it. I do not believe that. You do not teach them to keep clean and have
good hygiene by letting them go dirty and not bathe. You make them bathe
and that becomes a habit for life. So I feel the parent should find out if
the child has homework and make sure they do it. Then that teaches them if
they have things in life that they need to do…. Then get it done.
not think the parent should go over their homework and correct mistakes. (I
think I was guilty of that when young). Then that is the parent’s A and not
the child’s B or C. The parent does not go into their class and correct
their test papers to artificially increase their grade. So I feel the
parent should not correct the homework but just make sure it was done and
completed. If however the child missed almost all the homework, then the
child may not understand how to do the homework. Then the parent can
“reteach” the lesson and show them how to do it. Or the parent can make up
extra papers for them to complete in order to make sure the child
understands the lesson (Oh boy does that upset them…! Do it right the first
time or you get more work. Yeow!) Teach your child ways to memorize
things… by making flash cards, lists, repeating over and over, etc. And
also the parent should encourage them to do their best and not just a
minimal effort so it is enough to get a barely passing grade.
home atmosphere where they can do their homework with minimal distractions.
Yes turn the TV, cell phones, and ipads OFF! Record your programs for
later. I’m sure you parents have stuff you need to work on or need to read.
thought I was a tough Dad but I had one parent who turned off the sound of
the TV and turned on closed captions. Everyone’s reading improved. You
also might have a house rule that so many minutes of reading earns you so
many minutes of TV or screen time. Have them get a good night’s sleep to
help their school performance. Have a bed time even though teens are not
that sleepy. And their cell phones go in a charger in the parent’s
bedroom…. yes they have been found at 2AM under their covers texting.
Keeping the total screen time down helps. Most authorities recommend 2
hours a day when most kids are having 6 or more hours a day of screen time.
That should vary with the child and their performance in school and the type
some of you will disagree with my views and that is OK. We all raise our
children differently. It is just my opinion. Thanks for listening.
that time of year when many families fly to relatives in other states. A
frequent question we get concerns ear pain in children when they fly. It
does not seem to hurt children’s ears to fly until school age. You think it
would but I can’t remember when a parent told me they cried on flying. It
is the descent when they plane lands that it can cause ear pressure to cause
pain. The infants usually cry because they missed their nap, are just
tired, or want to get down and play. So many people will tell the parent to
give them to suck on, breast feed them, or chew gum but those actions are
child has an ear infection, the middle ear is filled with fluid that is
infected. Water does not expand or contract under atmospheric pressure
changes. Air does and there are compressed air tanks. You have not heard
of compressed water tanks. So it is OK to fly with ear infections in
children. If a person has normal ears and sinus/nasal congestion and fly,
then they are in trouble with pressure change because they cannot “Yawn and
pop” their ears equalizing pressure in that middle ear.
smart phones and i-pads and tablets. Search Roger Knapp. When searching on
i-pads, change setting at top of screen to search phone only setting.
the pumpkin patch in the Southlake area called Hall-Johnson Pumpkin patch
just west of 121 on Hall-Johnson road.
Speaking of pumpkin, here is the recipe for Pumpkin soup from Disney World:
from Tony’s Restaurant in the Magic Kingdom
3 ½ Lbs
(Diced) 13 Oz
Place all ingredients in a
pot except for the cream and let simmer for one hour.
While cooking the soup assemble garnish by mixing all together.
Puree the soup and finish with the heavy cream.
reports of processed meats causing cancer are true but you need to look at
the picture. If you are having too much of anything, it is bad for you.
Too much sun is bad but a little is good for you. A little red wine is good
but too much bad for you. So too much processed meats… a hotdog every day
is not healthy but you don’t need the news to tell you that. Just go easy
with red or processed meats. Too much milk is even bad for you…. Leaches
blood out of the intestines and cause anemia. Too much screen time is doing
more harm to our kids than hotdogs. Just keep it 1 or maybe two processed
meats a week.
The family evening meal is very important. We have moved away from that
routine and eat in the front room with the TV. Or going out too much. You
need to turn the phones, ipads, and TV off (yes off) and sit down together.
If you do, then later there is less divorce, less child obesity, less teen
delinquency and pregnancy. Sit down together and ask “How did your day
go?”. If one child is not hungry, then they can sip water and still sit
with the rest of the family. And no they should not have to finish their
plate. Use this time to express your morals on violence, sex, politics, and
other important values. The sage advice of my parents come back to me every
week. The values you express to your children actually go in them but you
may not see it in their behaviors for 20 years. But it is in them.
Many articles have shown the importance of family meals.
