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Newsymail 2009
Feb 7, 2009
We see a lot of
vomiting and diarrhea every winter. We can’t treat diarrhea with meds but
just give fluids that contain electrolytes to replace fluid loss. Usually
kids have to have both vomiting and diarrhea to dehydrate. It is unusual to
dehydrate with one or the other. Baby Jessica who fell down the well did
not get anything to drink for 3 days.(what was Baby Jessica’s favorite
Christmas Carol? Noel. We can’t give medication to stop diarrhea but if
the child has diarrhea past 1 week with no normal BMs, then call for some
antibiotic that will kill the germ that is doing it.
A study came out
showing that testing the urine for volume or concentration did not predict
dehydration. I have told many parents that as soon as the child starts
vomiting or diarrhea, the fluid content of their body decreases. They then
decrease their urine production in order to conserve fluids and try not to
dehydrate. Most kids drink and urinate gallons and are usually over
hydrated. So every child with V. and D. urinates very little and is not
necessarily a sign of dehydration. Watch their alertness and their eyes.
They will act drunk or lethargic and their eyes sink back in their sockets
like the kids starving on TV in third world countries. Their skin will feel
like playdough and when pinched, it will not snap back in place. So ignore
how often they urinate.
Talking about
measuring urine, here are some funny measurement facts.
The unit of an angle
is known as a "gon," which is one-four hundredth of a circle. (i.e. octagon)
A unit of
beauty is called the "millihelen," which by definition is a face that
launches just
one ship (mythical). Current literature measures fame in units of the
"Warhol," which of course is 15 minutes (a reference to Andy Warhol's
remark).
Heat is measured in "Scoville units," which by definition are based on chili
heat units
where a capsaicin is one part per million or 15 Scoville units. (I can tell
it is hot chili because my bald head sweats.) The diameter
of a tree is
measured in units known as "hug." This is about 1.5 meters or about
what one person is
capable of hugging, circumference-wise. If you were
unaware, a googol is simply a number that
is 1010° almost the amount
of money the founders of Google
have made. And last, a measurement
comes from Northern Finland. It is the "poronkusema." This is the
distance a reindeer can travel without
passing water.
Dr. Knapp
Feb 24
You can train your
kids in grade school age but good luck with teenagers.
During 5-12 yr you
need to “brainwash” them into your morals. When you see bad stuff happening
on TV or in real life, tell them how you feel about it. They don’t get it
out of thin air. So when you see bad stuff and you think.. Oh I hope they
did not see that. Actually you do (and they probably already saw it) and
then turn it around into a lesson of what not to do. For example: if you
see someone driving wrecklessly, state how you feel firmly “I don’t like
people who drink alcohol and drive at the same time. They are going to
cause a wreck. Isn’t that bad.” This really works if you start it early.
Actually it also
helps teens later. I can still remember the advice and words of my parents
even 20 yrs after they have been gone. Their sage advice comes back to me
almost daily. But I thought I knew it all at age 20. So the advice and
your words that you say to your teens will stay with them. It just won’t
take affect until their late 20s. Even though they seem to be ignoring you,
keep up the advice. It will work on them later.
I think we all learn
by the school of hard knocks. Our parents said don’t drive fast or you will
get a ticket or wreck…. And we did. They said don’t drink too much or you
will get sick…. And we did. I think we learn faster when our parents advice
comes back to us after trying what they said not to do. Hopefully our teens
and young 20 yr olds will not get hurt too bad as they test the limits.
So now at my age if
there is someone talking about retirement, I take notes. If they are older
and been-there-done-that, they have advice I need to heed. (No I am not
retiring any time soon.) I may not follow their exact advice but I weigh it
in heavily.
Roger Knapp MD
When things are easy,
a person doesn’t really learn about himself It’s what a person does at the
moment of his greatest struggle That shows him who he really is.
March 8
I have already been asked about swim
lessons for infants. I do not recommend them for several reasons.
They swallow too much water and can get
"water intoxication". It lowers their serum sodium and they have a seizure.
It gives the adults a false sense of
security and they think the baby will be safer. Then they do not watch them
close enough. It is the job of the parent to make sure the infant does not
drown. Do not put that responsibility on the infant.
Now if you want to get together with
other moms and babies, splash in the pool and socialize... great. That is
fun and OK. But that is not swim lessons where you teach the infant to
"swim" or paddle over to the edge and save themselves. Be sure to use plenty
of sunscreen and the shirts that block UV sun to swim in. The infants can
take only 3-10 minutes of colder water (depending on the size of the baby
and the temperature of the water) and they can get low body temperature:
hypothermia. If they start to shiver, take them out immediately and dry and
warm them. You also can take their body temperature every 5 minutes and
below 97 degrees axillary is bad. I prefer you get the blow up pool in the
backyard, let the water in the hose heat up in the sun and then pour it into
the pool of cold water to take the chill off of it, and let them splash in
the 3 inches of water.
Lets have fun but lets be safe. Tragedy
can happen quickly.
Dr. Knapp
March 17
Flat
feet… Oh my gosh. Lets get expensive special shoes!
As it turns out it is
not as bad as once thought. One study showed that 40% of one year olds had
flat feet and only 5-10 % had them as adults. Most grow out of it without
special shoes. Then another study published in Pediatrics this month showed
that the athletic performance was the same if the kids had flat feet or
not. It did not affect their athletic performance. Now some kids in their
teens will have sore feet caused by flat feet and even though it does not
cure it, the special shoes will help the discomfort.
Dr. Knapp
March 18
Well
the state of Texas keeps changing the vaccine requirements.
Even the American
Academy of Pediatrics does not “require” a second Chicken Pox (Varicella)
vaccine but it seems the drug company convinced enough state officials to
require it for school.The other vaccines listed below we have been giving
them for several years and now are going to be required.
So here are the new
changes as of this month (March 2009) for required vaccines for school
starting the school year 2009-2010 (next Fall):
Meningococcal
Meningitis Vaccine
7th grade requirement
Varicella Vaccine
2 dose requirement for kindergarten and 7th
grade entry
Tdap Vaccine
a booster dose requirement for Tdap for 7th
grade
MMR Vaccine
2 dose requirement of MMR vaccine for
kindergarten entry
Hepatitis A Vaccine
2 dose requirement for kindergarten entry
statewide
If your child has not
had a second dose of Varicella and they are going to start Kg or 7th
grade this coming Fall, they will need to get it. If you already had a well
check up in the last 12 months, then just call for a shot only appointment
with the nurse. If the child is already in school, then they will need the
Varicella some year between now and 7th grade. That can be done
at the next well checkup.
