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To find a certain email, click Edit in the top of this screen and in the drop
down menu, click "Find on this page". To print just that email instead of the whole list, highlight the email and
click file at the top of the screen. Then Newsymail 2005 1/3/2005
The National Institute of Health (NIH) studied programs to stop
repeat teen violence. The get tough programs like boot camps and
detention centers did not help. There were two that were shown by
external studies to help. They were Functional Family Therapy
(duh!... you mean the dysfunctional family has an affect on kids?)
and the other is Multisystemic Therapy. There were six other
programs that were not proven by outside studies to be effective but
they have numbers that suggest that they might help. They are Big
Brothers/Sisters, Multidimensional Treatment Foster Care,
Nurse-Family Partnership, Project Towards No Drug Abuse, Promoting
Alternative Thinking Strategies, and Brief Strategic Family
Therapy. See: http://consensus.nih.gov/ta/023/023youthviolencepostconfintro.htm
Dr. Knapp
1/19/2005
There is a new way to remove tonsils. Instead of an electric
cautery, there is a new device called coblation. The temperature
the old way is 300 degrees while the new coblation is only 30
degrees. So less damage to surrounding tissues. The recovery time
goes from an average 4 days to 1.5 days. Less pain is a good
thing. This instrument will be coming to the local hospitals for
the ENT doctors to use in the next few months. Yeah!
Dr. Knapp
1/22/2005
Things just keep getting younger and younger. There was a 14%
increase in cosmetic surgery in children below 18 last year. Ears,
nose and breast jobs. There were 3700 breast augmentation in
teenage girls and just as many breast reduction in teen boys. (I
guess we really are just a vain.) There are rare exceptions that
a defect you have make you repulsive ugly, then have it fixed. An
important thing we parents do is teach our children to accept what
God gave them like a bald head like mine. When you start down the
road of having this perfect body, then it is a sad road and you are
never happy with your body. Accept what you have. Everything will
eventually sag (darn gravity).
Dr. Knapp
1/27/2005
They just reported the first ever patient with Rabies living through
this terrible disease. They put the teenager into a coma, gave
antiviral drugs and vaccinations. The patient thought the bat just
brushed against her leg. And she thought sick bats would not fly. In
fact you cannot feel the bite of the bat so anyone coming in close
contact with a bat should get shots. It is better to prevent the
disease rather than trying to treat it, which is improving but you
probably will have some residual harm. So watch out for bats.
Dr. Knapp
2/6/2005
If you are thinking of government run health care, look to the
North. Canada's government-run health care reports that averaging
12 specialties in 10 provinces it takes 4 months to get a patient
into the hospital. It takes 1 year to get a hip replacement for
example. It has private clinics for the Mounted Police, workman's
comp cases, and prison inmates. There was a joke in the newspaper
up there about two prisoners talking. One prisoner asks the
cellmate "What are you in for?" Answer: "Hip replacement....." Our
system of healthcare in America is not perfect nor equal but it is
still the best in the world.
A friend of ours sat 5 rows behind Pres. Bush at the
inauguration. They passed the plate for donations at the prayer.
It is common knowledge that Pres. Bush does not carry any cash
money. So he whispered for some cash to put into the plate. V.P.
Chaney passed him some money and so did his father first Pres.
Bush. He took the money from his father and put the money into the
offering plate. The morals of this event are two: you never get too
old to ask for help from friends, and no matter how high in
society, your children never stop asking for money.... !!!!!!!!!
Dr. Roger Knapp 2/10/2005 It is vogue and cool to teach your infant/toddler sign language when you are teaching them to talk. I worry about how good that is for them. Ten years ago we started teaching the first graders “finger math” so that they could quickly figure addition and multiplication problems easily using their fingers. But then they did not memorize their math facts and were delayed in their ability to do regular math problems on paper. So we quit it. I just worry that the infant will rely on the hand language instead of learning to talk better. In fact if the 2 year old is not talking well and getting everything he wants by grunting and pointing, then I tell the parent to play like you do not understand what he wants and don’t give it to him until he says it. It will frustrate him but he will eventually understand that he is not going to get what he wants until he communicates in the language that everyone understands. There are quite a few children that learn both sign language and verbal language but there are some that it slows them down.
