Physical Activity – How Much is Enough? By Russell Alterman, D.O.

dr-alterman-lo-resIn our busy lives we try to balance work and play.  The more complexity we build into our lives, the greater is the need to play.  Anything that gets your body moving is physical activity, but jogging to catch the elevator is not exercise- it’s actually just the opposite.  Sudden acceleration of our heart and breathing rates for just a few seconds is counterproductive and can actually harm the less-physically fit person.

Let’s talk briefly about what the word CARDIO means and how this phrase relates to physical activity.  Cardio means aerobic activity and this means getting your heart beating faster and your breathing gets harder.  TEN MINUTES IS THE MINIMUM beneficial time frame to take your body into the aerobic phase.  Mowing your lawn, biking around your neighborhood, or even a ten minute exercise video in front of your television are all excellent forms of aerobic activity - if sustained for the FULL TEN MINUTES.

Another important concept for fitness is INTENSITY: how hard you push yourself - LIGHT, MODERATE, or VIGOROUS.  Unfortunately, cooking, shopping and laundry are activities of daily living (ADLs) and do not qualify for aerobic activity.  However, if you can keep up a pace of exercise as mentioned above for ten minutes which gets your heart pumping and you break a sweat, you have accomplished this small goal.  Some experts have even given a simple guideline: in light to moderate activity you should be able to talk but not have enough breath to sing the words to your favorite song.  In vigorous activity, you might be able to get a few words out between rapid breaths.

MODERATE-INTENSITY AEROBIC ACTIVITY EXAMPLES

  • Walking Fast (not race-walking)WORKING-OUT-HARD-ENOUGH-are-you

  • Water Aerobics

  • Bike Riding on Level Ground or a Few Hills

  • Ballroom Dancing

  • Pushing a Lawn Mower

  • Playing Doubles Tennis


 

VIGOROUS-INTENSITY AEROBIC ACTIVITY EXAMPLES

  • Swimming Laps

  • Jogging or Running

  • Fast Biking or Mountain Biking

  • Singles Tennis

  • Shooting Hoops


 

Rule of Thumb: 2:1   Two minutes of moderate activity equals one minute of vigorous activity.  Many of us might consider whether we are healthy enough to even begin an exercise program.  I would recommend scheduling a physical exam before you get going to affirm your healthy heart!

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

 

 

The Flu Season Is Here! By E. Chad Schmidgal, M.D.

dr-schmidgal-lo-resWhat is the flu?

The flu, short for influenza, is a respiratory illness caused by a virus that infects the nose, throat, and lungs. People infected with the virus may have symptoms of cough, sore throat, nasal congestion, headache, body aches, fatigue, and/or fever. Some people may have vomiting and diarrhea as well, although these symptoms are more common in kids. The virus is most likely spread through airborne droplets when infected people cough, sneeze, or talk.

Who should get vaccinated?

Everyone is at risk for becoming infected with the flu. The Center for Disease Control (CDC) recommends everyone over the age of 6 months be vaccinated every year against influenza by the end of October. Particular groups at risk for infection and complications include young children, pregnant women, adults over 65 years old, and people with chronic medical conditions like diabetes, asthma, or heart failure. Complications of the flu include pneumonia, sinus and ear infections, dehydration, worsening of underlying medical conditions, and even death.

Flu Shots Mission Viejo CAWill the vaccine make me sick?

The flu vaccine will not make you sick. It is an inactivated (dead) virus and cannot infect you. People who have allergies to eggs or other vaccine ingredients, who have had Guillain-Barre Syndrome (GBS), and people who are already ill should talk to their doctor before receiving the flu vaccine. The CDC also no longer recommends the flu-mist vaccine due to its questionable effectiveness in the past.

What should I do if I think I have the flu?

See a doctor to run a rapid test in clinic to determine if you have the flu. There are prescription anti-viral medications available that can decrease the length of time you are infected and the severity of your symptoms. A physician can also prescribe these medications to family members to help prevent infection in them as well. Covering your mouth, frequent hand-washing, and wearing a mask are important steps you can take to prevent the spread of infection until you see a doctor, but the best preventive step you can take is to get your flu vaccine!

*Information for this report was gathered from the Center for Disease Control website, www.cdc.gov

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

 

Seasonal Allergies in Children by Colleen Kraft, M.D.