If your child has not
had a Tdap and Meningococcal Vaccine at 11-12 yr old, then they need one
before entering the 7th grade.
If your child is now
in the 7th grade or higher, then this will not be required but we
strongly recommend these vaccines. (It is interesting they required a
second Chicken Pox shot and not the HPV and prevent cervical cancer.
Hmmmm!)
As an aside, the HPV
needs to be given to the boys also. The HPV germ causes many other diseases
and cancers and has by found in 50% of prostate cancers. We are trying to
get the FDA to approve this important vaccine for the boys. 10% have the
virus by 20 yr old, and 50% by 26 yr old.
Dr. Knapp
March 28
Survival of
the fittest?
Elk across America are
smaller. Every hunting season brings a greater challenge to find the
sought-after bull with a towering spread of antlers. Africa and Asia still
have elephants but they don't have tusks. Researchers describe what is
happening as none other than selection process of survival of the fittest.
The strongest survive and pass on their traits to succeeding generations.
Selective hunting ... picking out individuals with the best horns and
antlers, or the largest piece of hide... works in reverse. The evolutionary
loser that is small and defenseless is surviving since they do not want to
shoot that one.
We
also stopped evolution of the fittest with humans. There is a grandma
saying: “You gave so many antibiotics that you weakened the immune system.”
It is the other way around. The kids with the weak immune system had to get
more antibiotics. In the 1800s, 10% of the kids died the first year of life
because of weak immune systems. In the 1900s we developed antibiotics and
the kids survived. We had to give a lot of antibiotics so the kids grew
older and their immune system was better able to defend them against germs.
So the weak immune system caused us to give more antibiotics. It was not
the antibiotics that weakened the immune system. It is just Grandma did not
see them in the old days because they were 6 feet under. And these kids are
growing up and having more kids with weak immune systems. We interrupted
survival of the fittest.
Also
women with small pelvises died in child birth in the 1800s. Now we have
C-sections and they are living ..., which is a good thing. But these women
are having more daughters with small pelvises and we are having more
c-sections. Again we interrupted survival of the fittest.
Interesting
huh?
Dr.
Knapp
April 1
A
study came out in Feb 09 about people that had cardiac arrest who were
cooled way below normal body temperature had 20% more survival. Even if
they had been "dead" for more than 1 hour. There was a higher survival when
the person was cooled before restarting the heart. So if a person has a
cardiac event in the grocery store, one person should find the AED and the
other find the ice machine and load them down with ice bags.
April 5
The FDA is
considering approving the HPV vaccination for males. It was originally
approved for females to prevent cervical cancer. That virus also causes
genital warts, nodules on the vocal cords, oral cancer, and it is found in
50% of prostate cancer. They announced that the FDA will very likely
approve it for males this Fall. That is good.
Also they are in the
final stages for approving a better Pneumococcal (Prevnar) vaccine that has
14 strains instead of the present 7 strains of germs. That will help
decrease more pneumonia and ear infections and meningitis caused by that
germ. We have been seeing an increase of infections caused by the strains
that are not covered by the present vaccine.
http://www.windows.ucar.edu/
great site for kids (and adults) to learn about earth, climate, weather,
volcanoes and such. Very cool site.
Dr. Roger Knapp
p.s. We also saw a
study showing recess is tied to improved classroom behavior. No duh.
April 23
It’s summer time.
There are health problems with it.
Sun Screen is fine
down to 3 months and a SPF of 20 is adequate. There is not much difference
between SPF of 20 or 50. Also deet is safe for kids down to 6 months. Use
the standard “Off” with 20% deet or less. We see several cases of
encephalitis every summer. Put sun screen on first and then repellants.
But better is to cover the body. Farmers are out in the fields in the sun
with long blue jeans and long sleeve shirts. Put long pants and even shirts
when going to the park or out camping. Then you have less bug bites, less
itchy rashes from the grass, less sun, and less skinned knees. Use swimming
shirts that block the UV waves.
Drink plenty of water
and if they have red cheeks, cool them off with water, shade and wind. You
do not loose much salt so it does not have to be Gatorade. Just water is
fine.
Watch out for infants
in the pool. It is not the chorine but the temperature. They can get
hypothermia (low body temperature) fast. And if they start shivering, get
them out immediately and warm them up. And I do not recommend actual
swimming lessons for infants.
If your older kids do
not usually get swimmer’s ear, then don’t worry about putting stuff in their
ears. If they do tend to get it, then you can put olive oil in their ears
before they swim or afterwards you can put ½ alcohol + ½ white vinegar
solution. The products in the drug store like “Swim ear” & “Ear Dry” do not
work good since it is only alcohol. Swimmer’s ear hurts to move the ear lobe
and usually hurts to take off their t-shirts. None of these cure the
infections, they only prevent them.
Have a great summer.
Dr. Knapp
p.s. you thought you knew how to tie a
shoe? Try watching this:
http://www.rogerknapp.com/Miscellaneous/tieshoes.html
April 28
Everyone is talking
about the swine flu. It is a new strain of flu and we see this every few
years.
There are always a
certain number of people who will die of viral illnesses like measles,
chicken pox, and the flu. That is why we developed vaccines for chicken pox
since there were rare kids who died of the disease. The higher the death
rate then the more pressure there is to get a vaccine.
Across the country, 83 children
died from flu last winter, according to the CDC.
This
new strain will eventually go across the country. Travel should not be
stopped and wearing masks will only help those who cough from spreading
germs outward. Masks will not stop those tiny viruses. Good hand washing
is critical. Cough will spread the germ if you are within 3-6 feet of
someone ill.
The death
toll in Mexico is
152, with 1,614 cases ill. But all other countries have mild illnesses and
no deaths yet. (There will be some rare cases of death as mentioned
above.) Why is there 10% deaths in Mexico? We have had 50+ cases here in
America so we should have had 5 deaths. ??? We have not had any. My
personal opinion is that the air pollution in Mexico City is terrible and
there are cases of Aids that are not diagnosed or treated. But we will see
as the illness spreads and it will spread. I do not think it is a scary
thing but the news media loves this kind of hype. Just realize there are
always rare cases of death for even minor illnesses.
