Safe Alternatives to Tanning for Your Teens

Angela Bishop, beauty blogger

In recognition of Melanoma/Skin Cancer Detection and Prevention Month, check out these helpful tips for your teens from our guest blogger, Angela Bishop. This make-up connoisseur and mommy of two, usually shares her beauty tips and tricks on her blogs, Beauty Store Dropout and Nine More Months.

With summer around the corner, many people are getting their skin “ready” for the season. It doesn’t hurt to spend small amounts of time in the sun, however more than 15 minutes of unprotected sun exposure can be very bad. The number one danger of too much sun exposure is increased risk for melanoma – the deadliest form of skin cancer. Many people believe that a tanning bed is safer than going out in the sun, but the truth is that it can actually be worse.

Luckily, there are safer alternatives:

  • Spray tanning – Gives you almost immediate results, though only temporary. There are many different shades to choose from, so this works well for everyone. Read reviews and ask around to find the best tanning salon in your area.
  • Tanning lotion – Easy at-home way to get color, but can be tricky to apply. Most lotions are one shade only, so test a small spot on your skin before trying. For the best possible results, always exfoliate beforehand, and be sure to wash your hands well after applying.
  • Gradual tanner – Takes a few days to show, but as long as you regularly apply it you’ll continue to have a tan. Choose one with an SPF protection in it, and make it part of your daily routine.
  • Mineral bronzing powder – Instant gratification, can be adjusted to desired shade, and easily removable. One with shimmer will reflect light to give you a nice glow. Just like putting on makeup, make sure to highlight areas that are naturally touched by the sun, such as the top of your arms, shoulders, legs, and chest.
  • Tinted moisturizer – You may be familiar with this as a face product, but check your favorite beauty store and you may be surprised to find a tinted body lotion. Many of these are available with a shimmer as well, which will give you similar results to bronzing powder with the added benefit of moisturizing your skin.
  • Pale and pastel-colored clothing, such as light pinks, blues, or yellows. Try on different things to see what looks best with your skin tone. White is a good option as well, but if you have very fair skin, it can have the opposite effect, so be careful.

Whatever you choose, it’s important to always wear sunscreen if you plan on being outside for more than 15 minutes. Don’t forget about your scalp, either! A big floppy sun hat is a fashionable way to protect your head when you’re out.

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CHOC Nurse Shares Compassionate and Courageous Glimpse of the OICU

In honor of National Nurses Week, and the remarkable dedication and care that CHOC nurses provide to our patients and families every day, we’d like to share this narrative by one of our nurses, Kerry Jauregui, from the Hyundai Cancer Institute at CHOC Children’s.

Kerry Jauregui, OICU Clinical Nurse

Walking onto this unit, is like walking into another world. If you don’t live it, you don’t get it …

• Their hairless, shiny heads are an endearing sight.
• They decorate the face masks they must wear when stepping foot outside their room, with felt mustaches.
• They know how to maneuver their lines – arm up, lying on this side – to get the best lab draw.
• Their NG tubes are referred to as “nose noodles”… and they request that we start making them in pink!
• Their fears and worries are the dreaded painful chemotherapy IM injection they are about to receive, rather than which prom dress to wear.
• Their mile long ‘beads of courage’ hanging from their IV pole resembles so much more than courage… holidays missed at home, trips to the PICU, proms missed, hundreds of chemo and blood infusions, many bad days hurled over the toilet or bucket puking… it is only a mere symbol of their strength during this difficult battle.
• They get gifts and posters, and are sung ‘Happy Transplant Day’ by nurses and child life… while in the outside world, their friends gather and celebrate a birthday party.
• A teenager is not worried about her outfit, hairdo or makeup like her peers, but is more self-conscious of her puffy steroid-induced cheeks.
• They get pulled in wagons down the hallways of the hospital, rather than down the sidewalks to the park.
• They walk holding their IV pole alongside them, rather than the hand of a best friend.
• They wait in anticipation of the morning print out of lab results, comparing and keeping immaculate record of trends and changes… rather than studying algebra.
• They know the names of their chemos rather than their classmates, and will tell you which antiemetic will work best for which chemo.
• Their pain and tears from the injection you gave is disheartening… but seeing them laugh and smile just moments later, realizing the chemo you just gave is saving their life… is truly rewarding.
• Witnessing the newborn who has been on the unit for months, have all of its firsts within the walls of the tiny hospital room… from speaking its first babbles, to teeth beginning to come in… is exhilarating!
• Helping a mother of a child to let go is a heart-breaking, yet sacred, moment.
• The child who was nearing death’s bed in the PICU just weeks ago takes their first step… and from the priceless faces on patient and mom, you know that step means so much more than just a physical act!

