How to Talk to Your Children About Tragic Events

Wednesday, July 10, 2013 4:47 PM comments (0)

childrenAll parents hope to shield their children from the knowledge that bad things happen in the world for as long as possible. Unfortunately, protecting your children from this knowlege isn't possible forever.  Frequently, children learn about violent and tragic events from their friends as well as from television. These tragedies can confuse and frighten children if they don’t think they can discuss them openly. Limiting exposure to the news may be helpful; however, parents can do so much more to help their children feel safe and secure.

What and how much do you say to children? How do you know they want or need to talk? How can you get them to open up to you about their fears? Dr. Robert Farra, PhD, recommends that parents:

  • Watch children closely. Some children, especially younger children, might not express their anxieties with words but might exhibit signs of anxiety or worry like changes in behavior, sleep and appetite.
  • Allow them to ask the questions. By allowing them to ask the questions, children will move at a pace and level of discussion that is comfortable for them. It will also be an indicator to you of how much they need or are developmentally prepared to know.
  • Encourage kids to write or draw their feelings. For some children talking about their feelings might not come easily. Children might be more comfortable writing down or drawing pictures that express their feelings. You can communicate through the work they produce. 
  • Provide as much comfort as possible. Let children know that they are safe both with words and your behavior. Children look to parents and authority figures for cues on how to react to a situation. If you are upset, it is okay to show your own emotions. Make sure to process and seek support for your own feelings so that you can better provide comfort to your children. Also remind them that there are police, firefighters and other adults keeping them safe too.
  • Don't be afraid to say, "I don't know." You won’t have all the answers. Just like children, adults experience confusion and fear in the wake of a traumatic event. By saying, “I don’t know,” you are telling your children that it is okay to be confused because you are too.

How do you discuss difficult topics with your children?


The Benefits of Breastfeeding for Mom and Baby

Friday, July 05, 2013 1:00 PM comments (0)

breastfeedingIn return for sweet smiles and abundant cuteness, babies ask only for love, affection, the right to be awake when you want to sleep and nourishment. What form that nourishment takes is up to you.

New mothers who are unable to breastfeed should not feel guilty because formula is an effective way to feed your baby and ensure he or she receives proper nutrition.  But, the health benefits of breastfeeding for both mother and baby are many and exclusive breastfeeding for the first few months of a baby’s life is recommended. New moms should take note that many of the same benefits of breastfeeding can be achieved through a combination of breastfeeding and supplementing with formula.  

Ann Borders, MD, and Emmet Hirsch, MD, obsectrics/gynecology at NorthShore, share some of the valuable health benefits of breastfeeding:

  • Breast milk is nutritious and easy to digest. It’s the perfect combination of vitamins, fat and protein. It’s easy for a baby’s sensitive digestive system to break down, reducing constipation and gas.
  • Breast milk is an infection and disease fighter. It provides antibodies that help combat infection. Breastfed babies have fewer ear and respiratory infections. Breastfed babies have less risk of Sudden Infant Death Syndrome (SIDS). Babies breastfed for at least six months are less likely to become obese as children and adults. It’s believed that breastfeeding is linked to lower rates of asthma, type 2 diabetes and some forms of cancer later in life. 
  • Breastfeeding is a bonding experience. It is extremely important for a mother and child to establish a secure bond in the first months of a child’s life. The physical closeness and contact of breastfeeding is an important opportunity for bonding. 
  • Breastfeeding saves money. Formula comes with a heavy price tag. Breastfeeding can save thousands of dollars a year. Add to that sum the potential long-term costs of healthcare for issues breastfeeding might help prevent. The Centers for Disease Control and Prevention (CDC) reports that families that follow breastfeeding guidelines save $1,200 - $1,500 in formula costs alone in the first year.
  • Breastfeeding burns calories. A woman who breastfeeds burns approximately 500 extra calories per day, making it easier to shift those extra pounds from pregnancy. That’s the equivalent of jogging for one hour. It also helps her uterus return to the size it was before pregnancy.
  • Breastfeeding is healthy for mom too. Breastfeeding lowers a woman’s risk of developing type 2 diabetes, and breast and ovarian cancers. Breastfeeding has been linked to lower risk of postpartum depression. Some studies show that it could also lower her risk for osteoporosis. 

