Hello, Pandora.  What do you have in that box? Yes, I am going to talk about ... autism.  The last time I did so I was inundated with people trying to convince me of the dangers of immunizations and their causal link to autism.  I really, really, really don’t want to go anywhere near that one. No, I am not going to talk about the cause of autism; I am going to ...

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A recent Canadian study showed that the youngest children in each grade (born in the earliest month of the Canadian grade cutoff: December) were 30% more likely to be diagnosed with ADHD than the oldest children (born in January). For girls, who overall have a lower incidence of ADHD, the difference was even more pronounced: 70%. Interestingly, the overall rate of ADHD diagnosis in the sampling of children from this Canadian ...

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In recent years, childhood overweight and obesity statistics have received a good deal of media attention, but this has done little to slow their rise.  Data from the National Health and Nutrition Examination Survey shows that nearly 1 in 5 children aged 2-19 are obese.  Even more concerning, since 1980 obesity rates have tripled in the 6-11 and 12-19 age groups. Our ...

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I am a physician who was diagnosed with throat cancer and underwent laryngectomy four years ago. Prior to being diagnosed and treated for cancer I did not welcome or encourage my patients’ participation in their own care. Admittedly, there were instances when such input was helpful, but more often I regarded patients with data based on information obtained from the Web as a challenge to my expertise and authority.   I ...

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Two articles recently caught my eye while I was spending some time on Twitter. First, an op-ed piece was published on Time.com discussing how patients and doctors perceive the use of the online health information. The article was closely followed by the results of a recent PEW research study which stated that 80% of Americans used the internet to “prepare for or recover from” their doctor visit. The results of ...

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As citizens of the 21st century, we seem to have adapted personal technology for every conceivable use -- Siri, the iPhone’s newest darling, can literally remind us to call a proctologist. But as physicians, we may be missing some of the best opportunities to derive “meaningful use” from technology. I am an emergency physician, and a few nights ago I worked a shift in the ER. It was a typical, ...

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Recently there was a lovely story in the New York Times about a young couple struggling to navigate the complexities of a romantic relationship.   Both in their early 20’s, dating is a relatively new experience for them.  She likes physical affection; he prefers sitting alone on the couch.  She wants a pet; he is allergic.  They are learning to negotiate the small things while clinging to their common affection for ...

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Against the backdrop of life as it is really lived, the decision to breast-feed or bottle-feed is minuscule.  Whether or not you decide to breast-feed your baby -- and for how long -- is, in the scheme of things, just one decision out of a million. And ultimately, you should do what works best for you and your family. Full disclosure here: I never wanted to breast feed. I don't know why. ...

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I am sitting at home and the popular show American Idol is on. Randy Jackson has a red shirt on, which is color coordinated with a large red Coca-Cola cup. J-Lo is sitting by his side, also with a red Coca-Cola cup. Same with Steven Tyler.  When one of the artists takes the stage, there is a large red moving video banner promoting Coca-Cola. It’s called product placement and it ...

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Being a child in 21st century Mexico utterly differs from any other era. The last decade has been a constant whirlpool for Mexico. Political, cultural and economical changes have shaken the country to its core. Primary care physicians, particularly pediatricians, have a burdensome challenge at hand. Problems like obesity have quickly emerged in all age groups. Obese children, childhood type 2 diabetes and sedentary lifestyles have invaded Mexican homes. Nutrition related customs ...

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Parenthood.  It has changed everything. Snot on my sweater goes unnoticed.  Hobbies gather dust in the closet.  Kissing away the boo-boos and wiping away tears become daily ritual.  Screams, laughter, tantrums, and toys crashing to the floor become the household white noise.  All my Facebook status updates are about my kids. Some people manage to continue their lives with style. Me?  I’m just tired.  And I need a haircut.  Smartypants would say I need a ...

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Your baby had a great appetite.  Happily ate everything.  Tried lots of flavors and foods.  Then your baby became a toddler.  Suddenly meals feel like a horrible battle. Sound familiar? Picky eating is very common, especially in toddlers and pre-schoolers. After the first year of life, a toddler’s appetite decreases quite a bit as the rate of growth slows down.  Meanwhile, a toddler grows in independence, expressed by pushing limits, exploring new skills, and forming lots of opinions ...

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Here are some of the most common questions I encounter regarding vaccines and my answers.  I’m writing this post, from a parent to a parent, because I want to equip you with accurate information to protect your child. We give so many vaccines now and it seems like we are constantly adding more.  Isn’t this too much for my child’s immune system?  Isn’t it antigen overload?  The immune system is very complex, ...

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Stop what you’re doing to read this The New England Journal of Medicine perspective by Dr. Doug Diekema. It’s about vaccines, opportunities for health, and physician obligation. Written for physicians, it also speaks loudly to parents and includes a few very essential points. The whole time I read the article, my thoughts kept leaping to our imminent opportunities. Today, in 2012, we can harness the tools of social media ...

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Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do. Why? Because we think allowing patient to post links and commenting on our practice’s Facebook page helps us achieve these four things: 1. It encourages communication. 2. It allows us to address issues that we would otherwise have a hard time addressing. 3. Other patients will benefit by reading the discussions. 4. We ...

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In October 2011, the Centers for Disease Control and Prevention reported a 60% increase in “emergency department visits for sports– and recreation–related traumatic brain injuries, including concussions, among children and adolescents” over the past decade. That’s good news: as the CDC’s press release said, they believe the increase was due in part to “growing awareness among parents and coaches, and the public as a whole, about the need for individuals with a suspected ...

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While in residency, I took care of a toddler who was hospitalized following an anaphylactic reaction.  During a diaper change at home the child suddenly developed lip swelling and severe difficulty breathing for no apparent reason. The child was urgently brought to the hospital by ambulance and initially treated in the emergency room. By the time I met her on the inpatient floor her breathing and swelling had significantly improved. ...

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William Osler famously said (among other things):  “Listen to the patient. He is telling you the diagnosis.” I was doing my obstetrical rotation as a first year family practice resident. I had done nearly 100 deliveries and was feeling more confident in  my skills and knowledge than was justified.  Although this rotation did not involve actual care for the recently delivered newborns, I loved pediatrics and frequently stopped by the nursery ...

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The little boy, who looked to be about two, darted away in a fit of giggles. His young mother, who seemed thoroughly worn out and exasperated, ran after him, grabbed him by the arm and said in a harsh whisper, "You must stand here!" We were on line waiting to board a Southwest Airlines flight. For those of you not familiar with the Southwest system, there are no assigned seats. Rather, ...

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All play is not equal.  With the power of marketing, play has become increasingly associated with toys, electronic gadgets, television, and video games.  Just think about the amount of ads for children’s toys over the holidays.   Just think about the things your child might have asked for and the latest trends that become the new must-have of the season. Without realizing it, we may be intervening in a child’s most natural form of ...

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