I smile in admiration of their strength. I laugh at their playfulness and innocence. I stand amazed by their resilience. I stand speechless in awe of the amount of love and patience the families give. I applaud a mother, who despite her fear and self-doubt, does a perfect CVAD dressing change. I cry worrying about the loss of a child’s innocence and consequently their outlook on life, from such an earth-shattering experience. I hope on behalf of their fight.

I continue to love on these kids and families… and help them to fight their fight alongside of them, because I believe. I believe in a cure. I believe in our science. I believe in our technology. I believe in our mission. I believe in our amazing team. I believe in their resilience. I believe in their strength. I believe in their hope.

Fighting this fight can be tireless, sad, hopeless, draining and frustrating along the way. But saving the life of one of these children, and being there supporting these families every step of the way is the greatest gift and privilege I could possibly ask for! It is my duty to serve. And my honor to join the fight against childhood cancer!

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Tips To Prevent Allergy Symptoms

May is National Asthma and Allergy Awareness Month. Check out this video with Dr. Christina Schwindt, Allergist, explaining what parents can do around the house to help prevent allergy symptoms for their families.

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CHOC Recommends Tips for Choosing the Right Shoes and Avoiding Injury

May is National Physical Fitness and Sports Month. To avoid pain and injury while participating in athletic activities, check out the following guidelines to ensure that you and your family are wearing the proper shoes for your body and foot type, as recommended by the experts at the CHOC Children’s Orthopaedic Institute.

The alignment of your feet while standing, walking or running may be described as “neutral” (or “normal”), “flat” or “rigid.”

Neutral means the border of your foot curves slightly off the floor when standing, creating a visible arch.

Flat means that the border of your foot nearly or completely touches the floor when standing.

Rigid means that your weight is on the outside border of your foot when standing or walking.

Choosing the proper shoes for your foot type will help keep your foot and body better supported when walking and playing. Specialty athletic/running shoe stores will be best equipped to help you find the right shoes for your foot type. However, if you know what you are looking for, you should be able to find the right shoe anywhere.

If you have flat/overpronated feet, look for shoes that have:
1. A straight last. This means the bottom of the shoes is relatively straight.
2. A rigid sole. When you twist the shoe holding the toe and the heel, it does not move much.
3. Medial posting. The inside border of the shoe has extra firm plastic to prevent the inside border of your foot from collapsing; it is also called “arch support.”
4. A firm heel counter. When you squeeze the heel of the shoe near the sole, it should feel firm.

You can also improve the arch support of your current shoes by removing the insoles and putting in over-the-counter orthotics. These are sold at athletic shoe stores and in the CHOC outpatient pharmacy.

If you have rigid/supinated feet, look for shoes that have:
1. A curved last. This means the bottom of the shoes is relatively curved. Turn the shoe upside down and look to make sure the border is curved.
2. A flexible sole. When you twist the shoe holding the toe and the heel, it moves well. Shoe companies may call this “torsion” or “shock absorption.”

Be sure to make an appointment with your child’s physician should you have any questions or concerns, or if your child is experiencing pain tied to his or her feet, ankles, knees, hips, or spine. Your child’s physician will be able to advise on the proper treatment and ensure that your little one’s feet are getting the best care possible!

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What is Eosinophilic Esophagitis?

In recognition of National Eosinophil Awareness Week, coming up May 13-19, Shonda Brown, RD, CNSC, clinical dietitian at CHOC Children’s, explains what Eosinophilic Esophagitis is, and how this unique condition is treated.

Imagine having abdominal pain so severe you are taken to the emergency department in fear of yourself having a heart attack, or unable to eat a meal without thinking if you are going to get food stuck in your throat.  These are a few things I have heard from patients to describe their symptoms of Eosinophilic Esophagitis (EoE).  EoE is characterized by eosinophil (a type of white blood cell) accumulation in the esophageal lining creating inflammation and a variety of adverse symptoms.  Some common symptoms are vomiting, abdominal pain, reflux-like symptoms, poor weight gain, trouble swallowing and food impaction (when food gets stuck in the throat).