Allergies often start in childhood and continue throughout life. Allergies are caused by the body’s reaction to substances called “allergens,” which trigger the immune system to react to harmless substances as though they were attacking the body. Although allergies can’t be cured, with proper care they can usually be kept under control.

When to Suspect an Allergy

Some allergies are easy to identify by the pattern of symptoms that follows exposure to a particular substance. But others are subtler, and may masquerade as other conditions. Here are some common clues that could lead you to suspect your child may have an allergy.

Repeated or chronic cold-like symptoms that last more than a week or two, or that develop at about the same time every year. These could include:

  • Runny nose

  • Nasal stuffiness

  • Sneezing

  • Throat clearing

  • Nose rubbing

  • Sniffling

  • Snorting

  • Sneezing

  • Itchy, runny eyes


Common Allergens in Home and School

In the fall, many indoor allergens cause problems for children because they are inside of home and school for longer periods.

  • Dust: contains dust mites and finely ground particles from other allergens, such as pollen, mold, and animal dander

  • Fungi: including molds too small to be seen with the naked eye

  • Furry animals: cats, dogs, guinea pigs, gerbils, rabbits, and other pets

  • Clothing and toys: made, trimmed, or stuffed with animal hair

  • Latex: household and school articles, such as rubber gloves, toys, balloons; elastic in socks, underwear, and other clothing; airborne particles

  • Bacterial enzymes: used to manufacture enzyme bleaches and cleaning products

  • Certain foods


Controlling Allergy Symptoms

  • It’s helpful to use air conditioners, where possible, to reduce exposure to pollen in both your home and your car.

  • Molds are present in the spring and late summer, particularly around areas of decaying vegetation. Children with mold allergies should avoid playing in piles of dead leaves in the fall.

  • Dust mites congregate in places where food for them (e.g , flakes of human skin) is plentiful. That means they are most commonly found in upholstered furniture, bedding, and rugs.

  • Padded furnishings, such as mattresses, box springs, pillows, and cushions should be encased in allergen-proof, zip-up covers, which are available through catalogs and specialized retailers.

  • Wash linens weekly, and other bedding such as blankets, every 2 to 3 weeks in hot water to kill the dust mite.

  • Pillows should be replaced every 2 to 3 years.


Although there are many over-the-counter antihistamines, decongestants, and nasal sprays, it is very important that you work with your child’s doctor over the years to make sure that your child’s allergy and asthma are correctly diagnosed and the symptoms properly treated.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

 

 

 

On the Way to School by Colleen Kraft, M.D.

Now that the school year has started, it is good to know safety tips for all children as they travel to and from school. This includes safety on the school bus, in the car, riding a bike, or walking.

School Bus

  • Children should always board and exit the bus at locations that provide safe access to the bus or to the school building.

  • Remind your child to wait for the bus to stop before approaching it from the curb.

  • Make sure your child walks where she can see the bus driver (which means the driver will be able to see her, too).

  • Your child should not move around on the bus.

  • Check on the school's policy regarding food on the bus. Eating on the bus can present a problem for students with allergy and also lead to infestations of insects and vermin on the vehicles.


Car

  • All passengers should wear a seat belt or use an age- and size-appropriate car seat or booster seat.

  • Your child should ride in a belt-positioning booster seat until the vehicle's seat belt fits properly (usually when the child reaches about 4' 9" in height and is between 8 to 12 years of age).

  • Remember that many accidents occur while novice teen drivers are going to and from school. You should require seat belt use, limit the number of teen passengers, and do not allow eating, drinking, cell phone conversations even when using hands-free devices or speakerphone, texting or other mobile device use to prevent driver distraction..


Biking to School

  • Practice the bike route to school before the first day of school to make sure your child can manage it.

  • Always wear a bicycle helmet, no matter how short or long the ride.

  • Ride on the right, in the same direction as auto traffic and ride in bike lanes if they are present.

  • Use appropriate hand signals.

  • Respect traffic lights and stop signs.

  • Wear bright-colored clothing to increase visibility. White or light-colored clothing and reflective gear is especially important after dark.

  • Know the "rules of the road."


Walking to School

  • Make sure your child's walk to school is a safe route with well-trained adult crossing guards at every intersection.

  • Identify other children in the neighborhood with whom your child can walk to school.  In neighborhoods with higher levels of traffic, consider organizing a "walking school bus," in which an adult accompanies a group of neighborhood children walking to school.