Dr. Knapp 3/10/2005
Everyone has heard of the formulas with "Lipil".
This is an essential fatty acid called docosahexaenoic acid (DHA). This DHA
is needed in the development of the brain and retina of the eye. Studies
show improved development when there is higher intake of DHA in the diet of
infants. Also there is improvement if the mother takes in more DHA in her
diet the last trimester of the pregnancy. DHA you can get from fish oil and
fish but the risk of Mercury is too much. So pure extracts of DHA is
safer. The product Expecta is DHA that the pregnant mother can take every
day. Also if she takes it while breastfeeding her breast milk will have
more DHA and will be giving her infant "lipil breast milk". (You can make a
sticker and put it on your breast.. ha) The oriental mothers who eat alot
of fish have much more DHA than American mothers. Maybe that is why there
are many oriental children in the top of graduating high
school classes. Formulas have DHA added but Enfamil has the most. Good
Start has less and Similac has the least.
Iron is also needed for good brain development.
There is very little iron in breast milk compared with formula but we did
not see any anemic breast fed babies. But in studies coming out now show if
you compare breast fed babies who are given extra iron with those who are
not, the babies with iron developed better. So it would be better to give
breast fed infants vitamins with iron like Poly-Vi-Sol with iron or
Tri-Vi-Sol with iron.
Dr. Knapp 3/17/2005 The bacteria Neisseria meningitides causes blood infections and meningitis. This meningococcal disease occurs at any age but is most common 15 to 24 yr old. The 3000 cases that occur each year has an overall 10% mortality but the 15-24 has a mortality of 22% and 1/3 have major damage. We have been recommending a meningococcal vaccine for many years for the seniors who are going to college, but there is now a brand new meningococcal vaccine called Menactra that is approved for 11-12 yr olds. At that age it will protect them during high school as well as college, and also it eliminates many carriers of the germ. Most insurance policies will not pay for it since it is not required by high schools even though many colleges require it. It is about $90 but I think it is worth it. It is a nasty germ and even though not very frequent, it is a rapid and deadly infection.
http://www.drugs.com/NDA/menactra_040922.html
Dr. Knapp 4/6/2005 Acid stomach and ulcers are mostly caused by a bacterial infection of the lining of the stomach by a germ called H. pylori. Adults who were on antacids for years were treated with medication to eradicate it from the stomach and then threw away their antacids. It cured them (although it can relapse). China and Japan have a much higher incidence of this problem and a higher incidence of stomach cancer. A study just came out looking at 1500 patients. After 7 years there was 3% stomach cancer in the infected group and none in the uninfected group. In another study those that were treated had 37% less cancers. So there is not only a comfort issue in treating this but also a health and longevity issue. Children can also have this infection and sometimes is the cause of constant stomach aches in school children. This germ can be detected by aspirating the stomach with a tube down the throat (Ugh) or from a frozen stool specimen (less traumatic but more smelly!) or blood test. (stool was the more accurate.) So if you are eating a lot of antacids, get it checked out.
Dr. Knapp 4/17/2005
Diarrhea kills 600,000 children every year in the world. It is not
number one killer. Unsanitary drinking water kills 3,900 children every
day. The most important thing we could do for the underdeveloped
countries is to get them a water treatment system. Rotovirus is one of
the more common causes of severe vomiting and diarrhea around the world
and here in America. We should have a vaccine for it next year.
No S*%#....
