|
The Center for Disease Control and Prevention has issued information about certain lots of the new H1N1 vaccine that need to be recalled. The recall has nothing to be with the safety of the vaccine; on-going post delivery testing shows that certain lots don’t show the strength they should at stimulating antibody production by the body.
I want to inform our patients that the Pediatric Center of Round Rock DOES NOT have any of the H1N1 recall lots. The vaccine administered at our office remains safe and strong at inducing immunity. This news does indicate the commitment of the CDC to the ongoing monitoring of the safety and efficacy of the vaccine by health authorities. Click here to read the full article from the Centers for Disease Control. Posted in Health Alerts, Influenza (Flu) | No Comments »
Studies cited by the American Academy of Pediatrics (www.aap.org) find that “obese children have lower self esteem and self confidence than their thinner peers.” No big surprise. Kids haven’t learned to separate their sense of “self” from their body image, so when they perceive themselves to be less attractive than other kids, they believe they have less value, too. Unfortunately, this belief is reinforced by everything they see on TV and in magazines, which trumpet beauty as the most important asset a person can have. We know better, but our kids don’t. The other kids your children are around don’t know better, either, which means that overweight children get more than their fair share of teasing, and they have a harder time making friends. Remember how important your friends were when you were a child? Imagine getting through one hour on the playground without friends to play with, watching the other kids from a distance. Inside the classroom, your child’s schoolwork can suffer because of a lack of self esteem. Then poor grades make them feel even worse about themselves creating a downward spiral. What you can do The first and most important piece of advice is: Don’t become part of the problem. Don’t try to tease your child into changing their eating habits. Making fun of your child’s weight is not the way to help them lose a few pounds. Instead of positioning yourself as the enemy, become part of your child’s support system. Reinforce everything you love about this special person, every unique and wonderful quality. Let your home be a haven from the stresses of the world. At the same time, do encourage healthier eating by setting a positive example. Be honest with yourself. Do you prepare healthy meals for your kids? Do you make healthy choices when grocery shopping? Start by creating a more active life for your family by getting involved in fun activities with your child. Even taking a brisk walk around the neighborhood can be fun, and it can give you and your kids a chance to chat about your day. Being fit and healthy physically increases your child’s chance to be happy. Next time you reach for an unhealthy snack, think about the cost to your child’s long-term happiness. By Dr. Marta Katalenas Posted in Healthy Eating, Healthy Recipes | No Comments »
You may be thinking that you don’t want to ruin the wonder of Christmas for your kids by depriving them of holiday goodies. However, think about what allowing your kids to overindulge does to them. Childhood obesity causes joint pain, high blood pressure, and diabetes, as well as a host of other ailments associated more often with middle-aged adults. Here are some practical suggestions to keep Christmas fun and merry, while also encouraging your children toward better health. As a bonus gift to you, you might even lose a couple of pounds over the holidays, too. Walk more.
Eat less.