God
bless us all
Roger
Knapp MD
May 13
Well it is Spring and
the weather should be getting warmer. But the rains have increased the
mosquitoes so use deet in OFF and other repellants. It is safe down to 6
months old. The mosquitoes carry viral encephalitis and we see several
cases every Spring and Summer.
Well as we told you,
the swine flu H1N1 is not any worse than the regular flu and is not much in
the news anymore. But do get your flu vaccinations next Fall. I think a
more serious infection is the MRSA staph. It is not as much in the news
anymore but still alive and well. I worry about that germ on the grocery
cart handle more than the flu. Now reports are coming out how there is a
lot of MRSA on Pigs!!! More swine problems… ha ha. Here is an article from
the New York Times:
"The late Tom
Anderson, the family doctor in this little farm town in northwestern
Indiana, at first was puzzled, then frightened. MRSA (methicillin
resistant Staphylococcus aureus) sometimes arouses terrifying headlines
as a ‘superbug' or 'flesh‑eating bacteria.' The best‑known strain is found
in hospitals, where it has been seen regularly since the 1990s, but more
recently different strains also have been passed among high school and
college athletes. Dr Anderson at first couldn't figure out why he was seeing
patient after patient with MRSA in a small Indiana town. And then he began
to wonder about all the hog farms outside of town. Could the pigs be
incubating and spreading the disease? One of the first clues that pigs could
infect people with MRSA came in the Netherlands in 2004, when a young woman
tested positive for a new strain of MRSA, called ST398. The family lived on
a farm, so public health authorities swept in‑and found that 3 family
members, 3 co‑workers and 8 of 10 pigs tested all carried MRSA. Since then,
that strain of MRSA has spread rapidly through the Netherlands‑ especially
in swine producing areas. A small Dutch study found pig farmers there were
760 times more likely than the general population to carry MRSA, and
Scientific American reports that this strain of MRSA has turned up in
12% of Dutch retail pork samples. Now this same strain of MRSA has
also been found in the United States. A new study by Tara Smith, a
University of Iowa epidemiologist, found that 45% of pig farmers she sampled
carried MRSA, as did 49% of the hogs tested. The study was small, and
much more investigation is necessary."
New York Times.
March 12,2009
Oik Oik
Dr. Knapp
June 10
As parents it is our
job to watch our children closely. Children really do not have a right to
“privacy” since they are a minor and under our roof. We are responsible for
their wellbeing and as kids they will want to do things that are not right
or proper.
Keep an eye on what
they are saying to their friends. What would they say to their friends that
you should not be able to hear?? And of course there is text messages.
Teens have been caught under their blankets in bed texting all night. Or
cheating on tests by texting in class. There is an age when they should be
given a phone and also be able to text. Each parent has to decide when they
are mature enough to deal with the responsibility. Just like some parents
do not let their children drive until 17 or 18 yr old.
There is a list of
abbreviations that are used. ( 9 means parents are watching and 99 they are
gone.) So see:
http://www.netlingo.com/acronyms.php
if you need to learn what they are typing. They could be talking about very
sinister topics without you knowing.
There are programs to
record every key stroke on the computer:
TrueActive Monitor ($100)
Spector Pro ($100)
SpyBuddy ($70)
Dr. Knapp
p.s.: a good website
for children’s activities going on in the metroplex is this one:
http://www.metroplexbaby.com/
June 16
Kim Komando sent
message on her email and I thought I would send it on to you.
Microsoft's Bing.com gives people
instant access to hardcore porn. I know my children will stumble across
this. What should I do?
Bing
is a new search engine from Microsoft. It's trying to move beyond simply
providing a list of related links. And it uses some innovative tools to do
that. Unfortunately, one has backfired big time.
All search engines let you search
specifically for videos. But Bing provides in-result video previews. Roll
your mouse over a result and the video starts playing. You get about a
minute preview, complete with audio.
It's actually a neat idea. You can
preview videos without leaving Bing. But the site doesn't distinguish
between a funny YouTube clip and pornography. The right search turns Bing
into a porn theater.
This can circumvent parental controls.
And it leaves no trace. The porn site won't be logged in the browser
history. You may have no idea what your fifth grader is watching.
Bing has built-in obstacles for porn.
Unfortunately, any knowledgeable fifth grader—like yours!—can evade them.
See:
http://www.komando.com/
Roger Knapp MD
July 4
Man’s best friend.
Studies showed that children positive to allergies to skin tests who had a
dog had only 14% eczema and whose without a dog had 57% had eczema. Those
with negative skin tests who had a dog had only 9% eczema and whose without
a dog had 14% eczema. So a dog seems protective for getting eczema. Sorry…
eczema was increased if they owned a cat.
Also Tylenol
(Acetaminophen) was in the news about causing liver damage. Too much will
wipe out your liver and it was the main way people in England committed
suicide. So now it is only by prescription there. There is a medication to
stop the liver damage if you overdose Tylenol but you have to give it in 12
hours of taking the overdose. But some damage can occur when taking
Acetaminophen with other narcotics and medications. They are talking about
taking off the market Vicodin and
Percoset. Also alcohol and Tylenol can cause harm. That is why I do not
recommend alternating Tylenol and Motrin (Ibuprofen) for fever. It is too
much for the liver to handle … plus
FEVER DOES NOT HARM
YOU!
Have a great fourth….
try to stay cool.
Dr. Knapp
July 23
We are seeing a lot
of swimmer’s ear so if your child is prone to it or you are going to spend
several days in lake or ocean water, then put drops in their ears after
swimming. What is recommended is ½ alcohol and ½ white vinegar and put
several drops in their ears after swimming.
Also remember the
Swine Flu is not any worse than the regular flu we have had for decades. It
is dangerous to infants, elderly, those with immune problems, respiratory
problems, and heart problems. Otherwise I do not recommend Tamiflu to
children to prevent or treat the flu. It only shortens the illness 1 day if
you take it in the first 48 hours. Also the previous flu became resistant
to Tamiflu because it was used to everyone with a cough. So if we use these
medications too much, then the germs become resistant and it will not work
on them. Then we do not have anything for grandma or the infants if they
get the flu. So only take the Tamiflu if you are high risk.