  • Be realistic about your child's pedestrian skills. Because small children are impulsive and less cautious around traffic, carefully consider whether or not your child is ready to walk to school without adult supervision. If the route home requires crossing busier streets than your child can reasonably do safely, have an adult, older friend or sibling escort them home.

  • If your children are young or are walking to a new school, walk with them or have another adult walk with them the first week or until you are sure they know the route and can do it safely. If your child will need to cross a street on the way to school, practice safe street crossing with them before the start of school.

  • Bright-colored clothing or a visibility device, like a vest or armband with reflectors, will make your child more visible to driver


The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

 

 

Q. and A. with Dr. Kiskila- This Month’s Topic: Back to School and Sports Physicals

This Month’s Topic: Back to School and Sports Physicals

Question: Dr. Kiskila what are back to school and sports physicals?

Answer: Back to school sport physicals are a physical medical exam with a doctor to evaluate that the student is healthy enough to participate in school-related physical activities. They are often referred to as back to school exams, because they are typically done at the beginning of the school year and are valid for the entire school year, but they can be done anytime.  Ideally, sports physicals should be done 6 weeks before preseason practice begins.

Question: Who needs them?

Answer: Any student who participates in sports should have a physical once a year.

Question: What do you check and assess during these physicals?

Answer: Doctors check the student’s vital signs like blood pressure and heart rate to make sure they are healthy enough to participate in sports. We assess the heart and lungs for any murmurs or wheezing for asthma. Doctors also assess the student’s muscular and skeletal range of motion, and perform a neurological exam to check reflexes, pupil dilation, and vision. We palpate the abdomen to assess abdominal organs such as the spleen. Additionally, we look at the patient's ears, nose and throat. For males, we may need to check for a hernia by pressing on the groin area. We also review the student athlete’s personal and family medical history and answer any questions. We want the students to be healthy, active and successful as they participate in their sports.

Question: Are there particular questions that parents should ask the physician during the exam?

Answer: Back to school and sports physicals are a terrific opportunity to not only ask activity-related questions, but to also inquire about the child's overall health.

Question: What occurs after the exam?

Answer: If the doctor determines that that child is healthy and safe to participate, he will fill out a clearance form for the family to give to the school.  If the child needs further testing before they can be cleared to play, next steps will be scheduled for the second evaluation.  The objective is to get the young athlete healthy and fit to participate as soon as possible.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

Drowning Prevention: Information for Parents by Colleen Kraft, M.D.

Drowning is a leading cause of death among children, including infants and toddlers. Most infant drownings occur in bathtubs and buckets. Toddlers between one and four years most commonly drown in swimming pools. However, many children in this age group drown in ponds, rivers, and lakes. Children older than five years old are most likely to drown in rivers and lakes, but this varies from one area of the country to another. It is important to know that children can drown in even one inch of water.

Drowning refers to death that occurs in this way. When a child is rescued before death, the episode is called a nonfatal drowning.

What You Should Do in a Drowning Emergency:

  • Get your child out of the water immediately, then check to see if she is breathing on her own. If she is not, begin CPR immediately.

  • If someone else is present, send him or her to call for emergency medical help, but don't spend precious moments looking for someone, and don't waste time trying to drain water from your child's lungs.

  • Concentrate instead on giving her rescue breathing and CPR until she is breathing on her own. Vomiting of kids swimming in the poolswallowed water is very likely during CPR.

  • Only when the child's breathing has resumed should you stop and seek emergency help. Call 911. Once the paramedics arrive, they will administer oxygen and continue CPR if necessary.


 

Medical Exam Needed for Any Child Close to Drowning

Any child who has come close to drowning should be given a complete medical examination, even if she seems all right. If she stopped breathing, inhaled water, or lost consciousness, she should remain under medical observation for at least twenty-four hours to be sure there is no damage to her respiratory or nervous system.

Child Recovery from a Non-fatal Drowning

A child's recovery from a nonfatal drowning depends on how long she was deprived of oxygen. If she was underwater only briefly, she is likely to recover completely. Longer periods without oxygen can cause damage to the lungs, heart, or brain. A child who doesn't respond quickly to CPR may have more serious problems, but it's important to keep trying, because sustained CPR has revived children who have appeared lifeless or who have been immersed in very cold water for lengthy periods.