Have a wonderful – and healthy – holiday season! Dr. Marta Katalenas Posted in Healthy Eating | No Comments » We are scheduling a Flu Clinic on Wednesday, December 16th at our office. Due to the high volume of requests for both the Seasonal and the H1N1 vaccine for our patients, we will be able to immunize a larger number of patients with both the Seasonal and H1N1 vaccines during this clinic. Pediatric Center of Round Rock Posted in Health Alerts, Influenza (Flu) | 1 Comment » We are now administering the Seasonal Flu Vaccine to all our patients and parents. We also have a limited amount of the H1N1 Mist, and we are giving it to our patients by appointment and offering it when they come to the office for a physical exam or for a sick visit if indicated. The Health Department informs us that we can now start giving the second dose of the H1N1 vaccine for those patients who already had their first dose at least a month ago. There is some confusion and questions about the administration of those two vaccines that I am going to clarify by giving you some case scenarios. Q - My child received the first H1N1 injectable vaccine over a month ago. Can he now get the second H1N1 dose in the Mist form? A - Yes. It is safe to get one dose of the injectable H1N1 and the second dose in the Mist form if your child is over 2 years of age and doesn’t have asthma. The mist is safe, very effective and easy to administer. The only limitation of use relates to those who have asthma and children less than 2 years of age. Q - I am pregnant and I know I can’t get the H1N1 Mist; can my 3-year-old child get the mist? A - Pregnant woman should get the injectable form of the H1N1 instead of the mist, but it is safe for you to be around your son after he gets the mist form of the vaccine, even if you are pregnant. Q - My daughter had the Seasonal Flu Mist vaccine at school last week. We now have an appointment in the office to get the H1N1 Mist. Is it safe? A - We should wait a month before giving her the H1N1 Mist. She can get the H1N1 injectable at any time, but when administering the Mist form of Seasonal and H1N1 vaccine, they should be at least one month apart. Q - My child was diagnosed with Influenza A, H1N1 back in September. She had mild symptoms that resolved within a few days. Should she receive the H1N1 vaccine? A - Yes. The rapid test we have in the office to check for H1N1 is not reliable enough to assume she did have the infection. Since we can’t be certain, we don’t know if she is going to have antibodies to protect her when/if we have a second wave of H1N1 cases in the coming winter months. The safest thing to do is to immunize her. Please call our office if you would like to schedule an appointment for the second H1N1 vaccine dose.
Posted in Health Alerts, Influenza (Flu) | 1 Comment » Today we received our shipment of Seasonal Flu Vaccine and we are now ready to give it to our patients who have been graciously and patiently awaiting. We can also give it to parents and grandparents for those families who find it convenient to get their flu shot at our office. You can now call and make appointments. We have also received some H1N1 vaccine from the Health Department. We have the Mist form only at this time. The H1N1 mist can be given to children over 2 years of age. Those with a history of asthma should not get the mist form of the vaccine; they should wait until they can get the injectable.
Pediatric Center of Round Rock Posted in Health Alerts, Influenza (Flu) | No Comments »
It is a childhood disease and we all got immunized when we received the DTP vaccine, which stands for Diphtheria, Tetanus and Pertussis. But over the last few years those who look at national statistics for a living realized that the incidence of Whooping Cough in adolescents and beyond was increasing at a rate that was not acceptable. The Center for Disease Control then issued a recommendation for adults and children over the age of ten to receive a booster dose of the Whooping Cough vaccine. Here is how it is done: your adolescent or preadolescent child (over 10 years old) is going to be given a booster of Tetanus combined with Pertussis; the vaccine is called TdaP. The big letters indicate the main antigens present in the vaccine, Tetanus and Pertussis. The “d” refers to a small amount of diphtheria antigen that is present only to enhance the recognition by our immune system of the other two antigens, and the “a” (in case you are interested) refers to the presence in the vaccine of the “acellular” type of pertussis antigen. Back a couple of decades ago, the Pertussis vaccine had side effects such as very high fevers, irritability, etc. This lead to the development of the current “acelular” Pertussis vaccine, which enables the vaccine to stimulate the immune system without making us sick. If you are an adult you probably know you should receive a booster of Tetanus every 10 years. Tetanus is an almost-always fatal disease, and one for which there is no herd immunity. (Note to self: explain what “herd immunity” is). That is, no matter how many people you get immunized and protected, we are still going to see cases since the bacillus lives in the soil and it is not transmitted from person to person. So, you need your tetanus booster every 10 years, right? Next time you see your doctor, ask about the status of your tetanus protection. If you are due to receive a booster, ask to be given the TdaP. You don’t need to receive this combination every 10 years, just once is enough. Then you can continue with your regular tetanus-only vaccine every 10 years. By now you may still be wondering how this Pertussis business is affecting you. Well, it is not a pleasant set of symptoms when you get Whooping Cough; they last for a long time and the disease is very contagious. It may start like a cold, with runny nose and cough, fever and sneezing. After a couple of weeks the cough gets worse, occurring in very strong fits lasting six or more weeks. Children usually have fits of cough followed by a “whooping” sound as they try to catch their breath. The cough is often worse at night. If you are in contact with small children and babies, your chances of passing the disease to them are very high. Babies suffer greatly when infected with whooping cough; the cough may get so bad that it keeps them from eating, sleeping and breathing. Many end up admitted to the Intensive Care Unit, especially when it affects premature babies. So, the protection of the vaccine goes beyond you, like it is the case for the majority of the vaccines. Here are some case scenarios to help you clarify what choices you have to protect yourself and others around you.Q - I am a 50-year-old grandmother of a cute one-month old baby boy. Do I need to get immunized against Pertussis (Whooping Cough)?