The news media loves
to scare us to get viewers. This flu is not any more deadly than the
previous flu we have had for decades. But it started in Mexico where there
are many people with pulmonary problems from the air pollution and there are
many cases of Aids that go undiagnosed. Other countries have not had high
death rates from it. But the news media will blow this up coming this next
winter so don’t get rattled. I do recommend the flu shot this Fall,
but we have always recommended it. Especially for the infants below 2 yr,
those with lung problems, and the teens so they do not miss a week of high
school.
Roger Knapp MD
www.rogerknapp.com
Additional comment:
Twitter is a BIG deal
in the evolution of Internet communications however the spam problem has
grown quickly. And that is magnified by the fact that some people choose to
auto-follow. Auto-following is when a person uses an automatic system to
follow back a person who follows them. It is completely automatic, and not
personal. The problem is that it attracts other people who auto-follow. And
it leads to people who are seeking large numbers of followers just for ego
purposes. It completely defeats the point. If a person uses auto-follow,
then that person ends up following spammers and pornstars. Stop
auto-following, and unfollow the people you are not interested in. If you
use Twitter, I recommend that you not auto-follow. Having a large number of
followers isn't that big a deal. And if you get followed back by a person
who already follows thousands of people, realize they're not reading your
tweets. They don't care about you. Its just a numbers game. A shell game.
And completely meaningless.
August 4
Study just came out about Vit. D
More than 50
million children (or 60% of the U.S. pediatric population) get insufficient
vitamin D and another 7.6 million (9%) suffer from more severe deficiency,
according to one of the studies published online in Pediatrics.
Older
children, girls, non-Hispanic blacks, Mexican Americans, those born outside
the U.S., and obese children were more likely to suffer a deficiency.
Low serum
vitamin D in U.S. adolescents is strongly associated with hypertension,
hyperglycemia, and metabolic syndrome, independent of adiposity
I have always asked parents to give
their kids multivitamins starting at 1 yr. old. Give them a vitamin with
zinc and iron.
Roger Knapp MD
I love Nanny 911. They are very good at telling good parent techniques.
They have extreme cases but they have good advice.
http://www.parentsconnect.com/articles/child-discipline-boot-camp-nanny-911.jhtml
August 28
We see croup usually
in the Fall. It is a viral chest cold with a Seal Bark cough. They do not
need antibiotics since it is viral and some will have secondary ear
infections a week later from the congestion. We need to see them if they
are below 2 yr old or if they have breathing difficulties. There is a
steroid we give them to open their windpipes so they breath. It is safe and
keeps them from going into the ER. Also run a humidifier or take them into
the bathroom and steam it up. If it is cool and humid outside, take them
out on the back porch. It lasts a week and the worse nights are typically
the second and third nights. They will be better in the daytime and you can
get fooled into thinking it is getting better and not bring them in.
Like we have said in
the last few months, the swine flu is not more deadly than the regular flu.
We do not know how much swine (H1N1) flu vaccine we will have this Fall and
to which patients will be given. I will let you know as soon as we know.
They still recommend the regular flu vaccine too.
Roger Knapp MD
p.s. This is sports
time of year. See web site on treating acute injuries. Wrap… not ice.
http://www.rogerknapp.com/medical/injuries.htm
August 31
I
have always told parents that height of the child is the best way to choose
the correct car seat. Not age or weight. There is a double difference in
size or weight of children. A small 8 yr old could be the same as a large 4
yr old. So the new car restraint laws should be based on height and not
age.
Dr. Knapp
New Texas Law
Requires Kids up to Age 8 to Sit in Boosters
The Texas Legislature enacts new laws
every year that usually go into effect on September 1 of that year.
Beginning September 1, 2009, one of the new laws that will go into effect is
the requirement that children up to age 8 (or children up to 4 foot 9 inches
tall) must sit in a booster seat in a vehicle. Previously, children did not
have to ride in a car seat or booster seat once they reached their 5th
birthday or were at least 3 feet tall.
Traffic accident studies have shown that
children 5-8 years old are not properly protected by a normal adult seat
belt and are injured more often in auto accidents because of inadequate
protection. According to National Highway Transportation and Safety
Administration (NHTSA), seat belts are not designed for children and
children do not have the physical stature to be protected fully by a seat
belt. Children who are moved to an adult seat belt system prematurely are
at an increased risk of abdominal, spinal, facial and head injuries in the
case of an accident. Many children are not being properly restrained in a
car and surprisingly, a large number of children are not being restrained at
all. This puts children at a heightened risk for serious injury or even
death in the event of a car accident.
p.s. Also there is a neat place for
kids and parties with animals and dinosaurs in the DFW area. Looks like
fun.
http://www.indoorsafaripark.com/
September 12
Two things about
vaccines.
1. The HPV Gardasil
was approved by the committee of the FDA (and the full FDA board usually
follows it’s recommendations) to be given to boys/men 9 to 26 yr old. It
says it will be to prevent venereal warts but it will decrease other cancers
caused by HPV: mouth, esophagus, penis, anus, and prostate. It is a safe
vaccine. Ignore all the weirdos that come out when vaccines are mentioned.
But if you google it you will find parents who claim that their daughter’s
hair fell out or she died 2 days later or whatever. About the main thing to
watch for is fainting when you give them a shot. The FDA will announce the
official word soon.
2.The vaccine for the
H1N1 flu(swine) is close to production. We will have it late Oct or Nov.
Studies show good antibodies after one shot and they may only recommend one
shot instead of 2 shots like they were suggesting last month. That makes
sense to me. You need two vaccines 1 month apart if it is the first year
you get flu vaccines. We will not know how much vaccine supplies we will
have and what age or category will be given the vaccine. Maybe we will be
given enough vaccine to vaccinate everyone. We shall let you know.
Many parents have
asked should I give the H1N1 vaccine to my child? It is recommended for
all children to 18 yrs old. Remember this flu is not more dangerous than
past flu. There will be more cases because no one is immune to it. My
recommendation: do this year what you usually do. If you think it is a good
idea to vaccinate your children to flu and you have been doing that for
years, then vaccinate them to both flu viruses. If you don’t usually want
to vaccinate them in the years past and you still think it is not for your
child, then don’t vaccinate them for either flu.
Don’t let the news
media scare you on this thing. Use good hand sanitation all year.
Roger Knapp MD
September 14
I
generally do not get political in my Newsymail but this will affect all
parents and families.
