Monday, July 28, 2014

Latest Science Café 360 Draws Crowd, Sickle Cell Treatment Ideas

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Almost 100 people gathered at Busboys and Poets on Fifth and K streets, northwest last week to discuss research that could lead to improved treatments for sickle cell disease and challenges people living with the inherited blood disorder face.

The event was the third installment this year of Science Café 360°, a series that connects researchers with residents throughout the Washington, DC, metropolitan region. The gatherings allow the public to provide their perspective on medical research, usually on pressing local healthcare needs.

Dr. Susan Perrine-Faller, a hematologist and oncologist at Howard University, discussed research pertaining to the life-threatening disease including the possible benefits of high levels of fetal hemoglobin, the oxygen-carrying pigment produced in the womb, on inhibiting red blood cells to sickle in adolescent and adult patients.

“I feel research is so important,” Dr. Perrine-Faller said to the packed room. “We only know the tip of the iceberg of a disease.” Advocating participation in clinical trials, Dr. Perrine-Faller said that research needs a lot of people to find out what works best since medications affect individuals differently.

The event featured personal stories from adults living with sickle cell disease, many lamenting on the disparity of care from childhood to adulthood. One speaker ,Boston resident Cloret Clark, participated in clinical trials with Dr. Perrine-Faller read a poem that she wrote describing the challenges she has faced with the disease.

At one point in time, the audience was standing room only filled with local healthcare professionals, families living with sickle cell disease, and representatives from organizations and programs such as Be The Match, an initiative of the National Marrow Donor Program.

Shameka Jones of Silver Spring, Md., whose son has sickle cell disease, asked about the differences in managing the inherited blood disorder in an adult setting versus a pediatric one such as Children’s National, which has among the largest pediatric sickle cell disease programs in the country. Each year, Children’s National treats more than 1,400 children and young adults, from birth to age 21, with all types of sickle cell diseases. Several people voiced concern about how they feel adolescent and adult patients fall through the cracks in terms of receiving care because of the lack of attention on sickle cell disease in older patients.

“The power of the patient is huge,” said one audience member as she advocated individuals align themselves with local and national organizations committed to awareness, advocacy and research on the disease.

The Community Advisory Boards within Children's National Health System, George Washington University, Howard University, and Georgetown University hosted the community event. The free event was supported by a NIH Clinical and Translational Award Grant.

Providing opportunities to engage the public and connect clinicians with the community are vital and gatherings such as the Science Café meet that need, according to Joseph Wright, M.D., M.P.H., chair of Howard University’s Department of Pediatrics and former senior vice president for community affairs and head of the Child Health Advocacy Institute within Children’s National Health System.

He noted that Howard University President Wayne A.I. Frederick, a surgeon and researcher, supports the event and hopes to see more partnerships like it to address pressing issues. The university’s Center for Sickle Cell Disease assists teens and young adults transitioning from pediatric to adult providers and works with Children’s National and NIH to provide patient services for sickle cell disease in the region.

In 2013, two cafes focused on asthma and mental health, and one in early 2014 discussed bone marrow transplants for sickle cell disease. Organizers plan to address future topics such as reproductive/sexual health and obesity.

Friday, July 25, 2014

Teenage Driving Tips

Teens eagerly await the freedom they will have the day they receive their driver’s license and parents can’t wait to end their run as lead taxi driver. Before this happens, however, parents and their teens need to recognize that with driving comes great responsibilities and great dangers for which many teens are not prepared.

Remember that teens often experiment with authority and may feel invincible, letting their emotions get the best of them. These behaviors do not make the most attentive and cautious driver. Be up front with your child about the responsibilities of driving before he or she gets behind the wheel:
  • Establish driving rules with your teen from the beginning
  • Enforce those rules at all times
  • Encourage and model for your teen to be a cautious driver and follow all driving safety rules
The American Academy of Pediatrics recommends that “at a minimum, parents should place restrictions on nighttime driving (preferably after 9:00 pm) and limits on the number of teenaged passengers. Initially, the rules should be fairly strict, but they can be relaxed as the teenager becomes older and gains more driving experience.”
Children’s National’s Lawrence D’Angelo, MD, MPH, suggests that all families also have written rules for teen drivers. These need to include at a minimum the following:
  • No teen driver should carry more passengers than allowed by law. If your state doesn’t have a passenger limit law, here is a good guide: there should be no passengers for the first 6 months (other than family), one passenger for the next year, and never more than 3 passengers
  • No cell phone use while driving, including Bluetooth phones, unless the car is stopped and pulled to the side of the road
  • No texting
  • No excessively loud music
And “never, ever, ever any alcohol or drug use by them or anyone in the car with them,” D’Angelo said.