A- Yes. In order to protect your grandson it would be advisable for every member of the family, in immediate contact with the baby, to receive a TdaP booster. Remember, babies start their immunizations at about 2 months of age and Pertussis is one of them. But they don’t mount a protective immunity until they go through the primary series of 3 doses, ending after 6 months of age. Q - My two-month-old premature grandson is coming home after spending his first two months of life in the Neonatal ICU. He got his first set of shots in the hospital and one of them includes Pertussis. Is he protected during this winter Pertussis outbreak?
A- Because this baby is premature his immune system is not as developed and he needs special care and consideration. It is good that the immunizations have been started, but we must add the effect of “cocooning” the baby in order to protect from serious infections. One of the protective measures to take is to make sure all adults and children in contact with the baby are up to date with immunizations, including the TdaP for those older than 10 years of age, as explained above. Breast-feeding, vitamin supplementation and day care avoidance are other protective measures when dealing with a premature infant. Q - I am 25 years old and pregnant. I had my last Tetanus booster 5 years ago but I don’t think it included Pertussis. Should I get immunized again? A - The TdaP vaccine is not indicated during pregnancy. It is not that it is unsafe to receive it; we simply don’t have enough data to make that recommendation. But you can make sure your husband and those who are going to be in contact with your newborn are immunized. Right after you have the baby you can ask your doctor to give you the TdaP vaccine, even if you had a Tetanus booster 5 years ago. The added protection provided by the Pertussis part of the vaccine is good for your baby. If you are planning on breastfeeding, you are going to make antibodies as a response to the vaccine and you are going to pass them through your breast milk to the baby. We can’t measure the extent of that protection, but it is a real one. Q - I am a 16 year-old High School student. The nurse informed the students and parents about a case of Whooping Cough in the school. I received a Tetanus booster 6 years ago, but it did not include the Whooping Cough. Should I get immunized?
A - Yes. The Tetanus protection is still good, but you are at risk for contracting whooping cough, especially now that you have a case in your school. Those in direct contact with patients suffering from Pertussis get antibiotic prophylaxis, but your doctor or the school nurse will advise you if you need to start taking antibiotics. The best long-term protection you can have right now comes from the TdaP vaccine. Even if your Tetanus part is up to date, it is advisable and safe to get the combination vaccine that includes Whooping Cough. I hope this explanation and case-scenarios is helpful to you all. I would appreciate your comments. Marta Katalenas M.D. Posted in Health Alerts, Newborns & Infants | 1 Comment » Boil It, Cook It, Peel It, or Forget It – Tips for International TravelNovember 26th, 2009 | By : Dr. Katalenas International travel around this time of the year is exciting. Because of the global economic crisis you can find good deals to almost destination. Most countries are safe and don’t require extra precautions or vaccinations, but it is helpful to remember a few precautionary steps, just in case. Salmonella Typhi causes a disease transmitted through food or drinks that are handled or served after poor hand washing or when contaminated sewage gets into drinking or hand-washing water. It causes high fever, headache, body weakness, stomach pain and a rash. The Center for Disease Control and Prevention says there are about 300 cases of typhoid fever in the United States every year, the majority resulting from international travelers. The disease is more prevalent in the Indian subcontinent, Latin America, Asia, Middle East and Africa. Although there is a vaccine to prevent infection by S. Typhi, travelers to those countries should know that the vaccine is not a substitution for careful selection of food and drink. So, the CDC reminds us to “boil it, cook it, peel it, or forget it” as a rule of thumb when visiting countries with a high prevalence of enteric infections. About 5 % of sick patients who recover from the infection will continue to carry the bacteria in their bodies and pass it in their stools and urine. Remember Typhoid Mary? Mary Mallon was a cook in New York City who was healthy, but she was a carrier of typhoid fever, passing it to over 50 people before the problem was