Roger Knapp MD
- - - - - - - - - - - - -
- - -
This was an email from
Michael Farris of Parental Rights Organization. See:
http://www.parentalrights.org/index.asp?Type=B_BASIC&SEC={1F86E588-AA4A-43A1-998D-D9BF4FBE4D09}
Dear Friend of Parental
Rights,
Monday in a Harlem middle school, U.S. Ambassador to the United Nations
Susan Rice told a group of 120 students that administration officials are
actively discussing “when and how it might be possible to join” (that is,
ratify) the UN Convention on the Rights of the Child (CRC). {See below the
points of the UNCRC.} As before, she also communicated what a disgrace it
is that the U.S. would stand with only Somalia against such a
widely-accepted treaty.
This is the first direct public statement by the Obama administration that
it will seek ratification of the UN CRC.
In my 30 years of political involvement, I have learned to recognize this as
what is called a “trial balloon.” Like in World War I trench warfare, our
opponents have “sent up a balloon” to see if it will draw fire. If things
remain quiet, they will proceed with their plans to push for ratification of
the CRC in the U.S. Senate.
To discourage them from doing so, we need to make sure that our voices are
heard with unmistakable clarity. We must let the Obama administration know
that we oppose this anti-family, anti-American treaty.
Here’s what we need you all to do:
1. Call the White House comments line at 202-456-1111. Tell them you
heard the administration wants to ratify the CRC, and you strongly oppose
this giving away of U.S. sovereignty to the UN. Also keep in mind that this
treaty gives the government jurisdiction to override any decision made by
any parent if the government thinks that a better decision can be made—even
if there is no proof of any harm.
2. Call Ambassador Susan Rice’s office at the United Nations. Tell her
that you want her to represent the United States to the world rather than
trying to get the United States to go along with international law initiated
by the UN. Her office number is 212-415-4000.
3. Contact your Senators and urge them to oppose ratification of this
treaty. Ask them also to defeat it once and for all by cosponsoring SJRes
16 – the Parental Rights Amendment.
It is very important that we speak up right now. Please call
before you close this email!
Sincerely,
Michael Farris
To contact your
Senators: Click to this link:
Congress and put in your zip
code.
Ten things you
need to know about the structure of the CRC:
- It is a treaty
which creates binding rules of law. It is no mere statement of
altruism.
- Its effect would
be binding on American families, courts, and policy-makers.
- Children of other
nations would not be impacted or helped in any direct way by our
ratification.
- The CRC would
automatically override almost all American laws on children and families
because of the U.S. Constitution’s Supremacy Clause in Article VI.
- The CRC has some
elements that are self-executing, while others would require
implementing legislation. Federal courts would have the power to
determine which provisions were self-executing.
- The courts would
have the power to directly enforce the provisions that are
self-executing.
- Congress would
have the power to directly legislate on all subjects necessary to comply
with the treaty. This would constitute the most massive shift of power
from the states to the federal government in American history.
- A committee of 18
experts from other nations, sitting in Geneva, has the authority to
issue official interpretations of the treaty which are entitled to
binding weight in American courts and legislatures. This effectively
transfers ultimate authority for all policies in this area to this
foreign committee.
- Under
international law, the treaty overrides even our Constitution.
- Reservations,
declarations, or understandings intended to modify our duty to comply
with this treaty will be void if they are determined to be inconsistent
with the object and purpose of the treaty.
Ten things you
need to know about the substance of the CRC:
- Children would
have the ability to choose their own religion while parents would only
have the authority to give their children advice about religion.
- The best interest
of the child principle would give the government the ability to override
every decision made by every parent if a government worker disagreed
with the parent’s decision.
- A child’s “right
to be heard” would allow him (or her) to seek governmental review of
every parental decision with which the child disagreed.
- According to
existing interpretation, it would be illegal for a nation to spend more
on national defense than it does on children’s welfare.
- Children would
acquire a legally enforceable right to leisure.
- Christian schools
that refuse to teach "alternative worldviews" and teach that
Christianity is the only true religion "fly in the face of article 29"
of the treaty.
- Allowing parents
to opt their children out of sex education has been held to be out of
compliance with the CRC.
- Children would
have the right to reproductive health information and services,
including abortions, without parental knowledge or consent.
- Parents would no
longer be able to administer reasonable spankings to their children.
- A murderer aged
17 years and 11 months and 29 days at the time of his crime could no
longer be sentenced to life in prison.
September 16
The decision to do a
CT scan on children who come into the ER or clinic has gone through many
variations. There are rare side effects of the tests and one weighs that
against the benefits and needs of the tests. We do not want to scan
everyone who walks through the door. For children who do not likely have
serious injury, the risk of developing cancer because of radiation exposure
outweighs the risk of clinically important traumatic brain injuries.
Previous studies have
suggested that CT scans were being overused for pediatric head trauma, but
they were subject to various limitations for example small sample size. So,
using a derivation cohort of 33,785 children, Kuppermann and colleagues
developed rules for classifying children as low risk.
They found out that
certain children would not need CT scans:
1.
Older children are considered
low-risk if they have normal mental status, no loss of consciousness, no
vomiting, no signs of basilar skull fracture, and no severe headache, and
did not sustain their injury in a serious accident.
2.
Because children younger than 2 are
generally unable to communicate their symptoms, are more sensitive to the
effects of radiation, and have different mechanisms of injury, the
researchers said, they needed slightly different rules. Those who had
normal mental status, no scalp swelling except frontal, no loss of
consciousness more than five seconds, and no palpable skull fracture, and
were acting normally according to the parents and sustained their injury in
a non-severe way were classified as low risk.
So you know what to
expect when seeing the doctor. You could also use it to decide if you need
to bring in your child.
See the four
misconceptions of head injury at the web site and when I suggest you bring
them in:
http://www.rogerknapp.com/medical/Head%20Injury.htm
Dr. Knapp
September 22
Heart attack rates associated with
breathing secondhand smoke dropped rapidly and continued to decrease over
time after smoking was banned in public spaces in North American and
European communities, a new study found.
The number of acute myocardial
infarctions dropped by an average of 17% a year after smoking bans were put
into effect, compared with communities with no such smoking restrictions
according to a meta-analysis published in the Sept. 21 issue of
Circulation.
The decline in heart attacks continued
in subsequent years, with rates dropping by about 36% within three years of
smoking prohibitions taking effect.