Dr. Knapp
4/20/2005
There will be 132,000 cases of Milignant Melanoma yearly and 66,000
deaths. Keep sunscreen on you and your children. Exposure to UV
rays below 18 yr old is worse and below 30 is bad. Tanning beds are
just as dangerous as sunbathing. Keep at least 20 SPF sunscreen or
higher on them when outdoors in the mid day. If the teens just have
to have the dark skin then use the tanning oils that are safe. I
thought shirts stopped most of the UV rays but they say they do not
and they recommend sunscreen below the shirts!!
Children are not born with most of their moles so don't be worried
that they start popping up with a lot of moles between 4 yr old and
teens.
Take photos with your digital cameras of the big moles on you and
your children so you know what they looked like last year and you
can show the dermatologist what they looked like. Make a file in
your documents for mole pictures.
Dr. Knapp
5/1/2005
Contact allergic reactions can occur with just about anything.
Every one knows about poison ivy. Whereas laundry detergents are
very rare. Actually what is very common is an allergy to Nickel.
It is in many kinds of jewelry and in snaps of clothing. Nichel
allergies can be as high as 14% of the population. That can be seen
in pierced earrings, snaps, coins before 65, deys, sools, school
chairs, orthodonic braces, and even foods.
Also antibiotic ointments can cause an allergic reaction. Some are:
Bacitracin, Neomycin Polysporin, and triple antibiotic Ointment.
Another allergen is fragrences like perfumes, personal care and
household products, opys, cosmetics, medications, diaper wipes.
Then there was the baby that was allergic to the plastic in the
pacifier and had a rash around the mouth all the time. Lanolin can
cause a reaction and that is in cosmetics, lotions, medications,
leather, furs, and also Eucerin and Aquaphor.
I guess anything can cause it so watch the rashes and watch what
they get around and watch for a coorelation.
You treat it with hydrocortisone cream or call us for a stornger
steroid cream.
Dr. Knapp
5/11/2005
The rapid strep test that comes back in 4-5 minutes is fairly
accruate. A follow up culture was only positive 2% of the time when
there is a negative rapid test. So the rapid test is adequate.
Studies also showed that 5 days of Cephalosporin like Keflex had
only 8% failures where Penicillin had 16% failures. They did not
compare Amoxacillin but probably is similar. Sometimes we prefer
Amoxacillin since it helps sinus green mucous better than Keflex.
To make things more confusing, 4% of the population carry strep
around all the time in their throat so they have a sore throat from
allergies or something else then they do a culture and it is
positive for strep that has been in there all year. Plus the
culture is only accurate 90-95% of the time so you could have honest
to goodnest Strep throat and have a negative culture and not get
antibiotics. So the culture is not as accurate as you think.
There is a rare condition after strep infection where the child has
sudden onset of Obsessive Compulsive Disorder and nervous tics. It is
called Pandas and is a weird neurological condition after a strep
infection. Strange!!
Kinda strange huh?
Dr. Knapp
5/20/2005
The most common source that infants get Whooping Cough is from the
adults that are in the house. In adults it is just a bad cough that
lasts for 3 months. But it can be dangerous for the infant. We
give DPT (P is for Pertussis or Whopping Cough) and the last time
they get it is at 4 years old. Then the immunity wears off and they
get it as a late teen or adult. There will be a vaccine this
summer for the 14 year olds that instead of just dT it will be a
Tdap with some pertussis in it. That way the adult will not cough
for 3 months and they will not give it to some infant.
Dr. Knapp
6/8/2005 The complications of Circum. is rare and the benefits out weigh them:
Complications of Circ: 2000 infections or bleeding which are treated. 300 shaft repairs which are not bad. 2 loss of falus which is horrible.
