Weary
the mind
that takes
care of
a child.
Howling,
naked,
cloaking
the god
within.
I hum
to her,
my breath
once sung
is gone.
Now she
crashes
into
thorny
sleep.
I seal
my eyes
as I
hold her
closely.
Comets,
star stuff,
endless
blackness
ignite.
Resting
my ear
against
her chest,
warm like
a bath
that wells,
flooding
joyful
weakness
with the
voice of
Divinity:
a child’s
heart beat.
This is completely inappropriate, and hilarious:
(new, original post coming soon – life is busy pre-vasectomy!)
In life we sit at the table and refuse to eat, and in death we are eternally hungry.
~a quote from Great House, a novel by Nicole Krauss
A recent study confirmed that the doctor’s office may be one of the worst places to determine if your blood pressure is under control. The automatic rise in tension many people experience when they are being scrutinized contributes to artificially high blood pressure readings. Although many times the only way improve one’s blood pressure is through treatment (such as medication, a low salt diet, and weight loss), other times I’ve seen a simple 10 second relaxation routine drop a patient’s blood pressure reading by up to 20 systolic points. The following may help you obtain a better, more accurate reading the next time you have your pressure checked in the harried office.
1) Insist on being seated for at least 3 minutes before your pressure is taken. Even walking from the waiting room back into an examining room will briefly increase your blood pressure.
2) Take several deep, relaxed breaths in and out before the doctor begins to check your blood pressure.
3) Relax all your muscles, particularly focusing on the tightness in your neck and shoulders.
These three easy steps can make a huge difference. Anecdotally as I mentioned before I’ve seen 20 point differences before and after. Evidence supports this, including the most recent study which found:
The proportion of patients whose systolic BP was identified as controlled in the first 30 days varied by measurement type: 28% for clinic readings, 47% for home readings, and 68% for research-based readings
Research-based readings in this study were difficult to define, but it seems they used a more standard, resting technique than the typical fast paced office visit.
Go ahead and try this at home with a BP monitor, and discuss with your doctor. And then relax throughout the day regardless 🙂
CITATION(S):
Powers BJ et al. Measuring blood pressure for decision making and quality reporting: Where and how many measures? Ann Intern Med 2011 Jun 21; 154:781. (http://www.annals.org/content/154/12/781.long)
Daddy can bounce and play,
While he sleeps four hours a day,
He brushes the flies away,
But Daddy ain’t got no milk.
Daddy can sing you a lullaby,
Nonsense he makes up on the fly,
He marvels at the beauty in your eyes,
But Daddy ain’t got no milk.
Daddy ain’t got no milk.
With hopes and dreams that soar,
For happiness, health and more,
He watches you breathe from the door,
He’s so tired he’d sleep on the floor,
Chasing windmills and imagined wars,
Sniffing out dangers like a wild boar,
But Daddy ain’t got no milk.
Daddy ain’t got no milk.
Your Daddy ain’t got no milk.
A fever in an infant can be the first sign of an illness. While a rise in body temperature above 100.4 degrees Fahrenheit is part of a healthy immune system response, it does signal potential danger and need for further evaluation. Since a reading may lead to a call or visit to the child’s doctor or emergency room, accuracy is key. What is the best type of infant thermometer?
A digital rectal thermometer.
This is according to such authorities as the American Academy of Pediatrics, Consumer Reports, and the American Academy of Family Physicians.
The definition of a fever is important as well. According to the AAFP:
A normal temperature is about 98.6°F (37°C) when taken orally (in your child’s mouth) and 99.6°F (37.5°C) when taken rectally (in your child’s bottom). Many doctors define a fever as an oral temperature above 99.5°F (37.5°C) or a rectal temperature above 100.4°F (38°C).
Fever in infants less than 4 weeks old can be an emergency, and most likely will require the baby to be hospitalized for evaluation and treatment. Fevers in babies 4 weeks to 3 months old are also considered an emergency requiring prompt medical attention. Always call your doctor for advice regarding fever.
The old-fashioned mercury thermometer has been phased out due to potential toxicity if the thermometer breaks and leaks mercury.
Consumer Reports recommends purchasing a rectal thermometer that can also be used orally as the child gets older, perhaps above age 3.
Expensive thermometers are not necessarily any better, but brands such as Omron have passed muster. Consumer Reports also lists BD Digital, Bebe Sounds, Safety 1st, Summer Infant, The First Years, and Vicks.
Be patient. Thermometers advertising instant reads sound great, but a reading in 20-60 seconds is sufficient and perhaps more precise.