"Passage of strong smokefree legislation
produces rapid and substantial benefits in terms of reduced acute myocardial
infarctions, and these benefits grow with time," wrote James M. Lightwood,
PhD, and Stanton Glantz, PhD, of the University of California San Francisco.
Previous studies on smoking bans in
public areas and workplaces differed in their findings concerning rates of
acute myocardial infarction after prohibitions were put in place, with
reductions ranging from 11% in Italy and Ireland to 40% in Montana.
As annoying as these laws are... they
save lives. Not only with heart attacks but with cancer.
Roger Knapp MD
October 7
The news came out about a report in the
Pediatrics Journal about an increase of Autism and it is now 1/91 children.
This is study shows an over estimated
occurrence. 20 yr ago children were called Retarded.
That sounds bad so they started calling
them Autistic.
So there was an equal decrease in the
diagnosis of retardation as there was an increase in Autism. So there was
a shift in labels. Also they piled Downs
Syndrome, Aspergers, Rett’s Syndrome,
and many other problems into Autism
Spectrum. Then any child who was slow in reading or
had other problems were dumped into Autism
to get funding for help. (See links below.)
So most of us do not think there is a
significant increase in true Autism. And remember
Autism is NOT CAUSED by vaccines or mercury
in the vaccines.
http://www.nytimes.com/2009/10/06/health/research/06child.html
http://www.theatlantic.com/doc/200910u/autism-diagnoses
Dr. Roger Knapp
October 20
In
1975, the FDA banned the sale of turtles with a carapace length of less than
four inches to reduce turtle-associated
Salmonella
transmission. Those tiny turtles banned from sale are still on pet store
shelves and have been linked to disease outbreaks. During a 2007 outbreak,
youngsters who handled a small turtle were at a 41-fold increased risk of
contracting
Salmonella, compared with
controls.
Salmonellae are natural
intestinal flora for all reptiles, but turtles likely pose a greater hazard
for children than other reptiles since they may be handled differently from
pet snakes, lizards, or iguanas. The
American Veterinary Medical
Association estimates that America's household turtle population doubled
from roughly 950,000 in 1996 to almost 2 million in 2006. Now, evidence
suggests that reptile-transmitted Salmonella outbreaks may be on
the rise again. Public health officials discovered what turned out to be
the largest reported outbreak in the U.S. in September 2007 many patients
were from recent turtle exposure. More than a third of the turtles (34%)
were purchased in a retail pet store. Although some retail shops may
provide information on the risk of Salmonella, in many states there
is no legal obligation for them to do so. Some pet stores are under
investigation for claiming that they sell turtles that are "Salmonella-free."
Dr.
Knapp
October 22
This
is Breast Cancer Awareness Month.
A woman’s lifetime risk of developing
breast and/or ovarian cancer is greatly increased if she inherits a harmful
mutation in BRCA1 or BRCA2.
According to estimates of lifetime risk,
about 12 percent of women in the general population will develop breast
cancer sometime during their lives compared with about 60 percent of women
who have inherited a harmful mutation in BRCA1 or BRCA2.
Lifetime risk estimates for ovarian cancer among women in the general
population indicate that 1.4 percent will be diagnosed with ovarian cancer
compared with 15 to 40 percent of women who have a harmful BRCA1 or
BRCA2 mutation.
The likelihood of a harmful mutation in
BRCA1 or BRCA2 is increased with certain familial patterns
of cancer. These patterns include the following:
- For women who are
not of Ashkenazi Jewish descent:
- two
first-degree relatives (mother, daughter, or sister) diagnosed with
breast cancer, one of whom was diagnosed at age 50 or younger;
- three or more
first-degree or second-degree (grandmother or aunt) relatives
diagnosed with breast cancer regardless of their age at diagnosis;
- a combination
of first- and second-degree relatives diagnosed with breast cancer
and ovarian cancer (one cancer type per person);
- a
first-degree relative with cancer diagnosed in both breasts
(bilateral breast cancer);
- a combination
of two or more first- or second-degree relatives diagnosed with
ovarian cancer regardless of age at diagnosis;
- a first- or
second-degree relative diagnosed with both breast and ovarian cancer
regardless of age at diagnosis; and
- breast cancer
diagnosed in a male relative.
- For women of
Ashkenazi Jewish descent:
- any
first-degree relative diagnosed with breast or ovarian cancer; and
- two
second-degree relatives on the same side of the family diagnosed
with breast or ovarian cancer.
These family history patterns apply to
about 2 percent of adult women in the general population. Women who have
none of these family history patterns have a low probability of having a
harmful BRCA1 or BRCA2 mutation.
To see the whole article, go to my web
site:
http://www.rogerknapp.com/medical/BRCA.htm
The
reason I am bringing this topic up is the question: "Should I test my
daughter for this gene?"
Personal Opinion: Absolutely do not tell your daughter that this in the
family. If you do test her, do it secretly so they do not know. Tell them
if they are positive at age 20. They do not need to grow up thinking they
possibly may have their breasts removed.
October 26
The
X-ray and the diagnosis of pneumonia.
The X-ray is not as
accurate as most people think. Many children (and also adults) are
diagnosed with “pneumonia” in ERs, Emergency Clinics, and even physician’s
offices when they really do not. The X-ray does not see bacteria. It sees
fluid, mucous, congestion, or any stuff. The mucous in the chest could be
allergy like asthma, bacterial pneumonia, viral (pneumonia) infection like a
bad chest cold or flu, fungal infection, or even rarely cancer. The
radiologist reads the X-ray as “pneumonia” but that is the radiologist’s
term for congestion. And the radiologist does not know the patient so he
will call it pneumonia if there is very little congestion not wanting to
miss pneumonia and get sued later. Some physicians will also over call the
diagnosis not wanting to get sued. Most patients with an asthmatic attack
or flu will have an abnormal X-ray. When there is what is called a
consolidation, where the whole lobe of the lung is a white out, then it is
most likely a bacterial pneumonia. But many X-rays have steaks or some
fluffiness that is called “pneumonia”. and then the patient gets antibiotics
many times needlessly.
See full story :
http://www.rogerknapp.com/medical/pneumonia.htm
Dr. Knapp
October 28
Pennsylvania
researchers published in the journal Lancet using gene therapy have made
significant improvements in vision in 12 patients (5 children) with a rare
inherited visual defect, a finding that suggests it may be possible to
produce similar improvements in a much larger number of patients with
retinitis pigmentosa and macular degeneration.