Illnesses that are prevented with Circ: 7000+ cases of HIV that cannot be cured. 10,000+ cases of Syphilis that usually can be treated. 20,000 cases of kidney infections that can be treated but leave scars. 1000 cases of falus cancer and loss of falus which is horrible. 200,000 cases of phimosis (stricture) which can be treated buy painful. 500,000 cases of infected foreskin that can be treated but is painful
Dr. Knapp 6/16/2005 The statin drugs like Lipitor are very important advances in lowering cholesterol and are important to use if you have high levels at any age. We are sometimes even testing 14-18 yr olds to treat if they have high levels. These statin drugs can cause birth defects up to 40% of the babies and it is very important not to take them when getting pregnant. The ones with Cerivstatin, Simvastatin, Lovastatin and Atorvastatin are very bad. But one that does not go to the baby and not cause birth defects is Pravastatin. I would not take any of them if I were getting pregnant (?) but if one just has to take one, then take the pravastatin.
Dr. Knapp 6/21/05
Ten ways for Parents to help their teens avoid
Substance Abuse:
1. Set a good example.
2. Know your child's whereabouts, activities,
and friends.
3. Eat dinner together regularly
4. Set fair rules and hold your child to them.
5. Be caring, supportive and maintain open lines
of communication.
6. Have a strict dress code and don't let them
wear clothes that the "bad" kids wear.
7. Surround your child with positive role
models.
8. Incorporate religion or spirituality into
family life.
9. Learn the signs and symptoms of teen
substance abuse and conditions that increase risk.
10. If problems occur, get help sooner rather
than later.
6/23/05 Bug spray and Sunscreen
Use of Deet has been shown to be safe and effective in preventing insect bites. It can be used down to 2 months of age in concentrations of up to 25%. I prefer to keep it at 10-15% preparations and more start it’s use at 4-6 months old. All concentrations are just as effective but the higher ones last longer time. The 10% deet repels just as good as the 50% but they last a different length of time. I like to put less on the skin but apply it more frequently. 10% lasts 2 hours, 30% lasts 5 hours, and 50% lasts 10 hours. Older kids can use the higher concentrations and teens can use the 50% deet without worry. Do not apply to the hands of infants and small children. You can spray your hand and apply it to the face of infants. Careful about applications of deet. It can harm plastics (eyeglass frames) synthetic fibers like rayon and spandex, leather, some watch crystals. It does not harm cotton or wool.
There are two other repellants without deet. One is Picaridin is a synthetic safe repellant that does not harm fabrics like deet and it only lasts 2 hours. It is available in 7% concentrations (Cutter Advanced) The other product is Oil of lemon eucalyptus which is a plant based repellent and lasts 90 minutes of protection.
Sunscreen products are variable and act differently. The SPF is confusing. The higher number only lasts longer but does not protect any better.(Just like the deet.) The SPF 15 will protect even very sensitive skin but only lasts 2 hours. The SPF 30 would last 4 hours. The mistake is not putting enough on the skin to get the full effect and less SPF 15 would result in an effect of SPF 7. So put plenty on the skin. So many people recommend 20-30 SPF because they figure you will not put enough on the skin. You should use a sunscreen that protects both UVA and UVB rays. Apply it 30 minutes before going out and apply it before you put Deet repellents on the same areas. Do not use the combined products that have sunscreen and repellents in it. Apply sunscreen every 2 hours. The water resistant or sweat resistant products only last 40 minutes and the “very water resistant” products only last 80 minutes. So you need to apply them when swimming very frequently. Consider putting a small T-shirt on them when swimming a long time. They are also starting to manufacture “wet suit” type tops for children to wear. One study from Europe showed children whose parents always kept shirts on their children had far less moles as adults than those who did not wear shirts. Tanning beds are worse than the sun so use the tanning chemicals, which are safer.
We still see
sunburns in children even though we warn that 2 sunburns will double
your chance of Melanoma later. 80% of our lifetime sun exposure occurs
before 18 yr of age. So keep them covered with this stuff. Just like
buckling up in the car, think before you go and keep them safe.
Dr. Knapp
6/25/05 I raced into the grocery store, 8‑month‑old in my arms and 3‑year‑old in hand, to pick up Tylenol, a prescription and a few groceries. I was on my way home from the pediatrician's office, and my to‑do list was nowhere near done. There was dinner to cook as well as housework and dirty diapers waiting for me at home, and a meeting to attend that night.