Given the greater precison of rectal thermometers, my office has begun an ambitious initiative to check the temperatures of all our adult patients using the rectal technique as well. So far the response has been mixed. Some patients refuse the more painstaking measurements, while others seem to easily dismiss the added indignity as “just more of the same” they’ve come to expect from American healthcare. Just kidding.
But there’s no kidding about rectal thermometers being the best type for infants.
Happy Mother’s Day, and thanks for enduring all the unpleasantries, Mom.
Among the many dangers we face in our daily lives, from the hostile drivers who tailgate on our morning commutes, to the box of fried bread and sugar donuts bought in to the office, to the kid coughing on us with a 103 fever and influenza… it may seem alarmist to point out one more potential risk normally found in our own pockets. But the common cell phone, and the low level of radiation it emits, are increasingly subjects of debate. Depending on who you listen to, the cell phone is either a modern necessity beyond reproach, or a clear and present danger to which minimizing your exposure is worth the selectively Amish effort.
I picked up a copy of Devra Davis, P.h.D, M.P.H, new book entitled Disconnect. She purports to tell the truth about the cell phone radiation and what the industry has done to hide it, and to provide a few means of protecting yourself against the possible adverse effects of prolonged microwave radiation exposure. I have not fully read the book yet, but I have found it fascinating so far. As a family physician I believe in the value of preventative measures for health, but I am also aware of the paralyzing effect that excessive paranoia can have on our lives. I use a cell phone, but only minimally.
She centers her argument upon the central disconnect between the emerging science of cell phone radiation on human physiology, and the assumption that just because cell phones are omnipresent they must be safe. U.S. cell phone standards were set almost 30 years ago prior to the era of handheld wireless technology, and presumed that an average call would last 6 minutes. Dr. Davis makes the following points:
– At least one study has conclusively proven that cell phone radiation can unravel DNA. [Another recent study showed that cell phone radiation affects the metabolic activity of brain tissue, as proven by PET scans]
– Studies funded by the cell phone industry find dangers with cell phone radiation at only half the rate that independently funded studies do, signaling a conflict of interest in scientific results.
– Men who do not use cell phones have “healthier” sperm than men who use phones for 2-4 hours a day.
– In one experiment, rats that had mastered getting out of a tank without drowning got lost and swam in circles after being exposed to cell phone radiation for an hour.
– Other nations are already acting on emerging epidemiologic concerns. France is banning the sale of phones for its children, and Russia, the UK, Canada, Belgium, Israel, Finland, Germany, and India have all discouraged the use of cell phones by children. There is no mention of what North Korea or the Sudan are doing.
– The Israeli Dental Association has reported a dramatic rise in a type of rare cheek cancer in young adults under 20.
– Lloyds of London, the oldest insurance company still active in the world, refuses to insure cell phone manufacturers against health-related claims, as do a number of other major firms.
– There are stories of scientists who raised concerns about the long term impact of cell phones on health who were defunded or chased out of research altogether.
The quality of this evidence is often inferential and anecdotal, but it is still worth consideration. Dr. Devra Davis uses cell phones herself, which adds some credibility to her arguments since efficient life without wireless communication is just not practicable. She does make the point that we need to demand safer cell phones with higher safety standards, and offers these unproven but intuitive measures to possibly decrease the risks of cell phone radiation:
– Use a speaker, hands-free device, or even an earphone to distance the cell phone transmitter from the body and head. Radiation intensity decreases exponentially with distance.
– Try not to carry a cell phone on the body, as the phone still emits radiation when not in active use as it searches for towers, pushes notifications, etc.
– Beware of weak signals and standby mode when the signal strength is blocked, as radiation emission increases while the phone works harder to establish contact
– Keep cell phones away from children, as studies consistently show that their growing brains and skulls are more vulnerable to the effects of cell phone radiation. [I also think the younger generation as a whole is learning that communicating in a multitasking-simultaneously-oral-and-texted-polyconversation is socially acceptable]
– Don’t leave the cell phone on your nightstand. 75 years of low level radiation emission next to your head sounds like a bad idea to me, too.
– [I would add that I try to keep conversations on cell phones brief, and text when simple communication is all that’s needed]
I’m sure that cell phone radiation paranoia deserves it’s share of tempered reasoning. Realistic comparison to the relative risks of everything else in our often toxic environments shows that cell phone worry is not worth obsession. As I open my window to get some fresh air I’ll be sucking in nanoparticulates, and the stress of my day job will causing dysfunctional amounts of cortisol and adrenaline to be released. But I still think minimizing risks where prudent and possible it worth the fight, and I’ll be reading the rest of her book when I can.
Coincidentally the New York Times Magazine has an article about cell phones and brain cancer today.