Drowning Prevention: Know the Warning Signs

  • Head low in the water, mouth at water level

  • Head tilted back with mouth open

  • Eyes glassy and empty, unable to focus

  • Eyes closed

  • Hair over forehead or eyes

  • Not using legs — vertical

  • Hyperventilating or gasping

  • Trying to swim in a particular direction but not making headway

  • Trying to roll over on the back

  • Appear to be climbing an invisible ladder


For newborn infants and children through four years of age, parents and caregivers should never—even for a moment—leave children alone or in the care of another child, while in or near bathtubs, pools, spas, or wading pools, or near irrigation ditches or other open bodies of water. With children of this age, practice "touch supervision"; that means that a supervising adult should be within an arm's length of the child with full attention focused on the child at all times when she is in or near water. The supervising adult should not be engaged in distracting activities, such as talking on a telephone, socializing, or tending to household chores.

Home Swimming Pool Safety

Home swimming pools should be surrounded by a fence that prevents a child from getting to the pool from the house. There is no substitute for at least a four-foot-high, non-climbable, four-sided fence with a self-closing, self-latching gate. Parents, caregivers, and pool owners should learn CPR and keep a telephone and equipment approved by the US Coast Guard (life preservers, life jackets, shepherd's crook) at poolside.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

 

 

Sun Safety and Protection Tips for your Kids by Colleen Kraft

Spending time outdoors is a common activity on spring breaks or summer vacations, but remember to protect against the sun's rays. Everyone is at risk for sunburn. Children especially need to be protected from the sun's burning rays, since most sun damage occurs in childhood. Like other burns, sunburn will leave the skin red, warm, and painful. In severe cases, it may cause blistering, fever, chills, headache, and a general feeling of illness. The American Academy of Pediatrics offers tips to keep children safe in the sun.

Sun Safety and Protection under 6 Months



  • Babies under 6 months of age should be kept out of direct sunlight. Move your baby to the shade under a tree, umbrella or stroller canopy. Dress babies in lightweight clothing that covers the arms and legs, and use brimmed hats that shade the neck to prevent sunburn.

  • When adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen with at least 15 SPF It is okay to apply a small amount of sunscreen on infants under 6 months if there is no way to avoid the sun SPF (sun protection factor) to small areas, such as the infant's face and the back of the hands. Remember it takes 30 minutes to be effective.

  • If an infant gets sunburn, apply cool compresses to the affected area.


Sun Safety for Kids



  • The first, and best, line of defense against harmful ultraviolet radiation (UVR) exposure is covering up. Stay in the shade whenever possible, and limit sun exposure during the peak intensity hours - between 10 a.m. and 4 p.m.

  • Select clothes made of tightly woven fabrics. Cotton clothing is both cool and protective. Try to find a wide-brimmed hat that can shade the cheeks, chin, ears and back of the neck. Sunglasses with ultraviolet (UV) protection are also a good idea for protecting your child's eyes.

  • Apply sunscreen with an SPF 15 or greater to areas of your child's skin that aren't covered by clothing. Before applying, test the sunscreen on your child's back for an allergic reaction. Apply carefully around the eyes, avoiding eyelids. If a rash develops, talk with your pediatrician.

  • Be sure to apply enough sunscreen -- about one ounce per sitting for a young adult.

  • Reapply sunscreen every two hours, or after swimming or sweating.



  • If your child gets sunburn that results in blistering, pain or fever, contact your pediatrician.


Sun Safety for the Family



  • The sun's rays are the strongest between 10 a.m. and 4 p.m. Try to keep out of the sun during those hours.

  • The sun's damaging UV rays can bounce back from sand, water, snow or concrete; so be particularly careful of these areas.

  • Wear commercially available sun-protective clothing, like swim shirts.

  • Most of the sun's rays can come through the clouds on an overcast day; so use sun protection even on cloudy days.

  • When choosing a sunscreen, look for the words "broad-spectrum" on the label - it means that the sunscreen will protect against both ultraviolet B (UVB) and ultraviolet A (UVA) rays. Choose a water-resistant sunscreen and reapply every two hours or after swimming, sweating or towel drying. You may want to select a sunscreen that does not contain the ingredient oxybenzone, a sunscreen chemical that may have hormonal properties.

  • Zinc oxide, a very effective sunscreen, can be used as extra protection on the nose, cheeks, top of the ears and on the shoulders.