identified. Traveling is supposed to be fun and one can never pay attention too so many details. If being careful is going to make us become paranoid, we may as well stay home. And, believe me, I am not the kind of person who stays home because of being afraid of contamination. But a little information goes a long way, and I think the slogan the CDC came up with is cute and easy to remember. Another piece of advice: if you are thinking about traveling to an exotic destination, check with your local Travel Clinic to find out what vaccines you could receive before you go. Some of those vaccines are not going to be “required” to enter the country. Remember, the vaccines are for YOUR protection, that is, to prevent you from catching something in the new location. They are not for their protection, that is, the other country is not afraid you are going to bring in a disease. The phone number for the Travel Clinic in Austin is: 512-336-2727. Marta Katalenas M.D. Posted in Health Alerts | No Comments »
Childhood obesity rates have more than tripled since 1980. The states with a higher obesity rate are those in the South, including Alabama, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia; they all have a prevalence of 30 % or more. That means that out of 100 children, 30 meet criteria for obesity. Concerning and sad statistics. The latest CDC obesity data also indicates that none of the 50 states achieved the Healthy People 2010 goal of reducing obesity prevalence to 15 % or less. Pediatricians use Body Mass Index (BMI) to asses obesity in childhood. It is an easy, fast way to determine who is at risk during the yearly health supervision visit. Reviews of data from pediatric patients indicate a clear correlation between BMI and lower socioeconomic status, based on parent’s education and family income. But, why is this happening, contrary to what history teaches us? About 500 years ago, wealthy individuals were the ones showing a distension of their waistline. Looking at European history, those who were rich and powerful could afford more food, and being fat was a sign of prosperity. Today, the economic crisis is causing the opposite effect: food prices for nutritious foods are expected to go up and eating healthy is going to be more difficult to afford. These days it is less expensive to go out for a hamburger and fries that to make the effort to prepare good food at home. It is also faster and it takes less work. Parents today must make an effort to increase the quality of the food they give to their kids and make sure they are getting enough exercise. And don’t forget about portion size. The only way for parent to ensure their children’s future health is by taking control of their eating habits now. If we give it enough time Health Insurance Companies are going to start paying attention to the correlation between childhood obesity and the development of chronic health problems later in life. I believe they are already aware and considering what to do next. The only feasible solution will be to charge more to those at risk, that is, those who’s BMI is outside of what is considered normal. At our office we run a Nutrition Management Program for kids. I have observed how difficult it is to maintain good eating habits when the whole family already has an increased BMI. I have also decided to intervene earlier, when the child is starting to cross percentiles in the wrong direction. It is then apparent that loosing or maintaining weight is a lot easier and, since the results of a diet plan are seen faster, the whole family is more likely to participate. Exercise is at the other side of the equation. After all Energy Intake = Energy Expenditure, if we want to avoid accumulation of fat tissue. Studies have demonstrated a clear correlation between obesity and the presence of a TV set in the child’s bedroom. Remember when you used to walk 3 miles to school over 1 foot of snow? What are we supposed to do?My advice is to consult your doctor in order to identify where the main obstacle to good health is. We all know the list, but it is crucial to create a priority and tackle one difficulty at a time. It is reassuring to observe how some intervention, even a small one, makes an impact in the child’s weight when it is early enough. When the “to do” list is too long everybody gets discouraged and it is more improbable to delay doing anything. Don’t forget to ask your pediatrician what your child’s BMI is at a well-child visit. That is the time to discuss eating issues. Sick visits tend to be quicker, the main concern being to identify and treat what is wrong. Don’t feel embarrassed if you fail. It is important to keep trying and attend follow-up