Make sure violations of your written rules carry penalties up to and including license suspension. Also, stress to your kids the risk of driving under the influence of alcohol or drugs. Impaired driving is one of the leading causes of death in teens. Learn more about how to talk to your kids about impaired driving.

Finally, the best way to teach your teens to drive responsibly is to be a great role model. Like everything else, teens learn their behaviors primarily from their parents. Make sure that you are observing all traffic laws and abiding by the rules listed above. For even more information on teens and driving, click here.

Monday, July 21, 2014

Pesticide Safety

Pesticides are chemical compounds used to kill insects, rodents, worms, weeds, and fungi.  Exposure to pesticides can result in many different health effects and can be a real source of concern when raising children.

There are two types of exposure:  acute, high-level and chronic, low-level. 

Acute, high-level exposure, which occurs anywhere between a few minutes to several hours, can result in both immediate and delayed effects. Some of the immediate effects are changes in heart rate, nausea and vomiting, difficulty breathing, and seizures. The delayed effects include nerve damage in the arms and legs and muscle weakness. Though the effects of chronic, low-level exposure have yet to be thoroughly researched, Children’s National Health System environmental expert and Director of the Mid-Atlantic Center for Children's Health and the Environment, Jerome Paulson, MD, said that there is new evidence that this type of exposure can cause small decreases in IQ and small increases in learning problems in children.

Because pesticides are very widely used, the chances of children being exposed to them are great.  Pesticides generally enter the body through the nose, mouth, and skin. Young children are at an even greater risk of exposure due to their tendency to explore their environment with their mouths, closeness to the ground, and increased time playing outdoors.  There are several ways that children can be exposed, including:
  • In the home or outside in the yard or garden
  • In drinking water, since children drink more water than any other substance
  • Outside the home, such as schools, playgrounds, daycare, and commercial settings
  • In agricultural settings, particularly if if a parent works in that kind of environment
Children can also be exposed through food, such as fruits and vegetables. Dr. Paulson recommends that parents visit the Environmental Working Group’s website, where there is a list of conventionally grown foods that have been shown to have very low amounts of pesticide residue, along with a list of foods that can have high amounts of residue.

Although scary due to the varying time frame of noticeable effects, there are ways to reduce pesticide exposure for your child, including the following:
  • Growing plants that naturally grow well in your area
  • Pulling weeds by hand instead of using a pesticide
  • Preventing your child from consuming fruits and vegetables that are heavily contaminated with pesticides
  • Should your home need to be sprayed with an insecticide, covering children’s sheets, pillows, blankets, and stuffed animals and store them outside
Dr. Paulson also suggests using Integrated Pest Management instead of pesticides. With this approach, pests are deprived of access to food and water. Parents can incorporate this technique by cleaning up spills as soon as they happen, and to stop any leaks in the home as soon as they are identified.


Friday, July 18, 2014

Get Psyched Friday: Separation Anxiety

In her latest installment of Get Psyched Friday, Children’s National psychologist Eleanor Mackey, PhD, help children with separation anxiety.

Right now, my 2-year-old daughter, C, is in a serious “Mommy” phase. We’ve all seen it and for some kids it is more intense or lasts longer than for others. I’ll admit that there are moments when it feels nice that my daughter needs and wants me for comfort and reassurance. However, most of the time, it is challenging when I need to accomplish something, when her sister needs something, or if her dad wants to spend time with her. I also ultimately want her to feel comfortable without me!

Because of this, I have been thinking a lot about separation anxiety and know other parents face the same problems. At a minimum, we want to help our children get through it without being harsh, resulting in them feeling that their needs are being dismissed. It is also important to be able to identify when this moves past normative behavior and is affecting a child’s life negatively so that parents can seek help when needed.


What are the signs of separation anxiety?