Did you breastfeed? What were the advantages/disadvantages for you? For more advice on breastfeeding from Ann Borders, MD, click here


Summer Fun: Water Safety for Kids

Tuesday, July 02, 2013 5:05 PM comments (0)

water safetySpending time by the water is a great way to cool off during the hottest months of the year but it can be a dangerous place, too, especially for small children. There are a number of measures parents can take to ensure time by the pool or on the beach is always safe and lots of fun.

Joseph Terrizzi, MD, Pediatrician at NorthShore, shares his tips and precautions to ensure the entire family stays safe all summer long:

  • Always supervise children. Never leave children alone in the pool or near bodies of water. Infants and young children can drown in as little as one inch of water. If your children are frequently exposed to water, consider enrolling them in swim lessons. If your children can swim that doesn’t mean supervision isn’t necessary because even the strongest swimmers can drown after experiencing a muscle cramp or fatigue. Always be vigilant about supervision.
  • Fence backyard pools. It’s difficult to have both eyes on small children at all times. If you have a backyard pool, make sure it’s fenced with locks that can’t be easily opened by children.
  • Take swim breaks. Buoyed by the water, it can be hard to tell that your muscles are getting tired. Get out, rehydrate and relax throughout the day. Fatigue and dehydration can lead to drowning.
  • Establish safety rules. Public pools have rules in place and these rules can and should apply to backyard pools as well. Pool rules should include: no running or pushing near the pool; always swim with a buddy; no screaming; no diving in water less than five feet deep.
  • Avoid the use of flotation devices. Inflatable toys and rafts can deflate suddenly, leaving your child without protection in deep water. Don’t rely on them or allow children to use inflatable objects to swim into water that’s too deep for their age and ability level.
  • Always wear a lifejacket. Every member of your family, from the youngest to the oldest, should wear a lifejacket at all times on boats or in large bodies of water. A lifejacket fits correctly if it can’t be lifted over the head of the wearer when fastened.
  • Stay up-to-date on pool maintenance. Faulty pool drains can suck in and catch hair, and even arms and legs, so have your equipment inspected at the start of every swim season. Recreational water illnesses are caused by germs that are swallowed in contaminated pools and hot tubs. Keeping chlorine at recommended levels is essential.

What do you do to keep to promote water safety at home by the pool?


Enriching and Rewarding: Judy Zager, RN, Serves in Panama

Friday, June 28, 2013 3:07 PM comments (0)

This spring, Judy Zager, RN at NorthShore, and Ken Fox, MD, Pediatrician at NorthShore, joined a team of Chicago-area healthcare volunteers in Panama. The team traveled to a remote area of Western Panama to provide much needed healthcare to those with limited access, including individuals from one of the country’s last remaining indigenous tribes, the Ngobe-Bugle. 

Judy Zager tells us about the impact she made and the lasting impact the experience made on her.

Judy ZagerWhy did you choose Panama for your first medical mission trip?
A friend of mine was instrumental in building the dental clinic at this particular site. He’d asked repeatedly for me to join him on a mission. Once I made the commitment, I was asked to recruit a pediatrician and Dr. Fox readily accepted the invitation.

What were your expectations before you left?
My only expectation was that we would be seeing many people who would travel very far distances for care.  When I spoke with another nurse who had been at the site on other missions, she explained what I should expect to see.  It was useful to talk to her beforehand. Her information was a helpful “heads up” for what to anticipate.

What was a “typical” day at the clinic like?
A typical day started at about 9:00 AM. Our arrival was announced on the radio. The patients we saw walked far for care and came early. They often had to wait hours for their number to be called.  With the assistance of Ngobe and Spanish interpreters, each person was triaged prior to being seen by the physician. Vitals were established and their complaints, along with symptoms, were documented. After that, they were evaluated by Dr. Fox and tested when appropriate for pregnancy or strep.  Medication that had been donated to this project was distributed when appropriate.


Was there a case that made an impact on you?
There was a mother and her sister who walked four miles with twins. The twins had an advanced case of impetigo, which is a highly contagious bacterial skin infection common among younger children. This particular case was so advanced that one twin had developed cellulites and the other required IV antibiotic treatment. The minister in charge of our program facilitated getting them admitted to the local hospital.


