What would you like to ask the nurse practitioner about?

Do you have questions you want to ask? Things you've been wondering about but you never asked your doctor? Feel free to ask! Chances are someone else is wondering the same thing you are.

Comment, email, check out my facebook fan page, follow me on twitter. I'll do my best to answer your question..

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Mom I stuck a popcorn kernel in my nose..- foreign bodies

Little kids do this. I dont know why.

I have pulled many foreign bodies from little kids noses and ears. You ask the kid why they did it and the answer is always "I dont know"

Most of the time you will need a medical person to help you remove the offending object. But there are some things you can try on your own.

If it's in the ear there's not a whole lot you can do about it yourself. But if it's your nose, there is a trick you can try:

Cover your child's mouth. Blow as hard as you can into the unobstructed nose. The object should come flying out!

If it doesn't then you need to take your child to have it removed.

One thing to keep in mind- if your child has put a food item into their ear or nose such as a bean or popcorn kernel then DO NOT squirt water into the area. This will cause it to swell and make it harder to get out! (Think about what happens when you soak beans)

Next we'll talk about swallowed foreign bodies..

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How do I find reliable health information on the internet?

Simple.. only read this blog..  :) (Just kidding)

I often see patients who tell me about crazy stuff they've read on the internet and I wonder where they are getting their health information from.

Anyone can write anything they want on the internet.. there are tons of sites that claim whatever they want.

So how to know what's real?

First look at established, reliable sites. I recommend these:
http://emedicine.medscape.com/ - this is for medical professionals but a very good site
http://www.webmd.com/ - great site for laypeople
http://www.aap.org/ American Academy of Pediatrics
http://www.aafp.org/online/en/home.html American Academy of Family Physicians


When you google a topic and look at a random site you should look at a few things to decide if it's legit.

1. Is the site trying to sell you something? If you are going to give me all sorts of medical advice and tell me all about how great your supplement is or your special device to cure cancer I don't believe your medical advice!!
2. Who wrote the information? What are their credentials? Remember that anyone can say they are a doctor or a nurse.. I promise I really am a nurse practitioner. :)
3. Does it say claim to have some secret knowledge that doctors just dont want you to know? I have news for you. There is no secret knowledge that doctors just don't want you to know.
4. Can you find the same information on more than one site? It is more likely to be accurate if you read the same thing on many sites.
5. When in doubt, verify the information with your health care professional. If they tell you what you read is crazy, it probably is.



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Health insurance resources for kids

Today I want to provide a list of resources that will help you get health insurance for your kids. I'm seeing a lot of kids lately who don't have any insurance. There shouldn't really be any reason for this because most kids will qualify for some sort of program.

Feel free to add to this list:

New York State Child Health Plus
http://www.health.state.ny.us/nysdoh/chplus/

Insure Kids Now
http://www.health.state.ny.us/nysdoh/chplus/

Childrens Health Insurance Program
https://www.cms.gov/home/chip.asp

Arizona Childrens Health Insurance Program
http://www.azahcccs.gov/applicants/categories/KidsCare.aspx

Health Insurance for Uninsured Children
http://usgovinfo.about.com/od/medicarehealthinsurance/a/schip.htm

The bottom line here is that kids deserve health insurance. If you need help finding some then contact one of these places!
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But mom- my tummy hurts! Constipation in preschoolers

I've heard this one in my own house..

Mom.. my tummy hurts..
mom.. my poop is stuck..
mom.. mom.. mom...

You get the point.

I've also seen many 3-5 year old kids who come to see me complaining of abdominal pain. It happens in older kids too, but seems to be more common in young kids.

Why is this?
I think it might have something to do with increasing awareness of their bodily functions. Three year olds are newly toilet trained and can learn to hold their bowel movements when it suits them. Then of course that leads to trouble.

What can I do about it?
If your child is afraid to have a bowel movement in the toilet, I recommend letting them use a diaper for awhile if that's what they want. If you try to get into a standoff with your child and force them to use the toilet you will loose. You can gradually encourage them to use the toilet with all sorts of techniques.

Make sure your child has adequate fluid intake. You should also encourage them to have adequate fiber intake. Here is a great site with info about constipation and fiber intake.

http://www.aboutkidsgi.org/site/about-gi-health-in-kids/functional-gi-and-motility-disorders/constipation


If your child has progressed to having abdominal pain, or nausea and you are sure the problem is constipation then you should consider a laxative. I recommend miralax. It's tasteless, easy to take and is available over the counter. It is not habit forming and works well. (and no I'm not getting paid by miralax)
http://www.miralax.com/miralax/consumer/default.jsp

If your child has severe pain, fever, vomiting or you are really concerned about them then of course have them evaluated by a medical professional!!

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How to I prevent heat exhaustion?

The CDC has a great info page about preventing heat exhaustion. You can find it here.

http://www.bt.cdc.gov/disasters/extremeheat/heat_guide.asp

The most important thing is common sense. If you are hot, drink fluids. Get out of the heat.

Pay attention to your children and how much they are drinking. Kids get heat exhaustion and heat stroke much faster than adults do and often wont drink as much as they should.

How much should kids drink?

First of all- do not give babies water. See my post about water intoxication about this:

http://askthenp.blogspot.com/search/label/water%20intoxication

Babies need more breastmilk or formula or pedialyte but giving a baby plain water can lead to water intoxication which can cause seizures and could potentially fatal. There are no good guidelines I know of defining how much water is too much water so I tell people to avoid giving any water to a baby under 6 months and limit the amount of an older baby. It is much better to give them pedialyte or formula.

I can't find a guideline about how much water older kids should drink but I think this is where common sense comes into play. Offer kids fluids frequently. Make sure they are urinating regularly. Make them take breaks from the sun.

Comments welcome!
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Why do people die from the heat?

Every year you hear about people dying from the heat. It's scary stuff.

Just what do they die of?

Heat stroke is a severe form of heat illness that can be life threatening.

What is heat stroke?

The definition of heat stroke is a fever greater than 106 F with neurological dysfunction.

What causes heat stroke?

Heat stroke occurs when the body is exposed to large amounts of heat and is unable to disappate it adequately. This causes the body temperature to rise and can lead to neurological dysfunction (altered level of consciousness).

Who gets heat stroke?

The people who are at highest risk are the very young, the very old and people who are chronically ill. People who have significant physical exertion in high heat (like marathon runners) can also develop heat stroke.

What are the symptoms of heat stroke?

• High fever
• may or may not have sweating
• altered mental status, confusion
• fainting
• abdominal cramps, nausea, vomiting, weakness
• fast heart rate
• neurologic abnormalities- irritibility, difficulty walking, delusions

What do I do if someone I know has heat stroke?

This is an emergency. Call 911. They will require prompt treatment in the emergency department and will likely be admitted to the hospital.

next- how to prevent heat related illness
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