Some signs that separation anxiety is a problem are if an older child begins refusing school or is afraid to be away from a parent, which causes problems with school, with peers, or with social events. Separation anxiety can also lead to problems sleeping if the child is afraid to sleep without a parent nearby and co-sleeping is not desired by the family. In this case, it can be very helpful to talk with a professional to establish a plan specific to your child. Separation anxiety is very treatable and helps your child learn coping skills at an early age invaluable.


When do most children’s experience separation anxiety?

Most children go through phases of separation anxiety starting as young as about 8 months when they begin to understand that a parent can leave them. This is particularly heart-wrenching for parents to hear their child cry even when they know it will be briefly. The child is often fine within minutes of the parent leaving. But in these instances, it can be helpful to have a “good-bye” routine.


The “good-bye” routine

This may include a hug, cuddle, song, or something along those lines. Keep it brief, as drawing it out only prolongs the anxiety of leaving. Think about when you know something you are dreading is coming up – sometimes you just want to get it over with as thinking about it is often worse than the thing itself. It is the same for children. Remind your child that you will always come back. As tempting as it is to avoid the tears, never leave your child without telling them or sneaking out. This will confirm their fears that if they let you out of their sight, you might leave.

As your child gets older, you can tell them more about what is happening. I have found with C that I can now say, “Mommy is going to work now. You are going to be here at school with Ms. Christine. You are going to have lots of fun and I will see you right after nap!” It is now common for C to give me a hug and repeat, “Mommy go bye-bye. Mommy see you after nap.”


How can parents cope with separation anxiety?

In any situation, it is helpful to validate and identify the child’s feelings, for example, by saying “I can see that you are feeling upset and really need a hug.” If you can spare a moment for a quick hug, say “I’m going to give you a hug and then I have to put you down to make dinner. Would you like to sit next to me or help me?” You can stay calm, reassure them that you will be there, meet their needs, and then help them find a way to maintain some proximity. This makes them feel heard and respected, but also teaches them that they will be just fine if they are not being held or the center of your attention.


Wednesday, July 16, 2014

Hummus and Pepper Sun

Preparation time: 15 minutes
  • 1 can (15.5 oz.) chick peas (garbanzo beans), drained and rinsed
  • 1/2 small clove garlic
  • 2 tbsp. extra virgin olive oil
  • 1 1/2 tbsp. fresh lemon juice
  • 2 to 3 tbsp. warm water
  • Salt and freshly ground black pepper
  • Whole wheat pita bread (sliced into small triangles)
  • Red and yellow pepper strips
  • Carrot sticks or baby carrots
  • Combine the chick peas, garlic, and olive oil in the bowl of a food processor until the mixture is smooth.
  • With the food processor running slowly, add the lemon juice and 2 tablespoons of the warm water.
  • Pour the hummus into a small bowl. Adjust seasoning to your taste with salt and pepper.
  • Place the hummus bowl in the center of a round plate. Arrange items for dipping around the bowl, so that the hummus looks like the center of the sun, and the dippers look like the sun's rays.
Serves: 10


Monday, July 14, 2014

Shielding Kids from Internet Bullies

With the illumination of bullying over the past year, along with the popularity of social networking sites constantly increasing, internet bullying, or cyberbullying, among school-aged children is a major concern.

Children and teens spend much of their time online, which makes bullying even easier. Cyberbullying allows the bully to be bolder, due to the possible anonymity, and allows the bully to reach the victim at any time of the day or night, leaving the victim with nowhere to hide. Children’s National Medical Center general pediatrician, Ivor Horn, MD, MPH, said that another reason cyberbullying can be worse than physical bullying is the fact that it spreads much more quickly. Cyberbullying has been used for many purposes, and often parents have no idea their child is being bullied because the child is hesitant to tell them.

Keeping bullies at bay:
  • Block the bully from your child’s account, and do not respond to any messages from the bully
  • Refrain from sharing contact information online, such as email address and phone numbers
  • Take pictures of threatening messages for evidence
  • Remind your child to report any bullying or threatening messages to an authority figure
  • Visit sites such as and to learn about how to deal with bullying and other internet safety tips
Besides internet bullying, another concern is internet crime, as offenders continue to become smarter and sneakier and are able to lure children in. Parents should be cognizant of the ease of accessibility to their children for internet predators, and be sure their children are aware of the potential online dangers.