Why is mission work like this so important for you?
I stepped outside my comfort zone to travel to another country to provide care for others.  I did begin to second guess myself once I had made the commitment to go. Why was I giving up my vacation time and spending my own money to do this work? In the end, it was more rewarding than I ever could ever have imagined. 

What did you take away from your experience? Will you do this again?
The work environment was primitive.  The friend who recruited me helped build the dental clinic and it is a beautiful dental facility that’s very easy to work in.  We (me and Dr. Fox) were in a makeshift area. It was oppressive in the heat with minimal ventilation and just a couple ceiling fans.  There was also no running water.  I came home inspired to return but also inspired to help raise funds to make the medical clinic a better place to work and a better place to receive care. 


A Sense of Purpose: Ken Fox, MD, Serves in Panama

Wednesday, June 26, 2013 4:26 PM comments (0)

This spring, Ken Fox, MD, Pediatrician at NorthShore, and Judy Zager, RN at NorthShore, joined a team of Chicago-area healthcare volunteers in Panama. The team traveled to a remote area of Western Panama to provide much needed healthcare to those with limited access, including individuals from one of the country’s last remaining indigenous tribes, the Ngobe-Bugle. 

In part one of this two part series, Dr. Fox shares some of the most memorable moments and tells us why this wasn’t his first and certainly won’t be his last medical mission trip. 

dr foxWas this your first mission trip?
No. I was in Haiti for a week one month after the earthquake of 2010. And I’ve done work in Cape Town, South Africa as well.

Why are you drawn to this type of medical mission work?
I’ve always been drawn to other cultures and customs. And as a pediatrician, I’m fascinated by the varieties of ways that families and communities come together to do the work of caring for children’s health. My previous work in medical anthropology combined these interests to help inform my clinical work. This Panama trip was an opportunity to rekindle a kind of “vitality of practice” I hold dear.

Prior to leaving on this trip, what were you expecting? How closely did your experience match your expectations?
I wasn’t absolutely sure what to expect. Before we left, I read some on Panamanian history, society and indigenous cultures. And I even read some fiction by a contemporary Panamanian writer. What you learn in books is one thing; being out there on the frontline in the heat and the dust among people struggling to survive with very limited resources is something else entirely.

The abject poverty and absence of resources—poor transportation, housing, nutrition, scarcity of potable water, poor sanitation, low educational/literacy levels, inadequate clothing and shoes—create a perfect storm of risk for the people we served on this mission.

Describe a “typical” day at the clinic? What were some of the most common illnesses you helped treat?
We usually arrived about 9 AM to find a courtyard full of waiting patients. Most of them had walked for hours to get there. We often worked in three languages (Ngobe, Spanish and English). Recruiting all the clinical acumen we had to muster, we tried to figure out quickly and efficiently what was most at stake. Our focus was to address their questions as best we could. There was no lab, x-ray or subspecialist to consult. We had to think on our feet, use our physical exam skills and make decisions.

In this setting, the power of social forces to shape health and illness was so apparent. We had to be mindful of resource constraints and be creative in seeking solutions. But on a deeper level, the moral dimensions and “doctoring” were so much easier to see. It was all very challenging but often very gratifying. 

Was there a single case that had the most impact on you? 
The most memorable case was a pair of two-year-old twins who showed up one morning with their mom and aunt. They heard a radio broadcast about the medical care available at the community center and walked four hours from the mountains to get to us.

They had the worst case of bullous impetigo and ear cellulitis I’ve ever seen. The ear of one was just macerated and covered with sores and pus. Then we brushed back the other twin’s thick black hair to find a similar infection on her forehead. Wcleaned things up and decided to contact a Panamanian colleague with hospital privileges to get them admitted for IV antibiotics. We texted a picture and he arranged for admission to the closest hospital which was about an hour away. It just so happened that someone was delivering supplies to the site by truck at that moment. Since there is no ambulance service available, we arranged for him to drive the family to the hospital. I will never forget the sad sight of this mom climbing into the back of a truck with a twin tucked under each arm heading for the hospital. How difficult it must have been to face such uncertainty and threat. She’d already struggled to get to us, but she was relieved to get help.