9-year-old Corey, was considered nearly blind before treatment. He was
confined largely to his house and had difficulty in navigating obstacles.
Now, after a single injection of a gene-therapy in one eye, he rides his
bike, and needs no assistance in the classroom. He even played his first
game of softball.
The 12 patients have Leber's, a congenital amaurosis. Approximately 3,000
people in the United States have this. Patients are born with impaired
vision that deteriorates in childhood or adolescence. There was no
treatment. All 12 of the patients suffered a defect in a gene called RPE65.
The good copy of the RPE65 gene was inserted into a weakened version of a
human adenovirus. The engineered virus then invaded retinal cells and
inserted the gene into the cells' DNA. Within 2 weeks their vision
improved. Their improved vision has lasted 2 years.
Maguire inserted the preparation into the retina of the worst eye in each of
the patients. Within two weeks, the treated eyes began to become more
sensitive to light, and within a few more weeks, vision began to improve.
The younger the patients were, the better they responded.
A lot of research still has to be done. This disease is a form of retinitis
pigmentosa, which affects an estimated 100,000 Americans. The hope is that
this therapy will apply to macular degeneration, which affects an estimated
1.25 million Americans.
For the article in the
news:
See:
http://www.latimes.com/news/nationworld/nation/la-sci-gene-therapy25-2009oct25,0,2334183.story
For a video:
http://multivu.prnewswire.com/mnr/chop/40752/
Dr. Knapp
November 2
With all the news
about the Swine H1N1 flu, we forget about other illnesses. There was a
recent outbreak of E. coli illnesses up in New England with 2 deaths and 2
dozen sick. (http://www.nytimes.com/2009/11/03/health/03beef.html
) It usually is from poorly cooked hamburger but can be from lettuce and
other foods that are not washed. With our economy, we are eating more meals
at home which is a good thing. So cook your food well but also watch out
for your hands, utensils, and counter tops that touch the raw food before
cooking. Even Elton John because ill recently with E coli and flu (http://www.newsday.com/entertainment/celebrities/elton-john-recovering-from-flu-e-coli-1.1560117
)
Roger Knapp MD
November 14
We recommend vitamins
in breast fed infants and for children 1 yr and older through the teen
years.
Dr. Knapp
www.rogerknapp.com
It has traditionally
been believed that normal dietary vitamin D intake will produce adequate
serum levels. The most recent guidelines from the Food and Nutrition Board
suggest a daily minimum vitamin D intake of 200 International Units (5 mcg)
for infants, children, and adults up to 50 years of age to achieve serum D
levels ≥ 20 ng/mL and prevent bone disease. The recommended daily intake
increases to 400 International Units (10 mcg) for adults 51 to 70 years of
age and 600 International Units (15 mcg) for adults over 71 years of age.
In most clinical
studies, vitamin D deficiency has been defined as a serum D level < 20 ng/mL.
Levels between 20 and 30 ng/mL are indicative of vitamin D insufficiency.
The target D level goal of 20 ng/mL has recently come under criticism. Newer
research has strongly suggested that serum D levels of 30 ng/mL or greater
may be needed for optimal health benefits.
Prevention of vitamin
D deficiency may be most important during infancy, to produce optimal bone
formation and prevent rickets. After birth, vitamin D goals may not be met
with exclusive breastfeeding, since breast milk provides only 20–70
International Units/L.
Several studies have
documented a relatively high incidence of vitamin D insufficiency or
deficiency in infants and toddlers. In 2008, Gordon and colleagues evaluated
a cross-sectional sample of 380 healthy infants and toddlers in an urban
primary care clinic in Boston. 12.1% had serum D levels < 20 ng/mL, while
40% had levels less than 30 ng/mL. Three patients had radiographic evidence
of rickets and another 13 had evidence of bone demineralization.
Unlike some earlier
studies, the prevalence of vitamin D deficiency in this group of patients
was not correlated with age or skin pigmentation. There was an inverse
correlation between serum 25 (OH)D and parathyroid hormone levels (p < 0.001
for infants, p < 0.02 for toddlers), indicative of increasing secondary
hyperparathyroidism. Multivariate analysis revealed that breastfeeding
without vitamin D supplementation and a lower milk intake in toddlers were
significant predictors of vitamin D deficiency. The authors concluded that
their study added evidence for the increasing prevalence of vitamin D
deficiency in infants and young children and suggests the need for routine
supplementation.
In addition to
studies conducted in infants, there has been considerable interest in the
vitamin D status of older children and adolescents during the past decade.
Data collected between 1988 and 1994 showed 14% of the 2,955 teens had
vitamin D deficiency. 48% had levels below 30 ng/mL,
An extensive review on
vitamin D deficiency in children, with new recommendations for
supplementation, was published in the August 2008 issue of Pediatrics.
Based on a review of the literature, the group recommended that serum D
levels be maintained at least above 20 ng/mL and that daily supplementation
with 400 International Units (10 mcg) of vitamin D be initiated within days
of birth for all breastfed infants and in formula-fed infants and children
who do not ingest at least 1 L of vitamin D-fortified milk each day.
Premature infants, dark-skinned children, and children who live at higher
latitudes may require larger doses of vitamin D, up to 800 International
Units (20 mcg) per day.
In November 2008, the
American Academy of Pediatrics (AAP) released a guidance paper on the
prevention of rickets and vitamin D deficiency in infants, children, and
adolescents. This new report replaces their 2003 statement which
recommended a daily intake of 200 International Units. As in the Lawson
Wilkins Society article, the 2008 AAP statement recommends that the daily
vitamin D intake for all pediatric patients be increased to 400
International Units (10 mcg), with a goal vit D level of at least 20 ng/mL.
The AAP statement also recommends that breastfed infants receive a vitamin D
supplement at a dose of 400 International Units/day beginning shortly after
birth and continuing until they are weaned and consuming at least 1 L of
vitamin D-fortified formula or milk per day. Daily supplementation is also
recommended for older children and adolescents who do not consume at least
400 International Units of vitamin D with their usual diet. The AAP
guidelines were based on studies documenting the safety of vitamin D at this
higher dose as well as new evidence suggesting a possible role for vitamin D
in preventing cancer, cardiovascular disease, and diabetes
November 24
The
Growing Backlash Against Overparenting
By
Nancy Gibbs
http://www.time.com/time/nation/article/0,8599,1940395-1,00.html
This is a good article about over
bearing parents. We need to guard, protect and parent our children. But
how much? Are we too lax and let our children stagnate and be in danger?