I gathered up the things we needed and hit the checkout counter, impatiently waiting to get my change so I could dash out the door, when all of a sudden an older woman came up behind me. She stopped me and said, "Slow down and enjoy your boys while they're little. The time will go so fast! My two sons are grown and live on different coasts. How I miss them and wish I could see them and spend the day with them!"
The time didn't seem to be going fast. Those were the days when I could barely see over the stacks of dirty diapers, when I was cooped up with my children's bouts of bronchitis or ear infections, spilled milk and whines of "Mommy!" On those days, it seemed like I hadn't talked to an adult in what seemed like weeks. It didn't help that my husband worked long hours. Because we were newcomers to the city, I didn't know any other moms.
Yet I knew the woman was right. When I went home that day and days afterward, I slowed down enough to make Lego forts and castles with my boys and then stroll with them to the park to play.
Perhaps you've received similar advice from an older mom, too, but it bears pondering again. The truth is, your kids' childhood will pass so quickly. As Dorothy Evslin said, "It will be gone before you know it. The fingerprints on the wall will appear higher and higher, and then suddenly they disappear."
In the twinkling of an eye, they'll be taking off for college or career. Try this little exercise: Close your eyes and picture your child strolling down the aisle with his graduating class. Decked in cap and gown, he walks across the stage when his name is called and grasps his diploma. Then a few short months later, he piles all his stuff in his car and heads across the country for college. Graduation photos on the piano; Little League baseball trophies and GI Joes stored in the attic. No music blaring from his room.
When that happens, you
won't be thinking, I wish I’d spent more time at the office or polishing
the floors.
From:
Focus on the Family by Cheri Fuller
7/9/05
Not to scare you but just so you can put things
into perspective:
In the whole world newborn deaths:
3 % Diarrhea
7 % Other
7% Tetanus
8 % Congenital
23% Asphyxia (Not breathing)
26% Infection
28% Preterm (preme)
The death rate in the world in children less
than 5 yrs:
3% aids
3% injuries
4% Measles
8% Malaria
10% Other
17% Diarrhea
19% Pneumonia
Justs reminds us how lucky we are to live in the
USA.
Dr. Knapp
7/17/05 For a long time conventional wisdom has
been that it is good for teenagers to work after school. There are more than 5
million teens less than 18 working in America. Two different organizations
studying this found teens working more than 20 hours a week, had lowers grades,
higher alcohol use, and too little time with their parents and families.
Between 16 and 19 yrs. old, the percent teens working are: 53% Americans, 30%
Germany, and 18% Japan. But then how can they pay for their car and stuff. You
might think about limiting the hours they work! 7/19/05
Well the new Harry Potter Book came out and
I have had several patients who have already read it. One 11 yr old
said she read it in 24 hours!!! Kids are starting to read and this book
has inspired many children to read more. It has improved their reading
skills. In 2001 75% of children 11-13 yr old and 20% of adults said
that they had read at least one of the books. But there has been a
decline in reading over the last several decades. The number of 17 year
olds who reported never or hardly ever reading for fun rose from 9% in
1984 to 19% in 2004. Hopefully these books will begin a new trend in
children reading novels for fun and we will see an improvement in the
future. I personally do not think these books are "bad" because it
deals with Magic and witches. It is not any worse than star wars that
has more violence in it and they use magic light swords. What about
sleeping beauty with the witch and the apple. Harry Potter deals with
good over evil. And it helps children want to read more. 60% of UK
children say that the books have made them a better reader. If you have
not read them, get the potter books on CD. The man who reads it is
wonderful and it sure does make the trip to work go quick. They are
great books for adults too.
Roger Knapp MD
You also might get the series of books:
Artemis Fowl . They are just as good but no witches.