How a simple skin infection we see here every day gets transformed into such a severe illness is a reflection of the “structural violence” some people are forced to endure. It just doesn’t seem fair or necessary in a nation in the midst of a vast economic expansion with a 10.5% annual GDP growth rate. The experience just reminds me of the power of social inequalities to harm health—a truth evident here at home as well.

How will work like this help make you a better doctor?
It’s always healthy to have experiences that remind you of the fundamental reasons you go into a “helping profession” like medicine in the first place. The daily grind of primary care can sometimes dull the acute sense of purpose that enlivens our work. Patients are not customers—our work adds up to more. There’s something special about the relationships we form—something sacred—if we’re given the space to do the work.

Where were the other medical professionals from? How many were on this trip?The trip was organized by a prominent Chicago dentist and his wife who built a fantastic dental clinic in the community. They worked in collaboration with an American expat pastor who has longstanding relationships among the Ngobe community in Panama. They’ve done a number of impressive projects together over the years. NorthShore nurse Judy Zager and I joined them on this trip.

Do you think you will do something like this again?
Absolutely! I learned a lot about humanitarian medical relief efforts and community medicine in resource poor settings. And I want to try to build this kind of experience on a regular basis into my ongoing professional work and development.

I was so grateful to my colleagues here at NorthShore. People were interested in what we were doing and so supportive, from covering our patients and on call duties while we were gone to donating books and other materials for the trip. People had our backs. And that means the world to me.

In part two, Judy Zager will tell us about her experience on this medical mission to Panama. 


Delicious and Nutritious: Maximize Your Garden

Friday, June 21, 2013 2:28 PM comments (0)

Summer has arrived. Ice cold glasses of lemonade and cookouts are among the many perks of the warmer weather. But don’t forget to add the delicious fruits, vegetables and herbs in season during the summer to that list. Sure, it’s easy to find produce at your local grocery store, but when you grow it yourself, you reap both the nutritional and physical benefits of your harvest.

Geeta Maker-Clark, MD, Integrative and Family Medicine at NorthShore, shares some of the benefits gardening can have on your overall health:

  • Pesticide and preservative free. Homegrown produce and herbs mean you know exactly what went into the growth and harvesting of your food. You can rest assured that there are no unnecessary preservatives and/or pesticides.
  • Encourages healthy eating habits. Knowing that the food on your table is a direct result of your hard work can help you make smarter food choices. It might also encourage you to include more fruits and vegetables in your daily meals. You may end up growing some varieties of veggies and fruits that you have never tried before.
  • Saves some green. Keeping an edible garden reduces the amount of produce you have to buy at the grocery store.
  • Brightens your mood. Spending time outside can help improve your mental outlook and reduce stress. Getting your hands dirty, smelling the soil and connecting with the cycles of life can be meditative activities.
  • Slims your waistline. Not only does gardening provide you with deliciously healthy food, it’s also a great way to get some exercise. Weeding, trimming and harvesting can be hard work if you keep at it for 30 minutes or more.
  • Connects you to your family. Getting your family out in the garden is a great way to spend some quality time together, creating something that will benefit all of you. 
  • Provides vitamins and minerals. Fruits, vegetables and herbs are filled with nutrients your body needs to stay healthy. Here’s a sneak peek at just a few of the vitamins and minerals found in common produce items:
  1. Tomatoes are full of fiber, iron, magnesium, niacin, potassium and vitamins A, B6, and C, as well as the antioxidant lycopene.
  2. Red bell peppers are rich in potassium, riboflavin, vitamins A, B6 and C. 
  3. Broccoli is high in calcium, iron, magnesium and vitamins A, B6 and C.
  4. Zucchini is a good source of niacin, pantothenic acid, dietary fiber, protein, vitamins A, B6 and C, folate, iron, magnesium, phosphorous, potassium, zinc, copper and manganese.
  5. Cilantro is an excellent source of thiamin and zinc, and a very good source of dietary fiber, vitamins A, B6, C,  E (Alpha Tocopherol) and K, riboflavin, niacin, folate, pantothenic acid, calcium, iron, magnesium, phosphorus, potassium, copper and manganese.
  6. Basil is a good source of vitamin E (Alpha Tocopherol), riboflavin and niacin. It is also a great source of dietary fiber, vitamins A, B6, C  and K, folate, calcium, iron, magnesium, phosphorus, potassium, zinc, copper and manganese.
  7. Blueberries are a good source of dietary fiber, vitamins C and K, manganese and rich in antioxidants.
  8. Kale packs a high iron punch and it’s also high in vitamins A, C and K.
  9. Dill adds flavor and texture to a dinner salad but it also brings vitamins A and C, and lots of iron to the table.