Are we over protecting and smothering them so they cannot try things or make
mistakes (which is the way we learn). This article is great reading for all
of us. We can assess how we are and how is the job going. Ask others to
read this and give you an honest opinion about how you parent. We cannot
see ourselves as well as others see us. Most of us are OK. Some of us may
be helicopter parents.
Here is a small quote from
the article:
The insanity crept up on us
slowly; we just wanted what was best for our kids. We bought macrobiotic
cupcakes and hypoallergenic socks, hired tutors to correct a 5-year-old's
"pencil-holding deficiency," hooked up broadband connections in the
treehouse but took down the swing set after the second skinned knee. We
hovered over every school, playground and practice field — "helicopter
parents," teachers christened us, a phenomenon that spread to parents of all
ages, races and regions. Stores began marketing stove-knob covers and "Kinderkords"
(also known as leashes; they allow "three full feet of freedom for both you
and your child") and Baby Kneepads (as if babies don't come prepadded). The
mayor of a Connecticut town agreed to chop down three hickory trees on one
block after a woman worried that a stray nut might drop into her new
swimming pool, where her nut-allergic grandson occasionally swam. A Texas
school required parents wanting to help with the second-grade holiday party
to have a background check first. Schools auctioned off the right to cut the
carpool line and drop a child directly in front of the building — a spot
that in other settings is known as handicapped parking.
We were so obsessed with our
kids' success that parenting turned into a form of product development.
Parents demanded that nursery schools offer Mandarin, since it's never too
soon to prepare for the competition of a global economy. High school
teachers received irate text messages from parents protesting an exam grade
before class was even over; college deans described freshmen as "crispies,"
who arrived at college already burned out, and "teacups," who seemed ready
to break at the tiniest stress.
November 30
Here
are some new state laws of Texas concerning your teens and their driving. I
have always encouraged parents to make their teens drive for 9-12 months
before getting their driving license. Even pilots have to have so many
hours of flying before being allowed to solo their plane. Here is the
website that has a lot of other new laws.
Dr. Knapp
http://www.txdps.state.tx.us/director_staff/public_information/pr081109.pdf
1. HB 2730 requires that all
applicants under the age of 18 take the driving skills exam to receive a
driver license. The law also requires that a provisional driver license
(under 18) or instruction permit expire on an individual’s 18th birthday,
removes the requirement that a provisional driver license or instruction
permit be renewed annually and increases the fee for those licenses from $5
to $15. It also extends the current phase-two restrictions for holders of a
graduated driver license from 6 months to 1 year. These restrictions include
limited night driving and limits the number of passengers.
2. HB 2730 and HB 339 restrict all
drivers under the age of 18 from using a wireless communication device while
operating a motor vehicle.
3. HB 339 increases the total hours
of behind-the-wheel driving instruction a teen receives from 14 to 34 after
TEA develops criteria for curriculum. (Goes into effect May 1, 2010)
4. HB 2730 increases the driver
license sanction from a one-year CDL license disqualification to a lifetime
disqualification if a person uses a motor vehicle to transport, conceal or
harbor an alien. If a child is engaged in conduct involving a severe form of
trafficking persons, a judge at a juvenile hearing is required to order the
juvenile’s driver license or permit to be suspended.
December 14
The State of Texas
finally approved the screening of newborns for Cystic Fibrosis. We are the
last state in the Union to start this screening. The first states to screen
was in 1997.
CF affects all races,
and is the most common autosomal recessively inherited disorder in
Caucasians (about 1/3000 births). Fifty years ago, most children with CF
died before they reached school age, but today, with early diagnosis and
improved treatment, the median survival is 36 years. Carriers of the genes
can be tested for and councelled on pregnancy.
The screening will go
according to the chart below. They screen for a chemical with the initials
of IRT. The identification of increased immunoreactive trypsinogen (IRT)
levels in the blood of infants with CF has made neonatal screening for CF
possible. Trypsinogen is one of the secretory products of the pancreas
making its level in the blood a specific marker of pancreatic function.
Detection of high levels of IRT in the newborn period place the infant at
risk for CF.
See for more
information:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5313a1.htm
Roger Knapp MD
December 23
There was a recent
recommendation for car seats. You can see my web site for my suggestions.
http://www.rogerknapp.com/medical/restraint.htm
The recent reviews showed some are not
recommended.
Insurance Institute for Highway
Safety's best bets for booster seats:
- Combi Dakota
backless/clip
- Recaro Young
Sport
- Recaro Vivo
- Maxi-Cosi Rodi XR
- Evenflo Big Kid
Amp backless/clip
- Eddie Bauer Auto
Booster
- Cosco Juvenile
Pronto
- Britax Frontier
- Clek Oobr
Insurance Institute for Highway
Safety's list of "not recommended" booster seats:
- Harmony Secure
Comfort Deluxe backless/clip
- Combi Kobuk
- Evenflo Express
- Eddie Bauer
Deluxe
- Safety 1st Alpha
Omega Elite
- Evenflo Sightseer
- Alpha Omega Elite
- Eddie Bauer
Deluxe 3-in-1
- Safety 1st
All-in-One
- Alpha Omega Luxe
Echelon
- Alpha Omega
You all have a safe and fun holiday.
Merry Christmas
Roger Knapp MD
December 28, 2009
Teen drug gateways.
Studies show the seven top 10 drugs abused by high school seniors last year
were prescribed or purchased over the counter.
There has been a 20%
decrease in illicit drug use from 2001-2005. But there has been an increase
in use of OTC medications like Dextromethorphan cough suppressant. Also
prescription meds like Oxycontin, Vicodin, and Adderall (med for ADD).
These meds have now become the drug of choice replacing Mariquana as the
gateway drug of choice (22%).
Remember the pain
meds given Michael Jackson for the burn on his head.
Symptoms include
personality changes, mood swings, irritability, excessive energy,
sleepiness, loss of appetite, forgetfulness, clumsiness, secretiveness, loss
of interest in personal appearance, borrowing money, decline in school
performance, pills missing or running out of prescription meds too soon.
Things you can do:
-
Properly store or lock up meds.
-
Take regular inventory of meds that are
kept around the house.
-
Set clear rules with teens about
sharing medications.
-
Properly dispose of old meds.
Roger Knapp MD