Currently, the only way to make a diagnosis is by endoscopy with biopsies of the tissue lining the esophagus.  A small tube with a camera at the tip is inserted through the mouth and down through the GI tract.  The doctor looks for any signs of inflammation as well as takes small tissue samples to be examined with a microscope.

Research has shown that food allergies are the most common cause of EoE.  Once a diagnosis is confirmed, children are referred to an allergist for allergy testing to guide treatment.  Treatment options include food elimination diets, specialized formulas, and/or medication therapy (usually swallowed steroids from an inhaler).  A directed elimination diet is one dietary treatment approach that includes food avoidance of those showing a positive reaction on allergy testing.

Another approach is to eliminate the top known allergens; this is referred to as the six food elimination diet and includes elimination of milk, soy, egg, wheat, peanuts and tree nuts, and seafood.  Specialized formulas may be recommended (called elemental formulas) if a child has severe symptoms, if all food allergy testing was negative, or if previous treatment options were unsuccessful.  Elemental formulas contain proteins that have been completely broken down into their simplest form, amino acids, making them non-allergenic.

Treatment doesn’t end after foods are eliminated.  To determine the offending foods, a child must undergo another endoscopy after eliminating the possible allergens for a set period of time to see if the eosinophils have gone away.  After a clear endoscopy, foods are reintroduced in a stepwise fashion while monitoring for return of symptoms and confirmation of disease reappearance with further endoscopies.  Food and eating is much more than just providing our bodies with energy and nutrition.  The diet therapies that are used to treat and identify food allergens can radically change the way of life for a family. It’s difficult for a child to eliminate their favorite foods – think about a child who can’t even eat their own birthday cake!

The process of discovering the causative food(s) and establishing resolution of EoE can be a long, stressful and overwhelming experience.  CHOC Children’s has developed a multidisciplinary team centered approach in providing care for children with EoE.  Our clinic combines Allergy, Gastroenterology and Nutrition services so that our families receive comprehensive care for this chronic disease.

For more information on EoE, visit www.apfed.org  (The American Partnership for Eosinophilic Disorders).

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The Top 10 Questions Every Parent Should Ask Their NICU Care Team

Newborn babies who need intensive medical attention are often admitted into a special area of the hospital called the Neonatal Intensive Care Unit (NICU).  Most babies admitted into the NICU are premature (born before 37 weeks of pregnancy), have low birthweight (less than 5.5 pounds), or have a medical condition that requires special care. Dr. Vijay Dhar, medical director of the CHOC Children’s NICU,understands the fear and anxiety experienced by parents of NICU patients. As a veteran neonatologist, Dr. Dhar advises parents to ask their care team the following questions to help alleviate some of that anxiety:

• What is the anticipated length of stay for my baby? A NICU baby might stay in the unit for one night up to six months or longer, depending on the baby’s condition.

• What is my baby’s prognosis? Your baby’s neonatologist can provide you with information based on historical outcomes of babies with the same conditions, complications or illnesses.

• What can I expect in the short and long term? Along with asking about your baby’s prognosis, inquire about what you can expect. Never hesitate to speak with your child’s multidisciplinary team, and they’ll provide you with an assessment based on your child’s condition and current health status.

Vijay, Dhar, M.D., medical director of the CHOC Children’s NICU

• What can you tell me about your NICU?  CHOC’s NICU is an award-winning unit with a team specialized in caring for the most fragile and tiniest of babies. Our NICU offers state-of-the-art care and life-saving technologies around-the-clock. Our patients come from all over the region for our critical tertiary and quaternary care (Level 3C care) and excellent outcomes. Most babies will stay in the west wing of the unit. Babies born at 27 weeks gestation or earlier or weigh less than 1,000 grams will go to the east wing, which is known as the Small Baby Unit.

• What type of support services do you offer in the NICU and in the hospital for parents?  CHOC recognizes the impact of a child’s illness on a family. We use a family-centered approach – a belief that a family’s involvement in the healthcare of a child is important. Our psychologists and social workers provide supportive counseling to assist families in coping with the unpredictability of a potentially life-threatening condition. They also link families with community resources for emotional, as well as financial, support.