Find other tactics parents should employ to protect their children, along with these:
  • Use parental controls to block certain websites, and monitoring chat room use
  • Maintain access to your child’s account, and monitoring it regularly
  • Tell your child to NEVER arrange a meeting with anyone they met online
Dr. Horn also wants to remind parents that if they allow their children to be involved on the internet and on social networks, they should also have an online presence. She states that not only does this allow parents to monitor their child’s activities, it also provides a new means to bond with their children.

“It’s the same as riding a bike. You have to walk along beside them as they learn the internet and social media, just like you would if you were teaching them how to ride a bike,” said Dr. Horn.

Thursday, July 10, 2014

Heat-Related Illness - Know the Signs

On a hot and sunny summer day, the last thing a child wants to think about is sitting in the shade. Children produce more heat during activities and sweat less, which is why they are more susceptible to heat-related illnesses, especially on hot, humid days.

Parents can help to avoid heat-related illnesses by making sure their children are wearing the right clothes for hot weather and drinking plenty of water. Parents should also keep these tips in mind:

  • Keep kids in light colors
  • Wear loose fitting, cotton clothing
  • Wear a wide brim hat, preferably with ventilation
  • Stay hydrated

According to Children’s National Health System’s Joanna Cohen, M.D., heat-related illnesses exist on a spectrum, ranging from heat cramps to heat exhaustion, to the most severe, heat exhaustion. Below are some common heat-related illnesses, along with symptoms and treatment recommendations.

Heat Cramps
Heat cramps are the mildest form of heat-related illness and the first sign of trouble:

  • Children complain of painful cramps, especially in the legs
  • Skin becomes flushed, moist

If your child is experiencing the effects of heat cramps, there are a few ways to treat them:

  • Move the child to a cool place and rest
  • Remove excess clothing and place cool clothes on the skin (you can fan the skin too)
  • Give the child cool sports drinks containing salt and sugar, such as Gatorade
  • Stretch cramped muscles slowly and gently

Heat Exhaustion
Heat exhaustion is more severe than heat cramps and happens when water and salt lost from the body through excessive sweating is not replaced with enough fluid. When a child’s body is unable to cool down, he or she may feel these symptoms of heat exhaustion:

  • Muscle cramps
  • Pale, moist skin
  • A fever higher than 100.4°
  • Nausea
  • Vomiting
  • Diarrhea
  • Headache
  • Fatigue
  • Weakness
  • Anxiety, and faint feeling

The treatment for heat exhaustion is similar to that of heat cramps, but the fever heightens the need for further medical attention:

  • Move the child to a cool place and rest
  • Remove excess clothing and place cool clothes on the skin (you can fan the skin too)
  • Give the child cool sports drinks containing salt and sugar, such as Gatorade
  • Stretch cramped muscles slowly and gently
  • If there is no improvement or your child is unable to take fluids, call your child’s physician or take your child to an emergency department immediately. IV (intravenous) fluids may be needed

Heat Stroke
Heat stroke is the most severe heat-related illness and occurs when the body becomes overwhelmed by excessive heat and can no longer regulate temperature. Dr. Cohen says you can tell when a child is in danger of heat stroke when there is no sweat and the skin is dry. Children experiencing these life-threatening symptoms need medical attention:

  • Warm, dry skin
  • High fever, usually over 104º F
  • Rapid heart rate
  • Loss of appetite
  • Nausea
  • Vomiting
  • Headache
  • Fatigue
  • Confusion
  • Agitation
  • Lethargy
  • Stupor
  • Seizures, coma, and death are possible

If your child is experiencing heat stroke, these are the steps you should take to treat them:
  • Move to a cool place and rest
  • Call 911 or your local emergency medical service. Heat stroke is a life-threatening medical emergency and needs to be treated by a physician
  • Remove excess clothing and drench skin with cool water; fan skin
  • Place ice bags on the armpits and groin areas
  • Offer cool fluids if alert and able to drink

There is a simple rule to help children avoid these heat-related illnesses, courtesy of Children’s Medical Director of Disaster Preparedness and Emergency Management Daniel Fagbuyi, M.D. “Make sure children hydrate before, during and after an activity on extremely hot days,” Dr. Fagbuyi said.