  • Use a sun protection factor (SPF) of at least 15. The additional benefits of using sunscreen with SPF 50+ are limited.

  • Rub sunscreen in well, making sure to cover all exposed areas, especially the face, nose, ears, feet and hands, and even the backs of the knees.

  • Put on sunscreen 30 minutes before going outdoors - it needs time to work on the skin.

  • Sunscreens should be used for sun protection and not as a reason to stay in the sun longer.


The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

 

 

 

After a Concussion: Returning to School and Play by Colleen Kraft, M.D.

After a concussion, it is common for many parents and coaches ask when their child/athlete can return to their sport or to recreational activities. However, it is also important to for parents to remember that children are “students” first and “athletes” second.

The American Academy of Pediatrics (AAP) has developed the following guidance on when children with a concussion should return to school and learning.

How Concussions Affect Learning

A concussion is an injury that (usually only) temporarily disrupts the normal function the brain. A concussio

n will usually disrupt a child’s ability to:

  • Think

  • Concentrate

  • Remember

  • Be efficient at processing and learning new school material


When to Return to School?

The first few days following a concussion, when the brain is still healing, a child may be too symptomatic to attend school. Brain cells repair themselves daily, so the effects of the concussion should lessen and become more tolerab

le and manageable with time. When this happens, a child is encouraged to go back to school.

Following a concussion, it can be very difficult for a healthcare provider to know exactly when a child is ready to return to school. For example, if a healthcare provider sees a child on a Thursday she/he may or may not be ready to return to school on Monday morning. Therefore, it is important for parents and healthcare providers to watch a child’s symptoms to determine when to return to school.

When concussion symptoms have lessened and are tolerable for up to 30 to 45 minutes, a child should return to school. This will usually happen within a few days/within the first week of the concussion.









School Policies

Check with your child’s school to see if your district or school has a policy in place to help students recovering from a concussion succeed when they return to school. If not, consider working with your child’s school administration to develop such a policy.

Policy statements can include:

  • The district’s or school’s commitment to safety

  • A brief description of concussion for teachers and suggestions for academic adjustments

  • A plan to help students ease back into school life (learning, social activity, etc.)

  • Information on when students can safely return to physical activity following a concussion



Returning to School Does Not Mean Returning to Play!

In order to reduce the risk of another brain injury, a child must be removed from the following upon returning to school:

 

  • All school and club sports

  • Physical education (PE) class

  • Dance class

  • All physical play at recess


In addition, teachers should modify homework as needed for students. Children need an average of 3+ weeks recovery time after a concussion to perform at their pre-concussion state.

 

Team Effort to Adjust and Heal

Supporting a child recovering from a concussion requires a collaborative, team approach among school professionals, health care professionals, parents, and students.

It is encouraged that the family team (student, parents, guardians, grandparents, siblings, peers, family friends) help to facilitate feedback and information to, from and between the school teams and the medical teams (physician, concussion specialist, neurologist, psychologist, school/team physician).

It is important that the school have two teams:

  • Academic Team (teacher, counselor, speech-language pathologist, school mental health, school nurse, administrator)

  • Physical Team (certified athletic trainers, school nurse, coach, PE teacher, playground supervisor)


 

Before a child can even consider returning to the field or to recreational activities, he must successfully adjust back into the social and academic demands of school.

 

Work-Related Injuries by Nathan Kiskila, M.D.

Work-Related Injuries by Nathan Kiskila, M.D.


Approximately 3 million work-related injuries were reported by private industries in 2011. In 2007, the cost for workers’ compensation care in the United States was approximately $50 billion.  This is about four times the cost of breast cancer treatment (Am Family Physician. 2014;89 (1) 17-24).

Getting injured at work may not only be painful, but it can also be very stressful not knowing one’s limitations due to the work-related injury. Being evaluated by a physician is important to not only determine a diagnosis and treatment plan.  Additionally, the doctor can explain the worker’s work restrictions, limitations, schedule modifications, and the duration expected to recovery. The doctor will want to obtain a clear history of the worker’s baseline function of current work tasks in addition to the activities outside of work to determine the worker’s capabilities of what they can do safely while at work and at home.

The physician can provide medication, consult specialists and communicate specific issues to job authorities if needed to make the worker’s return to work as quick and easy as possible.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.