•  How can I bond with my baby?  Finding out your baby will have to spend time in the NICU is never easy. We believe bonding time with your baby provides many health benefits for your child and you. Our NICU experts promote contact with even the most fragile and smallest patients, including extremely low birth weight babies and those on ventilators. Babies have very positive responses to their parents’ closeness—whether it is a gentle caress with a fingertip or skin-to-skin cuddling. We have developed the Parenting in the NICU Guide with advice, information and support most helpful for NICU moms, dads and extended family. The guides are available through your baby’s NICU care team.

• Can I stay somewhere near my baby? CHOC has a partnership with the Ronald McDonald House, a cozy, 20 bedroom place located a few short blocks from the hospital. A social worker can provide you with more information on accommodations and help you with additional resources.

• Can my baby be transferred back to my referring hospital after he is in stable condition? Approximately 50 percent of our NICU patients are transported from hospitals across the region for lifesaving treatment – as close as Los Angeles County and Inland Empire, and as far as Hawaii. Speak to your care team about what will happen once your baby is in stable condition.

• Is there a way for me to obtain insight from my baby’s care team all at once? CHOC strongly encourages parents to be present during “rounds,” a time during the morning hours when the entire care team (nurses, doctors and additional specialty clinicians) check in with patients to review their health status and progress. Each patient case is evaluated and discussed during this time.

 What precautions can I take to avoid infections?  CHOC is strict and vigilant with our infection control policies and practices. Parents and visitors are expected to follow these guidelines to protect our NICU patients. Everyone must their wash their hands with alcohol gel.  If you have had recent contact or exposure to a communicable disease, or recent contact with an ill person, you must receive approval from the Infection Control Practitioner to come into the unit. Any visitor who is currently ill is not permitted to visit.

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Children and Fractures – What Every Parent Should Know

Young wrists, forearms and elbows are vulnerable to injury. Did you know up to 30 percent of all childhood fractures involve the growth plate? Growth plate fractures require prompt treatment to avoid surgery or life-long deformity.

Few kids grow up without breaking something. Prompt, expert care of fractures, especially those involving a bone’s growth plate, ensures childhood misadventures don’t linger into adulthood. CHOC Children’s Fracture Clinic offers rapid access to specialized fracture care. Patients are usually evaluated and treated within three to five days of injury, well within the narrow treatment window recommended by the American Academy of Orthopaedic Surgeons. Afshin Aminian, M.D., medical director of the CHOC Children’s Orthopaedic Institute, explains what every parent should know about growth plate fractures.

Q. Why do children’s fractures need to be treated so quickly?

Dr. Aminian: Growth plates, located near the ends of long bones, help regulate and determine a bone’s eventual shape in adulthood. However, growth plates are very soft and vulnerable to fracture. They also heal very quickly, which gives us a very short window to do minor, non-surgical manipulations to set broken bones correctly. Ideally, a growth plate fracture should be set within a week of injury. After that, surgery is necessary to prevent a life-long deformity.

Q. What are the main causes of growth plate fractures you commonly see? 

Afshin Aminian, M.D., Medical Director, CHOC Children’s Orthopaedic Institute

Dr. Aminian: An estimated one-third of growth plate injuries occur during competitive sports such as football, basketball or gymnastics. Monkey bars, skateboards, snowboards and “heelies” (roller shoes) are also very rough on young wrists, arms and elbows. Wrist guards provide some protection, but more importantly, children should always wear a helmet when engaging in those activities. I always tell my patients that it is much easier to fix a broken arm than a broken head.

 

For more information about the CHOC Children’s Fracture Clinic, please visit www.choc.org/orthopaedics.

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    Celebrate Earth Day – Eco-Friendly Tips for Your Family

    In recognition of Earth Day this Sunday, April 22, check out these easy tips that you and your family can do to help protect our environment.

    Courtesy of office.microsoft.com
    • Eliminate packaging – One way to eliminate the amount of packaging we use, is to buy necessities in bulk. If it’s something you use a lot, it’s worth it to buy a larger size or multi-pack. Bring your own reusable bags or containers to stores too, and skip packaging all together.
    • Pack a waste-free lunch – Include sandwiches in reusable containers, whole fruits without packaging, and drinks in containers that can be reused. When possible, don’t include: individually wrapped snacks; plastic baggies that are not reusable; disposable forks and spoons; and straws.
    • Buy Eco-Friendly School Supplies – Many chain stores carry “green” school supplies, including recycled notebooks, pencils, backpacks and more!
    • Easy recycling – Make it easy for your family to go green by designating different bins for glass, metal, paper and plastic. Have your kids draw fun pictures or signs of the recyclable categories to label each bin.
    • Improve the Outdoors –When visiting a beach, park or any outdoor space, be sure to deposit your trash in trash bins. Go the extra mile and participate in a cleanup day at a local beach with your kids.
    • Use Less Water – When using a dishwasher, scrape plates instead of pre-rinsing, use energy-saving options when you can, and only wash full loads. If you wash your dishes by hand, try to assess ways you can cut back. Keep in mind that faucets use about 2 gallons per minute. Teach your kids about the importance of saving water, and how they can help – this includes using less water in the shower or when brushing.
    • Change your light bulbs – Replace any incandescent light bulbs in your home with fluorescent CFL bulbs. You can save a good chunk on your electricity bill!