7/28/05
Well we are doing better in some areas and not so good in others:
1950 2002
Unintentional Injuries: 1-4 yr old:
36.8 10.7 per 100,000
5-14yr
22.7 6.7
15-24 yr
54.8 38
Homicide: 1-4 yr 0.6
2.7
5-14 yr
0.5 0.9
15-24 yr 6.3
13.1
Suicide: 1-4 yr __
__
5-14 yr
0.2 0.6
15-24
4.5 9.9
So we get hung up in the stress of making our children perfect that we
loose sight of the end goal. Note this:
"He didn't look like much at first. He was too fat and his head was so big his mother feared it was misshapen or damaged. He didn't speak until he was well past 2, and even then with a strange echolalia that reinforced his parents' fears. He threw a small bowling ball at his little sister and chased his first violin teacher from the house by throwing a chair at her. There was in short, no sign, other than the patience to build card houses 14 stories high, that little Albert Einstein would grow up to be 'the new Copernicus,' proclaiming a new theory of nature, in which matter and energy swapped faces, light beams bent, the stars danced and space and time were as flexible and elastic as bubblegum. No clue to suggest that he would help send humanity lurching down the road to the atomic age, with all its promise and dread, with the stroke of his pen on a letter to President Franklin D. Roosevelt in 1939, certainly no reason to suspect that his image would be on T‑shirts, coffee mugs, posters and dolls."
I think my main complaint of our education system is that we put huge amounts of money and effort into our weaknesses and very little into our strengths and talents. But that is where we will end up as far as our jobs and hobbies. So Michael Angelo could not go to art class because he was slow in reading. Albert Einstein could not go to Physics because he was Dyslexic and could barely read. He failed his college admission test. And look at his hand writing... Oh my God!! The loop did not go up to the line!!! So keep the big picture in mind when raising our kids and work on their strengths.... and it is amazing how some of the most troublesome kids turn out good. Keep on "Keeping on". Yea for Helen Keller who kept on trying.... and Mrs. Sullivan who probably wondered every day how the end result would be.
Dr. Knapp 7/31/05
There are some changes in the vaccine
recommendations.
1. Instead of giving the 12-14 yr olds the
Td (tetanus and diptheria) it will be replaced this next week with TdP
which includes pertussis (Whooping Cough). The reasoning:
The Whooping cough in adults does not kill you but you can give it to infants less than 6 months old and it is real bad for them. Also you cough for 3 months as an adult and that is not fun. 2. The other change is the requirement of Hep A vaccine for preschool kids 2 and older. We cannot give it until 2 yr so we will be giving the shots to 2 yr olds. There is a second booster of Hep A that is given 6-12 months later also. The Hep A is recommend for school age children but not required at this time. I really don't push this vaccine for school kids unless they are going to live in foreign countries that have poor sanitation or live along the Mexico border. We will be giving the TdP to teens 11-14 yr old and with the meningitis vaccine Menatra (Meningococcal Meningitis vaccine that is needed before College but can affect high school kids too).
8/2/05
Breath holding spells:
This occurs in children starting 1-2 yrs old
and usually gone by 4 yr old. It is where the child is usually hurt
physically or emotionally and when crying they hold their breath, turn
blue and pass out. When they pass out they start breathing again and
get up OK and the follow up in these children are normal. It is
associated in many children with iron deficiency anemia and when treated
with iron the spells stop. It is quite frightening to the parents and
must not be confused with a seizure. There also can be a very few
children who have a pale episode of passing out without holding their
breath and not turning blue. They are pale and white. There is a minor
head trauma that triggers a brief stopping of the heart with a temporary
drop in blood pressure. There is no crying and not holding their
breath. They need to be tested with an ECG to see if they have a short
QT Interval Syndrome. These are not as common.I recommend iron and
vitamins and Zinc to all children at 1 yr old and I hardly ever see this
problem. Give your kids vitamins with iron and zinc the whole time you
have them with you ...until 19 yr ...(or 29).
Dr. Knapp
8/25/05
Dr. Knapp |