What is your favorite fruit, vegetable or herb to grow in the summertime?

To see more on the health benefits of gardening, check out this video from Lake County's recent community gardening event, Dig Day


Sun Safety Tips: Protect Your Skin from the Sun [Infographic]

Wednesday, June 19, 2013 3:41 PM comments (0)

It’s finally here! Summer seems to have arrived and with it warm weather and sunshine. Don’t rush out into the sun just yet though! Sun exposure can damage your skin and increase your risk of skin cancer. That's why it’s so important to protect your skin from the sun’s harmful rays every day.

How can you protect your skin? What’s the right sunscreen to use? How often should you reapply it? Is sunscreen safe for everyone?  NorthShore University HealthSystem has you covered with sun safety tips for adults, kids and babies alike.  Click on the image below to access our full infographic with helpful sun safety tips and then go out and enjoy the summer sun without getting burned. 


Understanding and Coping with the Changes Brought on by Menopause

Friday, June 14, 2013 4:21 PM comments (0)

menopauseAt some point every woman will go through menopause—a time when the ovaries discontinue the production of estrogen and progesterone and monthly menstruation stops. For some women this transition can be difficult physically and emotionally. 

One important thing for women to understand about menopause is that it is a natural part of the aging process.  Although the age at which it starts may vary, it eventually will happen to all women.

Margaret Salamon, MD, Gynecologist at NorthShore, offers the following suggestions for relieving some of the discomforts that menopause may bring:

  • Know your hot flash triggers. If you can identify what brings on your hot flashes, you can work on finding ways to reduce them. Common triggers are: coffee, wine, chocolate, and spicy or acidic foods. Additionally, warm temperatures and stress can be triggers for some women. Keeping a diary for a couple of weeks can help you understand your own triggers. 
  • Make time to exercise. Staying active can help keep your spirits up. Additionally, many women experience a decrease in their hot flashes when they add regular exercise into their routines. The combination of reduced hot flashes and regular exercise will also help you to sleep better.  It’s also important to do exercises that help strengthen your pelvic muscles.  Weight-bearing exercise will keep your bones strong. 
  • Revamp your diet. Eating a well-balanced, healthy diet can keep you feeling well during this stage of your life. Be sure you are getting sufficient calcium, iron and fiber on a daily basis. If you can, try to reduce your daily fat, sugar and salt intake. Additionally, too much caffeine can exacerbate the sleep difficulties you may be having, and it can lead to more irritability. It may also be best to limit your consumption of alcohol.
  • Reduce your stress. Find time to relax and participate in activities that help you unwind. Do something just for yourself. This might include yoga, reading or meditation. 
  • Get involved! Different cultures view this stage of life in various ways – some have a more positive attitude about it.  For example, the Japanese see it as a time to be active in mentoring and guiding others in the community, and not a time of decline.  Consider finding a cause to champion or picking up a new hobby.
  • Consider hormone therapy. During menopause a woman’s body produces less estrogen and progesterone. This reduction in hormones can lead to various discomforts and symptoms. Those women who have mild symptoms are often able to use natural products and lifestyle changes, to help with their menopausal symptoms.  For others, these methods will not be enough to alleviate their discomfort. There has been a lot of attention to the risks of heart disease and breast cancer related to use of hormones, but for women who are really incapacitated by the loss of hormones, low doses of hormone replacement, for brief periods of time, can be a good option. As with any treatment option, how you perceive these risks is an individual choice, and you should talk with your physician about what would be best for you.

 What worked for you to help relieve some of the symptoms of menopause? 