    Do you have any green tips? Leave us a comment and share what your family is doing to help the planet!

    Protect Your Child With Vaccinations

    National Infant Immunization Week (April 21-28) is coming up, and highlights the importance of protecting infants from vaccine-preventable diseases. This important campaign is a call to action for parents, caregivers, and healthcare providers to ensure that infants are fully immunized against 14 vaccine-preventable diseases, such as influenza, hepatitis, pertussis, and more.

    In the United States, vaccines have reduced or eliminated many infectious diseases that once routinely killed or harmed thousands of infants and children each year. However, the viruses and bacteria that cause vaccine-preventable disease and death still exist and can be passed on to people who are not immunized. These diseases result in doctor visits, hospitalizations, and even death.

    To help protect your child, be sure to talk to your child’s pediatrician to ensure that your little one is up-to-date on his immunizations.

    For a schedule of recommended immunizations for children from birth to six years old, from the Centers for Disease Control and Prevention, please click here: http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf

    For an adolescent immunization schedule, or to learn more, please click here: http://www.cdc.gov/vaccines/recs/schedules/default.htm

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    Earthquake Preparedness Tips For Your Family

    It’s Earthquake Preparedness Month. To help keep you and your family safe during an earthquake, check out these important guidelines. Be sure to talk to your kids about the importance of being prepared for this, and other emergency situations.

     Have a safety checklist to make sure you’re prepared:

    • Become aware of fire evacuation and earthquake plans for all of the buildings you occupy regularly.

    • Pick safe places in each room of your home, workplace or school. A safe place could be under a piece of furniture or against an interior wall away from windows, bookcases or tall furniture that could fall on you.

    • Practice drop, cover and hold on in each safe place. If you don’t have sturdy furniture to hold on to, sit on the floor next to an interior wall and cover your head and neck with your arms.

    • Bolt and brace water heaters and gas appliances, as well as bookcases, china cabinets and other tall furniture, to wall studs.

    • Hang heavy items such as pictures and mirrors away from beds, couches and anywhere people sit or sleep.

    • Learn how to shut off gas valves in your home and keep a wrench handy for that purpose.

    • Keep an emergency supplies kit in an easy-to-access location. In addition, keep a flashlight and sturdy shoes by each person’s bed.

    During an earthquake:

    • Drop, cover and hold on.

    • Stay away from windows to avoid being injured by shattered glass.

    • Stay indoors until the shaking stops and you are sure it is safe to exit. If you must leave the building after the shaking stops, use stairs rather than an elevator in case there are aftershocks, power outages or other damage.

    • If you are outside when the shaking starts, find a clear spot and drop to the ground. Stay there until the shaking stops (away from buildings, power lines, trees, streetlights).

    • If you are in a vehicle, pull over to a clear location and stop. Stay inside with your seatbelt fastened until the shaking stops. Then, drive carefully, avoiding bridges and ramps that may have been damaged.

    After an earthquake:

    • After an earthquake, the disaster may continue. Expect and prepare for potential aftershocks, landslides or even a tsunami.

    • Check yourself for injuries and get first aid, if necessary, before helping injured or trapped persons.

    • Look quickly for damage in and around your home and get everyone out if your home is unsafe.

    • Listen to a portable, battery-operated or hand-crank radio for updated information and instructions.

    • Look for and extinguish small fires. Fire is the most common hazard after an earthquake.

    • Help people who require special assistance, such as infants, children and the elderly or disabled.

    • Watch out for fallen power lines or broken gas lines and stay out of damaged areas.

    • Keep animals under your direct control.

    • If you were away from home, return only when authorities say it is safe to do so.

    For more information on emergency preparedness, visit www.redcross.org.

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