“Consistent inverse relationships were found between the
frequency of family dinners and all high-risk behaviors measured (i.e.,
substance use, sexual activity, depression/suicide, antisocial behaviors,
violence, school problems, binge eating/purging, and excessive weight loss)”
The majority of people who think they're allergic to
penicillin, based on a doctor's opinion after an adverse reaction, are not
actually allergic, according to a new study. Most people never take
penicillin again, and are treated with more dangerous antibiotics and
exposed to unnecessary risk as doctors look to other treatment options. The
Centers for Disease Control and Prevention estimates between three and 10
percent of Americans are labeled allergic to penicillin, however about 90
percent of those people are not allergic. I had learned years ago it was 75%
not allergic. Anyone who has been told they are allergic to penicillin
should be tested. And just because a relative is allergic does not mean the
child is allergic. Hives are caused mostly by Medications, foods and most
frequently an infection. Many germs cause hives and especially strep. The
patient breaks out in hives from the infection and not the antibiotic we
gave to treat the infection. Interesting huh?
does not just develop bacterial bronchitis or pneumonia immediately. Viral
chest infections that can be diagnosed at pneumonia or bronchitis can come
up quickly but generally not bacterial.
lung and windpipes are damaged by smoking, asthma attack, or viral chest
infection. It takes a while for the bacteria to grow in it. The fever
during the first 4 days of cough and cold is generally a virus. Fever after
the 5th day and typically 7-10 days into the illness is when
bronchitis or pneumonia develops. Many people are diagnosed with
bronchitis/pneumonia but are just having the viral flu. See my article on
reading chest x-rays at my web site. The flu generally does not kill you
unless you have a lot of other health issues. The high risk groups are
infants below 2 yr, pregnant women, and children with cancer, heart disease,
lung diseases, diabetes, or immune troubles. So the average healthy child is
not at high risk of dying of the flu. But they can get pneumonia after the
5th day of cough/congestion.
So watch for fever after the fifth day.
See my web site about treating the flu. Tamiflu does not change the
incidence of pneumonia complicating the flu.
I recommend the flu vaccine even though it only prevents it 2/3 of the
Some studies suggest there are less complications of the flu if you had the
You are most contagious right as you develop symptoms so most people spread
the flu when they do not realize they are sick.
care this weekend and have a good Thanksgiving.
mosquito causing encephalitis illnesses are West Nile, Dengue fever,
chikungunya disease, Japanese Encephalitis, Eastern Equine Encephalitis, and
Western Equine Encephalitis.
Fever infects 200-400 million people yearly and 22,000 die every year in
other countries of the world. It has spread all over South and Central
America and Mexico. There was a big outbreak of Dengue fever in Hawaii this
year. Rare cases have been reported in South Florida and Texas. A recent
vaccine has been developed and is in trials now to see if effective.
Chikungunya is spreading fast across the Americas. In Latin America and the
Caribbean the rate of infection is about a million people a year. It’s name
comes from African dialects meaning Bends Up because patients are often
contorted in pain for weeks. It arrived on St. Martin in 2013 and in just 2
years has spread all over Central and South Americas. Death is very rare
but you might wish you would die.
came here in the 1900s and now present in every state. Last year there were
2,205 cases reported (but thousands of cases never diagnosed) with 858 brain
infections and 97 deaths. These cases are adults with children almost never
diagnosed because they are not seriously ill with it. (See my web site
article on West Nile.) With West Nile spreading all over America, the
concern is will other mosquito-borne diseases like Dengue and Chikungunya
spread all over. They have spread all over South and Central Americas,
Mexico, and Caribbean islands.
encephalitis viruses are transferred through saliva and body fluids. Common
is Enterovirus infections that cause several different illnesses. They are
everything from chest colds, to meningitis, myocarditis, pleurisy, and Hand,
Foot, and Mouth Disease.
Most of your children will get Hand, foot, and mouth but brain infection
from that is rare. Actually only 1/1000 people who were infected with polio
were paralyzed and most people had NO symptoms. Even Chickenpox can rarely
cause brain damage. And if your child developed one of these encephalitis
infections at the same time they received their routine vaccines, we would
of course blame the brain injury on the vaccine.
You may hear about these illnesses in the news. I am not trying to scare
you. I just want you to be aware and protect yourself from mosquito bites
here in America and especially when traveling South of our boarder.
recently wrote an article on Dengue and Ch viruses spread by mosquito. Now
Zika virus is in the news. This is a very mild form of Dengue and West Nile
and in fact only 20% have any symptoms. No deaths occur. It is a rash and
red eyes …. See picture below. Zika was discovered in Africa in the 1940s
and spread to South Asia countries.
spread to the French Polynesian Islands (In The Pacific Ocean South of
Hawaii) and then spread to South America mostly Brazil in 2013. This summer
it spread to most of that area.
Zika is now
covering most of South and Central America and “heading this way” just like
Dengue and Chikungunya. Now this map looks like this in a very short 5
disease is very mild and no deaths from it. The problem is that if
infection occurs during pregnancy, it causes brain damage and microcephaly.
Brazil went from 147 cases of microcephaly to 2400 this year! It is so bad
that the Brazilian government has asked women to hold off getting pregnant
for a few years. And I huge concern will be the 2016 Olympics in Rio de
Janeiro next year.
this from mosquito bites but there have been documented cases of blood
transfusions, bedroom activities, and mothers in labor giving it to
newborns. That does not cause microcephaly since the illness needs to be
earlier in the pregnancy.
caution if traveling to South America, Central America, Caribbean Islands,
or Mexico when pregnant.
About 1 in 5 people infected with Zika virus become ill (i.e., develop Zika).
The most common symptoms of Zika are fever, rash, joint pain, or red eyes.
Other symptoms include muscle pain, headache, pain behind the eyes, and
The illness is usually mild with symptoms lasting for several days to a
Severe disease requiring hospitalization is uncommon.
Deaths due to Zika have not been reported.