appointments to reinforce what you have learned and share difficulties you may encounter. It takes about 1 year to go through the process of changing eating habits. Just keep going. Never give up. Marta Katalenas M.D. Posted in Healthy Eating | No Comments » Do you experiment in the kitchen? I’ve found it to be one of the most relaxing activities at the end of the day. I like fish. But I am often disappointed when I walk through the fish section of the supermarket because the pieces I see are dull and unattractive. They don’t look fresh and shiny, which is the way I am used to seeing fish. Last Saturday I went to Central Market and I had a completely different experience. I saw a piece of codfish that was fresh looking and bright, with the pink marks of blood when the skin has recently been removed from the flesh. I took it home with the intention of cooking it for dinner the next day. When Sunday came I was not inspired at all. I just didn’t know how to prepare the codfish in order to bring out its freshness and flavor. So, I went on a “fishing” expedition through my refrigerator. I often try to rescue “dying” leftover pieces of vegetables or fruits, before they end up in the trashcan. I found an old ¼ of a semi-dry onion and a puny, wrinkly Clementine orange sitting by itself inside one of the lower drawers of the refrigerator. Then I went through the pantry to see if any other ingredients could be utilized. The creativity was sparkling now. Inside the pantry I collected a couple of Macadamia nuts and a few almonds. I always keep nuts at home and I often eat a few with my breakfast. It was clear to me that it was time to go back to the market to re-load my nuts department. So, I decided to place the fresh codfish in an oven-safe dish, applying salt to both sides. I then lightly fried the onion, cut into thin pieces, in about 3 tablespoons of olive oil and I poured it over the fish when the onion was still transparent. I squeezed out half of the Clementine’ orange juice over the fish and I grinded some of the zest of the orange on top. I finished up by grating 2 macadamia nuts and 2 almonds right on top of the fish. I placed in the oven at 350 degrees and, voila! 10 minutes later I had a delicious mixed flavors piece of cod ready to enjoy. My plans for dinner were ruined when Natalie walked into the house and spotted the fish at lunchtime. She ended up eating half of it right there. With half of it gone, I decided to prevent further damage by eating the other half myself. The mixed flavors of the fish, the tangy scent of orange and the deep, yet mild, forestry savor of the nuts gave a unique combination I was proud off. As far as the nutrition power of this dish, I don’t even know where to start. Fish provides a source of protein that is cholesterol-free and low calorie. It also provides Omega 3 fatty acids, essential in the prevention of chronic disorders, cancer, cardiovascular disease, etc. Cooking with olive oil provides the best choice when maintaining a healthy diet that is low in poly-unsaturated fats that are not good for the heart. Nuts provide minerals acting as antioxidants in the prevention of aging and chronic alignments, and onions are rich in vitamins and fiber. A win-win situation. It doesn’t work all the time, but when it works I so feel so accomplished. I have walked into some disasters while experimenting in the kitchen, but I also learned from those mistakes. Such is life. Marta Katalenas M.D. Posted in Healthy Eating | No Comments » |
  |
As a pediatrician, I care about more than just your children’s physical health. Mental and emotional wellbeing are equally important. Sadly, the greatest preventable threat to your child’s physical health also threatens their mental and emotional health. I’m talking, of course, about childhood obesity.
Santa Claus is magic in a red velvet suit. Only he can get away with being fat without facing consequences. When our stomachs are like a bowl full of jelly, we face health problems, some quite serious. There are ways that you and your kids can enjoy the holiday season without gaining weight.
You’ve probably heard it in the news. There is a Pertussis (Whooping Cough) outbreak in Williamson County and, I am sure, in other areas of the country. Whooping cough is a childhood disease, right? If you are an adult you may be thinking “who cares, it is not going to affect me anymore!” or “I was immunized as a child, I am protected”. Wrong and wrong again.
“Our heath care cost have grown along with our waist line”, said Jeff Levi, PhD, executive director of Trust for America’s Health. “The obesity epidemic is a big contributor to the skyrocketing health care costs in the United States”.