Summer Bug Safety: Tips to Stay Bite-Free

Friday, June 07, 2013 10:48 AM comments (0)

insect safetyThe warmer temperatures of late spring and summer mean more outdoor family time, from BBQs to pool parties, but it’s important to make sure that time is safe for you and your kids. Most of us know to practice vigilant sun safety during the hottest months of the year, when the sun’s rays are at their most intense, but sometimes we forget it’s also very important to protect against dangerous insect bites. Warm temperatures are just as appealing to insects as they are to Chicagoans ready to leave a long winter behind.

Most mosquito bites are irritating but otherwise harmless; however, some mosquitoes can transmit encephalitis and West Nile virus, which can cause severe illness with symptoms like headache, high fever and bodily weakness. Ticks can transmit Lyme disease, which can be treated if recognized early, so look for flu-like symptoms and possible rashes. Left untreated, Lyme disease can cause joint and muscle pain, fatigue, heart problems and neurological issues. 

Felissa Kreindler, MD, Pediatrician at NorthShore, shares her tips for preventing insect bites and protecting against the illnesses they can cause all summer long:

  • Don’t apply perfumes and avoid the use of scented soaps. The sweet scents of soaps and perfumes attract some insects. 
  • Stay away from stagnant water and heavily wooded areas. Insects, especially mosquitoes, congregate around pools of water. Deer ticks, which carry Lyme disease, are more likely to be in areas with lots of trees and brush. 
  • Avoid wearing bright clothing. Bright flowery prints also attract insects, including honey bees and hornets.
  • Do not use combination sunscreen/insect repellents. Sunscreen needs to be reapplied often but insect repellent should not.
  • Check DEET concentrations on insect repellents before use. Higher concentrations of DEET protect for longer lengths of time. Choose a concentration based on how long you need to protect yourself. Repellents containing DEET should not be used on children younger than six months old. 
  • Protect your pets, too. Your four-legged family members can also get diseases from insects. Make sure to bring and use your pet’s flea and tick repellants.

How do you protect your family from summer insect bites?


Tips for a Happy, Healthy Pregnancy After Age 35

Wednesday, June 05, 2013 12:42 PM comments (0)

pregnancyIncreasingly more women are waiting until later in life to start families. And while there are many benefits to postponing motherhood, there are some health risks that increase as a woman ages. 

What are the risks? Starting in their mid-30s, women face an increased risk for miscarriage, fetal chromosomal abnormalities, high blood pressure, gestational diabetes, placental abruption, preeclampsia, early labor and are more likely to require a cesarean. 

It’s important to remember that these are risks all women, no matter their age, face during pregnancy. While every woman’s pregnancy is unique, older moms-to-be often face some unique challenges. Knowing what challenges might arise and how to reduce your risk increases the likelihood you’ll enjoy a happy and healthy pregnancy.

Scott MacGregor, DO, Maternal-Fetal Medicine at NorthShore, shares his tips for staying healthy throughout your pregnancy: 

  • Talk to you doctor or midwife before getting pregnant. If you are older than 35 and thinking of starting a family, talk to your doctor or midwife about the current state of your health.  He or she can assess your personal risks and recommend certain lifestyle changes or evaluations to ensure you are at optimal health prior to getting pregnant. 
  • See your doctor or midwife early and regularly. As soon as you think you might be pregnant, see your doctor or midwife. The early stages are very important for any woman. Your doctor or midwife can assess your pregnancy and medical status in the early months and provide you with information to help guide you through the process.  Your doctor or midwife can also discuss your management plan and options during the pregnancy.
  • Take your vitamins. Again, this is important for any pregnant woman. Prenatal vitamins should contain at least 400 micrograms of folic acid. If you are not yet pregnant but are considering starting a family, start prenatal vitamins or folic acid now. Getting the recommended amount of folic acid before pregnancy and during the first trimester helps prevent birth defects. 
  • Make healthy lifestyle choices. Pregnancy is an excellent time to embark upon smart lifestyle choices. Moderate exercise—walking, swimming, yoga, stationary bike—for 30-45 minutes daily is encouraged. Make sure to maintain adequate hydration and avoid overexertion.  Cigarettes, alcohol and illicit drugs should be avoided.  Over-the-counter medications and herbal medicines should be avoided. 

Are you waiting until later to start your family? When did you have your first child?

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